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Raymond, J, Mungmode, A, Cases, J, Flores Garcia, J, Butler, A, Demeterco-Berggren, C, Rioles, N, Ochoa-Maya, M, Manukyan, M, Maahs, D, McDonough, R, Majidi, S.

Background: Individuals with gender-expansive identities and diverse sexual orientations are more likely to experience health disparities and psychosocial stressors when compared to their non-LGBTQ+ peers. It is uncertain if these identities are included in diabetes care discussions. We sought to understand LGBTQ+ supportive and inclusive care practices across the T1DX-QI.

Methods: Thirty-three pediatric (66%) and 17 adult (34%) T1DX-QI centers that serve patients from less than one year old to 99 years old completed a survey about their LGBTQ+ supportive and inclusive care practices in mid-2022. Significance testing was conducted using Fisher’s exact test.

Results: Most pediatric (88%) and adult (76%) centers reported gender-affirming care was legal in their state. Almost 90% of pediatric and adult centers document patients’ self-identified gender identity, but more pediatric (82%) than adult (65%) document pronouns used by patients with diabetes. A majority of pediatric and adult centers (97% and 82%, respectively) document sex assigned at birth (SAAB), but less than half of the institutions (39% pediatric and 24% adult) change SAAB in their electronic health record. Only 44% of pediatric and 47% of adult centers document sexual orientation, but 64% of pediatric and 53% of adult centers have implemented strategies to support asking about gender identity and sexual orientation within their clinics. The results for documented patient self-identified gender identity, and documented pronouns were both significant, with p-values less than 0.05.

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LGBTQ+ Supportive and Inclusive Care Practices in the T1D Exchange Quality Improvement Collaborative (T1DX-QI)