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FAQ: Collecting Sexual Orientation and Gender Identity Data

FAQ: Collecting Sexual Orientation and Gender Identity Data

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Better data collection will help policymakers and advocates better understand and address health disparities affecting the LGBT community.
Better data collection will help policymakers and advocates better understand and address health disparities affecting the LGBT community.

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Published by: Center for American Progress on Oct 15, 2012
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1Center or American Progress | FAQ: Collecting Sexual Orientation and Gender Identity Data
FAQ: Collecting Sexual Orientationand Gender Identity Data
Kellan Baker and Andrew Cray October 16, 2012
Healh insurance exchanges, esablished under he Aordable Care Ac, are new sae- based markeplaces or uninsured individuals and small businesses o shop or aord-able healh insurance producs. Te exchanges will also provide valuable new daa onhe healh care needs o people across he Unied Saes, including hisorically under-served groups such as he LGB populaion.Exchanges will have he opporuniy o collec hese daa hrough opional demo-graphic quesions on exchange applicaion orms, as well as hrough heir oversigh o insurance carriers oering plans in he exchange markeplaces. I done well, daa collec-ion will help policymakers and advocaes beter undersand and address healh dispari-ies aecing he LGB communiy, while also proecing he condenialiy o hose who voluneer inormaion on heir sexual orienaion and gender ideniy.Tis FAQ explains why collecing sexual orienaion and gender ideniy daa is impor-an, how hese daa can be colleced, and he proecions in place or LGB people whorespond o hese quesions.
Why collect data on sexual orientation and gender identity?
Public healh praciioners and healh care providers know ha he uure o healh andhealh care is buil on daa. Daa collecion is indispensable o eors o achieve beterhealh or all by ideniying, racking, and evenually eliminaing healh dispariies. Daahelp policymakers, advocaes, researchers, and communiy members beter collaboraein undersanding where dispariies exis, direcing resources o where hey are mosneeded, and ailoring healh programs o he specic needs o diverse communiies.Sexual orienaion and gender ideniy daa will aciliae numerous aciviies o he healhinsurance exchanges, including measuring he eeciveness o healh plan iniiaives opromoe culural compeency and qualiy improvemen, assessing he insurance coverage
2Center or American Progress | FAQ: Collecting Sexual Orientation and Gender Identity Data
needs o LGB communiies, and designing eecive oureach policies and programs orconnecing LGB people and heir amilies wih aordable, high-qualiy coverage. While sexual orienaion and gender ideniy daa may no iniially be sucienly robus o aciliae sraicaion or oher deailed analysis, iniiaing collecion o hese daa is vial o esablishing a baseline and, over ime, ideniying paterns o pracice ha poin o opporuniies or he exchanges o improve eors o serve heirdiverse consumer populaions.Mos imporanly, asking quesions abou sexual orienaion and gender ideniy com-municaes o LGB consumers ha he exchanges are ruly dedicaed o oseringinclusiviy and promoing insurance access or all.
What kind of questions can exchanges use to collect information aboutsexual orientation and gender identity?
Sexual orienaion and gender ideniy have several dieren componens relaed odemographics and legal relaionship saus, all o which have relevance o he exchanges’aciviies. Because everyone has a sexual orienaion and a gender ideniy, hese ques-ions will be relevan o all people who apply or coverage hrough exchanges.
Sexual orientation:
he responden’s ideniy wih regard o romanic and/orsexual atracion
he responden’s assigned sex a birh, which is he sex lised on he original birh cericae
Gender identity:
he responden’s curren gender ideniy, which is he responden’sinernal sense o being male, emale, or anoher gender; or ransgender people, gen-der ideniy may dier rom he sex hey were assigned a birh
Relationship status:
he responden’s legally recognized relaionship saus wih asame- or dieren-sex parner Adminisraive daa collecion eors by ederally suppored healh programs underagencies such as he Healh Resources and Services Adminisraion and he Subsance Abuse and Menal Healh Services Adminisraion currenly include sexual orienaionand gender ideniy quesions.
Several ederal and sae surveys, such as he BehavioralRisk Facor Surveillance Sysem and he Youh Risk Behavior Survey, also include hesedemographic variables.
3Center or American Progress | FAQ: Collecting Sexual Orientation and Gender Identity Data
Te primary developers o sexual orienaion and gender ideniy quesions haveincluded he Sexual Minoriy Research eam, or SMAR, group a he WilliamsInsiue—a naional sexual orienaion and gender ideniy law and policy hink ank ahe UCLA School o Law—and he Ceners or Disease Conrol and Prevenion.
TeNaional Cener or Healh Saisics is also developing a sexual orienaion measure ha will be added o he Naional Healh Inerview Survey in 2013.
Tough he adminis-raive and populaion survey daa collecion conexs are dieren, here is subsanialoverlap in research exploring how bes o collec sexual orienaion and gender ideniy daa under various circumsances.
Is it legal to ask questions about sexual orientation and gender identity?
 Yes. Federal regulaions clariy ha he Aordable Care Ac permis exchanges o col-lec any demographic daa using opional quesions.
Refecing his sandard, boh heproposed single sreamlined applicaion and Small Business Healh Opions Program,or SHOP, Exchange employee/employer applicaions developed by he Ceners orMedicare and Medicaid Services include opional daa elemens or race and ehniciy inormaion.
Daa elemens on sexual orienaion and gender ideniy can similarly beincluded as opional quesions on exchange applicaions.
Will people answer questions about this sort of sensitive information?
 Yes. As wih quesions on race, ehniciy, and primary language, respondens may beuncomorable sharing personal inormaion due o concerns abou privacy or poenialdiscriminaion. Acceped pracice, however, refecs he recogniion ha he useulnesso race, ehniciy, and language daa jusies he inclusion o hese opional quesions onenrollmen orms and or healh plan qualiy and perormance measures. Sexual oriena-ion and gender ideniy daa are no dieren.Moreover, while some individuals will reuse o answer quesions hey consider oo per-sonal, research has shown ha survey respondens are wice as likely o reuse o answerquesions abou income as abou sexual orienaion.
Oher research has demonsraedha including sexual orienaion and gender ideniy quesions does no cause respon-dens o reuse o coninue he survey.
For exchange applicans who are eiher unamiliar wih hese quesions or unsure how o respond, navigaors—eniies ha will assis consumers wih enrolling in coveragehrough he exchanges—and oher consumer-assisance personnel should be appropri-aely rained o alleviae conusion and help individuals proceed hrough he applicaionprocess wih minimal diculy.

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