Transgender Health最新文献

Purpose: This study describes Thai transfeminine individuals' exogenous hormone use.

Methods: During the period May-July 2017, a survey was conducted among Thai transfeminine adults (N=181) who reported their exogenous hormone use, age at onset of use, brands used, where they obtained hormones, and discontinuation of use.

Results: Most participants (86.74%) used exogenous hormones. The mean (standard deviation) age of onset of use was 16.59 (3.79) years. A range of 1-15 brands with varying chemical composition were used. Hormones were typically procured from pharmacies (91.39%) and seldom physician prescribed (8.61%). Discontinuing use for 6 or more months was common (59.62%).

Conclusions: Gender-affirming health care beginning in adolescence for Thai transfeminine individuals is needed.

Purpose: The goal of this study was to assess possible psychosocial contributors to delayed coronavirus disease 2019 (COVID-19) vaccination within a sample of transgender and gender diverse (TGD) individuals.

Methods: TGD participants (N=385) were recruited from Prolific.co. Survey items assessed COVID-19 vaccination status, experiences of discrimination in health care settings, medical mistrust, COVID-19 mistrust, and perceived barriers to vaccination. Logistic regressions were conducted using SPSS version 27 to assess whether demographic variables, medical mistrust, experiences of discrimination in health care, and COVID-19 mistrust predicted vaccination behaviors. A PATH model was developed using AMOS 21.0 to assess the relationship among experiences of discrimination, general medical mistrust, COVID-19 mistrust, and barriers to vaccination in predicting receipt of a booster at the time of the study.

Results: Results from the logistic regressions indicated a binary TGD identity and higher COVID-19 mistrust predicted experiencing a delayed first dose of a COVID-19 vaccination and receipt of a booster at the time of the study over and above racial identity, experiences of discrimination, and general medical mistrust. Results from a PATH model indicated an association among experiences of discrimination in health care, medical mistrust, COVID-19 mistrust, barriers to vaccination, and having not received a booster at the time of the study.

Conclusion: These findings support prior research demonstrating that vaccination rates among TGD individuals do not differ from other groups. However, TGD individuals with a binary gender may have experienced or anticipated experiencing barriers to COVID-19 vaccination and/or receipt of a booster. Public health and clinical implications for these findings are discussed.

Purpose: Using a community-engaged approach, we adapted a human immunodeficiency virus (HIV) prevention smartphone app, Transpire, to meet the HIV and sexually transmitted infection (STI) prevention needs of transgender men and other transmasculine people. We conducted a pilot study to assess the feasibility and acceptability of the app among participants in two cities in the southeastern United States.

Methods: Participants were recruited online and through community partners. Eligible and consenting participants used the Transpire app for 3 months and completed surveys at the beginning and end of the follow-up period. Transpire gave participants access to HIV and STI prevention information; the ability to order HIV and STI at-home self-test kits, condoms, and lube; and mental health and substance use resources. The primary feasibility outcome was the System Usability Scale (SUS), which measures the usability of technology-based products.

Results: Sixty participants were enrolled. Most were 18-24 years old (n=33, 55%) and identified as non-Hispanic white (n=46, 77%). The mean SUS score was 72.4, which meets established criteria for acceptability. Fifteen (32%) participants conducted an HIV test during the 3-month follow-up period and 2 (4%) initiated pre-exposure prophylaxis.

Conclusions: Following a community-engaged adaptation process, the Transpire app was found to be acceptable in a pilot study conducted among transmasculine participants. These pilot data indicate that app-based interventions have the potential to increase awareness of and access to sexual health resources for transmasculine people. Additional studies will be needed to assess the efficacy of Transpire or similar apps to improve sexual health outcomes.

Purpose: Trans and gender diverse (TGD) people are one of the world's most marginalized populations. Current evidence indicates that ostracism faced by these communities leads to multiple adverse conditions. The synergistic impact of these conditions -a syndemic-has been well established among other marginalized populations. Despite disproportionate rates of syndemic conditions, there is a dearth of literature exploring their effect among TGD people. This review sought to summarize the current literature regarding syndemic conditions among this population.

Methods: A comprehensive search of databases (Medline, Embase, Global Health, PsycInfo, and CINAHL) was conducted; search terms included syndemics, syndemic theory, transgender, sexual minority, and gender minority. References within selected articles were also reviewed. Inclusion criteria for this review included studies that (1) explored the impact of syndemic factors and/or theory among TGD people, (2) were written in English, and (3) published up to December 2020.

