Abstract
ABSTRACTObjective:To perform the cross-cultural adaptation of the original North American version of the Attitudes Toward Lesbians and Gay Men Scale (ATLG) for use in Brazil, and to evaluate the psychometric properties of the adapted instrument in a sample of Brazilian heterosexual physicians.Methods:Stages of cross-cultural adaptation were as follows: translation by two independent evaluators, translation synthesis, evaluation by the target population for semantic equivalence, pilot study with 42 physicians, and final instrument preparation involving 224 heterosexual physicians practicing medicine in the Federal District. Invitations containing a link to the study were sent to physicians via e-mail, social media and medical associations. Inclusion criteria were as follows: being a physician authorized to practice medicine in Brazil, practicing medicine in the Brazilian Federal District, and self-declared heterosexual, as stipulated in the original version of the ATLG scale. Exclusion criteria were not disclosed to potential participants to avoid inhibition and unwillingness to participate; respondents meeting exclusion criteria were removed from the sample during data analysis.Results:Exploratory and confirmatory factor analyses suggested a one-factor solution to be the most representative of the data, including all 20 items with high reliability (composite reliability coefficients =0.948).Conclusion:The ATLG scale is a suitable instrument to assess physicians’ attitudes toward homosexuals, with good validity and reliability evidence based on the sample studied.
Highlights
In the United States, about 2.4% of interviewees declared themselves as lesbian, gay or bisexual.[1]
In 1973, homosexuality ceased to be considered a mental disorder by the American Psychiatry Association (APA); still, discrimination against gay men and lesbians is recognized as a potential barrier in physician-patient relationships.[3,4] compared to heterosexuality, homosexuality is associated with differences in morbidity and risk factors for several diseases, such as higher smoking rates,(5-7) excessive alcohol use and greater tendency toward obesity,(5-8) increased frequency of drug use,(5) higher prevalence of cardiovascular diseases,(7) and greater likelihood of developing breast cancer.[8,9]
According to the position statement developed by the American Geriatrics Society (AGS) committee in 2015, discrimination faced by Lesbian, Gay, Bisexual or Transgender (LGBT) individuals when seeking health care is evidenced by the denial of certain medical care services, generalized heteronormative assumptions, refusal to accept a chosen caregiver during hospitalization and overt derogatory statements that may lead to health care seeking delay or avoidance out of fear of discrimination.[10,11]
Summary
In the United States, about 2.4% of interviewees declared themselves as lesbian, gay or bisexual.[1]. Brazilian studies investigating physicians’ attitudes toward or overt prejudice against homosexual patients, or how this construct interferes with the quality of medical care provided, are lacking. This gap is in part due to the lack of specific validated instruments aimed to assess physicians’ attitudes toward homosexuals. These instruments must address attitudes toward homosexuals only, excluding other sexual and gender minorities, such as transgender, if they are to distinguish attitudes toward lesbians and gay men. Specificity is required because physicians may deal with only one of these groups in clinical practice (e.g., lesbians and gynecologists) and due evidences pointing to considerable differences in attitudes toward lesbians and gay men.[12]
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