Transgender woman early in transition including need for distinct SFCU

A transgender (hence after, trans) woman is in the first six months of estradiol therapy. Current guidelines record a "male" range for eGFR at less than 3 months of estradiol therapy, and a "female" range for eGFR after 3 months of estradiol therapy. However, due to structural barriers, the individual has not been able to update their legal gender marker, which still reads as "M" in the EHR.

2022-01-14 American Clinical Laboratory Association (ACLA) suggests revising text to spell out the laboratory test name and remove reference to "legal gender marker" which is not clearly defined.

A transgender (hence after, trans) woman is in the first six months of estradiol therapy. Current guidelines record a "male" range for Glomerular Filtration Rate, Estimated (eGFR) at less than 3 months of estradiol therapy, and a "female" range for eGFR after 3 months of estradiol therapy. However, due to EHR system limitations, the patient record still reads as "M" in the EHR.

Provider

Trans Woman Patient

Laboratory Personnel

2022-01-14 American Clinical Laboratory Association (ACLA) suggests changing 'Lab' to 'Laboratory'

Before Gender Harmony:

1. The legal sex cannot be changed, being linked to Administrative Sex, and there is nowhere else in the record where the information can be indicated, so the Provider will have to communicate directly with Lab Personnel to assure correct ranges are used.

2022-01-14 American Clinical Laboratory Association (ACLA) suggests changing the text to indicate the provider and laboratory will have a Trading Partner Agreement (TPA) which may include policies for reporting that don't necessitate the provider and laboratory to "communicate directly" for every individual test ordered.

1. The legal sex cannot be changed, being linked to Administrative Sex, and there is nowhere else in the record where the information can be indicated.  Therefore, the Provider and the Laboratory must have a Trading Partner Agreement (TPA). Trading Partner Agreements originated under the Health Insurance Portability and Accountability Act (HIPAA) as defined in §160.103.  

After Gender Harmony:

1. The Provider will simply select the Sex For Clinical Use that is clinically indicated when submitting to the lab.