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Sample records for male-to-female transgender individuals

  1. Using Gender Role Conflict Theory in Counseling Male-to-Female Transgender Individuals

    Science.gov (United States)

    Wester, Stephen R.; McDonough, Tracy A.; White, Maureen; Vogel, David L.; Taylor, Lareena

    2010-01-01

    Ignoring gender socialization while counseling transgender clients neglects a significant aspect of the transgender experience. To address this, the authors review the literature on gender role conflict (GRC) theory as it pertains to the transgender experience of biological males whose authentic self is female. They explore the main types of…

  2. Adolescent Male-to-Female Transgender Voice and Communication Therapy

    Science.gov (United States)

    Hancock, Adrienne; Helenius, Lauren

    2012-01-01

    Current research to describe and evaluate effectiveness of voice and communication therapy for male-to-female transgender people is limited to adults. This paper provides rationale, procedures, and outcomes from voice and communication therapy for a male-to-female transgender adolescent 15 years of age. Treatment addressed vocal hygiene, breath…

  3. Perceptual and acoustic outcomes of voice therapy for male-to-female transgender individuals immediately after therapy and 15 months later.

    Science.gov (United States)

    Gelfer, Marylou Pausewang; Tice, Ruthanne M

    2013-05-01

    The present study examined how effectively listeners' perceptions of gender could be changed from male to female for male-to-female (MTF) transgender (TG) clients based on the voice signal alone, immediately after voice therapy and at long-term follow-up. Short- and long-term changes in masculinity and femininity ratings and acoustic measures of speaking fundamental frequency (SFF) and vowel formant frequencies were also investigated. Prospective treatment study. Five MTF TG clients, five control female speakers, and five control male speakers provided a variety of speech samples for later analysis. The TG clients then underwent 8 weeks of voice therapy. Voice samples were collected immediately at the termination of therapy and again 15 months later. Two groups of listeners were recruited to evaluate gender and provide masculinity and femininity ratings. Perceptual results revealed that TG subjects were perceived as female 1.9% of the time in the pretest, 50.8% of the time in the immediate posttest, and 33.1% of the time in the long-term posttest. The TG speakers were also perceived as significantly less masculine and more feminine in the immediate posttest and the long-term posttest compared with the pre-test. Some acoustic measures showed significant differences between the pretest and the immediate posttest and long-term posttest. It appeared that 8 weeks of voice therapy could result in vocal changes in MTF TG individuals that persist at least partially for up to 15 months. However, some TG subjects were more successful with voice feminization than others. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  4. Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques

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    Horbach, S.E.R.; Bouman, M.B.; Smit, J.M.; Özer, M.; Buncamper, M.E.; Mullender, M.G.

    2015-01-01

    Introduction: Gender reassignment surgery is the keystone of the treatment of transgender patients. For male-to-female transgenders, this involves the creation of a neovagina. Many surgical methods for vaginoplasty have been opted. The penile skin inversion technique is the method of choice for most

  5. Perceived discrimination and depression among low-income Latina male-to-female transgender women.

    Science.gov (United States)

    Bazargan, Mohsen; Galvan, Frank

    2012-08-15

    This study examines exposure to perceived discrimination and its association with depression among low-income, Latina male-to-female transgender women as well as evaluates the impact of sexual partner violence and mistreatment on depression. A total of 220 Latina male-to-female transgender women who resided in Los Angeles, California, were recruited through community based organizations and referrals. Participants completed individual interviews using a structured questionnaire. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Perceived discrimination was assessed using a fifteen-item measure that was designed to assess the experiences of maltreatment of transgender individuals. Multinomial logistic regression was used to examine the association between perceived discrimination and depression after controlling for the presence of other variables. Of the sample, 35% reported significant depressive symptoms (PHQ-9 ≥ 15). Additionally, one-third of the participants indicated that in the two weeks prior to the interviews they had thought either of hurting themselves or that they would be better off dead. The extent of perceived discrimination in this population was extensive. Many of the participants experienced discrimination on a daily basis (14%) or at least once or twice a week (25%) as demonstrated by a positive response to at least 7 of 15 items in the measure of perceived discrimination. Almost six out of ten participants admitted that they had been victims of sexual partner violence. Those who reported more frequent discrimination were more likely to be identified with severe depression. There was also a notable association between self-reported history of sexual partner violence and depression severity. A significant association between depression severity and perceived discrimination was identified. How exposure to discrimination leads to increased risk of mental health problems needs additional investigation. Models

  6. Perceived discrimination and depression among low-income Latina male-to-female transgender women

    Directory of Open Access Journals (Sweden)

    Bazargan Mohsen

    2012-08-01

    Full Text Available Abstract Background This study examines exposure to perceived discrimination and its association with depression among low-income, Latina male-to-female transgender women as well as evaluates the impact of sexual partner violence and mistreatment on depression. Methods A total of 220 Latina male-to-female transgender women who resided in Los Angeles, California, were recruited through community based organizations and referrals. Participants completed individual interviews using a structured questionnaire. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9. Perceived discrimination was assessed using a fifteen-item measure that was designed to assess the experiences of maltreatment of transgender individuals. Multinomial logistic regression was used to examine the association between perceived discrimination and depression after controlling for the presence of other variables. Results Of the sample, 35% reported significant depressive symptoms (PHQ-9 ≥ 15. Additionally, one-third of the participants indicated that in the two weeks prior to the interviews they had thought either of hurting themselves or that they would be better off dead. The extent of perceived discrimination in this population was extensive. Many of the participants experienced discrimination on a daily basis (14% or at least once or twice a week (25% as demonstrated by a positive response to at least 7 of 15 items in the measure of perceived discrimination. Almost six out of ten participants admitted that they had been victims of sexual partner violence. Those who reported more frequent discrimination were more likely to be identified with severe depression. There was also a notable association between self-reported history of sexual partner violence and depression severity. Conclusions A significant association between depression severity and perceived discrimination was identified. How exposure to discrimination leads to increased risk of

  7. Male-to-female transgender and transsexual clients of HIV service programs in Los Angeles County, California.

    Science.gov (United States)

    Edwards, Jordan W; Fisher, Dennis G; Reynolds, Grace L

    2007-06-01

    Data on HIV risk were collected with the Countywide Risk Assessment Survey from 2126 participants; 92 were male-to-female transgender persons (i.e., cross-dressers, and those who identify with the opposite sex), and 9 were male-to-female transsexual individuals (i.e., those who have undergone gender-reassignment surgery or other procedures). Transgender-identified individuals were more likely than the rest of the sample to have received hormone injections, offensive comments, and HIV testing; injected hormones with a used needle; been Asian or American Indian; been paid for sexual intercourse; and lived in unstable housing but less likely to have used heroin. Transgender-identified individuals are at high risk for HIV infection because of reuse of needles and being paid for sexual intercourse.

  8. Exploring barriers and facilitators to participation of male-to-female transgender persons in preventive HIV vaccine clinical trials.

    Science.gov (United States)

    Andrasik, Michele Peake; Yoon, Ro; Mooney, Jessica; Broder, Gail; Bolton, Marcus; Votto, Teress; Davis-Vogel, Annet

    2014-06-01

    Observed seroincidence and prevalence rates in male-to-female (MTF) transgender individuals highlight the need for effective targeted HIV prevention strategies for this community. In order to develop an effective vaccine that can be used by transgender women, researchers must understand and address existing structural issues that present barriers to this group's participation in HIV vaccine clinical trials. Overcoming barriers to participation is important for ensuring HIV vaccine acceptability and efficacy for the MTF transgender community. To explore barriers and facilitators to MTF transgender participation in preventive HIV vaccine clinical trials, the HIV Vaccine Trials Network conducted focus groups among transgender women in four urban areas (Atlanta, Boston, Philadelphia, and San Francisco). Barriers and facilitators to engagement of transgender women in preventive HIV vaccine clinical trials led to the following recommendations: (a) transgender cultural competency training, (b) creating trans-friendly environments, (c) true partnerships with local trans-friendly organizations and health care providers, (d) protocols that focus on transgender specific issues, and (e) data collection and tracking of transgender individuals. These results have implications for the conduct of HIV vaccine trials, as well as engagement of transgender women in research programs in general.

  9. HIV-related sexual risk behaviors among male-to-female transgender people in Nepal.

    Science.gov (United States)

    Bhatta, Dharma Nand

    2014-05-01

    Transgender women are a vulnerable and key risk group for HIV, and most research has shown an increased frequency of HIV infection among this minority population. This study examined the prevalence of HIV-related sexual risk behaviors and the socio-demographic correlates with HIV-related sexual risk behaviors among male-to-female (MtF) transgender persons. Data were collected from a sample of 232 individuals through venue-based and snowball sampling and face-to-face interviews. The HIV-related sexual risk behaviors among the MtF transgender persons were: sex without using a condom (48.3%; 95% confidence interval (CI) 41.8-54.8), unprotected anal sex (68.1%; 95% CI 62.0-74.2), and unprotected sex with multiple partners (88.4%; 95% CI 84.3-92.5). Statistically significant differences were found for age, income, education, alcohol habit, and sex with more than two partners per day for these three different HIV-related sexual risk behaviors. MtF transgender persons with a secondary or higher level of education were three times (OR 2.93) more likely to have unprotected sex with multiple partners compared to those with a primary level or no education. Age, education, income, frequency of daily sexual contact, and an alcohol habit remain significant with regard to HIV-related sexual risk behavior. There is an urgent need for programs and interventions to reduce risky sexual behaviors in this minority population. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

  10. ‘It’s really a hard life’: Love, gender and HIV risk among male-to-female transgender persons

    Science.gov (United States)

    MELENDEZ, RITA M.; PINTO, ROGÉRIO

    2012-01-01

    Scientific studies demonstrate high rates of HIV infection among male-to-female (MTF) transgender individuals and that stigma and discrimination place MTFs at increased risk for infection. However, there is little research examining how gender roles contribute to HIV risk. This paper reports on in-depth interviews with 20 MTFs attending a community clinic. Data reveal that stigma and discrimination create a heightened need for MTFs to feel safe and loved by a male companion and that in turn places them at a higher risk for acquiring HIV. Male-to-female transgender individuals appear to turn to men to feel loved and affirmed as women; their main HIV risk stems from their willingness to engage with sexual partners who provide a sense of love and acceptance but who also may also request unsafe sexual behaviours. A model illustrating how HIV risk is generated from stigma and discrimination is presented. PMID:17457728

  11. Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques.

    Science.gov (United States)

    Horbach, Sophie E R; Bouman, Mark-Bram; Smit, Jan Maerten; Özer, Müjde; Buncamper, Marlon E; Mullender, Margriet G

    2015-06-01

    Gender reassignment surgery is the keystone of the treatment of transgender patients. For male-to-female transgenders, this involves the creation of a neovagina. Many surgical methods for vaginoplasty have been opted. The penile skin inversion technique is the method of choice for most gender surgeons. However, the optimal surgical technique for vaginoplasty in transgender women has not yet been identified, as outcomes of the different techniques have never been compared. With this systematic review, we aim to give a detailed overview of the published outcomes of all currently available techniques for vaginoplasty in male-to-female transgenders. A PubMed and EMBASE search for relevant publications (1995-present), which provided data on the outcome of techniques for vaginoplasty in male-to-female transgender patients. Main outcome measures are complications, neovaginal depth and width, sexual function, patient satisfaction, and improvement in quality of life (QoL). Twenty-six studies satisfied the inclusion criteria. The majority of these studies were retrospective case series of low to intermediate quality. Outcome of the penile skin inversion technique was reported in 1,461 patients, bowel vaginoplasty in 102 patients. Neovaginal stenosis was the most frequent complication in both techniques. Sexual function and patient satisfaction were overall acceptable, but many different outcome measures were used. QoL was only reported in one study. Comparison between techniques was difficult due to the lack of standardization. The penile skin inversion technique is the most researched surgical procedure. Outcome of bowel vaginoplasty has been reported less frequently but does not seem to be inferior. The available literature is heterogeneous in patient groups, surgical procedure, outcome measurement tools, and follow-up. Standardized protocols and prospective study designs are mandatory for correct interpretation and comparability of data. © 2015 International Society for

  12. HIV Prevalence and Risk Behaviors in Male to Female (MTF) Transgender Persons in Tijuana, Mexico.

    Science.gov (United States)

    Salas-Espinoza, Kristian Jesús; Menchaca-Diaz, Rufino; Patterson, Thomas L; Urada, Lianne A; Smith, Davey; Strathdee, Steffanie A; Pitpitan, Eileen V

    2017-12-01

    Compared to HIV research on men who have sex with men, less is known about the risks and vulnerabilities for HIV among Male to Female (MTF) transgender persons, particularly in different geographic regions like Mexico. In Tijuana, Mexico, a border city experiencing a dynamic HIV epidemic, no precedent data exists on the MTF transgender population. Our aims were to estimate HIV prevalence and examine the behaviors and characteristics of the population. We conducted a cross-sectional study of 100 MTF transgender persons recruited through time location sampling in 2012. Participants underwent interviewer-administered (paper and pen) surveys and rapid tests for HIV. Descriptive univariate analyses were conducted on various factors, including sociodemographics, substance use, accessing social services (requested vs. received), stigma, and sex behaviors. A total of 22% tested positive for HIV, a prevalence higher than other key populations at risk for HIV in Tijuana.

  13. Social context of HIV risk behaviours among male-to-female transgenders of colour.

    Science.gov (United States)

    Nemoto, T; Operario, D; Keatley, J; Villegas, D

    2004-08-01

    To explore the social context of drug use and sexual behaviours that put male-to-female (MTF) transgenders at risk for HIV, focus groups were conducted consisting of African American, Latina and Asian and Pacific Islander MTF transgenders (N = 48) who reside or work in San Francisco, California. Participants were likely to report having unprotected sex with primary partners to signify love and emotional connection, as well as to receive gender validation from their partners. In contrast, viewing sex work with customers as a business encouraged intentious to use condoms. Safer sex intentions with customers were frequently undermined by urgent financial needs, which stemmed from transphobia, employment discrimination and costly procedures associated with gender transition. Participants reported using drugs as a way to cope with or escape life stresses associated with relationships, sex work, transphobia and financial hardship. Interventions with at-risk MTF transgenders should address the interpersonal and social context of unsafe sex and drug use, particularly the unique roles of relationship issues with male partners, stigma, discrimination and community norms regarding sex work and drug use.

  14. Impact of Sexual Orientation Identity on Medical Morbidities in Male-to-Female Transgender Patients.

    Science.gov (United States)

    Gaither, Thomas W; Awad, Mohannad A; Osterberg, E Charles; Romero, Angelita; Bowers, Marci L; Breyer, Benjamin N

    2017-02-01

    We aim to describe the relationship between sexual orientation identity and medical morbidities in a large sample of male-to-female (MTF) transgender patients. We reviewed medical records of patients presenting for MTF sex reassignment surgery (SRS) by a single, high-volume surgeon from 2011 to 2015. Sexual attraction to men (heterosexual), women (lesbian), or both (bisexual) was asked of each patient. We examined 16 medical morbidities for this analysis. During the study period, 330 MTF transgender patients presented for SRS. The average age at the time of surgery was 38.9 (range 18-76). One hundred and one patients (32%) reported being heterosexual, 110 patients (34%) reported being lesbian, and 108 patients (34%) reported being bisexual. Lesbian patients presented for SRS at older ages (mean = 43 years old) compared with heterosexual patients (mean = 36 years old) and bisexual patients (mean = 37), P sexual orientation identity. Lesbian patients had greater odds of having a history of depression, age-adjusted odds ratio (aOR) = 2.36, 95% confidence interval (CI) 1.26-4.40, compared with heterosexual patients. Lesbian patients had higher odds of being married or partnered, aOR = 2.31, 95% CI (1.27-4.19), compared with heterosexual patients. Heterosexual patients had higher odds of having human immunodeficiency virus (HIV), aOR = 9.07, 95% CI (1.08-76.5) compared with lesbian patients. Sexual orientation identity in MTF transgender patients is variable. The majority of medical morbidities are not associated with sexual orientation identity. Although HIV and depression are common morbidities among MTF patients seeking SRS, the prevalence of these morbidities differs by sexual orientation identity, but these findings need replication. Counseling and future research initiatives in transgender care should incorporate sexual orientation identity and associated risk behavior.

