the United States, about 8% of the population identifies as lesbian, gay, bisexual, transgender, or queer (LGBTQ+). Within the state of Utah, it is about 3.7%. That translates to over 104,000 people in Utah who identify as LGBTQ+.  

Every day, we see at least 270 LGBTQ+ patients at University of Utah Health. Providing consistent, compassionate care to our patients affirms their belonging and allows us to better understand our patients, our population, and ourselves—staff, clinicians, and learners.

We provide compassionate care without compromise for everyone. 

Understanding a patient’s sexual orientation and gender identity (SOGI) affects clinical decision-making. We know that people who identify as LGBTQ+ have higher incidence of cancer, higher suicide rates, higher smoking and drug alcohol use. They're less likely to seek preventative care, they're more likely to delay necessary care, and they have higher uninsured rates. These health care disparities are largely due to fear of discrimination and limited access to healthcare providers who are knowledgeable and supportive of LGBTQ+ needs.

Knowing this information directly affects health. Asking questions about a person’s sex assigned at birth and taking an organ inventory tells us what kind of care they may need— preventative care such as prostate cancer screenings for trans feminine patients and pap smears for trans masculine patients with a uterus; appropriate radiology precautions like shielding based on anatomy and preventative care for HIV prevention. 

It’s our responsibility to create an equitable, inclusive environment, and SOGI is an integral part of that. We want to make sure that people feel like they belong here, not just our patients, but also our staff, our clinicians, and our learners.

Focusing on steps to make care more inclusive enables all of us to thrive at the University of Utah.  

We’ve been working to care for LGBTQ+ patients for many years with the support of a big team. Hospitals and Clinics Chief Operating Officer Gina Hawley and I serve as the SOGI clinical executive sponsor. Dr. Cori Agarwal is the director of our transgender health program and our physician sponsor. Our project sponsor is Kim Pacheco. Project lead is Ariel Malan, and our project manager is Kimberly Killam. These people are the engine behind this whole program, with support from many people, including ITS, Revenue Cycle, Care Navigation, HR, Patient Experience, and Health Equity, Diversity, and Inclusion. 

Terminology 

Here are some commonly used terms that every health care provider should know. 

Sexual orientation and gender identity (SOGI): An acronym to describe the collection of important health related data pertaining to sexual orientation and gender identity. Everyone has a SOGI, not just those who identify as LGTBQ+. Someone may have more than one SOGI, and SOGI can also change over time. You can’t assume you know someone’s gender identity or sexual orientation just be looking at them. In order to get beyond assumptions, we need to ask our patients. 

Sexual orientation: Our physical, emotional, and romantic attachments to others.

Chosen name: A name a person chooses to be addressed by. Also known as preferred name. 

Pronouns: Words that refer to someone when not using a person's name. Examples include he/him/his, she/her/hers, they/them/theirs. 

Legal sex: Sex used for legal or administrative purposes, such as driver’s licenses. 

Sex assigned at birth: Sex documented by a clinician when an infant is born based on the absence or presence of certain anatomic structures. We don't use chromosomes or hormones to assign sex at birth.  

Gender identity: A person's inner sense of who they are. Gender identity isn’t a binary, meaning its not one or the other. Both gender identity and sexual orientation are not predictable by someone’s appearance, meaning – you can’t assume you know someone’s gender identity or sexual orientation. Sexual orientation doesn’t predict gender identity or vice versa. In order to get beyond assumptions, we need to ask our patients. 

Better data to deliver better care 

Asking patients for SOGI information is not about changing anybody's personal, religious, or political beliefs – not your beliefs or your patients. You're not expected to understand all the complexities of gender and sexuality. 

Most major accrediting bodies and best practice medical organizations including the CDC, Utah State Dept of Health, Joint Commission recommend asking SOGI of all of our patients. We know when we ask for this data, it helps us improve health outcomes.

When we allow patients to self-define, it takes the pressure off our staff and providers to know this by making incorrect assumptions. It gives all of our patients an opportunity to provide us with the language that best fits them. 

Seek to understand before being understood.

We don’t have to start from zero, and many patients have already opted to update their own chosen name, sexual orientation, and gender identity in MyChart. In the coming months, we’ll be kicking off pilots in several areas to test our new processes to better collect SOGI, which have been informed by our patient advisory boards and nationally accepted best practices.

We’ve already used SOGI information to create more respectful care. Visit and chart labels are now updated to display a patient’s chosen name, which helps every member of the team better connect with and care for every patient.  

Your participation and feedback will be important in guiding how we collect these data more effectively. 

Resources for learning 

Delivering high-quality compassionate care is who we strive to be, and a small amount of fundamental learning can help us get there. Our team has created many learning options to support you and your teams, no matter if you have 5 minutes or a few hours. Virtual learning is available in our LMS. Presentations like these are available for your team meeting. Epic how-tos and tip sheets are available in Pulse. We are developing a cadre of super users to help people understand how to navigate our system

• SOGI Pulse page
•  LMS E-Learnings (Search Best Practice for Gender Affirming Care.  Updated E-Learnings coming November 2023)
• Best Practices
• Tip sheets (Updated tip sheets coming soon)
• University of Utah Health SOGI
• University of Utah LGBTQ+ Health
• Transgender Health Program Patient Services 
• Ask Admin email – confidential inbox for SOGI-related questions