Objective:

To provide comprehensive guidance for laboratory medicine professionals on diagnostic services for gender-diverse patients.

Approach:

• Guidance Development: The guidance addresses challenges in interpreting laboratory test results for individuals receiving gender-affirming hormone therapy and offers practical recommendations for pathology and laboratory practice.
• Personalized Diagnostic Interpretation: It recommends a personalized approach to diagnostic interpretation that considers physiology, hormone exposure, and the patient's overall clinical presentation.
• Integration with Electronic Health Records: The document suggests incorporating organ inventories into electronic health records for better interpretation of laboratory findings.
• Standardization in Transfusion Medicine: It calls for standardized approaches in transfusion medicine for transgender and nonbinary donors and recipients.
• Documentation Practices: The guidance recommends documenting both legal sex and affirmed gender identity using anatomically accurate, gender-neutral terminology.

Key Findings:

• Hormone therapy can alter laboratory test results, complicating interpretation if traditional reference intervals are applied.
• The recommendations primarily apply to adults who have received gender-affirming hormone therapy for at least six months.
• The evidence base for these guidelines is still developing.

Interpretation:

ADLM's guidance aims to improve the accuracy of test result interpretation and enhance personalized care for gender-diverse patients.

Limitations:

• The guidance is based on the strongest available evidence, which is still developing.
• Recommendations primarily focus on adults, limiting applicability to other age groups.

Conclusion:

The guidance provides an initial framework for laboratories to adapt diagnostic workflows as knowledge evolves.

Sources:

• ADLM