Fluidity in Reporting Gender Identity Labels in a Sample of Transgender and Gender Diverse Adolescents and Young Adults, Los Angeles, California, and New Orleans, Louisiana, 2017-2019.

IF 3 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Public Health Reports Pub Date : 2024-07-01 Epub Date: 2024-01-29 DOI:10.1177/00333549231223922

Manuel A Ocasio, M Isabel Fernandez, Demi H S Ward, Marguerita Lightfoot, Dallas Swendeman, Gary W Harper

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Abstract

Objectives: Treating gender identity as a fixed characteristic may contribute to considerable misclassification and hinder accurate characterization of health inequities and the design of effective preventive interventions for transgender and gender diverse (TGD) adolescents and young adults. We examined changes in how an ethnically and racially diverse sample of TGD adolescents and young adults reported their gender identity over time, the implications of this fluidity on public health, and the potential effects of misclassification of gender identity.

Methods: We recruited 235 TGD adolescents and young adults (aged 15-24 y) in Los Angeles, California, and New Orleans, Louisiana, from May 2017 through August 2019 to participate in an HIV intervention study. We asked participants to self-report their gender identity and sex assigned at birth every 4 months for 24 months. We used a quantitative content analysis framework to catalog changes in responses over time and classified the changes into 3 main patterns: consistent, fluctuating, and moving in 1 direction. We then calculated the distribution of gender identity labels at baseline (initial assessment) and 12 and 24 months and described the overall sample by age, race, ethnicity, and study site.

Results: Of 235 TGD participants, 162 (69%) were from Los Angeles, 89 (38%) were Latinx, and 80 (34%) were non-Latinx Black or African American. Changes in self-reported gender identity were common (n = 181; 77%); in fact, 39 (17%) changed gender identities more than twice. More than 50% (n = 131; 56%) showed a fluctuating pattern.

Conclusions: Gender identity labels varied over time, suggesting that misclassification may occur if data from a single time point are used to define gender identity. Our study lays the foundation for launching studies to elucidate the associations between shifting gender identities and health outcomes.

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2017-2019 年，加利福尼亚州洛杉矶市和路易斯安那州新奥尔良市跨性别和性别多元化青少年样本中报告性别身份标签的流动性。

目的：将性别认同视为一种固定特征可能会造成相当大的分类错误，并妨碍对健康不平等现象的准确描述，以及为变性和性别多元化（TGD）青少年和年轻成人设计有效的预防干预措施。我们研究了不同民族和种族的变性和性别多元化青少年和年轻成人在报告其性别认同时的变化、这种流动性对公共卫生的影响以及性别认同分类错误的潜在影响：从 2017 年 5 月到 2019 年 8 月，我们在加利福尼亚州洛杉矶市和路易斯安那州新奥尔良市招募了 235 名 TGD 青少年和年轻人（15-24 岁）参与一项 HIV 干预研究。我们要求参与者在 24 个月内每 4 个月自我报告一次他们的性别认同和出生时的性别分配情况。我们使用了定量内容分析框架来记录回答随时间的变化，并将变化分为 3 种主要模式：一致、波动和单向移动。然后，我们计算了基线（初始评估）、12 个月和 24 个月时性别认同标签的分布情况，并按年龄、种族、民族和研究地点对总体样本进行了描述：在 235 名 TGD 参与者中，162 人（69%）来自洛杉矶，89 人（38%）为拉丁裔，80 人（34%）为非拉丁裔黑人或非裔美国人。自我报告的性别认同改变很常见（n = 181；77%）；事实上，有 39 人（17%）改变性别认同两次以上。超过 50%（n = 131；56%）的人表现出波动模式：结论：性别认同标签随着时间的推移而变化，这表明如果使用单一时间点的数据来定义性别认同，可能会出现分类错误。我们的研究为今后的研究奠定了基础，以便阐明性别认同的变化与健康结果之间的关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Public Health Reports 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.00

自引率

6.10%

发文量

164

审稿时长

6-12 weeks

期刊介绍： Public Health Reports is the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service and has been published since 1878. It is published bimonthly, plus supplement issues, through an official agreement with the Association of Schools and Programs of Public Health. The journal is peer-reviewed and publishes original research and commentaries in the areas of public health practice and methodology, original research, public health law, and public health schools and teaching. Issues contain regular commentaries by the U.S. Surgeon General and executives of the U.S. Department of Health and Human Services and the Office of the Assistant Secretary of Health. The journal focuses upon such topics as tobacco control, teenage violence, occupational disease and injury, immunization, drug policy, lead screening, health disparities, and many other key and emerging public health issues. In addition to the six regular issues, PHR produces supplemental issues approximately 2-5 times per year which focus on specific topics that are of particular interest to our readership. The journal''s contributors are on the front line of public health and they present their work in a readable and accessible format.