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Transgender Health

Jose J Martinez-Velez, Kyle Melin, Carlos E Rodriguez-Diaz
Purpose: Transgender and gender nonconforming (GNC) people continue to experience suboptimal health care, social exclusion, and lower quality of life. Globally, lack of access to services, institutional violence, and public harassment have been reported. However, there is limited data on transgender health in Puerto Rico and the Caribbean. The purpose of this study is to assess the social determinants of health and wellbeing of transgender and GNC people living in Puerto Rico. Methods: Utilizing a community-based participatory research approach, 52 self-identified transgender and GNC individuals living in Puerto Rico completed a survey, which included questions on access to health care services, social support, and violence, among others...
2019: Transgender Health
John Frank, Arjee Restar, Lisa Kuhns, Sari Reisner, Katie Biello, Robert Garofalo, Matthew J Mimiaga
Purpose: The physical health care needs of transgender women are not being adequately addressed in the United States. The current study adds to the literature on the state of health care among young transgender women (YTW) by describing the occurrence of unmet health needs among a sample of YTW and providing unique data on psychosocial and demographic factors associated with access to adequate care. Methods: Baseline data were analyzed from Project LifeSkills, an intervention study funded by the National Institutes of Health (NIH)...
2019: Transgender Health
Michelle A Tollit, Debi Feldman, Gabrielle McKie, Michelle M Telfer
Purpose: To explore experiences of care at the Royal Children's Hospital Gender Service (RCHGS). Methods: A total of 114 parents and 52 patients of the RCHGS completed an experience of care survey. Results: Most participants highly rated elements of the family-centered care and multidisciplinary team at RCHGS. The majority were satisfied with the RCHGS (parents: 88%, patients: 92%) and would recommend the service (parents: 95%, patients: 89%). Reductions in distress after participation in RCHGS were noted. Wait time was an area of dissatisfaction...
2018: Transgender Health
Rusi Jaspal, Lauren Kennedy, Shema Tariq
Trans women are a key, yet under-researched, population in the HIV epidemic. However, there remains a paucity of data on the health and wellbeing of trans women at risk of, or living with, HIV in the United Kingdom. This article provides a narrative review of key empirical research into HIV among trans women. In an effort to explore individual and social factors in relation to HIV in this population, we outline key tenets of identity process theory from social psychology and the concept of structural violence from medical anthropology...
2018: Transgender Health
Ada S Cheung, Olivia Ooi, Shalem Leemaqz, Pauline Cundill, Nicholas Silberstein, Ingrid Bretherton, Emily Thrower, Peter Locke, Mathis Grossmann, Jeffrey D Zajac
Background: Over the last 10 years, increases in demand for transgender health care has occurred worldwide. There are few data on clinical characteristics of Australian adult transgender individuals. Understanding gender identity patterns, sociodemographic characteristics, gender-affirming treatments, as well as medical and psychiatric morbidities, including neurobehavioral conditions affecting transgender and gender-diverse adults will help to inform optimal health service provision. Purpose: In an Australian adult transgender cohort, we aimed to first, assess referral numbers and describe the sociodemographic and clinical characteristics, and second, to specifically assess the prevalence of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD)...
2018: Transgender Health
Charlie Blotner, Micah Rajunov
Despite accelerated growth in the field of transgender health, mistrust between trans patients and their providers persists. Insufficient education for providers, research that overlooks patients' foremost concerns, and continued stigma and discrimination in medical settings are among the main barriers leading trans patients to delay or avoid care. Consequently, the transgender community often turns to social media as a self-serve resource for medical knowledge. This article discusses the benefits of directly engaging the trans community using social media to educate professionals, drive relevant research, and inform practice, to ultimately deliver higher quality care...
2018: Transgender Health
Steve N Du Bois, Wren Yoder, Arryn A Guy, Kelly Manser, Stephen Ramos
Compared with their cisgender counterparts, transgender individuals face both structural-level discrimination and health disparities across health domains. We used recent population-level data to examine associations between state-level policy ratings regarding transgender people and transgender health (poor physical and mental health days, health behaviors, and health care utilization). We hypothesized more inclusive and protective state-level policies would predict better health of transgender individuals...
