Transgender Health最新文献_第7页

Physical Health in Transgender and Nonbinary Adults: The Roles of Minority Stress and General Psychological Processes 跨性别和非二元成人的身体健康:少数民族压力和一般心理过程的作用

4区医学

Transgender Health Pub Date : 2023-11-02 DOI: 10.1089/trgh.2023.0079

Laura C. Wilson

引用次数: 0

Clinicians Report Less Comfort in Provision of Medical Care to Nonbinary Transgender Youth 临床医生报告在为非二元性别变性青年提供医疗护理时不那么舒适

4区医学

Transgender Health Pub Date : 2023-10-30 DOI: 10.1089/trgh.2023.0029

Abby Walch, Janet Y. Lee, Jenise C. Wong, Madeline Deutsch, Diane Ehrensaft, Megumi Okumura, Stephen M. Rosenthal

{"title":"Clinicians Report Less Comfort in Provision of Medical Care to Nonbinary Transgender Youth","authors":"Abby Walch, Janet Y. Lee, Jenise C. Wong, Madeline Deutsch, Diane Ehrensaft, Megumi Okumura, Stephen M. Rosenthal","doi":"10.1089/trgh.2023.0029","DOIUrl":"https://doi.org/10.1089/trgh.2023.0029","url":null,"abstract":"Purpose: The purpose of this study was to determine whether clinician comfort differs in the provision of gender-affirming medical care to transgender and gender diverse (TGD) youth with binary versus nonbinary gender identities. Methods: A cross-sectional survey was distributed to three international health professional electronic mailing lists. Comfort providing gonadotropin-releasing hormone agonist (GnRHa) and gender-affirming hormone therapy (GAHT) to nonbinary and binary TGD youth was assessed using 5-point Likert scales and analyzed with Wilcoxon signed-rank tests. Logistic regression modeling comfort providing GnRHa and GAHT to nonbinary compared to binary TGD youth was performed to identify relevant predictors. Results: Fifty-five respondents completed the survey. Respondents reported more comfort providing both GnRHa therapy and GAHT to binary compared to nonbinary TGD youth. In univariate analyses, being in a pediatric endocrinology specialty and work within a multidisciplinary clinic setting were associated with less comfort providing GAHT to nonbinary compared to binary TGD youth. Non-straight/non-heterosexual sexual orientation, being in a general pediatrics specialty, and higher estimated percentage of nonbinary TGD youth cared for in clinical practice were associated with more comfort. Only nonstraight/nonheterosexual sexual orientation maintained significance after adjusting for potential confounders in multivariate analyses. Conclusions: Clinicians are less comfortable providing gender-affirming medical care to nonbinary versus binary TGD youth. Efforts to decrease barriers and to inform development of clinical practice guidelines inclusive of nonbinary TGD youth are needed.","PeriodicalId":37265,"journal":{"name":"Transgender Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136022708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Association of Body Mass Index Category and Postoperative Complications in Gender Affirming Mastectomy for Chest Reconstruction 性别确认乳房切除术胸部重建术中体重指数类别与术后并发症的关系

4区医学

Transgender Health Pub Date : 2023-10-26 DOI: 10.1089/trgh.2023.0112

Jessica L. Marquez, Jack D. Sudduth, Ashraf A. Patel, Devin Eddington, Priya Lewis, Cori Agarwal

引用次数: 0

Two-Year Follow-Up Study of Health-Related Quality of Life Among Transgender and Gender Expansive Youth Receiving Gender-Affirming Care 接受性别肯定护理的跨性别和性别膨胀青年健康相关生活质量的两年随访研究

4区医学

Transgender Health Pub Date : 2023-10-17 DOI: 10.1089/trgh.2022.0165

Anne M. Gadomski, Melissa B. Scribani, Nancy Tallman, Jane O'Bryan, Christopher Wolf-Gould, Carolyn Wolf-Gould

