Evidence map›Paper›PMID 39438835›Full record

Observational studyBMC health services research2024

Oscillating US Department of Defense policies and medical record documentation of gender dysphoria in service members: an observational time-series analysis.

Krista B Highland, David A Klein, Sydney Rogers, Alexander G Velosky, Christina Roberts, Noelle S Larson

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Krista B HighlandDepartment of Anesthesiology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. krista.highland@usuhs.edu.
David A KleinDepartment of Family Medicine, David Grant Medical Center, Travis Air Force Base, CA, USA.
Sydney RogersSchool of Medicine, Uniformed Services University, Bethesda, MD, USA.
Alexander G VeloskyDepartment of Anesthesiology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
Christina RobertsDivision of Adolescent Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
Noelle S LarsonDepartment of Pediatrics, Uniformed Services University, Bethesda, MD, USA.

Funding

Uniformed Services University of the Health Sciences HU00011920042
6 · The paper itself

Abstract

backgroundUnited States military policies regarding service by transgender service members have shifted several times within the past decade. The relationships between policy changes and electronic health record documentation of gender dysphoria, a current and historic policy requisite for gender affirming care receipt, in active duty service members remain unknown.

methodsBayesian estimator of abrupt change, seasonality, and trend models identified changepoints in the proportion of service members who had new and then historical medical record documentation consistent with gender dysphoria from January 2015 to August 2022. Changepoints were evaluated as they related to salient military policy-related events.

resultsApproximately 3,853 active duty and activated National Guard or Reserve service members received a documented diagnosis corresponding to gender dysphoria from January 2015 to August 2022. Four significant changepoints were identified across both time series. Salient historical events that occurred during the changepoint periods were identified for contextualization.

conclusionsClinical documentation of gender dysphoria oscillated with changes to policies and public statements by government leaders, which may in turn, impact military recruitment and retention. This study highlights the need for equitable policies that optimize the strength of a diverse military force. Equity-oriented monitoring is needed to continually examine the impact of military service policies on readiness and retention to support actionable, data-driven improvements to policies and their implementation.

Indexed as

Gender DysphoriaMilitary PersonnelAdultBayes TheoremDocumentationElectronic Health RecordsFemaleHumansMaleUnited StatesUnited States Department of DefenseGender-affirming healthcareGender dysphoriaPatient disclosurePolicy

Identifiers

PMID39438835
PMCPMC11515744

What OpenQuestion holds

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LicenceCC BY
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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.