RNOtherPublic health nursing (Boston, Mass.)2026

Capturing Gender Identity Through Documentation: A Program Evaluation of a Rural Mental Health Clinic.

Pamela Byrnes, Julie Roebuck

PMID 41189306

WHAT IT FOUND

A rural clinic recorded gender identity for 95% of 101 children and adolescents in 2023, compared with none of 3 in 2020.

The paper did not measure whether this improved mental health or patient care.

Key findings

01In 2020, the clinic census totaled 3 patients and none had gender identity documented.

02In 2023, gender identity was documented for 95% of 101 patients treated.

03The clinic reported significant improvement in gender identity documentation from 0% to 95% over 2020 to 2023.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

The evaluation was done at one rural outpatient mental health clinic, so it may not apply to other settings. The first two years had small numbers: 3 patients in 2020 and 3 patients in 2021. The evaluation measured gender identity documentation, not patient mental health outcomes, distress or whether patients felt affirmed. Gender identity was assessed only at initial intake, not periodically, so records may not reflect changes over time. The paper notes that pronouns may not align with gender identity, but the evaluation focused on gender identity documentation rather than separate pronoun documentation.

Declared interests

The funding statement says the authors have nothing to report, and they declare no conflicts of interest.

The easy way to misread this

Do not read the 95% documentation rate as proof that the clinic became affirming or that mental health improved. The evaluation counted gender identity entries in charts, not patient outcomes, and it was limited to one rural clinic.

Read it on PubMed →