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Table 1

Descriptions of typical codes used for trans cohort inclusion and exclusion

CohortDescriptionExample Inclusion CodesExample Exclusion
Trans-specific diagnoses 302.X (trans-sexualism),
F64.X (gender identity disorders) 
None 
Ba Conclusive trans procedure code 64.5 (operations for sex transformation),
0W4N071 (creation of penis in female perineum) 
None 
Endocrine disorder not otherwise specified,
Endo NOS (259.9, E34.9) plus procedure code 
64.43 (construction of penis),
55175 (scrotoplasty) 
Cancer exclusions:
183.X (malignant neoplasm of ovary),
186.X (malignant neoplasm of testis)
Endo NOS exclusions:
243 (congenital hypothyroidism),
245 (thyroiditis) 
Endocrine disorder not otherwise specified, Endo NOS (259.9, E34.9) plus discordant hormone prescription Hormone discordant with sex at enrollment
(e.g., testosterone and female sex at enrollment) 
Estrogen exclusions:
398.91 (congestive heart failure),
428 (heart failure)
Testosterone exclusions:
302.71 (hypoactive sexual desire disorder),
799.81 (decreased libido)
Endo NOS exclusion:
See Cohort C for Endo NOS exclusions 
Discordant hormone prescription plus
discordant procedure code 
See Cohort D for hormone requirement
70.61 (vaginal construction),
54125 (amputation of penis),
0UTG0ZZ (resection of vagina) 
See Cohort D for hormone exclusions
Concordant sex with procedure code (F at enrollment with resection of vagina) 
CohortDescriptionExample Inclusion CodesExample Exclusion
Trans-specific diagnoses 302.X (trans-sexualism),
F64.X (gender identity disorders) 
None 
Ba Conclusive trans procedure code 64.5 (operations for sex transformation),
0W4N071 (creation of penis in female perineum) 
None 
Endocrine disorder not otherwise specified,
Endo NOS (259.9, E34.9) plus procedure code 
64.43 (construction of penis),
55175 (scrotoplasty) 
Cancer exclusions:
183.X (malignant neoplasm of ovary),
186.X (malignant neoplasm of testis)
Endo NOS exclusions:
243 (congenital hypothyroidism),
245 (thyroiditis) 
Endocrine disorder not otherwise specified, Endo NOS (259.9, E34.9) plus discordant hormone prescription Hormone discordant with sex at enrollment
(e.g., testosterone and female sex at enrollment) 
Estrogen exclusions:
398.91 (congestive heart failure),
428 (heart failure)
Testosterone exclusions:
302.71 (hypoactive sexual desire disorder),
799.81 (decreased libido)
Endo NOS exclusion:
See Cohort C for Endo NOS exclusions 
Discordant hormone prescription plus
discordant procedure code 
See Cohort D for hormone requirement
70.61 (vaginal construction),
54125 (amputation of penis),
0UTG0ZZ (resection of vagina) 
See Cohort D for hormone exclusions
Concordant sex with procedure code (F at enrollment with resection of vagina) 

aThe authors adapted the algorithm developed by Jasuja et al. (2020) by adding Cohort B: Trans-specific procedures.

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