Abstract
PURPOSE: Electronic health records (EHR) offer a unique opportunity to systematically collect sexual orientation and gender identity (SOGI) data. This study examined the prevalence and determinants of SOGI reporting in an EHR-based cohort of transgender and gender diverse (TGD) individuals. METHODS: We identified TGD people with and without SOGI documentation across four Kaiser Permanente health plans from January 1, 2022-2024. TGD status was determined through clinical notes, diagnostic codes, and SOGI data based on a previously established cohort. Factors associated with SOGI reporting were assessed using log-binomial regression, yielding prevalence ratios (PR) and the 95 % confidence intervals (CI). RESULTS: Among 23,060 TGD individuals, 71 % had SOGI documentation in the EHR. Reporting varied by sociodemographic and clinical characteristics. For example, compared to those < 20 years, SOGI reporting was higher for those aged 21-59 (PRs 1.10-1.21; 95 % CIs 1.06-1.24) and lower for those > 60 (0.93; 0.88-0.99). Documentation was slightly lower for those assigned male at birth (0.98; 0.97-1.00) and varied by race and ethnicity (e.g., Hispanic: 0.97; 0.95-0.99; Other: 1.02; 0.98-1.05 vs. White). CONCLUSIONS: KP's EHRs captured SOGI data for over 70 % of TGD individuals, though more research is needed to understand factors associated with missing data not captured in structured fields.