scholarly journals Transgender Data Collection in the Electronic Health Record (EHR): Current Concepts and Issues

2021 ◽  
Author(s):  
Clair Kronk ◽  
Avery Everhart ◽  
Florence Ashley ◽  
Hale Thompson ◽  
Theodore E. Schall ◽  
...  
Keyword(s):  
Data Collection ◽  
The United States ◽  
Data Representation ◽  
Population Based ◽  
Sex And Gender ◽  
Medical Providers ◽  
Related Data ◽  
Gender Diverse ◽  
Electronic Health ◽  
And Gender

There are over one million transgender people living in the United States and 33% report negative experiences with a healthcare provider, many of which are connected to data representation in electronic health records (EHRs). We present recommendations and common pitfalls involving sex- and gender-related data collection in EHRs. Our recommendations leverage the needs of patients, medical providers, and researchers to optimize both individual patient experiences and the efficacy and reproducibility of EHR population-based studies. We also briefly discuss adequate additions to the EHR considering name and pronoun usage. We add the disclaimer that these questions are more complex than commonly assumed. We conclude that collaborations between local transgender and gender-diverse persons and medical providers as well as open inclusion of transgender and gender-diverse individuals on terminology and standards boards is crucial to shifting the paradigm in transgender and gender-diverse health.

scholarly journals Missing in Action: Sex and Gender in Substance Use Research

2020 ◽  
Vol 17 (7) ◽  
pp. 2352 ◽  
Author(s):  
Lorraine Greaves
Keyword(s):  
Substance Use ◽  
Health Issue ◽  
Sex And Gender ◽  
Gender Diverse ◽  
Global Health Issue ◽  
Important Health ◽  
Gender Based ◽  
And Gender ◽  
Missing In Action ◽  
Important Health Issue

Substance use and misuse is a significant global health issue that requires a sex- and gender-based analysis. Substance use patterns and trends are gendered: that is, women and men, girls and boys, and gender-diverse people often exhibit different rates of use of substances, reasons for use, modes of administration, and effects of use. Sex-specific effects and responses to substances are also important, with various substances affecting females and males differentially. Nevertheless, much research and practice in responding to substance use and misuse remains gender blind, ignoring the impacts of sex and gender on this important health issue. This special issue identifies how various aspects of sex and gender matter in substance use, illustrates the application of sex- and gender-based analyses to a range of substances, populations and settings, and assists in progressing sex and gender science in relation to substance use.

Epistemic Injustice and Judicial Discourse on Transgender Rights in India: Uncovering Temporal Pluralism

2020 ◽  
Vol 26 (1) ◽  
pp. 30-49
Author(s):  
Dipika Jain ◽  
Kimberly M. Rhoten
Keyword(s):  
Gender Diversity ◽  
Case Law ◽  
Epistemic Injustice ◽  
Sex And Gender ◽  
Self Identity ◽  
Gender Binary ◽  
Gender Diverse ◽  
The Everyday ◽  
Judicial Discourse ◽  
And Gender

This article examines how efforts at legal legibility acquisition by gender diverse litigants result in problematic (e.g., narratives counter to self-identity) and, at times, erroneous discourses on sex and gender that homogenize the litigants themselves. When gender diverse persons approach the court with a rights claim, the narrative they present must necessarily limit itself to a normative discourse that the court may understand and, therefore, engage with. Consequently, the everyday lived experiences of gender diverse persons are often deliberately erased from the narrative as litigants mould themselves into the pre-existing normative legal categories of gender and sex. As a result of such mechanisms, the article finds that gender diverse litigants face epistemic injustice in the courts as their legal legibility is constructed within a constraining gender binary paradigm of judicial discourse. The article explores the trajectory of transgender rights in India, through an analysis of case law prior to and post the landmark NALSA decision, to understand how the approach to transgender rights and identities has been shaped by and shapes, in turn, normative conceptions of gender. The article argues for the incorporation of temporal pluralism into the law that would allow courts to hear gender diverse litigant accounts premised on contemporary gender diversity beyond the binary (rather than incontestable prior understandings based in past precedent), which would better account for such social injustices.

