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Epidemiology of Invisibility and Bias

It is estimated that up to 10% of the population identify themselves as lesbian, gay, bisexual or transgendered[1] [2] [8] [9] [10] [11]. Davis[1] states that if a physician believes they are not seeing any gay or lesbian patients, then they are not asking the right questions. One participant, in an in-depth survey of rural lesbians[12], said if you think that you don’t have lesbians or gay men as patients, it’s because "people perceive you as not being sensitive... we won’t share with you unless we feel safe." 

While the majority of patients will be heterosexual, a significant minority of patients will not be and for this reason, LGBTI health issues are important for any medical practitioner.


1. Davis V, Christilaw JE, Edwards C, Francoeur D, Grant LJ, Parish B, Saraf-Dhar R, Steben M. SOGC Clinical Practice Guidelines. Policy Statement No. 87. Lesbian Health Guidelines. Journal of the Society of Obstetricians and Gynecologists of Canada. 2000;22(3):202-205. Accessed on July 18, 2003.

2. Kaiser Permanente National Diversity Council. A Provider's Handbook on Culturally Competent Care: Lesbian, Gay, Bisexual and Transgendered Population. Oakland, CA. Kaiser Permanente; 2000.

8. Lee R. How to talk about sex with patients who are not heterosexual. Western Journal of Medicine. 2000;172(6):401-402.

9. Anonymous [Council on Scientific Affairs, American Medical Association]. Health care needs of gay men and lesbians in the United States. Journal of the American Medical Association. 1996;275(17):1354-1359.

10. Lee R. Health care problems of lesbian, gay, bisexual, and transgender patients. Western Journal of Medicine. 2000;172:403-408.

11. Solarz, AL Ed. Lesbian Health: Current Assessment and Directions for the Future. Washington DC. National Academy Press; 1999.

12. Tiemann AK, Kennedy SA, Haga MP. Rural Lesbians' Strategies for Coming Out to Health Care Professionals. In Ponticelli CM, Ed. Gateways to Improving Lesbian Health and Health Care: Opening Doors. pp. 61-75. Binghamton, NY. The Haworth Press, Inc.; 1998.

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