Remembering gender in sexual orientation-based research


John R. Blosnich
Mackey R. Friedman
Ken Ho


In their Original Investigation published in a recent issue of JAMA Internal Medicine, Haider et al1present 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