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<article xmlns:xlink="http://www.w3.org/1999/xlink" article-type="letter" dtd-version="2.0">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JMIR</journal-id>
      <journal-id journal-id-type="nlm-ta">J Med Internet Res</journal-id>
      <journal-title>Journal of Medical Internet Research</journal-title>
      <issn pub-type="epub">1438-8871</issn>
      <publisher>
        <publisher-name>JMIR Publications</publisher-name>
        <publisher-loc>Toronto, Canada</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">v25i1e52286</article-id>
      <article-id pub-id-type="pmid">37966876</article-id>
      <article-id pub-id-type="doi">10.2196/52286</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Letter to the Editor</subject>
        </subj-group>
        <subj-group subj-group-type="article-type">
          <subject>Letter to the Editor</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Authors’ Reply: Modernizing Gender, Sex, and Sexual Orientation Data Through Engagement and Education</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="editor">
          <name>
            <surname>Leung</surname>
            <given-names>Tiffany</given-names>
          </name>
        </contrib>
      </contrib-group>
      <contrib-group>
        <contrib id="contrib1" contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Queen</surname>
            <given-names>Roz</given-names>
          </name>
          <degrees>BSc</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <address>
            <institution>School of Health Information Science</institution>
            <institution>University of Victoria</institution>
            <addr-line>PO Box 1700 STN CSC</addr-line>
            <addr-line>Victoria, BC, V8W 2Y2</addr-line>
            <country>Canada</country>
            <phone>1 2507218575</phone>
            <email>rozomqueen@gmail.com</email>
          </address>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0002-6064-521X</ext-link>
        </contrib>
        <contrib id="contrib2" contrib-type="author">
          <name name-style="western">
            <surname>Courtney</surname>
            <given-names>Karen L</given-names>
          </name>
          <degrees>PhD</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0001-9326-116X</ext-link>
        </contrib>
        <contrib id="contrib3" contrib-type="author">
          <name name-style="western">
            <surname>Lau</surname>
            <given-names>Francis</given-names>
          </name>
          <degrees>PhD</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0001-7010-3281</ext-link>
        </contrib>
        <contrib id="contrib4" contrib-type="author">
          <name name-style="western">
            <surname>Davison</surname>
            <given-names>Kelly</given-names>
          </name>
          <degrees>MSc, MN</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0002-1965-4691</ext-link>
        </contrib>
        <contrib id="contrib5" contrib-type="author">
          <name name-style="western">
            <surname>Devor</surname>
            <given-names>Aaron</given-names>
          </name>
          <degrees>PhD</degrees>
          <xref rid="aff2" ref-type="aff">2</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0001-9037-5663</ext-link>
        </contrib>
        <contrib id="contrib6" contrib-type="author">
          <name name-style="western">
            <surname>Antonio</surname>
            <given-names>Marcy G</given-names>
          </name>
          <degrees>PhD</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <xref rid="aff3" ref-type="aff">3</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0001-9332-8512</ext-link>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <label>1</label>
        <institution>School of Health Information Science</institution>
        <institution>University of Victoria</institution>
        <addr-line>Victoria, BC</addr-line>
        <country>Canada</country>
      </aff>
      <aff id="aff2">
        <label>2</label>
        <institution>Chair in Transgender Studies</institution>
        <institution>University of Victoria</institution>
        <addr-line>Victoria, BC</addr-line>
        <country>Canada</country>
      </aff>
      <aff id="aff3">
        <label>3</label>
        <institution>School of Information</institution>
        <institution>University of Michigan</institution>
        <addr-line>Ann Arbor, MI</addr-line>
        <country>United States</country>
      </aff>
      <author-notes>
        <corresp>Corresponding Author: Roz Queen <email>rozomqueen@gmail.com</email></corresp>
      </author-notes>
      <pub-date pub-type="collection">
        <year>2023</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>15</day>
        <month>11</month>
        <year>2023</year>
      </pub-date>
      <volume>25</volume>
      <elocation-id>e52286</elocation-id>
      <history>
        <date date-type="received">
          <day>29</day>
          <month>8</month>
          <year>2023</year>
        </date>
        <date date-type="accepted">
          <day>27</day>
          <month>10</month>
          <year>2023</year>
        </date>
      </history>
      <copyright-statement>©Roz Queen, Karen L Courtney, Francis Lau, Kelly Davison, Aaron Devor, Marcy G Antonio. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 15.11.2023.</copyright-statement>
