Transgender health最新文献

{"title":"Gender-Affirming Care and Health Outcomes Among Transgender and Gender Expansive Youth: Research Advances and Future Priorities.","authors":"David J Inwards-Breland","doi":"10.1089/trgh.2025.0106","DOIUrl":"10.1089/trgh.2025.0106","url":null,"abstract":"","PeriodicalId":94256,"journal":{"name":"Transgender health","volume":"10 4","pages":"303-305"},"PeriodicalIF":1.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Patient-Reported Outcome Measure for Youth Receiving Gender-Affirming Care: The GENDER-Q Youth Module.","authors":"Shelby L Kennedy, Sylvie D Cornacchi, Manraj N Kaur, Shane Morrison, Charlene Rae, Natasha Johnson, Karine Khatchadourian, Kathleen Armstrong, Maja Marinkovic, Gina Sequeira, Brenda Bradley, Anne F Klassen","doi":"10.1089/trgh.2024.0203","DOIUrl":"10.1089/trgh.2024.0203","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop and establish the content validity of a patient-reported outcome measure for youth receiving gender-affirming care (GENDER-Q Youth).</p><p><strong>Methods: </strong>This mixed-methods study involved concept elicitation interviews with youth who were seeking/receiving gender-affirming care (February 2019-October 2023). Data were used to develop a conceptual framework and set of independent functioning scales. Scales were refined through clinical and research expert input and cognitive debriefing interviews with youth (December 2023-April 2024). A pilot test was conducted to examine scale psychometric performance, overall content validity, and acceptability (July 2024).</p><p><strong>Results: </strong>The concept elicitation interview sample included 47 youth aged 12-19 years. A conceptual framework with four main domains was created and included: health-related quality of life, gender practices, voice, and experience of care. To measure aspects of the framework, 17 scales (292 items) were developed and refined with input from 33 experts and 17 youth. The pilot test sample included 406 youth aged 18-25 years. Most respondents agreed that GENDER-Q Youth was easy to understand, thorough, asked important questions in a respectful way, felt safe to complete, and made them feel that their voice would be heard. The field test version of GENDER-Q Youth includes 16 scales (248 items).</p><p><strong>Conclusion: </strong>Evidence of content validity of GENDER-Q Youth was established based on extensive input from experts and youth.</p>","PeriodicalId":94256,"journal":{"name":"Transgender health","volume":"10 4","pages":"375-385"},"PeriodicalIF":1.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of Gender-Affirming Voice and Communication Training for Young People.","authors":"Brett R Myers, Catharine DeLong","doi":"10.1089/trgh.2024.0207","DOIUrl":"10.1089/trgh.2024.0207","url":null,"abstract":"<p><strong>Purpose: </strong>Gender-affirming voice training is an important service for transgender and gender-diverse (TGD) individuals who wish to modify their voice to be more congruent with their gender identity. For decades, the research in this area has focused on adults, yet TGD young people also receive these services regularly. The purpose of this study was to analyze patient-reported outcomes in TGD young people who completed voice training.</p><p><strong>Methods: </strong>This study consisted of a retrospective chart review of 118 TGD individuals ages 11 to 23 years old who were seen at a university clinic between 2019 and 2024. We assessed voice outcomes with the Utah Gender Presentation Scale for Communication (U-GPS), the Trans Woman Voice Questionnaire (TWVQ), and acoustic measures. These data were compared before and after voice training.</p><p><strong>Results: </strong>Data were available for 68 clients who completed voice training. There were significant improvements in gender congruence by the end of treatment (<i>t</i> = 15.918; <i>p</i> < 0.001) with a median reduction of 32 points on the U-GPS. The trans female clients had significant improvements in voice-related quality of life (<i>t</i> = 12.072; <i>p</i> < 0.001) with a median reduction of 23 points on the TWVQ. Acoustic data show that speaking fundamental frequency (f0) was more aligned with clients' gender by the end of voice training.</p><p><strong>Conclusion: </strong>This article is the first to demonstrate the benefits of voice training for TGD young people. This population warrants special attention in the literature, and further research should evaluate specific treatment protocols and associated outcomes for young people.</p>","PeriodicalId":94256,"journal":{"name":"Transgender health","volume":"10 4","pages":"364-374"},"PeriodicalIF":1.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic and Anthropometric Changes and Adverse Effects in Finnish Adolescents Using Gender-Affirming Hormonal Treatment.","authors":"Nico Vehmas, Elina Holopainen, Hanna Savolainen-Peltonen","doi":"10.1089/trgh.2024.0012","DOIUrl":"10.1089/trgh.2024.0012","url":null,"abstract":"<p><strong>Purpose: </strong>In this retrospective study our purpose was to assess whether hormone interventions for gender dysphoria pose additional somatic risks for adolescents. We examined changes in metabolic laboratory parameters, body mass index (BMI), and blood pressure (BP) and analyzed adverse effects during gender-affirming hormonal treatment (GAHT).