If They Don't Count Us, We Don't Count: Trump Administration Rolls Back Sexual Orientation and Gender Identity Data Collection.

The Trump Administration recently removed sexual orientation and gender identity (SOGI) questions from a national aging survey, and decided not to add a sexual orientation category and a transgender identity field to a national disability survey as planned. These actions have raised concerns that the major expansion of SOGI data collection on surveys and in clinical settings, which has occurred in recent years, may be under threat. SOGI data collection is essential to understand lesbian, gay, bisexual, and transgender (LGBT) health and the extent to which LGBT people access critical social services, including elder and disability services essential for living in community.

Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments.

Lesbian, gay, bisexual and transgender (LGBT) people face pervasive health disparities and barriers to high-quality care. Adequate LGBT sexual health education for emerging health professionals is currently lacking. Clinical training programs and healthcare organisations are well poised to start addressing these disparities and affirming LGBT patients through curricula designed to cultivate core competencies in LBGT health as well as health care environments that welcome, include and protect LGBT patients, students and staff.

Caring for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth in Inclusive and Affirmative Environments.

Lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) youth may experience interpersonal and structural stigma within the health care environment. This article begins by reviewing special considerations for the care of LGBTQ youth, then turns to systems-level principles underlying inclusive and affirming care. It then examines specific strategies that individual providers can use to provide more patient-centered care, and concludes with a discussion of how clinics and health systems can tailor clinical services to the needs of LGBTQ youth.

Transgender men and pregnancy.

Transgender people have experienced significant advances in societal acceptance despite experiencing continued stigma and discrimination. While it can still be difficult to access quality health care, and there is a great deal to be done to create affirming health care organizations, there is growing interest around the United States in advancing transgender health. The focus of this commentary is to provide guidance to clinicians caring for transgender men or other gender nonconforming people who are contemplating, carrying, or have completed a pregnancy.

Taking a Sexual History and Creating Affirming Environments for Lesbian, Gay, Bisexual, and Transgender People.

MISSISSIPPI RANKS AMONG THE TOP STATES IN THE COUNTRY FOR RATES OF HIV AND STDs. Among those at highest risk are gay and bisexual men and transgender women; yet these groups often delay or avoid care because they fear being misunderstood or stigmatized. This article focuses on how providers in Mississippi can minimize these barriers by taking sexual histories that are inclusive and affirming of all sexual orientations and gender identities.

Inclusion of Sexual Orientation and Gender Identity in Stage 3 Meaningful Use Guidelines: A Huge Step Forward for LGBT Health.

Final rules issued by the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology in October 2015 require electronic health record software certified for Meaningful Use to include sexual orientation and gender identity (SO/GI) fields. This is a critical step toward making SO/GI data collection a standard practice in clinical settings. Sexual orientation identity-whether one identifies as gay, lesbian, or bisexual-correlates with behavioral health burden, and it is important to collect these data.

Comprehensive transgender healthcare: the gender affirming clinical and public health model of Fenway Health.

This report describes the evolution of a Boston community health center's multidisciplinary model of transgender healthcare, research, education, and dissemination of best practices. This process began with the development of a community-based approach to care that has been refined over almost 20 years where transgender patients have received tailored services through the Transgender Health Program. The program began as a response to unmet clinical needs and has grown through recognition that our local culturally responsive approach that links clinical care with biobehavioral and health services research, education, training, and advocacy promotes social justice and health equity for transgender people.

Health status, behavior, and care of lesbian and bisexual women in Israel.

Introduction: Lesbian and bisexual women (LBs) have unique health needs compared with heterosexual women (HW).

Aim: This study aimed to associate the health status of LB, their health behavior, disclosure of sexual orientation (SO), and avoidance of health care with that of HW.

Methods: Participants in this cross-sectional study completed anonymous questionnaires, which were distributed in Internet sites and public venues in Israel, comparing health behaviors and outcomes between LB and HW.

Do ask, do tell: high levels of acceptability by patients of routine collection of sexual orientation and gender identity data in four diverse American community health centers.

Background: The Institute of Medicine and The Joint Commission have recommended asking sexual orientation and gender identity (SOGI) questions in clinical settings and including such data in Electronic Health Records (EHRs). This is increasingly viewed as a critical step toward systematically documenting and addressing health disparities affecting lesbian, gay, bisexual, and transgender (LGBT) people. The U.

Sexual Orientation and Gender Identity Data Collection Update: U.S. Government Takes Steps to Promote Sexual Orientation and Gender Identity Data Collection Through Meaningful Use Guidelines.

Collecting data on sexual orientation and gender identity (SO/GI) in healthcare settings and in electronic health records (EHRs) is essential to understanding, addressing, and reducing LGBT health disparities. The federal government took two key steps in early 2014 in support of asking SO/GI questions in clinical settings as part of the meaningful use of EHRs. First, the Office of the National Coordinator for Health Information Technology issued proposed 2015 Edition Certified EHR Technology (CEHRT) Criteria, which suggest Systematized Nomenclature of Medicine (SNOMED) code sets for SO/GI data collection in 2017.

