In January this year, New Democracy MP Gerasimos Giakoumatos caused outrage when he he made comments in a radio interview describing homosexuality as a contagious disease.

Despite protests from the public and the political community, no penalties were imposed on Giakoumatos. One of the people who was not surprised by this is Dr. Dimitra Giannou, who has documented institutionalized homophobia and transphobia in Greece as part of her thesis for Durham University.

Her study, which drew on interviews with LGBTQ groups and individuals as well as doctors is the first of its kind in Greece. While LGBTQ rights have improved in recent years in the country, discrimination remains a serious problem. The neo-Nazi group Golden Dawn's rise to power in 2012 heralded a sharp increase in homophobic attacks and a civil union bill passed by parliament in 2015 was heavily opposed by right wing groups and the church.

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"Health service providers start with the premise that everyone is heterosexual and that whether you are LGBTQ doesn't affect your healthcare. With this assumption, LGBTQ patients get the message that they cannot speak freely about their sexuality," Giannou told DW.

Fear of discrimination

This has numerous consequences. When faced with the assumption that they are straight, LGBTQ patients do not feel able to ask the medical questions they want to without fear of discrimination, delay treatment or avoid it altogether. One male gay interviewee faced homophobic attitudes when seeking treatment for the human papilloma virus (HPV), and said that the reluctance of doctors to openly discuss treatment options in relation to his sexuality was a problem other gay HPV patients had mentioned.

"An older lesbian might avoid a smear test because she feels embarrassed about being assumed to be a virgin if she doesn't have penetrative sex," Giannou said. "If she contracts a sexually transmitted infection (STI) through non-penetrative sex, which can happen, she might not seek the treatment she needs because she doesn't have a doctor she can comfortably explain her circumstances to."

In another one incident she documented, a dentist began expressing extremely transphobic views to a transsexual patient during a check-up. "This is traumatic, because at that moment you are vulnerable as a patient," said Giannou.

Giannou said that the majority of the doctors she interviewed for the study were helpful and cooperative, but in one incident, a doctor threw her survey request back at her in front of a full waiting room. "He said 'I'm not doing anything for faggots!' What if one of those patients in the waiting room was gay? How would he feel?"

Uncomfortable

Andreas, who is a 26-year-old NGO professional and gay said, "I definitely feel uncomfortable to freely ask questions because I don't want to handle their potential homophobic behavior against me. It's easier for me that way. However, I always correct the healthcare worker if they assume I'm straight."

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He told DW that he has at times felt uncomfortable with doctors who know he is gay and stereotype him, but that his dentist is aware of his sexuality and it was never an issue. He also said that his experience with specially trained professionals to deal with his HIV positive status had been problem-free.

Leo Kalovyrnas, a counselor-psychotherapist, said several of his clients came to him after experiencing homophobic attitudes with other therapists. "Assuming that one's client is straight can be extremely damaging. It's bad enough that most gay men and women are erased from society in their daily lives, but to go to a therapist for help and be made invisible again can be catastrophic."

Overcoming stigmatization

He said as a volunteer for an LGBT organisation, he is regularly asked for referrals to gay-friendly doctors or facilities either because of existing bad experiences or because the patients are too terrified to talk candidly. "The result is that they under-report symptoms or conceal information," Kalovyrnas told DW. 

Despite repeated requests, the Athens medical association was unavailable for comment.

But as Kalovyrnas also pointed out, assumptions about sexual behavior can affect all groups. "Lots of women I know have traumatic stories to tell about their gynecologists, who overstep all professional boundaries and judge women about their sexuality, telling them what to do with their bodies and fertility in very condescending ways."

Giannou said that steps were necessary for healthcare professionals in Greece to approach LGBTQ patients in an appropriate way. "We must overcome the invisibility of LGBTQ people, and understand what it means to be discriminated against on the basis of sexual orientation and gender identity. Until we efficiently address these two critical goals, sexual orientation and gender identity as bases of discrimination will remain abstract terms in official documents of health rights."