Showing papers on "Transgender published in 2021"

Mirrors, Windows, and Sliding Glass Doors: Exploring the 2020 Rainbow Book List

Abstract: Being familiar with the Rainbow Book List is one easy way for librarians to support the LGBTQ+ community and address the American Library Association’s (ALA) Response to Service for LGBTQ+ People. As stated on their website: “Libraries can serve lesbian, gay, bisexual, and transgender (LBGTQ) people by ensuring that this population is reflected in library collections and provided with services at the library. It further states, “As a population which is often the subject of discrimination and harassment, gay, lesbian, bisexual, and transgender people can benefit from the access to information which libraries provide and the sense of community which library programs can help foster. It is important to note that the LGBTQ population is diverse, spanning age groups, ethnic and racial groups, socio-economic groups, and personal identities.”

Systemic inequalities for LGBTQ professionals in STEM.

Abstract: Researchers have documented race and gender inequality in science, technology, engineering, and math (STEM) for decades. Do lesbian, gay, bisexual, transgender, and queer (LGBTQ) professionals face parallel experiences of disadvantage in STEM? Using representative survey data from 21 STEM professional societies (Nsample = 25,324; NLGBTQ = 1006), this paper presents multidimensional and methodologically robust documentation of 5 dimensions of LGBTQ inequality in STEM. Controlling for variation by demographic, discipline, and job factors, LGBTQ STEM professionals were more likely to experience career limitations, harassment, and professional devaluation than their non-LGBTQ peers. They also reported more frequent health difficulties and were more likely to intend to leave STEM. These trends were similar across STEM disciplines and employment sectors. We found no differences by LGBTQ status in education level, work effort, or job commitment. These findings reveal LGBTQ status as a clear axis of inequality in STEM and motivate further research into the mechanisms producing such outcomes.

What is gender, anyway: a review of the options for operationalising gender

Abstract: In the social sciences, many quantitative research findings as well as presentations of demographics are related to participants’ gender. Most often, gender is represented by a dichotomous variable...

Mental health among transgender and gender diverse youth: An exploration of effects during the COVID-19 pandemic

Abstract: Objective: The coronavirus 2019 (COVID-19) pandemic is raising concerns about mental health across the population Because transgender and gender-diverse youth have particular mental health vulnerabilities, this study examines their mental health challenges during the early stages of the pandemic Method: A cross-sectional survey was conducted in the early COVID-19 pandemic period, which included 29 transgender and gender-diverse youth and 593 cisgender youth Descriptive statistics, Fisher's exact tests, and logistic regression analyses were conducted to understand the differential impact of COVID-19 on mental health and related constructs Results: Results show that transgender and gender diverse youth are more greatly affected by mental health challenges during the COVID-19 pandemic than cisgender youth (p = 001) They report more mental health and substance use service disruptions (p < 001) and less social support from their families (p = 007) compared with cisgender youth A large proportion (63 0%) report unmet needs for mental health and substance use during the early pandemic period, compared with 27 9% of cisgender youth (p = 008) Conclusions: Transgender and gender-diverse youth constitute a vulnerable population during the COVID-19 pandemic and are experiencing substantial mental health impacts, in conjunction with high levels of service disruption and less support from family members Researchers and service planners are encouraged to engage directly with transgender and gender diverse youth to understand how their support needs evolve over the course of the pandemic and how services can be adapted to meet their needs (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement Because the COVID-19 pandemic is raising concerns about mental health, especially among vulnerable populations, we examined mental health during COVID-19 among youth with cisgender versus transgender and gender-diverse identities Results show that transgender and gender-diverse youth are experiencing substantial negative mental health impacts from the pandemic, more so than cisgender youth They also report more mental health and substance use service disruptions and less social support from their families compared with cisgender youth Researchers and service planners are encouraged to work directly with transgender and gender-diverse youth to understand how services can be adapted to meet their needs (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Assessing and Addressing Cardiovascular Health in People Who Are Transgender and Gender Diverse: A Scientific Statement From the American Heart Association

