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Stories & Snapshots

Why We Do What We Do: Inclusive Care for Transgender Patients

Software developer Randi Hagen describes how her experience in the healthcare system informs her work at Epic

When Randi received a letter from her doctor addressed to “Mr. Randi Hagen,” she called her healthcare provider and asked to have the error corrected. The provider explained that for insurance to cover her care, her record needed to show her sex assigned at birth, which is male.

Randi, a transgender woman and a software developer at Epic, knew that her experience wasn’t unique. Providers documenting sex in a patient’s record were limited to one field with binary options, which led to trans people being misgendered. Lack of accurate information related to patients’ sex and gender identity can even result in adverse health outcomes.

Randi knew that in her role at Epic, she could help change the status quo.

“My best experiences in healthcare have been those where my gender fades into the background,” Randi said. “My status as a trans woman is just one aspect of my care.”

Randi worked with a team at Epic to develop fields to discretely document sex assigned at birth, legal sex (including non-binary), gender identity, pronouns, and preferred names. Epic uses this data to present context-appropriate information to clinicians and staff.

When Randi recently underwent gender confirmation surgery at UW Health, her doctors and nurses all referred to her using female pronouns, and no one asked inapplicable questions about whether she was pregnant.

“Nobody misgendered me or made me feel outcast or othered,” Randi said. “The nurses demonstrated that they cared about me and wanted to learn how to better care for trans people in the future.”

Epic community members can learn more about Epic’s tools for documenting sex, gender, and sexual orientation on the UserWeb.

Photo: Randi smiles for the camera as she prepares for gender confirmation surgery at UW Health.

“Why We Do What We Do” is a series of stories from Epic staff about how their work relates to their personal missions to help our community members serve their patients and transform healthcare delivery.