Sexual Orientation and Gender Identity Data Reporting Among U.S. Health Centers

doi:10.1016/j.amepre.2021.12.017

. 2022 Jun;62(6):e325-e332.

doi: 10.1016/j.amepre.2021.12.017. Epub 2022 Feb 26.

Sexual Orientation and Gender Identity Data Reporting Among U.S. Health Centers

Alex McDowell¹, Catherine Myong², Delaney Tevis³, Vicki Fung⁴

Affiliations

¹ Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts. Electronic address: amcdowell4@mgh.harvard.edu.
² Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts; Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York.
³ Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts; School of Medicine, University of California San Francisco, San Francisco, California.
⁴ Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts.

PMID: 35232619
PMCID: PMC9843854
DOI: 10.1016/j.amepre.2021.12.017

Sexual Orientation and Gender Identity Data Reporting Among U.S. Health Centers

Alex McDowell et al. Am J Prev Med. 2022 Jun.

. 2022 Jun;62(6):e325-e332.

doi: 10.1016/j.amepre.2021.12.017. Epub 2022 Feb 26.

Authors

Alex McDowell¹, Catherine Myong², Delaney Tevis³, Vicki Fung⁴

Affiliations

¹ Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts. Electronic address: amcdowell4@mgh.harvard.edu.
² Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts; Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York.
³ Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts; School of Medicine, University of California San Francisco, San Francisco, California.
⁴ Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts.

PMID: 35232619
PMCID: PMC9843854
DOI: 10.1016/j.amepre.2021.12.017

Abstract

Introduction: Sexual orientation and gender identity data collection is necessary to address health inequities. This study examines sexual orientation and gender identity data reporting among community health centers.

Methods: Using the 2016-2019 Uniform Data System for 1,381 community health centers, trends in reporting of sexual orientation and gender identity data were examined. Multivariable logistic regression was used to assess associations between community health center characteristics and whether sexual orientation and gender identity data were available for ≥75% of a community health center's patients in 2019. Data were analyzed in 2021.

Results: In 2016-2019, the percentage of community health centers with sexual orientation and gender identity data for ≥75% of patients increased from 14.9% to 53.0%. In 2019, community health centers were more likely to have this data for ≥75% of patients if they were in nonmetro counties (OR=1.48, 95% CI=1.04, 2.10 versus metro), were in the South (OR=2.27, 95% CI=1.57, 3.31) or West (OR=1.91, 95% CI=1.27, 2.88 versus the Northeast), and had more patients aged between 18 and 39 years (OR=1.04, 95% CI=1.02, 1.07), between 40 and 64 years (OR=1.04, 95% CI=1.02, 1.06 vs <18 years), or veterans (OR=1.10, 95% CI=1.01, 1.20). This was less likely among community health centers serving 10,000-20,000 patients (OR=0.70, 95% CI=0.52, 0.95) and >20,000 patients (OR=0.44, 95% CI=0.32, 0.61 vs <10,000) and community health centers with more patients of American Indian/Alaskan Native (OR=0.98, 95% CI=0.97, 0.99) or unknown race (OR=0.92, 95% CI=0.86, 0.97 versus White).

Conclusions: Collection of sexual orientation and gender identity data by community health centers has increased substantially since 2016, although gaps remain.

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Figures

**Figure 1.**
Changes in proportion of CHCs with SOGI data for any, 50%, and 75% of patients in 2016‒2019. CHC, community health center; SOGI, sexual orientation and gender identity.

