Research has shown that sexual and gender minorities are at an increased risk for a number of health conditions, including higher rates of alcohol and tobacco use as well as psychological distress. They are also less likely to seek medical care, according to the Centers for Disease Control and Prevention (CDC).
So in order to help close these health care disparities, doctors would need to ask patients about their sexual and gender orientation. But until now, it remained unclear whether these types of questions would make patients uncomfortable.
In fact, previous studies have found that many health care providers assumed that sexual orientation and gender identity questions would offend their patients.
Now a new study by Mayo Clinic suggests that these worries were unfounded: The findings show that up to 97 percent of patients are comfortable with their health care provider asking sexual orientation and gender identity questions. The findings are published in the journal Health Services Research.
“Our results should help ease the concerns of providers who want to deliver the highest-quality care for their patients but may not ask sexual orientation or gender identity questions for fear of distressing or offending their patients,” said study coauthor Joan Griffin, Ph.D., a health services researcher at Mayo Clinic. Griffin is also the Robert D. and Patricia E. Kern Scientific Director for Care Experience at Mayo Clinic.
The new findings are important, because although multiple governmental reports have recommended asking these questions, there was little evidence about patient acceptance of these questions, the researchers say.
“In previous studies, there was more concern from health care providers about using the questions, but nobody had asked patients about their thoughts,” Griffin said. “Therefore, we were not sure what to expect from patients, but we were not surprised that patients were less concerned about the questions than the providers in other studies thought they would be.”
Patients will receive the questions at Mayo Clinic as it switches to a single, integrated electronic health record and billing system.
“At Mayo Clinic, the needs of the patient come first. These questions will help Mayo Clinic identify the unique, unmet needs of LGBTI patients and highlight that equitable care for all people is a top priority,” said Griffin.
The study was conducted at three Mayo Clinic sites in Minnesota from 2015 to 2016. The sites were chosen for their diversity in patient populations. One site is a women’s health clinic serving local, regional, and national patients. Another serves regional and national patients 65 and older. And the third site is in a rural community of less than 10,000 people.
A total of 491 new patients were given routine intake forms, or intake forms with sexual orientation and gender identity questions. Both groups received feedback forms that inquired about the intake questions. Responses between the two groups then were compared.
Mayo Clinic’s new sexual orientation and gender identity questions are as follows:
- What sex were you assigned at birth on your original birth certificate? (male, female, or choose not to answer);
- What is your current gender identity? (male, female, female-to-male/transgender male/trans man, male-to-female/transgender female/trans woman, gender queer/neither exclusively male nor female, additional gender category/other [describe], or choose not to answer);
- Do you think of yourself as … (lesbian/gay/homosexual, straight/heterosexual, bisexual, something else [describe], don’t know, or choose not to answer);
- What is your preferred gender pronoun? (he/him, she/her, something else [describe], or choose not to answer)
The researchers say that, although their study looked at multiple patient populations, more research may be needed to investigate other concerns.
“These findings may generalize to relatively similar areas in the country, especially the Midwest, but there may be differences in other regions in the U.S. or by cultural groups that we did not capture in our sample,” said Griffin.
As institutions begin to ask sexual orientation and gender identity questions, a simple explanation of why the information is being collected may increase patient participation, the researchers suggest. They add that patients also may benefit from being reminded of their health care institution’s nondiscrimination and confidentiality policies.
Source: Mayo Clinic