Health IT, Patient Engagement

Twitter helps shed light on gender identity in healthcare

What do people who consider themselves something other than fully male or female call themselves? That's not so easy, as a presenter at AMIA demonstrated.

Since 2011, the Institute of Medicine has recommended that healthcare providers collect data on patient gender identity. It’s part of an overall push by the IOM to increase research into social influences on the health of LGBT populations.

But what do people who consider themselves something other than fully male or female call themselves? That’s not so easy.

Amanda Hicks, an ontology researcher and developer on the Health Outcomes & Policy faculty at the University of Florida College of Medicine, turned to Twitter — with a decidedly jaundiced eye.

As Hicks said at the American Medical Informatics Association’s annual symposium in San Francisco, said Twitter is the “Wild West” when it comes to sensitivity. Indeed, in mining Twitter as a first step toward addressing gender identification on patient intake forms, Hicks found a lot of slangy and potentially offensive terms.

“Some of the words in our word cloud are not culturally sensitive,” Hicks advised. “Do not create intake forms based on these terms.”

One thing is clear: Offering even a third gender choice can set some LGBT patients at ease, Hicks said.

From there, it gets a little muddled. A handful of organizations have tested forms with terms such as “genderqueer,” “genderfluid” “trans male” and “trans female,” with mixed results. “We want to minimize the amount of free text that people write in these forms because that’s unstructured data and data that can be lost,” Hicks said.

Hicks and her colleagues created an algorithm based on the Twitter search application programming interface to look for keywords, but building the list of terms that describe gender minorities also involved a lot of manual work. “Hot Pockets are full of trans fats,” Hicks joked. “This is not the type of ‘trans’ we are looking for here.”

Some words mean different things in different regions, too Hicks said, so they looked for co-occurrences. “Genderqueer” appears frequently with “trans” in Washington state but not very often in Florida, for example. She hypothesized that genderqueer is a broader term in the Northwest than in the Southeast, and that there are regional differences in identity.

“This is all exploratory work, and with exploratory work comes limitations,” Hicks said. For example, only 0.3 percent of tweets the researchers collected over two months were relevant to their study. It was impossible to draw conclusions in some areas; there were so few relevant tweets in Montana about gender identity that the data was rather meaningless, Hicks said.

Shares0
Shares0