Lessons in asking patients' gender identity and sexual orientation

A recent study presented at the 2023 American Academy of Pediatrics National Conference & Exhibition evaluated how clinicians can ask patients' sexual orientation and gender identity for EHR documentation.

The research conducted between November 2022 and February 2023 at an academic adolescent medicine clinic in the northeastern United States sheds light on the importance of collecting and documenting sexual orientation and gender identity (SOGI) data, particularly among adolescent and young adult (AYA) patients.

The study involved 260 participants aged 10 to 26 years, with a majority falling into the 18-20 year age group. These patients sought care in various programs offered by the clinic, including primary care, gender, eating disorders, and gynecology/menstrual health. Among the participants, 50% identified as gender diverse (GD), 52% as lesbian, gay, or bisexual (LGB), and 38% identified as both GD and LGB. This diversity in the sample is essential for understanding the varied perspectives on SOGI data collection.

One of the key findings of this research was that a significant proportion of AYA patients, regardless of their SOGI, acknowledged the importance of healthcare providers inquiring about their gender identity, chosen name, and pronouns. Sixty-four percent of the respondents believed that asking about gender identity, chosen name, and pronouns was important. GD youth, in particular, expressed a significantly higher agreement (83%) than cisgender youth (45%), emphasizing the relevance of understanding gender diversity within the healthcare context.

The study also highlighted differences in the perceived importance of inquiring about sexual orientation. While a majority of LGB youth (56%) found it important for providers to ask about their sexual orientation, this perspective was less pronounced among heterosexual youth (38%). This finding underscores the significance of considering the specific needs and sensitivities of LGB individuals during patient-provider interactions.

Data also showed that the majority of AYA patients (70%) felt comfortable when asked about their SOGI. This suggests that young people are open to discussing their sexual orientation and gender identity in a health care setting, which can lead to more patient-centered care. Importantly, no single method of SOGI data collection was favored over another, indicating flexibility in the approach.

One significant aspect of the study was that over 96% of GD youth expressed a desire to have their chosen names and pronouns displayed in their electronic health records (EHRs). According to the authors, this speaks to the importance of providing a supportive and respectful environment for GD individuals, where their preferred names and pronouns are not only recognized but also incorporated into their medical records.

The study authors concluded that this research emphasizes the significance of collecting and documenting SOGI data in healthcare, particularly in the context of AYA patients. It shows that most AYA individuals are comfortable discussing their sexual orientation and gender identity with health care providers. Moreover, GD and LGB youth expressed higher rates of comfort compared to their cisgender and heterosexual counterparts when it comes to SOGI questions. The lack of a preferred method for SOGI data collection underlines the importance of flexibility and adaptability in healthcare practices.

Reference:

Rusley JC, Purian JJ, Kapadia JH, Li MM. 3A0P4A225: Asking Adolescents and Young Adults About Their Sexual Orientation and Gender Identity: Lessons for Clinic Staff and EHR Documentation. Poster. Presented at: Presented at: 2023 American Academy of Pediatrics National Conference & Exhibition.