{"title":"Two-Year Follow-Up Study of Health-Related Quality of Life Among Transgender and Gender Expansive Youth Receiving Gender-Affirming Care","authors":"Anne M. Gadomski, Melissa B. Scribani, Nancy Tallman, Jane O'Bryan, Christopher Wolf-Gould, Carolyn Wolf-Gould","doi":"10.1089/trgh.2022.0165","DOIUrl":"https://doi.org/10.1089/trgh.2022.0165","url":null,"abstract":"Purpose: To examine changes in health-related quality of life (HRQOL), this 2-year follow-up study reassessed the HRQOL of transgender and gender expansive (TG/GE) young people enrolled in a patient registry at the Gender Wellness Center (GWC) in upstate New York. Methods: Registry patients had to have a gender-affirming care follow-up visit at the GWC within a 2 year window (+6 months) of their baseline survey to complete follow-up. Youth <18 years of age completed the Child Health Questionnaire-Child Form 87 (CHQ-CF87); youth >18 years of age completed the Short Form-36v2 (SF-36v2). We analyzed change from baseline to follow-up for 11 CHQ-CF87 subscales and 8 SF-36v2 subscales. We compared follow-up HRQOL results to U.S. population standards. We abstracted receipt of gender-affirming care from GWC electronic medical records. Results: Among the 173 patients who completed HRQOL assessments at baseline, 108 completed follow-up (62% response rate) from May 2019 to March 2022. The mean age for those completing the CHQ-CF87 was 14.6±2.2 years (range 10–17) and for the SF-36v2 was 19.7±2.3 years (range 18–24). CHQ-CF87 Behavior and Role/Social Physical Functioning subscale scores improved significantly among youth 8–17 years of age from baseline. Follow-up SF-36v2 scores for patients 18–24 years of age did not change significantly. Follow-up HRQOL mental health scores remained statistically significantly lower than U.S. population standards for both age groups. Conclusions: Two year follow-up HRQOL data from TG/GE youth receiving gender-affirming care improved in two domains, but did not change among young adults (>18 years of age). Mental health remains suboptimal compared to national standards.","PeriodicalId":37265,"journal":{"name":"Transgender Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136033692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors of Mental Health Service Utilization Among Transgender and Gender Nonconforming Adults 跨性别及性别不符合成人心理健康服务利用的预测因素

4区医学

Transgender Health Pub Date : 2023-10-17 DOI: 10.1089/trgh.2023.0107

Kristin A. Schuller, Rebekah P. Crawford, Marilena Wolf

{"title":"Predictors of Mental Health Service Utilization Among Transgender and Gender Nonconforming Adults","authors":"Kristin A. Schuller, Rebekah P. Crawford, Marilena Wolf","doi":"10.1089/trgh.2023.0107","DOIUrl":"https://doi.org/10.1089/trgh.2023.0107","url":null,"abstract":"Purpose: The purposes of this study were to determine which transgender and gender nonconforming (TGNC) adults used mental health services in the past 12 months, to compare TGNC who did and did not access mental health care, to query reasons for not accessing mental health services, and to determine what indicators influenced mental health service utilization. Methods: The research team gathered data from 274 TGNC adults from September to November 2019 via an electronic survey. This exploratory study assessed mixed methods data on mental health services utilization. The convergent, parallel mixed methods design was used to compare and interpret the quantitative and qualitative data for convergence or divergence. Results: Approximately 24% of TGNC adults did not use mental health services, with 44% of that group indicating it was because they did not need them, which means that 56% needed services but did not use them. The top reasons for not accessing needed mental health services included: inability to pay, not believing that care would be effective, not expecting to find providers who understood specific TGNC experiences or needs, and not trusting mental health professionals. Income, location, and mental health status were significant indicators. Conclusion: This study provides evidence that some TGNC adults who do not utilize mental health services still need them while outlining the specific barriers that inhibit TGNC adults from accessing needed mental health care. Comparing TGNC adults who did and did not access mental health services reveals that mental health status, location, and income are predictive of mental health service utilization. Recommendations are discussed.","PeriodicalId":37265,"journal":{"name":"Transgender Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136034759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Validation of the Gender Minority Stress and Resilience Measure and Mental Health Among Chinese Transgender and Gender Nonconforming People 中国跨性别者和性别不符合者心理健康与性别少数群体压力和弹性测量的验证

