Jenesis Merriman, Christoffer Dharma, Su Hyun Park, Andrea Joiner, Roberta Scheinmann, Kim Watson, Cristina Herrera, John A Schneider, Sahnah Lim, Chau Trinh-Shevrin, Asa Radix, Dustin T Duncan
{"title":"有色人种跨性别女性获得性别确认护理、完成性别确认医疗干预和心理困扰的感知途径:TURNNT队列研究","authors":"Jenesis Merriman, Christoffer Dharma, Su Hyun Park, Andrea Joiner, Roberta Scheinmann, Kim Watson, Cristina Herrera, John A Schneider, Sahnah Lim, Chau Trinh-Shevrin, Asa Radix, Dustin T Duncan","doi":"10.1093/aje/kwaf136","DOIUrl":null,"url":null,"abstract":"<p><p>Transgender women of color (TWOC) are disproportionately impacted by psychological distress. Though gender-affirming care (GAC) has been recommended to alleviate this distress, research examining associations between perceived access to GAC, specific gender-affirming medical interventions (GAMIs), and mental health among TWOC in the United States remains limited. In this study, we examine cross-sectional and longitudinal associations between perceived access to GAC, completion of specific GAMIs, and psychological distress among TWOC, using modified Poisson regression and multilevel linear modeling. Data came from the TURNNT (\"Trying to Understand Relationships, Networks and Neighborhoods Among Transgender Women of Color\") Cohort Study. In multivariable analyses, increased access to GAC was associated with reduced psychological distress risk. All assessed GAMIs suggested protective effects against psychological distress (aRR < 1), with statistical significance found for breast augmentation and facial feminization surgery. On average, those with unmet GAMI needs experienced higher distress risk than those without. Longitudinally, those experiencing reduced access to GAC over 6 months faced the highest distress risk among all trajectory groups (aRR: 1.40, 95% CI: 1.08, 1.82). Our findings support the need for further inquiry in this area and suggest that policies protecting and increasing access to GAC may improve mental health among TWOC.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Perceived Access to Gender-Affirming Care, Completion of Gender-Affirming Medical Interventions, and Psychological Distress Among Transgender Women of Color: The TURNNT Cohort Study.\",\"authors\":\"Jenesis Merriman, Christoffer Dharma, Su Hyun Park, Andrea Joiner, Roberta Scheinmann, Kim Watson, Cristina Herrera, John A Schneider, Sahnah Lim, Chau Trinh-Shevrin, Asa Radix, Dustin T Duncan\",\"doi\":\"10.1093/aje/kwaf136\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Transgender women of color (TWOC) are disproportionately impacted by psychological distress. Though gender-affirming care (GAC) has been recommended to alleviate this distress, research examining associations between perceived access to GAC, specific gender-affirming medical interventions (GAMIs), and mental health among TWOC in the United States remains limited. In this study, we examine cross-sectional and longitudinal associations between perceived access to GAC, completion of specific GAMIs, and psychological distress among TWOC, using modified Poisson regression and multilevel linear modeling. Data came from the TURNNT (\\\"Trying to Understand Relationships, Networks and Neighborhoods Among Transgender Women of Color\\\") Cohort Study. In multivariable analyses, increased access to GAC was associated with reduced psychological distress risk. All assessed GAMIs suggested protective effects against psychological distress (aRR < 1), with statistical significance found for breast augmentation and facial feminization surgery. On average, those with unmet GAMI needs experienced higher distress risk than those without. Longitudinally, those experiencing reduced access to GAC over 6 months faced the highest distress risk among all trajectory groups (aRR: 1.40, 95% CI: 1.08, 1.82). Our findings support the need for further inquiry in this area and suggest that policies protecting and increasing access to GAC may improve mental health among TWOC.</p>\",\"PeriodicalId\":7472,\"journal\":{\"name\":\"American journal of epidemiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-06-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of epidemiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/aje/kwaf136\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/aje/kwaf136","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Perceived Access to Gender-Affirming Care, Completion of Gender-Affirming Medical Interventions, and Psychological Distress Among Transgender Women of Color: The TURNNT Cohort Study.
Transgender women of color (TWOC) are disproportionately impacted by psychological distress. Though gender-affirming care (GAC) has been recommended to alleviate this distress, research examining associations between perceived access to GAC, specific gender-affirming medical interventions (GAMIs), and mental health among TWOC in the United States remains limited. In this study, we examine cross-sectional and longitudinal associations between perceived access to GAC, completion of specific GAMIs, and psychological distress among TWOC, using modified Poisson regression and multilevel linear modeling. Data came from the TURNNT ("Trying to Understand Relationships, Networks and Neighborhoods Among Transgender Women of Color") Cohort Study. In multivariable analyses, increased access to GAC was associated with reduced psychological distress risk. All assessed GAMIs suggested protective effects against psychological distress (aRR < 1), with statistical significance found for breast augmentation and facial feminization surgery. On average, those with unmet GAMI needs experienced higher distress risk than those without. Longitudinally, those experiencing reduced access to GAC over 6 months faced the highest distress risk among all trajectory groups (aRR: 1.40, 95% CI: 1.08, 1.82). Our findings support the need for further inquiry in this area and suggest that policies protecting and increasing access to GAC may improve mental health among TWOC.
期刊介绍:
The American Journal of Epidemiology is the oldest and one of the premier epidemiologic journals devoted to the publication of empirical research findings, opinion pieces, and methodological developments in the field of epidemiologic research.
It is a peer-reviewed journal aimed at both fellow epidemiologists and those who use epidemiologic data, including public health workers and clinicians.