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"Our study indicates that it's more prevalent than one might have guessed." said Roland Dunbrack, Jr., co-author of the report, which appears in the March 18 issue of the New England Journal of Medicine.
"It's an exclusion that in many cases, maybe in most cases, doesn't need to be used," said Dunbrack, an associate professor at Fox Chase Cancer Center in Philadelphia.
Review boards, which approve studies at both the local and federal level, already keep a close eye on research that excludes minority groups or either gender, Dunbrack noted. He and his colleagues launched their research because they were curious about study restrictions involving gays and lesbians.
"If you want to exclude a particular group, you usually have to have a rationale for it," he said, but there aren't such restrictions for gays and lesbians.
The researchers suspected that the issue of inclusion -- or exclusion -- of gays and lesbians doesn't come up very much outside of research into sexuality. And they found that to be the case, at least in asthma research. Of more than a thousand studies on asthma that the researchers located, none had restrictions based on sexual orientation.
However, out of 243 studies that included the words "couple," "erectile dysfunction" or "hypoactive" (referring to low sex drive), 37 excluded non-heterosexuals in some way.
"It's not that every study we looked at should be rewritten," Dunbrack said, but there should be reasons given for the exclusions, and "we don't know for these studies what these rationales would be."
Those most likely to restrict people in same-sex relationships were industry sponsored trials, multi-regional studies and phase 3 clinical trials (the phase before drugs are typically submitted for FDA approval), the team found.
James Beaudreau, education and policy director of the Gay and Lesbian Medical Association, said it's important to include lesbians, gays, bisexuals and transgendered people in medical research because they experience certain medical conditions at different rates.
For example, studies suggest that lesbians may be more likely to develop breast cancer than other women. Also, he said, "the health effects of stress related to living with a stigmatized identity include higher rates of depression, anxiety disorders, suicide attempts, and substance abuse."
"The real danger is that gay and transgender people may respond differently to medical interventions, but we will never know if we don't collect the information," said Beaudreau, whose organization represents medical professionals.
"We don't believe that it places an undue burden on researchers to ask questions about sexual orientation and gender identity," he said.
-- Randy Dotinga
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