A decline in patient disclosure of heterosexuality in the English General Practice Patient Survey: a longitudinal analysis of cross-sectional data.
BACKGROUND
Persistent health inequalities in relation to both health care experiences and health outcomes continue to exist among patients identifying with a marginalized sexual orientation (MSO).


OBJECTIVE
To compare the patterns of sexual orientation disclosure within primary care in England over a 5-year period.


METHODS
Descriptive analysis of cross-sectional, repeat measure, fully anonymized survey data of adults responding to the General Practice Patient Survey (GPPS) January 2012 to 2017. Participants from each year varied between 808 332 (2017) and 1 037 946 (2011/2012).


RESULTS
The analysis samples comprised between 396 963 and 770 091 individuals with valid sexual orientation data depending on the year. For males, heterosexual disclosure decreased consistently from 92.3% to 91.2% from 2012 to 2017. Male patients reporting gay, bisexual and/or 'other' sexual orientations increased from 3.1% to 3.9%. For females, a larger reduction in heterosexual disclosure was recorded from 94% to 92.5%. Those reporting as lesbian, bisexual and/or 'other' increased from 1.82% to 2.68%, with the largest increase seen in the reporting of bisexuality, which nearly doubled from 2012 until 2017 (0.56-0.99%).


CONCLUSION
We found a year-on-year decline in patients reporting a heterosexual identity and an increase in the proportions of people reporting being either gay, bisexual, 'other sexual orientation' or preferring not to say. Heteronormative environments extend to health care settings, which may put increased stress on MSO individuals attending a GP practice. The introduction of environmental signs/symbols to show that a practice is inclusive of MSOs could reduce the potential stress experienced by patients.
['Cross|Harry|H|', 'Llewellyn|Carrie D|CD|']
D000328:Adult D001727:Bisexuality D003430:Cross-Sectional Studies D030881:Disclosure D005260:Female D058006:General Practice D020010:Heterosexuality D006801:Humans D008297:Male
Disclosure General Practice Patient Survey sexual orientation primary care LGB sexual identity