Promoting the successful development of sexual and gender minority youths.

Because of societal discomfort with atypical expressions of sexual orientation and gender identity, lesbian, gay, bisexual and transgender (LGBT) youths have experienced enhanced developmental challenges compared with their heterosexual peers. A recent special issue of the American Journal of Public Health delineated how social stigma affecting LGBT youths has resulted in a wide range of health disparities, ranging from increased prevalence of depression and substance use to downstream effects, such as an increased risk for cancer and cardiovascular disease when older. We review the clinical significance of these findings for health care professionals, who need to become informed about these associations to provide better care for their sexual and gender minority youth patients, and to be able to educate their parents and other caregivers.

Sexual Orientation and Gender Identity Data Collection in Clinical Settings and in Electronic Health Records: A Key to Ending LGBT Health Disparities.

The Institute of Medicine's (IOM's) 2011 report on the health of LGBT people pointed out that there are limited health data on these populations and that we need more research. It also described what we do know about LGBT health disparities, including lower rates of cervical cancer screening among lesbians, and mental health issues related to minority stress. Patient disclosure of LGBT identity enables provider-patient conversations about risk factors and can help us reduce and better understand disparities.

Men who have sex with men in India: a diverse population in need of medical attention.

A significant proportion of men engage in sexual relationships with other men which has direct health implications, but the unique health care needs of these patients are often ignored or overlooked. Moreover, due to a fear of stigmatization by the medical community, one of the more significant health risks for men who have sex with men (MSM) may be that they avoid routine or appropriate health care. Physicians and other providers can help overcome this barrier and improve the health care of MSM by keeping a non-judgmental attitude toward these patients, differentiating sexual behaviour from sexual identity, communicating with gender neutral terms, and maintaining awareness of how their own attitudes affect clinical judgment.

[Access to quality primary care for LGBT people].

This article offers a comprehensive approach to the health of lesbian, gay, bisexual and transgender (LGBT) people, where respect for diversity and non judgemental care play a central role. It calls for a health and medical vision that goes beyond HIV risk. For those who never had to question their own sexual orientation or gender identity, it is certainly difficult to understand how the discovery of one's identity trait in childhood or early adolescence can be transformed under social pressure into a burden which often remains invisible but is associated with considerable emotional and medical morbidity.

Ending LGBT invisibility in health care: the first step in ensuring equitable care.

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience health care disparities that will be eliminated only if clinicians elicit information about sexual orientation and gender identity from their patients through thoughtful, nonjudgmental discussion and history-taking.

Addressing intimate partner violence in lesbian, gay, bisexual, and transgender patients.

The medical community's efforts to address intimate partner violence (IPV) have often neglected members of the lesbian, gay, bisexual, and transgender (LGBT) population. Heterosexual women are primarily targeted for IPV screening and intervention despite the similar prevalence of IPV in LGBT individuals and its detrimental health effects. Here, we highlight the burden of IPV in LGBT relationships, discuss how LGBT and heterosexual IPV differ, and outline steps clinicians can take to address IPV in their LGBT patients.

Medical tourism: game-changing innovation or passing fad?

Outbound medical tourism presents several concerns for U.S. providers: Potential lost revenue could reach almost $600 billion by 2017.

Value management: optimizing quality, service, and cost.

Hospitals have wrestled with balancing quality, service, and cost for years--and the visibility and urgency around measuring and communicating real metrics has grown exponentially in the last decade. However, even today, most hospital leaders cannot articulate or demonstrate the "value" they provide to patients and payers. Instead of developing a strategic direction that is based around a core value proposition, they focus their strategic efforts on tactical decisions like physician recruitment, facility expansion, and physician alignment.

Bisexuality, sexual risk taking, and HIV prevalence among men who have sex with men accessing voluntary counseling and testing services in Mumbai, India.

Objectives: To describe sociodemographics, sexual risk behavior, and estimate HIV and sexually transmitted infection (STI) prevalence among men who have sex with men (MSM) in Mumbai, India.

Methods: Eight hundred thirty-one MSM attending voluntary counseling and testing (VCT) services at the Humsafar Trust, answered a behavioral questionnaire and consented for Venereal Disease Research Laboratory and HIV testing from January 2003 through December 2004. Multivariate logistic regression was performed for sociodemographics, sexual risk behavior, and STIs with HIV result as an outcome.

Sexual and gender minority health: what we know and what needs to be done.

We describe the emergence of lesbian, gay, bisexual, and transgender (LGBT) health as a key area of study and practice for clinicians and public health professionals. We discuss the specific needs of LGBT populations on the basis of the most recent epidemiological and clinical investigations, methods for defining and measuring LGBT populations, and the barriers they face in obtaining appropriate care and services. We then discuss how clinicians and public health professionals can improve research methods, clinical outcomes, and service delivery for lesbian, gay, bisexual, and transgender people.