LGBT health最新文献

{"title":"Sexual Identity and Heavy Drinking Among Adults in Canada by Racially Minoritized Status and Income, 2015-2020.","authors":"Julian Gitelman, Brendan Smith, Christine M Warren, Alessandra T Andreacchi, Roman Pabayo, Erin Hobin","doi":"10.1089/lgbt.2023.0187","DOIUrl":"10.1089/lgbt.2023.0187","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Our objective was to estimate inequities in heavy drinking between heterosexual, gay or lesbian, and bisexual or pansexual individuals, by sex/gender, and to determine whether this association is heterogeneous across racially minoritized status and income groups in Canadians aged 15 and older. <b><i>Methods:</i></b> We pooled three Canadian Community Health Survey cycles (2015-2020) and used separate modified Poisson regressions to explore the sex/gender-specific association between sexual identity and heavy drinking prevalence by racially minoritized status, and income, adjusted for survey cycle, age, marital status, and region. <b><i>Results:</i></b> With racially minoritized status, and income categories collapsed, heavy drinking was 1.3 times higher (95% confidence interval [CI] = 1.0-1.7) among bisexual or pansexual women compared with heterosexual women, with no differences among men. Among racially minoritized women, heavy drinking was 2.9 (95% CI = 1.3-6.4) times higher among bisexual or pansexual women and 1.9 (95% CI = 0.7-5.2) times higher among gay or lesbian women compared with heterosexual women. Among racially minoritized men, heavy drinking was 1.9 (95% CI = 0.9-4.0) times higher among gay men compared with heterosexual men. No differences were observed across sexual identity in White men or women. Bisexual or pansexual women reported increased heavy drinking relative to heterosexual women across income quintiles. <b><i>Conclusion:</i></b> Heavy drinking is distributed heterogeneously across sexual identity, sex/gender, racially minoritized status, and income. These results encourage equity-focused interventions to reduce heavy drinking among intersecting sociodemographic groups experiencing a greater burden of heavy drinking.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"51-60"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538064","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":"Prevalence, Determinants, and Trends in the Experience and Perpetration of Intimate Partner Violence Among a Cohort of Gay, Bisexual, and Other Men Who Have Sex with Men in Montréal, Toronto, and Vancouver, Canada (2017-2022).","authors":"Stephen Juwono, Jorge Luis Flores Anato, Allison L Kirschbaum, Nicholas Metheny, Milada Dvorakova, Shayna Skakoon-Sparling, David M Moore, Daniel Grace, Trevor A Hart, Gilles Lambert, Nathan J Lachowsky, Jody Jollimore, Joseph Cox, Mathieu Maheu-Giroux","doi":"10.1089/lgbt.2023.0265","DOIUrl":"10.1089/lgbt.2023.0265","url":null,"abstract":"<p><p><b><i>Purpose</i></b>: Longitudinal data on the experience and perpetration of intimate partner violence (IPV) among gay, bisexual, and other men who have sex with men (GBM) are limited. We estimated the prevalence of past 6-month (P6M) physical and/or sexual IPV (hereafter IPV) experience and perpetration, identified their determinants, and assessed temporal trends, including the impact of the coronavirus disease (COVID)-19 pandemic. <b><i>Methods:</i></b> We used data from the <i>Engage Cohort Study</i> (2017-2022) of GBM recruited using respondent-driven sampling in Montréal, Toronto, and Vancouver. Adjusted prevalence ratios (aPRs) for determinants and self-reported P6M IPV were estimated using generalized estimating equations, accounting for attrition (inverse probability of censoring weights) and relevant covariates. Longitudinal trends of IPV were also assessed. <b><i>Results:</i></b> Between 2017 and 2022, 1455 partnered GBM (median age 32 years, 82% gay, and 71% White) had at least one follow-up visit. At baseline, 31% of participants experienced IPV in their lifetime and 17% reported ever perpetrating IPV. During follow-up, IPV experience was more common (6%, 95% confidence interval [CI]: 5%-7%) than perpetration (4%, 95% CI: 3%-5%). Factors associated with P6M IPV experience included prior IPV experience (aPR: 2.68, 95% CI: 1.76-4.08), lower education (aPR: 2.31, 95% CI: 1.32-4.04), and substance use (injection aPR: 5.05, 95% CI: 2.54-10.05, non-injection aPR: 1.68, 95% CI: 1.00-2.82). Similar factors were associated with IPV perpetration. IPV was stable over time; periods of COVID-19 restrictions were not associated with IPV changes in this cohort. <b><i>Conclusion:</i></b> Prevalence of IPV was high among GBM. Determinants related to marginalization were associated with an increased risk of IPV. Interventions should address these determinants to reduce IPV and improve health.