Sexual Orientation Monitoring

The collection of demographic information in health settings is crucial to identifying patients at risk of particular conditions and to identify various prevalence rates.

Why is it important? How does it benefit user groups?

“The Bodey Centre were pioneers! How proactive and how up for it they were
– they really took ownership”

BHP participant

How can data on sexual orientation be used?

When using GP practice computer systems, for example to produce letters to remind women about cervical screens, it can be can cross referenced with sexual orientation, so that the letter you write to lesbian or bisexual patients have an added sentence about the need for lesbians to have screens, or include a targeted resource of further information.

Practicalities

Asking someone their sexual orientation should be similar to asking someone if they are married or asking their age; it is a part of their identity that affects their life but it does not define them, and you are certainly not asking about their sex life.

The reason sexual orientation seems different is the potential embarrassment, unfamiliarity or hostility towards lesbian, gay and bisexual people that exists today. It is not as commonly asked as other characteristics and is therefore unfamiliar to some people.

It is not about making everyone tell you about their sexual orientation but giving patients/clients the opportunity to tell you if they want to. The decision if they disclose or not is still up to them.

Quotes from doctors who have implemented sexual orientation include:

‘Having a patient’s sexual orientation on their file makes everything faster, and means we don’t dance around it at the start of the consultation or maybe have the need for so many consultations.’

‘It’s not about stereotyping but bringing things to the forefront of my mind –such as sign-posted specific services such as same sex domestic abuse services.’

Note: Gender identity monitoring is separate and currently not advisable at this time as the trans community has not come to a consensus about whether they want this to be monitored. Many (although not all) trans people wish to live fully in their acquired gender rather than being denoted ‘separate’ and ‘trans’.

The Sexual Orientation Monitoring workshops

These are tailored, a 45 minute session over lunchtime has been popular with GP practices and is enough time to get all the information needed to feel confident when implementing SOM, and to answer any queries received from patients.

Workshops are also available about the benefits and challenges of sexual orientation monitoring to health services and in particular GP practices across Greater Manchester (all of who have started monitoring or are in the process of implementing sexual orientation monitoring). 

Some feedback already received:

‘It educates you on the reasons why monitoring is needed and other misconceptions regarding sexual orientation.’

‘It was very informative.’

‘Very friendly and non-judgemental.’

What do I do if I’m interested to find out more?

Whether you want:

  • more information about booking a workshop
  • practical advice about read codes
  • support in answering staff questions / patient questions
  • queries about sharing patient summaries

Call 0845 3 30 30 30 or email pip@lgf.org.uk

Website links:

‘Everything you wanted to know about sexual orientation monitoring but were afraid to ask’ available to download from www.lgf.org.uk/SOM

Discussion point

What demographic information about service users does your organisation collect? How is it used?

Activity

Read the clinical rationale on sexual orientation monitoring and consider the recommendations (see also section 7 in this guide). How do they reflect practice in your own organisation? What improvements could be made?

Examples

  1. Reports can be extrapolated to identify patients to notify for screening e.g. prostate screening, breast and cervical screening.

    By cross referencing patients with diabetes and ethnicity, it was found that the South Asian community were at high risk, now work has begun to try and reduce the prevalence of diabetes within that community.
  2. Many lesbian women have been told previously by either a health professional or a member of the community that they do not need to attend cervical screens. They were told this not because people are homophobic, but people were working with the research that was currently available regarding prevalence rates and the transmission of HPV.

    Now we have research that highlights that any women who have had any type of sexual activity with either a man or woman, should be advised to have a cervical screen. However many lesbian women still believe they do not need a cervical screen.

Practical consideration

Is your IT system set up to record this information? Have all staff been trained in the importance of monitoring and how to ask the question? Have you communicated what you are doing, and why, to your service users?

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