Grant: Travel Awards - Institute Community Support

Transgender individuals (gender identity does not align with sex at birth) are an understudied population who face significant health challenges. Current understanding of their health and healthcare use is limited by cross-sectional and cohort studies. Routinely collected healthcare data (generated at every encounter with the healthcare system) provides a promising way to improve long-term surveillance and explore disease burden and progression in this population. However, where 'sex codes' are used to explore sex-stratified disease burden in the cisgender population (gender identity aligns with sex at birth), there is currently no way to properly identify transgender individuals in such databases. Therefore, we developed a series of different definitions, made up of variables specific s (e.g., hormone therapy regimes) and not-specific (e.g., physician billing codes used during patient visits) to transgender individuals. Nine algorithms were created for transgender women and five were created for transgender men stemming from combinations of transgender- and non-transgender-specific codes. The linkage of data across all datasets is complete. The next step is determining how accurately they were able to identify known transgender individuals. Quantifying definition performance of transgender individuals is currently underway and projected to be completed by November 2023. In summary, this study is the first of its kind to create and validate definitions for identifying transgender individuals in routinely collected Alberta healthcare data, and will be of use to clinicians, researchers and key stakeholders to address barriers, healthcare needs, and socioeconomic factors of this community.