The Opportunity for Medical Systems to Reduce Health Disparities Among Lesbian, Gay, Bisexual, Transgender and Intersex Patients

Abstract

Lesbian, gay, bisexual, transgender, and intersex (LGBTI) people experience a variety of health care disparities, including higher rates of certain chronic illnesses, substance abuse, and HIV. The growing adoption of electronic health records (EHRs) presents an important opportunity to optimize care for LGBTI individuals by routinely capturing in structured form patient sexual orientation and gender identity (SO/GI), as well as a patient's preferred name and pronoun. In addition to improving care provided to LGBTI patients, collection of structured SO/GI information will facilitate important public health data collection efforts that can be used to further reduce health care disparities in this underserved population.

Development of a Natural Language Processing Algorithm to Identify and Evaluate Transgender Patients in Electronic Health Record System

“…3 In 2016, the director of the National Institute on Minority Health and Health Disparities issued a statement declaring gender minorities a "health disparity population for research purposes," 6 and in 2011, the Institute of Medicine released a report calling for Additionally, there is no standardized way to collect gender identity information in EHR systems. 16 Transgender patients may be reluctant to share their transgender identity with health care providers due to the fear of discrimination. 7,16 This fear, combined with the obstacles many transgender people face in obtaining health care, has made the collection of epidemiologic data about transgender patient health services utilization challenging.…”

“…16 Transgender patients may be reluctant to share their transgender identity with health care providers due to the fear of discrimination. 7,16 This fear, combined with the obstacles many transgender people face in obtaining health care, has made the collection of epidemiologic data about transgender patient health services utilization challenging. 17 Even though EHR software upgrades to allow for collection of gender identity data are increasingly common, health care providers still rarely utilize these tools.…”

Preferred Names, Preferred Pronouns, and Gender Identity in the Electronic Medical Record and Laboratory Information System: Is Pathology Ready?

“…The use of preferred name for transgender patients has been identified as important in providing inclusion toward a class of patients that have historically been disenfranchised from the health-care system. [ 4 5 6 7 8 9 ]…”

Incorporating Transition-Affirming Language into Anatomical Pathology Reporting for Gender Affirmation Surgery

“…16 It is well established that transgender patients often report acute discomfort when addressed according to a gender that is discordant with the gender with which they self-identify and it is for this reason that EMRs are increasingly incorporating gender identity data. [17][18][19] Pathology reports that include gendered language such as ''female breast tissue'' rather than utilizing objective language such as ''breast tissue with terminal duct lobular units'' create a health care barrier in the form of disenfranchising the patient and adding to the lived reality of discrimination and harassment faced by trans individuals. 20 To best serve transgender patients while maintaining a high standard of diagnostic integrity, we propose a set of inclusive terminology to be utilized in pathology reports for gender-affirming surgery (see Table 1).…”