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Canadian Health Research Funding Patterns for Sexual and Gender Minority Populations Reflect Exclusion of Women. 加拿大对性和性别少数群体的健康研究资助模式反映了对妇女的排斥。
IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-11 DOI: 10.1089/lgbt.2024.0014
Amanda B Namchuk, Tori N Stranges, Tallinn F L Splinter, Katherine N Moore, Carmen H Logie, Liisa A M Galea

Purpose: We explored the funding areas of Two-Spirit, lesbian, gay, bisexual, transgender (trans), queer or questioning, and intersex individuals (2S/LGBTQI)-specific health research funded by the Canadian Institutes of Health Research (CIHR) mentioned in the grant abstracts. Methods: We analyzed the publicly available database of grant abstracts funded by CIHR from 2009-2020 to examine what types of 2S/LGBTQI-specific health outcomes would be studied and in what populations. Results: We found that 58% of awarded grant abstracts mentioned studying sexually transmitted diseases, the majority of which was on human immunodeficiency virus. Of the funded 2S/LGBTQI grant abstracts that specified the gender of the population to be studied (n=23), less then 9% mentioned studying cisgender women. Almost 40% mentioned including trans women/girls, and 30% mentioned including trans men/boys. None of the studies examined mentioned work with the Two-Spirit community. Conclusion: These results reflect larger social and health inequities that require structural level changes in research to support the 2S/LGBTQI community.

目的:我们探讨了拨款摘要中提到的加拿大卫生研究院(CIHR)资助的双灵、女同性恋、男同性恋、双性恋、变性人(跨性别)、同性恋或质疑者以及双性人(2S/LGBTQI)特定健康研究的资助领域。研究方法我们分析了 2009-2020 年由 CIHR 资助的、可公开获取的拨款摘要数据库,以研究将对哪些类型的 2S/LGBTQI 特定健康结果进行研究,以及在哪些人群中进行研究。结果:我们发现,在获得资助的论文摘要中,有 58% 提到了对性传播疾病的研究,其中大部分是关于人类免疫缺陷病毒的研究。在明确指出研究人群性别的 2S/LGBTQI 资助摘要中(n=23),只有不到 9% 的摘要提到研究顺性别女性。近 40% 的研究提到包括变性女性/女孩,30% 的研究提到包括变性男性/男孩。所审查的研究中没有一项提到与双灵群体的合作。结论这些结果反映了更大的社会和健康不平等,需要在研究中进行结构性变革,以支持双灵/LGBTQI 群体。
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引用次数: 0
Intersectional Oppression-Based Stress, Drinking to Cope Motives, and Alcohol Use and Hazardous Drinking Among Sexual and Gender Minority Adolescents Who Are Black, Indigenous, and People of Color. 黑人、原住民和有色人种青少年中基于压迫的交叉压力、饮酒应对动机以及酒精使用和危险饮酒。
IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-08 DOI: 10.1089/lgbt.2024.0023
Ethan H Mereish, Jessica R Abramson, Hyemin Lee, Ryan J Watson

Purpose: This study examined the associations between intersectional oppression-based stress and recent alcohol use and hazardous drinking among sexual and gender minority (SGM; e.g., queer or transgender) adolescents who were Black, Indigenous, and People of Color (BIPOC), also known as queer and transgender BIPOC (QTBIPOC) adolescents, and the mediating role of coping motives (i.e., drinking to cope) on these associations. Methods: Data were from a subsample of QTBIPOC adolescents who used alcohol in the past year (n = 1365) from a national U.S. sample of SGM adolescents aged 13-18 years. Results: Intersectional oppression-based stressors were associated with greater odds of recent alcohol use and hazardous drinking, as well as greater coping motives. Coping motives mediated the associations between intersectional-based stressors and both recent alcohol use and hazardous drinking among the aggregate sample of QTBIPOC adolescents, as well as among some subgroups of BIPOC adolescents. Conclusions: The results of this study highlight that intersectional oppression-based stressors are prevalent among QTBIPOC adolescents and serve as a risk factor for alcohol use and hazardous drinking. Multilevel interventions are needed to target and dismantle intersectional oppressions to address alcohol inequities impacting QTBIPOC adolescents. Drinking to cope motives mediated the associations between intersectional oppression-based stress and drinking outcomes, underscoring another important mechanism to target within a context of oppression in drinking interventions.

