Sexual Orientation and Gender Identity Data Collection: Clinical and Public Health Importance

The 2011 Institute of Medicine report on lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) health and subsequent reports from other normative bodies have recommended that sexual orientation and gender identity (SOGI), as well as sexual behavior, be routinely documented for all patients accessing clinical care. Although gathering and documenting SOGI data in electronic health records (EHRs) is consistent with federal efforts to gather health data on LGBTQIA+ populations as authorized under Section 4302 of the Patient Protection and Affordable Care Act, uptake ofSOGI data collection and documentation remains abysmally low.SOGI is an important dimension of individual self-perception and behavior, and has profound effects on health, whether a patient identifies as LGBTQIA+, as cisgender (nontransgender), or as heterosexual. If clinicians do not know their patients' SOGI status and sexual behavior, important therapeutic and preventive services may be ignored, including HIV screening, appropriate referrals for behavioral health care, and support services that incorporate patients' specific needs (e.g., cancer support groups for same-gender couples).SOGI data collection and documentation are a key component of enhancing meaningful dialogue during clinical encounters and promoting the provision of high-quality care. The collection ofSOGI data are a critical step in systematically documenting and addressing health disparities affecting LGBTQIA+ persons. Patient- provider discussions about SOGI can facilitate a more accurate assessment ofself-reported health and behaviors. Additionally, accurate SOGI data collection is a vital part ofestablishing a good patient-provider relationship and conveys competence and humility. By routinely eliciting SOGI status using a structured format, EHR systems are better equipped to notify health care providers of appropriate and targeted care and preventive services.1 Maintaining and using SOGI information in the EHR can promote communication among staff in health care organizations, improving delivery of care and patient satisfaction. Further, SOGI data capture can be used in concert with other data collection tied to social determinants of health to support a more patient-centered and comprehensive approach to patient care at the individual and systemic levels.