LGBT health最新文献

{"title":"Assessment of Autism Spectrum Disorder in Gender-Diverse Populations: A Systematic Review and Meta-Analysis.","authors":"Clara Gloanec, Guilhem Bonazzi, Mohamed-ElMehdi Boughanmi, Caroline Demily, Elodie Peyroux","doi":"10.1177/23258292261495121","DOIUrl":"https://doi.org/10.1177/23258292261495121","url":null,"abstract":"<p><strong>Purpose: </strong>This review aimed to determine how autism spectrum disorder (ASD) and autistic traits are assessed in gender-diverse populations.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines, we conducted a systematic review and meta-analysis of studies published from January 2013 in English or French that focused on gender-diverse individuals and reported diagnostic procedures and/or tools used to assess ASD. Only studies involving human participants were included. Reviews, meta-analyses, case reports, editorials, posters, and conference abstracts were excluded. Two independent reviewers screened records and extracted data using a standardized form, including study design, sample characteristics, diagnostic instruments, and assessment procedures. Data were synthesized qualitatively, and pooled prevalence estimates were calculated using random-effects meta-analysis when appropriate. Methodological quality and risk of bias were assessed using the Joanna Briggs Institute tools for analytical cross-sectional studies and for case-control studies.</p><p><strong>Results: </strong>Twenty-eight studies met the inclusion criteria. Eighteen assessed ASD diagnoses; only six (33%) used robust diagnostic criteria, identifying 100 participants with a confirmed ASD diagnosis (5.4%) among 1855 participants. Other studies relied mainly on self-report or screening instruments. Twenty-three studies examined the broader autism phenotype using 13 different tools. The pooled prevalence of robust ASD diagnosis was 12% (95% confidence interval [CI] = 7%-19%), and broader autism phenotype prevalence was 24% (95% CI = 17%-33%).</p><p><strong>Conclusions: </strong>Few studies met clinical gold standards. Elevated prevalence estimates may reflect methodological variability and barriers to appropriate evaluation. Training in both ASD and gender diversity is essential for inclusive and accurate diagnostic practices.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"23258292261495121"},"PeriodicalIF":3.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169725","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":"Care of the Sexual or Gender Minority Community Living with Cystic Fibrosis: A Survey of United States and Canadian Multidisciplinary Health Care Providers.","authors":"Traci M Kazmerski, Olivia M Stransky, MinJae Lee, Adrianne Alpern, Jonathan Greenberg, Raksha Jain, Mitchell R Lunn, John Palla, Asher Prangley, Rachel Salyer, Vin Tangpricha, Gregory S Sawicki, Kacie M Kidd","doi":"10.1177/23258292261495120","DOIUrl":"https://doi.org/10.1177/23258292261495120","url":null,"abstract":"<p><strong>Purpose: </strong>Lesbian, gay, bisexual, transgender, queer, intersex, asexual, or another sexual or gender minority (LGBTQIA+) people face health inequities and commonly report health care avoidance. We examined how multidisciplinary subspecialist providers care for LGBTQIA+ people with pediatric-onset chronic conditions, using cystic fibrosis (CF) as a model.</p><p><strong>Methods: </strong>We conducted a survey of United States and Canadian CF providers regarding their LGBTQIA+ health knowledge, attitudes, comfort, and practices from January-September 2024. We analyzed results descriptively and compared responses by key variables using chi-square tests.</p><p><strong>Results: </strong>Among 389 participants, 15% felt that there are only two genders and 6% reported discomfort working with LGBTQIA+ people based on personal beliefs. Nearly all (87%) agreed that asking about gender identity and sexual orientation is important to health care. Thirty percent felt unprepared to discuss concerns related to sexual orientation or gender identity, and 86% felt that they would be a better clinician if they had more training on supporting LGBTQIA+ people. Fifty-one percent reported asking their CF patients about their sexual orientation, 57% about their gender identity, and 73% about their affirmed name/pronouns. Forty-three percent of U.S. and 20% of Canadian respondents reported receiving training on supporting LGBTQIA+ people.</p><p><strong>Conclusion: </strong>CF providers valued addressing LGBTQIA+ health but lacked expertise, training, and resources to routinely do so. Future research should explore the experiences and health outcomes of LGBTQIA+ people with CF and develop needed provider education.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"23258292261495120"},"PeriodicalIF":3.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168173","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":"Mental Health Outcomes Among Transgender People in South Africa During the COVID-19 Pandemic: A Cross-Sectional Analysis of Service Disruptions and Social, Structural, and Relational Correlates.","authors":"Craig J Heck, Erik Lamontagne, Lara Lewis, Tian Johnson, Ntombenhle Mkhize, Danai Nyagani, Delivette Castor, Quarraisha Abdool Karim","doi":"10.1177/23258292261495119","DOIUrl":"https://doi.org/10.1177/23258292261495119","url":null,"abstract":"<p><strong>Purpose: </strong>We examined how sociodemographic, structural, and violence-related factors and disruptions in HIV services and gender-affirming care (GAC: nonmedical supplies, therapy/counseling, medications/hormones, surgeries) were associated with suicidal ideation and moderate/severe anxiety and depression symptoms among South African transgender people.