Liying Wang, Rachel Harris, Jane M Simoni, Qing Yue, Jie Fu, Huang Zheng, Zhen Ning, Casey D Xavier Hall, Paul A Burns, Frank Y Wong
{"title":"上海跨性别女性卫生服务利用与抑郁和性危险行为的关系","authors":"Liying Wang, Rachel Harris, Jane M Simoni, Qing Yue, Jie Fu, Huang Zheng, Zhen Ning, Casey D Xavier Hall, Paul A Burns, Frank Y Wong","doi":"10.1089/trgh.2021.0009","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Given the limited research on health care utilization among transgender women in China, we described the use of primary health care and gender-affirming health care, and the associations between utilization of gender-affirming health care and depression and sexual risk behaviors.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey in 2017 among a purposive sample of transgender women in Shanghai, China (<i>N</i>=199). We examined correlates of health care utilization and its association with depression and sexual risk behaviors with Chi-square (<i>χ</i><sup>2</sup>), Fisher's exact tests, and analysis of variance.</p><p><strong>Results: </strong>The majority of the sample (78.5%) only had physician appointments when having an illness, while about one-fifth of the sample had physician appointments for yearly checkups. Nineteen out of 199 participants (9.5%) received gender-affirming surgery, among which only five used hormone therapy prescribed by a doctor (26.3%). Receiving some form of gender-affirming surgery was associated with higher depression scores [Welch's <i>F</i><sub>(2, 12.22)</sub>=4.16, <i>p</i>=0.04], engagement in sex work (<i>p</i>=0.001), having 7 or more male sexual partners in the last 30 days (<i>p</i>=0.003), lifetime unprotected sex with a man (<i>p</i>=0.050), and unprotected sex with a main partner (<i>p</i>=0.043). Compared with transgender women who received both breast augmentation and vulvo-vaginoplasty (mean=5.86), those who received breast augmentation only (mean=12.33) scored higher on depression (<i>p</i>=0.04).</p><p><strong>Conclusions: </strong>Access to gender-affirming health care is low among transgender women in this study. The utilization of gender-affirming surgery is associated with depression and sexual risk behaviors. Findings suggest China should establish national guidelines on transgender-related health care and set up more clinics to provide consultation and services for the transgender population in China.</p>","PeriodicalId":37265,"journal":{"name":"Transgender Health","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10732171/pdf/","citationCount":"0","resultStr":"{\"title\":\"Health Service Utilization and Its Associations with Depression and Sexual Risk Behaviors Among Transgender Women in Shanghai, China.\",\"authors\":\"Liying Wang, Rachel Harris, Jane M Simoni, Qing Yue, Jie Fu, Huang Zheng, Zhen Ning, Casey D Xavier Hall, Paul A Burns, Frank Y Wong\",\"doi\":\"10.1089/trgh.2021.0009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Given the limited research on health care utilization among transgender women in China, we described the use of primary health care and gender-affirming health care, and the associations between utilization of gender-affirming health care and depression and sexual risk behaviors.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey in 2017 among a purposive sample of transgender women in Shanghai, China (<i>N</i>=199). We examined correlates of health care utilization and its association with depression and sexual risk behaviors with Chi-square (<i>χ</i><sup>2</sup>), Fisher's exact tests, and analysis of variance.</p><p><strong>Results: </strong>The majority of the sample (78.5%) only had physician appointments when having an illness, while about one-fifth of the sample had physician appointments for yearly checkups. Nineteen out of 199 participants (9.5%) received gender-affirming surgery, among which only five used hormone therapy prescribed by a doctor (26.3%). Receiving some form of gender-affirming surgery was associated with higher depression scores [Welch's <i>F</i><sub>(2, 12.22)</sub>=4.16, <i>p</i>=0.04], engagement in sex work (<i>p</i>=0.001), having 7 or more male sexual partners in the last 30 days (<i>p</i>=0.003), lifetime unprotected sex with a man (<i>p</i>=0.050), and unprotected sex with a main partner (<i>p</i>=0.043). Compared with transgender women who received both breast augmentation and vulvo-vaginoplasty (mean=5.86), those who received breast augmentation only (mean=12.33) scored higher on depression (<i>p</i>=0.04).</p><p><strong>Conclusions: </strong>Access to gender-affirming health care is low among transgender women in this study. The utilization of gender-affirming surgery is associated with depression and sexual risk behaviors. Findings suggest China should establish national guidelines on transgender-related health care and set up more clinics to provide consultation and services for the transgender population in China.</p>\",\"PeriodicalId\":37265,\"journal\":{\"name\":\"Transgender Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2023-12-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10732171/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transgender Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/trgh.2021.0009\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/12/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"Social Sciences\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transgender Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/trgh.2021.0009","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Social Sciences","Score":null,"Total":0}
Health Service Utilization and Its Associations with Depression and Sexual Risk Behaviors Among Transgender Women in Shanghai, China.
Purpose: Given the limited research on health care utilization among transgender women in China, we described the use of primary health care and gender-affirming health care, and the associations between utilization of gender-affirming health care and depression and sexual risk behaviors.
Methods: We conducted a cross-sectional survey in 2017 among a purposive sample of transgender women in Shanghai, China (N=199). We examined correlates of health care utilization and its association with depression and sexual risk behaviors with Chi-square (χ2), Fisher's exact tests, and analysis of variance.
Results: The majority of the sample (78.5%) only had physician appointments when having an illness, while about one-fifth of the sample had physician appointments for yearly checkups. Nineteen out of 199 participants (9.5%) received gender-affirming surgery, among which only five used hormone therapy prescribed by a doctor (26.3%). Receiving some form of gender-affirming surgery was associated with higher depression scores [Welch's F(2, 12.22)=4.16, p=0.04], engagement in sex work (p=0.001), having 7 or more male sexual partners in the last 30 days (p=0.003), lifetime unprotected sex with a man (p=0.050), and unprotected sex with a main partner (p=0.043). Compared with transgender women who received both breast augmentation and vulvo-vaginoplasty (mean=5.86), those who received breast augmentation only (mean=12.33) scored higher on depression (p=0.04).
Conclusions: Access to gender-affirming health care is low among transgender women in this study. The utilization of gender-affirming surgery is associated with depression and sexual risk behaviors. Findings suggest China should establish national guidelines on transgender-related health care and set up more clinics to provide consultation and services for the transgender population in China.