LGBT health最新文献

{"title":"Protective Effects of Online Safety and Parental Acceptance for Sexual and Gender Minority Latinx Youth: A Quantitative Analysis of Cyberbullying, Psychological Distress, and Coping with Alcohol.","authors":"Aldo M Barrita, Roberto L Abreu, Joshua G Parmenter, Ryan J Watson","doi":"10.1089/lgbt.2024.0396","DOIUrl":"https://doi.org/10.1089/lgbt.2024.0396","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study explored the relation between intersectional cyberbullying (racism and cis heterosexism) and alcohol use as a coping strategy among sexual and gender minority (SGM) Latinx youth and assessed the psychological impact of these experiences and protective factors such as online safety and parental acceptance. <b><i>Methods:</i></b> Focusing on SGM Latinx youth (<i>N</i> = 1145) from the 2022 LGBTQ National Teen Survey collected within the United States, we explored the effects of intersectional cyberbullying (predictor; adapted version of the Bullying and Victimization Scale) on coping strategies involving alcohol use (outcome; Drinking Motive Questionnaire Revised Short Form) and psychological distress (mediator; Patient Health Questionnaire) and its interaction with online safety and parental acceptance (moderators; LGBTQ Parents Support Scale) using a mediation and a moderated mediation analyses (Hayes Models 4 and 21). <b><i>Results:</i></b> Intersectional cyberbullying was associated with alcohol use to cope, and psychological distress mediated this relation. Furthermore, both online safety and parental acceptance were significant moderators in this mediated relation, where higher levels of either moderator were associated with lower psychological distress or use of alcohol as a coping strategy. <b><i>Conclusions:</i></b> Our findings present key clinical and public health implications for SGM Latinx youth experiencing virtual forms of oppression.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Health Care Discrimination and Medical Mistrust Among Black Assigned Female at Birth Adults with Minoritized Sexual and Gender Identities in the United States.","authors":"Madeline Noh, Neil Mehta, Chloe Kim, Keosha Bond, Megan Threats, John W Jackson, Nkiru Nnawulezi, Madina Agénor","doi":"10.1089/lgbt.2024.0263","DOIUrl":"10.1089/lgbt.2024.0263","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Black sexually and gender minoritized (SGM) people who were assigned female at birth (AFAB) experience compounding health care inequities, barriers to equitable care, and disproportionately adverse health outcomes. Given prior literature indicating that both experienced and/or anticipated reported health care discrimination and medical mistrust may shape these health care experiences of Black SGM AFAB people, we sought to investigate the specific interplay between these two factors to bolster understanding of their relationship. <b><i>Methods:</i></b> In January and February 2023, we conducted a cross-sectional online survey of 156 Black SGM AFAB adults in the United States (U.S.) assessing their reported lifetime experiences of all-cause and gender-, race/ethnicity-, and weight-based discrimination in health care settings, in addition to their ratings of medical mistrust on the Medical Mistrust Index (MMI). Univariate statistics, analysis of variance, <i>post hoc</i> pairwise tests, and multivariable linear regression were conducted to assess measures of health care discrimination, medical mistrust, and covariates and their associations among the analytic sample (<i>n</i> = 130). <b><i>Results:</i></b> Most participants reported prior experiences of health care discrimination. Adjusting for demographic, socioeconomic, and health care factors, we identified an association between experiencing any-cause-, race/ethnicity-, or weight-based discrimination and significantly higher MMI scores. The association for gender-based discrimination was not statistically significant. <b><i>Conclusion:</i></b> Black SGM AFAB people who experience any-cause-, race/ethnicity-, or weight-based discrimination may be more likely to experience higher levels of medical mistrust. Identifying interventions and pathways to tackle health care discrimination and the systemic and structural drivers of medical mistrust will be critical to augmenting health care outcomes and experiences of Black SGM communities.