Sexual Minorities

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Robert G. Badgett, M.D.[1]

Sexual Minorities, also called LGBT persons, are "individuals including lesbian, gay, bisexual, transgender, queer, intersex, gender non-conforming people, and other populations whose sexual orientation or gender identity and reproductive development is considered outside cultural, societal, or physiological norms".[1]

The Institute of Medicine has made recommendations for research areas.[2] For example, one recommendation was the "NIH should support the development and standardization of sexual orientation and gender identity measures"

The American Association of Medical Colleges has made curricular recommendations and competencies for training of physicians.[3]

Nomenclature

The optimal descriptors of the community have been debated with concerns that MSM and WSW are not adequate terms.[4]

The United States HealthIT.gov is considering including the documentation of sexual orientation as part of meaningful use of electronic health records.[5][6]

Proposed values considered for recommendation are:

  • For reporting sexual orientation, ONC’s 2015 Edition certification requirements reference the following value set for sexual orientation. Codes from (i) through (iii) are SNOMED CT® and (iv) through (vi) are from HL7 Version 3:
    • Lesbian, gay or homosexual.38628009
    • Straight or heterosexual. 20430005
    • Bisexual. 42035005
    • Something else, please describe. OTH
    • Don’t know. UNK
    • Choose not to disclose. ASKU*
  • For reporting gender identity:
    • Gender identity. LOINC® code: 76691-5
    • Male. SNOMED CT® code: 446151000124109
    • Female. SNOMED CT® code: 446141000124107
    • Female-to-Male (FTM)/Transgender Male/Trans Man. SNOMED CT® code: 407377005
    • Male-to-Female(MTF)/Transgender Female/Trans Woman. SNOMED CT® code: 407376001
    • Genderqueer, neither exclusively male nor female. SNOMED CT® code: 446131000124102
    • Additional gender category or other, please specify. HL7 Version 3 code: OTH
    • Choose not to disclose. HL7 Version 3 code: ASKU

Disparities

Disparities in the quality of health care provide for sexual minorities have been documented.[7][8][9][10]

References

  1. Anonymous (2024), Sexual Minorities (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington (DC): National Academies Press (US); 2011. PMID: 22013611
  3. Hollenbach, Andrew D., Kristen L. Eckstrand, and Alice Domurat Dreger, eds. Implementing curricular and institutional climate changes to improve health care for individuals who are LGBT, gender nonconforming, or born with DSD: a resource for medical educators. Association of American Medical Colleges, 2014.
  4. Young RM, Meyer IH (2005). "The trouble with "MSM" and "WSW": erasure of the sexual-minority person in public health discourse". Am J Public Health. 95 (7): 1144–9. doi:10.2105/AJPH.2004.046714. PMC 1449332. PMID 15961753.
  5. Anonymous. "I-R: Sexual Orientation and Gender Identity | HealthIT.gov". healthit.gov. Retrieved 2017-08-06.
  6. Cahill SR, Baker K, Deutsch MB, Keatley J, Makadon HJ (2016). "Inclusion of Sexual Orientation and Gender Identity in Stage 3 Meaningful Use Guidelines: A Huge Step Forward for LGBT Health". LGBT Health. 3 (2): 100–2. doi:10.1089/lgbt.2015.0136. PMID 26698386.
  7. Daniel H, Butkus R, Health and Public Policy Committee of American College of Physicians (2015). "Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians". Ann Intern Med. 163 (2): 135–7. doi:10.7326/M14-2482. PMID 25961598.
  8. Marrazzo JM (2015). "Advancing Care for Lesbian, Gay, Bisexual, and Transgender Persons: Enough Already?". Ann Intern Med. 163 (2): 143–4. doi:10.7326/M15-0329. PMID 25962057.
  9. Rubin R (2015). "Minimizing health disparities among LGBT patients". JAMA. 313 (1): 15–7. doi:10.1001/jama.2014.17243. PMID 25562250.
  10. Agénor M, Peitzmeier S, Gordon AR, Haneuse S, Potter JE, Austin SB (2015). "Sexual Orientation Identity Disparities in Awareness and Initiation of the Human Papillomavirus Vaccine Among U.S. Women and Girls: A National Survey". Ann Intern Med. 163 (2): 99–106. doi:10.7326/M14-2108. PMC 4509853. PMID 25961737.