  15. Prevalence of hepatitis B and hepatitis C Virus infections among male to female (MFT transgenders in Rawalpindi (Pakistan

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    Hashaam Akhtar

    2018-02-01

    Full Text Available Background: Transgenders are the individuals, who due to certain psychological or physical requirement mismatch with their naturally received genders. Among transgender types, male to female (MTF transgenders are highly prevalent in Indo-Pak and are feared to be at high risk for sexually transmitted viral (human immunodeficiency virus HIV, hepatitis B virus HBV, hepatitis C virus HCV and Epstein Barr virus EBV and bacterial diseases (gonorrhea, syphilis, campylobacter, chancroid, shigella, granuloma inguinale and chlamydia. This sensitive issue, therefore, requires more attention of researchers, policy-makers, and non-governmental organizations (NGOs in Pakistan. Methods: Prevalence of HCV and HBV infection was studied in 306 transgender males with a median age of 29 years (range 15-64years living in Rawalpindi, Pakistan. Molecular techniques such as ELISA and Nested PCR were performed to confirm the presence of the both viruses in each sample of subjects. Furthermore, logistic regression and chi-square test were used for statistical analysis. Results: This study showed that occurrence of HCV infection was predominant among the studied group; whereas presence of HBV was insignificant and was not included for statistical analysis. PCR confirmed that 25.5% of the test group was HCV positive, with the highest percentage (83.33 % of HCV positive among the individuals who claimed safe sex practices and had knowledge about the medical condition of their partners. 34.61% of the transgender men who shave outside their homes, were found to be HCV positive. Conclusion: In light of these statistics, ignoring this threat could be dangerous not only for the transgender community but also for the society, in general.

  16. Societal individualism predicts prevalence of nonhomosexual orientation in male-to-female transsexualism.

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    Lawrence, Anne A

    2010-04-01

    There are two distinct subtypes of male-to-female (MtF) transsexuals: homosexual and nonhomosexual. The relative prevalence of these two subtypes varies dramatically between countries, but no explanation of this variability has yet been proposed. This study examined the hypothesis that the prevalence of nonhomosexual MtF transsexualism, relative to homosexual MtF transsexualism, would be higher in individualistic countries than in collectivistic countries. I analyzed data from 22 studies of MtF transsexualism, conducted in 16 countries, examining the association between percentage of nonhomosexual participants and Hofstede's (Culture's consequences: Comparing values, behaviors, institutions, and organizations across nations, 2001) Individualism Index (IDV). IDV accounted for 77% of observed variance in the percentage of nonhomosexual MtF participants (r = 0.88, p individualistic countries for socially disruptive gender transitions by nonhomosexual gender dysphoric men, and the availability within many collectivistic countries of socially approved transgender roles for pervasively feminine homosexual gender dysphoric men, are plausible contributors.

  17. Venous and arterial thrombo-embolic complications of hormonal treatment in a male-to-female transgender patient.

    LENUS (Irish Health Repository)

    Mullins, G M

    2012-02-03

    We present a male-to-female (MTF) transgender patient admitted with a pulmonary embolism. The patient had been treated with high-dose oestrogens since the age of 16. Following a prolonged period of hypotension, our patient sustained cerebral border zone infarcts. There was evidence of bilateral carotid stenosis on Doppler ultrasound. We discuss the treatment and vascular complications of gender dysphoria.

  18. Family Rejection, Social Isolation, and Loneliness as Predictors of Negative Health Outcomes (Depression, Suicidal Ideation, and Sexual Risk Behavior) among Thai Male-to-Female Transgender Adolescents

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    Yadegarfard, Mohammadrasool; Meinhold-Bergmann, Mallika E.; Ho, Robert

    2014-01-01

    This study examined the influence of family rejection, social isolation, and loneliness on negative health outcomes among Thai male-to-female transgender adolescents. The sample consisted of 260 male respondents, of whom 129 (49.6%) were self-identified as transgender and 131 (50.4%) were self-identified as cisgender (nontransgender). Initial…

  19. Facilitating access to sexual health services for men who have sex with men and male-to-female transgender persons in Guatemala City.

    Science.gov (United States)

    Boyce, Sabrina; Barrington, Clare; Bolaños, Herbert; Arandi, Cesar Galindo; Paz-Bailey, Gabriela

    2012-01-01

    The purpose of this study was to identify barriers to accessing sexual health services among gay, bisexual and heterosexual-identifying men who have sex with men and male-to-female transgender persons in Guatemala City, to inform the development of high quality and population-friendly services. In-depth, semi-structured interviews were conducted with 29 purposively sampled individuals, including 8 transgender, 16 gay/bisexual and 5 heterosexual-identifying participants. Topical codes were applied to the data using software Atlas.ti™ to compare data between sub-groups. Analysis revealed that public clinics were most commonly used due to their lower cost and greater accessibility, but many participants experienced discrimination, violation of confidentiality and distrust of these services. Transgender and gay/bisexual-identifying participants preferred clinics where they felt a sense of belonging, while heterosexual-identifying participants preferred clinics unassociated with the men who have sex with men community. The most prominent barriers to sexual health services included fear of discrimination, fear of having HIV, cost and lack of social support. Findings highlight the need to strengthen existing public sexually transmitted infection clinics so that they address the multiple layers of stigma and discrimination that men who have sex with men and transgender persons experience.

  20. Descriptive Study of Gender Dysphoria in Japanese Individuals with Male-to-Female Gender Identity Disorder

    OpenAIRE

    Shinohara, Yoshie; Nakatsuka, Mikiya

    2018-01-01

    We focus on Japanese individuals with gender identity disorder (GID), especially male-to-female (MTF) GID, who have experienced difficulty in adapting to social life. We clarify what gender dysphoria is, and we examine methods of intervention. Semi-structured interviews were conducted with 11 individuals with MTF-GID from August 2015 to April 2017. We categorized the subjects’experiences regarding dysphoria into the ‘Onset of gender dysphoria,’ ‘Experience of feeling gender dysphoria,’ and ‘C...

  1. Sex Workers, Fem Queens, and Cross-Dressers: Differential Marginalizations and HIV Vulnerabilities Among Three Ethnocultural Male-to-Female Transgender Communities in New York City

    OpenAIRE

    Hwahng, Sel Julian; Nuttbrock, Larry

    2007-01-01

    This article describes 3 distinct ethnocultural male-to-female transgender communities in New York City: the low-income African American/Black1 and Latina(o) House Ball community; low-income, often undocumented immigrant Asian sex workers; and middle-class White cross-dressers. These communities are highly socially isolated from each other and are more connected to their ethnocultural contexts than to an abstract and shared transgender identity. Whereas previous research either has viewed mal...

  2. WHOQOL-100 Before and After Sex Reassignment Surgery in Brazilian Male-to-Female Transsexual Individuals.

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    Cardoso da Silva, Dhiordan; Schwarz, Karine; Fontanari, Anna Martha Vaitses; Costa, Angelo Brandelli; Massuda, Raffael; Henriques, Alexandre Annes; Salvador, Jaqueline; Silveira, Esalba; Elias Rosito, Tiago; Lobato, Maria Inês Rodrigues

    2016-06-01

    The 100-item World Health Organization Quality of Life Assessment (WHOQOL-100) evaluates quality of life as a subjective and multidimensional construct. Currently, particularly in Brazil, there are controversies concerning quality of life after sex reassignment surgery (SRS). To assess the impact of surgical interventions on quality of life of 47 Brazilian male-to-female transsexual individuals using the WHOQOL-100. This was a prospective cohort study using the WHOQOL-100 and sociodemographic questions for individuals diagnosed with gender identity disorder according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The protocol was used when a transsexual person entered the ambulatory clinic and at least 12 months after SRS. Initially, improvement or worsening of quality of life was assessed using 6 domains and 24 facets. Subsequently, quality of life was assessed for individuals who underwent new surgical interventions and those who did not undergo these procedures 1 year after SRS. The participants showed significant improvement after SRS in domains II (psychological) and IV (social relationships) of the WHOQOL-100. In contrast, domains I (physical health) and III (level of independence) were significantly worse after SRS. Individuals who underwent additional surgery had a decrease in quality of life reflected in domains II and IV. During statistical analysis, all results were controlled for variations in demographic characteristics, without significant results. The WHOQOL-100 is an important instrument to evaluate the quality of life of male-to-female transsexuals during different stages of treatment. SRS promotes the improvement of psychological aspects and social relationships. However, even 1 year after SRS, male-to-female transsexuals continue to report problems in physical health and difficulty in recovering their independence. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc

  3. Preparatory behaviours and condom use during receptive and insertive anal sex among male-to-female transgenders (Waria) in Jakarta, Indonesia

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    Prabawanti, Ciptasari; Dijkstra, Arie; Riono, Pandu; Tb, Gagan Hartana

    2014-01-01

    Introduction: The male-to-female transgender (waria) is part of a key population at higher risk for HIV. This study aims to test whether psychosocial determinants as defined by the theory of planned behaviour (TPB) can explain behaviours related to condom use among waria. Three preparatory

  4. Descriptive Study of Gender Dysphoria in Japanese Individuals with Male-to-Female Gender Identity Disorder.

    Science.gov (United States)

    Shinohara, Yoshie; Nakatsuka, Mikiya

    2018-04-01

    We focus on Japanese individuals with gender identity disorder (GID), especially male-to-female (MTF) GID, who have experienced difficulty in adapting to social life. We clarify what gender dysphoria is, and we examine methods of intervention. Semi-structured interviews were conducted with 11 individuals with MTF-GID from August 2015 to April 2017. We categorized the subjects'experiences regarding dysphoria into the 'Onset of gender dysphoria,' 'Experience of feeling gender dysphoria,' and 'Changes due to receiving medical care.' The subjects reported experiencing great pain and distress because they did not fully understand that they were experiencing dysphoria and could not align their gender identity and their self-identity. All subjects described their experiences of dysphoria as negative. Additionally, all said that the dysphoria was alleviated by a medical intervention such as visiting a gender clinic, receiving a diagnosis and treatment, and changing their physical sex to the sex congruent with their gender identity. The provision of information at the gender clinic and the physical changes achieved by medical intervention exerted a positive effect both mentally and socially on the subjects, who suffered various physical, mental and social problems.

  5. Social support, exposure to violence and transphobia, and correlates of depression among male-to-female transgender women with a history of sex work.

    Science.gov (United States)

    Nemoto, Tooru; Bödeker, Birte; Iwamoto, Mariko

    2011-10-01

    We determined racial/ethnic differences in social support and exposure to violence and transphobia, and explored correlates of depression among male-to-female transgender women with a history of sex work (THSW). A total of 573 THSW who worked or resided in San Francisco or Oakland, California, were recruited through street outreach and referrals and completed individual interviews using a structured questionnaire. More than half of Latina and White participants were depressed on the basis of Center For Epidemiologic Studies Depression Scale scores. About three quarters of White participants reported ever having suicidal ideation, of whom 64% reported suicide attempts. Half of the participants reported being physically assaulted, and 38% reported being raped or sexually assaulted before age 18 years. White and African American participants reported transphobia experiences more frequently than did others. Social support, transphobia, suicidal ideation, and levels of income and education were significantly and independently correlated with depression. For THSW, psychological vulnerability must be addressed in counseling, support groups, and health promotion programs specifically tailored to race/ethnicity.

  6. Sex Workers, Fem Queens, and Cross-Dressers: Differential Marginalizations and HIV Vulnerabilities Among Three Ethnocultural Male-to-Female Transgender Communities in New York City.

    Science.gov (United States)

    Hwahng, Sel Julian; Nuttbrock, Larry

    2007-12-01

    This article describes 3 distinct ethnocultural male-to-female transgender communities in New York City: the low-income African American/Black and Latina(o) House Ball community; low-income, often undocumented immigrant Asian sex workers; and middle-class White cross-dressers. These communities are highly socially isolated from each other and are more connected to their ethnocultural contexts than to an abstract and shared transgender identity. Whereas previous research either has viewed male-to-female transgender people as one monolithic group or has separated them into abstract racial categories unconnected to their communities and lifestyles, this article positions them within specific social networks, cultures, neighborhoods, and lifestyles. With regard to HIV vulnerabilities, violence, and rape, House Ball community members seemed to engage in the riskiest form of survival sex work, whereas Asian sex workers seemed to engage in moderate-risk survival sex work. White cross-dressers seemed to engage in very low-risk recreational sex work.

  7. Social marketing interventions to increase HIV/STI testing uptake among men who have sex with men and male-to-female transgender women.

    Science.gov (United States)

    Wei, Chongyi; Herrick, Amy; Raymond, H Fisher; Anglemyer, Andrew; Gerbase, Antonio; Noar, Seth M

    2011-09-07

    included. Posttest-only studies and studies that combined pre-post data were excluded. Interventions that targeted at general public but did not include MSM or transgender women as a segment or did not have outcome data for an MSM or transgender segment were excluded. Two authors independently extracted data from each included study and assessed study quality. Meta-analyses were conducted to compare pre- and post-intervention and intervention and control group outcomes of HIV and STI testing uptake. Quality of evidence was assessed using the GRADE approach. Three serial, cross-sectional pretest-posttest study designs (one with a control group and two without) were included in the final analysis. Statistical pooling was conducted for two studies and compared to pre-intervention level testing uptake, which showed that multi-media social marketing campaigns had a significant impact on HIV testing uptake (OR=1.58, 95%CI = 1.40 - 1.77). However, the campaigns were not found to be effective in increasing STI testing uptake (OR=0.94, 95%CI = 0.68 - 1.28). Overall, risk of bias was high and quality of evidence was low. None of the studies were conducted in developing countries or included male-to-female transgender women. This review provided limited evidence that multi-media social marketing campaigns can promote HIV testing among MSM in developed countries. Future evaluations of social marketing interventions for MSM should employ more rigorous study designs. Long-term impact evaluations (changes in HIV or STI incidence over time) are also needed. Implementation research, including detailed process evaluation, is needed to identify elements of social marketing interventions that are most effective in reaching the target population and changing behaviours.

  8. Breast Cancer Suspicion in a Transgender Male-to-Female Patient on Hormone Replacement Therapy Presenting with Right Breast Mass: Breast Cancer Risk Assessment and Presentation of a Rare Lesion

    Directory of Open Access Journals (Sweden)

    Krystina Tongson

    2017-01-01

    Full Text Available There has been an increasing use of hormonal therapy among male-to-female (MtF transgender individuals. This long-term hormone replacement therapy (HRT renders MtF individuals a unique patient subgroup in terms of breast cancer risk. This case describes a MtF transgender who presented with a breast lesion concerning for malignancy following hormonal replacement therapy. The patient additionally had a strong family history of breast cancer. Final pathology revealed lobular hyperplasia in the setting of gynecomastia and pseudoangiomatous stromal hyperplasia (PASH. Both pathology findings are rare in biological females, let alone in the setting of hormone replacement therapy in a MtF individual. While the number of reported cases of suspicious breast lesions in this population remains scarce, it presents both a diagnostic and therapeutic challenge due to the nature of the treatment course and the lack of research in this recently growing subgroup of patients.

