{"doi":"10.1371/journal.pone.0302895","title":"Characteristics of a transgender and gender-diverse patient population in Utah: Use of electronic health records to advance clinical and health equity research","abstract":"Transgender and gender-diverse (TGD) people, individuals whose gender identity differs from their sex assigned at birth, face unique challenges in accessing gender-affirming care and often experience disparities in a variety of health outcomes. Clinical research on TGD health is limited by a lack of standardization on how to best identify these individuals. The objective of this retrospective cohort analysis was to accurately identify and describe TGD adults and their use of gender-affirming care from 2003-2023 in a healthcare system in Utah, United States. International Classification of Disease (ICD)-9 and 10 codes and surgical procedure codes, along with sexual orientation and gender identity data were used to develop a dataset of 4,587 TGD adults. During this time frame, 2,985 adults received gender-affirming hormone therapy (GAHT) and/or gender-affirming surgery (GAS) within one healthcare system. There was no significant difference in race or ethnicity between TGD adults who received GAHT and/or GAS compared to TGD adults who did not receive such care. TGD adults who received GAHT and/or GAS were more likely to have commercial insurance coverage, and adults from rural communities were underrepresented. Patients seeking estradiol-based GAHT tended to be older than those seeking testosterone-based GAHT. The first GAS occurred in 2013, and uptake of GAS have doubled since 2018. This study provides a methodology to identify and examine TGD patients in other health systems and offers insights into emerging trends and access to gender-affirming care.","journal":"PLoS ONE","year":2024,"id":448609,"datarank":0.26876392038420827,"base_score":1.791759469228055,"endowment":1.791759469228055,"self_citation_contribution":0.26876392038420827,"citation_network_contribution":0.0,"self_endowment_contribution":0.26876392038420827,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9545,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":448982,"name":"Brian Zenger","orcid":"0000-0002-0039-9184","position":1,"is_corresponding":false},{"id":872215,"name":"Bayarmaa Mark","orcid":"0000-0003-1577-6859","position":2,"is_corresponding":false},{"id":809158,"name":"Laurel Hiatt","orcid":"0000-0003-1321-0325","position":3,"is_corresponding":false},{"id":1268001,"name":"Erika Sullivan","orcid":null,"position":4,"is_corresponding":false},{"id":337847,"name":"Benjamin A. Steinberg","orcid":"0000-0002-4729-7820","position":5,"is_corresponding":false},{"id":780256,"name":"Ann Lyons","orcid":"0000-0001-6791-4008","position":6,"is_corresponding":false},{"id":263027,"name":"Adam M. Spivak","orcid":"0000-0003-1815-7893","position":7,"is_corresponding":false},{"id":1267542,"name":"Cori Agarwal","orcid":"0000-0003-1817-5258","position":8,"is_corresponding":false},{"id":1268002,"name":"Marisa Adelman","orcid":null,"position":9,"is_corresponding":false},{"id":233429,"name":"James M. Hotaling","orcid":"0000-0002-4401-4565","position":10,"is_corresponding":false},{"id":1267543,"name":"Bernadette Kiraly","orcid":"0000-0003-2243-6553","position":11,"is_corresponding":false},{"id":1267544,"name":"Sharon Talboys","orcid":"0000-0001-6517-478X","position":12,"is_corresponding":false},{"id":1047356,"name":"Tiffany Ho","orcid":"0000-0001-9332-9777","position":0,"is_corresponding":true}],"reference_count":53,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:02:12.215092Z","pmid":"38713697","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}