Assessment of the inclusivity of the national CLAS standards enhancement initiative of bisexual identities

This chapter reports on the evaluation of state and local level National Standards for Culturally and Linguistically Appropriate Services in Health Care (aka CLAS Standards), specifically those standards addressing the health needs of sexual minority individuals, with an emphasis on the inclusion of bisexual+ communities and the implications of bisexual+ (non)inclusion in CLAS standards. At the state and local levels, bisexual identity is rarely recognized as distinct from other sexual identities. This lack of representation raises an essential issue of how local communities, states, and the federal government struggle with sexual minority data classification and prioritizing health benchmarks for sexual minority populations and subpopulations. We also found that the CLAS cultural competency policy definition at the federal level lacks an appropriate degree of bi‐inclusivity. The findings from this study reveal that the five states in our sample implemented CLAS Standards in ways that demonstrated bi‐erasure. Specifically, states defined gender and sexual minorities through exclusionary categories that place emphasis on the “Other”. LGBTQ+ evaluators can rely on the Principles of LGBTQ+ Evaluation to create strategies that demonstrate how to effectively address the intersecting ramifications of bi‐erasure at the policy level.