The Joint Commission Journal on Quality and Patient Safety
A Model for Improving Health Care Quality for Transgender and Gender Nonconforming Patients
Section snippets
Problem Definition
An estimated 1.4 million adults, or 0.6% of the adult population of the United States, identify as transgender.1 Current health care experiences of transgender and gender nonconforming (TGNC) patients, including both transition- (hormone replacement therapy, gender affirmation surgery, and so forth) and non-transition-related (care unrelated to a patient's TGNC identity), are often substandard and variable. Many TGNC patients choose not to seek medical help when necessary because they fear
Initial Approach
To improve the quality of health care for TGNC patients at both the patient-provider and health-systems levels, the Vanderbilt Program for LGBTQ Health has invested in the development of TGNC patient–specific initiatives since 2014. These include Trans Buddy, a transgender patient peer advocacy program (in which volunteers advocate and provide emotional/logistical support for trans patients during their health care visits), a community advisory board that includes both TGNC community members
Next Steps
As the number of TGNC patients identified within the VUMC health system increases due to the rollout of the new SOGI interface and growth of the Clinic for Transgender Health, analyses of patient clinical utilization and health outcomes will support identification of both provider-level and systems-level quality challenges and successes of the health care received by TGNC patient populations at VUMC. A key future direction is the semiautomated development of individualized reports to be
Conclusion
Currently, TGNC health care quality is substandard and variable, resulting in higher instances of negative health care experiences and contributing to poor health outcomes for TGNC patients. To address the dearth of systems-level TGNC quality of health care initiatives, Vanderbilt has developed and piloted a multifaceted, health systems–level approach to improving TGNC quality of care, one rooted in transgender community feedback through community outreach programs and clinical informatics
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2022, Joint Commission Journal on Quality and Patient SafetySex trouble: Sex/gender slippage, sex confusion, and sex obsession in machine learning using electronic health records
2022, PatternsCitation Excerpt :Machine learning researchers who work with more modern EHR data will have access to a wider variety of information about patients, and that, combined with the pressure to engage with sex differences, means that more and more machine learning researchers will confront questions about how to incorporate sex/gender data in their work. Previous literature about EHRs and transgender people advocate for the importance of collecting SOGI information and applaud its increased integration into new and existing systems.12–22 However, most of these works also assume that sex is a coherent concept with a consistent meaning, even for transgender people.
Barriers to sexual recovery in women with urologic cancers
2022, Urologic Oncology: Seminars and Original InvestigationsCitation Excerpt :To the authors’ knowledge, there is currently no published research that specifically addresses sexual minority women or transgender men with urologic cancers; very limited data exist regarding transgender women with prostate and testicular cancers [60,61]. This reflects the longstanding neglect of demographic issues relevant to assessing patient sexual orientation and gender identity, often known as “SOGI” data [62–64]. Unfortunately, such exclusive practices continue despite recommendations from The Joint Commission [65], Department of Health and Human Services [57], and the American Society of Clinical Oncology [66] to routinely collect SOGI data in healthcare settings and related research.