  9. Exploring the desires and sexual culture of men who have sex with male-to-female transgender women.

    Science.gov (United States)

    Mauk, Daniel; Perry, Ashley; Muñoz-Laboy, Miguel

    2013-07-01

    Men who have sex with transgender women (MSTW) currently constitute a gap in the research community's understanding of male sexuality and sexual desire. In an effort to address this lack of knowledge, an ethnographic study of MSTW in New York City was conducted between December 2005 and May 2007, including in-depth interviews with MSTW (n = 15), key informant interviews (n = 13), and ethnographic observation of semi-private "tranny" parties held at various venues throughout New York City. The specific objectives were to: (1) describe the sex marketplaces and the sexual experiences of an ethnographic sample of MSTW in New York City and (2) describe the ways MSTW construct their sexual partnering practices and the meanings attributed to those practices in relation to varying social contexts (in and outside the sex marketplace). In this analysis, we described the MSTW sex market landscape in New York and identified three major recurrent themes in the ways that MSTW organized their sexual desire for TW transitioning from sex marketplaces to social spaces in their lives: (1) phallus-centric trade sex market focus; (2) relational-companionship market focus; and (3) specialized market focus. Although the findings from the study are not representative of the broader MSTW population, they represent an important step in amassing a body of knowledge about an understudied and underserved sex market upon which future research is needed.

  10. HIV Infection, risk factors and health services use among male-to-female transgender sex workers: a cross-sectional study in Portugal.

    Science.gov (United States)

    Gama, Ana; Martins, Maria Rosário Oliveira; Mendão, Luís; Barros, Henrique; Dias, Sónia

    2018-01-01

    Male-to-female transgender sex workers (TSW) have been identified as a key population at risk for HIV. This study examined risk behaviors and HIV prevalence among TSW, and described health services use. A participatory cross-sectional survey was conducted with 125 TSW recruited in locations and networks where sex workers congregate. HIV-risk behaviors were common among participants. Inconsistent condom use with clients in the previous month was reported by 12.0% of participants and was associated with Portuguese nationality, inconsistent condom use with non-paying partners and not been reached by HIV prevention programs in the previous year. Ever use of psychoactive substances was reported by 61.6% of participants and was associated with being non-employed, doing full-time sex work, having higher number of non-paying partners and having never used health services. Also, ever use of psychoactive substances was negatively associated with older age and Portuguese nationality. About 34% of the participants reported having not been tested in the previous 12 months; 20.2% never used the health services. Overall, 14.9% (95%CI: 8.0-21.0%) reported being HIV-positive. Of those, 22.2% (95%CI: 1.0-43.5%) had unprotected sex with clients in the previous month, 26.7% (95%CI: 1.3-52.0%) had unprotected sex with non-paying partners in the previous year, 13.3% (95%CI: 0.0-33.0%) had ever injected drugs, 60.0% (95%CI: 23.0-97.0%) reported a past STI and 33.3% (95%CI: 2.0-64.6%) had currently HIV/STI co-infection. The socioeconomic, relational or partnering, and structural contexts conducive to increased risk are warranting further investigation. This knowledge would be valuable to inform prevention programs. HIV interventions, including secondary prevention, should address specific needs of TSW. Outreach initiatives aimed to reach TSW who are difficult to access can play a role in promoting access to health services and reducing HIV infection and transmission.

  11. The PICASSO Cohort: baseline characteristics of a cohort of men who have sex with men and male-to-female transgender women at high risk for syphilis infection in Lima, Peru.

    Science.gov (United States)

    Kojima, Noah; Park, Hayoung; Konda, Kelika A; Joseph Davey, Dvora L; Bristow, Claire C; Brown, Brandon; Leon, Segundo R; Vargas, Silver K; Calvo, Gino M; Caceres, Carlos F; Klausner, Jeffrey D

    2017-04-11

    Men who have sex with men (MSM) and male-to-female transgender women (transwomen) are disproportionately at risk of syphilis infection in Peru. From 2013 to 2014, MSM and transwomen seeking human immunodeficiency virus (HIV) or sexually transmitted infection (STI) testing and/or treatment were recruited into a 2-year observational cohort study to determine predictors of recently acquired syphilis infection (defined as a rapid plasma reagin [RPR] titer ≥1:16 and a reactive treponemal antibody test) in Lima, Peru. At baseline, interviewers collected sociodemographic, behavioral, and medical characteristics from participants. All cohort participants were tested for syphilis, HIV, Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG) infection. Using cross-sectional analyses, bivariate and multivariate models were used to determine factors associated with recently acquired syphilis infection and calculate adjusted prevalence ratios. We recruited 401 participants, 312 MSM and 89 transwomen, with median ages of 29.0 and 32.5 years old (interquartile ranges: 23.3, 37.4 and 27.2, 39.5, respectively). The prevalence of recently acquired syphilis infection at baseline was 16.8% for MSM and 6.7% for transwomen. Among MSM and transwomen, 30.1 and 33.7% were infected with HIV, 18.6 and 24.7% were infected with CT, and 14.2 and 19.1% were infected with NG, respectively. Co-infection rates among MSM with recently acquired syphilis infection included: 44.2% with HIV, 40.4% with CT (32.7% with anal CT and 7.7% with pharyngeal CT), and 19.2% with NG (11.5% with anal NG and 7.7% with pharyngeal NG). Co-infection rates among transwomen with recently acquired syphilis infection included: 66.7% with HIV, 0% with CT, and 16.7% with anal NG. In multivariate analysis among the entire cohort, recently acquired syphilis infection was independently associated with younger age (adjusted prevalence ratio [aPR] = 0.96, 95% confidence interval [CI] = 0.93-0.99), receptive role

  12. Barriers to healthcare for transgender individuals.

    Science.gov (United States)

    Safer, Joshua D; Coleman, Eli; Feldman, Jamie; Garofalo, Robert; Hembree, Wylie; Radix, Asa; Sevelius, Jae

    2016-04-01

    Transgender persons suffer significant health disparities and may require medical intervention as part of their care. The purpose of this manuscript is to briefly review the literature characterizing barriers to healthcare for transgender individuals and to propose research priorities to understand mechanisms of those barriers and interventions to overcome them. Current research emphasizes sexual minorities' self-report of barriers, rather than using direct methods. The biggest barrier to healthcare reported by transgender individuals is lack of access because of lack of providers who are sufficiently knowledgeable on the topic. Other barriers include: financial barriers, discrimination, lack of cultural competence by providers, health systems barriers, and socioeconomic barriers. National research priorities should include rigorous determination of the capacity of the US healthcare system to provide adequate care for transgender individuals. Studies should determine knowledge and biases of the medical workforce across the spectrum of medical training with regard to transgender medical care; adequacy of sufficient providers for the care required, larger social structural barriers, and status of a framework to pay for appropriate care. As well, studies should propose and validate potential solutions to address identified gaps.

  13. Characteristics of Transgender Individuals Entering Substance Abuse Treatment

    Science.gov (United States)

    Heck, Nicholas C.; Sorensen, James L.

    2014-01-01

    Little is known about the needs or characteristics of transgender individuals in substance abuse treatment settings. Transgender (n=199) and non-transgender (cisgender, n=13440) individuals were compared on psychosocial factors related to treatment, health risk behaviors, medical and mental health status and utilization, and substance use behaviors within a database that documented individuals entering substance abuse treatment in San Francisco, CA from 2007–2009 using logistic and linear regression analyses (run separately by identified gender). Transgender men (assigned birth sex of female) differed from cisgender men across many psychosocial factors, including having more recent employment, less legal system involvement, greater incidence of living with a substance abuser, and greater family conflict, while transgender women (assigned birth sex of male) were less likely to have minor children than cisgender women. Transgender women reported greater needle use and HIV testing rates were greater among transgender women. Transgender men and women reported higher rates of physical health problems, mental health diagnoses, and psychiatric medications but there were no differences in service utilization. There were no differences in substance use behaviors except that transgender women were more likely to endorse primary methamphetamine use. Transgender individuals evidence unique strengths and challenges that could inform targeted services in substance abuse treatment. PMID:24561017

  14. Collective Self-Esteem as a Coping Resource for Male-to-Female Transsexuals

    OpenAIRE

    Sánchez, Francisco J.; Vilain, Eric

    2009-01-01

    The fear of experiencing discrimination often provokes symptoms of psychological distress. One coping resource is positive identification with one’s social group—known as collective self-esteem. This preliminary study investigated whether collective self-esteem was related to fears regarding a transsexual identity and psychological distress among 53 self-identified male-to-female transsexuals (mean age = 50.79). Participants were recruited from transgender events held in Arizona and Californi...

  15. Measuring Transgender Individuals' Comfort with Gender Identity and Appearance: Development and Validation of the Transgender Congruence Scale

    Science.gov (United States)

    Kozee, Holly B.; Tylka, Tracy L.; Bauerband, L. Andrew

    2012-01-01

    Our study used the construct of congruence to conceptualize the degree to which transgender individuals feel genuine, authentic, and comfortable with their gender identity and external appearance. In Study 1, the Transgender Congruence scale (TCS) was developed, and data from 162 transgender individuals were used to estimate the reliability and…

  16. Gender identity disorder: general overview and surgical treatment for vaginoplasty in male-to-female transsexuals.

    Science.gov (United States)

    Selvaggi, Gennaro; Ceulemans, Peter; De Cuypere, Griet; VanLanduyt, Koen; Blondeel, Phillip; Hamdi, Moustapha; Bowman, Cameron; Monstrey, Stan

    2005-11-01

    After studying this article, the participant should be able to discuss: 1. The terminology related to male-to-female gender dysphoria. 2. The different theories regarding cause, epidemiology, and treatment of gender dysphoria. 3. The surgical goals of sex reassignment surgery in male-to-female transsexualism. 4. The surgical techniques available for sex reassignment surgery in male-to-female transsexualism. Gender identity disorder (previously "transsexualism") is the term used for individuals who show a strong and persistent cross-gender identification and a persistent discomfort with their anatomical sex, as manifested by a preoccupation with getting rid of one's sex characteristics, or the belief of being born in the wrong sex. Since 1978, the Harry Benjamin International Gender Dysphoria Association (in honor of Dr. Harry Benjamin, one of the first physicians who made many clinicians aware of the potential benefits of sex reassignment surgery) has played a major role in the research and treatment of gender identity disorder, publishing the Standards of Care for Gender Dysphoric Persons. The authors performed an overview of the terminology related to male-to-female gender identity disorder; the different theories regarding cause, epidemiology, and treatment; the goals expected; and the surgical technique available for sex reassignment surgery in male-to-female transsexualism. Surgical techniques available for sex reassignment surgery in male-to-female transsexualism, with advantages and disadvantages offered by each technique, are reviewed. Other feminizing nongenital operative interventions are also examined. This review describes recent etiopathogenetic theories and actual guidelines on the treatment of the gender identity disorder in male-to-female transsexuals; the penile-scrotal skin flap technique is considered the state of the art for vaginoplasty in male-to-female transsexuals, whereas other techniques (rectosigmoid flap, local flaps, and isolated skin

  17. Regional gray matter variation in male-to-female transsexualism

    Science.gov (United States)

    Luders, Eileen; Sánchez, Francisco J.; Gaser, Christian; Toga, Arthur W.; Narr, Katherine L.; Hamilton, Liberty S.; Vilain, Eric

    2009-01-01

    Gender identity—one's sense of being a man or a woman—is a fundamental perception experienced by all individuals that extends beyond biological sex. Yet, what contributes to our sense of gender remains uncertain. Since individuals who identify as transsexual report strong feelings of being the opposite sex and a belief that their sexual characteristics do not reflect their true gender, they constitute an invaluable model to understand the biological underpinnings of gender identity. We analyzed MRI data of 24 male-to-female (MTF) transsexuals not yet treated with cross-sex hormones in order to determine whether gray matter volumes in MTF transsexuals more closely resemble people who share their biological sex (30 control men), or people who share their gender identity (30 control women). Results revealed that regional gray matter variation in MTF transsexuals is more similar to the pattern found in men than in women. However, MTF transsexuals show a significantly larger volume of regional gray matter in the right putamen compared to men. These findings provide new evidence that transsexualism is associated with distinct cerebral pattern, which supports the assumption that brain anatomy plays a role in gender identity. PMID:19341803

  18. Committee Opinion no. 512: health care for transgender individuals.

    Science.gov (United States)

    2011-12-01

    Transgender individuals face harassment, discrimination, and rejection within our society. Lack of awareness, knowledge, and sensitivity in health care communities eventually leads to inadequate access to, underutilization of, and disparities within the health care system for this population. Although the care for these patients is often managed by a specialty team, obstetrician–gynecologists should be prepared to assist or refer transgender individuals with routine treatment and screening as well as hormonal and surgical therapies. The American College of Obstetricians and Gynecologists opposes discrimination on the basis of gender identity and urges public and private health insurance plans to cover the treatment of gender identity disorder.

  19. Anxiety and Depression in Transgender Individuals: The Roles of Transition Status, Loss, Social Support, and Coping

    Science.gov (United States)

    Budge, Stephanie L.; Adelson, Jill L.; Howard, Kimberly A. S.

    2013-01-01

    Objective: The purpose of the current study was to examine facilitative and avoidant coping as mediators between distress and transition status, social support, and loss. Method: A total of 351 transgender individuals (n = 226 transgender women and n = 125 transgender men) participated in this study. Participants completed measures on transgender…

  20. A study on perceived parenting style among transgender

    Directory of Open Access Journals (Sweden)

    Akanksha Mohta

    2017-06-01

    Full Text Available Background: The present study aims to explore the perceived parenting style among the transgender. Methods: It was a cross-sectional comparative study. Purposive sampling was used for the transgender group and group-matched non-transgender were included in the non-transgender comparative group. A sample of 62 individuals (30 transgender consisting of 22 male to female or MTF transgender and eight female to male or FTM transgender, and 32 non-transgender consisting of 24 males and eight females, male and females, between the age range of 18-40 years, and minimum educational qualification till class eight were selected after a basic interview and screening. They were assessed using the Parental Authority Questionnaire and t-test analysis was computed to analyse the obtained data. Results: Authoritative parenting style was found to be significantly lower for both the parents of the participants in the transgender group. On the contrary, authoritarian parenting was found to be significantly higher for both the parents in the transgender group. Conclusions: The study indicated that among the transgender group, both the parents fail to provide safe and nurturing emotional climate which has been found to be contributory to healthy development and respectful of an individual. Hence, the findings highlight the need that interventions should also focus on family acceptance as it acts as protective factor and promote their well-being.

  1. Needs and concerns of transgender individuals regarding interdisciplinary transgender healthcare: A non-clinical online survey.

    Directory of Open Access Journals (Sweden)

    Jana Eyssel

    Full Text Available This study investigates the needs and concerns transgender (short: trans individuals have concerning trans healthcare (THC in interdisciplinary THC centres. Trans individuals' gender does not (fully/constantly match their sex assigned at birth. To be able to live in their gender role and to prevent or minimise gender dysphoria, they might require a multidisciplinary set of transition related healthcare services. The current shift from the traditionally highly regulated, hierarchical and pathologising approach to THC towards a more patient-centred approach has highlighted the importance of trans patients' satisfaction with treatment processes and results. As the still influential regulations have a negative effect on patient satisfaction, and might also keep trans individuals from seeking transition related treatment, it is crucial to investigate what trans individuals, whether patients or not, need and fear regarding transition related healthcare. Against the backdrop of mixed reactions received from the local trans community regarding the foundation of the Interdisciplinary Transgender Healthcare Centre Hamburg (ITHCCH, Germany, this study seeks to determine what trans individuals need with respect to THC in order to guarantee for high quality service provision at the ITHCCH. To this end, an online questionnaire was developed. The researchers employed a participatory approach to questionnaire development by involving a working group consisting of local trans support group representatives and (THC specialists (N = 4. The sample consisted of N = 415 trans-identified individuals aged between 16 and 76. Most of them were based in Germany. 85.2% (n = 382 reported experience with transition related healthcare and 72.5% (n = 301 had (additional treatments planned. Analysis revealed a need for communication and feedback opportunities. Furthermore, during the treatment process, addressing individual needs was considered crucial by participants. They

  2. Needs and concerns of transgender individuals regarding interdisciplinary transgender healthcare: A non-clinical online survey

    Science.gov (United States)

    Koehler, Andreas; Dekker, Arne; Sehner, Susanne; Nieder, Timo O.