目的:本研究考察了性与性别少数群体(SGM,如同性恋或变性人)青少年中的黑人、土著人和有色人种(BIPOC)青少年(也称同性恋和变性人BIPOC青少年(QTBIPOC))基于交叉压迫的压力与近期饮酒和危险饮酒之间的关联,以及应对动机(即饮酒以应对)对这些关联的中介作用。研究方法:数据来自美国全国 13-18 岁 SGM 青少年样本中过去一年饮酒的 QTBIPOC 青少年子样本(n = 1365)。研究结果基于交叉压迫的压力因素与近期饮酒和危险饮酒的几率增加以及应对动机增加有关。在 QTBIPOC 青少年总样本中,以及在 BIPOC 青少年的一些亚群中,应对动机对基于交织的压力源与近期饮酒和危险饮酒之间的关联起着中介作用。结论:本研究的结果突出表明,基于跨部门压迫的压力因素在 QTBIPOC 青少年中普遍存在,并成为酗酒和危险饮酒的风险因素。需要采取多层次的干预措施,有针对性地消除交叉压迫,以解决影响 QTBIPOC 青少年的酒精不平等问题。为应对压力而饮酒的动机在基于交叉压迫的压力和饮酒结果之间起到了中介作用,这强调了在压迫背景下针对饮酒干预的另一个重要机制。
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引用次数: 0
The Concealment of Health Information at the Intersection of Sexual Orientation and Race. 在性取向与种族交汇处隐藏健康信息。
IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-05 DOI: 10.1089/lgbt.2023.0423
Soocheol Cho, Robert T Gallagher

Purpose: Sexually and racially minoritized people often have mistrust toward the healthcare system due to both perceived and actual experiences of discrimination. This may result in increased privacy concerns and a reluctance to share health-related information with health care providers. Drawing upon minority stress and an intersectionality framework, this study examines how rates of concealing health information differ between non-Hispanic White heterosexual people, non-Hispanic White lesbian, gay, and bisexual (LGB) people, racially minoritized heterosexual people, and those who are both sexually and racially minoritized. Methods: Using nationally representative cross-sectional data from the Health Information National Trends Survey from 2017 and 2018 (n = 4575), we fit logistic regression models to examine (1) whether sexually and racially minoritized people conceal health information from their providers more than their counterparts and (2) whether this tendency increases for those with multiple marginalized identities. Furthermore, we fit linear regression models to examine whether and how concealing health information from providers are linked to health outcomes. Results: Sexually and racially minoritized people had higher odds of concealing health information from providers than their counterparts. Those with multiple marginalized identities had even higher odds of withholding health information than other groups. Finally, we found a significant negative association between concealing health information and mental health. Conclusion: Our findings underscore the need to consider how the intersection of multiple marginalized identities shape health experiences and concerns over privacy in health care matters. We call for further research to better understand the complex dynamics of patient-provider relationships for marginalized populations.

目的:在性别和种族上属于少数群体的人往往会因为感知到的和实际经历到的歧视而对医疗保健系统产生不信任感。这可能会导致他们更加关注隐私,不愿与医疗服务提供者分享与健康相关的信息。本研究借鉴了少数群体压力和交叉性框架,探讨了非西班牙裔白人异性恋者、非西班牙裔白人女同性恋、男同性恋和双性恋者(LGB)、种族上属于少数群体的异性恋者以及在性和种族上都属于少数群体的异性恋者之间隐瞒健康信息的比例有何不同。研究方法利用 2017 年和 2018 年健康信息全国趋势调查(n = 4575)中具有全国代表性的横截面数据,我们拟合了逻辑回归模型,以研究:(1)在性取向和种族上属于少数群体的人是否比同类人更多地向医疗服务提供者隐瞒健康信息;(2)具有多重边缘化身份的人这种倾向是否会增加。此外,我们还建立了线性回归模型,以研究向医疗服务提供者隐瞒健康信息是否以及如何与健康结果相关联。研究结果与同类人相比,在性别和种族上属于少数群体的人向医疗服务提供者隐瞒健康信息的几率更高。与其他群体相比,具有多重边缘化身份的人隐瞒健康信息的几率更高。最后,我们发现隐瞒健康信息与心理健康之间存在明显的负相关。结论我们的研究结果强调,有必要考虑多重边缘化身份的交叉如何影响健康体验以及对医疗保健事务中隐私的关注。我们呼吁进一步开展研究,以更好地了解边缘化人群与患者和医疗服务提供者之间复杂的动态关系。
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引用次数: 0
Sexual Identity and Heavy Drinking Among Adults in Canada by Racially Minoritized Status and Income, 2015-2020. 2015-2020 年按少数族裔身份和收入分列的加拿大成年人的性特征和酗酒情况》(Sexual Identity and Heavy Drinking Among Adults in Canada by Racially Minoritized Status and Income)。
IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-05 DOI: 10.1089/lgbt.2023.0187
Julian Gitelman, Brendan Smith, Christine M Warren, Alessandra T Andreacchi, Roman Pabayo, Erin Hobin

