International Journal of Transgender Health最新文献

Background: The proliferation of trans-led online health resources constitutes a purposive community response to the limitations that many trans people face globally in accessing healthcare information and services. While such resources are typically community run or administered by individuals, and hence not subject to reporting mandates, it is useful to examine how end-users perceive online health resources for trans people.

Aims: This paper reports on an evaluation of one trans-led online health resource, focused on South Australia.

Methods: Interviews were undertaken with 15 trans people who accessed the website Trans Health SA. Participants were invited to view the website alongside the first author, and to share their thoughts about the website design and content.

Results: Thematic analysis resulted in the development of three themes: (1) transnormativity and the intended viewer, (2) the website as a welcoming community space, and (3) discrepancies between content and design.

Conclusions: The paper concludes by considering what it means to create inclusive online trans health resources in the context of both ongoing marginalization and community diversity.

Introduction: Transgender and nonbinary (TNB) persons' healthcare experiences and related transition decisions have received increasing attention in recent years. Growing literature indicates gender non-affirming practices, such as gender identity conversion efforts (GICE), are harmful for the wellbeing of TNB persons. Yet, how exposure to GICE is linked to transition related decisions among TNB persons remains unexplored. This study examines links between GICE and TNB persons' transition decisions and identity exploration, using a conceptual framework that distinguishes adaptive transition decisions (e.g. transition interruptions due to interpersonal coercion) from identity-related transition decisions.

Methods: This study is a secondary data analysis of the 2015 U.S. Transgender Survey (N = 27,630). Multinomial logistic regression was conducted to examine the relationship between GICE and transition decisions among TNB persons while controlling for demographic covariates.

Results: Overall, 13.5% of TNB participants experienced GICE. Participants interrupted their transition due to interpersonal coercion (4.9%), structural factors (2.0%), and identity-related factors (0.4%). Participants with GICE exposure were more likely to report interrupting their transition due to interpersonal coercion than not interrupting their transition. However, GICE-exposed participants did not have a higher chance of identity-related transition interruptions than no interruptions.

Conclusions: These findings point to a potentially harmful role GICE may play in the transition decisions of TNB persons. Our analysis adds to evidence indicating the need for banning GICE and calls for a more nuanced understanding, recognition, and respect for TNB persons' non-linear transitioning trajectories. Otherwise, we risk vilifying gender-affirming practices and pathologizing adaptive transitioning decisions of TNB persons.

Background: Young transgender adults report higher levels of mental health difficulties compared to the general population. These difficulties reportedly improve following gender-affirming care and transition. However, gender-dysphoric people wait up to 5+ years in the UK to access gender-affirming treatment.

Aims: The study aimed to qualitatively explore the psychological challenges and impact of waiting to access UK Gender Dysphoria Clinics (GDCs) for young trans adults.

Methods: Recruitment via two GDCs resulted in a sample of 10 participants (aged 17-26) who had been waiting at least 12 months for assessment. Qualitative semi-structured interviews were conducted online or by phone with four men, four women, and two gender nonconforming people. Data were analyzed through Interpretive Phenomenological Analysis (IPA).

Results: Challenges and impact of waiting were represented within eight themes. Five psychosocial challenges included "Grasping on a spider web of hope that's about to snap," "People are uneducated and they don't understand," "Society or whatever made me second guess myself," "I'm too autistic for that shit', and "It sounded like the phone was just being left all day every day." Mental health impacts of waiting were captured in the themes "(Gender) Dysphoria attacks" and "If it doesn't go well by 30, I'm gonna kill myself." A final theme, "I'm going to just go on with me life," focused on healthy and less-adaptive coping strategies.

Conclusion: Waiting to access GDCs is a fragile and vulnerable time; experiences of discrimination, stigma, transphobia, and uncertainty during the waiting period appear to increase feelings of hopelessness and diminish mental health. Focusing on social transitioning was reported by most participants as a coping strategy for waiting. Findings highlight the importance of reducing waiting times for GDCs and offering psychosocial support during the wait.

Background: Despite a high national demand for genital gender-affirming surgery, training within United States obstetrics and gynecology (OB/GYN) residencies is limited.

Method: OB/GYN residents from eight programs, including two programs in each geographic area of the United States, participated in a standardized, clinical scenario-based educational module on genital gender-affirming surgery for transmasculine and nonbinary patients from August 2022 to July 2023. Residents completed pre- and post-surveys associated with this educational module.

Results: Eighty-three residents participated in the course, including thirty-two (38.6%) from the Midwest, thirty (36.1%) from the Northeast, thirteen (15.7%) from the South, and eight (9.6%) from the West. Pre-intervention comfort counseling on genital gender-affirming surgery differed by residency region (p = 0.04), with residents in the West demonstrating the most comfort. Residents in the Midwest, Northeast, and South demonstrated increased comfort with counseling after the module (p < 0.01, p < 0.01, p = 0.01 respectively), while no change was observed in the West (p > 0.99). Residents in all regions had increased comfort with preoperative requirements for genital gender-affirming surgery after the module (p < 0.01, p < 0.01, p = 0.04, p = 0.03). A majority (81.9%) of residents felt that incorporation of this module would be beneficial to their OB/GYN training (99%).