    2017-01-01

    This study investigates the needs and concerns transgender (short: trans) individuals have concerning trans healthcare (THC) in interdisciplinary THC centres. Trans individuals’ gender does not (fully/constantly) match their sex assigned at birth. To be able to live in their gender role and to prevent or minimise gender dysphoria, they might require a multidisciplinary set of transition related healthcare services. The current shift from the traditionally highly regulated, hierarchical and pathologising approach to THC towards a more patient-centred approach has highlighted the importance of trans patients’ satisfaction with treatment processes and results. As the still influential regulations have a negative effect on patient satisfaction, and might also keep trans individuals from seeking transition related treatment, it is crucial to investigate what trans individuals, whether patients or not, need and fear regarding transition related healthcare. Against the backdrop of mixed reactions received from the local trans community regarding the foundation of the Interdisciplinary Transgender Healthcare Centre Hamburg (ITHCCH), Germany, this study seeks to determine what trans individuals need with respect to THC in order to guarantee for high quality service provision at the ITHCCH. To this end, an online questionnaire was developed. The researchers employed a participatory approach to questionnaire development by involving a working group consisting of local trans support group representatives and (THC) specialists (N = 4). The sample consisted of N = 415 trans-identified individuals aged between 16 and 76. Most of them were based in Germany. 85.2% (n = 382) reported experience with transition related healthcare and 72.5% (n = 301) had (additional) treatments planned. Analysis revealed a need for communication and feedback opportunities. Furthermore, during the treatment process, addressing individual needs was considered crucial by participants. They agreed

  3. [The social background of male to female transsexuals].

    Science.gov (United States)

    Bruck, J C

    2013-08-01

    Gender alignment surgery was introduced into German law in 1981. Judicial guidelines for the change of first names and gender were established and transsexuality was labelled as a psychosomatic and somatopsychic syndrome and disorder, thus opening the way for treatment to the social health-care under well-defined conditions requesting cross-dressing and hormone therapy as well as psychological counselling by 2 independent psychologists or psychiatrists. In a retrospective, chart-related survey of questionnaires on male to female transsexuals it was found that patients start to suspect being born into the wrong gender at the onset of puberty, it takes them however approximately 20 years to have gender alignment surgery. More than half the patients are single at this time, while the remaining group is married or divorced with equal rates. 68% regard themselves as heterosexual, 21% lesbian and 11% were undecided. About half the patients experienced support by their families for their decision. Despite numerous secondary corrections of the surgical alignment, patients were content with the result, although emotional acceptance of the desired result took about one year. In general plastic surgical gender alignment treatment was perceived as the major contribution to harmonise their phenotype with their identity. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Increased Cortical Thickness in Male-to-Female Transsexualism.

    Science.gov (United States)

    Luders, Eileen; Sánchez, Francisco J; Tosun, Duygu; Shattuck, David W; Gaser, Christian; Vilain, Eric; Toga, Arthur W

    2012-08-01

    The degree to which one identifies as male or female has a profound impact on one's life. Yet, there is a limited understanding of what contributes to this important characteristic termed gender identity . In order to reveal factors influencing gender identity, studies have focused on people who report strong feelings of being the opposite sex, such as male-to-female (MTF) transsexuals. To investigate potential neuroanatomical variations associated with transsexualism, we compared the regional thickness of the cerebral cortex between 24 MTF transsexuals who had not yet been treated with cross-sex hormones and 24 age-matched control males. Results revealed thicker cortices in MTF transsexuals, both within regions of the left hemisphere (i.e., frontal and orbito-frontal cortex, central sulcus, perisylvian regions, paracentral gyrus) and right hemisphere (i.e., pre-/post-central gyrus, parietal cortex, temporal cortex, precuneus, fusiform, lingual, and orbito-frontal gyrus). These findings provide further evidence that brain anatomy is associated with gender identity, where measures in MTF transsexuals appear to be shifted away from gender-congruent men.

  5. Outcome and preferences in male-to-female subjects with gender dysphoria: Experience from Eastern India.

    Science.gov (United States)

    Majumder, Anirban; Sanyal, Debmalya

    2017-01-01

    Gender dysphoria (GD) is an increasingly recognized medical condition in India, and little scientific data on treatment outcomes are available. Our objective is to study the therapeutic options including psychotherapy, hormone, and surgical treatments used for alleviating GD in male-to-female (MTF) transgender subjects in Eastern India. This is a retrospective study of treatment preferences and outcome in 55 MTF transgender subjects who were presented to the endocrine clinic. Descriptive statistical analysis is carried out in the present study, and Microsoft Word and Excel are used to generate graphs and tables. The mean follow-up was 1.9 years and 14 subjects (25.5%) were lost to follow-up after a single or 2-3 contact sessions. Rest 41 subjects (74.5%) desiring treatment had regular counseling and medical monitoring. All 41 subjects were dressing to present herself as female and all of them were receiving cross-sex hormone therapy either estrogen only (68%), or drospirenone in combination with estrogen (12%) or gonadotropin-releasing hormone agonist (GnRH) in combination with estrogens (19.5%). Most of the subjects preferred estrogen therapy as it was most affordable and only a small number of subjects preferred drospirenone or GnRH agonist because of cost and availability. 23.6% subjects underwent esthetic breast augmentation surgery and 25.5% underwent orchiectomy and/or vaginoplasty. Three subjects presented with prior breast augmentation surgery and nine subjects presented with prior orchiectomy without vaginoplasty, depicting a high prevalence of poorly supervised surgeries. Standards of care documents provide clinical guidance for health professionals about the optimal management of transsexual people. The lack of information among health professionals about proper and protocolwise management leads to suboptimal physical, social, and sexual results.

  6. Acceptance of lesbian, gay, bisexual and transgender individuals in the Netherlands 2013

    NARCIS (Netherlands)

    Saskia Keuzenkamp; Lisette Kuyper

    2013-01-01

    Original title: Acceptatie van homoseksuelen, biseksuelen en transgenders in Nederland 2013 The Dutch government is committed to equal rights for and social acceptance of lesbian, gay, bisexual and transgender (LGBT) individuals, and also to securing their acceptance in Dutch society. Since

  7. Predictors of Suicidal Ideation in a Statewide Sample of Transgender Individuals

    OpenAIRE

    Rood, Brian A.; Puckett, Julia A.; Pantalone, David W.; Bradford, Judith B.

    2015-01-01

    Transgender individuals experience violence and discrimination, which, in addition to gender transitioning, are established correlates of psychological distress. In a statewide sample of 350 transgender adults, we investigated whether a history of violence and discrimination increased the odds of reporting lifetime suicidal ideation (SI) and whether differences in SI were predicted by gender transition status. Violence, discrimination, and transition status significantly predicted SI. Compare...

  8. Collective Self-Esteem as a Coping Resource for Male-to-Female Transsexuals.

    Science.gov (United States)

    Sánchez, Francisco J; Vilain, Eric

    2009-01-01

    The fear of experiencing discrimination often provokes symptoms of psychological distress. One coping resource is positive identification with one's social group-known as collective self-esteem. This preliminary study investigated whether collective self-esteem was related to fears regarding a transsexual identity and psychological distress among 53 self-identified male-to-female transsexuals (mean age = 50.79). Participants were recruited from transgender events held in Arizona and California. The majority (81%) reported living full-time as women (mean length of time living as a woman = 6.33 years). Negative feelings about the transsexual community and fears regarding the impact of a transsexual identity were positively related to psychological distress. A regression model revealed that the fear of how a transsexual identity would affect one's life was the best predictor of the severity of psychological distress. These results are consistent with findings from other historically marginalized groups whereby the stress of being stigmatized by society adversely affects mental health.

  9. African American Transgender Women's Individual, Family, and Organizational Relationships: Implications for Nurses.

    Science.gov (United States)

    Cornelius, Judith B; Whitaker-Brown, Charlene D

    2017-06-01

    Guided by the relational cultural theory, we conducted a qualitative study to examine the relationship experiences of African American transgender women living in North Carolina. A convenience sample of 15 transgender women participated in the study. Semi-structured interviews, guided by an investigator-developed interview guide, were used to explore the personal experiences of transgender women on individual, family, and organizational levels. The findings provide a scheme for understanding the process through which transgender women's relationships hinder or enhance their ability to connect with individuals, family, and organizations. Nurses can use these findings to better understand the connectedness that occurs or does not occur in transgender women's relationships and provide culturally competent care to empower them to become resilient.

  10. HIV Testing by Transgender Status at Centers for Disease Control and Prevention–Funded Sites in the United States, Puerto Rico, and US Virgin Islands, 2009–2011

    Science.gov (United States)

    Wang, Guoshen; Mulatu, Mesfin S.; Larish, Nili

    2015-01-01

    Objectives. We examined HIV testing services, seropositivity, and the characteristics associated with newly identified, confirmed HIV-positive tests among transgender individuals. Methods. We analyzed data (2009–2011) using bivariate and multivariable logistic regression to examine the relationships between HIV positivity and sociodemographic and risk characteristics among male-to-female transgender individuals. Results. Most of the testing was conducted in females (51.1%), followed by males (48.7%) and transgender individuals (0.17%). Tests in male-to-female transgender individuals had the highest, newly identified confirmed HIV positivity (2.7%), followed by males (0.9%), female-to-male transgender individuals (0.5%), and females (0.2%). The associated characteristics with an HIV-positive test among male-to-female transgender individuals included ages 20 to 29 and 40 to 49 years (adjusted odds ratio [AOR] = 2.8; 95% confidence interval [CI] = 1.4, 5.6 and AOR = 2.8; 95% CI = 1.3, 5.9, respectively), African American (AOR = 4.6; 95% CI = 2.7, 7.9) or Hispanic/Latino (AOR = 2.6; 95% CI = 1.5, 4.5) race/ethnicity, and reporting sex without condom within the past year (AOR = 1.9; 95% CI = 1.3, 2.6), sex with an HIV-positive person (AOR = 1.5; 95% CI = 1.1, 2.0), or injection drug use (AOR = 2.0; 95% CI = 1.3, 3.0). Conclusions. High levels of HIV positivity among transgender individuals, particularly male-to-female transgender individuals, underscore the necessity for targeted HIV prevention services that are responsive to the needs of this population. PMID:26180964

  11. Homicide Rates of Transgender Individuals in the United States: 2010-2014.

    Science.gov (United States)

    Dinno, Alexis

    2017-09-01

    To estimate homicide rates of transgender US residents and relative risks (RRs) of homicide with respect to cisgender comparators intersected with age, gender, and race/ethnicity. I estimated homicide rates for transgender residents and transfeminine, Black, Latin@, and young (aged 15-34 years) subpopulations during the period 2010 to 2014 using Transgender Day of Remembrance and National Coalition of Anti-Violence Programs transgender homicide data. I used estimated transgender prevalences to estimate RRs using cisgender comparators. I performed a sensitivity analysis to situate all results within assumptions about underreporting of transgender homicides and assumptions about the prevalence of transgender residents. The overall homicide rate of transgender individuals was likely to be less than that of cisgender individuals, with 8 of 12 RR estimates below 1.0. However, the homicide rates of young transfeminine Black and Latina residents were almost certainly higher than were those of cisfeminine comparators, with all RR estimates above 1.0 for Blacks and all above 1.0 for Latinas. Antiviolence public health programs should identify young and Black or Latina transfeminine women as an especially vulnerable population.

  12. Mental Health Disparities Within the LGBT Population: A Comparison Between Transgender and Nontransgender Individuals.

    Science.gov (United States)

    Su, Dejun; Irwin, Jay A; Fisher, Christopher; Ramos, Athena; Kelley, Megan; Mendoza, Diana Ariss Rogel; Coleman, Jason D

    2016-01-01

    Purpose: This study assessed within a Midwestern LGBT population whether, and the extent to which, transgender identity was associated with elevated odds of reported discrimination, depression symptoms, and suicide attempts. Methods: Based on survey data collected online from respondents who self-identified as lesbian, gay, bisexual, and/or transgender persons over the age of 19 in Nebraska in 2010, this study performed bivariate t - or chi-square tests and multivariate logistic regression analysis to examine differences in reported discrimination, depression symptoms, suicide attempts, and self-acceptance of LGBT identity between 91 transgender and 676 nontransgender respondents. Results: After controlling for the effects of selected confounders, transgender identity was associated with higher odds of reported discrimination (OR=2.63, p LGBT identity was associated with substantially lower odds of reporting depression symptoms (OR=0.46, p LGBT identity was associated with depression symptoms among transgender individuals.

  13. Geographic and Individual Differences in Healthcare Access for U.S. Transgender Adults: A Multilevel Analysis.

    Science.gov (United States)

    White Hughto, Jaclyn M; Murchison, Gabriel R; Clark, Kirsty; Pachankis, John E; Reisner, Sari L

    2016-12-01

    To identify geographic and individual-level factors associated with healthcare access among transgender people in the United States. Multilevel analyses were conducted to investigate lifetime healthcare refusal using national data from 5831 U.S. transgender adults. Hierarchical generalized linear models examined associations between individual (age, gender, race, income, insurance, and healthcare avoidance) and state-level factors (percent voting Republican, percent same-sex couple households, income inequality, and transgender protective laws) and lifetime refusal of care. Results show that individual-level factors (being older; trans feminine; Native American, multiracial, or other racial/ethnic minority; having low income; and avoiding care due to discrimination) are positively associated with care refusal (all P-values transgender residents at increased odds of experiencing care refusal, relative to other regions of the United States. When adjusting for state-level factors, the percentage of the state population voting Republican was positively associated with care refusal among the transgender adults sampled (P Transgender adults surveyed reported differential access to healthcare by geographic region. Identifying geographic and individual-level factors associated with healthcare barriers allows for the development of targeted educational and policy interventions to improve healthcare access for transgender people most in need of services.

  14. Transgender Transitioning and Change of Self-Reported Sexual Orientation

    OpenAIRE

    Auer, M.; Fuss, J.; Höhne, N.; Stalla, G.; Sievers, C.

    2014-01-01

    Objective Sexual orientation is usually considered to be determined in early life and stable in the course of adulthood. In contrast, some transgender individuals report a change in sexual orientation. A common reason for this phenomenon is not known. Methods We included 115 transsexual persons (70 male-to-female “MtF” and 45 female-to-male “FtM”) patients from our endocrine outpatient clinic, who completed a questionnaire, retrospectively evaluating the history of their gender transition pha...

  15. Answers to Your Questions about Transgender Individuals and Gender Identity

    Science.gov (United States)

    ... organization devoted to the treatment of transgender people, publishes The Standards of Care , which offers recommendations for ... Jill Davidson, PhD, NCSP; J. Rhodes Perry, Associate Director of Policy & Programs, Parents, Families, and Friends of ...

