Prevention and health inequalities 

LTP Priority: Prevention and health inequalities Cancer Maternity and CYP Mental Health

Population Intervention Triangle: Segments (link to Section 1 PHE PBA): Service

Type of Interventions: Sexual Orientation Monitoring

Major driver of health inequalities in your area of work

As the Government’s LGBT Action Plan highlights; your sexual orientation or gender identity can have a significant impact on your physical, mental and sexual health and wellbeing. Existing evidence shows that health outcomes are generally worse for LGBT people than the rest of the population, and that many LGBT people feel that their specific needs are not taken into account in their care (NIESR (2016), ‘Inequality among lesbian, gay bisexual and transgender groups in the UK July 2016’).

The national LGBT survey asked questions about people’s experiences of public healthcare in the 12 months preceding the survey. It asked questions about people’s access to physical, mental and sexual health services, and gender identity services. It also asked whether they had disclosed their sexual orientation or gender identity to healthcare staff, and how they felt this affected their care. While many respondents to the survey said they had a positive experience accessing healthcare, there is clearly more to do. The survey showed that large numbers of respondents had difficulty accessing healthcare services and especially gender identity clinics. It also showed many respondents had experienced inappropriate questioning and curiosity from healthcare staff, and that some respondents feel their specific needs were ignored or not taken into account when accessing healthcare. Some of the most important findings include:

  1. at least 16% of survey respondents who accessed or tried to access public health services had a negative experience because of their sexual orientation, and at least 38% had a negative experience because of their gender identity.
  2. 51% of survey respondents who accessed or tried to access mental health services said they had to wait too long, 27% were worried, anxious or embarrassed about going and 16% said their GP was not supportive.
  3. 80% of trans respondents who accessed or tried to access gender identity clinics said it was not easy, with long waiting times the most common barrier

Target groups

Protected Characteristics: LGBT


Sexual Orientation Monitoring Information Standard


The SOM information standard provides a consistent mechanism for recording the sexual orientation of all patients/service users aged 16 years across all health services in England. It will also cover local authorities with responsibilities for adult social care in all service areas where it may be relevant to record this data using a standardised format.

This standard provides the categories for recording sexual orientation but does not mandate a collection.

This is a significant milestone in promoting Lesbian Gay Bisexual equality in England.  Recording sexual orientation will allow policy makers, commissioners and providers to better identify health risks and will help support targeted preventative and early intervention work to address the health inequalities for people who are Lesbian, Gay or Bisexual.

The Information Standard was accepted by the Standardisation Committee for Care Information on 22 February 2017, and approved by the Data Coordination Group on 18 May 2017 and 14 September 2017. It was published on 5 October 2017.

The ‘Information Standards Notice’ (ISN) and other official information relating to the Standard can be found on the Information Standard page


The SOM has been based on research conducted by the Office for National Statistics (ONS) and the Equality and Human Rights Commission (EHRC), and on current practice by those organisations which monitor sexual orientation.