Purpose: Our objective was to estimate inequities in heavy drinking between heterosexual, gay or lesbian, and bisexual or pansexual individuals, by sex/gender, and to determine whether this association is heterogeneous across racially minoritized status and income groups in Canadians aged 15 and older. Methods: We pooled three Canadian Community Health Survey cycles (2015-2020) and used separate modified Poisson regressions to explore the sex/gender-specific association between sexual identity and heavy drinking prevalence by racially minoritized status, and income, adjusted for survey cycle, age, marital status, and region. Results: With racially minoritized status, and income categories collapsed, heavy drinking was 1.3 times higher (95% confidence interval [CI] = 1.0-1.7) among bisexual or pansexual women compared with heterosexual women, with no differences among men. Among racially minoritized women, heavy drinking was 2.9 (95% CI = 1.3-6.4) times higher among bisexual or pansexual women and 1.9 (95% CI = 0.7-5.2) times higher among gay or lesbian women compared with heterosexual women. Among racially minoritized men, heavy drinking was 1.9 (95% CI = 0.9-4.0) times higher among gay men compared with heterosexual men. No differences were observed across sexual identity in White men or women. Bisexual or pansexual women reported increased heavy drinking relative to heterosexual women across income quintiles. Conclusion: Heavy drinking is distributed heterogeneously across sexual identity, sex/gender, racially minoritized status, and income. These results encourage equity-focused interventions to reduce heavy drinking among intersecting sociodemographic groups experiencing a greater burden of heavy drinking.

目的:我们的目的是按性别估计异性恋、男同性恋或女同性恋、双性恋或泛双性恋者之间在大量饮酒方面的不平等,并确定在 15 岁及以上的加拿大人中,这种关联在少数种族身份和收入群体中是否具有异质性。研究方法我们汇集了三个加拿大社区健康调查周期(2015-2020 年)的数据,并使用单独的修正泊松回归来探索性身份与少数民族身份和收入之间的特定性/性别关联,并对调查周期、年龄、婚姻状况和地区进行了调整。结果:将种族少数化状况和收入类别合并后,与异性恋女性相比,双性恋或泛双性恋女性的重度酗酒率是异性恋女性的 1.3 倍(95% 置信区间 [CI] = 1.0-1.7),而男性之间没有差异。在少数种族女性中,与异性恋女性相比,双性恋或泛双性恋女性的重度酗酒率是异性恋女性的 2.9 倍(95% 置信区间 = 1.3-6.4),同性恋女性的重度酗酒率是异性恋女性的 1.9 倍(95% 置信区间 = 0.7-5.2)。在少数种族男性中,与异性恋男性相比,同性恋男性的酗酒率是异性恋男性的 1.9 倍(95% CI = 0.9-4.0)。在白人男性或女性中,没有观察到不同性身份的差异。与异性恋女性相比,双性恋或泛双性恋女性的重度酗酒率在不同收入的五分位数中都有所上升。结论:重度饮酒在性身份、性/性别、少数种族身份和收入方面的分布是不均衡的。这些结果鼓励采取以公平为重点的干预措施,以减少交叉社会人口群体中的大量饮酒。
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引用次数: 0
Receptive Anal Intercourse: Impact on Colorectal and Urologic Diagnoses. 接受性肛交:对结肠直肠和泌尿系统诊断的影响。
IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-05 DOI: 10.1089/lgbt.2023.0469
Thomas W Gaither, Tara Shahrvini, Nathan W Vincent, Marcia Russell, Mark S Litwin