Abstract: There is growing evidence that people who are transgender and gender diverse (TGD) are impacted by disparities across a variety of cardiovascular risk factors compared with their peers who are cisgender. Prior literature has characterized disparities in cardiovascular morbidity and mortality as a result of a higher prevalence of health risk behaviors. Mounting research has revealed that cardiovascular risk factors at the individual level likely do not fully account for increased risk in cardiovascular health disparities among people who are TGD. Excess cardiovascular morbidity and mortality is hypothesized to be driven in part by psychosocial stressors across the lifespan at multiple levels, including structural violence (eg, discrimination, affordable housing, access to health care). This American Heart Association scientific statement reviews the existing literature on the cardiovascular health of people who are TGD. When applicable, the effects of gender-affirming hormone use on individual cardiovascular risk factors are also reviewed. Informed by a conceptual model building on minority stress theory, this statement identifies research gaps and provides suggestions for improving cardiovascular research and clinical care for people who are TGD, including the role of resilience-promoting factors. Advancing the cardiovascular health of people who are TGD requires a multifaceted approach that integrates best practices into research, health promotion, and cardiovascular care for this understudied population.

Impact of COVID-19 Pandemic on Sexual Minority Populations in Brazil: An Analysis of Social/Racial Disparities in Maintaining Social Distancing and a Description of Sexual Behavior.

Abstract: We conducted a web-based survey to understand the impact of social distancing measures on Brazilian MSM and transgender/non-binary lives. A total of 3486 respondents were included in this analysis and the great majority were cismen (98%). The median age was 32 years (IQR: 27-40), 44% non-white, 36% low schooling and 38% low income. Most of participants reported HIV negative/unknown status (77%). Participants on-PrEP reported more condomless anal sex than those off-PrEP. Conversely, 24% off-PrEP were at substantial HIV-risk. PrEP/ART continuation were reported by the majority, despite reports of impediments to medication refill. Transgender/non-binary reported more mental health problems and challenges to access health care. Social and racial disparities were associated with unattainability of maintaining social distancing. Tailored social and economic support policies during COVID-19 pandemic should be made available to these populations. Challenges for PrEP/ART access will demand the implementation of innovative solutions to avoid the expansion of the HIV epidemic.

Association Between Gender-Affirming Surgeries and Mental Health Outcomes.

Abstract: Importance Requests for gender-affirming surgeries are rapidly increasing among transgender and gender diverse (TGD) people. However, there is limited evidence regarding the mental health benefits of these surgeries. Objective To evaluate associations between gender-affirming surgeries and mental health outcomes, including psychological distress, substance use, and suicide risk. Design, Setting, and Participants In this study, we performed a secondary analysis of data from the 2015 US Transgender Survey, the largest existing data set containing comprehensive information on the surgical and mental health experiences of TGD people. The survey was conducted across 50 states, Washington, DC, US territories, and US military bases abroad.A total of 27 715 TGD adults took the US Transgender Survey, which was disseminated by community-based outreach from August 19, 2015, to September 21, 2015. Data were analyzed between November 1, 2020, and January 3, 2021. Exposures The exposure group included respondents who endorsed undergoing 1 or more types of gender-affirming surgery at least 2 years prior to submitting survey responses. The comparison group included respondents who endorsed a desire for 1 or more types of gender-affirming surgery but denied undergoing any gender-affirming surgeries. Main Outcomes and Measures Endorsement of past-month severe psychological distress (score of ≥13 on Kessler Psychological Distress Scale), past-month binge alcohol use, past-year tobacco smoking, and past-year suicidal ideation or suicide attempt. Results Of the 27 715 respondents, 3559 (12.8%) endorsed undergoing 1 or more types of gender-affirming surgery at least 2 years prior to submitting survey responses, while 16 401 (59.2%) endorsed a desire to undergo 1 or more types of gender-affirming surgery but denied undergoing any of these. Of the respondents in this study sample, 16 182 (81.1%) were between the ages of 18 and 44 years, 16 386 (82.1%) identified as White, 7751 (38.8%) identified as transgender women, 6489 (32.5%) identified as transgender men, and 5300 (26.6%) identified as nonbinary. After adjustment for sociodemographic factors and exposure to other types of gender-affirming care, undergoing 1 or more types of gender-affirming surgery was associated with lower past-month psychological distress (adjusted odds ratio [aOR], 0.58; 95% CI, 0.50-0.67;P Conclusions and Relevance This study demonstrates an association between gender-affirming surgery and improved mental health outcomes. These results contribute new evidence to support the provision of gender-affirming surgical care for TGD people.

Understanding the Impact of the COVID-19 Pandemic on the Mental Health of Transgender and Gender Nonbinary Individuals Engaged in a Longitudinal Cohort Study.

