June 2, 2023


LGBTQ+ in America

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adults in the U.S. who identify as LGBT

Source: CDC National Health Interview Survey, 2019

While the exact number of individuals who identify as LGBTQ+ in America can be challenging to determine–due to factors such as varying definitions, self-identification and potential underreporting or social stigma–studies estimate at least 14 million adults in the U.S. identify as lesbian, gay, bisexual or transgender. 

According to Gallup’s LGBT Annual Identification Poll conducted in 2020, 5.6 percent of adults in the U.S. identified as LGBT. That translates to roughly 18 million adults. Meanwhile, the National Health Interview Survey (NHIS)–a large-scale survey conducted by the U.S. Centers for Disease Control and Prevention (CDC)–reported that 4.5 percent of adults identified as LBGT in 2019. 

The LGBTQ+ community faces unique healthcare challenges and disparities, making it crucial to prioritize LGBTQ+ inclusivity and support within the healthcare system. Some key reasons why LGBTQ+ inclusion is so important in healthcare include:

Health Disparities

LGBTQ+ individuals often experience health disparities, including higher rates of mental health issues, substance abuse, suicide, and certain chronic conditions. Recognizing and addressing these disparities is essential for promoting equitable health outcomes.

Trust and Disclosure

LGBTQ+ individuals may face concerns about disclosing their sexual orientation or gender identity due to fear of discrimination or bias. Inclusive healthcare environments that prioritize confidentiality, respect, and non-judgmental care can build trust and encourage open and honest communication. This enables patients to disclose vital information and seek appropriate care.

Gender-Affirming Care

Transgender and gender-nonconforming individuals may seek gender-affirming care, including hormone therapy or gender-affirming surgeries. Inclusive healthcare environments provide access to knowledgeable healthcare providers who can offer appropriate services, information, and support throughout the transition process.

Culturally Competent Care

LGBTQ+ individuals have specific healthcare needs related to sexual orientation, gender identity, and gender-affirming care. Healthcare providers need to be knowledgeable, sensitive, and culturally competent to provide appropriate care and support to LGBTQ+ patients.

Mental Health and Well-Being

LGBTQ+ individuals often face higher rates of mental health challenges, including depression, anxiety, and suicidal ideation. Access to affirming mental health services and support networks is critical for promoting their well-being and reducing mental health disparities.

Preventive Care and Screening

LGBTQ+ individuals may have unique healthcare needs related to sexual health, including HIV/STI prevention and screening. Providing inclusive and comprehensive sexual health education, access to preventive measures, and routine screenings can significantly improve overall health outcomes within the LGBTQ+ community.

Advocacy and Policy Changes

Inclusive healthcare practices and policies contribute to broader advocacy efforts for LGBTQ+ rights and social equality. By prioritizing LGBTQ+ inclusivity in healthcare, the healthcare system can be a powerful ally in advancing societal acceptance and reducing stigma and discrimination.

The role EHR systems can play in LGBTQ+

Electronic Health Record (EHR) systems can help to ensure LGBTQ+ individuals’ healthcare needs are met in a respectful, inclusive and sensitive manner. To effectively support LGBTQ+ individuals, an EHR system should include the following features and functionalities:

Gender Identity and Sexual Orientation Fields

The EHR system should provide specific fields to capture accurate and comprehensive information about gender identity and sexual orientation. This can include options beyond the traditional binary choices, allowing individuals to self-identify and express their identities accurately.

Pronoun Preferences

The EHR system should offer options for patients to specify their preferred pronouns. This can ensure that healthcare providers address patients using their correct pronouns, promoting respectful and inclusive care.

Non-Binary and Other Gender Options

In addition to male and female options, the EHR system should include non-binary and other gender identity options to reflect the diversity of gender identities. This allows individuals to select the gender category that aligns with their identity.

Preferred Name Display

The EHR system should allow patients to indicate their preferred name, which may differ from their legal name. This ensures that healthcare providers address individuals using their chosen name, promoting a welcoming and affirming environment.

Sensitive and Respectful Documentation

The EHR system should provide guidelines and prompts to help healthcare providers document information about gender identity, sexual orientation, and other sensitive aspects of a patient's history in a respectful and non-discriminatory manner. This can help avoid assumptions, misgendering, or using outdated terminology.

Cultural Competence Resources

The EHR system can include resources such as clinical decision support tools or links to educational materials to assist healthcare providers in delivering culturally competent care for LGBTQ+ patients. These resources can cover topics such as LGBTQ+ health disparities, gender-affirming care, and recommended screenings.

Privacy and Confidentiality Measures

Robust privacy and security features should be integrated into the EHR system to protect the confidentiality of LGBTQ+ patients' information. This is particularly important for individuals who may not be out or who face unique challenges related to disclosure.

Research and Reporting Capabilities

The EHR system should support the collection and analysis of data related to LGBTQ+ health to contribute to research, population health studies and the identification of health disparities.



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