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Gay men, like most other population groups, rely on general practitioners (GPs) to provide primary health care when they are unwell.1 However despite greater social and legal acceptance of homosexuality, sexuality remains one of the few minority status groups where socially sanctioned bigotry is accepted (and at times encouraged), resulting in heterosexism and anti-gay prejudice in many social institutions.2 In relation to healthcare provision, gay men's anticipation and experience of negative experiences have contributed to the avoidance or delaying of medical visits.3, 4
In New Zealand the medical-related literature records a relationship between doctors and gay men that has not always been beneficial for gay men. For instance, much of the early interest in homosexuality framed it as pathology and tried to identify the causes of homosexuality.5,6 This focus was challenged by the removal of homosexuality as a mental disorder from the Diagnostic and Statistical Manual (DSM) in 1973, which contributed to a shift from the disease model to an acceptance of homosexuality and concern for the health of gay men.7 Since the identification of AIDS in the mid-1980s, HIV/AIDS has been the predominant health focus for gay men in New Zealand,8 and several related publications have appeared in this journal.9-15
More recently, along with HIV/AIDS, there has been a shift internationally to consider a wider range of health issues as important for gay men.8 This has included increased concern with the development of gay-focused health policy16 and attention being paid to the nature and quality of the doctor-gay patient clinical relationship.4 However, neither of these issues have been substantively addressed in the New Zealand context. Other jurisdictions such as Australia and America have issued significant position papers and developed targeted policy concerning gay men.17,18 Locally the limited formal documentation makes only passing references to gay men through requiring doctors to be aware of cultural factors, including gay culture,19 and not to let views about a patient's sexuality prejudice treatment.20
Concerning the relationship between gay patients and doctors there has been some local quantitative research which has investigated the health of non-heterosexual New Zealanders.21 These data confirmed that 71.5% of the 2256 participants report their health as 'excellent' or 'very good', which appears broadly in keeping with self-reports of general health status by New Zealanders.22