Gender-Affirming Hormone Therapy and Cervical Cancer Screening Rates in Transgender Men and Nonbinary People: A Cross-Sectional Study from a Boston Community Health Center.

IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
LGBT health Pub Date : 2024-10-01 Epub Date: 2024-04-26 DOI:10.1089/lgbt.2023.0418
Julia Fleming, Chris Grasso, Kenneth H Mayer, Sari L Reisner, Jennifer Potter, Carl G Streed
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Abstract

Purpose: Clinical monitoring for patients receiving gender-affirming hormone therapy (GAHT) has the potential to facilitate their receipt of preventive health services. We aimed to determine whether GAHT is associated with increased utilization of cervical cancer screening among transgender men (TM) and nonbinary persons assigned female at birth (NB-AFAB). Methods: We conducted a cross-sectional observational study of a single community health center in Boston. Persons of all gender identities eligible for cervical cancer screening during 2008-2019 were assessed. The outcome of interest was receipt of cervical cancer screening based on U.S. Preventive Services Task Force recommendations. We compared the proportion of persons who received cervical cancer screening by prescription of GAHT. Results: We identified 13,267 eligible persons. This cohort included 10,547 (79.5%) cisgender women, 1547 (11.7%) TM, and 1173 (8.8%) NB-AFAB persons. Among all persons eligible for cervical cancer screening, TM and NB-AFAB persons were less likely to receive screening than cisgender women (56.2% and 56.1% vs. 60.5% respectively; odds ratio [OR] = 0.84; 95% confidence interval [CI] = 0.75-0.93; OR = 0.84; 95% CI = 0.74-0.94, respectively). Among TM, those prescribed testosterone were more likely to receive cervical cancer screening than those not prescribed testosterone (57.9% vs. 48.2%, OR = 1.47; 95% CI = 1.14-1.92). Among NB-AFAB adults, those prescribed testosterone were more likely to receive cervical cancer screening than those not prescribed testosterone (61.9% vs. 51.5%, OR = 1.53; 95% CI = 1.21-1.93). Conclusions: The benefits of engagement in care to access GAHT may extend beyond the hormonal intervention to preventive health services.

变性男性和非二元人群的性别确认激素疗法和宫颈癌筛查率:波士顿一家社区医疗中心的横断面研究》(Cross-Sectional Study from a Boston Community Health Center)。
目的:对接受性别确认激素疗法(GAHT)的患者进行临床监测有可能促进他们接受预防保健服务。我们旨在确定 GAHT 是否与变性男性 (TM) 和出生时被指派为女性的非二元性人士 (NB-AFAB) 宫颈癌筛查利用率的提高有关。研究方法我们对波士顿的一家社区医疗中心进行了横断面观察研究。我们对 2008-2019 年期间符合宫颈癌筛查条件的所有性别认同者进行了评估。研究结果是根据美国预防服务工作组的建议接受了宫颈癌筛查。我们比较了根据 GAHT 处方接受宫颈癌筛查的人数比例。结果:我们确定了 13,267 名符合条件的人员。其中包括 10,547 名(79.5%)顺性别女性、1547 名(11.7%)TM 和 1173 名(8.8%)NB-AFAB 患者。在所有符合宫颈癌筛查条件的人群中,TM 和 NB-AFAB 患者接受筛查的可能性低于顺性别女性(分别为 56.2% 和 56.1% vs. 60.5%;几率比 [OR] = 0.84;95% 置信区间 [CI] = 0.75-0.93;OR = 0.84;95% CI = 0.74-0.94)。在TM中,与未服用睾酮的人相比,服用睾酮的人更有可能接受宫颈癌筛查(57.9% vs. 48.2%,OR = 1.47; 95% CI = 1.14-1.92)。在 NB-AFAB 成人中,处方睾酮的人比未处方睾酮的人更有可能接受宫颈癌筛查(61.9% 对 51.5%,OR = 1.53;95% CI = 1.21-1.93)。结论参与护理以获得 GAHT 的益处可能会超出激素干预的范围,扩大到预防保健服务。
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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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