{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T20:44:40Z","timestamp":1789245880692,"version":"build-2803163510"},"reference-count":8,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"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":["Respir Care"],"published-print":{"date-parts":[[2018,2]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Sex is an important determinant of lung capacity and function. This study examined the impact of using non-birth sex on the interpretation of spirometry data in transgender subjects with air-flow obstruction.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n This study was a retrospective analysis of anonymous spirometry data. Eighty adult male and 80 adult female subjects were chosen from the database via random sampling. FVC, FEV\n 1<\/jats:sub>\n , and FEV\n 1<\/jats:sub>\n \/FVC were collected and analyzed. Differences in percent of predicted, Z scores, classification of disease severity, and the incidence of a value migrating above or below the lower limit of normal between sex assignments were examined.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n For born male subjects, percent of predicted for FVC and FEV\n 1<\/jats:sub>\n were significantly higher when the female sex was used: 100.5% versus 118.5% and 78% versus 91.5%, respectively (\n P<\/jats:italic>\n < .001). FEV\n 1<\/jats:sub>\n \/FVC Z score was \u22122.53 for male sex and \u22122.65 for female sex (\n P<\/jats:italic>\n = .004). The presence of obstruction was not affected by sex assignment. Use of non-birth sex moved some FVC and FEV\n 1<\/jats:sub>\n data above the lower limit of normal and improved severity classification in others. For born female subjects, percent of predicted for FVC and FEV\n 1<\/jats:sub>\n were significantly lower when the male sex was used: 102% versus 87.5% and 81.5% versus 70.5%, respectively (\n P<\/jats:italic>\n < .001). FEV\n 1<\/jats:sub>\n \/FVC Z score was \u22122.17 for female sex and \u22122.12 for male sex (\n P<\/jats:italic>\n < .001). Six born female subjects had their FEV\n 1<\/jats:sub>\n \/FVC normalized when male sex was used. Use of non-birth sex moved some FVC and FEV\n 1<\/jats:sub>\n data below the lower limit of normal and worsened severity classification in others. In total, using the non-birth sex affected spirometry interpretation in 45% of born male subjects and 70% of born female subjects.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n In transgender subjects with air-flow obstruction, using non-birth sex to calculate predicted spirometry values may have a significant impact on test interpretation and place these patients at risk for misdiagnosis and inappropriate treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.4187\/respcare.05586","type":"journal-article","created":{"date-parts":[[2017,11,28]],"date-time":"2017-11-28T20:10:45Z","timestamp":1511899845000},"page":"215-218","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["The Impact of Using Non-Birth Sex on the Interpretation of Spirometry Data in Subjects With Air-Flow Obstruction"],"prefix":"10.1177","volume":"63","author":[{"given":"Jeffrey M","family":"Haynes","sequence":"first","affiliation":[{"name":"Pulmonary Function Laboratory, St Joseph Hospital, Nashua, New Hampshire."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph W","family":"Stumbo","sequence":"additional","affiliation":[{"name":"Departments of Pulmonary, Sleep, and Critical Care Medicine, Kaiser Permanente, Tacoma, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,2,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2005.10.010"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00035205"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-014-3148-7"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2013.0001"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00143209"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2007.08.003"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303578"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.05586","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.05586","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.05586","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:26:43Z","timestamp":1775467603000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.05586"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2]]},"references-count":8,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.4187\/respcare.05586"],"URL":"https:\/\/doi.org\/10.4187\/respcare.05586","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2018,2]]}}}