Purpose: We evaluated the relationship between lifetime receptive anal intercourse (RAI) and the risk of common colorectal and urologic diagnoses. Methods: We conducted an internet-based survey on sensations during RAI between July 2022 and March 2023. We used multivariable logistic regression to assess the independent impact of lifetime RAI exposure on the diagnosis of common urologic and colorectal conditions. Participants completed a main survey and were invited to complete randomly assigned patient-reported outcome measures (PROMs), which measured pelvic symptoms, mental health symptoms, and sexual satisfaction. Results: In total, 1100 participants completed the main survey and 416 completed the PROMs. Participants of the main survey ranged from 18 to 78 years old and the median age of the sample was 32 years. There was no significant association between lifetime RAI exposure and any medical diagnosis, except for anal fissures, which increased linearly with additional RAI exposure. Both sexual satisfaction and mental health symptoms improved with RAI exposure. Conclusions: RAI was not associated with most of the colorectal and urologic diagnoses tested and was associated with fewer mental symptoms and increased sexual satisfaction. Development of anal fissures may be directly related to trauma of the anal canal from penetration.

目的:我们评估了终生接受性肛交(RAI)与常见结直肠和泌尿系统疾病诊断风险之间的关系。方法:我们在互联网上对 RAI 期间的感觉进行了调查:我们在 2022 年 7 月至 2023 年 3 月期间通过互联网对 RAI 期间的感觉进行了调查。我们使用多变量逻辑回归评估终生 RAI 暴露对常见泌尿系统和结直肠疾病诊断的独立影响。参与者完成了一项主要调查,并被邀请完成随机分配的患者报告结果测量(PROMs),该测量可测量骨盆症状、心理健康症状和性满意度。结果:共有 1100 名参与者完成了主要调查,416 名参与者完成了 PROMs。主调查的参与者年龄从 18 岁到 78 岁不等,样本年龄中位数为 32 岁。除肛裂外,一生中接触过的 RAI 与任何医疗诊断之间均无明显关联,而肛裂会随着接触 RAI 的增加而呈线性增加。性满意度和心理健康症状都会随着 RAI 暴露的增加而改善。结论:RAI 与所检测的大多数结直肠和泌尿系统诊断无关,而与较少的精神症状和较高的性满意度有关。肛裂的发生可能与插入造成的肛管创伤直接相关。
{"title":"Receptive Anal Intercourse: Impact on Colorectal and Urologic Diagnoses.","authors":"Thomas W Gaither, Tara Shahrvini, Nathan W Vincent, Marcia Russell, Mark S Litwin","doi":"10.1089/lgbt.2023.0469","DOIUrl":"https://doi.org/10.1089/lgbt.2023.0469","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> We evaluated the relationship between lifetime receptive anal intercourse (RAI) and the risk of common colorectal and urologic diagnoses. <b><i>Methods:</i></b> We conducted an internet-based survey on sensations during RAI between July 2022 and March 2023. We used multivariable logistic regression to assess the independent impact of lifetime RAI exposure on the diagnosis of common urologic and colorectal conditions. Participants completed a main survey and were invited to complete randomly assigned patient-reported outcome measures (PROMs), which measured pelvic symptoms, mental health symptoms, and sexual satisfaction. <b><i>Results:</i></b> In total, 1100 participants completed the main survey and 416 completed the PROMs. Participants of the main survey ranged from 18 to 78 years old and the median age of the sample was 32 years. There was no significant association between lifetime RAI exposure and any medical diagnosis, except for anal fissures, which increased linearly with additional RAI exposure. Both sexual satisfaction and mental health symptoms improved with RAI exposure. <b><i>Conclusions:</i></b> RAI was not associated with most of the colorectal and urologic diagnoses tested and was associated with fewer mental symptoms and increased sexual satisfaction. Development of anal fissures may be directly related to trauma of the anal canal from penetration.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Sexual Orientation and Gender Identity Reporting in Highly Cited Current Alcohol Research. 高引用率的当前酒精研究中的性取向和性别认同报告。
IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2023-10-20 DOI: 10.1089/lgbt.2023.0085
Dean J Connolly, Santino Coduri-Fulford, Connor Tugulu, Meron Yalew, Elizabeth Moss, Justin C Yang

