Asking Patients Questions about Sexual Orientation and Gender Identity in Clinical Settings

The Institute of Medicine, the U.S. government’s Healthy People 2020 strategy, and the Joint Commission on Accreditation of Healthcare Organizations are among many entities that have recommended asking sexual orientation and gender identity (SOGI) questions in clinical settings and including such data in Electronic Health Records (EHRs). Many health care providers are in the process of considering how to do this. In order to better understand how a diverse group of people would respond when these questions are asked, several hundred patients at four health centers across the United States were surveyed about asking SOGI questions in their health center. This sample was predominantly heterosexual, racially diverse, geographically broad (South, Mid-West, Mid-Atlantic, and Northeast regions), and comes from both rural and urban health centers. There was a strong consensus among patients surveyed—heterosexual and non-transgender as well as lesbian, gay, bisexual, and transgender (LGBT)—about the importance of asking questions about sexual orientation and gender identity. Most of the LGBT respondents thought that the questions presented on the survey allowed them to accurately document their sexual orientation and gender identity. While some LGBT patients would ask the questions differently, most agreed or strongly agreed that the options presented addressed their needs.

This validation of SOGI questions in an array of clinical settings with a diverse population of patients has important implications for public policy. The Centers for Medicare and Medicaid Services and the Office of the National Coordinator of Health Information Technology within the U.S. Department of Health and Human Services are currently considering whether to include SOGI data collection in the Stage 3 guidelines for the incentive program promoting meaningful use of electronic health records. This study provides evidence that integrating SOGI data collection into the meaningful use requirements is both acceptable to patients and feasible using existing SOGI question designs.

This article was originally published in The Fenway Institute.