Gays, Theys, and LPHAs: Why Collecting LGBTQ+ Health Data in Colorado Matters

By Ash Neufeldt (she) and Lindsey Whittington (they) from the Colorado Health Institute

At the start of 2024, Rocky Mountain Equality (RMEQ) received a grant from the CDC Foundation to help advance health equity in Colorado. We decided to focus this project on a problem that often flies under the radar: the lack of reliable data about LGBTQ+ people in public health systems.

Why does this matter? Without data on sexual orientation and gender identity (known as SOGI), it's almost impossible to see the real health challenges LGBTQ+ Coloradans face, which means those challenges can’t be addressed.

Some Background

In 2022, RMEQ (then known as Out Boulder County) helped pass a state law that requires the Colorado Department of Public Health and Environment (CDPHE) to start collecting demographic data that includes sexual orientation, gender identity, race, ethnicity, and disability status. This is a big step forward, but it’s still being rolled out.

Meanwhile, changes at the federal level are threatening to take away protections for LGBTQ+ people and make collecting this kind of data even harder. That left us with a big question:

How can we push for better data while also protecting the safety and privacy of LGBTQ+ people?

What We Set Out to Learn

We realized that even though the state is working on collecting this data, we didn’t know how local public health agencies (LPHAs), which run health programs in communities around the state, were handling it. So we partnered with the Colorado Health Institute (CHI) to find out.

These were our key questions going in:

• Are local agencies collecting data on LGBTQ+ people?

• If so, how are they using it?

• And how are they keeping it safe?

To answer these, CHI interviewed staff at 12 LPHAs across Colorado. They asked about current practices, challenges, and ideas for the future.

What We Found

The Big Takeaways:

• Most LPHAs want to collect LGBTQ+ health data — but they don’t have the tools, training, or funding to do it well.

• They know it’s important to build partnerships with LGBTQ+ organizations to do this work effectively.

• There’s uncertainty about the future of collecting this kind of data, especially with changing federal policies.

  
  

What Else:

• Agencies often collect information about gender identity, but sexual orientation is usually missing.

• In smaller communities, there often aren’t enough responses to report on LGBTQ+ data accurately.

• Many local health departments already work with LGBTQ+-serving organizations — those relationships could be expanded to improve data efforts.

• In rural areas, agencies often don’t have the staff or training to gather this data. Urban agencies struggle with inconsistent systems and standards.

• Agencies sometimes partner with local hospitals or other health systems to fill gaps in their data.

  
  

What We Recommend

To make sure LGBTQ+ people are represented in public health work across Colorado, we recommend:

1. Building stronger connections between local health agencies and LGBTQ+ community organizations to improve trust and participation.

2. Offering training and education to help staff understand why LGBTQ+ and disability data matter — and how to collect it responsibly.

3. Creating clear, consistent guidance so all agencies are collecting the same types of data in similar ways.

4. Working with organizations like CALPHO (the Colorado Association of Local Public Health Officials) to reduce the burden on local agencies as they update their systems.

   
   

By improving how we collect and use data about LGBTQ+ Coloradans, we can make sure public health programs actually meet our communities' needs all across Colorado.