Ignorance of the health care needs of lesbians and gay men is common throughout the medical community. Sometimes we confide in our health care providers only to find that they do not have sufficient knowledge to provide us with appropriate assistance. On occasion we are faced with outright hostility and what amounts to a denial of service. On the other hand, a decision not to disclose same-sex relationships may cause serious problems.
In the most general way, lack of openness impairs the provider-client relationship. If clients are unwilling to acknowledge their sexual orientation, they are likely also to be less open in confiding all sorts of health-relevant information and less likely to follow the provider's advice. Gay and lesbian patients who are trying to appear "straight" cannot discuss potentially important areas of stress such as relationship difficulties, job discrimination, and conflict with parents without revealing sexual orientation. Nor can they discuss important areas of social and emotional support such as lovers or gay friends, which might be crucial in times of acute or chronic illness.
Lack of openness with one's lawyer may not be life-threatening, but many homosexual persons have gotten into needless difficulty by failing to discuss with their lawyers all of the important aspects of a case. What is good advice for a heterosexual person may not be good advice for a gay man or lesbian, and if the lawyer does not bring up the subject of the client's sexual orientation, the client must do so.
Lesbians face more specific difficulties, particularly with gynecological care. Many simply avoid routine pap smears rather than having to deal with questions and assumptions about their sexual practices. Others pretend they need contraception in order to gain access to the other health services of low cost family planning clinics. Finally, lesbians who seek alternative insemination services meet with resistance from many physicians.