Distance Traveled to Access Knowledgeable Trans-Related Healthcare Providers

2020 ◽  
Vol 1 (2) ◽  
pp. 83-95
Author(s):  
Shanna K. Kattari ◽  
Joseph Grange ◽  
Kristie L. Seelman ◽  
Matthew Bakko ◽  
Vern Harner
Keyword(s):  
Health Knowledge ◽  
Educational Achievement ◽  
Healthcare Access ◽  
Healthcare Providers ◽  
Medical Providers ◽  
Chi Square ◽  
Gender Diverse ◽  
Logistic Regressions ◽  
And Gender ◽  
Tests Of Independence

Transgender and gender diverse (TGD) individuals experience a variety of disparities regarding healthcare and healthcare access. While many of these disparities are interpersonal, such as discrimination and experiences of violence at the hands of medical providers, there are also systemic issues that contribute to these inequities. One such issue is that of finding and accessing providers who are knowledgeable about trans-related care. This study examines how far TGD people are traveling to access providers with more trans-related health knowledge and explores gender differences regarding distance traveled. Data from the 2015 U.S. Transgender Survey are used, with an analytic sample of N = 5,639. Findings from the chi-square tests of independence and logistic regressions indicate there is a relationship between highly knowledgeable care and distance traveled, such that certain groups of TGD individuals (across race, income level, and educational achievement) are taking on the burden of having to travel further in order to access the most knowledgeable healthcare providers, with few significant differences across genders. Overall, 34.5% of TGD individuals have to travel over 25 miles to access providers knowledgeable about trans-related care. While much of the discussion about increasing trans-affirming healthcare has centered on reducing interpersonal issues, the hardship potentially caused by traveling further to get knowledgeable care should certainly be part of this conversation.

scholarly journals Sex and gender differences in hypertensive kidney injury

2017 ◽  
Vol 313 (4) ◽  
pp. F1009-F1017 ◽  
Author(s):  
Jennifer C. Sullivan ◽  
Ellen E. Gillis
Keyword(s):  
Sex Differences ◽  
Experimental Animal ◽  
Animal Studies ◽  
Molecular Mechanisms ◽  
Kidney Injury ◽  
Science Research ◽  
The United States ◽  
Sex And Gender ◽  
Participation Of Women ◽  
And Gender

Hypertension is a complex, multifaceted disorder, affecting ~1 in 3 adults in the United States. Although hypertension occurs in both men and women, there are distinct sex differences in the way in which they develop hypertension, with women having a lower incidence of hypertension until the sixth decade of life. Despite observed sex differences in hypertension, little is known about the molecular mechanisms underlying the development of hypertension in females, primarily because of their underrepresentation in both clinical and experimental animal studies. The first goal of this review is to provide a concise overview of the participation of women in clinical trials, including a discussion of the importance of including females in basic science research, as recently mandated by the National Institutes of Health. The remaining portion of the review is dedicated to identifying clinical and experimental animal studies that concentrate on gender and sex differences in hypertensive kidney disease, ending with a proposed role for T cells in mediating sex differences in blood pressure.

Impact of Sex and Gender on Irritable Bowel Syndrome

2003 ◽  
Vol 5 (1) ◽  
pp. 56-65 ◽  
Author(s):  
Margaret Heitkemper ◽  
Monica Jarrett ◽  
Eleanor F. Bond ◽  
Lin Chang
Keyword(s):  
Health Care ◽  
Irritable Bowel Syndrome ◽  
Visceral Pain ◽  
Partial Agonist ◽  
The United States ◽  
Care Seeking ◽  
Sex And Gender ◽  
Seek Health Care ◽  
And Gender ◽  
Irritable Bowel

Irritable bowel syndrome (IBS) is a common functional bowel disorder characterized by abdominal pain and change in defecation pattern. This review addresses the topic of possible sex (genetic, biological) and gender (experiential, perceptual) differences in individuals with and without IBS. Several observations make the topic important. First, there is a predominance of women as compared to men who seek health care services for IBS in the United States and other industrialized societies. Second, menstrual cycle-linked differences are observed in IBS symptom reports. Third, women with IBS tend to report greater problems with constipation and nongastrointestinal complaints associated with IBS. Fourth, serotonin (5-HT3) receptor antagonist and 5-HT4 partial agonist drugs appear to more effectively diminish reports of bowel pattern disruption in women with IBS as compared to men. This review examines sex and gender modulation of gastrointestinal motility and transit, visceral pain sensitivity, autonomic nervous system function, serotonin biochemistry, and differences in health care-seeking behavior for IBS.