Purpose: This study aimed to measure the frequency of high-quality and transparent sexual orientation and gender identity (SOGI) data collection and reporting in highly cited current alcohol use research, using the extant literature to identify community-informed priorities for the measurement of these variables. Methods: A single search to identify alcohol use literature was conducted on PubMed with results restricted to primary research articles published between 2015 and 2022. The 200 most highly cited studies from each year were identified and their titles and abstracts reviewed against inclusion criteria after deduplication. After full-text review, study characteristics and data indicating quality of SOGI reporting were extracted. The fidelity of the results was verified with a random sample before analyses. Results: The final sample comprised 580 records. Few studies reported gender identity (n = 194; 33.4%) and, of these, 7.2% reported the associated gender identity measure. A two-stage approach to measure gender was adopted in 3 studies, one study used an open-ended question with a free-text response option, and 13 studies recorded nonbinary gender identities (reported by 0.9% of the whole sample). Nineteen (3.3%) studies reported sexual orientation and more than half of these provided the sexual orientation measure. Eight of the 20 studies that reported sexual orientation and/or gender identity measures were classified as sexual and gender minority specialist research. Conclusions: Culturally competent SOGI reporting is lacking in highly cited current alcohol research. SOGI measures should be disclosed in future research and should provide free-text response options.

目的:本研究旨在衡量当前被高度引用的酒精使用研究中高质量、透明的性取向和性别认同(SOGI)数据收集和报告的频率,利用现有文献确定社区知情的优先事项,以衡量这些变量。方法:在PubMed上进行单一检索,以确定酒精使用文献,结果仅限于2015年至2022年间发表的主要研究文章。确定了每年被引用率最高的200项研究,并在重复数据消除后根据纳入标准对其标题和摘要进行了审查。全文综述后,提取了研究特征和表明SOGI报告质量的数据。分析前用随机样本验证了结果的保真度。结果:最终样本包括580份记录。很少有研究报告性别认同(n = 194;33.4%),其中7.2%报告了相关的性别认同测量。在3项研究中采用了两阶段的方法来衡量性别,一项研究使用了带有自由文本回答选项的开放式问题,13项研究记录了非二元性别认同(占整个样本的0.9%)。19项(3.3%)研究报告了性取向,其中一半以上提供了性取向测量。在报告性取向和/或性别认同指标的20项研究中,有8项被归类为性和性别少数群体专家研究。结论:在目前被高度引用的酒精研究中,缺乏具有文化能力的SOGI报告。SOGI措施应在未来的研究中披露,并应提供免费文本回复选项。
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引用次数: 0
Examining Factors Associated with Cannabis Use Among Sexual and Gender Minority and Cisgender Heterosexual Emerging Adults in California. 研究加利福尼亚州性与性别少数群体和同性异性新成人使用大麻的相关因素。
IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-02-01 DOI: 10.1089/lgbt.2023.0050
Juan C Jauregui, Chenglin Hong, Ryan D Assaf, Nicole J Cunningham, Evan A Krueger, Risa Flynn, Ian W Holloway

Purpose: We explored correlates of cannabis risk and examined differences between sexual and gender minority (SGM) and cisgender heterosexual emerging adults (ages 18-29) in California. Methods: We recruited 1491 participants aged 18-29 years for a cross-sectional online survey. Ordinal logistic regressions assessed associations between minority stress (discrimination and internalized homophobia [IH]), social support (perceived social support and lesbian, gay, bisexual, transgender, and queer+ [LGBTQ+] community connectedness), and cannabis risk scores (low, medium, and high risk of developing problems related to their cannabis use). We also explored differences in cannabis risk scores by sexual orientation and gender identity (SOGI). Results: Higher everyday discrimination scores were associated with increased odds of self-scoring in a higher cannabis risk range (adjusted odds ratio = 1.53, 95% confidence interval [CI] = 1.31-1.79). We found no significant associations for IH, LGBTQ+ community connectedness, or social support on cannabis risk scores. There were also no statistically significant differences by SOGI groups; however, SOGI did moderate the relationship between IH and cannabis risk score such that the slope for IH was 0.43 units higher for cisgender sexual minority women compared to cisgender sexual minority men (95% CI = 0.05-0.81). Conclusion: Our findings suggest that experiences of everyday discrimination are important contributors to developing cannabis-related problems and IH may have more pronounced effects for sexual minority women compared to sexual minority men. More research is needed to better understand risk and protective factors of cannabis risk to inform the development of culturally tailored interventions for SGM emerging adults.

