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What LGBTQ+ Patients Reveal—and Hide—from Their Doctors

April 20, 2025 by bespoke

Navigating the healthcare system isn’t always straightforward, especially for LGBTQ+ individuals, who often face unique challenges and barriers. LGBTQ+ patients experience higher rates of discrimination in medical settings, and recent executive orders in 2025 threaten to restrict access to affirming care further, exacerbating these issues. 

To better understand LGBTQ+ patient experiences, we surveyed 1,500+ Americans, asking them what they feel comfortable sharing with their doctors, what they keep hidden, and the discrimination they may have faced in healthcare settings. From disclosing sexual history to finding affirming care post-election, we explored how identity impacts honesty, trust, and access to the right treatment. Finally, we examined how these experiences compare to those of straight individuals, revealing key disparities in medical care and patient-provider relationships.

How Many Americans Aren’t Completely Honest With Their Doctors?

An infographic showing how many Americans aren’t fully honest with their doctors.

 

Going to the doctor is stressful enough without feeling like you have to censor yourself, but for many LGBTQ+ patients, that’s exactly what happens. 1 in 5 LGBTQ+ respondents (21.5%) feel uncomfortable disclosing their sexual orientation or gender identity to their doctor—a rate eight times higher than that of straight patients (2.6%). While the majority of both groups feel at ease having these conversations, the numbers suggest that for many LGBTQ+ folks, the doctor’s office isn’t always a safe space.

For non-binary patients, the gap is even more pronounced. A striking 40% of non-binary respondents report feeling uncomfortable sharing their gender identity or sexual orientation with their doctor. 

When it comes to discussing sexual history with healthcare providers, LGBTQ+ respondents (25%) are nearly twice as likely as straight respondents (13%) to feel uneasy bringing it up. When we zoom in, transgender (27%) and non-binary (33%) respondents report the highest levels of unease. While most people, regardless of identity, do feel comfortable discussing their sexual history with their doctor, the discomfort among a quarter of LGBTQ+ patients raises important questions about trust and inclusivity in medical settings.

Generational differences also play a role. Gen Z is the most uncomfortable discussing their sexual history with a doctor, with younger generations overall feeling more discomfort than older ones. But does this signal a step backward in openness, or is something else at play? Some researchers have noted that Gen Z is having less sex overall compared to previous generations, a trend widely reported in the media. If sexual experience plays a role in comfort levels at the doctor’s office, this could help explain why Gen Z is more hesitant to open up. 

When discomfort becomes a barrier to honesty, the consequences can be serious. More than 1 in 4 people (28%) admit to lying to their doctor about their health or sexual history. LGBTQ+ patients (36%) are more than twice as likely as straight respondents (16%) to withhold or misrepresent the truth, and Gen Z (34%) leads all generations in being less than fully honest with their doctors. Among transgender (41%) and non-binary (47%) respondents, the numbers are even higher.

What’s Stopping Patients From Being Honest With Their Doctors?

a bar chart showing the reasons respondents aren’t fully honest with their doctors

 

Honesty might be the best policy, but when it comes to doctor’s visits, plenty of people hold back about their health, sexual identity, and sexual history—and for good reason. 

The top three reasons all respondents aren’t fully honest with their doctor are:

  1. Fear of judgment or discrimination (43%)
  2. A provider making assumptions about them (32%)
  3. Feeling blamed for a health problem (24%)

For LGBTQ+ patients, these fears run even deeper. While nearly half (49%) of heterosexual respondents say there’s nothing preventing them from being fully honest with their doctor, that number drops to just 24% for LGBTQ+ respondents. LGBTQ+ patients are also more than twice as likely as straight patients to fear being blamed for a health problem (33% vs. 16%)—a clear sign that medical settings still don’t feel equally safe for everyone.

Which Health Topics Are Patients Most—and Least—Comfortable Discussing With Their Doctors?

a bar chart showing which topics respondents feel most and least comfortable discussing with their doctors

 

When it comes to doctor’s visits, some health topics are a lot easier to bring up than others. We asked survey respondents which topics related to their sexual and general health they feel comfortable discussing with their healthcare providers.

The topics all respondents are most comfortable discussing with their doctors are:

  1. Diet and exercise habits (76%)
  2. Relationship status (74%)
  3. Alcohol consumption (70%)

On the opposite end, the topics all respondents are least comfortable discussing with their doctors are:

  1. Sexual kinks and fetishes (15%)
  2. Anal health and anal pap smears (38%)
  3. Satisfaction with their sex life (42%)

For LGBTQ+ patients, these conversations can feel even more complicated. LGBTQ+ respondents report less comfort than heterosexual respondents when discussing most general and sexual health topics with their doctors. Out of the 14 health topics surveyed, HIV/HPV/STI status and smoking/vaping are the only ones that LGBTQ+ respondents feel more comfortable discussing with their doctors than straight respondents.

