Evidence map›Paper›PMID 40484628›Full record

ArticleBMJ quality & safety2026

Patient and clinician perspectives on misgendering in healthcare.

Kyle Okamuro, Alan Card, Hanna J Barton, Falisha Kanji, Victor Trasvina, Jill Blumenthal, Tara Cohen, Jennifer T Anger

Abstract read
In one paragraph

Article in BMJ quality & safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

8 authors.

Kyle OkamuroDepartment of Urology, University of California San Diego, La Jolla, California, USA.ORCID http://orcid.org/0009-0004-7041-9656
Alan CardDivision of Global Health Management & Policy, San Diego State University, San Diego, California, USA.
Hanna J BartonBerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.ORCID http://orcid.org/0000-0003-0457-1153
Falisha KanjiDepartment of Surgery, Cedars-Sinai, Los Angeles, California, USA.
Victor TrasvinaDepartment of Urology, University of California San Diego, La Jolla, California, USA.
Jill BlumenthalDepartment of Medicine, University of California San Diego, La Jolla, California, USA.
Tara CohenDepartment of Surgery, Cedars-Sinai, Los Angeles, California, USA.ORCID http://orcid.org/0000-0003-2137-6093
Jennifer T AngerDepartment of Urology, University of California San Diego, La Jolla, California, USA janger@health.ucsd.edu.

Funding

AHRQ HHS R18 HS029299
6 · The paper itself

Abstract

purposeMisgendering of transgender and non-binary (TGNB) individuals in healthcare settings can lead to worsened mental and physical health outcomes and decreased utilisation of care. Few studies have investigated the factors that contribute to this phenomenon. The purpose of this study was to apply qualitative methods to explore sources of misgendering, its perceived impact, prevention strategies and clinician responses to accidentally misgendering a patient, as identified by TGNB patients and gender-affirming care clinicians.

methodsBetween April and June 2022, 20 semi-structured interviews were performed at an academic medical centre in Southern California. Participants were recruited via purposive sampling and included: (1) TGNB patients (n=8) recruited from an interdisciplinary gender-affirming urological practice and (2) gender-affirming care clinicians (n=12) recruited from a regional interdisciplinary Gender Health conference, three of whom identified as TGNB. Interviews were conducted in person or virtually using an open-ended topic guide, audio recorded and transcribed verbatim. Inductive thematic analysis was performed by two independent study personnel who hand-coded the transcripts.

resultsFour overarching themes were identified: (1) misgendering originates from multiple sources, (2) misgendering discourages individual access to healthcare, creates community hesitation and its perceived impact is modified by setting and intentionality, (3) building a gender-affirming healthcare system requires integration of behaviour, policy and technology and (4) clinicians respond to accidental misgendering by acknowledging, apologising, advancing and acting.

conclusionOur data suggest that misgendering arises from both interpersonal communication and structural factors within healthcare systems, leading to perceived harm and diminished TGNB access to health services. Any potential solution to reduce this phenomenon will require a multifaceted approach integrating behavioural, technological and institutional policy strategies with system-level implementation efforts.

Indexed as

Attitude of Health PersonnelSexual and Gender MinoritiesTransgender PersonsAdultCaliforniaFemaleHumansInterviews as TopicMaleMiddle AgedQualitative Researchpatient-centred carepatient safetyqualitative researchquality improvementsafety culture

Identifiers

PMID40484628
PMCPMC13165897

What OpenQuestion holds

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Registered trials

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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.