{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:56:26Z","timestamp":1782924986614,"version":"3.54.5"},"reference-count":199,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014386","name":"Abbott Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014386","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016545","name":"Roche Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The first international clinical standards of care for the gender-diverse population were formulated in the late 1970s. In the last 15 years, multiple subspecialty societies within the United States have developed clinical care guidelines for those with gender dysphoria, including gender-affirming hormone therapy (GAHT) and surgical treatments. To date, there are no pathology- and laboratory medicine\u2013specific recommendations in the United States for the gender-diverse population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Content<\/jats:title>\n                    <jats:p>This document outlines pathology- and laboratory medicine\u2013specific recommendations for providing optimal care to the gender-diverse population, with a predominant focus on the adult population. The scope of this document focuses on the following 5 topics: (a) reference intervals and interpretation of laboratory tests impacted by use of GAHT (testosterone for transgender men; estradiol with or without antiandrogens for transgender women), focusing on those stably on GAHT for 6 months or longer; (b) transfusion medicine considerations for the gender-diverse patient population, (c) consideration of gender diversity in autopsy and death investigation, (d) interpretation of histology from tissues that are impacted by GAHT and surgical procedures; and (e) pathology and laboratory medicine informatics challenges and opportunities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>A relatively small group of laboratory tests is significantly impacted by GAHT. The histology of some tissues shows changes attributable to GAHT or to nonhormonal medical procedures. Autopsy and transfusion medicine practices for the gender-diverse population currently lack standardization, although this is evolving. The landscape of pathology informatics related to gender diversity is complicated by varying electronic health record and laboratory informatics systems functionality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jalm\/jfag071","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T11:13:15Z","timestamp":1776510795000},"page":"887-926","source":"Crossref","is-referenced-by-count":0,"title":["ADLM Guidance Document on Incorporating Gender Diversity in Pathology and Laboratory Medicine"],"prefix":"10.1093","volume":"11","author":[{"given":"Tiffany A","family":"Thomas","sequence":"first","affiliation":[{"name":"Department of Pathology and Cell Biology, Columbia University , New York, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle N","family":"Winston-McPherson","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Wisconsin , Madison, WI ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina","family":"Amarillo","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Penn State Health , Hershey, PA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisha D","family":"Berry","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine & Pathology, University of Washington , Seattle, WA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9393-7745","authenticated-orcid":false,"given":"Caroline J","family":"Davidge-Pitts","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Nutrition, Mayo Clinic , Rochester, MN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sridevi","family":"Devaraj","sequence":"additional","affiliation":[{"name":"Department of Pathology, Baylor College of Medicine and Texas Children's Hospital , Houston, TX ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zil","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Callen-Lorde Community Health Center , Brooklyn, NY ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad S","family":"Karon","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, MN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke M","family":"Katzman","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, MN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud A","family":"Khalifa","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, MN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2001-4031","authenticated-orcid":false,"given":"Hung S","family":"Luu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Children\u2019s Health , Dallas, TX ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3652-1612","authenticated-orcid":false,"given":"James H","family":"Nichols","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center , Nashville, TN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy L","family":"Stockley","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Program, University Health Network and University of Toronto , Toronto, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4041-748X","authenticated-orcid":false,"given":"Michelle R","family":"Stoffel","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, MN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6966-9904","authenticated-orcid":false,"given":"Dina N","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine & Pathology, University of Washington , Seattle, WA ,","place":["United 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