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Comment & Response
January 2018

Remembering Patient Gender in Sexual Orientation–Based Research

Author Affiliations
  • 1Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 3Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
  • 4Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 5Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
JAMA Intern Med. 2018;178(1):151. doi:10.1001/jamainternmed.2017.4919

To the Editor In their Original Investigation published in a recent issue of JAMA Internal Medicine, Haider et al1 present important findings about patient willingness to disclose sexual orientation information in an emergency department setting and physician hesitancy to elicit this demographic information. However, our enthusiasm for this study1 was dampened by the analyses of the sexual orientation groups, which introduced confounding by respondent sex—namely, the authors considered sexual orientation groups as gay, lesbian, bisexual, and straight. In so doing, the authors conflate bisexual men with bisexual women and heterosexual men with heterosexual women. The gay and the lesbian groups both represent a single sexual orientation group (ie, persons attracted to the same sex or homosexual), yet they were treated as separate sexual orientations, meaning, logically, only men were in the gay group and only women were in the lesbian group, as evidenced in Table 3.1

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