Andrea Markowski said she and her partner Ginette were stunned when the Winnipeg doctor told them during a “meet-and-greet” appointment she was uncomfortable accepting them as patients and had never treated “people like you” before.

The doctor said she only treated “husbands and wives,” said Markowski, who is legally married to her partner of 18 years.

“It was like a kick in the stomach,” said Markowski, who just moved to the city from the Northwest Territories. “It was definitely a traumatic and unexpected experience … She is a doctor who is paid with public funds.

“I have a really hard time understanding how her religion affects her ability to care for me as a human being.”

The couple has lodged a complaint with the province’s human rights commission and the Manitoba College of Physicians and Surgeons.

The Charter of Rights and Freedoms ensures no one can be denied health care on the grounds of sexual orientation, Markowski pointed out. The bodies regulating doctors in Canada must therefore take more responsibility to ensure foreign-trained physicians are ready to practise here, she added.

“We’ve stumbled upon a pretty serious problem and we want to make sure that it gets fixed. In some ways you feel a bit like a prisoner. There are so few doctors, it’s hard to see one, but they still are accountable to provide good service,” Markowski said.

“The College of Physicians and Surgeons in Manitoba and other places in Canada has to broaden the way that it assesses the skills -  particularly of foreign doctors who may be coming from places where beliefs and norms are quite different – to make sure that they really are able to practise the physical, mental and emotional care of patients.”

Dr. Kamelia Elias did not return phone calls seeking comment. But she told the Winnipeg Free Press that she has no experience treating gays and lesbians who have “sexual problems” and “a lot of diseases and infections.”

“I said it’s better to find someone who has experience and will take this type of patients,” she told the newspaper.

Gay-rights organizations are calling for better programs specifically aimed at nipping prejudice in the bud.

The registrar of Manitoba’s physicians college said foreign-trained doctors do undergo an orientation before they can practise in the province. Bill Pope said doctors coming from other countries suffer from culture shock when they come to Canada. Some of them have never done a pelvic exam on a woman or put on a plastic cast, he said.

“How much of a change do you think it would be if you or I were put down somewhere in a Muslim Arabic country or Uzbekistan? It would be a shock,” Pope said. “We would hope that we would be forewarned about areas where we could potentially create problems without our knowing it.”

The province’s college has recently extended its orientation for foreign-trained doctors from one week to a month, he said. There is also some discussion of holding a session with the Manitoba Human Rights Commission so doctors get a briefing of the expectations of them under the charter.

The head of Canada’s gay-rights organization said transgendered people are sometimes denied health care. But Helen Kennedy with EGALE said this is the first instance she’s heard of involving a lesbian.

As the number of foreign-trained doctors in Canada increases, it’s incumbent upon colleges and the country’s Immigration Department to ensure they accept gay, lesbian and transgendered patients, she said.

“This is really sad. It really shows a bigger problem with people who are medically trained coming to Canada from other cultures. There is nothing in place to assist them to make the adjustment and to get the training that they need when they come here.”

Still others say all doctors would benefit from a better understanding of gay and lesbian health issues.

“All physicians need to get more training on this,” said Gens Hellquist, executive director of the Canadian Rainbow Health Coalition. “What little they get tends to be focused on HIV and AIDS, which is only one of the range of health issues.”

In a letter to the editor of Pulse – a journal for general practitioners – Dr Muhammad Siddiq, the head of the Islamic Medical Association, said that gay patients deserve neither help nor pity but they do need “the stick of the law to put them on the right path.”

“There is punishment and a fine if you throw rubbish or filth in the streets. The gays are worse than the ordinary careless citizen,” the letter said. It also claimed that gays “are causing the spread of disease with their irresponsible behavior. They are the root of many sexually transmitted diseases.”

In addition, the letter said that a depressed transsexual awaiting gender reassignment was “twisted.”

After a complaint was filed with the medical board, Siddiq denied writing the letter, claiming that it was written by his son as a joke and he signed it not knowing the son would send it to the publication.

But the Pulse editor testified before a board hearing that the publication checked with Siddiq prior to publishing the letter and he did not deny writing it. Colleagues also say that he told them he had written the letter.

The chair of the board hearing the complaint, Dr. Andrew Popat, called the Siddiq’s actions inappropriate and not in the best interests of his patients.

Popat said that the letter was “liable to undermine public confidence in the medical profession and liable to bring the profession into disrepute”, adding that “the panel continues to have concerns regarding Dr Siddiq’s insight into his actions.”

Siddiq refused to attend the hearing, claiming the board was biased against him.

In addition, Aetna has awarded GLMA a $50,000 grant as the diamond sponsor of GLMA’s 26th Annual Conference scheduled for Oct. 22-25 in Seattle. The conference will feature presentations and workshops on HIV/AIDS; lesbian, gay, transgender and bisexual health; substance abuse; aging; families and relationships; and legal issues.

Joel Ginsberg, GLMA’s executive director, said he hopes to see other insurance companies follow Aetna’s lead by linking to the database.

“This is a valuable tool that allows LGBT individuals to find LGBT-friendly health care providers whom they can trust,” said Ginsberg.

“All patients must feel comfortable speaking candidly with their health care providers so that the care delivered is appropriate and effective, and patients can take greater control of their health and well-being,” said Troyen Brennan, M.D., Aetna’s chief medical officer.

“Aetna and the GLMA share a similar goal of eliminating disparities in health care, including unequal health care access and outcomes that critically challenge the American health care system today.”

Openness between patients and their health care providers can be an issue for the LGBT community and can impact their quality of care. A study released in July by the New York City Department of Health and Mental Hygiene showed that men who disclose having sex with men to their physicians were twice as likely as those who did not to have been tested for HIV (63 percent vs. 36 percent).

The study also revealed in a survey of 452 New York City men who have sex with other men that 39 percent had not disclosed their sexual orientation to their doctors.

Any provider who is willing to affirm their commitment to providing a welcoming environment for LGBT patients and clients is invited to join the GLMA Provider Directory, the association said. GLMA also has resources available for providers on how to meet the unique health care needs of LGBT individuals, which includes creating an environment where patients can feel comfortable talking openly.

Aetna said it will alert its participating health care providers of the link between the DocFind tool and GLMA’s database to raise additional awareness of GLMA among providers.

Aetna has earned the top rating of 100 percent in the 2009 Corporate Equality Index by the Human Rights Campaign. This is the seventh consecutive year that Aetna has received a perfect score for its service to LGBT employees and consumers.