I went to the doctor today for a regular checkup. Since my last "home" doctor was in Washington, I go to school in Massachusetts, and I'm living in New Jersey this summer, I had to go to a new doctor. I haven't been to any doctor in a while, so I was nervous about going. I was also nervous about giving my medical history, especially the part about sexual activity. I'm a sexually active woman. But I'm also sexually active with a woman, and it is daunting to have to disclose my sexual orientation to a stranger whom I have to trust with my body and health. (The first time after I became sexually active that a doctor asked me about it, I said I wasn't sexually active just so I wouldn't have to go through that ordeal. Not my finest moment, I admit.)
So the doctor I saw gets:
+30 points for asking me whether I'm sexually active with men or women
+20 points for reacting neutrally to my answer
-20 points for not asking me if I use protection
-20 points for thinking pap smears are irrelevant for young gold-star lesbians
+20 points for suggesting I get the HPV vaccine
...For a total of +30 sexual orientation competence points.
Her office had me fill out a lengthy, annoying questionnaire about my medical history. The office gets:
+10 points for using the word "sex" to ask about physical sex
+20 points for formatting it so the patient can write in "F," "M," or "I"
-30 points for not including a separate question about gender
...For a total of 0 gender competence points.
Which cursory, informal assessment leaves this particular clinic with a total of +30 lgbtq competence points, on an arbitrary scale yet to be determined. I'm sure I would have more to talk about if I were trans; since I'm cis, my actual medical care does not involve trans-specific issues, so I can't comment on how well the doctor I saw would handle them.
All this is simply to highlight the fact that it makes a difference when doctors and other health care providers are competent in talking about and dealing with lgbtq issues, even when those issues aren't directly related to health. In my case, I was relieved when my doctor asked about my sexual orientation, and her good response allowed me to be more open about my health. This in turn allowed her to do her job better, and means that I am more likely to receive adequate medical care. On the other hand, her failure to ask about protection and insist on regular pap smears leads me to think that her medical knowledge about lesbian sexual health is limited to common knowledge that assumes pap smears and protection are unnecessary for women like me.