Lesbian, gay, bisexual, and transgender (LGBT) health care will, increasingly, be a feature of the primary care repertoire.1 Pride in Practice, which is supported by the Royal College of General Practitioners, provides a rating system that judges primary care surgeries on a welcoming environment, access, the GP, patient consultation, staff awareness and training, and health promotion for LGBT people. For those surgeries signed up to the initiative, plans to address shortfalls will be developed in consultation with the Lesbian and Gay Foundation. Another initiative, Transgender Awareness, is attempting to address matters that are important to a diverse group of transgender patients. While acknowledging these very positive developments, it is important to understand what we mean by ‘LGBT primary health care’. We will draw on the concept of LGBT health care to explore the benefits and potential harms that this term can engender, and on the different ways that the relatively sparse LGBT health literature has addressed and accounted for the different foci of LGBT health care over the years. In doing so, we will argue for a more nuanced approach to primary health care for these groups.
Student teaching has tended to position heterosexuality and gender normativity — people conforming to social standards of what is ‘appropriate’ feminine and masculine behaviour — as the primary context in which health and illness is viewed. Models of health care that promote these views of sexuality and gender identity over others can create an environment in which gender stereotypes and heteronormativity — the cultural bias in favour of opposite-sex …