Fordham University’s Dr. Celia Fisher on Patient-Provider Communications with Gay Teens

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Image via Fordham News

Fordham University’s Celia Fisher, PhD was the Principal Investigator on a recently completed quantitative study that resulted in a paper published in the journal AIDS and Behavior titled “Patient-Provider Communication Barriers and Facilitators to HIV and STI Preventive Services for Adolescent MSM.” The purpose of this study was to explore adolescent men who have sex with men (AMSM) patient–provider sexual health communications and services. Fisher found that AMSM were “reticent to discuss sex with their doctors.” But when doctors initiated the conversation, they were more forthcoming with “vital information that could affect their health,” according to Fordham News.

If talking to teens about sex is difficult for parents, physicians face an increase of awkwardness. “Many doctors simply don’t ask about it,” said Fisher, Professor of Psychology, the Marie Ward Doty University Chair in Ethics and Director of Fordham’s Center for Ethics Education. The subject gets touchier when it comes to asking young men about gay sex.

The nationwide study was conducted anonymously via a questionnaire linked to from a trusted website frequented by gay teens. It surveyed 198 AMSM between the ages of 14 and 17. Several participants said they completed the survey because they wanted to help their community.

“This is the first study to ask kids about their attitudes on getting sexual health care. Pediatricians and general practitioners are the gateway of youth experiences with health care, but [these patients] only go once a year, so this is an ideal time to ask [about their sexual activity],” said Fisher.

Fisher emphasized the conversation needs to be initiated by the doctors, even though doctors often have the “misperception that the kid would be uncomfortable.”

“Physicians need to be well versed in safety advice and should be able to communicate to all,” she said. “The kids don’t bring it up because they think the doctor will be prejudiced.”

Another concern among the young men was that the doctors might reveal their sexual orientation or identity, but Fisher said most states allow doctors to provide information to teens on sexual health, including HIV prevention, without parental consent. Some states, like New York, even allow doctors to prescribe PrEP, the pill that protects against HIV, to minors without getting parents involved.

“The gray area is if the child is having sex with an adult that might be considered sexual abuse and that needs to be reported,” said Fisher. But such cases only “reinforce the need for doctors to be proactive in their conversations with youth,” she said.

For more on this, please read the original article on Fordham News.


For LGBT resources, please visit RELAY (Research and Education for LGBT and Allied Youth). RELAY is a project of Fordham University’s Center for Ethics Education which looks to advance the conversation about health for lesbian, gay, bisexual, and especially trans youth. Please also visit the resource page for creating an LGBTQ-inclusive classroom.

Celia B. Fisher, Ph.D. is the Fordham University Marie Ward Doty University Chair in Ethics and Director of the Center for Ethics Education and the HIV and Drug Abuse Prevention Research Ethics Training InstituteFisher’s  Decoding the Ethics Code: A Practical Guide for Psychologist, is now in its fourth edition from Sage Publications.

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