# Beyond the Binary: Advancing Gender-Inclusive Data Policy for Health Equity in the US National Provider Identifier System

## TL;DR

This paper argues for updating the US NPI system to better reflect provider gender diversity and promote health equity.

## Contribution

The paper proposes specific policy changes to make the NPI system more gender-inclusive and scientifically grounded.

## Key findings

- Current NPI gender data standards conflate sex and gender and exclude nonbinary identities.
- Outdated standards hinder research and equity efforts for transgender and nonbinary providers.
- Updating the NPI system can serve as a model for inclusive data policy.

## Abstract

Achieving health equity requires data systems that recognize and reflect provider diversity. The National Provider Identifier (NPI) system underpins United States health care administration, yet its gender data standards remain outdated, conflating sex and gender and lacking inclusive options. These deficiencies undermine research, equity initiatives, and the visibility of transgender and nonbinary providers. In an era of growing political hostility to diversity, administrative neutrality is insufficient. The National Plan and Provider Enumeration System must establish itself as a model of gender-inclusive policy by separating sex and gender variables, expanding identity categories, and implementing transparent, regularly updated standards grounded in science.