A vast amount of information is available to both the LGBT community and nurses-in print, online, and in various support groups. All patients should be treated as people first, with individual needs requiring individual care plans. Reading "Addressing Health Care Disparities in the Lesbian, Gay, Bisexual, and Transgender Population: A Review of Best Practices" (June) made me think that when the patient's sexual orientation is turned into a primary need, this may override the concerns for which the patient is being seen. Sexual orientation doesn't matter when the patient is having a laparoscopic cholecystectomy, for example, and it doesn't make a difference when a patient with diabetes is hospitalized for a blood sugar level of 800.

During my hospitalizations, no one asked about my sexual orientation, nor did I expect them to. Unless it is a necessary part of my care, or I bring up the subject, it's not the business of my nurses.

Vicki Nesbitt, RN

Cleveland, GA

Authors Fidelindo A. Lim, Donald V. Brown Jr., and Sung Min Justin Kim respond: Patient-centered and culturally sensitive care can only be delivered when the provider takes into consideration the patient's enduring values, identity, and sexual orientation. Otherwise, how can we individualize the care plan? Similarly, providers must understand why it's difficult for LGBT patients to come out (some may even refuse) to their providers, and how this impacts health care outcomes.

Sexual orientation is not a need but a sense of being that is closely tied to a person's identity-and ultimately to her or his health. When providers fail to acknowledge this, we run the risk of perpetuating the health disparities referred to in our article.

While it's true that "a vast amount of information is available to both the LGBT community and nurses," the nursing profession has been slow to join discussions about LGBT health. From 2005 to 2009, only eight out of almost 5,000 articles published in the top 10 nursing journals addressed LGBT health issues.1 It's our aim to contribute to the ongoing efforts by nurses to ensure LGBT health equality.

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