{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:12:46Z","timestamp":1777666366759,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Equity"],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:p>Achieving health equity requires data systems that recognize and reflect provider diversity. The National Provider Identifier (NPI) system underpins United States health care administration, yet its gender data standards remain outdated, conflating sex and gender and lacking inclusive options. These deficiencies undermine research, equity initiatives, and the visibility of transgender and nonbinary providers. In an era of growing political hostility to diversity, administrative neutrality is insufficient. The National Plan and Provider Enumeration System must establish itself as a model of gender-inclusive policy by separating sex and gender variables, expanding identity categories, and implementing transparent, regularly updated standards grounded in science.<\/jats:p>","DOI":"10.1089\/heq.2025.0059","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T03:50:21Z","timestamp":1749700221000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Beyond the Binary: Advancing Gender-Inclusive Data Policy for Health Equity in the US National Provider Identifier System"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5719-9685","authenticated-orcid":false,"given":"Jeremy W.","family":"Jacobs","sequence":"first","affiliation":[{"name":"Department of Pathology, Microbiology, &amp; Immunology, Vanderbilt University, Nashville, Tennessee, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shazia S.","family":"Khan","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9101-9326","authenticated-orcid":false,"given":"Laura D.","family":"Stephens","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of California San Diego, La Jolla, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8422-9480","authenticated-orcid":false,"given":"Garrett S.","family":"Booth","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, &amp; Immunology, Vanderbilt University, Nashville, Tennessee, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"National Plan & Provider Enumeration System. 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All rights reserved.; 2022."},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2022.2026"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2015.1134615"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2402139"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.16405"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01425-8"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1037\/sgd0000346"},{"key":"e_1_3_4_13_2","unstructured":"Jarvis EP. Putting Gender Inclusion into Practice. Michigan Medicine; June 14 2022. Available from: https:\/\/www.michiganmedicine.org\/health-lab\/putting-gender-inclusion-practice?utm_"},{"key":"e_1_3_4_14_2","unstructured":"Medina C Santos T Mahowald L et al. Protecting and Advancing Health Care for Transgender Adult Communities. Center for American Progress; August 18 2021. Available from: https:\/\/www.americanprogress.org\/article\/protecting-advancing-health-care-transgender-adult-communities\/?utm_ [Last accessed: March9 2025]."},{"key":"e_1_3_4_15_2","unstructured":"United States White House. Executive Order 14168 \u201cDefending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government\u201d. Available from: https:\/\/www.whitehouse.gov\/presidential-actions\/2025\/01\/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal-government\/ [Last accessed: March2 2025]."},{"key":"e_1_3_4_16_2","unstructured":"Brown A. About 5% of young adults in the U.S. say their gender is different from their sex assigned at birth. Pew Research Center. June 7 2022. Available from: https:\/\/www.pewresearch.org\/short-reads\/2022\/06\/07\/about-5-of-young-adults-in-the-u-s-say-their-gender-is-different-from-their-sex-assigned-at-birth\/ [Last accessed: March18 2025]."},{"key":"e_1_3_4_17_2","unstructured":"Sorcher R. Health Care Professionals Who Are Transgender and Non-Binary Are Changing the Exclusionary Health Care System. Pulitzer Center; June 28 2022. Available from: https:\/\/pulitzercenter.org\/stories\/health-care-professionals-who-are-transgender-and-non-binary-are-changing-exclusionary [Last accessed: March22 2025]."},{"key":"e_1_3_4_18_2","unstructured":"Veterans Health Administration. Transgender and Gender Diverse Veteran Healthcare: Birth Sex and Gender Identity. January 2022. Available from: https:\/\/www.patientcare.va.gov\/LGBT\/docs\/2022\/Birth-Sex-Gender-Identity-FactSheet-for-Veterans-2022.pdf [Last accessed: March18 2025]."},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/trgh.2023.0084"},{"key":"e_1_3_4_20_2","unstructured":"Schreiber M. Trump\u2019s Anti-diversity Executive Orders Threaten Americans\u2019 health experts say. The Guardian; February 10 2025. Available from: https:\/\/www.theguardian.com\/us-news\/2025\/feb\/10\/trump-health-dei-orders-risk?utm_source=chatgpt.com [Last accessed: March9 2025]."}],"container-title":["Health Equity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/heq.2025.0059","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/heq.2025.0059","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/heq.2025.0059","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:42:35Z","timestamp":1777448555000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/heq.2025.0059"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,12]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,8,1]]}},"alternative-id":["10.1089\/heq.2025.0059"],"URL":"https:\/\/doi.org\/10.1089\/heq.2025.0059","relation":{},"ISSN":["2473-1242","2473-1242"],"issn-type":[{"value":"2473-1242","type":"print"},{"value":"2473-1242","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,12]]},"article-number":"heq.2025.0059"}}