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Am J Public Health. 2015 Sep;105(9):1831-41. doi: 10.2105/AJPH.2015.302631. Epub 2015 Jul 16.

Health Care Providers' Implicit and Explicit Attitudes Toward Lesbian Women and Gay Men.

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Janice A. Sabin is with Department of Biomedical Informatics and Medical Education, University of Washington, Seattle. Rachel G. Riskind is with Department of Psychology, Guilford College, Greensboro, NC. Brian A. Nosek is with Department of Psychology, University of Virginia, Charlottesville.



We examined providers' implicit and explicit attitudes toward lesbian and gay people by provider gender, sexual identity, and race/ethnicity.


We examined attitudes toward heterosexual people versus lesbian and gay people in Implicit Association Test takers: 2338 medical doctors, 5379 nurses, 8531 mental health providers, 2735 other treatment providers, and 214,110 nonproviders in the United States and internationally between May 2006 and December 2012. We characterized the sample with descriptive statistics and calculated Cohen d, a standardized effect size measure, with 95% confidence intervals.


Among heterosexual providers, implicit preferences always favored heterosexual people over lesbian and gay people. Implicit preferences for heterosexual women were weaker than implicit preferences for heterosexual men. Heterosexual nurses held the strongest implicit preference for heterosexual men over gay men (Cohen d = 1.30; 95% confidence interval = 1.28, 1.32 among female nurses; Cohen d = 1.38; 95% confidence interval = 1.32, 1.44 among male nurses). Among all groups, explicit preferences for heterosexual versus lesbian and gay people were weaker than implicit preferences.


Implicit preferences for heterosexual people versus lesbian and gay people are pervasive among heterosexual health care providers. Future research should investigate how implicit sexual prejudice affects care.

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