This study explored the experiences of gay and bisexual men in primary care. The study was mindful of both the wider context of the HIV epidemic and the increasing acknowledgement of the role of social factors in determining health and well-being. The study informants were 17 gay and bisexual men, all of whom were registered with general practices. Two major barriers to effective communication and possibly treatment were identified. First, despite the fact that all the informants had come out – or disclosed their sexuality – in many areas of their lives, there was considerable anxiety and fear of stigmatisation in relation to doing so in the context of primary care. Second, many practices and practitioners appeared to assume that all their patients were heterosexual; there were few signals in practice environments of any awareness of gay and bisexual men. This generated problems for men wishing to discuss health needs and treatments in relation to their sexuality and to gay social networks; few practitioners had made referrals to any these networks as part of their health promotion strategy. The study raises questions about the organisation of primary care provision and its willingness to acknowledge and form partnerships with gay social networks.