Collecting Sexual Orientation and Gender Identity Data in Electronic Health Records Workshop Summary (2013) / Chapter Skim
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2 Clinical Rationale for Collecting Sexual Orientation and Gender Identity Data
2 Clinical Rationale for Collecting Sexual Orientation and Gender Identity Data
Pages 5-14
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From page 5... ...
Harvey Makadon began his talk by recognizing the Surgeon General's report Healthy People 2020, which, for the first time, acknowledged that health disparities exist in LGBT populations. Health disparities among LGBT people are rooted in bias, stigma, discrimination, and social determinants of health, not genetics or other molecular issues, or even sexual orientation and gender identity, said Makadon.
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From page 6... ...
The IOM, in its report The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding, noted the direct benefit of collecting data on sexual orientation and gender identity for individual patients. Only by asking patients about their LGBT status and collecting data on the LGBT population will it be possible to end LGBT invisibility in health care.
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From page 7... ...
Yet, for clinicians, it can be helpful to understand the different dimensions and manifestations of sexual orientation in order to build a better therapeutic relationship with their patients. ACCESS TO CARE According to the aforementioned IOM study, lesbians and bisexual women may use preventive health services less frequently than heterosexual women.
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From page 8... ...
These data highlight the fact that LGBT people are not one homogeneous group, but rather that they reflect the same cultural diversity seen throughout the general population. Understanding the cultural diversity among, in this case, men who have sex with men, is going to be key to developing ways to reach underserved populations, but that lesson applies to all LGBT people, said Makadon.
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From page 9... ...
SUPPORTING PATIENTS IN THE COLLECTION OF DATA In 2009, Lambda Legal, together with more than 100 partner organizations, surveyed 4,916 people representing a diverse sampling of LGBT communities and people living with HIV, regardless of sexual orientation, gender identity, HIV status, race, ethnicity, age, and geography. The resulting report, When Health Care Isn't Caring: Lambda Legal's Survey on Discrimination Against LGBT People and People Living with HIV, was the first to document refusal of care and barriers to health care among LGBT and HIV communities on a national scale, said Beverly Tillery.
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From page 10... ...
10 FIGURE 2-1 New opportunities for gathering LGBT data during the process of care. NOTE: EHR = electronic health record.
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From page 11... ...
In nearly every case, people of color and lowincome people had higher rates of experiencing discrimination. In terms of barriers to care, the survey found that significant percentages of LGBT individuals expressed concerns about accessing health care.
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From page 12... ...
While I was filling out my health history information sheet, I was pleasantly surprised to find that the sheet indicated both male and female partners, the number of partners, and the type of birth control I used. I thought this was a great example of LGBT-friendly medical facilities.
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From page 13... ...
It is clear from the data that Lambda Legal collected, she said, that LGBT people experience real discrimination and a significant level of it, which makes them cautious about getting the health care they need. It is also important, she added, to focus on confidentiality and privacy because privacy breaches can have repercussions that go far beyond health care.
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From page 14... ...
Leslie Calman, of the Mautner Project: The National Lesbian Health Organization, asked if Makadon had any insights into how to communicate these issues to her community. She noted that she regularly encounters lesbians, particularly older lesbians, who are terrified of having this information available and are particularly terrified that they will find themselves in a situation where they have an accident, go to the hospital, and receive poor care because they are lesbians.
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