Abstract: While the COVID-19 pandemic in the United States disproportionately impacts marginalized communities, no empiric US-based research has focused specifically on transgender and gender nonbinary (TGNB...

Imagining a Trans* Epistemology: What Liberation Thinks Like in Postsecondary Education:

Abstract: Postsecondary institutions of education, similar to the broader society in which they are embedded, are steeped in and further trans* oppression. In addition, the knowledge produced at these instit...

Sex/Gender Differences in Obesity Prevalence, Comorbidities, and Treatment

Abstract: Purpose of review Obesity is a heterogeneous condition, yet sex/gender is rarely considered in the prevention or clinical care of this disease. This review examined and evaluated recent literature regarding the influence of sex and gender on obesity prevalence, comorbidities, and treatment in adults. Recent findings Obesity is more prevalent in women than men in most countries, but in some countries and population subgroups, this gap is more pronounced. Several obesity-related comorbidities, including type 2 diabetes and hypertension, demonstrate sex-specific pathways. Women, compared to men, are more likely to be diagnosed with obesity and seek and obtain all types of obesity treatment including behavioral, pharmacological, and bariatric surgery. Men tend to have greater absolute weight loss, but this difference is attenuated once accounting for baseline weight. Obesity is a multifactorial condition with complex interactions among sex/gender, sociocultural, environmental, and physiological factors. More sex/gender research is needed to investigate mechanisms underlying sex/gender differences in prevalence, comorbidities, and treatment, identify ways to increase men's interest and participation in obesity treatment, and examine differences in obesity prevalence and treatments for transgender and gender non-conforming individuals.

Suicidal Thoughts and Behaviors Among LGBTQ Youth: Meta-Analyses and a Systematic Review.

Abstract: Suicide continues to be the second-leading cause of death for all youths aged 15–24. Lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth are at a significantly higher risk for suicid...

Gender-affirming care, mental health, and economic stability in the time of COVID-19: A multi-national, cross-sectional study of transgender and nonbinary people.

Abstract: Background Transgender and nonbinary people are disproportionately affected by structural barriers to quality healthcare, mental health challenges, and economic hardship. This study examined the impact of the novel coronavirus disease (COVID-19) crisis and subsequent control measures on gender-affirming care, mental health, and economic stability among transgender and nonbinary people in multiple countries. Methods We collected multi-national, cross-sectional data from 964 transgender and nonbinary adult users of the Hornet and Her apps from April to August 2020 to characterize changes in gender-affirming care, mental health, and economic stability as a result of COVID-19. We conducted Poisson regression models to assess if access to gender-affirming care and ability to live according to one’s gender were related to depressive symptoms, anxiety, and changes in suicidal ideation. Results Individuals resided in 76 countries, including Turkey (27.4%, n = 264) and Thailand (20.6%, n = 205). A majority were nonbinary (66.8%, n = 644) or transfeminine (29.4%, n = 283). Due to COVID-19, 55.0% (n = 320/582) reported reduced access to gender-affirming resources, and 38.0% (n = 327/860) reported reduced time lived according to their gender. About half screened positive for depression (50.4%,442/877) and anxiety (45.8%, n = 392/856). One in six (17.0%, n = 112/659) expected losses of health insurance, and 77.0% (n = 724/940) expected income reductions. The prevalence of depressive symptoms, anxiety, and increased suicidal ideation were 1.63 (95% CI: 1.36–1.97), 1.61 (95% CI: 1.31–1.97), and 1.74 (95% CI: 1.07–2.82) times higher for individuals whose access to gender-affirming resources was reduced versus not. Discussion The COVID-19 crisis is associated with reduced access to gender-affirming resources and the ability of transgender and nonbinary people to live according to their gender worldwide. These reductions may drive the increased depressive symptoms, anxiety, and suicidal ideation reported in this sample. To improve health of transgender and nonbinary communities, increased access to gender-affirming resources should be prioritized through policies (e.g., digital prescriptions), flexible interventions (e.g., telehealth), and support for existing transgender health initiatives.

Hormone Therapy, Mental Health, and Quality of Life Among Transgender People: A Systematic Review.