Results: The search generated 192 articles; 10 met the inclusion criteria. Substance use, mental health, and victimization were the most prominent syndemic conditions assessed. Current evidence is limited to sexual risk behaviors and provides preliminary support for an association between syndemic conditions and sexual risk behaviors.

Conclusion: Understanding syndemics is vital to developing contextually suitable interventions or TGD people. Future researchers should work toward longitudinal or high-level modeling approaches of syndemic theory to effectively design interventions to improve health outcomes among TGD people. Furthermore, scholars should study the relationship between syndemic conditions and other outcomes to better understand the impact of syndemics on broader health consequences.

Purpose: The purpose of this research study was to describe and compare the prevalence of substance use behaviors in a sample of transgender and nonbinary young adults by gender subgroup (transgender men, transgender women, nonbinary people), and to examine relationships between substance use behaviors, racism, and antitransgender stigma.

Methods: This was an analysis of a cross-sectional sample of 215 transgender and nonbinary young adults recruited from the San Francisco Bay area between January 2019 and July 2021. We used multivariable regression models to examine associations between self-reported experiences of antitransgender stigma, racism, and substance use behaviors.

Results: Approximately half of the total sample reported recent heavy episodic drinking (52.8%) and club drug use (50.5%); 19.2% reported daily tobacco use, and 35.7% reported daily marijuana use. There were no gender differences in substance use behaviors. Antitransgender stigma was associated with daily marijuana use, heavy episodic drinking, and club drug use (cocaine, amphetamines, hallucinogens). Black/African American participants were more likely to report daily tobacco use and recent heavy episodic drinking than White participants, and multiracial/multiethnic participants reported greater levels of daily tobacco use compared with White participants. In addition to these main effects, a significant interaction between antitransgender stigma and racism on daily marijuana was found, suggesting risk exacerbation due to intersecting stigmas for participants of color.

Conclusion: Findings demonstrate a need for prevention and treatment interventions addressing linkages between antitransgender stigma, racism, and substance use behaviors among transgender and nonbinary young adults.

Purpose: Transgender and gender diverse (TGD) individuals continue to face adversity, stigma, and inequality, especially in health care. This study aimed to characterize the experience of TGD people and partners of TGD people with regard to fertility treatment.

Methods: All TGD patients presenting to a single academic center between 2013 and 2021 were included. Baseline demographics collected included patient age, body mass index, anti-Mullerian hormone, basal antral follicle count, history of gender-affirming surgery, and/or gender-affirming hormone therapy. Outcomes included total patients who progressed to treatment, cycle type(s), and clinical outcomes.

Results: In total, 82 patients who identified as TGD or had a partner who identified as TGD presented to care seeking fertility treatment. Of the 141 planned cycles, 106 (75.2%) progressed to treatment. Of the 15 in vitro fertilization (IVF) and co-IVF cycles, 12 achieved live birth. Of the 76 intrauterine inseminations 7 patients were discharged with ongoing pregnancies and one achieved live birth.

Conclusion: These findings reaffirm that TGD individuals utilize the entire array of fertility services. With recent advances in access to care and modern medicine, assisted reproductive technology treatment has the power to support TGD patients in building contemporary family structures.

Purpose: The purpose of this study was to determine if human immunodeficiency virus (HIV) practitioners offer gender-affirming hormone therapy (GAHT) to their transgender patients living with HIV, as previous studies have shown that these patients are more likely to be virally suppressed and retained in care.

Methods: We conducted an online survey sent to 2570 HIV practitioners who attended an International Antiviral Society-USA event between 2017 and 2019. We also assessed demographics, transgender care training, comfort, prescribing practices, and knowledge.

Results: Respondents (N=385) were mainly primary care (49%) and infectious disease (ID)/HIV (42%) practitioners. Fifty-seven percent prescribed GAHT to transgender people living with HIV, but only 7% received formal training. Thirty-five percent were ID/HIV, 60% were primary care, and 5% were other specialty practitioners. Most felt that it would be beneficial to have formal education in GAHT practices during training (83%). There were statistically significant differences in GAHT education, experiences, knowledge, and interest in future training and prescribing by health care specialty. Commonly cited barriers to providing therapy included lack of training (33%), lack of transgender people living with HIV in practice (18%), and lack of qualified mental health professionals (15%).

Conclusion: This survey is the first to assess GAHT practices among HIV practitioners from across the United States. The majority of those surveyed prescribe GAHT to their transgender patients living with HIV. Although most felt comfortable doing so, few had formal training and knowledge scores were low. We advocate for the integration of GAHT education into formal training programs and offer resources for those who wish to pursue education.