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"37-50"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300984","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":"Commentary on \"Mental Health Diagnoses and Suicidality Among Transgender Youth in Hospital Settings,\" by Nunes-Moreno et al.","authors":"John R Blosnich","doi":"10.1089/lgbt.2024.0200","DOIUrl":"10.1089/lgbt.2024.0200","url":null,"abstract":"","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"1-2"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627092","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":"Desire for Gender-Affirming Medical Care Before Age 18 in Transgender and Nonbinary Young Adults.","authors":"Gina M Sequeira, Nicole F Kahn, Moira A Kyweluk, Kacie M Kidd, Peter G Asante, Baer Karrington, Kevin Bocek, Ruby Lucas, Dimitri Christakis, Wanda Pratt, Laura P Richardson","doi":"10.1089/lgbt.2023.0436","DOIUrl":"10.1089/lgbt.2023.0436","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> We aimed to understand transgender and nonbinary (TNB) young adults' desire to receive gender-affirming medical care (GAMC) before age 18 and identify barriers and facilitators to receiving this care in adolescence. <b><i>Methods:</i></b> A cross-sectional survey was administered to TNB young adults presenting for care between ages 18 and 20 in 2023. Descriptive statistics characterized the sample, χ² tests with <i>post hoc</i> pairwise comparisons identified differences in desire for gender-affirming medications, outness, and parental consent by gender identity and sex assigned at birth, and <i>t</i>-tests evaluated differences in barriers and facilitators to receiving care by outness to parents. <b><i>Results:</i></b> A total of 230 TNB respondents had complete data. Nearly all (94.3%) indicated they desired GAMC before age 18. Half (55.7%) of the respondents reported being out about their gender identity to a parent before age 18. Outness, discussing desire for GAMC, and asking for consent to receive GAMC from a parent were significantly more common among participants who identified as men compared to those who identified as women and among those assigned female at birth compared to those assigned male at birth. No such differences emerged when comparing nonbinary individuals to those who identified as men or women. Lack of parental willingness to consent for GAMC was cited as the primary contributor of not having received care in adolescence. <b><i>Conclusions:</i></b> Many TNB young adults desire GAMC in adolescence; however, lack of parental support is a key barrier to receiving this care, suggesting a need for more readily available resources for parents to support TNB adolescents.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"29-36"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social and Systemic Barriers to Transition-Related Surgical Procedures for Transgender Americans.","authors":"Andrew A Marano, Amitai S Miller, Wendy Castillo, Sari L Reisner, Loren S Schechter, Devin Coon","doi":"10.1089/lgbt.2023.0341","DOIUrl":"10.1089/lgbt.2023.0341","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Transgender and gender-diverse (TGD) individuals in the United States face disproportionate barriers to health care access. This study compared characteristics of individuals who have and have not undergone gender-affirming surgery with the goal of identifying social and systemic barriers to transition-related surgery. <b><i>Methods:</i></b> Data were extracted from the 2015 United States Transgender Survey, a cross-sectional nonprobability sample of nearly 28,000 TGD adults. The primary outcome was having undergone gender-affirming surgery. Multivariable logistic regression models were constructed to determine correlates of receipt of gender-affirming surgery. A subgroup analysis was performed to explore differences by insurance types regarding coverage of surgical procedures and presence of in-network providers. <b><i>Results:</i></b> In total, 6009 (21.7%) participants underwent transition-related procedures. Increased odds of undergoing surgery were associated with older age, living in congruent gender, higher education attainment, and greater income. Decreased odds were linked with male sex assignment at birth, first recognizing TGD status at older ages, living in states without trans-protective health laws, no close transgender-knowledgeable health care provider, nonbinary status, and identifying as sexual minority. Residing in states without trans-protective health laws correlated with increased surgery denials over the previous 12-month period. Compared to White TGD individuals, TGD individuals who were Black, Latinx, or Another Race were significantly more likely to encounter health equity-related barriers to surgery. <b><i>Conclusions:</i></b> Gender-affirming surgery access is differentially distributed across demographic and modifiable equity-related factors amenable to interventions. Efforts are needed to address the number and geographic distribution of transgender health-competent providers, improve TGD legal protections, and increase access to health insurance for minority TGD individuals, who are disproportionately under/uninsured.