120 - Representing Transgender People in Medical Subject Headings

Objectives: How well do current Medical Subject Headings (MeSH) terms represent transgender (shortened to trans) people? How well do their scope notes reflect transgender people?

Methods: The MeSH term relating to the transgender people is “Transgender Persons”, with entry terms including “Transexuals”, “Transgendered Persons”, “Transgenders”, “Transsexual Persons”, and “Two-Spirit Persons”. Previous indexing of this term was “Transsexualism”. Intersex people, who may identify as cis or trans, are grouped with the “Transgender Peoples” term. "Gender Identity" is related to the "Transgender Persons" and many of the terms nested under it are binary (female, male, masculine, feminine). The scope note of this term was reviewed against a topical literature review about the transgender experience, including gender transition, non-binary gender, and the limitations of the “wrong body” narrative.

Results: The notion of identifying with and expressing certain gender-coded behavior is cis-centered, meaning it centers around people who identify with the gender they were assigned at birth, and reflects on the wrong-body narrative. Nonbinary people are included within transgender studies, but the nonbinary identity centers on living outside the gender binary, excluding them from the MeSH terms entirely. Cisgender people do not always display gender-coded behavior associated with the gender they identify and highlighting this difference for trans people is discriminatory.

Conclusions: The MeSH description, like other medical classification systems, positions transgender people to prove that they are “trans enough” to require the care they need. The term for transgender people and its scope note does not fully encompass the nuances of identifying and living as a transgender person, requiring those whose experiences and feelings do not align with it to “prove” they are transgender. Medical professionals utilize MeSH terms to search for up to date literature about trans people and classifying the literature in this way may directly impact how they perceive and view trans patients, which may directly harm the care and access trans people have to healthcare. More transgender people should be included in roundtable discussions of MeSH terminology.