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"340-349"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating Transgender and Gender-Diverse Veterans in the Veterans Health Administration: 23 Years of Findings.","authors":"Laurel A Copeland, Hill L Wolfe, Sarah S Jackson, Neda Buljubasic, Michael R Kauth, Leila Hashemi","doi":"10.1089/lgbt.2024.0314","DOIUrl":"10.1089/lgbt.2024.0314","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Many transgender and gender-diverse (TGD) people experience significant barriers to health care access, facing disparities in care, limited payments for gender-affirming services, or insufficient training and knowledge among providers. Given validation studies reporting increasing rates of TGD-related status, we documented health care types used by TGD veterans to signal whether engagement in Veterans Health Administration (VHA) care increased or decreased following documentation of a TGD-related diagnosis code. <b><i>Methods:</i></b> The cohort was defined by receipt of a TGD-related diagnosis code in the VHA Corporate Data Warehouse from October 1, 1999, through September 30, 2021 (fiscal years 2000 through 2021). Data were summarized in two 1-year periods before and after TGD-related diagnosis. Logistic regression estimated predictors of VHA care post-TGD-related diagnosis as well as filling gender-affirming prescriptions in the VHA. <b><i>Results:</i></b> Over the 23-year study period, 9894 transgender veterans were identified. Among the 91% using VHA both before and after TGD diagnosis, visits for primary, specialty, and mental and behavioral health care increased whereas emergency care did not change. Factors associated with discontinuing VHA care were Black/African American and another race, married status, older age, and service in recent versus earlier eras. Younger, highly disabled from military service veterans and those in the West (vs. South) were more likely to fill gender-affirming prescriptions in the VHA. <b><i>Conclusion:</i></b> This study established high levels of disability and apparent willingness to continue with care in the VHA following establishment of TGD status. The role of interpersonal, provider, and policy in VHA retention remains to be examined.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"363-371"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minority Stress Clusters and Health and Cancer Care Outcomes of Sexual and Gender Minority Cancer Survivors.","authors":"Oscar Y Franco-Rocha, Ashley M Henneghan, Shelli R Kesler, Christopher W Wheldon","doi":"10.1089/lgbt.2024.0311","DOIUrl":"10.1089/lgbt.2024.0311","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Structural factors affect the health of sexual and gender minority (SGM) cancer survivors, yet how people experience minority stress within their social and health care systems remains unclear. We explored experiences of minority stress across health care and sociocultural contexts and their impact on health and cancer outcomes. <b><i>Methods:</i></b> We conducted a K-medoid cluster analysis (grouping technique) using data from 2519 participants (training subset = 2015, testing subset = 504) from OUT: The National Cancer Survey (2020-2021). Cluster differences in the testing subset were assessed using chi-square, analysis of variance, and nonparametric tests. Regression models examined associations between cluster membership and health (mentally unhealthy days) and cancer outcomes (perceived welcomeness after identity disclosure and treatment satisfaction), adjusting for demographic and clinical factors. <b><i>Results:</i></b> Five clusters emerged, differing in demographics, mental and social health outcomes, SGM identity disclosure, and perceived welcomeness after disclosure (0.017 < <i>p</i> < 0.001). Cluster one experienced poorer mental health than cluster five (odds ratio [OR] = 1.182, 95% confidence interval [CI] = 1.003-1.392), lower cancer care satisfaction than all other clusters (1.177 < OR <1.265; 1.091 < 95% CI <1.389), and perceived less welcoming or unchanged environments after SGM identity disclosure than all other clusters (1.278 < OR <1.314; 1.161 < 95% CI <1.431). <b><i>Conclusion:</i></b> The study highlights the impact of minority stress across different contexts. The findings emphasize the need for targeted interventions to address the unique vulnerabilities of SGM individuals, particularly in health care contexts, to improve their overall health and cancer care experiences.