Background: Individuals with gender-expansive identities and diverse sexual orientations are more likely to experience health disparities and psychosocial stressors when compared to their non-LGBTQ+ peers. It is uncertain if these identities are included in diabetes care discussions. We sought to understand LGBTQ+ supportive and inclusive care practices across the T1DX-QI.

Methods: Thirty-three pediatric (66%) and 17 adult (34%) T1DX-QI centers that serve patients from less than one year old to 99 years old completed a survey about their LGBTQ+ supportive and inclusive care practices in mid-2022. Significance testing was conducted using Fisher’s exact test.

Results: Most pediatric (88%) and adult (76%) centers reported gender-affirming care was legal in their state. Almost 90% of pediatric and adult centers document patients’ self-identified gender identity, but more pediatric (82%) than adult (65%) document pronouns used by patients with diabetes. A majority of pediatric and adult centers (97% and 82%, respectively) document sex assigned at birth (SAAB), but less than half of the institutions (39% pediatric and 24% adult) change SAAB in their electronic health record. Only 44% of pediatric and 47% of adult centers document sexual orientation, but 64% of pediatric and 53% of adult centers have implemented strategies to support asking about gender identity and sexual orientation within their clinics. The results for documented patient self-identified gender identity, and documented pronouns were both significant, with p-values less than 0.05.

Conclusion: Most T1DX-QI centers document gender identity and pronouns. Fewer centers document sexual orientation. Although these are promising first steps, more is needed to support and empower the LGBTQ+ community with diabetes. Additionally, further research is needed to understand how implementing supportive and inclusive care practices impacts outcomes for LGBTQ+ patients with diabetes.

Disclosure

J.Raymond: None. D.M.Maahs: Advisory Panel; Medtronic, LifeScan Diabetes Institute, MannKind Corporation, Consultant; Abbott, Research Support; Dexcom, Inc. R.Mcdonough: None. S.Majidi: None. T1dx-qi collaborative: n/a. A.Mungmode: None. J.Cases-villablanca: None. J.J.Flores garcia: None. A.Butler: None. C.Demeterco-berggren: Speaker's Bureau; Glooko, Inc. N.Rioles: None. M.Ochoa-maya: None. M.Manukyan: None.

Funding

The Leona M. and Harry B. Helmsley Charitable Trust

© 2023 by the American Diabetes Association
2023
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