Socioeconomic status in Danish transgender persons: a nationwide register-based cohort study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Gender dysphoria could be associated with low socioeconomic status (SES). SES could be modified by age, ethnic background, and medical morbidity.

Aim

To determine SES in a national study population including transgender persons in Denmark.

Methods

National register-based cohort study in Danish transgender persons and age-matched controls. The transgender study cohort included persons with ICD-10 diagnosis code of 'gender identity disorder' and/or persons with legal sex change and persons who fulfiled the inclusion criteria during 2000–2018. The main outcome measure was SES including personal income, occupational status, and education.

Results

The cohort included 2770 transgender persons and 27,700 controls. In the transgender study cohort, 1437 were assigned male at birth (AMAB), median age (interquartile range, IQR) 26.0 (17.3) years, and 1333 were assigned female at birth (AFAB), median age 22.5 (10.3) years. Adjusting for age and sex, the relative risk ratio (RRR) of low vs high personal income was 5.6 (95% CI: 4.9; 6.3) in transgender persons compared to controls. The RRR of low vs high income was 6.9 (5.8; 8.3) in persons AMAB compared to control males and 4.7 (3.9; 5.6) in persons AFAB compared to control females. The RRR of low vs high income was 3.7 (3.2; 4.3) in transgender persons of Danish origin compared to controls. The Charlson comorbidity index was comparable in transgender persons vs controls.

Conclusions

Being transgender was negatively associated with SES. In transgender persons, the risk of low vs high income could be more pronounced in transgender persons of foreign origin.

Related collections

Most cited references 29

Record: found
Abstract: found
Article: not found

Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.

Hude Quan, Vijaya Sundararajan, Patricia Halfon … (2005)

Implementation of the International Statistical Classification of Disease and Related Health Problems, 10th Revision (ICD-10) coding system presents challenges for using administrative data. Recognizing this, we conducted a multistep process to develop ICD-10 coding algorithms to define Charlson and Elixhauser comorbidities in administrative data and assess the performance of the resulting algorithms. ICD-10 coding algorithms were developed by "translation" of the ICD-9-CM codes constituting Deyo's (for Charlson comorbidities) and Elixhauser's coding algorithms and by physicians' assessment of the face-validity of selected ICD-10 codes. The process of carefully developing ICD-10 algorithms also produced modified and enhanced ICD-9-CM coding algorithms for the Charlson and Elixhauser comorbidities. We then used data on in-patients aged 18 years and older in ICD-9-CM and ICD-10 administrative hospital discharge data from a Canadian health region to assess the comorbidity frequencies and mortality prediction achieved by the original ICD-9-CM algorithms, the enhanced ICD-9-CM algorithms, and the new ICD-10 coding algorithms. Among 56,585 patients in the ICD-9-CM data and 58,805 patients in the ICD-10 data, frequencies of the 17 Charlson comorbidities and the 30 Elixhauser comorbidities remained generally similar across algorithms. The new ICD-10 and enhanced ICD-9-CM coding algorithms either matched or outperformed the original Deyo and Elixhauser ICD-9-CM coding algorithms in predicting in-hospital mortality. The C-statistic was 0.842 for Deyo's ICD-9-CM coding algorithm, 0.860 for the ICD-10 coding algorithm, and 0.859 for the enhanced ICD-9-CM coding algorithm, 0.868 for the original Elixhauser ICD-9-CM coding algorithm, 0.870 for the ICD-10 coding algorithm and 0.878 for the enhanced ICD-9-CM coding algorithm. These newly developed ICD-10 and ICD-9-CM comorbidity coding algorithms produce similar estimates of comorbidity prevalence in administrative data, and may outperform existing ICD-9-CM coding algorithms.

0 comments Cited 2265 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: found

Is Open Access

The Danish National Patient Registry: a review of content, data quality, and research potential

Morten Schmidt, Sigrun Alba Johannesdottir Schmidt, Jakob Sandegaard … (2015)