Abstract: We sought to systematically review the effect of gender-affirming hormone therapy on psychological outcomes among transgender people. We searched PubMed, Embase, and PsycINFO through June 10, 2020 for studies evaluating quality of life (QOL), depression, anxiety, and death by suicide in the context of gender-affirming hormone therapy among transgender people of any age. We excluded case studies and studies reporting on less than 3 months of follow-up. We included 20 studies reported in 22 publications. Fifteen were trials or prospective cohorts, one was a retrospective cohort, and 4 were cross-sectional. Seven assessed QOL, 12 assessed depression, 8 assessed anxiety, and 1 assessed death by suicide. Three studies included trans-feminine people only; 7 included trans-masculine people only, and 10 included both. Three studies focused on adolescents. Hormone therapy was associated with increased QOL, decreased depression, and decreased anxiety. Associations were similar across gender identity and age. Certainty in this conclusion is limited by high risk of bias in study designs, small sample sizes, and confounding with other interventions. We could not draw any conclusions about death by suicide. Future studies should investigate the psychological benefits of hormone therapy among larger and more diverse groups of transgender people using study designs that more effectively isolate the effects of hormone treatment.

Disproportionate Removals and Differing Content Moderation Experiences for Conservative, Transgender, and Black Social Media Users: Marginalization and Moderation Gray Areas

Abstract: Social media sites use content moderation to attempt to cultivate safe spaces with accurate information for their users. However, content moderation decisions may not be applied equally for all types of users, and may lead to disproportionate censorship related to people's genders, races, or political orientations. We conducted a mixed methods study involving qualitative and quantitative analysis of survey data to understand which types of social media users have content and accounts removed more frequently than others, what types of content and accounts are removed, and how content removed may differ between groups. We found that three groups of social media users in our dataset experienced content and account removals more often than others: political conservatives, transgender people, and Black people. However, the types of content removed from each group varied substantially. Conservative participants' removed content included content that was offensive or allegedly so, misinformation, Covid-related, adult, or hate speech. Transgender participants' content was often removed as adult despite following site guidelines, critical of a dominant group (e.g., men, white people), or specifically related to transgender or queer issues. Black participants' removed content was frequently related to racial justice or racism. More broadly, conservative participants' removals often involved harmful content removed according to site guidelines to create safe spaces with accurate information, while transgender and Black participants' removals often involved content related to expressing their marginalized identities that was removed despite following site policies or fell into content moderation gray areas. We discuss potential ways forward to make content moderation more equitable for marginalized social media users, such as embracing and designing specifically for content moderation gray areas.

“It’s Complicated”: Negotiating Accessibility and (Mis)Representation in Image Descriptions of Race, Gender, and Disability

Abstract: Content creators are instructed to write textual descriptions of visual content to make it accessible; yet existing guidelines lack specifics on how to write about people’s appearance, particularly while remaining mindful of consequences of (mis)representation. In this paper, we report on interviews with screen reader users who were also Black, Indigenous, People of Color, Non-binary, and/or Transgender on their current image description practices and preferences, and experiences negotiating theirs and others’ appearances non-visually. We discuss these perspectives, and the ethics of humans and AI describing appearance characteristics that may convey the race, gender, and disabilities of those photographed. In turn, we share considerations for more carefully describing appearance, and contexts in which such information is perceived salient. Finally, we offer tensions and questions for accessibility research to equitably consider politics and ecosystems in which technologies will embed, such as potential risks of human and AI biases amplifying through image descriptions.

Review: Puberty blockers for transgender and gender diverse youth-a critical review of the literature.

Abstract: Background Increasingly, early adolescents who are transgender or gender diverse (TGD) are seeking gender-affirming healthcare services. Pediatric healthcare providers supported by professional guidelines are treating many of these children with gonadotropin-releasing hormone agonists (GnRHa), which reversibly block pubertal development, giving the child and their family more time in which to explore the possibility of medical transition. Methods We conducted a critical review of the literature to answer a series of questions about criteria for using puberty-blocking medications, the specific drugs used, the risks and adverse consequences and/or the positive outcomes associated with their use. We searched four databases: LGBT Life, PsycINFO, PubMed, and Web of Science. From an initial sample of 211 articles, we systematically reviewed 9 research studies that met inclusion/exclusion criteria. Results Studies reviewed had samples ranging from 1 to 192 (N = 543). The majority (71%) of participants in these studies required a diagnosis of gender dysphoria to qualify for puberty suppression and were administered medication during Tanner stages 2 through 4. Positive outcomes were decreased suicidality in adulthood, improved affect and psychological functioning, and improved social life. Adverse factors associated with use were changes in body composition, slow growth, decreased height velocity, decreased bone turnover, cost of drugs, and lack of insurance coverage. One study met all quality criteria and was judged 'excellent', five studies met the majority of quality criteria resulting in 'good' ratings, whereas three studies were judged fair and had serious risks of bias. Conclusion Given the potentially life-saving benefits of these medications for TGD youth, it is critical that rigorous longitudinal and mixed methods research be conducted that includes stakeholders and members of the gender diverse community with representative samples.

