Health Service Utilization and Its Associations with Depression and Sexual Risk Behaviors Among Transgender Women in Shanghai, China.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
ACS Applied Bio Materials Pub Date : 2023-12-13 eCollection Date: 2023-12-01 DOI:10.1089/trgh.2021.0009
Liying Wang, Rachel Harris, Jane M Simoni, Qing Yue, Jie Fu, Huang Zheng, Zhen Ning, Casey D Xavier Hall, Paul A Burns, Frank Y Wong
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引用次数: 0

Abstract

Purpose: Given the limited research on health care utilization among transgender women in China, we described the use of primary health care and gender-affirming health care, and the associations between utilization of gender-affirming health care and depression and sexual risk behaviors.

Methods: We conducted a cross-sectional survey in 2017 among a purposive sample of transgender women in Shanghai, China (N=199). We examined correlates of health care utilization and its association with depression and sexual risk behaviors with Chi-square (χ2), Fisher's exact tests, and analysis of variance.

Results: The majority of the sample (78.5%) only had physician appointments when having an illness, while about one-fifth of the sample had physician appointments for yearly checkups. Nineteen out of 199 participants (9.5%) received gender-affirming surgery, among which only five used hormone therapy prescribed by a doctor (26.3%). Receiving some form of gender-affirming surgery was associated with higher depression scores [Welch's F(2, 12.22)=4.16, p=0.04], engagement in sex work (p=0.001), having 7 or more male sexual partners in the last 30 days (p=0.003), lifetime unprotected sex with a man (p=0.050), and unprotected sex with a main partner (p=0.043). Compared with transgender women who received both breast augmentation and vulvo-vaginoplasty (mean=5.86), those who received breast augmentation only (mean=12.33) scored higher on depression (p=0.04).

Conclusions: Access to gender-affirming health care is low among transgender women in this study. The utilization of gender-affirming surgery is associated with depression and sexual risk behaviors. Findings suggest China should establish national guidelines on transgender-related health care and set up more clinics to provide consultation and services for the transgender population in China.

上海跨性别女性卫生服务利用与抑郁和性危险行为的关系
目的:鉴于对中国变性女性医疗保健使用情况的研究有限,我们描述了初级医疗保健和性别肯定医疗保健的使用情况,以及性别肯定医疗保健使用情况与抑郁和性风险行为之间的关联:我们于 2017 年对中国上海的变性女性进行了一次横断面调查(样本数=199)。我们通过卡方检验(χ2)、费雪精确检验和方差分析研究了医疗保健利用率及其与抑郁和性风险行为的相关性:大多数样本(78.5%)只在生病时才去看医生,约五分之一的样本每年都去看医生做检查。199 名参与者中有 19 人(9.5%)接受了性别确认手术,其中只有 5 人使用了医生开具的荷尔蒙疗法(26.3%)。接受某种形式的性别确认手术与较高的抑郁评分[Welch's F(2, 12.22)=4.16, p=0.04]、从事性工作(p=0.001)、过去 30 天内有 7 个或更多男性性伴侣(p=0.003)、终生与男性发生无保护性行为(p=0.050)以及与主要性伴侣发生无保护性行为(p=0.043)有关。与同时接受隆胸手术和外阴阴道成形术的变性女性(平均值=5.86)相比,仅接受隆胸手术的变性女性(平均值=12.33)在抑郁方面的得分更高(p=0.04):结论:在这项研究中,变性妇女获得性别确认医疗保健的机会较少。结论:在这项研究中,变性女性获得性别确认医疗服务的比例较低,性别确认手术的使用与抑郁和性风险行为有关。研究结果表明,中国应制定变性相关医疗保健的国家指导方针,并设立更多的诊所为中国的变性人群提供咨询和服务。
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
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
期刊介绍: ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.
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