The requirement that local health departments and health care providers must report the sexual orientation and gender identity data of COVID-19 cases does not apply to everyone being tested — only to those who have received positive tests.
But SOGI information is requested as part of San Francisco's contact tracing protocols, an official said.
As the Bay Area Reporter previously reported, Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, announced July 28 that SOGI data of COVID-19 cases must be asked going forward.
A careful reading of the July 28 regulations defines a case as "a person who has been diagnosed by a health care provider ... to have a particular disease or condition."
Senate Bill 932, authored by gay state Senator Scott Wiener (D-San Francisco) and signed by Governor Gavin Newsom in September, requires SOGI data collection for reportable communicable diseases, including COVID-19. But this only applies to cases or suspected cases.
When asked for comment, the San Francisco Department of Emergency Management, which is overseeing the city's COVID-19 response, deferred to Clair Farley, a trans woman who is the director of the Mayor's Office of Transgender Initiatives.
Farley said November 6 that it is her understanding that both the regulations and SB 932 only mandate reporting SOGI data for positive test results.
Test SF, a project of the San Francisco Department of Public Health being conducted in coordination with the lab Color, is not asking the sexual orientation question as part of the demographic questions to answer before testing that are available to fill out online.
It is, however, asking under a banner labeled "Gender Identity" if someone is "Female," "Male," "Trans Female," "Trans Male," "Genderqueer/Gender Nonbinary," "Not Listed," or "Prefer not to say."
A subsequent banner labeled "Sex" asks if someone is "Female," "Male," or "Nonbinary."
Farley said that the sexual orientation of COVID-19 positive tests is ascertained by DPH during contact tracing and that the questions asked on the aforementioned demographic form were decided upon by Color, which has not responded to a B.A.R. request for comment.
"We started to ask for the information for contact tracing before the order," Farley told the B.A.R. "We are still exploring how we can incorporate the question into testing. We want to make sure the community is getting tested."
Farley said that DPH is in charge of the "contact tracing piece."
"The legislation and the health order require [SOGI] data collection for those who test positive," Farley said. "For anyone who tests positive, they ask about gender identity and sexual orientation. For testing it looks that as of November 3, there's 5.5% who have tested positive in San Francisco who are lesbian, gay, bisexual, or other, and 1% who are transgender."
The SOGI questions have been asked as part of the city's contact tracing efforts since April 28, Farley said. Originally, there was not a gender identity banner in the demographic questions Color asks.
"The reason that the testing piece is still up in the air is because the collection of demographic data has a different origin, in the lab working with Test SF," Farley said, referring to Color. "[Color] was just asking about sex assigned at birth so we were brought in to ask gender identity."
The reason why the gender identity question was added was to provide consistency between the city's efforts and private test providers, Farley explained.
But Color's lack of a sexual orientation question is not universal, as the question "How do you identify your sexual orientation?" is being asked by Logistics Health Inc. if one signs up for a COVID-19 test through that provider in California. Logistics Health has not responded to a request for comment.
When asked during a news conference November 4, Ghaly responded to the lack of a sexual orientation question among the demographic questions City Test SF asks when people take a COVID-19 test.
"I don't know the specifics," Ghaly said. "Again, it's a fairly new order and expectation, and I think we can certainly find those exceptions. I don't want to minimize it in any way. We'll look into that specific issue. I'm always interested to hear from those who have to put into practice some of these changes, what the difficulties are, whether there is a reason it's delayed, that at the state level or the local level we can intervene and support.
"So I will highlight we are getting more and more of the sexual orientation-gender identity data attached to our cases," Ghaly added. "Of course, there's going to be some entities we know that don't put into practice the expectations and those are all worth following up."
When asked November 9 if Ghaly's remarks could be clarified in light of the order's definition of a "case," California Health and Human Services spokesman Rodger Butler responded, "I will let his remarks stand for themselves."
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