4区医学

Transgender Health Pub Date : 2023-10-16 DOI: 10.1089/trgh.2023.0059

Lijun Zheng, Yuqi Li, Zhaoyang Xie, Can Yang

{"title":"The Validation of the Gender Minority Stress and Resilience Measure and Mental Health Among Chinese Transgender and Gender Nonconforming People","authors":"Lijun Zheng, Yuqi Li, Zhaoyang Xie, Can Yang","doi":"10.1089/trgh.2023.0059","DOIUrl":"https://doi.org/10.1089/trgh.2023.0059","url":null,"abstract":"Purpose: Gender minority stress is a key factor contributing to mental health problems among transgender and gender nonconforming (TGNC) people. The Gender and Minority Stress and Resilience Measure (GMSR) is a valid instrument to assess distal stressors (discrimination, rejection, victimization, and nonaffirmation), proximal stressors (internalized transphobia, negative expectations, and nondisclosure), and resilience factors (pride and community connectedness) in Western societies. This study aimed to examine the psychometric characteristics of the Chinese version of the GMSR and mental health in Chinese TGNC people. Methods: A total of 282 (Meanage=20.9, Standard deviation=5.02) Chinese TGNC individuals completed measures of the GMSR, Depression Anxiety Stress Scale, and Multidimensional Scale of Perceived Social Support. Results: The confirmatory factor analysis showed that a Chinese revision of the 42-item GMSR with 9-factor model had adequate fit to the data. All the stressors were positively correlated with mental health problems. However, pride and community connectedness were not associated with mental health problems. Three stressors (rejection, nonaffirmation, and negative expectations) were negatively correlated with social support, and both pride and community connectedness were positively correlated with social support. All correlations between constructs were below 0.60. The criterion and convergent and discriminant validities of the Chinese version of the GMSR were greatly supported. Moreover, in line with the minority stress model, distal stressors had a significant indirect effect on mental health problems through proximal stressors. Conclusion: Our results validate a revised 42-item Chinese version of the GMSR, which indicated the cross-cultural validation of the gender minority stress model in China.","PeriodicalId":37265,"journal":{"name":"Transgender Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Behavioral and Nutritional Needs of Transgender and Gender Diverse Patients 跨性别和不同性别患者的行为和营养需求

4区医学

Transgender Health Pub Date : 2023-10-16 DOI: 10.1089/trgh.2023.0108

Daniela Delgado, Esther H. Kang, Kristen Williams, Amy K. Weimer

引用次数: 0

Demands for Health Care and Barriers to Health Care Access Among Transgender and Nonbinary People in Chile: A Nationwide Survey 智利跨性别和非二元性人群对医疗保健的需求和获得医疗保健的障碍:一项全国性调查

