Healthcare professionals’ perspectives on sex and gender documentation in electronic health records
An exploratory qualitative study of Sweden and China
Bibliographic Data
| ID | 15294527 |
|---|---|
| Authors | Jiahe Chen (0000-0003-3466-3016, Karolinska Institutet), Stefano Bonacina (0000-0002-5717-0647, Karolinska Institutet), Nadia Davoody (0000-0003-1813-8529, Karolinska Institutet, corresponding author) |
| Year | 2025 |
| Volume | 35 |
| Issue | 1 |
| Publication date | 2025-07-20 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Critical Public Health (JOURNAL) |
| Journal identifiers | ISSN: 0958-1596 • E-ISSN: 1469-3682 |
| Publisher | Taylor & Francis (PUBLISHER • GB) |
| DOI | 10.1080/09581596.2025.2535077 |
| OpenAlex | W4412508225 |
| Language | EN |
| References cited | 42 |
Sex and gender, though often conflated in clinical settings, are distinct concepts that are essential for equitable healthcare. Despite the growing recognition of diverse gender identities, many healthcare information systems still adhere to a binary perspective. The lack of inclusive sex and gender documentation in electronic health records exacerbates healthcare inequities for transgender and gender nonconforming individuals. This study investigated how healthcare professionals in Sweden and China currently document gender and sex in electronic health records, aiming to identify issues that could improve healthcare inclusiveness and equity. Fifteen interviews were conducted with healthcare professionals from Sweden and China, and a thematic analysis was applied to identify key themes. Six key themes were identified. Most participants observed that healthcare professionals prioritize patients’ sex over gender in patient communication due to limited gender-focused medical education, binary-based clinical procedures, and inadequate electronic health record fields for documenting sex and gender. They also noted that biased sociocultural and political context influence documentation practices, and may raise concerns about the privacy of patients’ gender information. This study identifies key challenges in sex/gender documentation within electronic health record systems, including binary-focused practices, electronic health record design limitations, educational training gaps, and sociocultural barriers. Despite recognizing its importance, healthcare providers face implementation challenges due to operational constraints and a lack of standardization. The findings highlight the need for electronic health record redesign, improved training, and policy reforms to ensure equitable, gender-affirming care while protecting patient privacy. Further research should explore implementation strategies across diverse healthcare settings
China · Documentation · Exploratory research · Health care · Health professionals · Political science · Public relations · Qualitative research · Social science · Sociology · Gender Studies · LGBTQ Health, Identity, and Policy · Medicine · Nursing · Psychology · Sex and Gender in Healthcare · Sex work and related issues
Standards of Care for the Health of Transgender and Gender Diverse People, Version 8
Transgender people
International Ethical Guidelines for Health-related Research involving Humans
Systematic methodological review
Saturation in qualitative research
Qualitative Metasynthesis
Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records
Narratives of gender, sexuality, and community in three generations of genderqueer sexual minorities
Looking at Population Health Beyond “Male” and “Female”
Using thematic analysis in psychology
A point of reference
| Citation velocity | historical |
|---|---|
| Highly cited | No |