Automatic Gender Recognition (AGR) is a subfield of facial recognition that aims to algorithmically identify the gender of individuals from photographs or videos. In wider society the technology has proposed applications in physical access control, data analytics and advertising. Within academia, it is already used in the field of Human-Computer Interaction (HCI) to analyse social media usage. Given the long-running critiques of HCI for failing to consider and include transgender (trans) perspectives in research, and the potential implications of AGR for trans people if deployed, I sought to understand how AGR and HCI understand the term "gender", and how HCI describes and deploys gender recognition technology. Using a content analysis of papers from both fields, I show that AGR consistently operationalises gender in a trans-exclusive way, and consequently carries disproportionate risk for trans people subject to it. In addition, I use the dearth of discussion of this in HCI papers that apply AGR to discuss how HCI operationalises gender, and the implications that this has for the field's research. I conclude with recommendations for alternatives to AGR, and some ideas for how HCI can work towards a more effective and trans-inclusive treatment of gender.

The Misgendering Machines: Trans/HCI Implications of Automatic Gender Recognition

Recent reports estimate that 0.6% of adults in the United States, or approximately 1.4 million persons, identify as transgender. Despite gains in rights and media attention, the reality is that transgender persons experience health disparities, and a dearth of research and evidence-based guidelines remains regarding their specific health needs. The lack of research to characterize cardiovascular disease (CVD) and CVD risk factors in transgender populations receiving cross-sex hormone therapy (CSHT) limits appropriate primary and specialty care. As with hormone therapy in cisgender persons (that is, those whose sex assigned at birth aligns with their gender identity), existing research in transgender populations suggests that CVD risk factors are altered by CSHT. Currently, systemic hormone replacement for cisgender adults requires a nuanced discussion based on baseline risk factors and age of administration of exogenous hormones because of concern regarding an increased risk for myocardial infarction and stroke. For transgender adults, CSHT has been associated with the potential for worsening CVD risk factors (such as blood pressure elevation, insulin resistance, and lipid derangements), although these changes have not been associated with increases in morbidity or mortality in transgender men receiving CSHT. For transgender women, CSHT has known thromboembolic risk, and lower-dose transdermal estrogen formulations are preferred over high-dose oral formulations. In addition, many studies of transgender adults focus predominantly on younger persons, limiting the generalizability of CSHT in older transgender adults. The lack of randomized controlled trials comparing various routes and formulations of CSHT, as well as the paucity of prospective cohort studies, limits knowledge of any associations between CSHT and CVD.

Cardiovascular Disease Among Transgender Adults Receiving Hormone Therapy: A Narrative Review

Purpose: Data on the health and well-being of the transgender population are limited. However, using claims data we can identify transgender Medicare beneficiaries (TMBs) with high confidence. We seek to describe the TMB population and provide comparisons of chronic disease burden between TMBs and cisgender Medicare beneficiaries (CMBs), thus laying a foundation for national level TMB health disparity research. Methods: Using a previously validated claims algorithm based on ICD-9-CM codes relating to transsexualism and gender identity disorder, we identified a cohort of TMBs using Medicare Fee-for-Service (FFS) claims data. We then describe the demographic characteristics and chronic disease burden of TMBs (N = 7454) and CMBs (N = 39,136,229). Results: Compared to CMBs, a greater observed proportion of TMBs are young (under age 65) and Black, although these differences vary by entitlement. Regardless of entitlement, TMBs have more chronic conditions than CMBs, and more TMBs have been diagnosed wi...

Transgender Medicare Beneficiaries and Chronic Conditions: Exploring Fee-for-Service Claims Data.

Purpose: Research on healthcare among gender-diverse populations has largely focused on people who describe their gender in binary terms, either as trans men or trans women. This qualitati...

/pdf/healthcare-experiences-among-young-adults-who-identify-as-qrr6nhjjo5.pdf

Healthcare Experiences Among Young Adults Who Identify as Genderqueer or Nonbinary

Transgender people experience disproportionately high mental and physical health risks. Minority stress theory identifies distal and proximal stressors that contribute to negative mental health out...

Psychological Interventions Promoting Resilience Among Transgender Individuals: Transgender Resilience Intervention Model (TRIM):

Purpose: Transgender and gender-nonconforming (TGNC) individuals often are the target of enacted or external (i.e., distal) experiences of stigma, discrimination, and violence, which are linked to adverse health, particularly psychological distress. There is limited research, however, examining felt or internal (i.e., proximal) stressors faced by TGNC individuals. This study sought to examine one type of internal stressor, expecting rejection, and aimed to (1) identify how and to what extent rejection expectations operate day-to-day for TGNC individuals and (2) explore how TGNC individuals respond to expectations of rejection. Methods: In-depth interviews were conducted with 30 participants from 2014 to 2015 who identified as TGNC (mean age=30.4; 60% people of color); data were analyzed using a consensual qualitative research method. Results: Four thematic categories emerged about expecting rejection: (1) where to expect rejection; (2) thoughts and feelings associated with expectations of rejecti...

W PantaloneDavid

Papers

Expecting Rejection: Understanding the Minority Stress Experiences of Transgender and Gender-Nonconforming Individuals.