title: Do ask, do tell: high levels of acceptability by patients of routine collection of sexual orientation and gender identity data in four diverse American community health centers.
abstract: BACKGROUND
  The Institute of Medicine and The Joint Commission have recommended asking sexual orientation and gender identity (SOGI) questions in clinical settings and including such data in Electronic Health Records (EHRs). This is increasingly viewed as a critical step toward systematically documenting and addressing health disparities affecting lesbian, gay, bisexual, and transgender (LGBT) people. The U.S. government is currently considering whether to include SOGI data collection in the Stage 3 guidelines for the incentive program promoting meaningful use of EHR. However, some have questioned whether acceptable standard measures to collect SOGI data in clinical settings exist.
  
  
  METHODS
  In order to better understand how a diverse group of patients would respond if SOGI questions were asked in primary care settings, 301 randomly selected patients receiving primary care at four health centers across the U.S. were asked SOGI questions and then asked follow-up questions. This sample was mainly heterosexual, racially diverse, and geographically and regionally broad.
  
  
  RESULTS
  There was a strong consensus among patients surveyed about the importance of asking SOGI questions. Most of the LGBT respondents thought that the questions presented on the survey allowed them to accurately document their SOGI. Most respondents--heterosexual and LGBT--answered the questions, and said that they would answer such questions in the future. While there were some age-related differences, respondents of all ages overwhelmingly expressed support for asking SOGI questions and understood the importance of providers' knowing their patients' SOGI.
  
  
  CONCLUSIONS
  Given current deliberations within national health care regulatory bodies and the government's increased attention to LGBT health disparities, the finding that patients can and will answer SOGI questions has important implications for public policy. This study provides evidence that integrating SOGI data collection into the meaningful use requirements is both acceptable to diverse samples of patients, including heterosexuals, and feasible.
authors.affiliation: The Fenway Institute, Northeastern University Department of Political Science, Boston, MA, United States of America/New York University Wagner School, New York, NY, United States of America.
authors.forename: Sean
authors.initials: S
authors.lastname: Cahill
authors.affiliation: The Fenway Institute, Boston, MA, United States of America.
authors.forename: Robbie
authors.initials: R
authors.lastname: Singal
authors.affiliation: The Fenway Institute, Boston, MA, United States of America.
authors.forename: Chris
authors.initials: C
authors.lastname: Grasso
authors.affiliation: The Fenway Institute, Boston, MA, United States of America.
authors.forename: Dana
authors.initials: D
authors.lastname: King
authors.affiliation: The Fenway Institute/Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States of America.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mayer
authors.affiliation: Center for American Progress, Washington, DC, United States of America.
authors.forename: Kellan
authors.initials: K
authors.lastname: Baker
authors.affiliation: The Fenway Institute/Harvard Medical School, Boston, MA, United States of America.
authors.forename: Harvey
authors.initials: H
authors.lastname: Makadon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003151:Community Health Centers; D003625:Data Collection; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D057566:Self Report; D012725:Sexual Behavior; D019529:Sexuality; D014481:United States; D055815:Young Adult