Descriptions of typical codes used for trans cohort inclusion and exclusion
| Cohort . | Description . | Example Inclusion Codes . | Example Exclusion . |
|---|---|---|---|
| A | 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 |
| C | 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) |
| D | 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 |
| E | 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) |
| Cohort . | Description . | Example Inclusion Codes . | Example Exclusion . |
|---|---|---|---|
| A | 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 |
| C | 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) |
| D | 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 |
| E | 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.