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"329-339"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Reliability of Assessing Gender Minority Status Based on Gender Identity and Sex Assigned at Birth in the African Context: Findings from the HIV Prevention Trials Network 075 Study.","authors":"Theo G M Sandfort, Karen Dominguez, Yamikani Chimwaza, Calvin Mbeda, Jonathan Lucas, Erica I Hamilton","doi":"10.1089/lgbt.2024.0221","DOIUrl":"10.1089/lgbt.2024.0221","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study evaluated the reliability of assessing transgender status in African populations using questions about current gender identification and sex assigned at birth. <b><i>Methods:</i></b> Data were obtained from the HIV Prevention Trials Network 075, a study designed to assess the feasibility of recruiting and retaining 400 men who have sex with men (MSM) in a 1-year prospective cohort study in Kenya, Malawi, and South Africa and conducted from 2015 to 2017. We compared responses of 401 participants to questions about gender identity obtained at the screening and enrollment visits and, for a subset of participants, in open interviews 6-9 months after enrollment. <b><i>Results:</i></b> One hundred and eleven of the 401 persons reported to identify as female or transgender at either the screening visit and/or the enrollment visit. Of those 111 persons, 42 (37.8%) switched between the two assessment moments from male to female or transgender, or vice versa. Furthermore, most transgender women were sexually attracted to men and identified as gay. In the follow-up interview with a subset of participants, almost all persons categorized as transgender identified as MSM. <b><i>Conclusion:</i></b> Categorizing persons as transgender based on self-identified gender and sex assigned at birth has limited reliability in African populations. Possible explanations for the observed inconsistencies in the responses to gender-related questions are discussed. For future studies, an understanding is needed of what specific words and labels such as gender, female, or transgender mean to study participants.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"378-385"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking Down Barriers for Same-Sex Female Couples Building Families: <i>In Vitro</i> Fertilization Utilization Following the Enactment of 2021 Legislation in New York State.","authors":"Katrina S Nietsch, Bethany Dubois, Isabelle Band, Shawn Kripalani, Dmitry Gounko, Joseph A Lee, Eric Flisser, Alan B Copperman, Samantha L Estevez","doi":"10.1089/lgbt.2024.0199","DOIUrl":"10.1089/lgbt.2024.0199","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> In 2021, New York State passed legislation that eliminated the requirement that same-sex female couples needed up to 12 months of intrauterine insemination with donor sperm to meet the medical definition of infertility and qualify for insurance coverage. This study compared the duration of time from consultation to utilization of <i>in vitro</i> fertilization (IVF) by same-sex female couples before and after the New York legislative change. <b><i>Methods:</i></b> Same-sex female couples who underwent IVF or reciprocal IVF between 2010 and 2023 in New York City were categorized into pre- and postlegislation cohorts based on when they sought initial treatment. The primary outcome was time from consultation to initiation of IVF or reciprocal IVF. Secondary outcomes included time from consultation to clinical pregnancy with discharge to obstetrical care. <b><i>Results:</i></b> Overall, 239 couples were included. The postlegislation cohort had a shorter median length of time from consultation to initiation of IVF (173 vs. 297 days, <i>p</i> < 0.001; hazard ratio 2.36, <i>p</i> < 0.001) and a significant increase in the proportion of couples initiating treatment less than 1 year after consultation (86% vs. 57%, <i>p</i> = 0.01). They also had a decreased median time to discharge with ongoing pregnancy (383 vs. 535 days, <i>p</i> = 0.006). Same-sex female couples had 136% increased chances of initiating IVF after consultation compared with before the legislation. <b><i>Conclusion:</i></b> After the expansion of fertility insurance coverage, same-sex couples at a single New York City institution initiated IVF treatment and achieved pregnancy more rapidly after consultation than prior to the expansion.