Health-care providers hold biases based on sexual orientation, study says

The study, "Health care providers' implicit and explicit attitudes toward lesbian women and gay men," published in the American Journal of Public Health finds that moderate to strong implicit preferences for straight people over lesbian and gay people are widespread among heterosexual providers. Also lesbian and gay health providers expressed implicit and explicit preferences for lesbian and gay people over straight people. Bisexual providers were found to have mixed preferences, mental health providers held the weakest implicit bias for heterosexual people over lesbian and gay people and nurses held the strongest implicit bias for heterosexual people over lesbian and gay people.

In short, healthcare providers, similar to others in society, hold a bias for people who shared their own sexual identity.

Lead researcher, Janice Sabin, UW research associate professor in biomedical informatics and medical education, said that clinical care of the LGBT population is a somewhat neglected area in curriculum in nursing, medicine and other areas of healthcare education.

"We want all providers to be proficient in treating diverse populations, including the LGBT population," she said.

Rachel G. Riskind with the Department of Psychology at Guilford College in Greensboro, N.C., and Brian A. Nosek with the Department of Psychology at the University of Virginia in Charlottesville, were co-authors on the study.

Researchers used results from the Sexuality Implicit Association Test developed to assess presence of implicit bias towards either heterosexual or homosexual individuals. The test captured demographic data and implicit association test results for more than 200,000 participants between May 2006 and December 2012. Test takers were asked to indicate their explicit preferences towards heterosexual, lesbian and gay people by endorsing statements ranging from "I strongly prefer straight people to gay people to "I strongly prefer gay people to straight people." The study categorized healthcare respondents by their profession ¬¬¬-- medical doctor, nurse, mental health provider, other treatment provider or non-provider --to assess attitudes specifically from healthcare providers.

Test takers voluntarily accessed the Sexuality Implicit Association Test on Project Implicit, a non-profit organization founded in 1998 by three scientists -- Tony Greenwald (University of Washington), Mahzarin Banaji (Harvard University), and Brian Nosek (University of Virginia). Project Implicit provides a "virtual laboratory" for collecting data on the Internet in a mission to educate the public about hidden biases or thoughts and feelings outside of conscious awareness and control.

Sabin said, "training for healthcare providers about treating sexual minority patients is an area in great need of attention."

"For healthcare organizations that aim to serve these populations, these data suggest an opportunity to examine methods likely to mitigate implicit biases, such as eliminating discretion from decision-making, use of clinical guidelines, awareness of personal bias as self-caution, organizational policies that promote objective decision-making, and inclusion of counter-stereotypical experiences in educational programs," the authors conclude.

While this study found implicit bias among healthcare providers, Sabin said future research should examine how providers' implicit and explicit preferences toward sexual orientation affect delivery of care to members of sexual minority populations.