Respecting all genders in an online Health Risk Appraisal: Kaiser Permanente’s new Total Health Assessment

Kaiser Permanente just launched its new Total Health Assessment on, with choices that respect the genders of our members. Here’s a screen shot:

Digital Health Coaching kp.or all genders respected 2015

When a user selects “Transgender or Gender Non-conforming” as their gender they will then select whether they would like screening information relevant to male or female biology:

Digital Health Coaching kp.or all genders respected 2015-2

The Innovation Story
The story behind this important change started with a person, a patient, who brought the disparity of a gender binary health risk appraisal to the attention of their employee benefits board, who requested Kaiser Permanente review for our members.

Upon review, we agreed that our current Total Health Assessment did not accomodate the gender spectrum of our members and initiated a conversation with its manufacturer, Johnson and Johnson Health and Wellness Solutions. With the facilitation of Doug Nau, in Kaiser Permanente’s Digital Services Group, KP worked with the physicians and health educators at Health and Wellness Solutions to craft this solution.

Now a part of the core product
Doug informed me that based on this work, Johnson and Johnson Health and Wellness Solutions has decided to make this part of their core product for all of their clients.

Doug said it best: “Scored a win here – its for everyone!”

I wrote previously about changes made to our Healthy Workforce Platform (Kaiser Permanente’s Healthy Workforce digital platform to respect all genders), impacting close to 200,000 people who power Kaiser Permanente.

This improvement impacts all of the 10,000,000+ members of Kaiser Permanente, and I assume/hope every patient in every health system who has access to this digital health coaching solution.

It’s important because many employers incentivize their employees to complete a/the Total Health Assessment in the interest of their good health.

Total Health for all, leadership by all
Respecting a person’s gender identity and providing accurate recommendations helps everyone achieve their health and life goals and sends an important message about inclusion. One of the most important roles of the physician is to recognize, acknowledge, and respect the patient. Their electronic systems should do the same.

The other important thing that helps everyone achieve their health and life goals is the ability to control their own destiny. I want to acknowledge Brenda McComb, PhD, Dean of the Graduate School of Oregon State University for her leadership in making this happen. When I asked if it was okay that I mention her, she said, “Ok by me to mention me but it is not just me of course. It is all of us pushing for change.” Duly noted and conveyed.

This experience is showing us that change happens, and it is being led by the members of the LGB and especially Transgender communities themselves. Isn’t the 21st Century marvelous? 🙂

As usual, comments and ideas welcome, feel free to post them below.


This is a huge improvement, but it could be even better. I personally feel that the three options are confusing and appear to imply that transgender and gender nonconforming people are not male or female.
While no method is perfect, using the two‐step method (asking about the sex assigned at birth and about gender identity) would be more clear and more respectful. The newly released APA Guidelines for Psychological Practice with Transgender and Gender Nonconforming People may be a good resource to review before the next update. Still… this is a great step forward!


Thank you for taking a look and for your time in commenting. Your perspective and well taken and agreed that the two-step method is more clear and this is a great step forward, and putting those ideas together means that we are not at an ideal state yet. I hope you would use this as an example of a work in progress that helps others innovate as we continue on the journey – as you point out, it gives an idea of where we have yet to go. Thanks again, Ted

Ted Eytan, MD