BACKGROUND
Outdated gender, sex, and sexual orientation information practices in healthcare contribute to health inequities for sexual and gender minorities (SGM). Some governments, statistics organizations and healthcare services have developed and implemented modernized practices that support health equity for SGM. Extending the work of our research team, we conducted a rapid review of grey literature to explore information practices that support quality healthcare for SGM.
OBJECTIVE
To elucidate modern gender, sex and sexual orientation information practices from leading agencies for adaptation, adoption and application by healthcare providers and organizations seeking to redress outdate information practices that contribute to health inequities for SGM.
METHODS
We searched MEDLINE and Google from 2015 to 2020 with terms related to gender, sex, sexual orientation, and electronic health/medical records for English-language grey literature resources including government and non-governmental organization publications, whitepapers, data standards, toolkits, healthcare organization and health quality practice and policy guides, conference proceedings, unpublished academic work and statistical papers. Peer-reviewed journal articles were excluded, as were resources irrelevant to information practices. In addition to reviewed search results, we screened references sections of included articles for additional resources, and canvassed an working group of international topic experts for resources. Duplicates were eliminated. ATLAS.tiTM was used to support analysis. Themes and codes were developed through an iterative process of writing and discussion with the research team.
RESULTS
Twenty-six grey literature resources met the inclusion criteria. The overarching theme that emerged from the literature are the congruent behaviours, attitudes and policies that constitute SGM cultural competence: shared language with unambiguous definitions of GSSO concepts; welcoming and inclusive care environments and affirming practices to reduce barriers to access; healthcare policy that supports competent healthcare; and adoption of modernized GSSO information practices and EHR design requirements that address invisibility in health data.
CONCLUSIONS
Health equity for sex and gender minoritized people requires a holistic approach to systemic change that equips the agencies and agents in healthcare with the tools they need to cultivate modern attitudes, policies and practices with respect to sex and gender diversity that enable health equity. Adopting small but important changes to the language and terminology used to interact with SGM and their care records is a core requirement for institutionalizing SGM-competence in human and technical systems. Modern GSSO information practices both depend on and reinforce SGM-competency in healthcare.