  16. The Association of Multiple Identities with Self-directed Violence and Depression among Transgender Individuals

    Science.gov (United States)

    Lytle, Megan C.; Blosnich, John R.; Kamen, Charles

    2016-01-01

    Transgender individuals have a high prevalence of self-directed violence; however, there is scant literature focusing on their unique experiences. This study examined the differences in self-harm, suicidal ideation, suicide attempt, and depression based on racial/ethnic identity and sexual orientation among transgender individuals. Data were gathered from the Fall 2008 and Spring 2009 National College Health Assessment. Across racial/ethnic identities, greater proportions of transgender students endorse self-directed violence than their cisgender peers. Among transgender individuals, sexual minorities were more likely to report suicidal ideation than their heterosexual peers, and racial/ethnic minorities had higher odds of attempting suicide than non-Hispanic white individuals. PMID:26916366

  17. A Grounded Theory of Sexual Minority Women and Transgender Individuals' Social Justice Activism.

    Science.gov (United States)

    Hagen, Whitney B; Hoover, Stephanie M; Morrow, Susan L

    2018-01-01

    Psychosocial benefits of activism include increased empowerment, social connectedness, and resilience. Yet sexual minority women (SMW) and transgender individuals with multiple oppressed statuses and identities are especially prone to oppression-based experiences, even within minority activist communities. This study sought to develop an empirical model to explain the diverse meanings of social justice activism situated in SMW and transgender individuals' social identities, values, and experiences of oppression and privilege. Using a grounded theory design, 20 SMW and transgender individuals participated in initial, follow-up, and feedback interviews. The most frequent demographic identities were queer or bisexual, White, middle-class women with advanced degrees. The results indicated that social justice activism was intensely relational, replete with multiple benefits, yet rife with experiences of oppression from within and outside of activist communities. The empirically derived model shows the complexity of SMW and transgender individuals' experiences, meanings, and benefits of social justice activism.

  18. HIV Prevalence and Risks Associated with HIV Infection among Transgender Individuals in Cambodia

    OpenAIRE

    Weissman, Amy; Ngak, Song; Srean, Chhim; Sansothy, Neth; Mills, Stephen; Ferradini, Laurent

    2016-01-01

    Introduction Recognizing transgender individuals have a high risk of HIV acquisition, and to inform policies and programming, we conducted an HIV prevalence and risk behaviors survey among transgender individuals in Cambodia. Methods Cross-sectional survey using a respondent driven sampling method with self-administered audio-computer assisted interviews. HIV testing was performed prior to the questionnaire with results available immediately after. Eligible participants were ?18 years, identi...

  19. Geographic and Individual Differences in Healthcare Access for U.S. Transgender Adults: A Multilevel Analysis

    Science.gov (United States)

    Murchison, Gabriel R.; Clark, Kirsty; Pachankis, John E.; Reisner, Sari L.

    2016-01-01

    Abstract Purpose: To identify geographic and individual-level factors associated with healthcare access among transgender people in the United States. Methods: Multilevel analyses were conducted to investigate lifetime healthcare refusal using national data from 5831 U.S. transgender adults. Hierarchical generalized linear models examined associations between individual (age, gender, race, income, insurance, and healthcare avoidance) and state-level factors (percent voting Republican, percent same-sex couple households, income inequality, and transgender protective laws) and lifetime refusal of care. Results: Results show that individual-level factors (being older; trans feminine; Native American, multiracial, or other racial/ethnic minority; having low income; and avoiding care due to discrimination) are positively associated with care refusal (all P-values care refusal, relative to other regions of the United States. When adjusting for state-level factors, the percentage of the state population voting Republican was positively associated with care refusal among the transgender adults sampled (P < 0.01). Conclusion: Transgender adults surveyed reported differential access to healthcare by geographic region. Identifying geographic and individual-level factors associated with healthcare barriers allows for the development of targeted educational and policy interventions to improve healthcare access for transgender people most in need of services. PMID:27636030

  20. Teaching Transgender

    Science.gov (United States)

    Wentling, Tre; Windsor, Elroi; Schilt, Kristen; Lucal, Betsy

    2008-01-01

    The recent visibility of transgender lives demonstrates the dawning of a new period in the potential to include transgender topics in sociology courses. The focus on transgender individuals, communities, and inclusive initiatives are gaining momentum on many public and private college and university campuses, awakening old and new curiosities,…

  1. Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals

    Directory of Open Access Journals (Sweden)

    Cristiano Scandurra

    2018-03-01

    Full Text Available Transgender and gender nonconforming (TGNC people are a highly-stigmatized population. For this reason, they might internalize society’s normative gender attitudes and develop negative mental health outcomes. As an extension of the minority stress model, the psychological mediation framework sheds light on psychological processes through which anti-transgender discrimination might affect mental health. Within this framework, the current study aimed at assessing in 149 TGNC Italian individuals the role of internalized transphobia as a mediator between anti-transgender discrimination and mental health, considering resilience as the individual-level coping mechanism buffering this relationship. The results suggest that both indicators of internalized transphobia (i.e., shame and alienation mediate the relationship between anti-transgender discrimination and depression, while only alienation mediates the relationship between anti-transgender discrimination and anxiety. Furthermore, the results suggest that the indirect relation between anti-transgender discrimination and anxiety through alienation is conditional on low and moderate levels of resilience. Findings have important implications for clinical practice and psycho-social interventions to reduce stigma and stress caused by interpersonal and individual stigma.

  2. Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals

    Science.gov (United States)

    Bochicchio, Vincenzo; Amodeo, Anna Lisa; Esposito, Concetta; Valerio, Paolo; Maldonato, Nelson Mauro; Bacchini, Dario; Vitelli, Roberto

    2018-01-01

    Transgender and gender nonconforming (TGNC) people are a highly-stigmatized population. For this reason, they might internalize society’s normative gender attitudes and develop negative mental health outcomes. As an extension of the minority stress model, the psychological mediation framework sheds light on psychological processes through which anti-transgender discrimination might affect mental health. Within this framework, the current study aimed at assessing in 149 TGNC Italian individuals the role of internalized transphobia as a mediator between anti-transgender discrimination and mental health, considering resilience as the individual-level coping mechanism buffering this relationship. The results suggest that both indicators of internalized transphobia (i.e., shame and alienation) mediate the relationship between anti-transgender discrimination and depression, while only alienation mediates the relationship between anti-transgender discrimination and anxiety. Furthermore, the results suggest that the indirect relation between anti-transgender discrimination and anxiety through alienation is conditional on low and moderate levels of resilience. Findings have important implications for clinical practice and psycho-social interventions to reduce stigma and stress caused by interpersonal and individual stigma. PMID:29534023

  3. Cricothyroid approximation and subluxation in 21 male-to-female transsexuals

    NARCIS (Netherlands)

    Kanagalingam, Jeeve; Georgalas, Christos; Wood, Gary R.; Ahluwalia, Suki; Sandhu, Guri; Cheesman, Anthony D.

    2005-01-01

    OBJECTIVES: To evaluate the medium-term outcome of cricothyroid approximation and subluxation (CTAS) with postoperative speech therapy for pitch elevation in male-to-female transsexuals. STUDY DESIGN: Retrospective study of male-to-female transsexuals who underwent pitch-raising surgery between

  4. Predictors of Suicidal Ideation in a Statewide Sample of Transgender Individuals.

    Science.gov (United States)

    Rood, Brian A; Puckett, Julia A; Pantalone, David W; Bradford, Judith B

    2015-09-01

    Transgender individuals experience violence and discrimination, which, in addition to gender transitioning, are established correlates of psychological distress. In a statewide sample of 350 transgender adults, we investigated whether a history of violence and discrimination increased the odds of reporting lifetime suicidal ideation (SI) and whether differences in SI were predicted by gender transition status. Violence, discrimination, and transition status significantly predicted SI. Compared with individuals with no plans to transition, individuals with plans or who were living as their identified gender reported greater odds of lifetime SI. We discuss implications for SI disparities using Meyer's minority stress model.

  5. Hormone therapy in transgender adults is safe with provider supervision; A review of hormone therapy sequelae for transgender individuals

    OpenAIRE

    Weinand, Jamie D.; Safer, Joshua D.

    2015-01-01

    Introduction: Some providers report concern for the safety of transgender hormone therapy (HT). Methods: This is a systematic literature review of HT safety for transgender adults. Results: Current literature suggests HT is safe when followed carefully for certain risks. The greatest health concern for HT in transgender women is venous thromboembolism. HT among transgender men appears to cause polycythemia. Both groups experienced elevated fasting glucose. There is no increase in cancer...

  6. Strength in the Face of Adversity: Resilience Strategies of Transgender Individuals

    Science.gov (United States)

    Singh, Anneliese A.; Hays, Danica G.; Watson, Laurel S.

    2011-01-01

    This phenomenological inquiry explored the lived experiences of resilience of 21 transgender individuals. Through individual semistructured interviews (3 interviews each with 5 participants) and 1 focus group interview (16 participants), the authors identified 5 common resiliency themes (evolving a self-generated definition of self, embracing…

  7. Structural Discrimination is Associated With Smoking Status Among a National Sample of Transgender Individuals.

    Science.gov (United States)

    Shires, Deirdre A; Jaffee, Kim D

    2016-06-01

    Limited evidence suggests that transgender individuals smoke at significantly higher rates than the general population. We aimed to determine whether structural or everyday discrimination experiences predict smoking behavior among transgender individuals when sociodemographic, health, and gender-specific factors were controlled. Data from the National Transgender Discrimination Survey (N = 4781), a cross-sectional online and paper survey distributed to organizations serving the transgender community, were analyzed in order to determine the association between current smoking and discrimination experiences and other potential predictors. Logistic regression models were used to establish factors that predict smoking. Participants reported experiencing both structural (80.4%) and everyday (65.9%) discrimination. Multivariate analyses showed that participants who reported attending some college, graduating college, or having a graduate degree were less likely to smoke compared to those with a high school degree or less. Uninsured participants were more likely to report smoking compared to those with private insurance. Those who used alcohol or drugs for coping were also more likely to smoke. Participants whose IDs and records listed their preferred gender were less likely to smoke (OR = 0.84); those who had experienced structural discrimination were more like to report smoking (OR = 1.65). Further research is needed in order to explore the relationship between smoking and legal transition among transgender individuals. Strategies to prevent smoking and encourage cessation among this vulnerable population are also needed. In addition, comprehensive collection of gender identity data in the context of national surveys, tobacco-related research, and clinical settings is sorely needed. This study establishes a link between experiences of structural discrimination among transgender individuals and smoking status. © The Author 2015. Published by Oxford University Press on

  8. Career Development Practitioners as Advocates for Transgender Individuals: Understanding Gender Transition

    Science.gov (United States)

    Sangganjanavanich, Varunee Faii

    2009-01-01

    Assisting transgender individuals is a concern for career development practitioners because there is a lack of knowledge on this topic. The complexity of gender reassignment surgery brings challenges and unique needs to this population, throughout gender transition, and requires career development practitioners to understand these challenges and…

  9. Transgender Individuals' Workplace Experiences: The Applicability of Sexual Minority Measures and Models

    Science.gov (United States)

    Brewster, Melanie E.; Velez, Brandon; DeBlaere, Cirleen; Moradi, Bonnie

    2012-01-01

    The present study explored whether 3 existing measures of workplace constructs germane to the experiences of sexual minority people could be modified to improve their applicability with transgender individuals. To this end, the Workplace Heterosexist Experiences Questionnaire (WHEQ; C. R. Waldo, 1999); the Lesbian, Gay, Bisexual, and Transgendered…

  10. Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization.

    Science.gov (United States)

    Clements-Nolle, Kristen; Marx, Rani; Katz, Mitchell

    2006-01-01

    To determine the independent predictors of attempted suicide among transgender persons we interviewed 392 male-to-female (MTF) and 123 female-to-male (FTM) individuals. Participants were recruited through targeted sampling, respondent-driven sampling, and agency referrals in San Francisco. The prevalence of attempted suicide was 32% (95% CI = 28% to 36%). In multivariate logistic regression analysis younger age (discrimination, and gender-based victimization were independently associated with attempted suicide. Suicide prevention interventions for transgender persons are urgently needed, particularly for young people. Medical, mental health, and social service providers should address depression, substance abuse, and forced sex in an attempt to reduce suicidal behaviors among transgender persons. In addition, increasing societal acceptance of the transgender community and decreasing gender-based prejudice may help prevent suicide in this highly stigmatized population.

  11. Male-to-female gender dysphoria: Gender-specific differences in resting-state networks.

    Science.gov (United States)

    Clemens, Benjamin; Junger, Jessica; Pauly, Katharina; Neulen, Josef; Neuschaefer-Rube, Christiane; Frölich, Dirk; Mingoia, Gianluca; Derntl, Birgit; Habel, Ute

    2017-05-01

    Recent research found gender-related differences in resting-state functional connectivity (rs-FC) measured by functional magnetic resonance imaging (fMRI). To the best of our knowledge, there are no studies examining the differences in rs-FC between men, women, and individuals who report a discrepancy between their anatomical sex and their gender identity, i.e. gender dysphoria (GD). To address this important issue, we present the first fMRI study systematically investigating the differences in typical resting-state networks (RSNs) and hormonal treatment effects in 26 male-to-female GD individuals (MtFs) compared with 19 men and 20 women. Differences between male and female control groups were found only in the auditory RSN, whereas differences between both control groups and MtFs were found in the auditory and fronto-parietal RSNs, including both primary sensory areas (e.g. calcarine gyrus) and higher order cognitive areas such as the middle and posterior cingulate and dorsomedial prefrontal cortex. Overall, differences in MtFs compared with men and women were more pronounced before cross-sex hormonal treatment. Interestingly, rs-FC between MtFs and women did not differ significantly after treatment. When comparing hormonally untreated and treated MtFs, we found differences in connectivity of the calcarine gyrus and thalamus in the context of the auditory network, as well as the inferior frontal gyrus in context of the fronto-parietal network. Our results provide first evidence that MtFs exhibit patterns of rs-FC which are different from both their assigned and their aspired gender, indicating an intermediate position between the two sexes. We suggest that the present study constitutes a starting point for future research designed to clarify whether the brains of individuals with GD are more similar to their assigned or their aspired gender.

  12. Exploring Individual and Structural Factors Associated with Employment Among Young Transgender Women of Color Using a No-Cost Transgender Legal Resource Center.

    Science.gov (United States)

    Hill, Brandon J; Rosentel, Kris; Bak, Trevor; Silverman, Michael; Crosby, Richard; Salazar, Laura; Kipke, Michele

    2017-01-01

    The purpose of this study was to explore individual and structural factors associated with employment among young transgender women (TW) of color. Sixty-five trans women of color were recruited from the Transgender Legal Defense and Education Fund to complete a 30-min interviewer-assisted survey assessing sociodemographics, housing, workplace discrimination, job-seeking self-efficacy, self-esteem, perceived public passability, and transactional sex work. Logistic regression models revealed that stable housing (structural factor) and job-seeking self-efficacy (individual factor) were significantly associated with currently being employed. Our findings underscore the need for multilevel approaches to assist TW of color gain employment.

  13. Male-to-female transsexuals have female neuron numbers in a limbic nucleus

    NARCIS (Netherlands)

    Kruijver, F. P.; Zhou, J. N.; Pool, C. W.; Hofman, M. A.; Gooren, L. J.; Swaab, D. F.

    2000-01-01

    Transsexuals experience themselves as being of the opposite sex, despite having the biological characteristics of one sex. A crucial question resulting from a previous brain study in male-to-female transsexuals was whether the reported difference according to gender identity in the central part of

  14. Differences in Experiences of Discrimination in Accessing Social Services Among Transgender/Gender Nonconforming Individuals by (Dis)Ability.

    Science.gov (United States)

    Kattari, Shanna K; Walls, N Eugene; Speer, Stephanie Rachel

    2017-01-01

    Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.