Conclusion: OB/GYN resident competence with counseling on genital gender-affirming surgery for transmasculine and nonbinary patients improved in the Midwest, Northeast, and South following a five-part clinical scenario-based educational module. Absence of a change in comfort counseling in the West suggest a decreased utility in this region.

Background: Transgender women of color in the US are disproportionately vulnerable to HIV risks. Pre-Exposure Prophylaxis (PrEP) has demonstrated effectiveness in preventing HIV transmission among transgender women of color. However, factors across multiple levels can hinder oral PrEP adherence.

Methods: We analyzed the baseline data from The Trying to Understand Neighborhoods and Networks Among Transgender Women of Color (TURNNT) Cohort Study of women not living with HIV. We analyzed questionnaire responses to identify why participants stopped using PrEP and if they would consider taking it again. To identify multi-level determinants that were associated with PrEP discontinuation, we conducted bivariate analysis and created multivariable modified Poisson models comparing factors between former users and current users.

Results: Among 140 transgender women of color included in this analysis, 44.3% were currently on PrEP, 25.0% were on formerly on the regimen, and 30.7% had never used it. Participants reported many reasons for discontinuing PrEP, notably, 22.9% reported being concerned about interactions with hormones. 60.0% reported that they were likely to take PrEP again in the future. Discontinuation was positively associated with history of sexual assault (Prevalence Ratio: 1.78; 95% CI: 1.01, 3.14) and negatively with having a primary care provider (PR: 0.43; 95% CI: 0.25, 0.73).

Conclusion: Many factors can influence PrEP discontinuation among transgender women of color. A majority of those who discontinued PrEP were interested in restarting it again, indicating a potential for reengagement. We recommend a holistic approach to HIV prevention to reduce PrEP discontinuation.

Introduction: Some transgender individuals opt for gender-affirming orchiectomy. Data on postoperative outcomes in the transgender population are scarce.

Methods: All individuals who underwent gender-affirming orchiectomy between 01-2010 and 01-2024 were retrospectively identified at two centers that provide surgical transgender care. Individual demographics, motivations, intra- and postoperative complications, reoperations and postoperative regret were recorded. Surgical risk factors were identified using logistic regression analysis.

Results: A total of 119 individuals were retrospectively identified with a median clinical follow-up of 2.3 years (range 0.3-9.4). A total of 109 identified as transgender woman, eight as non-binary and two as agender. 18 (15%) individuals opted for sperm cryopreservation before surgery. The postoperative course was without complications in 102 (86%) individuals. Complications comprised hemorrhage (n = 5, 4%, Clavien-Dindo 3b) and abscess formation (n = 7, 6%, Clavien-Dindo 2), (n = 1), 3a (n = 3) and 3b (n = 3))). In the follow-up time, seven individuals underwent vaginoplasty, two vulvoplasty and two were on the waiting list for vaginoplasty. There were no cases of regret. A BMI >35 was identified as risk factor for infectious complications (p = .045, OR 9.8, 95% CI 1.0-99.3).

Discussion: Gender-affirming orchiectomy is a simple and safe procedure. It can be performed as standalone gender-affirming surgical procedure, or as bridge to another gender-affirming procedure.

Background: Sexual well-being is crucial for overall health, but research on bisexual individuals' sexual experiences across gender modalities is limited. This study aims to address this gap by examining differences in sexual interest and satisfaction among bisexual adults of various gender modalities.

Objectives: To investigate whether there are differences in sexual interest and satisfaction levels among bisexual adults across gender modalities (cisgender men, cisgender women, and transgender/gender diverse individuals).

Methods: A cross-sectional online survey was conducted with 475 self-identified bisexual adults (161 cisgender men, 228 cisgender women, 86 transgender/gender diverse). Participants completed demographic questionnaires and standardized measures of sexual interest and satisfaction from the PROMIS Sexual Function and Satisfaction Version 2.0. One-way ANOVAs were used to compare scores across gender modality groups.

Results: Significant differences were found in sexual interest across gender modalities (F(2, 472) = 10.131, p < .001). Cisgender men reported higher sexual interest (M = 52.958) compared to cisgender women (M = 48.563, p < .001) and transgender/gender diverse individuals (M = 50.566, p = .170). No significant differences were found in sexual satisfaction across gender modalities (i(2, 387) = 2.102, p = .124).

Conclusions: While cisgender bisexual men reported higher levels of sexual interest, sexual satisfaction was comparable across all gender modalities. These findings highlight the need for nuanced understanding of sexual experiences among bisexual individuals and underscore the importance of considering gender modality in research and clinical practice related to sexual health.

Implications: This study contributes to the limited research on bisexual individuals' sexual experiences across gender modalities. The findings can inform more inclusive and tailored approaches to sexual health care and support for bisexual individuals of all gender modalities.