2018: Transgender Health
Brett M Millar, Devin English, Raymond L Moody, H Jonathon Rendina, Demetria Cain, Nadav Antebi-Gruszka, Joseph A Carter, Jeffrey T Parsons
Purpose: Transgender women in the United States face elevated rates of HIV and of substance use. Studies measuring overall or aggregate levels of substance use have linked use to increased HIV transmission risk behavior (TRB). Although intensive longitudinal studies in other populations have found day-level links between substance use and TRB, no study has yet explored such links among transgender women. This study aimed to fill this gap in the literature. Methods: Utilizing survey and 60-day timeline follow-back interview data from a sample of 214 transgender women in New York City, we tested whether day-level heavy drinking, marijuana use, and/or nonprescription stimulant use were associated with odds of engaging in any sex (vs...
2018: Transgender Health
Jerel M Ezell, Matthew J Ferreira, Dustin T Duncan, John A Schneider
Background: Little research has evaluated the social and sexual network-related health outcomes of young black transgender women (TGW) or compared these outcomes with those of black men who have sex with men (MSM). Social network analysis offers one potent means of understanding the dynamics driving the broad spectrum of adverse outcomes experienced by these subgroups. Methods: We examined the social and sexual health network traits of 618 black individuals assigned male at birth who have sex with men, 47 (7...
2018: Transgender Health
Sarah Alexandra Marshall, Mary Kathryn Allison, Mary Kathryn Stewart, Noel D Thompson, Dani S Archie
Purpose: Transgender (trans) and nonbinary (NB) individuals experience a number of health and health care disparities when compared with cisgender individuals. While this has been reflected in nationwide surveys of trans/NB people in the United States, few studies capture the unique experiences of trans people living in the South, and fewer studies have collected qualitative data directly from trans/NB people. The purpose of this trans/NB-led initiative was to engage the trans/NB community in a southern state in defining their most pressing health and health care concerns and comparing those results with those reported by their cisgender allies, as well as national samples of trans individuals...
2018: Transgender Health
Jane O'Bryan, Kimberly Leon, Carolyn Wolf-Gould, Melissa Scribani, Nancy Tallman, Anne Gadomski
Purpose: Significant knowledge gaps regarding outcomes of gender-affirming therapy in transgender (TG) and gender expansive (GE) youth impede an evidence-based approach to these patients. The Gender Wellness Center (GWC) Pediatric Patient Registry was established in 2017 to enable systematic, longitudinal research to describe the physical, mental, and quality-of-life outcomes of these youth. Methods: All TG/GE youth, ages 8-21 years, presenting to the GWC were recruited on site. Ten research questions guided the creation of data fields...
2018: Transgender Health
Brooke A Jarrett, Alexandra L Corbet, Ivy H Gardner, Jamie D Weinand, Sarah M Peitzmeier
Purpose: Chest binding, or compressing the chest tissue, is a common practice among transmasculine individuals that can promote mental health, but frequently results in negative physical health symptoms. The purpose of this study was to assess the prevalence and correlates of care seeking for binding-related health concerns among transmasculine adults. Methods: Descriptive statistics were calculated and logistic regression models were run using data from the Binding Health Project, a cross-sectional online survey among transgender adults who had practiced chest binding ( n =1800)...
2018: Transgender Health
Zowie Davy, Michael Toze
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association has changed the diagnosis of gender identity disorder to gender dysphoria (GD). In this critical narrative review we ask: What is gender dysphoria? We report on some of the inconsistencies in the articles that foreground distress while obfuscating the fact that not all trans and intersex people suffer stress or impaired functioning, and the inappropriate referencing to intersex people in the diagnostic criterion, claims about the GD diagnosis contributing to the depathologization of and reducing stigma surrounding trans people, the conceptualizations of "gender dysphoric" research subjects, and finally we question the etiological approaches using GD as a conceptual framework...
