Stanford Medicine Enhances LGBTQ+ Patient Care with Identity Training 

A new initiative from Stanford Medicine aims to reduce health disparities among LGBTQ people by collecting more information about gender identity and sexual orientation during patient intake. 

The “We Ask Because We Care” program will provide training to healthcare professionals to ask patients about their sexual orientation and gender identity, ideally helping the practitioner to deliver better care and create a better, more empathic healthcare experience.  

The healthcare experience for members of the LGBTQ+ community isn’t always compassionate or empathetic, placing an exhausting burden on LGBTQ+ individuals, who are frequently required to explain their identity to healthcare providers, sometimes more than once. 

This challenge is compounded by the fear of encountering healthcare providers who may lack adequate understanding or sensitivity, which poses a risk to care quality and can deter LGBTQ+ individuals from seeking healthcare altogether. 

Given that many healthcare providers don't routinely discuss sexual orientation and gender identity (SO/GI) with patients, plus the lack of systems to gather structured SO/GI data, the initiative takes on added importance, the press release stated. 

“There are many stories of patients who are cisgender woman and share they are sexually active who then face a barrage of insistence they take birth control,” Bláz Bush, executive director of the LGBTQ+ Health Program at Stanford, said in a public statement. “What healthcare providers miss is asking about romantic and sexual attraction. They don’t learn that the patient identifies as lesbian and is not sexually active with someone they can become pregnant with.” 

“I’ve also heard of health care professionals arguing with patients, saying, ‘Your medical records say that you are a woman. If you say you are not, then you can’t be this person,’” Bush added. “What happens is that these people don’t come back, and they don’t get the care they need and deserve.” 

The primary phase of the "We Ask Because We Care" initiative emphasizes improved data collection on each patient's race, ethnicity, sexual orientation, and gender identity.  

“We want to be affirming of each patient’s identity and be as inclusive as possible,” said Jaclyn Liu, community health program manager at Stanford Health Care.  

By expanding these efforts to capture information regarding sexual orientation and gender identity, Stanford Medicine seeks to build a dependable data foundation for the purpose of addressing health disparities. 

“Health disparities exist for this community in almost every area,” said Bush. “From mental health to substance use to HIV and mpox infection — even body image and the likelihood of having an unhealthy relationship with food. Knowing this information is critical to addressing these problems.”  

The initiative comprises several components, such as revising the EHR to accommodate details about a patient’s gender identity and preferred name and guaranteeing that wristbands and in-room televisions display the patient’s preferred name, rather than their legal name.  

Liu and Bush acknowledge that some members of the LGBTQ+ community might be hesitant or wary of divulging their sexual orientation and gender identity. This has led some healthcare providers to abstain from asking patients about these aspects, fearing such queries might be excessively intrusive.  

However, research has indicated the opposite. Questions about gender identity and sexual orientation can significantly enhance patient care, inform providers, and mitigate health inequity. The benefits of understanding a patient’s sexual orientation and gender identity are clear to healthcare professionals.

Those who have this information can better comprehend a patient’s current health status and make more informed treatment decisions.  

Bush, a member of the LGBTQ+ community himself, noted that people, particularly from the LGBTQ+ community, generally appreciate being asked these questions.  

“The more we can ask questions and engage with our patients, the better their experiences will be,” Bush added. “Today we could not tell you with confidence the population of our patients at Stanford Medicine who are LGBTQ+,” he said. “We just don’t know. Until we have that data, we can’t look at outcomes in this population and recognize what we’re doing well, and we can’t address disparities that may exist.”