  15. Attitudes and Perceptions of the Brazilian Public Health System by Transgender Individuals

    Directory of Open Access Journals (Sweden)

    Kátia Bones Rocha

    2009-05-01

    Full Text Available This study aims to describe how transgender people perceive services offered by the Brazilian Public Health System (SUS. This qualitative study, using the phenomenological technique, is based on eight semi-structured interviews conducted with individuals whose gender identity and/or gender expression differs from the sex they were assigned at birth. Each interview was evaluated by two interviewers and a content analysis performed by all members of the research group. The analysis identified the following categories as having high relevance to the participants’ experiences: homophobia, receptiveness, and humanization, access to health care, and suggestions to improve the SUS. Information shared by participants emphasized their belief that health care professionals are not adequately prepared to assist transgendered individuals and that health care providers should use a more sensitive approach towards them. A recurrent theme was the need to use appropriate and socially acceptable terminology when providing health care services in order to facilitate transgendered individuals' inclusive treatment. Despite the effort of Brazilian authorities, there is a need for significant improvement in health care practices in order to comply with SUS quality standards. This study highlights the importance of qualitative investigations to improve planning and to help define public health policies with the goal of including the most vulnerable and marginalized groups of the population. URN: urn:nbn:de:0114-fqs0902281

  16. Reversal Surgery in Regretful Male-to-Female Transsexuals After Sex Reassignment Surgery.

    Science.gov (United States)

    Djordjevic, Miroslav L; Bizic, Marta R; Duisin, Dragana; Bouman, Mark-Bram; Buncamper, Marlon

    2016-06-01

    Sex reassignment surgery (SRS) has proved an effective intervention for patients with gender identity disorder. However, misdiagnosed patients sometimes regret their decision and request reversal surgery. This review is based on our experience with seven patients who regretted their decision to undergo male-to-female SRS. To analyze retrospectively seven patients who underwent reversal surgery after regretting their decision to undergo male-to-female SRS elsewhere. From November 2010 through November 2014, seven men 33 to 53 years old with previous male-to-female SRS underwent reversal phalloplasty. Preoperatively, they were examined by three independent psychiatrists. Surgery included three steps: removal of female genitalia with scrotoplasty and urethral lengthening, total phalloplasty with microvascular transfer of a musculocutaneous latissimus dorsi flap, and neophallus urethroplasty with penile prosthesis implantation. Self-reported esthetic and psychosexual status after reversion surgery and International Index of Erectile Function scores for sexual health after phalloplasty and penile prosthesis implantation. Follow-up was 13 to 61 months (mean = 31 months). Good postoperative results were achieved in all patients. In four patients, all surgical steps were completed; two patients are currently waiting for penile implants; and one patient decided against the penile prosthesis. Complications were related to urethral lengthening: two fistulas and one stricture were observed. All complications were repaired by minor revision. According to patients' self-reports, all patients were pleased with the esthetic appearance of their genitalia and with their significantly improved psychological status. Reversal surgery in regretful male-to-female transsexuals after SRS represents a complex, multistage procedure with satisfactory outcomes. Further insight into the characteristics of persons who regret their decision postoperatively would facilitate better future

  17. Conservatively treated perforation of the neovagina in a male to female transsexual patient

    DEFF Research Database (Denmark)

    Amirian, Ilda; Gögenur, Ismail; Rosenberg, Jacob

    2011-01-01

    An unknown number of patients have had male to female gender transformation. Various surgical techniques have been employed to construct the neovagina. The more traditional techniques include inverted penile grafts and vascular pedicle grafts, but also the small bowel and sigmoid colon have been ...... with contrast through the neovagina showed leakage from the neovaginal top. The patient was treated conservatively with antibiotics and discharged after 7 days....

  18. Individual- and Structural-Level Risk Factors for Suicide Attempts Among Transgender Adults.

    Science.gov (United States)

    Perez-Brumer, Amaya; Hatzenbuehler, Mark L; Oldenburg, Catherine E; Bockting, Walter

    2015-01-01

    This study assessed individual (ie, internalized transphobia) and structural forms of stigma as risk factors for suicide attempts among transgender adults. Internalized transphobia was assessed through a 26-item scale including four dimensions: pride, passing, alienation, and shame. State-level structural stigma was operationalized as a composite index, including density of same-sex couples; proportion of Gay-Straight Alliances per public high school; 5 policies related to sexual orientation discrimination; and aggregated public opinion toward homosexuality. Multivariable logistic generalized estimating equation models assessed associations of interest among an online sample of transgender adults (N = 1,229) representing 48 states and the District of Columbia. Lower levels of structural stigma were associated with fewer lifetime suicide attempts (AOR 0.96, 95% CI 0.92-0.997), and a higher score on the internalized transphobia scale was associated with greater lifetime suicide attempts (AOR 1.18, 95% CI 1.04-1.33). Addressing stigma at multiple levels is necessary to reduce the vulnerability of suicide attempts among transgender adults.

  19. Use of the Internet to Meet Sexual Partners, Sexual Risk Behavior, and Mental Health in Transgender Adults.

    Science.gov (United States)

    Benotsch, Eric G; Zimmerman, Rick S; Cathers, Laurie; Heck, Ted; McNulty, Shawn; Pierce, Juan; Perrin, Paul B; Snipes, Daniel J

    2016-04-01

    The purpose of this study was to examine the use of the internet to meet sexual partners among transgender individuals and examine correlates of this use, including sexual risk behavior, discrimination experiences, and mental health. A sample of 166 transgender adults (112 male-to-female transgender women and 54 female-to-male transgender men) were recruited in community venues and anonymously completed measures assessing these variables. Most participants (64.5 %) were HIV-negative, 25.2 % were HIV-positive, and 10.3 % did not know their HIV status. Overall, 33.7 % of participants reported having met a sexual partner over the internet, which did not differ significantly between transgender women and men. Among these individuals, transgender women reported significantly more lifetime internet sexual partners (median = 3) than transgender men (median = 1). Use of the internet to meet sexual partners was associated with lower self-esteem but not with depression, anxiety, somatic distress or discrimination experiences. Among transgender women, use of the internet to meet sexual partners was associated with each of the 11 sexual risk behaviors examined, including having multiple partners, sex under the influence of drugs, number of unprotected anal or vaginal sex acts, and history of commercial sex work. The use of the internet to meet partners was not associated with sexual risk behavior among transgender men (0/11 variables assessed). Although the internet is a common mode of meeting sexual partners among some transgender adults, it may also be a potential venue for prevention interventions targeting transgender individuals at particularly high risk for HIV acquisition.

  20. HIV-related risk behaviors among kathoey (male-to-female transgender) sex workers in Bangkok, Thailand.

    Science.gov (United States)

    Nemoto, Tooru; Iwamoto, Mariko; Perngparn, Usaneya; Areesantichai, Chitlada; Kamitani, Emiko; Sakata, Maria

    2012-01-01

    Based on combined methods, this study investigated substance use and HIV risk behaviors among kathoey sex workers (KSWs) in Bangkok, Thailand. The study found that only half of the KSW participants reported having been tested for HIV, and that except for one participant, all others had not seen health care providers in the past 12 months. About one third of the participants reported having engaged in unprotected anal sex with customers in the past six months. Almost all participants reported alcohol use, as well as having had sex with customers under the influence of alcohol. The prevalence of marijuana and ecstasy use in the past 12 months was high (32 and 36%, respectively); as was for ketamine (20%) and non-injecting methamphetamine (yaba) use (10%). A multiple regression analysis showed that the participants who were post-operative status, had used illicit drugs, or had been abused by their father and brothers were less likely to use condoms for anal sex with customers. Three quarters of the participants sent money to their families and 35% of the participants expressed their willingness to engage in unsafe sex when customers offer extra money. The qualitative interviews revealed that many identified as girl or kathoey in early age and had been exposed to transphobia and violence from father and brothers. Some reported support for gender transition from their mothers. More than half of the participants currently had difficulties in living as kathoey, such as challenges in the job market and relationship with family members. Family obligation for sending money and the Buddhist concept of karma were discussed in relation to risk behaviors among KSWs. The study provided implications for facilitating HIV testing and developing future HIV prevention intervention programs for KSWs in Thailand.

  1. HIV-Related Risk Behaviors among Kathoey (Male-to-Female Transgender) Sex Workers in Bangkok, Thailand

    OpenAIRE

    Nemoto, Tooru; Iwamoto, Mariko; Perngparn, Usaneya; Areesantichai, Chitlada; Kamitani, Emiko; Sakata, Maria

    2011-01-01

    Based on combined methods, this study investigated substance use and HIV risk behaviors among kathoey sex workers (KSWs) in Bangkok, Thailand. The study found that only half of the KSW participants reported having been tested for HIV, and that except for one participant, all others had not seen health care providers in the past 12 months. About one third of the participants reported having engaged in unprotected anal sex with customers in the past 6 months. Almost all participants reported al...

  2. BIRTH ORDER AND ANDROPHILIC MALE-TO-FEMALE TRANSSEXUALISM IN BRAZIL.

    Science.gov (United States)

    Vanderlaan, Doug P; Blanchard, Ray; Zucker, Kenneth J; Massuda, Raffael; Fontanari, Anna Martha Vaitses; Borba, André Oliveira; Costa, Angelo Bradelli; Schneider, Maiko Abel; Mueller, Andressa; Soll, Bianca Machado Borba; Schwarz, Karine; Da Silva, Dhiordan Cardoso; Lobato, Maria Inês Rodrigues

    2017-07-01

    Previous research has indicated that biological older brothers increase the odds of androphilia in males. This finding has been termed the fraternal birth order effect. The maternal immune hypothesis suggests that this effect reflects the progressive immunization of some mothers to male-specific antigens involved in fetal male brain masculinization. Exposure to these antigens, as a result of carrying earlier-born sons, is hypothesized to produce maternal immune responses towards later-born sons, thus leading to female-typical neural development of brain regions underlying sexual orientation. Because this hypothesis posits mechanisms that have the potential to be active in any situation where a mother gestates repeated male fetuses, a key prediction is that the fraternal birth order effect should be observable in diverse populations. The present study assessed the association between sexual orientation and birth order in androphilic male-to-female transsexuals in Brazil, a previously unexamined population. Male-to-female transsexuals who reported attraction to males were recruited from a specialty gender identity service in southern Brazil (n=118) and a comparison group of gynephilic non-transsexual men (n=143) was recruited at the same hospital. Logistic regression showed that the transsexual group had significantly more older brothers and other siblings. These effects were independent of one another and consistent with previous studies of birth order and male sexual orientation. The presence of the fraternal birth order effect in the present sample provides further evidence of the ubiquity of this effect and, therefore, lends support to the maternal immune hypothesis as an explanation of androphilic sexual orientation in some male-to-female transsexuals.

  3. HIV Prevalence and Risks Associated with HIV Infection among Transgender Individuals in Cambodia.

    Directory of Open Access Journals (Sweden)

    Amy Weissman

    Full Text Available Recognizing transgender individuals have a high risk of HIV acquisition, and to inform policies and programming, we conducted an HIV prevalence and risk behaviors survey among transgender individuals in Cambodia.Cross-sectional survey using a respondent driven sampling method with self-administered audio-computer assisted interviews. HIV testing was performed prior to the questionnaire with results available immediately after. Eligible participants were ≥18 years, identified as male at birth and self-identified/expressed as a different gender, and reported having sex with at least one male partner in past year. From six major urban centers of Cambodia, 891 transgender individuals were recruited.The majority of the 891 participants self-identified as third gender or female (94.5%, were young (median age 23, IQR [20-27], had secondary education or higher (80.5%, not married (89.7%, and employed (90.2%. The majority had first sex before 18 years (66.8%, with a male (79.9%, 37.9% having been paid or paying for this first sex. The rate of HIV positivity among participants was found to be 4.15%. Consistent condom use with male and female partners was low with all partner types, but particularly low with male partners when paying for sex (20.3%. The majority of participants reported having experienced discrimination in their lifetime (54.8% and 30.3% had been assaulted. Multivariate analysis revealed that older age (adjusted OR = 14.73 [4.20, 51.67] for age 35-44 and adjusted OR = 7.63 [2.55, 22.81] for age 30-34, only having a primary school education or no schooling at all (adjusted OR = 2.62 [1.18, 5.80], being a resident of Siem Reap (adjusted OR = 7.44 [2.37, 23.29], receiving payment at first sex (adjusted OR = 2.26 [1.00, 5.11], having sex during/after using drugs (adjusted OR = 2.90 [1.09, 7.73], inconsistent condom use during last anal sex (adjusted OR = 3.84 [1.58, 9.33], and reporting low self-esteem (adjusted OR = 3.25 [1.35, 7.85] were

  4. The Importance of Human Immunodeficiency Virus Research for Transgender and Gender-Nonbinary Individuals.

    Science.gov (United States)

    Gianella, Sara; Sonya Haw, J; Blumenthal, Jill; Sullivan, Brooke; Smith, Davey

    2018-04-17

    Transgender and gender-nonbinary (trans/GNB) individuals are disproportionally affected by human immunodeficiency virus (HIV), yet they are not adequately represented in HIV research and often underserved in clinical care. By building on community strengths and addressing structural, psychological and biological challenges, we can improve the engagement of trans/GNB people in research and ultimately improve prevention, testing, and care for this population. Here, we review the current state of the science related to HIV for trans/GNB people and discuss next steps to expand research that aims to improve the lives and well-being of trans/GNB persons.

  5. Perforation of the neovagina in a male-to-female transsexual: a case report.

    Science.gov (United States)

    Shimamura, Yuto; Fujikawa, Aoi; Kubota, Keisuke; Ishii, Naoki; Fujita, Yoshiyuki; Ohta, Keiichiro

    2015-01-23

    There are several techniques for creation of a neovagina in male-to-female reassignment surgery. Although vaginoplasty with the sigmoid colon is not a common procedure, it is becoming more common. Perforation of the recto-sigmoid neovagina after sex reassignment surgery is very rare. We hereby report a case of perforation of the neovagina that presented as acute peritonitis, with a massive abscess in the intra-abdominal cavity. This case report describes a 33-year-old Asian woman presenting with mild persistent abdominal pain, nausea, and vomiting who had undergone male-to-female sex reassignment surgery four years prior. Physical examination revealed mild abdominal pain without rebound tenderness. An abdominal computed tomography scan showed a massive abscess that occupied a significant portion of the intra-abdominal cavity. Perforation of the neovagina was confirmed by exploratory laparotomy and surgical drainage with primary closure was performed without any complications. This is a rare case involving perforation of the neovagina that was successfully treated with surgical intervention. This case emphasizes the importance of taking a detailed medical history and to make physicians and patients aware that bowel vaginoplasty can result in a weak vagina.

  6. Hypogonadism in a male-to-female transsexual with super obesity.

    Science.gov (United States)

    Ayanian, S; Irwig, M S

    2013-08-01

    The global obesity epidemic is having a profound impact on the health of populations. From a reproductive standpoint, obesity has been associated with infertility and hypogonadism. We present the case of a 29-year-old male-to-female transsexual with super obesity (body mass index >50) who was found to have profound hypogonadism with total and free testosterone levels in the normal female reference range. There is virtually no literature on the hormonal sequelae of obesity in transsexual people. The patient was prescribed an aromatase inhibitor, letrozole 2.5 mg twice daily for 2 weeks, to determine the role of oestrogen in the hypogonadism. The aromatase inhibitor reduced the serum oestradiol concentration from 125 to 6.9 pm. There were dramatic corresponding rises in total testosterone (2.8 to 10.7 nm), luteinising hormone (4.1 to 20.5 mIU ml(-1) ) and follicle stimulating hormone (1.8 to 15.3 mIU ml(-1) ). This diagnostic test demonstrated the important role of oestrogen in mediating the hypogonadism. After the testing, the patient was started on oestrogen therapy after a careful discussion of the benefits versus risks of oestrogen therapy. We anticipate that similar cases of hypogonadism in male-to-female transsexuals will likely become more common in an era of increased obesity rates. © 2012 Blackwell Verlag GmbH.

