Investigators analyze trends in LGBTQ care among urologists

Based on findings from a recent Urology study, investigators suggest that ongoing education on LGBTQ patient concerns and needs is necessary for urologists to provide effective care in this patient population.¹

“Fortunately, there is a strong desire from practicing urologists to be educated on this topic and to create a safe space for their LGBTQ+ patients," says Alex J. Xu, MD.

"The results of our study demonstrate that urologists are aware that LGBTQ+ patients may require variation of care from heterosexual patients, but the specifics of this variation require further elucidation," said lead author Alex J. Xu, MD, in correspondence with Urology Times®. Xu is a urology resident at New York University Langone Health.

For the study, investigators sent out a 35-question survey via email to urology resident program directors in the United States, asking for the survey to be distributed among faculty members. In total, 154 responses were included for analysis. Respondents were more likely to be male, heterosexual, and work in academia.

The survey first assessed history-taking patterns among practitioners, with 60.4% of respondents stating that they do not ask about a patient’s sexual orientation during history-taking, and 57.9% reporting not having an intake form to allow patients to disclose this information. A majority of respondents (66.7%) who reported not asking about a patient’s sexual orientation stated that they “only ask patients… if it is immediately relevant to their clinical problem”.¹ 

When asked whether it was important to know a patient’s gender identity in order to provide the best care, 65.8% of respondents stated that it was. However, respondents were split on whether it was important to know their patients’ sexual orientation in order to provide the best care, with 43.5% saying it was, compared with 42.9% indicating it was not.

Respondents were then asked if they believed men who are gay/bisexual have different prostate cancer-specific health concerns compared with patients who are straight. Practitioners were divided, with 52.3% stating that health concerns were similar and 47.7% stating that LGBT patients had different concerns than straight patients. Respondents also provided mixed responses when asked when patients can resume receptive anal intercourse following prostate cancer treatment, with approximately 30% of respondents each indicating 4 to 6 weeks, 6 to 8 weeks, or longer than 8 weeks.

The survey also included 3 knowledge-based questions, 2 of which the majority of participants correctly answered. However, responses were divided on the statement, “There is a higher sense of bother from anejaculation after treatment for [prostate cancer] in gay men than straight men,”¹ with 60.1% indicating that they didn’t know, and only 20.9% proving the correct response, “agree”.

Physicians were also asked to recall how many hours of education on LGBT health they received in medical school, with the majority (32.7%) recalling between 1 to 5 hours. A total of 74.3% of respondents indicated that more training dedicated to care for patients in the LGBT community was needed.

"Fortunately, there is a strong desire from practicing urologists to be educated on this topic and to create a safe space for their LGBTQ+ patients. Education should focus on the specific differences in healthcare needs between heterosexual and LGBTQ-identifying patients as they pertain to particular clinical scenarios and how to apply this knowledge in order to develop LGBTQ-friendly best practices which are effective in addressing the needs of a rapidly aging LGBTQ population," Xu concluded.

Reference

1. Xu AJ, Panken EJ, Gonzales-Alabastro CD, et al. Urologists and LGBTQ patients: a survey-based study of the practice patterns, attitudes, and knowledge base of urologists toward their LGBTQ patients. Urology. Published June 5, 2023. Accessed June 14, 2023. doi: 10.1016/j.urology.2023.05.019