In 1991 the authors surveyed all U.S. medical schools to assess both the number of curriculum hours devoted to the topic of homosexuality and the instructional strategies employed in its academic treatment; responses were sought from faculty with responsibility for teaching the topic (mostly directors of medical student education in psychiatry). Of the 126 schools, 82 (65%) responded. The mean number of hours reported was 3 hours and 26 minutes, with significant differences based on geographic region. The most frequently cited strategy was lectures in human sexuality, followed distantly by panel presentations and meetings with gay men or lesbians (both health care providers and others). To enhance sensitivity and comfort with gay and lesbian issues and to counter stereotypic responses, the authors propose that the topic of homosexuality be wholly integrated throughout the curriculum.