Study: Hospitals Should Track Patients’ Genders and Sexual Orientations

It could help patients get equitable, high quality care.

Medical history photo via iStock Photo

Medical history photo via Studio

While doctors may be uncomfortable asking for a patient’s sexual orientation, most people are ready and willing to provide it, suggests new research from Brigham and Women’s Hospital (BWH). 

The findings, presented last week at at AcademyHealth’s Annual Research Meeting, are significant, given that the LGBTQ community has historically struggled to find adequate medical care. Knowing patients’ genders and sexual identities may begin closing that gap, according to lead author Adil Haider.

“If we don’t ask, how will we know the inequalities or different kinds of treatment we’re subjecting our LGBTQ colleagues to?” Haider says. “This is a new way of collecting vital information.”

For the study, researchers at BWH interviewed a relatively small group—1,516 people in all—of lesbian, gay, bisexual, and straight individuals, as well as emergency department care providers. They found that, while 80 percent of ED doctors thought they might offend patients by asking about sexual orientation, only 11 percent of respondents indicated that they actually would be offended. Both patients and providers preferred non-verbal self-reporting, such as a written question on a form.

“There’s an intense sense of, ‘Do no harm,'” Haider says. “Doctors feel like they shouldn’t be asking these questions. But when you put them down on paper, patients say, ‘Sure! Ask me!’ They want to be normalized.”

Right now, patients are usually asked about their sexual identity in what Haider calls the “social” section on medical forms, lumped in with questions about smoking and drinking. By moving questions about gender and sexuality toward the top of the page—beside age and name, for instance—he says these topics will likely become more important and less taboo.

Haider’s team is currently fine-tuning the process by which doctors ask patients personal questions. “In the hospital, in general, you’re vulnerable,” he says. “It’s not usually your best day of the week. We want to figure out the most effective way to understand a patient’s background while still being delicate.” These trials, which test different wordings of questions and their placements on forms, will occur at BWH, Johns Hopkins, Faulkner, and Maryland’s Howard County Hospital.

Haider says this research isn’t only important from a public health perspective. By allowing patients to be totally open about their lives, care providers may be able to establish a deep, personal connection.

“People just want to be and say exactly who they are,” he says. “They don’t want to have to feel as if they’re hiding something.”