</p><p><strong>Methods: </strong>In September-November 2021, surveyors sampled populations with high HIV risk to understand COVID-19 pandemic experiences. We analyzed sociodemographic, structural (housing, food, financial insecurities), and violence correlates of suicidal ideation and anxiety and depression symptoms. We estimated associations of disruptions in HIV services and GAC with suicidal ideation and anxiety and depression symptoms, adjusting for identified correlates. Additional analyses were stratified by HIV status and age (15-24, 25-30, >30).</p><p><strong>Results: </strong>Among 194 transgender people, 27% (<i>N</i> = 190) reported suicidal ideation and 37% (<i>N</i> = 178) reported anxiety and depression symptoms. Factors positively associated with suicidal ideation included living with disabilities, increasing educational attainment, unemployment, financial and housing insecurity, and emotional violence; social and structural vulnerabilities affected nearly all HIV and age strata. Correlates positively associated with moderate/severe anxiety and depression symptoms comprised age, housing insecurity, and economic violence. Disruptions in gender-affirming therapy/counseling, medications/hormones, and/or surgeries were positively associated with moderate/severe anxiety and depression symptoms (overall; people without HIV; aged 15-24, 25-30) and suicidal ideation (aged 15-24). In those reporting HIV service disruptions, suicidal ideation (overall, aged 15-24) and anxiety and depression symptoms (overall, aged 25-30) were higher.</p><p><strong>Conclusions: </strong>Social and structural inequalities were associated with suicidal ideation; GAC and HIV service disruptions were mostly associated with moderate/severe anxiety and depression symptoms. Improving transgender people's mental health requires reducing inequalities while preserving care linkages and access.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"23258292261495119"},"PeriodicalIF":3.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137443","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":"Inclusion of Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Populations in Mongolian Health Policy: A Scoping Review and Critical Discourse Analysis.","authors":"Dorjjantsan Ganbaatar, Thiago M Santos, Nicholas Hill, Enkhmaa Enkhbold, Erdeneburen Dorjpurev, Sugarmaa Myagmarjav, Cathy Vaughan, Meghan A Bohren","doi":"10.1177/23258292261474885","DOIUrl":"10.1177/23258292261474885","url":null,"abstract":"<p><strong>Purpose: </strong>This review explored the inclusion of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) people in current Mongolian health policies, providing an overview and identifying gaps to improve inclusion.</p><p><strong>Methods: </strong>We conducted a scoping review of health policies and used critical discourse analysis (CDA) to explore how policy language constructs LGBTQI identities, representation in policies, and opportunities for inclusion. CDA assessed LGBTQI inclusion across three levels: textual, contextual, and societal. We included currently active, publicly accessible policies relevant to LGBTQI health, with no date restrictions. Policies were identified through targeted searches of two government websites (Legal Info, Ministry of Health), incorporated with a reference search and expert consultation.</p><p><strong>Results: </strong>The final analysis included 24 documents, and 25 different LGBTQI related terms were identified. LGBTQI communities were mostly mentioned in sexually transmitted infection (STI) related policies, and the most common terms were associated with high-risk sexual behavior. Only one document specifically focused on the LGBTQI community, while four identified LGBTQI people as a priority group; however, all primarily referred to men who have sex with men (MSM), with some including transgender women. At the societal level, we identified three recurring framings (problem, victimhood, and invisible) which reflected broader social norms and values about LGBTQI people.</p><p><strong>Conclusion: </strong>LGBTQI inclusion in Mongolia's health policies remains limited, and primarily centered on STI risk among MSM and sometimes transgender women. This has resulted in the needs of other sub-communities being overlooked, rendering lesbian and bisexual women, transgender men, and intersex people largely invisible.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"417-429"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684972","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":"A National Audit of Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual Inclusive Practice Curriculum Content in Australian Tertiary Medicine Programs.","authors":"Holly Moss, Helen Wilcox, Jeneva L Ohan, Penelope Strauss, Helen A Morgan, Kirsty Hird, Yael Perry","doi":"10.1177/23258292261486038","DOIUrl":"10.1177/23258292261486038","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to describe current lesbian, gay, bisexual, transgender, queer, intersex, and asexual people and those with other diverse sexualities or genders (LGBTQIA+) curriculum content in Australian medical programs, as well as methods for development and improvement of inclusive practice content.