目的: 我们探索了大麻风险的相关因素,并研究了加利福尼亚州性与性别少数群体 (SGM) 与同性异性恋新成人(18-29 岁)之间的差异。研究方法:我们招募了 1491 名 18-29 岁的参与者进行横截面在线调查。顺序逻辑回归评估了少数群体压力(歧视和内部化恐同症 [IH])、社会支持(感知的社会支持和女同性恋、男同性恋、双性恋、跨性别者和同性恋者+ [LGBTQ+] 社区联系)和大麻风险评分(与大麻使用有关的问题的低风险、中风险和高风险)之间的关联。我们还探讨了不同性取向和性别认同(SOGI)的大麻风险得分差异。研究结果较高的日常歧视分数与自我评分处于较高大麻风险范围的几率增加有关(调整后的几率比 = 1.53,95% 置信区间 [CI] = 1.31-1.79)。我们没有发现 IH、LGBTQ+ 社区联系或社会支持与大麻风险评分有明显关联。在统计学上,不同社会性别群体之间也没有显著差异;不过,社会性别群体确实缓和了 IH 与大麻风险得分之间的关系,例如,与同性别的性少数群体男性相比,同性别的性少数群体女性的 IH 斜率高出 0.43 个单位(95% CI = 0.05-0.81)。结论我们的研究结果表明,日常歧视经历是导致大麻相关问题的重要因素,与性少数群体男性相比,IH 对性少数群体女性的影响可能更为明显。需要进行更多的研究,以更好地了解大麻风险的风险因素和保护因素,为制定针对性少数群体新成人的文化干预措施提供信息。
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引用次数: 0
Protective and Risk Factors for Suicidal Ideation and Behavior Among Sexual Minority Women in the United States: A Cross-Sectional Study. 美国性少数群体妇女自杀意念和行为的保护因素和风险因素:一项横断面研究。
IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-02-06 DOI: 10.1089/lgbt.2023.0003
Emylia Terry, Jennifer R Pharr, Ravi Batra, Kavita Batra

Purpose: The purpose of this study was to understand the factors associated with suicidal ideation and behavior and serious suicidal ideation and behavior among sexual minority women (SMW), including resilience, discrimination, mental health, and sociodemographic characteristics. Methods: Web-based surveys were conducted with SMW from across the United States during January-February, 2022 using psychometric valid tools. Bivariate, hierarchical regression, and logistic regression analyses were used to analyze the data. Results: Of 497 participants, 70% were identified as bisexual and 30% as lesbian. The mean scores for anxiety, depression, and stress were significantly higher among bisexual women compared to their lesbian counterparts (p < 0.05). The proportion of serious suicidal ideation and behavior was higher among bisexual women compared to lesbian women (53.9% vs. 41.2%, p = 0.012). Conversely, the mean scores of resilience were lower among bisexual women compared to lesbian women (139.7 ± 33.4 vs. 147.5 ± 33.6, p = 0.024). Lesbian women had nearly 57.4% lower odds of having serious suicidal ideation and behavior as compared to bisexual women (adjusted odds ratio = 0.426; p = 0.023). Experiencing anxiety, depression, victimization distress, and family discrimination distress were positively associated with serious suicidal ideation and behavior, whereas personal resilience and family cohesion were negatively associated with serious suicidal ideation and behavior. Conclusions: Tackling structural inequities such as racism and homophobia remains vital to improving the mental health of SMW. Interventions to strengthen social and familial supports may be particularly impactful, especially at the family level.

