Transgender Health最新文献

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.