Three months after the National Provider Identifier system rolled out two additional gender options — undisclosed and unspecified/another gender identity — 0.7% of clinicians did not select the female or male options.
Clinicians who electronically transfer health information or prescribe are required to gain an identifier in the NPI system. In April, the system added the gender options to "accurately reflect [clinicians'] gender identity, enhance data inclusivity, prevent misgendering, align with legal documents, and improve research and directory accuracy," according to Jae Corman, PhD, and Julia Przedworski, PhD.
Dr. Corman works at the Oregon Health & Science University-Portland State University college of public health, and Dr. Przedworski works at the Institute for Equity and Inclusion Sciences in Portland, Ore.
The two researchers studied the prevalence and characteristics of clinicians who registered for an NPI between April 3 and July 6 and who chose undisclosed (U) or unspecified/another (X) as their gender identity.
Here are three findings, which were published Oct. 21 in JAMA:
1. Among the 126,773 clinicians who registered for an NPI during these three months, 941 selected U (365) or X (576). The percentage, 0.7%, closely matches the national average of nonbinary U.S. adults (1%).
2. The clinicians were divided into groups, including physicians, advanced practice nurses, students, nurses and dentists. Among behavioral health and social service clinicians, 1.2% chose U or X; compared to 0.2% of physicians, physician assistants and advanced practice nurses.
About 0.4% of unlicensed medical students, interns, residents, nurses, pharmacists, physical therapists and dentists chose U or X.
3. The study assigned a negative or positive gender policy environment to each state, which is a sum of all LGBTQ+ policies in a state. Clinicians who identify as U or X were significantly less prevalent in the 21 states with negative gender policy environments (0.4%) compared to other states (0.9%).