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Research Letter
February 24, 2020

Affirming Transgender Youths’ Names and Pronouns in the Electronic Medical Record

Author Affiliations
  • 1Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
  • 2University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania
  • 3Division of Adolescent Medicine, Ann & Robert H. Lurie Children’s Hospital, Chicago, Illinois
  • 4Division of General Academic Pediatrics, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
JAMA Pediatr. Published online February 24, 2020. doi:10.1001/jamapediatrics.2019.6071

Transgender youths experience significant health disparities compared with their cisgender peers. Recent data suggest that use of gender-affirming language, specifically name and pronouns, in more life contexts is associated with improved mental health outcomes.1

The use of electronic medical records (EMRs) has become ubiquitous in medicine. However, limitations built into these systems can restrict the provision of gender-affirming care. In 2015, the Office of the National Coordinator for Health Information Technology began recommending that EMRs collect gender identity data to be certified for meaningful use.2 Many practices have moved to the “2-step” model of asking patients about both their gender identity and sex assigned at birth. Unfortunately, neither of these questions provides information about the name and pronouns a patient would like to use, which are critical to ensuring that a clinical encounter is respectful and affirming.3-5 A clear gap exists in the literature as there is a limited understanding of transgender youths’ preferences regarding name and pronoun documentation in the EMR. The objectives of this study were to: (1) assess transgender youths’ preferences regarding EMR-wide name and pronoun documentation and (2) investigate how these preferences differ by demographic and gender-related characteristics.

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