  7. Gender confirming medical interventions and eating disorder symptoms among transgender individuals.

    Science.gov (United States)

    Testa, Rylan J; Rider, G Nicole; Haug, Nancy A; Balsam, Kimberly F

    2017-10-01

    Studies indicate that transgender individuals may be at risk of developing eating disorder symptoms (EDS). Elevated risk may be attributed to body dissatisfaction and/or societal reactions to nonconforming gender expression, such as nonaffirmation of a person's gender identity (e.g., using incorrect pronouns). Limited research suggests that gender-confirming medical interventions (GCMIs) may prevent or reduce EDS among transgender people. Participants included 154 transfeminine spectrum (TFS) and 288 transmasculine spectrum (TMS) individuals who completed the Trans Health Survey. Serial multiple mediation analyses controlling for age, education, and income were used to examine whether body satisfaction and nonaffirmation mediate any found relationships between various GCMIs (genital surgery, chest surgery, hormone use, hysterectomy, and hair removal) and EDS. For TFS individuals, the nonaffirmation to body satisfaction path mediated relationships between all GCMIs and EDS, although body satisfaction alone accounted for more of the indirect effects than this path for chest surgery. For TMS individuals, relationships between all GCMIs and EDS were mediated by the nonaffirmation to body satisfaction path. Findings support the hypothesis that GCMIs reduce experiences of nonaffirmation, which increases body satisfaction and thus decreases EDS. Among TFS participants, the relationship between chest surgery and lower levels of EDS was mediated most strongly by body satisfaction alone, suggesting that satisfaction with one's body may result in lower EDS even if affirmation from the external world is unchanged. Implications of these findings for intervention, policy, and legal efforts are discussed, and future research recommendations are provided. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Self-Reported Changes in Attractions and Social Determinants of Mental Health in Transgender Adults.

    Science.gov (United States)

    Katz-Wise, Sabra L; Reisner, Sari L; White Hughto, Jaclyn M; Budge, Stephanie L

    2017-07-01

    This study examined associations between changes in self-reported attractions and mental health in a community-based sample of self-identified transgender adults. Participants were purposively recruited in 2013 using bimodal sampling methods and completed a one-time survey. Multivariable logistic regression models estimated adjusted risk ratios and 95 % confidence intervals to examine associations between changes in attractions and mental health outcomes (lifetime self-harm, suicide attempts, depression diagnosis; past-week clinically significant depressive distress assessed via CES-D 10) among the entire sample (N = 452; 285 female-to-male spectrum, 167 male-to-female spectrum) and after gender transition among those who had socially transitioned (n = 205; 156 female-to-male spectrum, 49 male-to-female spectrum). Models were adjusted for known population social determinants (age, race/ethnicity, gender identity, socioeconomic status, sexual orientation identity), transgender-specific determinants (age of transgender realization, social transition, medical transition, visual gender nonconformity, non-binary gender identification), and survey mode (online vs. in-person sampling). Lifetime changes in attractions were significantly associated with increased probability of all mental health outcomes; individuals reporting any change in attractions were more likely than individuals not reporting changes to indicate lifetime self-harm, suicide attempts, depression diagnosis, and current depressive distress (all ps social transition were not significantly associated with mental health outcomes. Many, but not all, population and transgender-specific social determinants were significantly associated with mental health in the full sample and among those who had socially transitioned. Clinical implications of findings about changes in attractions and mental health are discussed for transgender individuals.

  9. Productivity in Lesbian, Gay, Bisexual, and Transgender Scholarship in Counseling Psychology: Institutional and Individual Ratings for 1990 through 2008

    Science.gov (United States)

    Smith, Nathan Grant

    2010-01-01

    This study examined individual and institutional productivity in lesbian, gay, bisexual, and transgender (LGBT) scholarship published in counseling psychology--oriented journals for the years 1990 through 2008. Eight journals were included in the analyses. An author-weighted score was calculated for each scholar, using a formula developed by…

  10. Quality of Life and Patient Satisfaction Following Male-to-Female Sex Reassignment Surgery.

    Science.gov (United States)

    Papadopulos, Nikolaos A; Lellé, Jean-Daniel; Zavlin, Dmitry; Herschbach, Peter; Henrich, Gerhard; Kovacs, Laszlo; Ehrenberger, Benjamin; Kluger, Anna-Katharina; Machens, Hans-Guenther; Schaff, Juergen

    2017-05-01

    Surveys on quality of life (QOL) of male-to-female (MTF) transsexuals have found low QOL scores before and increased satisfaction scores after sex-reassignment surgery (SRS). To our knowledge, many of them lack standardized questionnaires and comparisons with normative data to evaluate different vaginoplasty techniques. To analyze patient satisfaction and QOL after SRS. Forty-seven patients participated in this study. All patients had surgery with our self-developed combined technique on average 19 months before the survey. They completed a self-developed indication-specific questionnaire concerning demographic and socioeconomic issues and postoperative satisfaction. Furthermore, a standardized self-assessment questionnaire on satisfaction and QOL (Fragen zur Lebenszufriedenheit Module [FLZ M ]; Questions on Life Satisfaction Modules ) was used. The FLZ M consists of three modules (general life satisfaction, satisfaction with health, and satisfaction with body image) with scores of weighted satisfaction for each item. Results of the general and health modules were compared with normative data. Demographics, QOL, general life satisfaction, satisfaction with health, and satisfaction with body image. The self-developed indication-specific questionnaire showed that 91% experienced an improvement of QOL. All patients stated they would undergo SRS again and did not regret it at all. Patients stated their femininity significantly increased. For the FLZ M , the sum score for general life satisfaction (P patient satisfaction of this complex and non-standardized surgery. This is the first description of a new surgical technique (combined technique) for MTF SRS. QOL was assessed by a large number of patients by standardized questionnaires and could be compared with normative data. Because this is a retrospective study, we can draw only careful conclusions for pre- and postoperative changes. Our self-developed combined surgical technique seemed to have a positive influence on

  11. Relational and sexual fluidity in females partnered with male-to-female transsexual persons.

    Science.gov (United States)

    Aramburu Alegría, C

    2013-03-01

    This paper reports on a study examining sexuality in females who remain partnered with male-to-female transsexual persons. Participants' self-view and sexual fluidity following their partners' transition from man to woman is examined. Sixteen females participated in in-depth, semi-structured interviews. An inductive process of data analysis was conducted, using the constant comparative method, an iterative process by which data are compared within and across subjects. Data were collected until thematic saturation was achieved. Four themes related to sexuality emerged: (1) questioning of sexual orientation; (2) sexual orientation categorization; (3) relational fluidity without sexual relations; and (4) relational fluidity with sexual relations. Participants maintained a heterosexual identity, yet modified their self-view to include an identity that reflected their reformed relationship. The majority of the respondents reported sexual lives that were active or evolving. Others remained in relationships that no longer included sexual activity. The study findings highlight the potential fluidity within the sexual and relational lives of females, and can enhance healthcare providers' preparedness and efficacy with diverse populations. Providers are in a unique position to offer resources to patients who identify as sexually or gender-diverse, or who are in relationships with sexually or gender-diverse persons. © 2012 Blackwell Publishing.

  12. Dimensional profiles of male to female gender identity disorder: an exploratory research.

    Science.gov (United States)

    Fisher, Alessandra D; Bandini, Elisa; Ricca, Valdo; Ferruccio, Naika; Corona, Giovanni; Meriggiola, Maria C; Jannini, Emmanuele A; Manieri, Chiara; Ristori, Jiska; Forti, Gianni; Mannucci, Edoardo; Maggi, Mario

    2010-07-01

    Male-to-Female Gender Identity Disorder (MtF GID) is a complex phenomenon that could be better evaluated by using a dimensional approach. To explore the aggregation of clinical manifestations of MtF GID in order to identify meaningful variables describing the heterogeneity of the disorder. A consecutive series of 80 MtF GID subjects (mean age 37 +/- 10.3 years), referred to the Interdepartmental Center for Assistance Gender Identity Disorder of Florence and to other Italian centers from July 2008 to June 2009, was studied. Diagnosis was based on formal psychiatric classification criteria. Factor analysis was performed. Several socio-demographic and clinical parameters were investigated. Patients were asked to complete the Bem Sex Role Inventory (BSRI, a self-rating scale to evaluate gender role) and Symptom Checklist-90 Revised (SCL-90-R, a self-rating scale to measure psychological state). Factor analysis identified two dimensional factors: Factor 1 was associated with sexual orientation, and Factor 2 related to behavioral and psychological correlates of early GID development. No correlation was observed between the two factors. A positive correlation between Factor 2 and feminine BSRI score was found, along with a negative correlation between Factor 2 and undifferentiated BSRI score. Moreover, a significant association between SCL-90-R Phobic subscale score and Factor 2 was observed. A variety of other socio-demographic parameters and clinical features were associated with both factors. Behavioral and psychological correlates of Factor 1 (sexual orientation) and Factor 2 (gender identity) do not constitute the framework of two separate clinical entities, but instead represent two dimensions of the complex MtF GID structure, which can be variably intertwined in the same subject. By using factor analysis, we offer a new approach capable of delineating a psychopathological and clinical profile of MtF GID patients.

  13. Satisfaction and Healthcare Utilization of Transgender and Gender Non-Conforming Individuals in NYC: A Community-Based Participatory Study.

    Science.gov (United States)

    Radix, Anita E; Lelutiu-Weinberger, Corina; Gamarel, Kristi E

    2014-12-01

    Transgender and gender non-conforming (TGNC) individuals face high levels of discrimination and mistreatment, including within social and medical service settings, which may lead to negative health and psychosocial sequelae. Given the many barriers to competent care, we sought to determine points of intervention by assessing the current needs, satisfaction, and health care utilization of TGNC individuals in New York City as reported by TGNC individuals. In January 2013, fifty TGNC individuals were recruited via flyers and direct referrals from healthcare professionals within community spaces and pertinent venues. We administered a brief survey and conducted four focus groups exploring participants' health care utilization and perceived barriers to care, routine care, hormone and silicone use, and recommendations for improving transgender services. Participants were 18- to 64-years-old, racially/ethnically diverse, and the majority were medically insured, underwent routine health care in the last year, and received an HIV test in their lifetime. A significant proportion reported taking hormones prescribed by a medical provider and were in the care of knowledgeable providers. Participants perceived four areas where barriers persisted: utilization of preventive services, access to transition-related procedures, access to legal assistance, and inclusion of TGNC individuals in public health education and campaigns. Structural interventions are needed, such as comprehensive provider training programs for all level staff to better serve the needs of TGNC individuals, increase service utilization and improve wellbeing, while effecting lasting institutional change. Service provision establishments should hire more TGNC staff and integrate transgender care into existing practices.

  14. Factors associated with health care discrimination experiences among a national sample of female-to-male transgender individuals.

    Science.gov (United States)

    Shires, Deirdre A; Jaffee, Kim

    2015-05-01

    Transgender individuals experience harassment, violence, and discrimination in a number of settings. Although health care discrimination against transgender people has been documented, this issue is understudied. Using a national cross-sectional survey data set (N = 1,711), the authors sought to determine how gender identity and presentation predict health care discrimination experiences among female-to-male (FTM) transgender people after demographic and socioeconomic characteristics are controlled. Analyses were conducted using chi-square tests and a two-step logistic regression. The majority of participants were white (73.9 percent) and between 25 and 44 years old (65.2 percent). Overall, 41.8 percent of FTM participants reported verbal harassment, physical assault, or denial of equal treatment in a doctor's office or hospital. When other factors were controlled, being Native American or multiracial, identifying as queer or asexual/other, having a graduate degree, living full-time as nonbirth gender, using hormones or surgery for medical transition, and having identification documents that list one's preferred gender were associated with increased reporting of health care discrimination experiences; being 45 years or older and reporting an annual income of $60,000 or more were associated with decreased risk. The study's findings can be useful to social workers, who play a role in educating health care providers and advocating for policies that improve health care experiences for FTM and other transgender patients.

  15. The Transgender Conundrum

    OpenAIRE

    Tornøe, Marie Schou; Lund, Simone Harlev; Ivanescu, Zlate; Gabriela, Roxana; Edske, Amalie Frejvald; Vigholt Olsen, Nina

    2016-01-01

    This paper aims at investigating the way gender affects identity, with an emphasis on transgender individuals. It explores concepts of identity development and gender identity, uncovering the historical and transformative character of gender by looking into personal stories, statistics and laws in the transgender community. As transgender individuals do not adhere to the normative markers of intelligible reality, by not acting in accordance to the gender roles they were assigned, their very e...

  16. Masculine Voices Predict Well-Being in Female-to-Male Transgender Individuals.

    Science.gov (United States)

    Watt, Seth O; Tskhay, Konstantin O; Rule, Nicholas O

    2018-05-01

    Voices convey important social information about an individual's identity, including gender. This is especially relevant to transgender individuals, who cite voice alteration as a primary goal of the gender alignment process. Although the voice is a primary target of testosterone therapy among female-to-male (FTM) trans people, little research has explored the effects of such changes on their psychological well-being. Here, we investigated how FTMs' vocal gender related to their well-being. A total of 77 FTMs (M age  = 25.45 years, SD = 6.77) provided voice samples and completed measures of their well-being and psychological health. An independent group of 32 naïve raters (M age  = 22.16 years, SD = 8.21) subsequently rated the voice samples for masculinity. We found that FTMs whose voices sounded more congruent with their experienced gender (i.e., sounded more masculine) reported greater well-being (better life satisfaction, quality of life, and self-esteem; lower levels of anxiety and depression) than FTMs with less gender congruent (i.e., more feminine) voices (β = .48). The convergence between outwardly perceived vocal gender and gender identity brought about through hormone replacement therapy may therefore support greater well-being for FTMs.

  17. Mental Health Disparities Within the LGBT Population: A Comparison Between Transgender and Nontransgender Individuals

    OpenAIRE

    Su, Dejun; Irwin, Jay A.; Fisher, Christopher; Ramos, Athena; Kelley, Megan; Mendoza, Diana Ariss Rogel; Coleman, Jason D.

    2016-01-01

    Abstract Purpose: This study assessed within a Midwestern LGBT population whether, and the extent to which, transgender identity was associated with elevated odds of reported discrimination, depression symptoms, and suicide attempts. Methods: Based on survey data collected online from respondents who self-identified as lesbian, gay, bisexual, and/or transgender persons over the age of 19 in Nebraska in 2010, this study performed bivariate t- or chi-square tests and multivariate logistic regre...

  18. Cortical activation during mental rotation in male-to-female and female-to-male transsexuals under hormonal treatment.