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"386-393"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring HIV Risk Among Sexual Minority Women by Identity and Behavior in a Population-Based Sample of Low-Income Heterosexually Active Women.","authors":"Jennifer L Glick, Amy R Baugher, Elana Morris, Danielle German, Kamila A Alexander, Susan Cha, Catlainn Sionean","doi":"10.1089/lgbt.2024.0098","DOIUrl":"10.1089/lgbt.2024.0098","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Research suggests that sexual minority women (SMW) face elevated HIV risk compared with their heterosexual counterparts. This study examined the association between sexual minority status-defined by identity and behavior-and HIV-related vulnerabilities among heterosexually active low-income women. <b><i>Methods:</i></b> This analysis used National HIV Behavioral Surveillance data (<i>n</i> = 5542) collected in 2019 from heterosexually active low-income women in 23 U.S. urban areas. We examined sexual minority identity and behavior and a set of substance use, sexual behavior, health and health care, and social determinants of health indicators commonly associated with heightened HIV transmission risk. Log-linked Poisson regression models generated adjusted prevalence ratios and 95% confidence intervals. <b><i>Results:</i></b> Among women who reported sexual minority identity (22.2%; <i>n</i> = 1231), 34.6% (<i>n</i> = 426) reported past-year sex with only men. Of women who reported past-year sex with both women and men (17.8%; <i>n</i> = 985), 18.3% (<i>n</i> = 180) identified as heterosexual. In adjusted models, SMW had significantly higher prevalence of nearly every HIV risk-associated factor examined than their heterosexual counterparts. Risk profiles by identity and behavior were similar. Notably, SMW defined by behavior had similar or higher prevalence of nearly every risk factor than those defined by identity. <b><i>Conclusions:</i></b> This study demonstrates disproportionate HIV-related vulnerabilities among SMW compared with their heterosexual counterparts. The findings underscore the importance of measuring multiple dimensions of sexual orientation (identity and behavior), as SMW and their associated risks show important nuances. Implications include tailoring HIV prevention and health promotion interventions to meet the needs of low-income SMW.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"350-362"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Joint Pain Disparities for U.S. Transgender Adults: Behavioral Risk Factor Surveillance System, 2020.","authors":"Noah Zazanis, Seth J Prins","doi":"10.1089/lgbt.2024.0067","DOIUrl":"10.1089/lgbt.2024.0067","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Several studies have found that sexual minority individuals are at greater risk for chronic pain. However, these studies did not ask about gender identity, and research on chronic pain in transgender populations remains scarce. This present study examined the relationship between transgender status and chronic joint pain disorders among U.S. adults. <b><i>Methods:</i></b> Data were obtained from the 2020 Behavioral Risk Factor Surveillance System. We compared odds of chronic joint pain disorders by transgender status (<i>n</i> transgender = 967, cisgender = 217,943, don't know/not sure = 648, refused = 2072) using logistic regression adjusting for age. <b><i>Results:</i></b> After adjusting for age, transgender respondents reported greater odds of chronic joint pain disorders (adjusted odds ratio [AOR] = 1.24, 95% confidence interval [CI] = 1.05-1.48), compared with cisgender respondents. Odds for chronic joint pain disorders were lower for the \"refused\" group (AOR = 0.84, 95% CI = 0.76-0.93) and for those who answered \"don't know/not sure\" (AOR = 0.73, 95% CI = 0.61-0.88). <b><i>Conclusion:</i></b> Consistent with preliminary evidence and with the minority stress model, transgender respondents were at increased odds of chronic joint pain disorders when adjusting for age.