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Reference Ranges for All: Implementing Reference Ranges for Transgender and Nonbinary Patients.

Anthony B Cardillo1,2, Dan Chen2, Nina Haghi2

  • 1MCIT Department of Health Informatics, NYU Langone Health, New York, United States.

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|December 18, 2024
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Summary
This summary is machine-generated.

Developing specific laboratory reference ranges for transgender and nonbinary (TGNB) patients is crucial for accurate health assessments. Implementing these ranges improves patient safety and equitable healthcare by preventing misinterpretation of lab results.

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Area of Science:

  • Medical Informatics
  • Clinical Pathology
  • Health Equity

Background:

  • Current laboratory systems often lack specific reference ranges for transgender and nonbinary (TGNB) individuals.
  • This absence can lead to misinterpretation of diagnostic test results for TGNB patients.
  • Ensuring accurate lab interpretation is vital for providing equitable healthcare.

Purpose of the Study:

  • To underscore the need for tailored reference ranges for TGNB populations.
  • To address the challenges posed by undefined laboratory reference ranges for gender diverse patients.
  • To promote the development and implementation of inclusive laboratory practices.

Main Methods:

  • A case report detailing a situation where a TGNB patient's abnormal lab values were missed due to lack of "X" gender reference ranges.
  • Implementation of sex-invariant reporting as an interim measure.
  • Mapping additional reference ranges to the "X" sex label within the Laboratory Information System (LIS).

Main Results:

  • The implementation of "X" sex label reference ranges significantly improved the flagging of abnormal laboratory results.
  • Sex-invariant reporting served as an effective interim solution.
  • Monitoring for emerging TGNB-specific reference ranges is ongoing.

Conclusions:

  • Informatics professionals must review and update institutional policies for TGNB patient registration and lab reporting.
  • Failure to implement appropriate reference ranges presents significant patient safety risks.
  • Adopting emerging TGNB-specific reference ranges and utilizing sex-invariant reporting are recommended best practices.