目的:本研究旨在了解与性少数群体女性(SMW)自杀意念和行为以及严重自杀意念和行为相关的因素,包括复原力、歧视、心理健康和社会人口特征。调查方法在 2022 年 1 月至 2 月期间,使用有效的心理测量工具对全美的性少数群体女性进行了网络调查。数据分析采用了二元分析、层次回归分析和逻辑回归分析。结果:在 497 名参与者中,70% 被认定为双性恋,30% 被认定为女同性恋。与女同性恋相比,双性恋女性的焦虑、抑郁和压力平均得分明显更高(P = 0.012)。相反,与女同性恋相比,双性恋女性的复原力平均得分较低(139.7 ± 33.4 vs. 147.5 ± 33.6,p = 0.024)。与双性恋女性相比,女同性恋有严重自杀意念和行为的几率要低近 57.4%(调整后的几率比 = 0.426;p = 0.023)。焦虑、抑郁、受害困扰和家庭歧视困扰与严重自杀意念和行为呈正相关,而个人复原力和家庭凝聚力与严重自杀意念和行为呈负相关。结论解决种族主义和仇视同性恋等结构性不平等问题对于改善法定最低年龄人群的心理健康仍然至关重要。加强社会和家庭支持的干预措施可能会产生特别大的影响,尤其是在家庭层面。
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引用次数: 0
Body Composition and Metabolic Syndrome Components in Transgender/Gender Diverse Adolescents and Young Adults. 变性/性别多元化青少年和年轻成年人的身体成分和代谢综合征成分。
IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-04-01 DOI: 10.1089/lgbt.2023.0065
Ophir Borger, Liat Perl, Michal Yackobovitch-Gavan, Roni Sides, Avivit Brener, Anat Segev-Becker, Tamar Sheppes, Galit Weinstein, Asaf Oren, Yael Lebenthal

Purpose: The objective of this study was to examine the association of designated sex at birth, body composition, and gender-affirming hormone treatment (GAHT) with the components of metabolic syndrome (MetS) (overweight/obesity, elevated blood pressure [BP], altered glucose metabolism, and dyslipidemia) in transgender/gender diverse (TGD) adolescents and young adults. Methods: TGD individuals underwent body composition studies by bioelectrical impedance analysis according to designated sex at birth, and their muscle-to-fat ratio (MFR) z-scores were calculated. Generalized estimating equations with binary logistic models (n = 326) were used to explore associations while adjusting for potential confounders. Results: A total of 55 TGD females and 111 TGD males, with mean age of 18 ± 1.9 years and median duration of GAHT of 1.4 years (interquartile range = 0.6-2.5), were enrolled. Overall, 118/166 (71%) of the TGD cohort showed evidence of at least one MetS component, with a significantly higher rate among TGD males compared with TGD females (91.1% vs. 50.9%, p < 0.001). TGD males were at increased odds for overweight/obesity, elevated/hypertensive BP, elevated triglycerides (TGs), and an atherogenic dyslipidemia index (TG/high-density lipoprotein cholesterol [HDL-c], TG:HDL-c). The odds of overweight/obesity increased by 44.9 for each standard deviation decrease in the MFR z-score, while the odds for an elevated TG:HDL-c index increased by 3.7. Psychiatric morbidity increased the odds for overweight/obesity by 2.89. Conclusions: After considering confounding variables, the TGD males on GAHT were found to be at an increased risk for cardiometabolic disease. Our observations support the importance of targeted medical nutrition intervention in this group of individuals.