Unmet Expectations in Health Care Settings: Experiences of Transgender and Gender Diverse Adults in the Central Great Plains

2019 ◽  
Vol 30 (3) ◽  
pp. 409-422 ◽  
Author(s):  
Heather M. Meyer ◽  
Richard Mocarski ◽  
Natalie R. Holt ◽  
Debra A. Hope ◽  
Robyn E. King ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Great Plains ◽  
Care Provider ◽  
Community Based Participatory Research ◽  
The United States ◽  
Unmet Expectations ◽  
Gender Diverse ◽  
Patient Health ◽  
And Gender

Transgender and gender diverse (TGD) individuals face a long-term, multifaceted process if they choose to begin a gender affirmation journey. Decisions to go on hormone therapy and/or have a surgical procedure necessitate the TGD individual to set up an appointment with a health care provider. However, when TGD patients interact with health care practitioners, problems can arise. This article documents and categorizes the types of unmet expectations that are common in the TGD patient–health care provider social dynamic in the Central Great Plains of the United States. Utilizing a community-based participatory research model, qualitative in-depth interviews were conducted with 27 TGD individuals about their health care experiences. From this, the researchers identified four main themes of unmet expectations: probing, gatekeeping, stigmatizing stance, and misgendering/deadnaming. Steps that can be taken by both the health care provider and the TGD individual to have a more successful encounter are discussed.

scholarly journals “When the pain is so acute or if I think that I’m going to die”: Health care seeking behaviors and experiences of transgender and gender diverse people in an urban area

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246883
Author(s):  
Mandi L. Pratt-Chapman ◽  
Jeanne Murphy ◽  
Dana Hines ◽  
Ruta Brazinskaite ◽  
Allison R. Warren ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Screening ◽  
Care Coordination ◽  
The United States ◽  
Health Care Seeking ◽  
Provider Communication ◽  
Care Seeking ◽  
Gender Diverse ◽  
And Gender ◽  
Health Care Seeking Behaviors

Introduction Approximately 1.4 million transgender and gender diverse (TGD) adults in the United States have unique health and health care needs, including anatomy-driven cancer screening. This study explored the general healthcare experiences of TGD people in the Washington, DC area, and cancer screening experiences in particular. Methods Twenty-one TGD people were recruited through word of mouth and Lesbian Gay Bisexual Transgender Queer (LGBTQ)-specific community events. Participant interviews were conducted and recorded via WebEx (n = 20; one interview failed to record). Interviews were transcribed using Rev.com. Two coders conducted line-by-line coding for emergent themes in NVivo 12, developed a codebook by consensus, and refined the codebook throughout the coding process. Member checking was conducted to ensure credibility of findings. Results Three major themes served as parent nodes: health-care seeking behaviors, quality care, and TGD-specific health care experiences. Within these parent nodes there were 14 child nodes and 4 grand-child nodes. Subthemes for health care seeking behaviors included coverage and costs of care, convenience, trust/mistrust of provider, and provider recommendations for screening. Subthemes for quality of care included professionalism, clinical competence in transgender care, care coordination, provider communication, and patient self-advocacy. Overall, transgender men were less satisfied with care than transgender women. Conclusions Results suggest a need for improved provider communication skills, including clear explanations of procedures and recommendations for appropriate screenings to TGD patients. Results also suggest a need for improved clinical knowledge and cultural competency. Respondents also wanted better care coordination and insurance navigation. Overall, these findings can inform health care improvements for TGD people.

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