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"615-624"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288228","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 Effect of Minority Stress Processes on Smoking for Lesbian, Gay, Bisexual, Transgender, and Queer Individuals: A Systematic Review.","authors":"Mirandy Li, Kelly Chau, Kaitlyn Calabresi, Yuzhi Wang, Jack Wang, Jackson Fritz, Tung Sung Tseng","doi":"10.1089/lgbt.2022.0323","DOIUrl":"10.1089/lgbt.2022.0323","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are more likely to smoke than non-LGBTQ individuals. Smoking has been posited as a coping mechanism for LGBTQ individuals facing minority stress. However, the exact relationship between minority stress and smoking behaviors among LGBTQ individuals is unclear. Therefore, the purpose of this systematic review was to examine how minority stress processes are associated with smoking behaviors for LGBTQ individuals. <b><i>Methods:</i></b> Searches of the PubMed and PsycINFO databases were conducted for smoking-, LGBTQ-, and minority stress-related terms. No date, geographic, or language limits were used. For inclusion, the study must have (1) been written in English, (2) had an LGBTQ group as the study population or a component of the study population, (3) assessed the cigarette smoking status of participants, and (4) assessed at least one minority stress-related process (internalized stigma, perceived stigma, or prejudice events). <b><i>Results:</i></b> The final review included 44 articles. Aside from two outlier studies, all of the reviewed studies exhibited that increased levels of minority stress processes (internalized queerphobia, perceived stigma, and prejudice events) were associated with increased probability of cigarette use in LGBTQ individuals. Increased minority stress was also associated with greater psychological distress/mental health decline. <b><i>Conclusion:</i></b> The findings of this review suggest that minority stress processes represent a contributing factor to smoking health disparities in LGBTQ populations. These results highlight the need for smoking cessation and prevention programs to address minority stress and improve smoking disparities in these populations.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"583-605"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336190","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":"Retrospective Examination of Peripubertal Return for Patients of Western Australia's Gender Diversity Service.","authors":"Blake S Cavve, Xander Bickendorf, Jack Ball, Liz A Saunders, Larissa Marion, Cati S Thomas, Penelope Strauss, Georgia Chaplyn, Aaron Wiggins, Uma Ganti, Aris Siafarikas, Ashleigh Lin, Julia K Moore","doi":"10.1089/lgbt.2023.0256","DOIUrl":"10.1089/lgbt.2023.0256","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Children far in advance of pubertal development may be deferred from further assessment for gender-affirming medical treatment until nearer puberty. It is vital that returning peripubertal patients are seen promptly to ensure time-sensitive assessment and provision of puberty suppression treatment where appropriate. This study investigates (1) how many referrals to the Child and Adolescent Health Service Gender Diversity Service at Perth Children's Hospital are deferred due to prepubertal status; and (2) how many deferred patients return peripubertally. <b><i>Methods:</i></b> A retrospective review of all closed referrals to the service was conducted to determine the frequency of prepubertal deferral and peripubertal re-referral. <b><i>Results:</i></b> Of 995 referrals received (2014 to 2020), 552 were closed. The reason for closure was determined for 548 referrals (99.3%). Prepubertal status was the second-most frequent reason for closure, and the most frequent for birth-registered males. Twenty-five percent of all deferred prepubertal patients returned peripubertally, before audit closure. A greater return frequency (55.6%) was estimated for those older than 13 years at audit closure. <b><i>Conclusion:</i></b> High rates of prepubertal referral indicate the importance of pediatric gender services in providing information, advice, and reassurance to concerned families. With increasing service demand, high rates of return peripubertally have implications for service planning to ensure that returning peripubertal patients are seen promptly for time-sensitive care. Frequency of peripubertal re-referral cannot, however, speak to the stability of trans identity or gender incongruence from childhood to adolescence. Clinics advising prepubertal deferral must proactively plan to ensure that sufficient clinical resources are reserved for this purpose.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"606-614"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850309","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":"Receptive Anal Intercourse: Impact on Colorectal and Urologic Diagnoses.","authors":"Thomas W Gaither, Tara Shahrvini, Nathan W Vincent, Marcia Russell, Mark S Litwin","doi":"10.1089/lgbt.2023.0469","DOIUrl":"10.1089/lgbt.2023.0469","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> We evaluated the relationship between lifetime receptive anal intercourse (RAI) and the risk of common colorectal and urologic diagnoses. <b><i>Methods:</i></b> We conducted an internet-based survey on sensations during RAI between July 2022 and March 2023. We used multivariable logistic regression to assess the