ArticleBMJ open2021
Development of a computable phenotype to identify a transgender sample for health research purposes: a feasibility study in a large linked provincial healthcare administrative cohort in British Columbia, Canada.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Pooled it
- Impact of gender-affirming hormone therapy on dry eye.Journal of clinical & translational endocrinology · 2026Article
- A scoping review of models to identify transgender patients in electronic health records.Journal of the American Medical Informatics Association : JAMIA · 2026Article
- Co-creating an Inclusion, Diversity, Equity, and Accessibility (IDEA) Strategy in a Pan-Canadian Health Data Research Network.International journal of population data science · 2026Article
- The burden of chronic pain in transgender and gender diverse populations: Evidence from a large US clinical database.European journal of pain (London, England) · 2025Article
- Validating a Case Definition for Transgender Adults Using Administrative Data.JAMA network open · 2025Article
- The impact of gender-affirming interventions on eating disorder diagnosis risk among transgender and gender-diverse individuals.Communications medicine · 2024Article
- Using focus groups to inform a peer health navigator service for people who are transgender and gender diverse in Saskatchewan, Canada.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Gallbladder disease in transgender individuals: associations with gender-affirming hormone therapy.International journal of transgender health · 2024Article
- Identifying a Cohort of People Who Are Transgender and Gender-Diverse Within Saskatchewan's Administrative Health Databases.Health services insights · 2024Article
- The risk of psychosis for transgender individuals: a Dutch national cohort study.Psychological medicine · 2023Article
- The Health of Transmasculine Patients Compared With Cisgender Patients Treated With Hysterectomy in the U.S. South, 2014-2017.Annals of LGBTQ public and population health · 2023Article
- Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
Abstract
objectivesInnovative methods are needed for identification of transgender people in administrative records for health research purposes. This study investigated the feasibility of using transgender-specific healthcare utilisation in a Canadian population-based health records database to develop a computable phenotype (CP) and identify the proportion of transgender people within the HIV-positive population as a public health priority.
designThe Comparative Outcomes and Service Utilization Trends (COAST) Study cohort comprises a data linkage between two provincial data sources: The British Columbia (BC) Centre for Excellence in HIV/AIDS Drug Treatment Program, which coordinates HIV treatment dispensation across BC and Population Data BC, a provincial data repository holding individual, longitudinal data for all BC residents (1996-2013).
settingBritish Columbia, Canada.
participantsCOAST participants include 13 907 BC residents living with HIV (≥19 years of age) and a 10% random sample comparison group of the HIV-negative general population (514 952 individuals). PRIMARY AND SECONDARY OUTCOME MEASURES: Healthcare records were used to identify transgender people via a CP algorithm (diagnosis codes+androgen blocker/hormone prescriptions), to examine related diagnoses and prescription concordance and to validate the CP using an independent provider-reported transgender status measure. Demographics and chronic illness burden were also characterised for the transgender sample.
resultsThe best-performing CP identified 137 HIV-negative and 51 HIV-positive transgender people (total 188). In validity analyses, the best-performing CP had low sensitivity (27.5%, 95% CI: 17.8% to 39.8%), high specificity (99.8%, 95% CI: 99.6% to 99.8%), low agreement using Kappa statistics (0.3, 95% CI: 0.2 to 0.5) and moderate positive predictive value (43.2%, 95% CI: 28.7% to 58.9%). There was high concordance between exogenous sex hormone use and transgender-specific diagnoses.
conclusionsThe development of a validated CP opens up new opportunities for identifying transgender people for inclusion in population-based health research using administrative health data, and offers the potential for much-needed and heretofore unavailable evidence on health status, including HIV status, and the healthcare use and needs of transgender people.
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