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"372-377"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the State of Published Research Concerning COVID-19 and Transgender and Nonbinary People in the United States via a Scoping Review: Lessons Learned for Future Public Health Crises.","authors":"Jennifer L Glick, Aaron A Wiegand, Katrina S Kennedy, Molly Gribbin, Arjee Restar, Colin P Flynn, Danielle German","doi":"10.1089/lgbt.2023.0422","DOIUrl":"10.1089/lgbt.2023.0422","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Transgender and nonbinary people (TNB) experienced a disproportionate burden of poor health and socioeconomic outcomes resulting from the coronavirus disease 2019 (COVID-19) pandemic, largely driven by increased vulnerability due to pervasive structural discrimination. To characterize the extent and nature of TNB inclusivity within COVID-19 research, we conducted a scoping review of studies published in English from 2019-2022 reporting COVID-19 pandemic impacts on TNB individuals in the United States. <b><i>Methods:</i></b> We searched PubMed (PubMed.gov), Embase (Elsevier), PsycInfo (EBSCO), Sociological Abstracts (ProQuest), and CINAHL (EBSCO), and TNB-focused organizational websites using search concepts 1) COVID-19, 2) TNB people. Studies were systematically reviewed for inclusion. Findings were extracted then summarized using systematic narrative synthesis. <b><i>Results:</i></b> Our search identified 1518 studies; 80 articles (65 peer-reviewed, 15 gray literature) met eligibility criteria. Most studies collected data early in the pandemic (69%) utilizing quantitative methods (79%), survey data (81%), and convenience sampling methods (65%); geographic foci varied. Many studies lacked transparent reporting on TNB involvement (80%), race/ethnicity of TNB subsamples (67%), and gender measurement (30%). The findings addressed COVID-19 (39%), mental health (29%), socioeconomics (26%), health care access (24%), physical health (13%), substance use (11%), violence/discrimination (8%), resiliency/coping (5%), gender identity/expression (5%), and sexual health (4%). <b><i>Conclusions:</i></b> A substantial amount of COVID-19 research inclusive of TNB people was conducted during the initial 2.5 years of the pandemic. However, there were key methodological (e.g., standardized measurement, enhanced community involvement) and topical gaps (e.g., social and structural resiliencies), which should be addressed in future research and practice to reduce TNB health disparities related to COVID-19 and future public health crises.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"313-328"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estradiol Concentrations for Adequate Gender-Affirming Feminizing Therapy: A Systematic Review.","authors":"Gabrielle N Winston-McPherson, Tiffany A Thomas, Matthew D Krasowski, Sofia B Ahmed, Lauren R Cirrincione, Brooke M Katzman, Christina C Pierre, Chantal L Rytz, Keila Turino Miranda, Zil Goldstein, Dina N Greene","doi":"10.1089/lgbt.2024.0407","DOIUrl":"https://doi.org/10.1089/lgbt.2024.0407","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Guidelines recommend serum estradiol concentrations of 100-200 pg/mL for transgender women prescribed oral, subcutaneous, or transdermal estradiol with or without adjunct antiandrogen as gender-affirming feminizing hormone therapy (HT). The purpose of this systematic review was to evaluate if the guideline range of 100-200 pg/mL for estradiol concentration is associated with indicators of adequate gender-affirming feminizing HT, specifically feminizing sufficiency, insufficiency, testosterone suppression, or toxicity in transgender women. <b><i>Methods:</i></b> The Populations/Intervention/Comparator/Outcome model was applied to the study question, whereby the target population included transgender, gender-diverse, and nonbinary adults using gender-affirming feminizing HT by any route of administration, with or without adjunct antiandrogen use. The comparator was defined as estradiol concentrations within (100-200 pg/mL or 367-734 pM) versus outside (</>100-200 pg/mL) the guideline range; evaluated outcomes were listed by the same clinical guidelines that recommend using the 100-200 pg/mL range. Embase, MEDLINE, and Web of Science were queried over a 24-year time frame (January 1, 1999-April 20, 2023); the search was restricted to English. The extracted outcomes were categorized as indicators of therapeutic insufficiency, sufficiency, toxicity, or hormone concentration. <b><i>Results:</i></b> There were 49 studies that met the inclusion criteria, of which 9, 42, 25, and 5 studies included indicators of therapeutic insufficiency, sufficiency, toxicity, or hormone concentration, respectively. The search did not identify articles demonstrating that the 100-200 pg/mL guideline range provides optimal feminizing outcomes or reduces adverse events. <b><i>Conclusions</i></b>: Evidence does not support using the guideline range of 100-200 pg/mL to indicate sufficient feminization in transgender women using gender-affirming feminizing HT.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}