Interestingly, more people are comfortable discussing drug use than unprotected sex or STI exposure, suggesting that while some stigmas are fading, others remain strong. At the end of the day, a doctor’s office should be a place where nothing health-related feels off-limits—but for many, that’s still not the reality.

What Health Topics Are Patients Most Likely to Lie About—And Why?

a bar chart showing what respondents are lying to their doctors about the most

 

Not all doctor’s visits are filled with full disclosure. In fact, plenty of people admit to fudging the truth—or outright lying—when it comes to certain health topics. 

The top five topics overall respondents are most likely to be dishonest about with their doctors include:

  1. Drug use (18.1%)
  2. Mental health (16.3%)
  3. Number of sexual partners (14.9%)
  4. Alcohol consumption (14.5%)
  5. Sexual kinks/fetishes (14.1%)

So, why these topics? They all share a common thread: stigma. Drug and alcohol use, mental health struggles, and sexual behaviors are often tied to judgment, shame, or fear of consequences, making them harder to discuss openly—even in a space that’s supposed to be free of judgment.

For LGBTQ+ patients, that fear is even more pronounced. LGBTQ+ respondents are significantly more likely than straight respondents to lie about mental health with their doctors (21% vs. 12.0%) and are twice as likely to hide drug use (24% vs. 12%). Whether due to past experiences with bias in healthcare or a general mistrust of medical providers, many queer patients feel the need to hold back information that could impact their care. 

Interestingly, drug use is a topic many respondents say they feel comfortable discussing with their doctors—yet it tops the list of topics people are most likely to lie about. This contrast may come down to how people define “comfort” versus “honesty.” Patients might feel okay mentioning past or occasional use, but hesitate to share the full truth—especially when it involves illegal substances, frequent use, or fear of judgment. In contrast, more sensitive topics like unprotected sex might feel awkward to bring up, but when directly asked, patients may feel less pressure to hide the truth.

What Health Topics Are Doctors Most Likely to Ask About During Appointments?

We also asked respondents which topics their doctors are most likely to bring up during appointments. Doctors routinely ask about lifestyle habits like alcohol consumption (66.4%), diet and exercise (65.7%), and drug use (57.8%)—all standard topics tied to overall health. But some conversations rarely make it onto the exam room checklist, even with specialists. The topics least likely to be proactively asked about include sexual kinks and fetishes (2%), satisfaction with sex life (9%), and anal health and anal pap smears (11%).

One interesting pattern? Doctors are more than twice as likely to ask LGBTQ+ patients about their relationship status (41%) compared to heterosexual patients (17%). This could reflect an effort to provide more personalized care, but it may also be tied to assumptions—such as the stereotype that LGBTQ+ individuals are more likely to be promiscuous. That bias could influence follow-up questions about condom use, STI testing, and safe sex practices. While medical professionals are increasingly aware of the need for inclusive care, these differences in approach suggest that not all conversations are happening equally—or without assumptions.

The Reality of Doctor’s Visits for LGBTQ+ Patients

an infographic with statistics about the reality of doctor’s visits for LGBTQ+ patients

Judgement & Gaslighting in Healthcare

Nearly 60% of all respondents say they have felt judged by a doctor at some point. That experience is even more common for LGBTQ+ individuals. 71% of LGBTQ+ respondents report feeling judged, compared to just 42% of straight respondents. Among non-binary and transgender patients, the numbers are even starker—90% of non-binary respondents and 83% of transgender respondents say they have felt judged in a medical setting.

Judgment isn’t the only issue—many patients feel outright dismissed. Nearly half (49%) of LGBTQ+ respondents say that they’ve experienced a provider dismissing or minimizing their health concerns. On top of that, 44% of all respondents have felt gaslit by a doctor, with LGBTQ+ patients experiencing this at much higher rates (54% vs. 30% of straight respondents).

LGBTQ+ Patients Find It Difficult to Find Affirming Care

With so many LGBTQ+ patients feeling judged or dismissed by doctors, it’s no surprise that many are actively seeking out more inclusive care. More than three-quarters (78%) of LGBTQ+ respondents say they would feel more comfortable speaking openly and honestly with a doctor who shares their sexual orientation. This highlights the importance of representation in healthcare—not just for visibility but for building trust between providers and patients.

