Identifying sexual orientation and gender identity in clinical settings in order to better understand and address LGBT health disparities

Issues: Healthcare reform underscores the need for accurate information on patients' sexual orientation and gender identity. The IOM report on LGBT health recommends collecting these measures in electronic health records (EHR) as part of the meaningful-use objectives for the Office of the National Coordinator for Health Information Technology (HIT). EHRs and HIT enable secure, timely access to information, benefiting patients through better health care decisions and more coordinated care. Description: Sexual orientation measures have been field-tested; gender identity measures have not been similarly examined. These challenges were recently explored in a clinical setting. Two sexual orientation question-sets were rotated on the patient registration form to assess demographic differences and refusal rates. A community advisory board and research staff conducted a mixed methods survey about best ways to ask about gender identity on the form. Lessons learned. Without relevant, tested information, providers in clinical settings cannot address the unique concerns of LGBT patients. Providers may be uncomfortable or not know how to gather this information from their patients. Including patients in the design of data collection systems may increase their confidence in the clinical setting and facilitate better provider-patient communication. Recommendations: Presenters will describe and provide results about effective ways to gather sexual orientation and gender identity from patients in a community health center with a substantial proportion of LGBT patients. Capturing sexual orientation and gender identity of LGBT patients will contribute to more respectful care. Nondiscrimination and confidentiality policies are essential to ensure that equal rights are accorded to sexual and gender minorities in clinical settings.