Do I need to know my patient's sexual orientation and gender identity? Insights from Swiss primary care physicians.
Primary care physicians (PCPs) play a pivotal role in the Swiss healthcare system, serving as the first point of contact for diverse populations, including sexual and gender minorities (SGM). The collection and use of sexual orientation and gender identity (SOGI) information is increasingly recognized in public health as a tool to address health inequities. This study explores PCPs' perspectives, practices, and perceived relevance of collecting, documenting, and using SOGI information in Swiss primary care.
Semi-structured interviews with 11 PCPs in German-speaking Switzerland were conducted. The data were analysed via a hybrid thematic analysis approach that combined inductive and deductive coding, guided by the minority stress model and a health equity perspective.
The PCPs generally acknowledged the relevance of SOGI information in specific clinical contexts, particularly mental and sexual health; however, they saw limited relevance in routine care. Documentation practices were inconsistent, often informal, and constrained by binary electronic systems. Open communication was described as a facilitator, although discomfort and fear of stigmatization limited proactive inquiry. SOGI is often framed in behavioural rather than identity terms. Most participants had received little to no formal training on SGM health and expressed ambivalence about the need for further education. Structural barriers, assumptions, and lack of visibility of SGM patients further contributed to the limited use of the SOGI in clinical decision-making.
Despite the growing awareness of the SOGI as a social determinant of health, it is still rarely addressed in Swiss primary care. Addressing documentation barriers, promoting inclusive communication, and embedding SOGI-related information in medical education are critical steps toward equitable, patient-centred care.
Semi-structured interviews with 11 PCPs in German-speaking Switzerland were conducted. The data were analysed via a hybrid thematic analysis approach that combined inductive and deductive coding, guided by the minority stress model and a health equity perspective.
The PCPs generally acknowledged the relevance of SOGI information in specific clinical contexts, particularly mental and sexual health; however, they saw limited relevance in routine care. Documentation practices were inconsistent, often informal, and constrained by binary electronic systems. Open communication was described as a facilitator, although discomfort and fear of stigmatization limited proactive inquiry. SOGI is often framed in behavioural rather than identity terms. Most participants had received little to no formal training on SGM health and expressed ambivalence about the need for further education. Structural barriers, assumptions, and lack of visibility of SGM patients further contributed to the limited use of the SOGI in clinical decision-making.
Despite the growing awareness of the SOGI as a social determinant of health, it is still rarely addressed in Swiss primary care. Addressing documentation barriers, promoting inclusive communication, and embedding SOGI-related information in medical education are critical steps toward equitable, patient-centred care.
Authors
Schädler Schädler, Lampart Lampart, Schiltknecht Schiltknecht, Ort Ort, Tomaschek Tomaschek
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