Beyond that, more than a third (36%) of LGBTQ+ respondents believe their doctor could improve their knowledge of LGBTQ+ health concerns. Whether it’s understanding the unique risks LGBTQ+ individuals face, being aware of gender-affirming care options, or simply fostering a judgment-free environment, some patients feel their providers still have a long way to go in delivering truly inclusive care.

With these challenges, it’s no surprise that more than half (54%) of LGBTQ+ respondents are willing to go out of network to receive adequate care. But finding the right provider isn’t always easy—1 in 3 LGBTQ+ respondents say it’s difficult to find LGBTQ+-affirming healthcare in their area. The struggle is especially real in some states where LGBTQ+ patients report the highest difficulty rates:

  • South Carolina – 70% find it difficult
  • Pennsylvania – 53%
  • Texas – 49%
  • Missouri – 45%
  • Tennessee 42%

South Carolina, Texas, Missouri, and Tennessee are all Southern or conservative-leaning states where LGBTQ+ protections are limited and access to affirming care has long been a challenge. Pennsylvania may seem like more of an outlier, but its large rural regions likely contribute to the difficulty. While cities like Philadelphia and Pittsburgh offer more inclusive options, many LGBTQ+ patients in other parts of the state may still struggle to find providers they feel comfortable with.

Fears Over Changing Healthcare Policies Are Growing

For LGBTQ+ individuals, healthcare concerns go beyond personal experiences—they’re also shaped by shifting policies. 64% of all respondents worry that legislative changes under the new presidential administration could reduce access to LGBTQ+-specific health services. That concern is even higher among LGBTQ+ respondents, with 81% expressing worry, and for non-binary and transgender respondents, the number jumps to over 90%.

What Would Make Healthcare Feel Safer for LGBTQ+ Patients?

When asked what would make them feel safer or more comfortable accessing healthcare in 2025, LGBTQ+ respondents responded as follows:

  • Stronger anti-discrimination laws protecting LGBTQ+ individuals – 68%
  • More inclusive healthcare networks with affirming providers – 60%
  • Easier ways to verify if a provider is LGBTQ+-affirming before scheduling an appointment – 56%
  • LGBTQ+-specific training for healthcare providers – 54%
  • Legal protections for accessing gender-affirming care – 51%
  • Expanded insurance coverage for LGBTQ+-specific health needs – 49%

At the end of the day, the data shows a clear gap in trust between LGBTQ+ patients and the healthcare system. While many providers are making strides toward inclusivity, the reality is that too many patients still feel unheard, judged, or outright dismissed.

Closing Thoughts

This study reveals a troubling reality: many Americans—particularly LGBTQ+ individuals—don’t always feel safe being honest with their doctors. Whether due to fear of judgment, discrimination, or lack of affirming providers, these barriers impact trust, access, and overall well-being. As legislative changes continue to shape healthcare in 2025, the need for inclusive, stigma-free care has never been more urgent.

As Dr. Evan Goldstein of Bespoke Surgical explains:

Transparency can be lifesaving in the medical world. Because of this, it is crucial that patients trust their doctors and feel understood. Through our findings, it is clear for LGBTQ+ people this is not always the case – many feel judged and uncomfortable with their available medical practices, leading to dishonesty.

This is a big reason why I started my practice, Bespoke Surgical — so anyone who engages anally could get the proper care they need, free of judgment or shame. As not everyone is in the geographic position to visit me in NYC, I have made it my goal to create access to the information and care needed for everyone engaging anally through my book, Butt Seriously, my product line, Future Method, and our education hub, the Science of Sex. My hope is that one day, every doctor in America will have compassion and understanding for all their patients’ sexual preferences.

Methodology

This study is based on a survey of 1,523 Americans conducted between February 4 and February 7, 2025. Of the respondents, 60% identified as LGBTQ+ (916 respondents), while 40% identified as heterosexual (607 respondents), ensuring a diverse range of perspectives on healthcare experiences.

For this study, gaslighting was defined as a situation where someone manipulates an individual into doubting their own experiences, feelings, or reality—often by dismissing concerns, minimizing symptoms, or making them feel at fault for their health issues. In healthcare, this can include ignoring symptoms, downplaying medical conditions, or denying necessary prescriptions without a valid medical reason.

An LGBTQ+-affirming doctor was defined as a healthcare provider who fosters a welcoming, inclusive, and nonjudgmental environment by respecting LGBTQ+ identities, understanding their unique health needs, and delivering culturally competent care.

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About the Author

bespoke avatar

Consistent, proactive, and thoughtful healthcare is not only a priority, it is a demand by men who live well. Bespoke Surgical is built on this understanding. Today's modern, urban male has become adept at making the most of life, believing in living fully and completely in all aspects of work, fitness, relationships, and family. This makes excellent health more important than ever.

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