Availability of sexual orientation and gender identity (SOGI) information in a cohort of transgender and gender diverse people: An analysis of electronic health records Restricted; Files & ToC
MaWhinney, Kristine (Spring 2021)
Background: In 2015, the U.S. Department of Health and Human Services issued a directive that electronic health record (EHR) systems should enable providers to systematically record patients’ sexual orientation and gender identity (SOGI). Kaiser Permanente (KP) health systems began implementing SOGI data capture in 2019. The objective of this study was to investigate what proportion of transgender and gender diverse (TGD) people enrolled in KP plans have SOGI information in their health records, and to identify factors associated with SOGI status availability.
Methods: This analysis used EHR data from KP health plans in Northern and Southern California. TGD persons with and without SOGI data were compared with respect to their age, race, recorded sex, and study site. A separate analysis examined a subset of participants with SOGI data to compare demographic characteristics among TGD persons reporting binary (e.g., transman or transwoman) and non-binary gender identities. Each comparison was carried out using multiple logistic regression models.
Results: Among 19,057 study participants, 9,190 (48%) had SOGI information indicative of TGD status. Participants with SOGI data were younger, and more likely to be Non-Hispanic White, reside in Northern California and have female sex recorded in the EHR files. Among participants with SOGI data, those identified as non-binary were more likely to be 18-35 years of age, and have female gender assigned at birth, but were less likely to be African American or Hispanic.
Conclusion: Although KP plans in California adopted SOGI data collection relatively early, approximately half of their TGD members still do not have SOGI information recorded in the EHR. SOGI data availability appears to differ by age, race ethnicity.
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