Factors Leading to "Detransition" Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis.

Abstract: Purpose: There is a paucity of data regarding transgender and gender diverse (TGD) people who "detransition," or go back to living as their sex assigned at birth. This study examined reasons for past detransition among TGD people in the United States. Methods: A secondary analysis was performed on data from the U.S. Transgender Survey, a cross-sectional nonprobability survey of 27,715 TGD adults in the United States. Participants were asked if they had ever detransitioned and to report driving factors, through multiple-choice options and free-text responses. A mixed-methods approach was used to analyze the data, creating qualitative codes for free-text responses and applying summative content analysis. Results: A total of 17,151 (61.9%) participants reported that they had ever pursued gender affirmation, broadly defined. Of these, 2242 (13.1%) reported a history of detransition. Of those who had detransitioned, 82.5% reported at least one external driving factor. Frequently endorsed external factors included pressure from family and societal stigma. History of detransition was associated with male sex assigned at birth, nonbinary gender identity, bisexual sexual orientation, and having a family unsupportive of one's gender identity. A total of 15.9% of respondents reported at least one internal driving factor, including fluctuations in or uncertainty regarding gender identity. Conclusion: Among TGD adults with a reported history of detransition, the vast majority reported that their detransition was driven by external pressures. Clinicians should be aware of these external pressures, how they may be modified, and the possibility that patients may once again seek gender affirmation in the future.

Prevalence of Gender-Diverse Youth in an Urban School District

Abstract: * Abbreviation: GDY — : gender-diverse youth In many studies on gender-diverse youth (GDY), those whose gender identity and sex assigned at birth do not fully align, researchers cite the 2017 Youth Risk Behavior Survey finding that 1.8% of US high school students identify as “transgender.”1 This was the first nationally representative prevalence estimate of GDY and was higher than previous estimates. However, the question assessing gender identity (“Do you identify as transgender?”) likely underrepresents the prevalence of GDY because many do not identify with the word “transgender.” As an alternative, researchers recommend a 2-step question: (1) What was your sex assigned at birth? (2) Which of the following best describes your gender identity?2,3 Much of the research involving GDY has been conducted in clinical settings, in which there is a predominance of white and masculine-identified youth.4–7 GDY … Address correspondence to Kacie M. Kidd, MD, West Virginia University School of Medicine, Department of Pediatrics, 1 Medical Center Drive, Morgantown, WV 26506. E-mail: kkidd3{at}hsc.wvu.edu

Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners

Abstract: The study’s purpose was to describe a population of individuals who experienced gender dysphoria, chose to undergo medical and/or surgical transition and then detransitioned by discontinuing medications, having surgery to reverse the effects of transition, or both. Recruitment information with a link to an anonymous survey was shared on social media, professional listservs, and via snowball sampling. Sixty-nine percent of the 100 participants were natal female and 31.0% were natal male. Reasons for detransitioning were varied and included: experiencing discrimination (23.0%); becoming more comfortable identifying as their natal sex (60.0%); having concerns about potential medical complications from transitioning (49.0%); and coming to the view that their gender dysphoria was caused by something specific such as trauma, abuse, or a mental health condition (38.0%). Homophobia or difficulty accepting themselves as lesbian, gay, or bisexual was expressed by 23.0% as a reason for transition and subsequent detransition. The majority (55.0%) felt that they did not receive an adequate evaluation from a doctor or mental health professional before starting transition and only 24.0% of respondents informed their clinicians that they had detransitioned. There are many different reasons and experiences leading to detransition. More research is needed to understand this population, determine the prevalence of detransition as an outcome of transition, meet the medical and psychological needs of this population, and better inform the process of evaluation and counseling prior to transition.

Prevalence and Co-occurrence of Alcohol, Nicotine, and Other Substance Use Disorder Diagnoses Among US Transgender and Cisgender Adults.