independent impact of lifetime RAI exposure on the diagnosis of common urologic and colorectal conditions. Participants completed a main survey and were invited to complete randomly assigned patient-reported outcome measures (PROMs), which measured pelvic symptoms, mental health symptoms, and sexual satisfaction. <b><i>Results:</i></b> In total, 1100 participants completed the main survey and 416 completed the PROMs. Participants of the main survey ranged from 18 to 78 years old and the median age of the sample was 32 years. There was no significant association between lifetime RAI exposure and any medical diagnosis, except for anal fissures, which increased linearly with additional RAI exposure. Both sexual satisfaction and mental health symptoms improved with RAI exposure. <b><i>Conclusions:</i></b> RAI was not associated with most of the colorectal and urologic diagnoses tested and was associated with fewer mental symptoms and increased sexual satisfaction. Development of anal fissures may be directly related to trauma of the anal canal from penetration.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"633-638"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538063","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":"Examining the Performance of the Sexual Minority Adolescent Stress Inventory with Transgender and Gender-Diverse Youth and Sexual Minority Emerging Adults: A Methodological Study.","authors":"Manuel A Ocasio, Ahnalee M Brincks, M Isabel Fernandez","doi":"10.1089/lgbt.2023.0253","DOIUrl":"10.1089/lgbt.2023.0253","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> We examined the psychometric properties and criterion validity of the Sexual Minority Adolescent Stress Inventory (SMASI) among 730 sexual minority (SM) and transgender and gender-diverse (TGD) youth aged 14 to 24 years who participated in a human immunodeficiency virus study. <b><i>Methods:</i></b> We tested the factor structure of the global scale and subscales and measurement invariance across age, gender identity, sex assigned at birth, sexual identity, ethnoracial identity, and city. For criterion validity, we regressed mental health and substance use measures on the global scale. <b><i>Results:</i></b> The global scale had excellent fit (comparative fit index = 0.95) and high reliability (omega = 0.89). Subscale model fit was adequate. We confirmed invariance by gender identity and age and established criterion validity. <b><i>Conclusion:</i></b> The SMASI exhibits strong psychometric properties among SM emerging adults and TGD youth. Modifications could enhance the SMASI to better capture both sexual and gender minority stress among ethnoracial minority youth.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"639-644"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Utilization During the First 5½ Years of Authorized Service by Transgender U.S. Service Members (2016-2021).","authors":"Christina M Roberts, Wendy Funk, Veronika Pav, Kevin W Sunderland, Jennifer A Thornton, David A Klein","doi":"10.1089/lgbt.2023.0419","DOIUrl":"10.1089/lgbt.2023.0419","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study examined the utilization of gender-affirming health care by active-duty service members during the initial 5½ years that transgender and gender-diverse (TGD) individuals were authorized to serve in the U.S. military. The aim of this study was to inform policy discussions regarding inclusion of TGD individuals in the military. <b><i>Methods:</i></b> We conducted a retrospective cohort study using administrative health care data from the Military Data Repository (MDR). We assessed the association of demographic factors with the utilization of gender-affirming medical and surgical care. We calculated the incidence rate of initial TGD-related encounters and new prescriptions for gender-affirming hormones among Defense Department Service members between July 2016 and December 2021. <b><i>Results:</i></b> We identified 2481 service members with an initial health care encounter with an associated TGD-related diagnosis. More than half (53%) of these service members started gender-affirming hormones, and 14% underwent gender-affirming surgery. Mastectomies and hysterectomies accounted for more than 70% of surgeries. Service members made 3.22 initial encounters with a TGD-related diagnosis per 10,000 service members per year, with an overrepresentation of service members who were designated female in the MDR (8.62), junior enlisted (4.98), and young (4.64). Individuals designated female in the MDR comprised 17% of all service members but accounted for 46% of initial encounters, 51% of new prescriptions, and 73% of surgeries. <b><i>Conclusion:</i></b> The study revealed a higher-than-expected number of service members seeking gender-affirming care, particularly among service members designated female in the MDR. Military Health System clinicians provided most of this care, which may mitigate the cost of delivering this essential medical care.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"625-632"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898017","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}