Journal article
ADLM Guidance Document on Incorporating Gender Diversity in Pathology and Laboratory Medicine
The journal of applied laboratory medicine, Vol.11(4), pp.887-926
07/01/2026
DOI: 10.1093/jalm/jfag071
PMID: 42383916
Abstract
The first international clinical standards of care for the gender-diverse population were formulated in the late 1970s. In the last 15 years, multiple subspecialty societies within the United States have developed clinical care guidelines for those with gender dysphoria, including gender-affirming hormone therapy (GAHT) and surgical treatments. To date, there are no pathology- and laboratory medicine-specific recommendations in the United States for the gender-diverse population.
This document outlines pathology- and laboratory medicine-specific recommendations for providing optimal care to the gender-diverse population, with a predominant focus on the adult population. The scope of this document focuses on the following 5 topics: (a) reference intervals and interpretation of laboratory tests impacted by use of GAHT (testosterone for transgender men; estradiol with or without antiandrogens for transgender women), focusing on those stably on GAHT for 6 months or longer; (b) transfusion medicine considerations for the gender-diverse patient population, (c) consideration of gender diversity in autopsy and death investigation, (d) interpretation of histology from tissues that are impacted by GAHT and surgical procedures; and (e) pathology and laboratory medicine informatics challenges and opportunities.
A relatively small group of laboratory tests is significantly impacted by GAHT. The histology of some tissues shows changes attributable to GAHT or to nonhormonal medical procedures. Autopsy and transfusion medicine practices for the gender-diverse population currently lack standardization, although this is evolving. The landscape of pathology informatics related to gender diversity is complicated by varying electronic health record and laboratory informatics systems functionality.
Details
- Title: Subtitle
- ADLM Guidance Document on Incorporating Gender Diversity in Pathology and Laboratory Medicine
- Creators
- Tiffany A Thomas - Columbia UniversityGabrielle N Winston-McPherson - University of Wisconsin–MadisonIna Amarillo - Pennsylvania State UniversityAlisha D Berry - University of WashingtonCaroline J Davidge-Pitts - Mayo ClinicSridevi Devaraj - Texas Children's HospitalZil Goldstein - Community Health CenterBrad S Karon - Mayo Clinic in ArizonaBrooke M Katzman - Mayo Clinic in ArizonaMahmoud A Khalifa - University of MinnesotaHung S Luu - Medical City Children's HospitalJames H Nichols - Vanderbilt University Medical CenterTracy L Stockley - University Health NetworkMichelle R Stoffel - University of MinnesotaDina N Greene - University of WashingtonMatthew D Krasowski - University of Iowa Health Care
- Resource Type
- Journal article
- Publication Details
- The journal of applied laboratory medicine, Vol.11(4), pp.887-926
- DOI
- 10.1093/jalm/jfag071
- PMID
- 42383916
- ISSN
- 2576-9456
- eISSN
- 2475-7241
- Publisher
- Oxford University Press
- Grant note
- Roche Diagnostics Abbott Diagnostics
- Language
- English
- Date published
- 07/01/2026
- Academic Unit
- Pathology
- Record Identifier
- 9985179093102771
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