134 - Prevalence of Deadnaming and Misgendering in the Electronic Medical Record of Transgender Patients Receiving Care at A North Carolina Inpatient Rehabilitation Hospital

Objectives: The objective of this study is to evaluate and quantify the use of deadnaming and misgendering of transgender patients by healthcare providers in the medical record.



Design: A retrospective chart review of patients that identified as transgender in their medical records was conducted for patients who underwent inpatient rehabilitation between the years of July 2018 and July 2023. The primary outcome was to identify the percentage of transgender patients whose dead names or discordant pronouns were utilized in the medical record. The secondary outcome was to examine the variation in the rate of deadnaming and misgendering during the inpatient rehabilitation stay based on the role of the provider in the patient's care.

Results:
Between July 2018 and July 2023, five patients who identified as transgender were admitted to inpatient rehabilitation. One hundred percent of these patients were both misgendered and deadnamed in their admission history and physical, physician progress notes, and discharge summary. Among therapy documentation, physical therapists deadnamed and misgendered the patients in ninety-four percent of documentation, occupational therapists in eighty-three percent of documentation, and speech-language pathologists in sixty-seven percent of documentation. Neuropsychologists deadnamed and misgendered the patients in thirty-three percent of documentation.

Conclusions:
As transgender patients now have access to their medical records it is more important than ever to use correct identifying names and pronouns in our documentation. Deadnaming is harmful to the care of patients as well as the hospital system itself and is pervasive throughout both physician and therapy documentation. Future interventions should focus on provider education and electronic medical system integration to ensure correct pronouns and identified names are included in all documentation. Further, investigation into barriers preventing transgender patients from being admitted to inpatient rehabilitation should be completed.