Beyond Two-Step Methodology: The Atomic Approach to Transgender Data Collection in Biobanks

Current approaches to transgender data collection in U.S. biobanks center self-identification questions, typically one-step or two-step items that classify participants as transgender or cisgender based on gender identity and sex assigned at birth, give comparatively little attention to the systematic capture of granular biological and treatment-related information. As a result, crucial details such as hormone regimens, surgical history, organ inventories, and other component-level variables are often treated as secondary or optional, referenced briefly if at all rather than embedded as core elements of study design and data infrastructure for transgender data. This paper argues that such an imbalance limits both scientific validity and ethical adequacy; without consistently collected granular data, which I term Atomic Approach, researchers cannot distinguish between biological and structural pathways of risk, design targeted interventions, or avoid epistemic harms that arise when broad identity categories are used as imprecise proxies for complex constellations of traits and experiences.