Sexual orientation monitoring Information Standard


by Mike Cullen
LGBT Foundation

In recent years we’ve seen huge steps towards achieving equality for LGBT people. Equal marriage, the Equality Act 2010 and, of course, the sexual orientation monitoring Information Standard.

So maybe I’m being ambitious with the third one in that list, but I promise it’s up there. It has a huge #EqualityWinspotential for reducing the inequalities that lesbian, gay and bi people face. I know that “a standardised way of monitoring the sexual orientation of patients aged 16+ in health and social care” doesn’t have the same ring as equal marriage, but it’s something you need to know about.

Here at LGBT Foundation, we’ve been working hard with colleagues and key stakeholders over the past three years to develop the Information Standard, and prior to that we were lobbying for years just so we could get our foot in the door to speak to the right people. We wouldn’t have spent all these years to get to this stage if we didn’t genuinely believe this would improve the lives of LGB people.

To put it simply, if we’re not counted we don’t count!

We already know that that LGB people are disproportionately affected by a range of health inequalities and experience significant barriers to accessing health and care services. Research by LGBT Foundation has shown that:

  • Just 8% of LGB people in Greater Manchester report they have never experienced a mental health problem.
  • LGB people are twice as likely as the general population to commit suicide.
  • It’s estimated that 1 in 11 gay and bisexual men in Manchester are living with HIV, approximately 14% of whom will be undiagnosed.
  • LGB people are seven times more likely to use drugs, twice as likely to binge drink, and show higher levels of substance dependency compared to their heterosexual peers.

It’s just not good enough that these health inequalities are far too often overlooked or ignored, or that people accessing services aren’t given the right support as their health care professionals are unaware of their service users’ sexual orientation. It’s not good enough that we’re still lacking a substantial evidence base around the inequalities and needs that LGB people face. It’s not good enough that LGB people still feel that their needs are being ignored when accessing services.

Sexual orientation monitoring isn’t going to fix all of this overnight, but it’s certainly a huge step in the right direction. We already know from our work with Pride in Practice that sexual orientation monitoring works. Part of the training that our Pride in Practice team deliver to primary care providers is around implementing sexual orientation monitoring. When we visit practices a month or two later to present them with their award, even those GPs who were at first resistant or failed to see the importance of monitoring say that their interactions with LGB patients have improved.

“Invisibility within a system means that our community’s needs are ignored, and finally we have a chance to fix that”

Monitoring helps create trust and openness in patient-clinician interactions which, in turn, helps increase disclosure rates and therefore leads to people receiving the right support much sooner. It means that when they see a ring on your wedding finger they’re not going to refer to your partner in the wrong gender. You don’t have to repeatedly come out to your health care provider when they ask you for the 10th time how you can be sure you’re not pregnant when you’re having unprotected sex. It means that an evidence base around LGB need can be built so that targeted preventative care can take place. For example, we know that lesbian and bi women are much less likely to have a smear test than their straight counterparts despite there being a clear evidenced need for one. Monitoring means that we can address this so that people are receiving the care they need, surely that’s a key part of an equitable health and social care system?

Of course not everyone is going to appreciate being asked about their sexual orientation, and that’s absolutely fine, it’s up to you. All that’s changed is now people have a choice. Moving forwards, you might see a little question on a demographic form which asks you about your sexual orientation, and you can either tick that box, or leave it blank and move onto the next question. If you can, tick that box. It’s the easiest way to be an activist. You’re making sure that we’re counted. Invisibility within a system means that our community’s needs are ignored, and finally we have a chance to fix that.

See more here: LGBT Foundation SOM

You can access an e-learning resource developed by Health Education England, 
Stonewall and the LGBT Foundation to support the SOM here: 
this resource will be going live this February.