4区医学

Transgender Health Pub Date : 2023-10-13 DOI: 10.1089/trgh.2023.0088

Miguel Roselló-Peñaloza, Lukas Julio, Pablo Gómez

{"title":"Demands for Health Care and Barriers to Health Care Access Among Transgender and Nonbinary People in Chile: A Nationwide Survey","authors":"Miguel Roselló-Peñaloza, Lukas Julio, Pablo Gómez","doi":"10.1089/trgh.2023.0088","DOIUrl":"https://doi.org/10.1089/trgh.2023.0088","url":null,"abstract":"Purpose: This article reports the results of the first national survey carried out in Chile on health care for transgender and nonbinary people. Knowledge of their main demands for interventions, and of the barriers to care that they face, is currently lacking. We seek to address this gap and provide data useful to policymakers in improving care for this population. Methods: The survey was conducted between January 2021 and June 2022. The sample, consisting of 1116 participants, was recruited through social networks and transgender-rights organizations. Using chi-squared tests, statistically significant differences between items of interest and relevant sociodemographic information were identified. Data collected are reported based on frequencies (f) and percentages (%), and in contingency tables for the analysis of inter and intragroup variations. Results: Individual psychological attention (54.5%) and endocrinological follow-up (41%) were the interventions most received by the full sample. Of all treatments desired but not yet received, speech therapy headed the list (50.8%). Costs (74.2%), long waiting lists (34.6%), and insufficiently trained professionals (30.8%) were significant barriers to access. These percentages varied according to both participants' gender identity and area of residence. Conclusion: Provision for the care needs of the population surveyed was sparse. Differences in demands and access barriers were found between those declaring a female or male gender identity, and those whose identity was nonbinary or gender fluid, as well as between those enrolled in a public versus a private health system. These variations should be carefully weighed in developing effective trans and nonbinary health policies.","PeriodicalId":37265,"journal":{"name":"Transgender Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135854506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Metabolic Features of Assigned Female at Birth Transgender People on Gender-Affirming Hormone Therapy: A Meta-analysis 性别确认激素治疗对出生时指定女性变性人代谢特征的影响:一项meta分析

4区医学

Transgender Health Pub Date : 2023-09-23 DOI: 10.1089/trgh.2023.0040

Daniele Tienforti, Chiara Castellini, Francesca Di Giulio, Luca Spagnolo, Mario Muselli, Alessandra D. Fisher, Linda Vignozzi, Marco Giorgio Baroni, Arcangelo Barbonetti

{"title":"Metabolic Features of Assigned Female at Birth Transgender People on Gender-Affirming Hormone Therapy: A Meta-analysis","authors":"Daniele Tienforti, Chiara Castellini, Francesca Di Giulio, Luca Spagnolo, Mario Muselli, Alessandra D. Fisher, Linda Vignozzi, Marco Giorgio Baroni, Arcangelo Barbonetti","doi":"10.1089/trgh.2023.0040","DOIUrl":"https://doi.org/10.1089/trgh.2023.0040","url":null,"abstract":"Purpose: There is a paucity of data on the safety and efficacy of long-term testosterone (T)-based gender-affirming hormone therapy (GAHT) on anthropometric parameters, body composition, and glycolipid metabolism in assigned female at birth (AFAB) persons. The purpose of this study was to provide an updated meta-analysis on this topic. Methods: We searched PubMed, Scopus, and Cochrane Library for relevant studies. Pre-/post-therapy changes in body mass index (BMI), waist-to-hip ratio (WHR), body composition, lipid glycemic/insulinemic profiles were combined as mean differences (MD) with 95% confidence interval (CI), using random-effect models. Results: Thirty-nine studies (N=1949) were analyzed. At pooled estimates, GAHT was associated with significant decrease in fat mass (MD: −1.29 kg; 95% CI: −2.52 to −0.05; p=0.04) and increase in lean mass (4.12 kg; 95% CI: 3.07–5.16; p<0.00001), BMI (0.78 kg/m2; 95% CI: 0.50–1.07; p<0.00001), and WHR (0.02; 95%CI: 0.01–0.03; p=0.003) in the absence of heterogeneity (I2=0%). T therapy was also accompanied by unfavorable effects on lipid profile, including increases in total cholesterol (4.95 mg/dL; 95% CI: 1.53–8.37; p=0.005), LDL (11.15 mg/dL; 95% CI: 7.57–14.74; p<0.00001), and triglycerides (9.49 mg/dL; 95% CI: 4.39–14.58; p=0.0003) and decrease in HDL concentration (−7.52 mg/dL; 95% CI: −9.38 to −5.67; p<0.00001). Finally, T therapy resulted in a significant decrease in blood glucose concentration (−2.06 mg/dL; 95% CI: −3.37 to −0.74; p=0.002), with no significant effects on homeostatic model assessment index of insulin resistance. Conclusion: T-based GAHT in AFAB people is associated with androgenic changes in body composition and body fat distribution, accompanied by the acquisition of a more unfavorable cardiovascular lipid profile.","PeriodicalId":37265,"journal":{"name":"Transgender Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135959853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intimate Partner Violence Among Brazilian Trans and Cisgender Women Living with HIV or at HIV Risk During COVID-19 Era: Another Epidemic? 在2019冠状病毒病时代，巴西跨性别和顺性别妇女感染艾滋病毒或面临艾滋病毒风险的亲密伴侣暴力:另一种流行病?

