Postdoctoral Fellow
National Cancer Institute
Project Title: “Pilot study to identify transgender individuals within electronic health records.”
Transgender refers to individuals whose gender identity is different from their assigned sex at birth (e.g., assigned male at birth and identifies as a woman), whereas cisgender is a term for those whose gender identity is aligned with their sex assigned at birth (e.g., assigned male at birth and identifies as a man). When seeking gender-affirming care, transgender individuals often receive a diagnosis of “gender dysphoria”, which is not a requirement for transgender identity but may be an insurance requirement for some forms of gender-affirming care.
The reliance on gender dysphoria diagnosis codes in U.S. electronic health records excludes many transgender individuals, as they may lack a gender dysphoria diagnosis due to concerns regarding stigma or discrimination. As gender affirming care is not covered by all private health insurance plans and only by Medicaid in 16 states, clinicians may use alternative diagnoses to ensure insurance coverage for gender affirming care for their patients. However, these diagnostic codes alone may lack the sensitivity and specificity to fully identify transgender patients in medical records.
To address the issue of identifying transgender population in administrative healthcare database and electronic health records without reliance on gender dysphoria diagnoses alone, Dr. Jackson proposes to build an algorithm using a combination of sociodemographic, diagnostic, procedure, and medication codes extracted from electronic health records to identify transgender men and women, separately. Dr. Jackson’s team proposes to use data from NIH’s All of Us study to create an algorithm that can differentiate between transgender and cisgender participants.
