Challenging heteronormativity in the consultation:: a focus group study among general practitioners

Objective-To reflect on and further understand mechanisms of heteronormativity in the consultation, with special focus on the relative invisibility of lesbian women. Design-Tape-recorded focus group interviews transcribed verbatim and analysed using qualitative methods. Setting-General practitioners (GPs) from the city of Goteborg, Sweden, who had formerly answered a postal questionnaire about lesbian women in the consultation, were invited to take part in subsequent focus groups. Subjects-Ten GPs from the questionnaire who accepted the invitation and volunteered to participate in focus groups. Main outcome measures-A discourse analytical approach using interaction regarding consensus and disagreement between informants in creating major and minor themes. Results-Consultation skills were forwarded as a major tool in receiving optimal information from patients. However, traditional concepts of family and sexuality restricted information and hampered an accepting attitude. Bringing up issues of sexual identity/orientation was left to the lesbian patient and strongly related to her reason for attending. Conclusion-Consultation skills are a useful but not sufficient means of making lesbian women visible in the doctor-patient relationship. Doctors also need to transcend traditional concepts of family and sexuality and reflect on what is a relevant issue from the patient's perspective.