Monitoring Sexual Orientation, Gender and Trans Status

Over the last two decades, the lesbian, gay, bisexual and trans (LGBT) communities have seen legislative change which has led to greater acceptance. However, there is still a huge lack of evidence about LGBT people, our needs and experiences. Monitoring sexual orientation, gender identity and trans status is a proven way to address that lack of evidence. Championing sexual orientation and trans status monitoring for service users and staff across all public services is a key an organisational priority for LGBT Foundation. You can read more about our recommended approach and download our guidance to implementing monitoring here. 

Sexual Orientation Monitoring

Good Practice Guide to Sexual Orientation Monitoring tempReleased/updated: 2017

Good Practice Guide to Monitoring Sexual Orientation , offers advice and practical tips for your organisation on how to best monitor sexual orientation.

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This guide has been written to give public sector bodies, their staff and their service users confidence in the purpose and value of sexual orientation monitoring. The guide references often to the NHS, but procedures and principles equally apply to other sectors. Based on research conducted in the NHS and the wider public sector, it offers a step-by-step guide to the process of sexual orientation monitoring, illustrated with best practice examples and real-life case studies.

Good Practice Guide to Monitoring Sexual Orientation, highlights that investing in equality makes good business sense, as understanding the needs of staff and service users leads to more targeted and successful work, saving money in the long run.

We worked with NHS England to encourage comprehensive and consistent sexual orientation monitoring across the healthcare system through developing a Sexual Orientation Monitoring Information Standard. Read more about this work here

Trans Status Monitoring

LGBT Foundation supports monitoring trans* status as there is a significant lack of evidence about the needs and experiences of trans people. We believe that monitoring, sensitively implemented, is a clear way to address that lack of evidence and make our needs and experiences heard. Not counting trans people as part of wider equalities monitoring suggests that trans people’s needs don’t count, and we want to contest that. 

Download a PDF of our briefing sheet on trans status monitoring.

We are developing fuller best practice guidance on successfully implementing trans status monitoring which will be based on up to date evidence and community consultation. In the meantime, please contact for futher information. 

*Trans is an umbrella and inclusive term used to describe people whose gender identity differs in some way from that which they were assigned at birth; including non-binary people, cross dressers and those who partially or incompletely identify with their sex assigned at birth.

Clinical Rationale for Monitoring

Building Health Partnerships (2013-14) was a national programme designed by NHS England to improve health outcomes through supporting the development of partnerships. In Greater Manchester, we worked with Clinical Commissioning Groups and other voluntary, community and social enterprise (VCSE) organisations to focus on the health inequalities faced by lesbian, gay, bisexual and trans (LGBT) people, exploring the challenges encountered and working in partnership to identify solutions and reduce barriers for LGBT people accessing healthcare services.

As part of the project, we published a Clinical Rationale for Sexual Orientation Monitoring, written by Dr Simon Rogers. This discusses the evidence on existing health inequalities among LGB communities and attitudes towards patient sexual orientation monitoring in a general practice setting among staff at South Manchester Clinical Commissioning Group.

We also published a Rationale for Implementing Service User Sexual Orientation Monitoring in Service Provision which outlines the benefits of monitoring and the potential uses of the data collected to improve service user outcomes and reduce inequalities.

Both these reports, and the other publications from the project, can be downloaded from