A retrospective cross-sectional study of nearly 3 years of emergency department (ED) encounters was performed with the goal of developing an electronic medical record (EMR) search strategy to identify transgender and gender diverse (TGD) youth. A search of nine keywords to identify TGD youth was conducted in the EMR, and text from clinician notes was extracted and reviewed. Among 15,413 ED encounters, 1126 keywords were identified, and 91.2% were classified as TGD. The final dataset classified 605 ED encounters (428 unique youth) as TGD. The study offers a feasible technique to identify and prioritize TGD youth in health research using EMR data.
ColemanE, RadixAE, BoumanWP, et al.Standards of care for the health of transgender and gender diverse people, version 8. Int J Transgend Health, 2022; 23(Suppl 1):S1–S259; doi: 10.1080/26895269.2022.2100644
Olson-KennedyJ, Cohen-KettenisPT, KreukelsBPC, et al.Research priorities for gender nonconforming/transgender youth: Gender identity development and biopsychosocial outcomes. Curr Opin Endocrinol Diabetes Obes, 2016; 23(2):172–179; doi: 10.1097/MED.0000000000000236
4.
RoblinD, BarzilayJ, TolsmaD, et al.A novel method for estimating transgender status using electronic medical records. Ann Epidemiol, 2016; 26(3):198–203; doi: 10.1016/j.annepidem.2016.01.004
5.
FoerD, RubinsDM, AlmazanA, et al.Challenges with accuracy of gender fields in identifying transgender patients in electronic health records. J Gen Intern Med, 2020; 35(12):3724–3725; doi: 10.1007/s11606-019-05567-6
6.
Becerra-CulquiTA, LiuY, NashR, et al.Mental health of transgender and gender nonconforming youth compared with their peers. Pediatrics, 2018; 141(5):e20173845; doi: 10.1542/peds.2017-3845
7.
KiddKM, SequeiraGM, DouglasC, et al.Prevalence of gender-diverse youth in an urban school district. Pediatrics, 2021; 147(6):e2020049823; doi: 10.1542/peds.2020-049823
8.
EhrenfeldJM, GottliebKG, BeachLB, et al.Development of a natural language processing algorithm to identify and evaluate transgender patients in electronic health record system. Ethn Dis, 2019; 29(Suppl 2):441–450; doi: 10.18865/ed.29.S2.441
9.
Acevedo-GarciaD, NoelkeC, McArdleN, et al.Racial and ethnic inequities in children’s neighborhoods: Evidence from the new child opportunity index 2.0. Health Aff (Millwood), 2020; 39(10):1693–1701; doi: 10.1377/hlthaff.2020.00735
10.
R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing: Vienna, Austria; 2013.
11.
SaferJD, ColemanE, FeldmanJ, et al.Barriers to healthcare for transgender individuals. Curr Opin Endocrinol Diabetes Obes, 2016; 23(2):168–171; doi: 10.1097/MED.0000000000000227
12.
HilarioC, Louie-PoonS, TaylorM, et al.Racism in health services for adolescents: A scoping review. Int J Soc Determinants Health Health Serv, 2023; 53(3):343–353; doi: 10.1177/27551938231162560
13.
ForcierM, WagnerJ, HollandS. Gender diverse youth: Opportunities to identify and address systemic inequities. Pediatrics, 2021; 147(6):e2021050278; doi: 10.1542/peds.2021-050278
14.
KcomtL, GoreyKM, BarrettBJ, et al.Healthcare avoidance due to anticipated discrimination among transgender people: A call to create trans-affirmative environments. SSM Popul Health, 2020; 11:100608; doi: 10.1016/j.ssmph.2020.100608