</p><p><strong>Methods: </strong>The study utilized a cross-sectional, mixed-methods online survey design of course directors of Australian Medical Council-accredited medical programs (a qualification from these programs leads to general registration as a medical practitioner [doctor] in Australia). In 2024, <i>N</i> = 15 of 22 (68%) eligible programs completed the 21-item survey. Key content within the survey included duration of dedicated content, mode of delivery, coverage of 36 content areas, and identification of strategies for improvement of content. Descriptive statistics were calculated, and open-text responses were reviewed descriptively to contextualize the quantitative findings.</p><p><strong>Results: </strong>The number of hours of LGBTQIA+ curriculum content delivered ranged from 3 to 40 (median = 10, interquartile range = 6-10), with most (80%) of programs interspersing content throughout the curriculum, rather than providing dedicated modules. The most frequently taught content areas in compulsory curricula included defining common sexuality and gender terms (93%), using LGBTQIA+ inclusive language (80%), and social/legal gender affirmation (80%). Content regarding the health of people with innate variations of sex characteristics was least commonly taught. Overall, respondents described coverage of LGBTQIA+ content in their programs as fair to good.</p><p><strong>Conclusion: </strong>Although LGBTQIA+ curriculum content in Australian medical programs has increased over time, its delivery, duration, and scope remain variable. Inclusion of LGBTQIA+ specific competencies in future competency frameworks will ensure more consistent and effective delivery of inclusive practice training and care.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"438-447"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920414","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":"Twelve Years of <i>LGBT Health</i>: An Editorial Farewell.","authors":"William Byne","doi":"10.1177/23258292261480717","DOIUrl":"10.1177/23258292261480717","url":null,"abstract":"","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"401-402"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864956","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":"Reproductive Intentions and Fertility Preservation Among Transgender and Nonbinary Individuals: A Cross-Sectional Study in Brazil.","authors":"Letícia A Mendonça, Isabela G Silva, Iris T T Umeda, Phelipe E Silva, Heitor Bernardes P Delfino, Camila Toffoli-Ribeiro","doi":"10.1177/23258292261480721","DOIUrl":"10.1177/23258292261480721","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated reproductive intentions, fertility-related knowledge, prior fertility counseling, and factors associated with reproductive intentions among transgender and nonbinary individuals receiving care at a Brazilian public reference center.</p><p><strong>Methods: </strong>This cross-sectional study with a qualitative component was conducted between July and November 2025 in a specialized gender-affirming care clinic in Brazil. Quantitative data included sociodemographic characteristics, reproductive history, gender-affirming hormone therapy (GAHT), and fertility-related variables. Logistic regression was used to assess factors associated with desire for future parenthood. Responses to a single open-ended question regarding perceived effects of GAHT on fertility were analyzed using thematic content analysis.</p><p><strong>Results: </strong>Eighty-two participants were included (mean age 27.5 ± 7.4 years). Most identified as transgender men (65.9%), followed by transgender women (26.8%) and nonbinary individuals (7.3%); 79.3% were receiving GAHT. Although 63.4% expressed a desire for future parenthood, only 7.3% had children. Current interest in fertility preservation was reported by 20.8% (15/72). Having children (adjusted odds ratio [aOR] = 0.03; 95% confidence interval [CI]: 0.001-0.62; <i>p</i> = 0.023) and each additional year of GAHT duration (aOR = 0.83; 95% CI: 0.70-0.99; <i>p</i> = 0.038) were associated with lower odds of desiring future parenthood. Sex assigned at birth was not independently associated with reproductive intentions. Qualitative analysis revealed misconceptions, uncertainty, and conditional beliefs regarding fertility.</p><p><strong>Conclusions: </strong>Desire for future parenthood was common among transgender and nonbinary individuals, whereas engagement with fertility preservation remained limited. These findings highlight the need for longitudinal, patient-centered reproductive counseling integrated into gender-affirming care.