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References

1. Streed CG, Grasso C, Reisner SL, Mayer KH. Sexual orientation and gender identity data collection: clinical and public health importance. Am J Public Health. 2020;110(7):991–993. 10.2105/ajph.2020.305722. - DOI
1. Grasso C, McDowell MJ, Goldhammer H, Keuroghlian AS. Planning and implementing sexual orientation and gender identity data collection in electronic health records. J Am Med Inform Assoc. 2019;26(1):66–70. 10.1093/jamia/ocy137. - DOI - PMC - PubMed
1. Grasso C, Goldhammer H, Thompson J, Keuroghlian AS. Optimizing gender-affirming medical care through anatomical inventories, clinical decision support, and population health management in electronic health record systems. J Am Med Inform Assoc. 2021;28(11):2531–2535. 10.1093/jamia/ocab080. - DOI - PMC - PubMed
1. Maragh-Bass AC. The “Ask” Is the “Answer”: implementing routine documentation of sexual orientation and gender identity in health care. Am J Public Health. 2019;109(8):1071–1073. 10.2105/ajph.2019.305192. - DOI - PMC - PubMed
1. Cahill S, Grasso C, Keuroghlian A, Sciortino C, Mayer K. Sexual and gender minority health in the COVID-19 pandemic: why data collection and combatting discrimination matter now more than ever. Am J Public Health. 2020;110(9):1360–1361. 10.2105/ajph.2020.305829. - DOI - PMC - PubMed

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[1] Streed CG, Grasso C, Reisner SL, Mayer KH. Sexual orientation and gender identity data collection: clinical and public health importance. Am J Public Health. 2020;110(7):991–993. 10.2105/ajph.2020.305722. - DOI

[2] Streed CG, Grasso C, Reisner SL, Mayer KH. Sexual orientation and gender identity data collection: clinical and public health importance. Am J Public Health. 2020;110(7):991–993. 10.2105/ajph.2020.305722. - DOI

[3] Grasso C, McDowell MJ, Goldhammer H, Keuroghlian AS. Planning and implementing sexual orientation and gender identity data collection in electronic health records. J Am Med Inform Assoc. 2019;26(1):66–70. 10.1093/jamia/ocy137. - DOI - PMC - PubMed

[4] Grasso C, McDowell MJ, Goldhammer H, Keuroghlian AS. Planning and implementing sexual orientation and gender identity data collection in electronic health records. J Am Med Inform Assoc. 2019;26(1):66–70. 10.1093/jamia/ocy137. - DOI - PMC - PubMed

[5] Grasso C, Goldhammer H, Thompson J, Keuroghlian AS. Optimizing gender-affirming medical care through anatomical inventories, clinical decision support, and population health management in electronic health record systems. J Am Med Inform Assoc. 2021;28(11):2531–2535. 10.1093/jamia/ocab080. - DOI - PMC - PubMed

[6] Grasso C, Goldhammer H, Thompson J, Keuroghlian AS. Optimizing gender-affirming medical care through anatomical inventories, clinical decision support, and population health management in electronic health record systems. J Am Med Inform Assoc. 2021;28(11):2531–2535. 10.1093/jamia/ocab080. - DOI - PMC - PubMed

[7] Maragh-Bass AC. The “Ask” Is the “Answer”: implementing routine documentation of sexual orientation and gender identity in health care. Am J Public Health. 2019;109(8):1071–1073. 10.2105/ajph.2019.305192. - DOI - PMC - PubMed

[8] Maragh-Bass AC. The “Ask” Is the “Answer”: implementing routine documentation of sexual orientation and gender identity in health care. Am J Public Health. 2019;109(8):1071–1073. 10.2105/ajph.2019.305192. - DOI - PMC - PubMed

[9] Cahill S, Grasso C, Keuroghlian A, Sciortino C, Mayer K. Sexual and gender minority health in the COVID-19 pandemic: why data collection and combatting discrimination matter now more than ever. Am J Public Health. 2020;110(9):1360–1361. 10.2105/ajph.2020.305829. - DOI - PMC - PubMed

[10] Cahill S, Grasso C, Keuroghlian A, Sciortino C, Mayer K. Sexual and gender minority health in the COVID-19 pandemic: why data collection and combatting discrimination matter now more than ever. Am J Public Health. 2020;110(9):1360–1361. 10.2105/ajph.2020.305829. - DOI - PMC - PubMed

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Sexual Orientation and Gender Identity Data Reporting Among U.S. Health Centers

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Sexual Orientation and Gender Identity Data Reporting Among U.S. Health Centers

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