Current systems do not allow for accurate recording of patients’ names and pronouns and are rife with antiquated terminology, leading to discriminatory care.
Inflexible, binary categorisations for sex and gender and “outdated terminology” in radiology information systems (RISs) do not accommodate accurate data capturing for transgender and gender diverse patients and affects quality of care, according to a new data review.
Authors from Curtin University found “inadequate” recording of sex and gender data across these systems was a significant factor in the “non-inclusive and discriminatory” care experienced by transgender and gender diverse patients.
Frequently reported issues included conflating sex and gender as a single concept, systems that treated sex and gender as binary concepts, and inaccurately recording a patient’s name and pronouns.
The reviewers were particularly alarmed by the use of “male”, “female”, or “other” as categories for recording sex and gender across RISs, which they argued “minimises and diminishes the gender of all patients who do not align with ‘male’ or ‘female’”.
Published in the Journal of Medical Radiation Sciences the review synthesised findings from 18 studies across 25 radiology information systems presently in use.
“Not all RISs appropriately capture gender, sex, or other related information of transgender and gender diverse (TGD) patients, resulting in non-inclusive and discriminatory care,” the authors concluded.
“For current systems to facilitate inclusivity, they must implement more comprehensive information and data models incorporating sex and gender and be more flexible to accommodate the transient and fluid nature of gender.
“While a system with a flexible, comprehensive model incorporating a wealth of information is ideal, the logistics of implementing such a system, given that most systems would need to be upgraded to fulfil this need, is challenging.”
According to Carolyn Heyes, president of the Australian Society of Medical Imaging and Radiation Therapy, while there was “no single point of responsibility” for implementing the recommended changes to make RISs more inclusive, any effort to do so needed to involve greater consultation with transgender and gender diverse people to avoid repeating the same mistakes.
“We are definitely concerned that non-gender-affirming systems within healthcare are barriers to transgender and gender diverse people seeking the help that they need,” Ms Heyes said.
“It is clear that health information systems as a whole need to move away from conflating sex and gender and treating sex and gender as a binary concept.
“Flexibility needs to be built into health information systems that carries through the patients’ journey in the healthcare system to ensure there is respect, consistency and optimal care.
“Crucially transgender and gender-diverse people need to be consulted as part of this change, and for us seeing a lack of engagement with these communities is a major failing.
“The study calls for consultation with transgender and gender-diverse people, but frequently cisgender people who are developing improvements to systems aren’t seeing the negative impacts of current system parameters and therefore vital changes for transgender and gender-diverse people are not prioritised.”