A significant proportion of the population is predominantly gay or lesbian, but the unique health care needs of these patients and their families often are ignored. The most significant health risk for lesbians and gays may be that they avoid routine health care. Families that include gay members may have special needs, largely related to how homosexuality is perceived. Physicians can improve the health care of gay and bisexual men and women and their families by maintaining a non-homophobic attitude, being sure to distinguish sexual behavior from sexual identity, communicating clearly and sensitively by using gender-neutral terms, and being aware of how their own attitudes affect clinical judgment.