Perceived Access to Gender-Affirming Care, Completion of Gender-Affirming Medical Interventions, and Psychological Distress Among Transgender Women of Color: The TURNNT Cohort Study.

IF 5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Jenesis Merriman, Christoffer Dharma, Su Hyun Park, Andrea Joiner, Roberta Scheinmann, Kim Watson, Cristina Herrera, John A Schneider, Sahnah Lim, Chau Trinh-Shevrin, Asa Radix, Dustin T Duncan
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引用次数: 0

Abstract

Transgender women of color (TWOC) are disproportionately impacted by psychological distress. Though gender-affirming care (GAC) has been recommended to alleviate this distress, research examining associations between perceived access to GAC, specific gender-affirming medical interventions (GAMIs), and mental health among TWOC in the United States remains limited. In this study, we examine cross-sectional and longitudinal associations between perceived access to GAC, completion of specific GAMIs, and psychological distress among TWOC, using modified Poisson regression and multilevel linear modeling. Data came from the TURNNT ("Trying to Understand Relationships, Networks and Neighborhoods Among Transgender Women of Color") Cohort Study. In multivariable analyses, increased access to GAC was associated with reduced psychological distress risk. All assessed GAMIs suggested protective effects against psychological distress (aRR < 1), with statistical significance found for breast augmentation and facial feminization surgery. On average, those with unmet GAMI needs experienced higher distress risk than those without. Longitudinally, those experiencing reduced access to GAC over 6 months faced the highest distress risk among all trajectory groups (aRR: 1.40, 95% CI: 1.08, 1.82). Our findings support the need for further inquiry in this area and suggest that policies protecting and increasing access to GAC may improve mental health among TWOC.

有色人种跨性别女性获得性别确认护理、完成性别确认医疗干预和心理困扰的感知途径:TURNNT队列研究
有色人种的跨性别女性(TWOC)受到心理困扰的影响尤为严重。虽然性别肯定护理(GAC)已被推荐用于减轻这种痛苦,但在美国的TWOC中,关于获得性别肯定护理(GAC)、特定性别肯定医疗干预(GAMIs)和心理健康之间关系的研究仍然有限。在这项研究中,我们使用改进的泊松回归和多水平线性模型,研究了TWOC中感知到的GAC获取、特定GAMIs完成和心理困扰之间的横断面和纵向关联。数据来自TURNNT(“试图理解有色人种变性女性之间的关系、网络和社区”)队列研究。在多变量分析中,获得GAC的机会增加与心理困扰风险降低有关。所有评估的GAMIs均显示对心理困扰有保护作用(aRR < 1),隆胸和面部女性化手术具有统计学意义。平均而言,那些没有满足GAMI需求的人比没有满足GAMI需求的人经历了更高的痛苦风险。纵向上,在所有轨迹组中,6个月内GAC接触减少的患者面临最高的痛苦风险(aRR: 1.40, 95% CI: 1.08, 1.82)。我们的研究结果支持在这一领域进行进一步调查的必要性,并建议保护和增加获得GAC的机会的政策可能会改善TWOC的心理健康。
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来源期刊
American journal of epidemiology
American journal of epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.40
自引率
4.00%
发文量
221
审稿时长
3-6 weeks
期刊介绍: The American Journal of Epidemiology is the oldest and one of the premier epidemiologic journals devoted to the publication of empirical research findings, opinion pieces, and methodological developments in the field of epidemiologic research. It is a peer-reviewed journal aimed at both fellow epidemiologists and those who use epidemiologic data, including public health workers and clinicians.
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