Background The Danish National Patient Registry (DNPR) is one of the world’s oldest nationwide hospital registries and is used extensively for research. Many studies have validated algorithms for identifying health events in the DNPR, but the reports are fragmented and no overview exists. Objectives To review the content, data quality, and research potential of the DNPR. Methods We examined the setting, history, aims, content, and classification systems of the DNPR. We searched PubMed and the Danish Medical Journal to create a bibliography of validation studies. We included also studies that were referenced in retrieved papers or known to us beforehand. Methodological considerations related to DNPR data were reviewed. Results During 1977–2012, the DNPR registered 8,085,603 persons, accounting for 7,268,857 inpatient, 5,953,405 outpatient, and 5,097,300 emergency department contacts. The DNPR provides nationwide longitudinal registration of detailed administrative and clinical data. It has recorded information on all patients discharged from Danish nonpsychiatric hospitals since 1977 and on psychiatric inpatients and emergency department and outpatient specialty clinic contacts since 1995. For each patient contact, one primary and optional secondary diagnoses are recorded according to the International Classification of Diseases. The DNPR provides a data source to identify diseases, examinations, certain in-hospital medical treatments, and surgical procedures. Long-term temporal trends in hospitalization and treatment rates can be studied. The positive predictive values of diseases and treatments vary widely (<15%–100%). The DNPR data are linkable at the patient level with data from other Danish administrative registries, clinical registries, randomized controlled trials, population surveys, and epidemiologic field studies – enabling researchers to reconstruct individual life and health trajectories for an entire population. Conclusion The DNPR is a valuable tool for epidemiological research. However, both its strengths and limitations must be considered when interpreting research results, and continuous validation of its clinical data is essential.

0 comments Cited 1475 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

The Danish Civil Registration System as a tool in epidemiology.

Morten Schmidt, Lars Østergaard Pedersen, Henrik Toft Sørensen (2014)

The methodological advances in epidemiology have facilitated the use of the Danish Civil Registration System (CRS) in ways not previously described systematically. We reviewed the CRS and its use as a research tool in epidemiology. We obtained information from the Danish Law on Civil Registration and the Central Office of Civil Registration, and used existing literature to provide illustrative examples of its use. The CRS is an administrative register established on April 2, 1968. It contains individual-level information on all persons residing in Denmark (and Greenland as of May 1, 1972). By January 2014, the CRS had cumulatively registered 9.5 million individuals and more than 400 million person-years of follow-up. A unique ten-digit Civil Personal Register number assigned to all persons in the CRS allows for technically easy, cost-effective, and unambiguous individual-level record linkage of Danish registers. Daily updated information on migration and vital status allows for nationwide cohort studies with virtually complete long-term follow-up on emigration and death. The CRS facilitates sampling of general population comparison cohorts, controls in case-control studies, family cohorts, and target groups in population surveys. The data in the CRS are virtually complete, have high accuracy, and can be retrieved for research purposes while protecting the anonymity of Danish residents. In conclusion, the CRS is a key tool for epidemiological research in Denmark.

0 comments Cited 963 times – based on 0 reviews      Review now

All references

Author and article information

Journal

Journal ID (nlm-ta): Endocr Connect

Journal ID (iso-abbrev): Endocr Connect

Journal ID (hwp): EC

Title: Endocrine Connections

Publisher: Bioscientifica Ltd (Bristol )

ISSN (Electronic): 2049-3614

Publication date (Electronic): 17 August 2021

Publication date Collection: 01 September 2021

Volume: 10

Issue: 9

Pages: 1155-1166

Affiliations

[1 ]Department of Endocrinology , Odense University Hospital, Odense, Denmark

[2 ]Institute of Clinical Research , University of Southern Denmark, Odense, Denmark

[3 ]Open Patient Data Explorative Network , Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark

[4 ]Department of Gynecology , Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

[5 ]Department of Clinical Medicine , University of Copenhagen, Copenhagen, Denmark

[6 ]Department of Endocrinology and Center for Sexology and Gender , Ghent University Hospital, Gent, Belgium

[7 ]Centre for Gender Identity , Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

Author notes

Correspondence should be addressed to D Glintborg: dorte.glintborg@ 123456rsyd.dk

^*(D Glintborg and K H Rubin contributed equally to this work as first authors)

Author information

Dorte Glintborg http://orcid.org/0000-0002-8338-8025

Malene Hilden http://orcid.org/0000-0002-2946-4912

Article

Publisher ID: EC-21-0119

DOI: 10.1530/EC-21-0119

PMC ID: 8494405

PubMed ID: 34414901

SO-VID: f7c4eda6-ed8a-4b26-90de-48a8ed841c43

License:

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

The flagship journal of the Society for Endocrinology. Learn more

Socioeconomic status in Danish transgender persons: a nationwide register-based cohort study

Read this article at

Abstract

Background

Aim

Methods

Results

Conclusions

Related collections

Bioscientifica Open Endocrinology

Most cited references 29

Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.

The Danish National Patient Registry: a review of content, data quality, and research potential

The Danish Civil Registration System as a tool in epidemiology.

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Categories

Comments

Comment on this article

Similar content 439

Cited by 7

Most referenced authors 362