Assessment of Patient-Centered Approaches to Collect Sexual Orientation and Gender Identity Information in the Emergency Department

Abstract

Key Points Question What is the optimal patient-centered approach to collecting sexual orientation and gender identity information in the emergency department? Findings In this matched cohort study of 540 adults, sexual and gender minority patients reported significantly higher patient satisfaction with registrar form collection compared with nurse verbal collection. Non–sexual and gender minority patients, in addition to those for whom sexual orientation and gender identity information was not collected, reported no worse outcomes with registrar form collection. Meaning Registrar form collection is the optimal patient-centered approach to collecting sexual orientation and gender identity information in the emergency department.

Dermatologic care of sexual and gender minority/LGBTQIA youth, Part I: An update for the dermatologist on providing inclusive care

“…One way that providers and staff can exhibit openness is by evaluating their own implicit bias and not assuming heterosexuality or a cisgender “norm” with their patients . Directly asking a patient with which gender they identify and what pronoun they prefer (eg, “he,” “she,” “they,” or other) and inquiring about their sexuality in a direct, nonjudgmental manner (“Are you attracted to or do you have sex with women, men, or both?” “Do you have oral, vaginal, or anal sex?” “When was the last time you had sexual intercourse?”) are simple but effective ways of demonstrating inclusiveness . For providers and staff concerned about offending cisgender/heterosexual (non‐SGM) patients who may regard such questions negatively, it may be helpful to preface such questions by stating, “To make sure that our clinic is a safe space for all of our patients, we like to ask everyone…,” thereby normalizing the process by which gender and sexual identity/activity is obtained during the clinical encounter.…”

“…are simple but effective ways of demonstrating inclusiveness. 16,32,35,37 For providers and staff concerned about offending cisgender/heterosexual (non-SGM) patients who may regard such questions negatively, it may be helpful to preface such questions by stating, "To make sure that our clinic is a safe space for all of our patients, we like to ask everyone…," thereby normalizing the process by which gender and sexual identity/activity is obtained during the clinical encounter. Alternatively, SGM status may be acquired via patient intake form, a method that was found to be preferred by SGM adults in the emergency room setting, while non-SGM adults were comfortable with either approach.…”

“…Alternatively, SGM status may be acquired via patient intake form, a method that was found to be preferred by SGM adults in the emergency room setting, while non-SGM adults were comfortable with either approach. 37 Patient intake forms may be less applicable for the pediatric population for whom parents often complete medical intake forms, however. Electronic medical record systems that subsequently incorporate this information into a patient's profile may also help providers and staff address patients appropriately (specifically with respect to preferred pronouns), strengthening trust with their SGM patients.…”

Patients Seeking Care in Emergency Departments Prefer to Nonverbally Disclose Sexual Orientation and Gender Identity—Are We Ready to Act?

“…Identifying an efficient and culturally sensitive method for collecting SOGI information in the ED is particularly relevant because, as the authors note, it is a frequent source of care for uninsured and underinsured patients and SGMs are at greater risk for being uninsured compared with their cisgender and heterosexual counterparts. 4,5 The authors found SGM patients reported significantly greater satisfaction when SOGI information was collected nonverbally compared with verbally. Why does this matter?…”

“…8 Precision-based, or patient-centered, approaches have shown the efficacy of treating the whole patient and not just the symptoms or the disease. Haider and colleagues 4 showed the importance of a patient-centered approach in identifying optimal and evidence-based methods to collect patient SOGI information.…”