Emergency department presentations by trans and gender diverse people in Sydney, Australia: Retrospective case series

IF 1.7 4区医学 Q2 EMERGENCY MEDICINE Emergency Medicine Australasia Pub Date : 2025-03-19 DOI:10.1111/1742-6723.70031

Emily Symes MBBS, FACEM, Naomi Derrick BN, Thomas Hicks BN, MNurs, Rhys Ross-Browne MBBS, FACEM, Louisa Degenhardt PhD, Rachel Sutherland PhD, Radhika Seimon PhD, Michael Dinh MBBS, MPH, PhD, FACEM

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Abstract

Objective

Comprehensively describe patient and presentation characteristics of trans and gender diverse (TGD) people attending the ED.

Methods

Retrospective case series that evaluated TGD people of all ages presenting to a tertiary, inner-city ED in Sydney, New South Wales, over a 5-year period. TGD people were identified using the ED patient tracking system, triage text and clinical notes in the electronic medical records (eMR). Patient and presentation data were extracted and descriptively analysed, including clinical characteristics, mismatches in registered gender and name, and use of non-affirming language in discharge letters.

Results

A total of 340 TGD patients with 1519 ED presentations were identified. The number of ED presentations per year by TGD people increased by 74.2% over 5 years. Presentations were prioritised Australasian Triage Scale category 1–3 in 76.7%. Hospital admission was required in 25.5%, and 8.7% left prior to treatment completion. Suicidal ideation was the most common presenting problem (13.8%) and mental health was the most common ED diagnostic category (29.4%). The gender and name registered in the eMR correctly matched the patient's current identity in 47.1% and 56.8%, respectively. Misgendering and/or deadnaming occurred in 22.6% of those receiving an ED discharge letter.

Conclusion

Most TGD people identified by the present study had high acuity ED presentations, often presenting with acute mental health problems, and one-quarter were subsequently admitted to hospital. Mismatched patient details and misgendering and/or deadnaming on discharge letters were common. These findings highlight clear opportunities to improve the care of TGD people in the ED.

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目的全面描述在急诊室就诊的变性和性别多元化 (TGD) 患者的特征。方法对新南威尔士州悉尼市一家三级内城急诊室 5 年来就诊的各年龄段变性人进行回顾性病例系列评估。通过急诊室病人追踪系统、分诊文字和电子病历 (eMR) 中的临床记录识别出 TGD 患者。提取并描述性分析了患者和病例数据，包括临床特征、登记的性别和姓名不匹配以及出院信中使用的非确认性语言。结果共发现 340 名 TGD 患者，1519 次急诊就诊。5 年间，TGD 患者每年在急诊室就诊的次数增加了 74.2%。76.7%的患者被列为澳大利亚分诊量表 1-3 类。25.5%的患者需要入院治疗，8.7%的患者在治疗结束前离开。自杀意念是最常见的就诊问题（13.8%），精神健康是最常见的急诊室诊断类别（29.4%）。电子病历中登记的性别和姓名与患者当前身份相符的比例分别为 47.1% 和 56.8%。在收到急诊室出院信的患者中，有 22.6% 的人出现了性别和/或姓名错误。结论本研究中发现的大多数 TGD 患者在急诊室就诊时病情较重，通常伴有急性精神健康问题，其中四分之一的患者随后入院治疗。患者详细信息不匹配、出院通知书上性别错误和/或死名现象十分普遍。这些发现凸显了改善急诊室对 TGD 患者护理的明显机会。

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来源期刊

Emergency Medicine Australasia 医学-急救医学

CiteScore

3.70

自引率

13.00%

发文量

217

审稿时长

6-12 weeks

期刊介绍： Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine. Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.