Symes Emily, Derrick Naomi, Hicks Thomas, Ross-Browne Rhys, Degenhardt Louisa, Sutherland Rachel, Seimon Radhika, Dinh Michael
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Green Light Institute, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Emerg Med Australas. 2025 Apr;37(2):e70031. doi: 10.1111/1742-6723.70031.
Comprehensively describe patient and presentation characteristics of trans and gender diverse (TGD) people attending the ED.
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.
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.
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.
全面描述前往急诊科就诊的跨性别及性别多样化（TGD）人群的患者特征及就诊表现。
回顾性病例系列研究，评估了新南威尔士州悉尼市一家市中心三级急诊科在5年期间接待的各年龄段TGD人群。通过急诊科患者追踪系统、分诊文本及电子病历（eMR）中的临床记录来识别TGD人群。提取患者及就诊数据并进行描述性分析，包括临床特征、登记性别与姓名的不符情况以及出院小结中使用的非肯定性语言。
共识别出340例TGD患者，其急诊科就诊次数达1519次。TGD人群每年的急诊科就诊次数在5年期间增加了74.2%。76.7%的就诊被优先归类为澳大利亚分诊量表1 - 3级。25.5%的患者需要住院治疗，8.7%的患者在治疗完成前离开。自杀意念是最常见的就诊问题（13.8%），心理健康是最常见的急诊科诊断类别（29.4%）。电子病历中登记的性别和姓名分别有47.1%和56.8%与患者当前身份正确匹配。22.6%收到急诊科出院小结的患者存在性别错称和/或使用曾用名的情况。
本研究识别出的大多数TGD人群在急诊科就诊时病情严重，常伴有急性心理健康问题，四分之一的患者随后住院治疗。患者信息不匹配以及出院小结中的性别错称和/或使用曾用名的情况很常见。这些发现凸显了在急诊科改善对TGD人群护理的明显机会。
