In reply:.

Abstract

The letter to the editor from Egan and Lutwak regarding our article contains interesting and likely little known information on health care disparities of VA sexual minorities. Despite this information, it should be acknowledged that not only is there a need for education on lesbian, gay, bisexual and transgender (LGBT) health and disparities, but also and importantly a substantial research void exists in LGBT health. The Institute of Medicine, Department of Health and Human Services, and The Joint Commission among others have highlighted the lack of inquiry in understanding the health care of the estimated 9 million Americans who identify as LGBT.1 If the population is expanded to include anyone who does not necessarily identify as LGBT but engages in same-sex activity, it would balloon to 19 million.1 The fact that little is known about this size population's health beyond HIV, which affects a minority of LGBT people, is surprising. Admittedly, it is challenging given that self-identification is required for reliable and accurate research, and sexual orientation is a demographic rarely collected in the health care database. There are also understandable barriers for many patients to disclose their sexuality to their health care providers. However, it is difficult to investigate what you did not previously consider. Perhaps with education on what we do know, more EM and other researchers will take action to close this substantial research gap. It is time to move past social debate and provide the education and research needed to deliver equitable health care.