Sexual Orientation and Gender Identity Data Collection in the Behavioral Risk Factor Surveillance System

By Kellan Baker and Margaret Hughes with Center for American Progress

An Issue Brief from the Center for American Progress. The full brief can be accessed here.

The United States is home to at least 9 million people who identify as lesbian, gay, bisexual, and transgender, or LGBT. Despite recent advances in social acceptance and legal protections, such as the 2015 U.S. Supreme Court ruling that gave same-sex couples in every state the right to marry, LGBT people and their families across the country continue to face discrimination in areas of everyday life such as employment, housing, and health care.

In order to make meaningful progress in improving the lives of LGBT Americans, policymakers, researchers, advocates, and service providers need more and better data related to the experiences and needs of the LGBT population. Sexual orientation and gender identity, or SOGI, data are a critical component of accurately assessing the current problems that LGBT people experience—such as mental health and substance use disparities and barriers in access to health insurance coverage and health care—and developing effective policies and programs to address them.

Surveys coordinated by the federal government are an essential source of data about the U.S. population. Most major federally supported surveys—including those that assess racial, ethnic, and other disparities that intersect with disparities related to sexual orientation and gender identity—are missing opportunities to collect SOGI data. Fortunately, some surveys are beginning to take steps to gather these data, including the Behavioral Risk Factor Surveillance System, or BRFSS—the largest continuously conducted health survey system in the world.

In 2013, the Centers for Disease Control and Prevention, or CDC, developed a question module for BRFSS to collect data on sexual orientation and gender identity. This SOGI module follows the recommendations of the expert Sexual Minority Assessment and Research Team, or SMART, and the Gender Identity in U.S. Surveillance, or GenIUSS, Group about how to optimally design sexual orientation and gender identity questions. The CDC began giving states the option to add this module to their BRFSS questionnaires in 2014.

The Center for American Progress analyzed the 2015 BRFSS questionnaires from all 50 states, the District of Columbia, and the U.S. territories currently conducting the survey to determine how many ask about sexual orientation and gender identity and whether they use the SOGI module. This analysis found that 25 states and territories used the module in 2015, up from 20 in 2014. An additional 11 jurisdictions asked about sexual orientation and/or gender identity using questions that differ from the CDC-approved module. In order to most effectively assess and address health disparities affecting the LGBT population, all states and territories should collect SOGI data using the CDC-approved module on their BRFSS questionnaires.