Transgender health最新文献

Purpose: Gender-affirming voice training is an important service for transgender and gender-diverse (TGD) individuals who wish to modify their voice to be more congruent with their gender identity. For decades, the research in this area has focused on adults, yet TGD young people also receive these services regularly. The purpose of this study was to analyze patient-reported outcomes in TGD young people who completed voice training.

Methods: This study consisted of a retrospective chart review of 118 TGD individuals ages 11 to 23 years old who were seen at a university clinic between 2019 and 2024. We assessed voice outcomes with the Utah Gender Presentation Scale for Communication (U-GPS), the Trans Woman Voice Questionnaire (TWVQ), and acoustic measures. These data were compared before and after voice training.

Results: Data were available for 68 clients who completed voice training. There were significant improvements in gender congruence by the end of treatment (t = 15.918; p < 0.001) with a median reduction of 32 points on the U-GPS. The trans female clients had significant improvements in voice-related quality of life (t = 12.072; p < 0.001) with a median reduction of 23 points on the TWVQ. Acoustic data show that speaking fundamental frequency (f0) was more aligned with clients' gender by the end of voice training.

Conclusion: This article is the first to demonstrate the benefits of voice training for TGD young people. This population warrants special attention in the literature, and further research should evaluate specific treatment protocols and associated outcomes for young people.

Purpose: Estradiol for gender-affirming hormone therapy can be taken in different routes: oral, sublingual, transdermal patch or gel, and injectable estradiol. We aimed at comparing the estrone and estradiol ratios and levels achieved in each of these different routes of estradiol.

Methods: We conducted a retrospective chart review of transfeminine individuals attending an endocrinology clinic in Toronto, Canada. Study participants were grouped according to the route of estradiol administration: oral, injectable, transdermal, and sublingual. Our primary outcome was the estrone/estradiol ratio (E1/E2). Our secondary outcomes were the estradiol and estrone levels in each of these four groups.

Results: We included 286 patients. The oral estradiol group had the highest E1/E2 ratio (9.28), followed by the sublingual group (6.88). Both the transdermal and injectable groups had substantially lower E1/E2 ratios (2.22 and 0.84, respectively). We observed a large variability of the E1/E2 ratio in the oral and sublingual groups, whereas the transdermal and the injectable groups' ratios had much smaller standard deviation. The mean estradiol in the injectable group (1557 pmol/L, 424.1 pg/mL) was markedly higher than the estradiol levels observed in all other routes of estradiol.

Conclusion: Our data demonstrate significantly different E1/E2 ratios in the four different routes of estradiol administration, with oral and sublingual routes having the highest E1/E2 ratios followed by transdermal and injectable routes.

Transgender Latina women are disproportionately affected by HIV in the United States. Given unique needs, elevated risk, and a paucity of tailored interventions, we adapted an evidence-based HIV prevention program for this population. Following a needs assessment with transgender Latina immigrants, we adapted Project LifeSkills, a six-session group intervention for transgender youth, into a modified program titled "Somos Chingonas," using methods from the ADAPT-ITT framework. Our adaptation process underscores the critical role of community involvement in developing tailored interventions for minority communities. Future research will pilot and evaluate the modified intervention to examine its impact on HIV prevention outcomes.

Purpose: Little is known about the prevalence and risks associated with transgender and gender diverse (TGD) persons' misuse of prescription pain relievers (PPRs). This study explores the relationship between PPR misuse and various sociodemographic identities and experiences of discrimination in health care among TGD adults.

Methods: TGD participants (n=595) were recruited in 2018 to participate in a cross-sectional statewide trans health survey through convenience sampling. Chi-square tests of independence and logistic regressions were conducted to explore associations between sociodemographics and experiences of discrimination among persons who had ever misused PPRs, or who had misused PPRs in the past year.

Results: Sociodemographics such as gender identity (odds ratio [OR]=0.44, p=0.01), race/ethnicity (OR=0.14, p<0.001), and sexual orientation influence TGD individuals likeliness of misusing PPRs (OR=0.40, p<0.001). Notably, those who were ever diagnosed with anxiety had a higher likeliness of having lifetime PPR misuse compared with those who were never diagnosed (OR=2.05, p=0.05), and those reporting past-year discrimination within the mental health care setting because of their gender identity were more than twice as likely to report past-year misuse than those who reported not experiencing it (OR=2.43, p=0.004).

Conclusion: Certain subpopulations of TGD individuals may be at elevated risk of PPR misuse. It is imperative to acknowledge the impact of multimarginalized identities as well as differences across various identities and experiences within the TGD community while working to address non-PPR misuse.

Transgender and gender nonbinary (TGNB) individuals are at high risk for HIV acquisition. However, TGNB individuals are often excluded from research and public health surveillance, both as participants and as reported sexual partners. This research study aimed to be inclusive, correctly classify TGNB participants, and accurately describe sex partners and sexual activity of participants to assess HIV risk while minimizing participant burden. The adaptation of survey questions designed for cisgender men to include TGNB participants and partners was feasible and relatively straightforward. However, additional work is still needed in this area to increase inclusivity and research participation by TGNB individuals. Clinical Trial Registration Number - NCT03584282.

A large body of research finds that sexual and gender minorities experience disparities in health equity that stem from structural discrimination. In particular, transgender and gender diverse (TGD) patients face barriers in access to gender-affirming care (GAC). As of December 2021, 35 state legislatures have introduced >100 bills that categorically deny TGD individuals' human rights and outlaw medically necessary GAC. Importantly, the economic consequences of discriminatory legislation and denial of health care for TGD individuals are void in the literature. This perspective outlines the economic impact of antitransgender policy and calls for federal intervention to protect TGD rights.