Abstract: Importance Substance use disorders are a major source of morbidity and mortality in the United States. National data comparing the prevalence of substance use disorder diagnoses (SUDDs) among transgender and cisgender individuals are lacking in the United States. Objectives To investigate the prevalence of SUDDs among transgender and cisgender adults and to identify within-group and between-group differences by age, gender, and geographic location. Design, Setting, and Participants This cross-sectional study used the OptumLabs Data Warehouse to analyze deidentified claims from approximately 74 million adults aged 18 years or older enrolled in commercial or Medicare Advantage insurance plans in 2017. A total of 15 637 transgender adults were identified based on a previously developed algorithm using a combination ofInternational Classification of Diseases, Tenth Revision (ICD-10) transgender-related diagnosis and procedure codes and sex-discordant hormone prescriptions. A cohort of 46 911 cisgender adults was matched to the transgender cohort in a 3:1 ratio based on age and geographic location. Main Outcomes and Measures SUDDs, based onICD-10codes, were assessed overall and compared between transgender and cisgender cohorts and by geographic region (ie, Northeast, Midwest, South, and West); age groups (eg, 18-25, 26-30, 31-35 years), and gender (ie, transfeminine [TF; assigned male sex at birth, identify along feminine gender spectrum], transmasculine [TM; assigned female sex at birth, identify along masculine gender spectrum], male, and female). Results In this study of 15 637 transgender adults (4955 [31.7%] TM) and 46 911 cisgender adults (23 664 [50.4%] female), most (8627 transgender adults [55.2%]; 25 882 cisgender adults [55.2%]) were aged between 18 and 40 years, and 6482 transgender adults (41.5%) and 19 446 cisgender adults (41.5%) lived in the South. Comparing transgender to cisgender groups, significant differences were found in the prevalence of a nicotine (2594 [16.6%] vs 2551 [5.4%];P Conclusions and Relevance In this study, the prevalence of SUDDs was significantly elevated among transgender adults relative to their cisgender peers. These findings underscore the need for culturally tailored clinical interventions to treat substance use disorder in transgender populations.

Cancer Stage, Treatment, and Survival among Transgender Patients in the United States.

Abstract: BACKGROUND Transgender persons face many barriers to health care that may delay cancer diagnosis and treatment, possibly resulting in decreased survival. Yet, data on cancer in this population are limited. We examined cancer stage at diagnosis, treatment, and survival among transgender patients compared with cisgender patients in the National Cancer Database (NCDB). METHODS Gender (male, female, or transgender) was extracted from medical records from patients diagnosed with cancer between 2003 and 2016. Logistic regression estimated odds ratios (ORs) for the associations between gender and stage at diagnosis and treatment receipt. Cox proportional hazards regression estimated hazard ratios (HRs) for associations between gender and all-cause survival. RESULTS Among 11 776 699 persons with cancer in NCDB, 589 were transgender. Compared with cisgender patients, transgender patients may be more likely to be diagnosed with advanced stage lung cancer (OR = 1.76, 95% confidence interval [CI] = 0.95 to 3.28); be less likely to receive treatment for kidney (OR = 0.19, 95% CI = 0.08 to 0.47) and pancreas (OR = 0.33, 95% CI = 0.11 to 0.95) cancers; and have poorer survival after diagnosis with non-Hodgkin lymphoma (HR = 2.34, 95% CI = 1.51 to 3.63), prostate (HR = 1.91, 95% CI = 1.06 to 3.45), and bladder cancers (HR = 2.86, 95% CI = 1.36 to 6.00). Similar associations were found for other cancer sites, although not statistically significant. CONCLUSION Transgender patients may be diagnosed at later stages, be less likely to receive treatment, and have worse survival for many cancer types. Small sample size hampered our ability to detect statistically significant differences for some cancer sites. There is a need for transgender-focused cancer research as the population ages and grows.

The lesbian, gay, bisexual and transgender communities' mental health care needs and experiences of mental health services: An integrative review of qualitative studies.