</p><p><strong>Methods: </strong>We analyzed follow-up data on 119 transgender adolescents using GAHT at the adolescent gynecology clinic in Helsinki University Hospital, Finland from January 2010 to January 2022.</p><p><strong>Results: </strong>During the study period, 99 (83%) transgender males and 20 (17%) transgender females started GAHT. The median GAHT follow-up duration was 34.0 (interquartile range 17.2) months. Mean hemoglobin (HB) and hematocrit (HCT) levels increased by 16% (<i>p</i> < 0.001) during testosterone treatment, decreased by 10% (<i>p</i> < 0.01) during estrogen treatment, and plateaued after one year. During the initial follow-up, no clinically relevant changes were seen in glucose and lipid metabolism, BMI, or BP. Adverse effects leading to testosterone dose reduction were reported in 19% of transgender males and were less common when gonadotropin-releasing hormone analog was used in testosterone treatment initiation (11.1% vs. 27.8%, <i>p</i> = 0.04). Somatic adverse effects requiring hospitalization or permanent discontinuation of GAHT were not reported.</p><p><strong>Conclusion: </strong>The somatic changes observed in this study were typical for GAHT. No serious somatic adverse effects occurred. Regular measuring of HB and HCT in transgender males undergoing GAHT is warranted, but excessive monitoring of glucose and lipid metabolism, BMI, and BP during the initial follow-up period may not be necessary for somatically healthy adolescents.</p>","PeriodicalId":94256,"journal":{"name":"Transgender health","volume":"10 4","pages":"306-315"},"PeriodicalIF":1.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Identity and Gender-Related Medical Outcomes of Autistic Young Adults Who Experienced Transgender Identity as Adolescents.","authors":"Lauren Baczewski, Laura Campos, Josh Lee, Christine Wu Nordahl, Anna I R van der Miesen, Lucy S McClellan, Sanam Parwani, Amy Tishelman, Minneh Song, John F Strang","doi":"10.1089/trgh.2024.0242","DOIUrl":"10.1089/trgh.2024.0242","url":null,"abstract":"<p><strong>Purpose: </strong>We examined gender identity and gender-affirming care outcomes of autistic transgender adolescents followed into young adulthood, as well as relationships between gender-related medical care receipt and mental health across time.</p><p><strong>Methods: </strong>This longitudinal two-timepoint study was conducted between 2018 and 2024, with 4 years between timepoints. Twenty-seven autistic transgender youth participated, with one lost to follow-up. Measures included self-reported gender, interest in and receipt of gender-related medical care, LGBT-related stigma (via the LGBT Stigma Scale), and anxiety and depression symptoms (via the Achenbach System of Empirically Based Assessment). Intelligence quotients were estimated using the Wechsler Abbreviated Scale of Intelligence-2. We employed data visualization of gender and gender-related care trajectories and multiple linear regression to understand the relationships between care trajectories and mental health.</p><p><strong>Results: </strong>Most youth remained gender-diverse at Time 2. Two of 26 identified as cisgender as young adults. Half of the sample moved toward nonbinary identities either as an additional component to a binary identity (e.g., transgender nonbinary woman) or shifted from a binary identity to a nonbinary identity. For those who wanted gender-related care, earlier care receipt was associated with a significant reduction in anxiety across time. Care timing was not significantly related to changes in depression across time.</p><p><strong>Conclusion: </strong>A majority of autistic gender-diverse youth (24/26; 92.3%) remained gender diverse into young adulthood. Unlike previous studies of autistic youth entering adulthood, which report worsening mental health, participants showed reductions in anxiety across time. Earlier receipt of gender-related care was associated with fewer anxiety symptoms at Time 2.</p>","PeriodicalId":94256,"journal":{"name":"Transgender health","volume":"10 4","pages":"345-354"},"PeriodicalIF":1.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Care Utilization, Unmet Care Needs, and Barriers to Receiving Care in Adolescence Among Transgender and Nonbinary Young Adults.","authors":"Gina M Sequeira, Nicole F Kahn, Marlene Chamonica Hernandez, Ruby Lucas, Kacie M Kidd, Moira Kyweluk, Wanda Pratt, Dimitri Christakis, Sarah Danzo, Laura P Richardson","doi":"10.1089/trgh.2024.0140","DOIUrl":"10.1089/trgh.2024.0140","url":null,"abstract":"<p><strong>Purpose: </strong>Few studies have explored mental health needs and barriers to accessing care among transgender and nonbinary (TNB) individuals during adolescence. The purpose of this study was to explore TNB young adults' mental health care utilization, unmet care needs, and barriers to receiving care in adolescence.