目的:本研究旨在探讨变性/性别多元化(TGD)青少年和年轻人出生时的指定性别、身体组成和性别确认激素治疗(GAHT)与代谢综合征(MetS)(超重/肥胖、血压[BP]升高、糖代谢改变和血脂异常)的关联。方法:根据出生时指定的性别,通过生物电阻抗分析对变性人进行身体成分研究,并计算他们的肌脂比(MFR)z-分数。采用二元逻辑模型的广义估计方程(n = 326)来探讨相关性,同时对潜在的混杂因素进行调整。结果:共纳入 55 名 TGD 女性和 111 名 TGD 男性,平均年龄为 18 ± 1.9 岁,中位 GAHT 持续时间为 1.4 年(四分位间范围 = 0.6-2.5)。总体而言,TGD 队列中有 118/166 人(71%)显示出至少一种 MetS 成分,与 TGD 女性相比,TGD 男性的这一比例明显更高(91.1% 对 50.9%,P 结论:TGD 男性的这一比例明显高于 TGD 女性(91.1% 对 50.9%,P 结论:TGD 男性的这一比例明显高于 TGD 女性):在考虑了各种混杂变量后,发现接受 GAHT 治疗的 TGD 男性罹患心脏代谢疾病的风险更高。我们的观察结果表明,对这类人群进行有针对性的医学营养干预非常重要。
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引用次数: 0
Demographic Differences in Gender Dysphoria Diagnosis and Access to Gender-Affirming Care Among Adolescents. 青少年中性别失调诊断和获得性别确认护理的人口统计学差异。
IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-01-08 DOI: 10.1089/lgbt.2023.0273
Nicole F Kahn, Peter G Asante, Tumaini R Coker, Kacie M Kidd, Dimitri A Christakis, Laura P Richardson, Gina M Sequeira

Purpose: The goal of this article was to identify demographic differences in receipt of gender dysphoria (GD) diagnosis and access to gender-affirming care (GAC) among adolescents whose gender identity and/or pronouns differed from their sex assigned at birth. Methods: Data were from 2444 patients who were 13-17 years old and had a documented gender identity and/or pronouns that differed from their sex assigned at birth in the electronic health record. Adjusted logistic regression models explored associations between demographic characteristics (sex assigned at birth, gender identity, race and ethnicity, language, insurance type, rural status) and presence of GD diagnosis and having accessed GAC. Results: The average predicted probability (Pr) of having received a GD diagnosis was 0.62 (95% confidence interval [CI] = 0.60-0.63) and of having accessed GAC was 0.48 (95% CI = 0.46-0.50). Various significant demographic differences emerged. Notably, Black/African American youth were the least likely to have received a GD diagnosis (Pr = 0.43, 95% CI = 0.33-0.54) and accessed GAC (Pr = 0.32, 95% CI = 0.22-0.43). Although there were no significant differences in GD diagnosis by insurance type, youth using Medicaid, other government insurance, or self-pay/charity care were less likely to have accessed GAC compared with youth using commercial/private insurance. Conclusion: Results indicate significant differences in both receipt of GD diagnosis and accessing GAC by various demographic characteristics, particularly among Black/African American youth. Identification of these differences provides an opportunity to further understand potential barriers and promote more equitable access to GAC among adolescents who desire this care.

目的:本文旨在确定性别认同和/或代词与出生时性别不同的青少年在接受性别焦虑症(GD)诊断和获得性别确认护理(GAC)方面的人口统计学差异。研究方法数据来自 2444 名 13-17 岁的患者,他们在电子健康记录中记录的性别认同和/或代词与其出生时的性别不同。调整后的逻辑回归模型探讨了人口统计学特征(出生时的性别分配、性别认同、种族和民族、语言、保险类型、农村状况)与是否存在 GD 诊断和是否使用过 GAC 之间的关联。结果:获得 GD 诊断的平均预测概率 (Pr) 为 0.62(95% 置信区间 [CI] = 0.60-0.63),获得 GAC 的平均预测概率 (Pr) 为 0.48(95% 置信区间 [CI] = 0.46-0.50)。人口统计学中出现了各种重大差异。值得注意的是,黑人/非洲裔美国青少年接受 GD 诊断(Pr = 0.43,95% CI = 0.33-0.54)和获得 GAC(Pr = 0.32,95% CI = 0.22-0.43)的可能性最小。虽然不同保险类型的 GD 诊断结果没有明显差异,但与使用商业/私人保险的青少年相比,使用医疗补助、其他政府保险或自费/慈善护理的青少年获得 GAC 的可能性较低。结论研究结果表明,在接受 GD 诊断和获得 GAC 方面,各种人口统计学特征存在明显差异,尤其是在黑人/非裔美国青少年中。找出这些差异为进一步了解潜在的障碍并促进希望获得 GAC 的青少年更公平地获得这种护理提供了机会。
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引用次数: 0
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