Gender minority refers to transgender and gender-nonconforming people whose sex assigned at birth is different from their current gender identity. US health surveillance systems do not routinely include questions to identify gender minority respondents, resulting in a lack of representative health data that can be used to evaluate the health of gender minorities. This omission represents a missed opportunity to understand the health and well-being of transgender and gender-nonconforming people as well as to learn more about sex and gender differences that may be relevant for the health of all people—gender minority and majority alike. In 2011, the Williams Institute at the University of California, Los Angeles, School of Law convened the Gender Identity in US Surveillance (GenIUSS) Group, bringing together a multidisciplinary and multi-institutional group of experts to increase population-based data about gender minority people through the inclusion of gender-related measures (e.g., assigned sex at birth, gender identity, transgender status) in surveys, with a particular consideration for publicly funded data-collection efforts. Drawing on the expertise and experience of the GenIUSS Group, this article provides an overview of challenges and opportunities and makes eight recommendations for “counting” gender minority adults in health research, with an emphasis on adult population-based surveys.

Gender-affirming hormones have been shown to improve psychological functioning and quality of life among transgender and nonbinary (trans) people, yet, scant research exists regarding whether and why individuals take more or less hormones than prescribed. Drawing on survey data from 379 trans people who were prescribed hormones, we utilized multivariable logistic regression models to identify factors associated with hormone-dosing behaviors and content analysis to examine the reasons for dose modifications. Overall, 24% of trans individuals took more hormones than prescribed and 57% took less. Taking more hormones than prescribed was significantly associated with having the same provider for primary and gender-affirming care and gender-based discrimination. Income and insurance coverage barriers were significantly associated with taking less hormones than prescribed. Differences by gender identity were also observed. Addressing barriers to hormone access and cost could help to ensure safe hormone-dosing behaviors and the achievement trans people's gender-affirmation goals.

Health equity is the state in which everyone has fair and just opportunities to attain their highest level of health. The field of human genomics has fallen short in increasing health equity, largely because the diversity of the human population has been inadequately reflected among participants of genomics research. This lack of diversity leads to disparities that can have scientific and clinical consequences. Achieving health equity related to genomics will require greater effort in addressing inequities within the field. As part of the commitment of the National Human Genome Research Institute (NHGRI) to advancing health equity, it convened experts in genomics and health equity research to make recommendations and performed a review of current literature to identify the landscape of gaps and opportunities at the interface between human genomics and health equity research. This Perspective describes these findings and examines health equity within the context of human genomics and genomic medicine.