</p><p><strong>Methods: </strong>A 42-item cross-sectional survey was administered to TNB individuals aged 18-20 years. Chi² and Fisher's exact tests were used to identify differences in receipt of mental health care by demographics. Post-hoc pairwise comparisons were conducted using the Bonferroni correction for multiple comparisons when indicated.</p><p><strong>Results: </strong>Of 286 participants, approximately half (42.3%) were women and 50.7% reported being \"out\" to at least one parent before the age of 18. More than half (55.2%) reported having seen a mental health provider in adolescence; however, only 10.1% indicated that they had received enough mental health support. Significant differences were found in having seen a mental health provider by gender identity (<i>p</i> = 0.02) and outness to parents during adolescence (<i>p</i> < 0.001). The most common barriers included confidentiality (59.9%), unsupportive parents (58.0%), and uncertainty about where to get care (52.9%).</p><p><strong>Conclusions: </strong>These findings provide a better understanding of the mental health care utilization and needs among TNB individuals in adolescence. Further research focused on ways to support TNB adolescents and how parents can support their TNB adolescents' mental health is warranted.</p>","PeriodicalId":94256,"journal":{"name":"Transgender health","volume":"10 4","pages":"394-400"},"PeriodicalIF":1.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Estrone/Estradiol Ratio and Levels in Transfeminine Individuals on Different Routes of Estradiol.","authors":"Navin M Kariyawasam, Tehmina Ahmad, Shohinee Sarma, Raymond Fung","doi":"10.1089/trgh.2023.0138","DOIUrl":"10.1089/trgh.2023.0138","url":null,"abstract":"<p><strong>Purpose: </strong>Estradiol for gender-affirming hormone therapy can be taken in different routes: oral, sublingual, transdermal patch or gel, and injectable estradiol. We aimed at comparing the estrone and estradiol ratios and levels achieved in each of these different routes of estradiol.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of transfeminine individuals attending an endocrinology clinic in Toronto, Canada. Study participants were grouped according to the route of estradiol administration: oral, injectable, transdermal, and sublingual. Our primary outcome was the estrone/estradiol ratio (E1/E2). Our secondary outcomes were the estradiol and estrone levels in each of these four groups.</p><p><strong>Results: </strong>We included 286 patients. The oral estradiol group had the highest E1/E2 ratio (9.28), followed by the sublingual group (6.88). Both the transdermal and injectable groups had substantially lower E1/E2 ratios (2.22 and 0.84, respectively). We observed a large variability of the E1/E2 ratio in the oral and sublingual groups, whereas the transdermal and the injectable groups' ratios had much smaller standard deviation. The mean estradiol in the injectable group (1557 pmol/L, 424.1 pg/mL) was markedly higher than the estradiol levels observed in all other routes of estradiol.</p><p><strong>Conclusion: </strong>Our data demonstrate significantly different E1/E2 ratios in the four different routes of estradiol administration, with oral and sublingual routes having the highest E1/E2 ratios followed by transdermal and injectable routes.</p>","PeriodicalId":94256,"journal":{"name":"Transgender health","volume":"10 3","pages":"261-268"},"PeriodicalIF":1.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Conditions and Health Care Use Comparison Between Transgender/Gender Diverse and Cisgender Medicare Beneficiaries.","authors":"Gray Babbs, Jaclyn M W Hughto, Landon D Hughes, Theresa I Shireman, David J Meyers","doi":"10.1089/trgh.2024.0231","DOIUrl":"10.1089/trgh.2024.0231","url":null,"abstract":"<p><strong>Purpose: </strong>We compared how transgender and gender diverse (TGD) and cisgender adults in the United States develop age-related chronic conditions and use health care throughout their lives.</p><p><strong>Methods: </strong>Using an established algorithm, we identified TGD beneficiaries in Medicare claims data from 2011 to 2020. We identified the 10 nearest-neighbor cisgender matches for each TGD beneficiary based on propensity scores estimated from the original basis of eligibility, years of Medicare enrollment, race, ethnicity, age, and hospital service area. Our primary outcomes were chronic conditions and health care utilization variables as measured by the Chronic Conditions Warehouse. We used generalized estimating equations with a logit link to compare age-related chronic conditions and health utilization between the TGD and matched cisgender cohorts, controlling for original eligibility, years of Medicare enrollment, race, ethnicity, and age. We plotted age-related chronic conditions and health care utilization over age for TGD and cisgender beneficiaries.