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"430-437"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865881","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":"Clinical Setting-Based Medical Care of Transgender and Gender-Diverse Individuals in East Asia: A Scoping Review.","authors":"Isu Hong, Junseo Oh, Seyoung Son, Yu-Mi Kim","doi":"10.1177/23258292261480722","DOIUrl":"10.1177/23258292261480722","url":null,"abstract":"<p><strong>Purpose: </strong>Transgender and gender-diverse (TGD) individuals in East Asia face significant structural barriers in health care utilization, yet systematic evidence focusing on clinical delivery remains scarce. This scoping review mapped available evidence on clinical setting-based medical care utilization for TGD populations in East Asia, analyzing health care delivery models, diagnostic practices, and institutional gaps affecting service utilization within medical facilities.</p><p><strong>Methods: </strong>Following the Arksey and O'Malley framework, a comprehensive search of PubMed, Scopus, and Web of Science was conducted for original peer-reviewed studies published between January 2000 and December 2024. Inclusion criteria targeted research published in English involving TGD participants receiving medical services within East Asian clinical settings. Two reviewers independently performed study selection and data extraction, focusing on clinical characteristics, diagnostic nomenclature, and policy contexts.</p><p><strong>Results: </strong>Thirty-five studies met the inclusion criteria, primarily from university-based tertiary care settings in Japan, Korea, Taiwan, and China. Clinical care concentrated heavily on tertiary prevention, such as surgical interventions and hormone therapy, whereas primary prevention and long-term rehabilitative care were significantly underrepresented. Diagnostic terminology showed marked heterogeneity, with many institutions still relying on pathologizing frameworks. Insurance coverage for gender-affirming care varied widely, reflecting fragmented legal and institutional recognition across the region.</p><p><strong>Conclusion: </strong>Research on TGD health care in East Asia is largely restricted to specialized tertiary centers, highlighting an urgent need for evidence from primary and community-based clinical settings. To ensure equitable medical care, regional health care systems must prioritize inclusive clinical protocols, standardized terminology, and expanded insurance coverage for essential gender-affirming treatments.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"403-416"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874487","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":"Endometriosis in Transgender and Gender-Diverse People: A Mixed-Methods Study.","authors":"Roselyn Terrazos-Moreno, Jessica Liu, Iman Berrahou","doi":"10.1177/23258292261493166","DOIUrl":"https://doi.org/10.1177/23258292261493166","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the experiences of transgender and gender-diverse (TGD) individuals assigned female at birth with endometriosis.</p><p><strong>Methods: </strong>This was a mixed-methods study conducted from August 2024 to March 2025. TGD individuals assigned female at birth with endometriosis were recruited through LGBTQ+ forums, mailing lists, and clinical sites. Surveys and semi-structured interviews were conducted. The survey included demographic questions and the Endometriosis Health Profile-30 (EHP-30), scored 0-100 (100 = worst health status). Interview transcripts were coded with ATLAS.ti, and codes were grouped into themes.</p><p><strong>Results: </strong>Among 29 participants, the mean participant age was 29.5 ± 6.8 years. The mean age of symptom onset was 15.5 years (standard deviation 6.2). Most identified as nonbinary (<i>n</i> = 18, 62.1%). The highest EHP-30 dimension was \"control and powerlessness\" (65.2). Interview themes included the following: (1) impact of pain on well-being and identity, (2) barriers to trust in health care providers, and (3) desire for collaborative care. Participants highlighted a desire for gender identity representation, along with racial representation, in endometriosis support groups. Although most reported that the EHP-30 captured their experiences, some stated that the intersection of their TGD identity and symptoms was missed.</p><p><strong>Conclusion: </strong>TGD individuals assigned female at birth with endometriosis face unique barriers that impact health care experiences and diminish the quality of life. Health care systems must focus on gender inclusive provider education, care models, and support groups that acknowledge the distinct challenges TGD individuals face in accessing endometriosis care.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"23258292261493166"},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111692","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":"Response to Schuler and Prince Re: \"Disparities in Substance Use and Psychological Distress During Pregnancy Among Pregnant Bisexual and Heterosexual Females in the United States\".","authors":"Colleen A Reynolds, Payal Chakraborty","doi":"10.1177/23258292261488844","DOIUrl":"https://doi.org/10.1177/23258292261488844","url":null,"abstract":"","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"23258292261488844"},"PeriodicalIF":3.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148969492","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}