3.7 Sexuality: Alcohol and other Drugs

Alongside mental health, alcohol and other drugs are a vital aspect of LGBTIQ health. Similar to negative mental health outcomes, constant minority stress can lead to increased rates of smoking, alcohol and recreational drug use in the LGBTIQ community. Being aware of these risk factors can help provide better preventative care. Consider the following scenario

Jules Hawkins is a young Aboriginal woman who has recently started coming to the clinic. She has booked in a long appointment to have a chat.”


This scenario focuses on obtaining an alcohol history, eliciting frequency and quantity of use, as well as relevant psychosocial factors. Students should display sensitivity to Jules’ Indigenous background. Though not explored in this scenario, a patient presenting with alcohol use in an OSCE station may need to be screened for Substance Use Disorder, as per the DSM V criteria.

Sometimes, clinicians can make assumptions about a person’s sexual practices.  Several reports have shown that when health professionals discriminate or impose their prejudices on their patients, the quality of their healthcare suffers. Many LGBTIQ patients have experienced discrimination at some stage in their lives and may be highly sensitive to discrimination or judgement from healthcare professionals. As such, clinical settings must be spaces where LGBTIQ individuals feel safe to disclose their sexuality without fear of judgement.

In the following section, we’ll develop clinical skills with lesbian, gay and bisexual patients.

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