Original article“It'd Be Great to Have the Options There”: A Mixed-Methods Study of Gender Identity Questions on Clinic Forms in a Primary Care Setting
Section snippets
Methods: semistructured interviews
The first phase of this Quality Improvement Project (following the plan-do-study-act approach) [17] was qualitative to adapt existing methods for gathering gender identity information [13,18,19]. The specific questions we tested were chosen based on best practice methods to assess gender identity [[20], [21], [22], [23]]. The method, sometimes known as the “Two-Step” approach, involves asking patients about assigned sex and current gender identity. This method had been shown to be both highly
Themes from qualitative patient interviews
Twenty-one adolescents participated in qualitative interviews between March 2018 and January 2019. Participants had a mean age of 18.8 years (range: 15–25 years) and reported a range of gender identities (Table 1). By design, half the sample identified as cisgender and half as transgender with three participants (14.3%) who identified as genderqueer/nonbinary. Over half of participants (62%) were assigned a female sex at birth. The majority of participants (29%) identified as Black or
Discussion and Implications
Emerging evidence demonstrates that collection of gender identity information can improve health outcomes. For example, the use of a transgender adolescent's chosen name at home, at school, at work and with friends is associated with lower depression, suicidal ideation, and suicidal behaviors [27]. In this study, all patients found the name, pronoun, and gender identity questions to be acceptable and relevant to their health care. Cisgender adolescents expressed positive sentiment toward the
Acknowledgments
Portions of this project were presented at the Society for Adolescent Health and Medicine Annual Meeting in 2019. The authors would like to thank the Sexual Orientation and Gender Identity and Expression (SOGIE) research group and our study participants, including people of color.
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Conflicts of interest: The authors have no conflicts of interest to disclose.
Disclaimer: Anqa Khan's author's affiliation is included for informational purposes only; this work was not conducted under the auspices of the Guttmacher Institute. The views expressed herein are those of the authors and do not necessarily reflect the views of the Guttmacher Institute.