</p><p><strong>Results: </strong>We identified 38,187 TGD Medicare beneficiaries. We found that TGD beneficiaries had higher rates of age-related chronic conditions than cisgender beneficiaries. These disparities grew as beneficiaries aged for endocrine and renal conditions, musculoskeletal conditions and chronic pain, and neurological conditions. TGD beneficiaries were more likely to use inpatient, outpatient, emergency department, skilled nursing facility, home health, and dialysis care than cisgender beneficiaries.</p><p><strong>Conclusion: </strong>As the number of TGD-identified adults grows, these findings underscore the need for Medicare to create policies and programs that address the needs of TGD beneficiaries.</p>","PeriodicalId":94256,"journal":{"name":"Transgender health","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12889157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Perspectives on Gender-Affirming Medical Care of Nonbinary Youth.","authors":"Abby Walch, Sophia Collis, Megumi Okumura","doi":"10.1089/trgh.2024.0158","DOIUrl":"10.1089/trgh.2024.0158","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate the perceptions, challenges, and opportunities in providing care to nonbinary youth from the clinician perspective.</p><p><strong>Methods: </strong>This was a qualitative study investigating views of pediatric and adult primary care and subspecialty clinicians who provide gender-affirming medical care to nonbinary adolescents. Purposeful sampling was used to select and interview clinicians from across the United States from July to November 2022. Data were analyzed using a grounded theoretical approach. Major categories were chosen by consensus from the research team, and a conceptual model regarding the provision of gender-affirming medical care to nonbinary youth was developed.</p><p><strong>Results: </strong>Sixteen clinicians were interviewed to reach saturation. Five main categories were developed: clinical approach, clinician resources, clinician characteristics, nonbinary youth supported in their decision-making and treatment, and society-level factors. An overarching category was acknowledgment and acceptance of gender as nonbinary. The conceptual model incorporates these categories and demonstrates the importance of an embodiment-goal approach in the care of nonbinary adolescent patients.</p><p><strong>Conclusion: </strong>Recognition and acceptance of nonbinary genders are critical in the provision of gender-affirming medical care to nonbinary youth from the clinician perspective. Use of an embodiment-goal approach-goals that focus on how an individual wishes to embody their gender-may facilitate gender-affirming care of nonbinary adolescents delivered by clinicians. Future prospective research studies acknowledging and testing treatment approaches and best practices for nonbinary persons should be incorporated into future standards of care and clinical practice guidelines.</p>","PeriodicalId":94256,"journal":{"name":"Transgender health","volume":"11 4","pages":"236-244"},"PeriodicalIF":1.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the Sociopolitical Climate on Distress and Relocation of Families of Transgender Youth.","authors":"Ximena Lopez, Puja Singh, Pooja Choudhari, Sarah Baker, Chieh-An Chen, Jhulianna Vivar, Laura E Kuper","doi":"10.1089/trgh.2024.0039","DOIUrl":"10.1089/trgh.2024.0039","url":null,"abstract":"<p><strong>Purpose: </strong>An unprecedented increase of legislative action targeting transgender and gender-diverse (TGD) youth has been observed across the United States, including Texas. The aim of this study was to assess the effects of the current sociopolitical climate on the well-being of families of TGD youth, as well as their intent to relocate.</p><p><strong>Methods: </strong>This is a cross-sectional survey of parent(s) and guardian(s) of TGD youth of age 17 or younger being seen in a clinic for gender-affirming care in Texas.</p><p><strong>Results: </strong>Out of 124 participants, 107 (88%) described the sociopolitical climate in Texas regarding TGD youth as \"very hostile.\" Just before the ban on gender-affirming care for youth was implemented, 18 (14%) families had relocated out of Texas. Of those remaining, 75 (75%) reported that they were at least somewhat likely to move in the near future, and 2 (2%) were in the process of relocating. Concern for their child's mental health, physical health, access to gender-affirming care, as well as safety; risk of being accused of child abuse; and the parent's own mental health were the main reasons for the intent to relocate.</p><p><strong>Conclusions: </strong>Current sociopolitical efforts directed at TGD youth in Texas are leading to distress and migration of families. Future studies need to assess how restrictive government policies directed at TGD youth impact their mental health and quality of life as well as that of their family members.</p>","PeriodicalId":94256,"journal":{"name":"Transgender health","volume":"11 2","pages":"97-105"},"PeriodicalIF":1.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}