2018: Transgender Health
Jay P Pierce
Purpose: To evaluate the prevalence of synesthesia in transgender versus cisgender individuals. Methods: A 10-question, self-administered written survey, developed to assess the prevalence of synesthesia, was distributed to transgender individuals ( n =96) attending support groups as well as to cisgender participants ( n =103) identified among individuals accompanying transgender attendees. Demographic data and prevalence of synesthesia were analyzed using descriptive statistics. Differences between groups were analyzed using a chi-square test...
2018: Transgender Health
Ken C Pang, Debi Feldman, Ralph Oertel, Michelle Telfer
Purpose: The presence of a disorder of sexual development (DSD) acts as a diagnostic specifier for gender dysphoria (GD) under DSM-5, while the International Classification of Diseases (ICD)-10 specifically states that its equivalent diagnosis, gender identity disorder (GID), must not be the result of a chromosomal abnormality. For these reasons, routine karyotyping has been previously advocated in the clinical work-up of children and adolescents with suspected GD or GID. However, the utility of such testing remains unclear...
2018: Transgender Health
Richard A Crosby, Laura F Salazar, Brandon J Hill
Purpose: This study tested three psychosocial measures for their potential to serve as counseling goals for promoting ART to transgender women living with HIV (TWLH). Methods: Among 69 TWLH, 17.4% were not taking ART; these volunteers were compared to the remainder using multivariate regression analyses. Results: Only one psychosocial measure achieved significance: Personal Competence (Adjusted Odds Ratio = 0.80, 95% CI = 0.67-0.97, P  = 0.02). Because this was a continuous measure, assessed on a 7-point scale, the protective adjusted odds ratio of 0...
2018: Transgender Health
Pamela Klein, Supraja Narasimhan, Joshua D Safer
Despite increasing appreciation for the medical needs of transgender individuals, the organization of transgender medical care remains suboptimal. Transgender individuals report difficulty in finding providers who have adequate expertise in caring for transgender patients, a lack of provider cultural competence, health system barriers, and discrimination in healthcare settings. At Boston Medical Center (BMC), we sought to address these gaps within an existing academic medical center. In February 2016, BMC established a Center for Transgender Medicine and Surgery (CTMS) to provide a single address for patients to obtain transgender-specific services across a spectrum of healthcare needs...
2018: Transgender Health
Oralia Loza, Paulina Hernandez, Jessica Calderon-Mora, Shaked Laks, Marie Leiner, Sireesha Reddy, Patricia Lara, Hector Granados
Purpose: Gender-nonconforming patients are at higher risk for medical problems that require prompt medical and mental health intervention. Barriers to healthcare for transgender individuals have been well characterized in the literature, but not in low resource settings. The purpose of this paper is to present the barriers encountered when bringing healthcare to transgender children, adolescents, and adults in a medically underserved, predominantly Hispanic area of the United States. Methods: In this medically underserved area on the U...
2018: Transgender Health
Jennifer L Glick, Katherine M Andrinopoulos, Katherine P Theall, Carl Kendall
Purpose: Gender Minority (GM) individuals experience healthcare access barriers, including financial concerns and discrimination, which influence their health seeking behaviors. This study explores the alternative navigation strategies used by GM individuals to cope with these barriers and access care, both biomedical and complementary and alternative medicine (CAM). Methods: In-depth interviews were conducted with GM individuals ( n =18) and healthcare providers ( n =5) identified through purposive sampling...
2018: Transgender Health
Douglas Knutson, Meredith A Martyr, Travis A Mitchell, Tori Arthur, Julie M Koch
Purpose: Scholars indicate that rates of mental and physical health issues (e.g., substance use, anxiety, depression) may be much higher among transgender individuals relative to the general population. This disparity may be even greater for transgender individuals in rural areas. Clinical researchers suggest using affirmative therapeutic approaches and interventions to address the health concerns of transgender individuals, specifically to connect individuals with the transgender community. However, little is known about the content of information that is shared in transgender communities in rural areas...
2018: Transgender Health
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