Evidence map›Paper›PMID 35641720›Full record

ArticleJournal of general internal medicine2023

Experiences of Transgender People Reviewing Their Electronic Health Records, a Qualitative Study.

Ash B Alpert, Jamie E Mehringer, Sunshine J Orta, Emile Redwood, Tresne Hernandez, Lexis Rivers, Charlie Manzano, Roman Ruddick, Spencer Adams, Catherine Cerulli and 2 more

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In one paragraph

Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Authentic Allyship for Trans and Gender Diverse People: A Patterns of Knowing Perspective in Nursing.Nursing philosophy : an international journal for healthcare professionals · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Ash B AlpertDepartment of Health Services, Policy & Practice, Center for Gerontology and Healthcare Research, Brown University School of Public Health, Box G-S121-6, Providence, RI, 02903, USA. ash_alpert@brown.edu.ORCID 0000-0003-1736-898X
Jamie E MehringerDepartment of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
Sunshine J OrtaTrillium Health, Rochester, NY, USA.
Emile RedwoodDepartment of Obstetrics and Gynecology, New York University Langone Health, New York, NY, USA.
Tresne HernandezSchool of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
Lexis RiversTransgender Cancer Patient Project, Ashland, OR, USA.
Charlie ManzanoTransgender Cancer Patient Project, Ashland, OR, USA.
Roman RuddickTransgender Cancer Patient Project, Ashland, OR, USA.
Spencer AdamsWestern Michigan University, Kalamazoo, MI, USA.
Catherine CerulliDepartment of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
Don OperarioDepartment of Behavior and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
Jennifer J GriggsDivision of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe 21st Century Cures Act and the OpenNotes movement have brought patients immediate access to their electronic health records (EHRs). The experiences of marginalized people, including transgender people, accessing and reviewing their EHRs could inform documentation guidelines to improve patient-clinician rapport and reduce harm.

objectiveTo investigate the experiences of transgender people reviewing EHRs.

designQualitative study using community-engaged research and an interpretive description methodology. Participants were recruited via social media, snowball sampling was employed, and purposive sampling was used to ensure diversity in terms of age, race/ethnicity, and other factors. In focus groups, participants were asked to discuss their experiences reviewing their EHRs and, for those participants who were clinicians, their experiences reviewing other clinicians' documentation.

participantsThirty transgender adults aged 20 to 67 years, including 10 clinicians. APPROACH: Digital audio-recordings of focus groups were transcribed verbatim. Content was analyzed to identify emerging essential elements and analysis was continued until no new themes emerged (i.e., saturation). KEY

resultsFour themes were noted. (1) Using the wrong name, pronoun, or gender marker for patients is common in the EHR, erodes trust, and causes trauma. (2) Various aspects of clinicians' notes contradict, blame, or stigmatize patients, across multiple axes of oppression. (3) Limitations of EHR capabilities create barriers to quality care. (4) Certain medical customs set the stage for marginalizing, objectifying, and pathologizing transgender people.

conclusionsTransgender people experience harm via various aspects of EHR documentation, suggesting that changes must be made to improve patient-clinician relationships and reduce ill-effects for patients.

Indexed as

Transgender PersonsAdultElectronic Health RecordsFemaleFocus GroupsGender IdentityHumansMaleQualitative Researchelectronic health recordspatient-clinician communicationqualitative researchsocial stigmatransgender persons

Identifiers

PMID35641720
PMCPMC10039220

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read2
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.