• Harry Cross and Carrie D Llewellyn.
• Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK.
• Fam Pract. 2020 Oct 19; 37 (5): 661-667.

BackgroundPersistent health inequalities in relation to both health care experiences and health outcomes continue to exist among patients identifying with a marginalized sexual orientation (MSO).ObjectiveTo compare the patterns of sexual orientation disclosure within primary care in England over a 5-year period.MethodsDescriptive 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).ResultsThe 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%).ConclusionWe 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.© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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