Demographic Differences in Gender Dysphoria Diagnosis and Access to Gender-Affirming Care Among Adolescents.

IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
LGBT health Pub Date : 2024-07-01 Epub Date: 2024-01-08 DOI:10.1089/lgbt.2023.0273
Nicole F Kahn, Peter G Asante, Tumaini R Coker, Kacie M Kidd, Dimitri A Christakis, Laura P Richardson, Gina M Sequeira
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引用次数: 0

Abstract

Purpose: The goal of this article was to identify demographic differences in receipt of gender dysphoria (GD) diagnosis and access to gender-affirming care (GAC) among adolescents whose gender identity and/or pronouns differed from their sex assigned at birth. Methods: Data were from 2444 patients who were 13-17 years old and had a documented gender identity and/or pronouns that differed from their sex assigned at birth in the electronic health record. Adjusted logistic regression models explored associations between demographic characteristics (sex assigned at birth, gender identity, race and ethnicity, language, insurance type, rural status) and presence of GD diagnosis and having accessed GAC. Results: The average predicted probability (Pr) of having received a GD diagnosis was 0.62 (95% confidence interval [CI] = 0.60-0.63) and of having accessed GAC was 0.48 (95% CI = 0.46-0.50). Various significant demographic differences emerged. Notably, Black/African American youth were the least likely to have received a GD diagnosis (Pr = 0.43, 95% CI = 0.33-0.54) and accessed GAC (Pr = 0.32, 95% CI = 0.22-0.43). Although there were no significant differences in GD diagnosis by insurance type, youth using Medicaid, other government insurance, or self-pay/charity care were less likely to have accessed GAC compared with youth using commercial/private insurance. Conclusion: Results indicate significant differences in both receipt of GD diagnosis and accessing GAC by various demographic characteristics, particularly among Black/African American youth. Identification of these differences provides an opportunity to further understand potential barriers and promote more equitable access to GAC among adolescents who desire this care.

青少年中性别失调诊断和获得性别确认护理的人口统计学差异。
目的:本文旨在确定性别认同和/或代词与出生时性别不同的青少年在接受性别焦虑症(GD)诊断和获得性别确认护理(GAC)方面的人口统计学差异。研究方法数据来自 2444 名 13-17 岁的患者,他们在电子健康记录中记录的性别认同和/或代词与其出生时的性别不同。调整后的逻辑回归模型探讨了人口统计学特征(出生时的性别分配、性别认同、种族和民族、语言、保险类型、农村状况)与是否存在 GD 诊断和是否使用过 GAC 之间的关联。结果:获得 GD 诊断的平均预测概率 (Pr) 为 0.62(95% 置信区间 [CI] = 0.60-0.63),获得 GAC 的平均预测概率 (Pr) 为 0.48(95% 置信区间 [CI] = 0.46-0.50)。人口统计学中出现了各种重大差异。值得注意的是,黑人/非洲裔美国青少年接受 GD 诊断(Pr = 0.43,95% CI = 0.33-0.54)和获得 GAC(Pr = 0.32,95% CI = 0.22-0.43)的可能性最小。虽然不同保险类型的 GD 诊断结果没有明显差异,但与使用商业/私人保险的青少年相比,使用医疗补助、其他政府保险或自费/慈善护理的青少年获得 GAC 的可能性较低。结论研究结果表明,在接受 GD 诊断和获得 GAC 方面,各种人口统计学特征存在明显差异,尤其是在黑人/非裔美国青少年中。找出这些差异为进一步了解潜在的障碍并促进希望获得 GAC 的青少年更公平地获得这种护理提供了机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
LGBT health
LGBT health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
6.60
自引率
6.20%
发文量
80
期刊介绍: LGBT Health is the premier peer-reviewed journal dedicated to promoting optimal healthcare for millions of sexual and gender minority persons worldwide by focusing specifically on health while maintaining sufficient breadth to encompass the full range of relevant biopsychosocial and health policy issues. This Journal aims to promote greater awareness of the health concerns particular to each sexual minority population, and to improve availability and delivery of culturally appropriate healthcare services. LGBT Health also encourages further research and increased funding in this critical but currently underserved domain. The Journal provides a much-needed authoritative source and international forum in all areas pertinent to LGBT health and healthcare services. Contributions from all continents are solicited including Asia and Africa which are currently underrepresented in sex research.
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