4区医学

Transgender Health Pub Date : 2023-09-23 DOI: 10.1089/trgh.2023.0057

Ricardo de Mattos Russo Rafael, Emilia M. Jalil, Luciane de Souza Velasque, Ruth Khalili Friedman, Michelle Ramos, Cynthia B. Cunha, Eduardo Mesquita Peixoto, Lívia Machado de Mello Andrade, Davi Gomes Depret, Adriana Costa Gil, Dandara Costa Alcântara, Laylla Monteiro, Virginia Maria de Azevedo Oliveira Knupp, Valdiléa G. Veloso, Erin C. Wilson, Beatriz Grinsztejn

{"title":"Intimate Partner Violence Among Brazilian Trans and Cisgender Women Living with HIV or at HIV Risk During COVID-19 Era: Another Epidemic?","authors":"Ricardo de Mattos Russo Rafael, Emilia M. Jalil, Luciane de Souza Velasque, Ruth Khalili Friedman, Michelle Ramos, Cynthia B. Cunha, Eduardo Mesquita Peixoto, Lívia Machado de Mello Andrade, Davi Gomes Depret, Adriana Costa Gil, Dandara Costa Alcântara, Laylla Monteiro, Virginia Maria de Azevedo Oliveira Knupp, Valdiléa G. Veloso, Erin C. Wilson, Beatriz Grinsztejn","doi":"10.1089/trgh.2023.0057","DOIUrl":"https://doi.org/10.1089/trgh.2023.0057","url":null,"abstract":"Purpose: Our study was conducted to estimate intimate partner violence (IPV) prevalence and associated factors among trans and cisgender women at risk of or living with HIV during the coronavirus disease (COVID-19) pandemic in Rio de Janeiro, Brazil. Methods: A cross-sectional study was conducted between May and August 2020 through telephone surveys with cisgender and trans women enrolled in two cohort studies in Rio de Janeiro. We assessed IPV employing the Revised Conflict Tactics Scale during the initial months of shelter-in-place ordinances. Regression models evaluated the factors associated with IPV for each population. Results: We surveyed 796 women, and 341 participants (47.78%) were eligible and included in the current analysis. All cisgender women and 41 (64.06%) trans women were living with HIV. Overall IPV prevalence was 27.86% (95% confidence interval [95% CI] 23.34–32.88). IPV was 63% higher among trans women than among cisgender women (prevalence ratio 1.63, 95% CI 1.14–2.34, p=0.008). Loneliness was significantly associated with IPV in both groups. Younger age and binge drinking were associated with IPV prevalence among trans women. For cisgender women, IPV was associated with withdrawal of cash transfer programs during the shelter-in-place. Conclusion: Trans women experienced significantly more IPV than cisgender women in the early phase of the COVID-19 epidemic. Plans to prevent and address violence against cisgender and trans women, especially those with heightened vulnerability that may be associated with living with HIV, are needed in public health planning for future pandemics.","PeriodicalId":37265,"journal":{"name":"Transgender Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135959852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0