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The Fenway Institute Policy Focus: Why Gather Data On Sexual Orientation and Gender Identity in Clinical Settings

The Fenway Institute Policy Focus: Why Gather Data On Sexual Orientation and Gender Identity in Clinical Settings

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Published by Fenway Health
Gathering sexual orientation and gender identity data from patients is essential to providing appropriate health care to lesbian, gay, bisexual and transgender (LGBT) people, who face significant documented health disparities. It also helps us to better understand these disparities. However, limited data indicate that most providers do not ask questions about sexual orientation, either during initial medical history or during annual exams.
Gathering sexual orientation and gender identity data from patients is essential to providing appropriate health care to lesbian, gay, bisexual and transgender (LGBT) people, who face significant documented health disparities. It also helps us to better understand these disparities. However, limited data indicate that most providers do not ask questions about sexual orientation, either during initial medical history or during annual exams.

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Published by: Fenway Health on Jan 12, 2012
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04/08/2013

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POLICY FOCUS:
WHY GATHER DATA ONSEXUAL ORIENTATIONAND GENDER IDENTITYIN CLINICAL SETTINGS
 
WHY GATHER DATA ON SEXUAL ORIENTATION AND GENDER IDENTITY IN CLINICAL SETTINGS 
01
POLICY FOCUS:
 
Why gather data on sexual orientation andgender identity in clinical settings
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Judith B. Bradford, PhD; Sean Cahill, PhD; Chris Grasso, MPH; and Harvey J. Makadon, MD
Gathering sexual orientation and gender identity data from patients is essential toproviding appropriate health care to lesbian, gay, bisexual and transgender (LGBT)people, who face significant documented health disparities. It also helps us to betterunderstand these disparities. However, limited data indicate that most providersdo not ask questions about sexual orientation, either during initial medical historyor during annual exams.
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Gathering LGBT data in electronic health records (EHR)is consistent with key recommendations in Healthy People 2020, the 2011 Instituteof Medicine report on LGBT health issues and research gaps, and the federalgovernment’s implementation of the Patient Protection and Affordable Care Act,which expands access to health care to most Americans and enhances protectionsagainst discrimination in health coverage.If LGBT patients are told why it is important to gather such information,and that such information will be kept private and confidential, most will beforthcoming with this information.
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Provider knowledge about their patients’sexual orientation and gender identity can facilitate optimal care.By 2014, when the U.S. government hopes that Americans’ health records willbe fully computerized, data from intake/registration forms and data obtainedin the course of provider-patient interactions should be merged into one datarecord. A second, related brief in this series provides best practices for gatheringsexual orientation and gender identity data through both formats.
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WHY GATHER DATA ON SEXUAL ORIENTATION AND GENDER IDENTITY IN CLINICAL SETTINGS 
02
WHY ASK THESE QUESTIONS? 
Asking questions about sexual orientation and gender identity
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is importantbecause there are significant documented health disparities affecting LGBTpeople.
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While we know about some disparities, there remain wide gaps inresearch on LGBT health. Gathering sexual orientation and gender identity datain a standardized way will allow us to better understandLGBT health disparities, as well as to prevent, screenand early detect conditions that disproportionatelyaffect LGBT people. Gathering such data in clinicalsettings will allow providers to better understand andtreat their patients, and to compare their patients’health outcomes with national samples of LGB orLGBT people from national health surveys.
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 Optimal and effective provision of healthcare and prevention services to LGBT peoplerequires that providers be informed of the healthdisparities affecting this population, includingspecific risk factors and health conditions. Forexample, lesbians are more likely than heterosexualand bisexual women to be overweight and obese,increasing their risk for cardiovascular disease, lipidabnormalities, glucose intolerance, and morbidityrelated to inactivity.
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Bisexuals may have poorer health than homosexuals andheterosexuals, as well as higher rates of mental health issues and smoking.
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 Transgender patients may be at greater risk of cardiovascular disease due toexogenous hormone use.
 Gathering data on sexual and gender identity is consistent with keyrecommendations in Healthy People 2020 and the 2011 Institute of Medicine’s reporton LGBT health issues and research gaps.
Healthy People 2020 calls on health careproviders to “appropriately inquir[e] about and be…supportive of a patient’s sexualorientation to enhance the patient-provider interaction and regular use of care.
The
Lesbians aremore likely thanheterosexual andbisexual womento be overweightand obese.

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