Abstract: WHAT IS KNOWN ON THE SUBJECT?: There is evidence that the LGBT communities experience greater health disparities, particularly in relation to their mental health needs. The LGBT communities are often faced with stigma and discrimination within mental health services. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: People within the LGBT communities have identified that their experiences of mental health services reinforce stigma and lack an understanding of their specific needs. Their needs can be addressed by mental health services that challenge heteronormative assumptions and promote self-acceptance and equity. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The existing heteronormative culture in mental health nursing practice needs to be challenged. Practice needs to demonstrate self-awareness of personal and societal LGBT biases, prejudices, and stigma. Practice needs to demonstrate knowledge of important LGBT health care and psychosocial issues. Practice needs to reflect LGBT clinical skills grounded in professional ethics, guidelines, and standards of care. Abstract INTRODUCTION: The lesbian, gay, bisexual and transgender (LGBT) communities are a minority population that experience a range of health disparities, including mental health. Because these groups have higher rates of mental disorder than the general population it is, therefore, pertinent to identify their specific mental health needs and their experiences when accessing mental health care. Aim To identify the mental health needs of the LGBT communities and their experiences of accessing mental health care. Methods An integrative review of qualitative studies was conducted. Results A total of fourteen studies were selected for this review. The studies identified that participants' experiences of accessing mental health care were related to (a) experiencing stigma and (b) staff's lack of knowledge and understanding of LGBT people's needs. They identified a need for mental health care that promotes the principles of equity, inclusion and respect for diversity. Discussion The LGBT communities while not a homogenous group, face unique challenges when dealing with their mental health needs. Services that promote health equity and self-acceptance are important for this group. Implications for practice It is vital that mental health nursing education incorporate models that promote equity, inclusion and respect for diversity regarding this group of people.

Evidence for the Model of Gender Affirmation: The Role of Gender Affirmation and Healthcare Empowerment in Viral Suppression Among Transgender Women of Color Living with HIV

Abstract: Transgender women of color are disproportionately impacted by HIV, poor health outcomes, and transgender-related discrimination (TD). We tested the Model of Gender Affirmation (GA) to identify intervention-amenable targets to enhance viral suppression (VS) using data from 858 transgender women of color living with HIV (49% Latina, 42% Black; 36% virally suppressed) in a serial mediation model. Global fit statistics demonstrated good model fit; statistically significant (p ≤ 0.05) direct pathways were between TD and GA, GA and healthcare empowerment (HCE), and HCE and VS. Significant indirect pathways were from TD to VS via GA and HCE (p = 0.036) and GA to VS via HCE (p = 0.028). Gender affirmation and healthcare empowerment significantly and fully mediated the total effect of transgender-related discrimination on viral suppression. These data provide empirical evidence for the Model of Gender Affirmation. Interventions that boost gender affirmation and healthcare empowerment may improve viral suppression among transgender women of color living with HIV.

Detransition-Related Needs and Support: A Cross-Sectional Online Survey

Abstract: The aim of this study is to analyze the specific needs of detransitioners from online detrans communities and discover to what extent they are being met. For this purpose, a cross-sectional online ...

Pregnancy intentions and outcomes among transgender, nonbinary, and gender-expansive people assigned female or intersex at birth in the United States: Results from a national, quantitative survey.

Abstract: Background: Transgender, nonbinary, and gender-expansive (TGE) people experience pregnancy. Quantitative data about pregnancy intentions and outcomes of TGE people are needed to identify patterns i...

Experiences of Intimate Partner Violence Among Lesbian, Gay, Bisexual, and Transgender College Students: The Intersection of Gender, Race, and Sexual Orientation.

Abstract: Lesbian, gay, bisexual, and transgender (LGBT) college students experience disproportionate rates of intimate partner violence (IPV) compared with their heterosexual and cisgender counterparts. Some studies report rates of IPV among lesbian, gay, and bisexual college students as high as 50%, and 9 times greater among transgender students compared with their cisgender peers. Few studies have investigated the impact of intersectional identity on experiencing different types of IPV, such as emotional, physical, and sexual IPV. The present study utilized the National College Health Assessment-II from 2011 to 2013 (n = 88,975) to examine the differences in types of IPV among college students based on sexual orientation, gender identity, and the intersection of these two identities. Bivariate Rao-Scott chi-square and multilevel logistic regression was used to test the associations between sexual orientation, gender identity, and the intersection of these identities on multiple types of IPV. Adjusting for covariates and school clustering, LGBT college students had higher odds of reporting emotional IPV (adjusted odds ratios [AORs] = 1.34-1.99), physical IPV (AOR = 1.58-2.93), and sexual IPV (AOR = 1.41-6.18). Bisexual and transgender college students demonstrated the highest odds of reporting IPV based on sexual orientation and gender identity, respectively. Intersectional identities were not significantly associated with IPV. These findings demonstrate a need for clinicians working with college students to be aware of the disproportionate prevalence of IPV among LGBT individuals, particularly for those clients those who identify as bisexual and/or transgender and participate in continuing education related to these populations. Furthermore, these findings illustrate the need for additional intersectional research with LGBT college students.