Increased Ascertainment of Transgender and Non-binary Patients Using a 2-Step Versus 1-Step Gender Identity Intake Question in an STD Clinic Setting
Affiliation
- 1 Public Health, Seattle & King County HIV/STD Program.
- PMID: 30516726
- DOI: 10.1097/OLQ.0000000000000952
Increased Ascertainment of Transgender and Non-binary Patients Using a 2-Step Versus 1-Step Gender Identity Intake Question in an STD Clinic Setting
Authors
Affiliation
- 1 Public Health, Seattle & King County HIV/STD Program.
- PMID: 30516726
- DOI: 10.1097/OLQ.0000000000000952
Abstract
Background: Transgender inclusive and gender affirmative healthcare includes asking patients about gender identity and sex assigned at birth through what is known as the “2-step” methodology. In May 2020, the sexually transmitted disease (STD) clinic in Seattle, WA switched from using a 1-step to a 2-step gender identity question. We aimed to determine if the updated questions increased ascertainment of transgender and gender nonconforming (TGNC) patients and used the improved gender identity data to describe the human immunodeficiency virus/STD risk profile of TGNC patients.
Methods: We conducted a pre-post analysis comparing the proportion of patients that identified as TGNC during the year before and after implementation of the 2-step questions. Gender identity and medical history questions were ascertained using a computer-assisted self-interview. The 2-step question included 2 new gender response options: non-binary/genderqueer and write-in.
Results: Institution of the 2-step question resulted in a 4.8-fold increase in patients who were identified as TGNC: 36 (0.5%) of 6635 to 172 (2.4%) of 7025 patients (P Conclusions: Using a 2-step gender identity question and including non-binary/genderqueer options increased our clinic’s ascertainment of TGNC patients and more accurately captured gender identity among STD clinic patients.
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