Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Clinical

Addressing questions related to “incidence of prostate cancer in trans-women in the US: a large database analysis”

Prostate Cancer and Prostatic Diseases (2024)Cite this article

Subjects

We thank Berner et al. and Lawerence et al. for their insightful comments about our paper titled “Incidence of prostate cancer in transgender women in the US: a large database analysis.” [1,2,3] We hope that this response letter will clarify some of the comments by these authors and provide a greater context of understanding for our initial publication. In this response, we will group issues together from both Berner et al. and Lawrence et al. so they may be addressed more clearly [1, 2].

Many of the methodological concerns that both corresponding papers highlight concern the appropriateness of using TriNetX to conduct transgender health research. The lack of standardization of SOGI field information as well as a lack of standardized guidance for providers in coding for transgender healthcare are inherent limitations to using EMR/EHR to study transgender health. However, TriNetX provides access to data from the largest cohort of transgender women in the world. We designed this project to answer some of our initial questions about the incidence of prostate cancer among this patient population. We strongly encourage others to repeat this study and use other databases.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Berner AM, Buchanan D, Seal L, O’Callaghan S. Methodological considerations in the use of a large database to estimate incidence of prostate cancer in transgender women in the US. Prostate Cancer Prostatic Dis. 2024. https://doi.org/10.1038/s41391-024-00839-7.

  2. Lawrence WR, Streed CG. Letter to the editor: “Incidence of prostate cancer in transgender women in the US: a large database analysis.”. Prostate Cancer Prostatic Dis. 2024. https://doi.org/10.1038/s41391-024-00846-8.

  3. Loria, M, Gilbert, D, Tabernacki, T, Maravillas, MA, McNamara, M, Gupta, K, et al. Incidence of prostate cancer in transgender women in the US: a large database analysis. Prostate Cancer Prostatic Dis. 2024. https://doi.org/10.1038/s41391-024-00804-4.

  4. Hines NG, Greene DN, Imborek KL, Krasowski MD. Patterns of gender identity data within electronic health record databases can be used as a tool for identifying and estimating the prevalence of gender-expansive people. JAMIA Open. 2023;ume 6:ooad042. https://doi.org/10.1093/jamiaopen/ooad042.

    Article  Google Scholar 

  5. Nik-Ahd F, Waller J, De Hoedt AM, Garcia MM, Figueiredo JC, Carroll PR, et al. Seeing the unseen: how can we best identify transgender women within the Veterans Affairs healthcare system’s electronic medical record? J Sex Med. 2023;20:559–67. https://doi.org/10.1093/jsxmed/qdac033.

    Article  PubMed  Google Scholar 

  6. Wolfe HL, Reisman JI, Yoon SS, Blosnich JR, Shipherd JC, Vimalananda VG, et al. Validating Data-Driven methods for identifying transgender individuals in the veterans health administration of the US Department of Veterans Affairs. Am J Epidemiol. 2021;190:1928–34. https://doi.org/10.1093/aje/kwab102.

    Article  PubMed  Google Scholar 

  7. Jasuja GK, de Groot A, Quinn EK, Ameli O, Hughto JMW, Dunbar M, et al. Beyond gender identity disorder diagnoses codes: an examination of additional methods to identify transgender individuals in administrative databases. Med Care. 2020;58:903–11. https://doi.org/10.1097/MLR.0000000000001362.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Population Analysis for Policies and Programmes: Comparison of Direct and Indirect Standardization.” United Nations Population Fund (UNFPA), London School of Hygiene and Tropical Medicine and University of London, n.d. Web 5/26/2016. http://papp.iussp.org/.

  9. National Library of Medicine. (n.d.). Finding and using health statistics- Age Adjustment. Retrieved from https://www.nlm.nih.gov/oet/ed/stats/02-600.html.

Download references

Funding

This publication was made possible through the support of the Clinical Research Center of University Hospitals Cleveland Medical Center (UHCMC) and the Case Western Reserve University Clinical and Translational Science Collaborative (CTSC) 4UL1TR000439.

Author information

Authors and Affiliations

  1. University Hospitals, Urology Institute, Cleveland, OH, USA

    Matthew Loria, Tomasz Tabernacki, David Gilbert, Mart Andrew Maravillas, Shubham Gupta & Kirtishri Mishra

  2. Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Matthew Loria, Tomasz Tabernacki, David Gilbert, Megan McNamara & Kirtishri Mishra

  3. Louis Stokes Veterans Association Cleveland, Cleveland, OH, USA

    Megan McNamara

  4. Metro Health Hospitals, Cleveland, OH, USA

    Kirtishri Mishra

Authors
  1. Matthew Loria
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomasz Tabernacki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Gilbert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mart Andrew Maravillas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Megan McNamara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shubham Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kirtishri Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

ML, DG, TT contributed to writing this manuscript. MAM, MM, SG, KM contributed with manuscript editing and supervision.

Corresponding author

Correspondence to Matthew Loria.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Loria, M., Tabernacki, T., Gilbert, D. et al. Addressing questions related to “incidence of prostate cancer in trans-women in the US: a large database analysis”. Prostate Cancer Prostatic Dis (2024). https://doi.org/10.1038/s41391-024-00863-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41391-024-00863-7

Search

Advanced search

Quick links