      <copyright-year>2023</copyright-year>
      <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
        <p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.</p>
      </license>
      <self-uri xlink:href="https://www.jmir.org/2023/1/e52286" xlink:type="simple"/>
      <related-article related-article-type="commentary-article" id="v25i1e51632" ext-link-type="doi" xlink:href="10.2196/51632" vol="25" page="e51632" xlink:type="simple">http://www.jmir.org/2023/1/e51632/</related-article>
      <related-article related-article-type="commentary-article" id="v25i1e46773" ext-link-type="doi" xlink:href="10.2196/46773" vol="25" page="e46773" xlink:type="simple">http://www.jmir.org/2023/1/e46773/</related-article>
      <kwd-group>
        <kwd>data sharing</kwd>
        <kwd>digital health systems</kwd>
        <kwd>digital health</kwd>
        <kwd>gender, sex, and sexual orientation</kwd>
        <kwd>electronic health records</kwd>
        <kwd>GSSO</kwd>
        <kwd>health information standards</kwd>
        <kwd>LGBT health</kwd>
        <kwd>LGBT</kwd>
        <kwd>policy</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <p>The authors [<xref ref-type="bibr" rid="ref1">1</xref>] agree with the letter to the editor [<xref ref-type="bibr" rid="ref2">2</xref>] that education and engagement are necessary for the successful modernization of gender, sex, and sexual orientation in digital health systems. The participants in our knowledge translation project tended to focus on the need for more short-term education initiatives with providers, staff, patients, and family members related to implementing changes. We appreciate that the authors of the letter identify the need for long-term education initiatives such as changes to health care provider curriculum as well as health education provided to the public. We fully and strongly encourage the development, implementation, and sharing of education initiatives as an important part of modernization efforts. SOGI Nursing is a great example of an educational initiative [<xref ref-type="bibr" rid="ref3">3</xref>].</p>
  </body>
  <back>
    <app-group/>
    <fn-group>
      <fn fn-type="conflict">
        <p>None declared.</p>
      </fn>
    </fn-group>
    <ref-list>
      <ref id="ref1">
        <label>1</label>
        <nlm-citation citation-type="journal">
          <person-group person-group-type="author">
            <name name-style="western">
              <surname>Queen</surname>
              <given-names>R</given-names>
            </name>
            <name name-style="western">
              <surname>Courtney</surname>
              <given-names>KL</given-names>
            </name>
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              <surname>Lau</surname>
              <given-names>F</given-names>
            </name>
            <name name-style="western">
              <surname>Davison</surname>
              <given-names>K</given-names>
            </name>
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              <surname>Devor</surname>
              <given-names>A</given-names>
            </name>
            <name name-style="western">
              <surname>Antonio</surname>
              <given-names>MG</given-names>
            </name>
          </person-group>
          <article-title>What's next for modernizing gender, sex, and sexual orientation terminology in digital health systems? Viewpoint on research and implementation priorities</article-title>
          <source>J Med Internet Res</source>
          <year>2023</year>
          <month>07</month>
          <day>25</day>
          <volume>25</volume>
          <fpage>e46773</fpage>
          <comment>
            <ext-link ext-link-type="uri" xlink:type="simple" xlink:href="https://www.jmir.org/2023//e46773/"/>
          </comment>
          <pub-id pub-id-type="doi">10.2196/46773</pub-id>
          <pub-id pub-id-type="medline">37490327</pub-id>
          <pub-id pub-id-type="pii">v25i1e46773</pub-id>
          <pub-id pub-id-type="pmcid">PMC10410371</pub-id>
        </nlm-citation>
      </ref>
      <ref id="ref2">
        <label>2</label>
        <nlm-citation citation-type="journal">
          <person-group person-group-type="author">
            <name name-style="western">
              <surname>Ginaldi</surname>
              <given-names>G</given-names>
            </name>
            <name name-style="western">
              <surname>De Martinis</surname>
              <given-names>M</given-names>
            </name>
          </person-group>
          <article-title>Modernizing gender, sex, and sexual orientation data through engagement and education</article-title>
          <source>J Med Internet Res</source>
          <year>2023</year>
          <pub-id pub-id-type="doi">10.2196/51632</pub-id>
        </nlm-citation>
      </ref>
      <ref id="ref3">
        <label>3</label>
        <nlm-citation citation-type="web">
          <source>SOGI Nursing</source>
          <year>2019</year>
          <access-date>2023-01-07</access-date>
          <comment>
            <ext-link ext-link-type="uri" xlink:type="simple" xlink:href="https://soginursing.ca/">https://soginursing.ca/</ext-link>
          </comment>
        </nlm-citation>
      </ref>
    </ref-list>
  </back>
</article>
