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Variation in patient gender and sexual identity recording within ambulance records

02 January 2024
Volume 16 · Issue 1



Health inequality among lesbian, gay, bisexual and transgender people has been highlighted in several reports. Ambulance services have been advised to record the gender identity and sexuality of all patients treated to support monitoring of health equity.


Four NHS ambulance services in England were asked for their data showing whether the completed patient record for each incident included gender identity and sexuality.


All services responded; data from three were used in the analysis. Only one service had the means to record a patient's sexual orientation. Gender identity was recorded by all services but the rate of data capture as well as potential responses varied between organisations.


There was little consistency between the three services regarding rates of data being captured, responses and potential answers. These variations could not be explained, although introduction of electronic patient records may impact data capture and quality.

The healthcare inequality experienced by lesbian, gay, bisexual, transgender, queer and other (LGBTQ+) people has been highlighted in the Stonewall (2018) healthcare report, which found that 13% report experiencing unequal treatment from healthcare staff because they are LGBTQ+ and 14% avoided treatment for fear of discrimination because of belonging to this group.

A recent report from LGBTQ+ Health and Wellbeing, a charity in Scotland, had similar findings, highlighting health inequality among LGBTQ+ people. It said: ‘LGB people are twice as likely to report symptoms of poor mental health’ and ‘have 1.5 times higher prevalence of depression and anxiety disorders than heterosexual adults; LGB people aged 55+ showed twice the prevalence of poor mental health’ (Semlyen et al, 2016). It found similar statistics of high rates of anxiety, depression and self-harm in young LGBTQ+ people, with higher rates among transgender people of all ages. This report discusses healthcare providers' attitudes and perceptions towards LGBTQ+ people, noting that ‘22% of LGBTQ+ people felt uncomfortable being open about their sexual orientation or gender identity, rising to 33% for people accessing social care’ (LGBTQ+ Health and Wellbeing, 2018).

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