The clinical approach to the homosexual patient.

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Since publication of the Kinsey report more than 30 years ago, which estimated that 10% of the white American male population was predominantly or exclusively homosexual, several studies have indicated that heterosexuals and homosexuals cannot be distinguished on the basis of psychological adjustment or sexual response. Recent studies have also indicated the absence of homosexual stereotypes; homosexual men and women are quite diverse in the way they organize their lives sexually as well as socially. The implication of this finding for physicians is that a complete history, including sexual history, is necessary in any patient regardless of sexual orientation to determine factors that may be placing the patient at an increased risk for disease. Additionally, the primary care physician may be called upon by the homosexual patient to provide psychosexual counselling or treatment of sexual dysfunctions. Certain verbal and nonverbal signals may facilitate or inhibit the relationship between the physician and the homosexual patient. Homosexual patients may need special reassurance about confidentiality in the doctor-patient relationship and about the physician's respect for their life-styles and significant relationships.