    Science.gov (United States)

    Carrillo, Beatriz; Gómez-Gil, Esther; Rametti, Giuseppina; Junque, Carme; Gomez, Angel; Karadi, Kazmer; Segovia, Santiago; Guillamon, Antonio

    2010-09-01

    There is strong evidence of sex differences in mental rotation tasks. Transsexualism is an extreme gender identity disorder in which individuals seek cross-gender treatment to change their sex. The aim of our study was to investigate if male-to-female (MF) and female-to-male (FM) transsexuals receiving cross-sex hormonal treatment have different patterns of cortical activation during a three-dimensional (3D) mental rotation task. An fMRI study was performed using a 3-T scan in a sample of 18 MF and 19 FM under chronic cross-sex hormonal treatment. Twenty-three males and 19 females served as controls. The general pattern of cerebral activation seen while visualizing the rotated and non-rotated figures was similar for all four groups showing strong occipito-parieto-frontal brain activation. However, compared to control males, the activation of MF transsexuals during the task was lower in the superior parietal lobe. Compared to control females, MF transsexuals showed higher activation in orbital and right dorsolateral prefrontal regions and lower activation in the left prefrontal gyrus. FM transsexuals did not differ from either the MF transsexual or control groups. Regression analyses between cerebral activation and the number of months of hormonal treatment showed a significant negative correlation in parietal, occipital and temporal regions in the MF transsexuals. No significant correlations with time were seen in the FM transsexuals. In conclusion, although we did not find a specific pattern of cerebral activation in the FM transsexuals, we have identified a specific pattern of cerebral activation during a mental 3D rotation task in MF transsexuals under cross-sex hormonal treatment that differed from control males in the parietal region and from control females in the orbital prefrontal region. The hypoactivation in MF transsexuals in the parietal region could be due to the hormonal treatment or could reflect a priori cerebral differences between MF transsexual

  19. Understanding and Counseling Transgender Clients

    Science.gov (United States)

    Kirk, James; Belovics, Robert

    2008-01-01

    Because transgender individuals experience widespread employment discrimination, counselors need to understand and be able to work with members of the gay, lesbian, bisexual, and transgender communities. The aim of this article is to help counselors become more transgender literate by (a) defining gender dysphoric disorder and related terms; (b)…

  20. Living Outside the Gender Box in Mexico: Testimony of Transgender Mexican Asylum Seekers.

    Science.gov (United States)

    Cheney, Marshall K; Gowin, Mary J; Taylor, E Laurette; Frey, Melissa; Dunnington, Jamie; Alshuwaiyer, Ghadah; Huber, J Kathleen; Garcia, Mary Camero; Wray, Grady C

    2017-10-01

    To explore preimmigration experiences of violence and postimmigration health status in male-to-female transgender individuals (n = 45) from Mexico applying for asylum in the United States. We used a document review process to examine asylum declarations and psychological evaluations of transgender Mexican asylum seekers in the United States from 2012. We coded documents in 2013 and 2014 using NVivo, a multidisciplinary team reviewed them, and then we analyzed them for themes. Mexican transgender asylum applicants experienced pervasive verbal, physical, and sexual abuse from multiple sources, including family, school, community, and police. Applicants also experienced discrimination in school and in the workplace. Applicants immigrated to the United States to escape persistent assaults and threats to their life. Applicants suffered health and psychological effects from their experiences in Mexico that affected opportunities in the United States for employment, education, and social inclusion. Additional social protections for transgender individuals and antidiscrimination measures in Mexican schools and workplaces are warranted as are increased mental health assessment and treatment, job training, and education services for asylum seekers in the United States.

  1. Birth Order and Sibling Sex Ratio in a Population with High Fertility: Are Turkish Male to Female Transsexuals Different?

    Science.gov (United States)

    Bozkurt, Ali; Bozkurt, Ozlem Hekim; Sonmez, Ipek

    2015-07-01

    Western studies have consistently found that androphilic (sexually attracted to men) male-to-female transsexuals have a later birth order and a relative excess of brothers compared with appropriate control participants. However, non-Western studies on birth order and sibling sex ratio in androphilic males (transsexual or non-transsexual) are rare. The objective of the study was to test the hypothesis that androphilic male-to-female transsexuals have a late birth order and a relative excess of brothers in a non-Western culture with a higher fertility rate. The participants were 60 androphilic male-to-female transsexuals and 61 male heterosexual controls. The transsexual participants had significantly more older brothers than the control participants, but the groups did not differ in their numbers of older sisters, younger brothers, or younger sisters. The foregoing pattern is usually referred to as the "fraternal birth order effect." Slater's and Berglin's Indexes both showed that the mean birth order of the control participants was very close to that expected from a random sample drawn from a demographically stable population whereas the mean birth order of the transsexual participants was later. A measure of sibship composition, brothers/all siblings, showed that the transsexual group had a higher proportion of male siblings compared with the control group. In conclusion, the present study found that Turkish androphilic male-to-female transsexuals show the same high fraternal birth order that has been found in comparable androphilic samples in Western Europe, North America, and the South Pacific, which suggests a common underlying biological causal mechanism.

  2. SEX REASSIGNMENT SURGERY WITH LAPAROSCOPIC SIGMOID COLON VAGINOPLASTY IN A MALE TO FEMALE TRANSSEXUAL: A CASE REPORT.

    Science.gov (United States)

    Ichihara, Koji; Masumori, Naoya

    2016-01-01

    We herein report and discuss our first experience about a sex reassignment surgery (SRS) with laparoscopic sigmoid colon vaginoplasty for a 40s male to female gender identity disorder. SRS for this subject included bilateral orchiectomy, penectomy, clitoroplasty, vaginoplasty, and vulvoplasty. About 20 cm of the sigmoid colon was harvested laparoscopicaly for the neovagina. Total operating time was about 9 hours, and the estimated blood loss was 900 ml without transfusion. There was no trouble during the postoperative course, and a sufficient length of vagina has been maintained.

  3. What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Loomes, Rachel; Hull, Laura; Mandy, William Polmear Locke

    2017-06-01

    To derive the first systematically calculated estimate of the relative proportion of boys and girls with autism spectrum disorder (ASD) through a meta-analysis of prevalence studies conducted since the introduction of the DSM-IV and the International Classification of Diseases, Tenth Revision. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The Medline, Embase, and PsycINFO databases were searched, and study quality was rated using a risk-of-bias tool. Random-effects meta-analysis was used. The pooled outcome measurement was the male-to-female odds ratio (MFOR), namely the odds of being male in the group with ASD compared with the non-ASD group. In effect, this is the ASD male-to-female ratio, controlling for the male-to-female ratio among participants without ASD. Fifty-four studies were analyzed, with 13,784,284 participants, of whom 53,712 had ASD (43,972 boys and 9,740 girls). The overall pooled MFOR was 4.20 (95% CI 3.84-4.60), but there was very substantial between-study variability (I 2  = 90.9%). High-quality studies had a lower MFOR (3.32; 95% CI 2.88-3.84). Studies that screened the general population to identify participants regardless of whether they already had an ASD diagnosis showed a lower MFOR (3.25; 95% CI 2.93-3.62) than studies that only ascertained participants with a pre-existing ASD diagnosis (MFOR 4.56; 95% CI 4.10-5.07). Of children meeting criteria for ASD, the true male-to-female ratio is not 4:1, as is often assumed; rather, it is closer to 3:1. There appears to be a diagnostic gender bias, meaning that girls who meet criteria for ASD are at disproportionate risk of not receiving a clinical diagnosis. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  4. The Transgender Military Experience

    Directory of Open Access Journals (Sweden)

    Michelle Dietert

    2015-04-01

    Full Text Available Although there have been studies that focus on the experiences of the gay and lesbian population serving in the United States military, few have focused on the experience of active duty transgender service members. Transgender individuals transgress the binary conception of gender by deviating from societal gender norms associated with assigned sex at birth. The Department of Defense has set policies and standards that reflect a binary conception of gender, with a focus on conformity. We argue that able-bodied gender variant service personnel are just as capable of serving their country as anyone else. Because of the repercussions associated with active duty transgender military personnel, our sample is small and involves nine clandestine service members and two international service members who wanted to share their stories from a different perspective. Snowball sampling was aimed at finding current active duty and reserve transgender service members. Using a combination of telephone interviews and questionnaires, data were collected from active duty transgender service personnel throughout the United States and two from international militaries that allow transgender people to serve. Data collection focused on the overall experiences of the participants along with questions regarding workplace discrimination, suggestions for policy changes, and their views about the overturn of Don’t Ask, Don’t Tell. Our findings add to a growing source of information about the transgender military experience in the U.S. armed forces and the importance of overturning discriminatory workplace policies that negatively impact transgender service members.

  5. Policing Transgender People

    Directory of Open Access Journals (Sweden)

    Toby Miles-Johnson

    2015-04-01

    Full Text Available Police policy documents often articulate strategies and approaches that police organizations want to implement in their efforts to break down barriers with minority groups. However, most police policy documents are written for police audiences and not for members of the public. Police policy documents serve as a reflection of the aspirations of the agency and not necessarily the practice of the officers. Differential policing has been a salient experience for members of transgender communities because, as individuals who express gender in ways that deviate from the norm, they have experienced numerous documented cases of police mismanaged practice. In Australia, achieving police reform in the area of policing of diverse community groups has been difficult as new initiatives implemented to educate police officers about diverse groups such as transgender communities are scarce. My study sought to analyze a police policy document to assess how one police agency’s policy aspires to shape police contact/experiences with transgender people and how this document might shape intergroup identity differences between transgender people and the police. It is argued that the policy document will negatively affect police perceptions of transgender people and may enhance adverse perceptions of intergroup difference between police and transgender people. I also argue that using this document to achieve police reform in the area of policing of transgender people will be problematic as the policy document lacks substantial procedural guidelines regarding interaction with transgender people and may not favorably constrain discretionary police power.

  6. Exploring the diversity of gender and sexual orientation identities in an online sample of transgender individuals.

    Science.gov (United States)

    Kuper, Laura E; Nussbaum, Robin; Mustanski, Brian

    2012-01-01

    Although the term transgender is increasingly used to refer to those whose gender identity or expression diverges from culturally defined categories of sex and gender, less is known about the self-identities of those who fall within this category. Historically, recruitment of transgender populations has also been limited to specialized clinics and support groups. This study was conducted online, with the aim of exploring the gender identities, sexual orientation identities, and surgery and hormonal statuses of those who identify with a gender identity other than, or in addition to, that associated with their birth sex (n = 292). Genderqueer was the most commonly endorsed gender identity, and pansexual and queer were the most commonly endorsed sexual orientation identities. Participants indentified with a mean of 2.5 current gender identities, 1.4 past gender identities, and 2 past sexual orientation identities. The majority of participants either did not desire or were unsure of their desire to take hormones or undergo sexual reassignment surgery. However, birth sex and age were significant predictors of "bottom" surgery and hormone status/desire, along with several identities and orientations. This study explores explanations and implications for these patterns of identification, along with the potential distinctiveness of this sample.

  7. Gender and Sexual Health: Care of Transgender Patients.

    Science.gov (United States)

    Hayon, Ronni

    2016-10-01

    Transgender and gender-nonconforming individuals experience significant health disparities. They are more likely to use drugs and alcohol, smoke, be diagnosed with HIV infection or other sexually transmitted infections, and experience depression or attempt suicide. Many also experience discrimination within the health care system. Office-level strategies to create a safe and affirming space for gender-expansive patients include posting of a nondiscrimination statement, use of intake forms that ask about current gender identity and birth-assigned sex, provision of gender-neutral restrooms, and staff training in use of appropriate language. Hormone or surgical therapy can be initiated for patients with persistent gender dysphoria who are of age and have the capacity to make informed decisions, and have reasonable control of coexisting medical and psychiatric conditions. Estrogens, antiandrogens, and progestins are used for feminization, and testosterone for masculinization. Hormone treatment should be followed by careful monitoring for potential adverse effects. Surgical options include male-to-female and female-to-male procedures. The family physician may need to provide a referral letter, preoperative and postoperative examinations and care, and advocacy with health insurance providers. Preventive care for transgender patients includes counseling for cardiovascular health, cancer screening, provision of appropriate contraception, and screening for sexually transmitted infections. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  8. Armed conflict, homonegativity and forced internal displacement: implications for HIV among Colombian gay, bisexual and transgender individuals.

    Science.gov (United States)

    Zea, Maria Cecilia; Reisen, Carol A; Bianchi, Fernanda T; Gonzales, Felisa A; Betancourt, Fabián; Aguilar, Marcela; Poppen, Paul J

    2013-01-01

    Colombia has endured six decades of civil unrest, population displacement and violence. We examined the relationships between contextual conditions, displacement and HIV among gay, bisexual and transgender individuals in Bogotá, Colombia. A total of 19 key informants provided information about internal displacement of sexual minorities. Life-history interviews were conducted with 42 participants aged 18 to 48 years and included questions about displacement experiences, sexual behaviour, life prior to displacement and participants' economic and social situation in Bogotá. The interplay of a variety of factors - including internal conflict and violence, homonegativity and 'social cleansing', gender and sexual identity and poverty - strongly shaped the varied experiences of displacement. Migration, sexual violence, exchange sex and low rates of HIV testing were risk factors that increased vulnerability for HIV in this displaced sample. Although displacement and HIV in Colombia are major problems, both are understudied.

  9. Transgender community belongingness as a mediator between strength of transgender identity and well-being.

    Science.gov (United States)

    Barr, Sebastian M; Budge, Stephanie L; Adelson, Jill L

    2016-01-01

    This study examined transgender community belongingness as a mediator between strength of transgender identity and well-being. A total of 571 transgender adults (n = 209 transgender women, n = 217 transgender men, and n = 145 nonbinary-identified individuals) completed an online survey assessing transgender community belongingness, strength of transgender identity (operationalized as the extent to which a person self-categorizes their identity as transgender and the extent to which they believe their gender transition to be important to their self-definition), and well-being (using measures of self-esteem, satisfaction with life, and psychological well-being). Structural equation modeling was used to analyze the data. When controlling for participants' income, age, and stage of gender transition, transgender community belongingness fully mediated the relationship between strength of transgender identity and well-being. Strength of transgender identity was indirectly and positively related to well-being through community belongingness, but was not directly related to well-being. Results suggest that transgender community belongingness is an important construct in the mental health of transgender people. The strength of a person's transgender identity also appears to be a significant construct in transgender people's well-being via its relationship with transgender community belongingness. Implications of the findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. High impact of sleeping problems on quality of life in transgender individuals: A cross-sectional multicenter study.

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    Matthias K Auer

    Full Text Available Studies in the general population suggest that determinants of QoL are often sex-dependent. Sex-dependent analyses of QoL in transgender populations have not been performed so far.To identify sex-specific and potentially modifiable determinants of QoL in transgender patients.In this cross-sectional multicentre study including 82 transwomen (TW and 72 transmen (TM at different treatment stages, we investigated potential determinants for QoL focusing on the impact of mood (BDI, STAI-X, sleep quality (PSQI, chronic pain (GPQ, body image (FBeK and social support (SSS.Health-related quality of life measured with the Short Form (36 Health Survey (SF-36.The age-adjusted SF-36 total score and its subscales did not significantly differ between TM and TW. Using a multivariate regression analysis approach, we identified common but also sex-dependent determinants for QoL (Adjusted R2 = 0.228; 0.650 respectively. Accounting for general characteristics such as age, BMI and treatment status, sleep quality according to the PSQI was an independent and strong determinant of QoL in both sexes (β = -0.451, p = 0.003 TM; β = -0.320; p = 0.0029 TW. Chronic pain was a significant independent predictor of QoL in TM (β = -0.298; p = 0.042 but not in TW. In contrast, anxiety (β = -0.451; p< 0.001 being unemployed (β = -0.206; p = 0.020 and insecurity about the own appearance (FBeK (β = -0.261; p = 0.01 were independent predictors of QoL in TW. The rate of those reporting high sleep disturbances (PSQI ≥5 was high with 79.2% in TW and 81.2% in TM. Accordingly, age-adjusted QoL was also significantly lower in those reporting poor sleep in both sexes.Sleep strongly affected QoL in both genders, while other factors, like pain and body image, seem to be gender specific in transgender individuals.

  11. Infecciones de transmisión sexual en personas transgénero y otras identidades sexuales Sexually transmitted infections among transgender individuals and other sexual identities

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    Javier J. Toibaro

    2009-06-01

    Full Text Available Existen pocos datos disponibles acerca del comportamiento de riesgo y la prevalencia de infecciones de transmisión sexual (ITS, incluyendo HIV-1, en personas transgénero. El objetivo del estudio fue comparar las características demográficas, factores de riesgo, prevalencia de HIV-1 e ITS en personas transgénero versus personas no transgénero que consultan al Centro de Prevención, Asesoramiento y Diagnóstico del Hospital General de Agudos J.M. Ramos Mejía. Se utilizó el diseño de estudio de corte transversal y se incluyeron pacientes asistidos en nuestro centro que firmaron consentimiento informado entre noviembre de 2002 y abril de 2006. Se obtuvieron datos sociodemográficos, uso de drogas, utilización de preservativos, nivel de educación alcanzado, diagnóstico de ITS y estado actual de la pareja. Se utilizó estadística descriptiva y chi² para comparar proporciones. En la población estudiada (n: 4118 se identificaron a 105 personas transgénero. La prevalencia de infección por HIV-1 fue del 27.6% (29/105, mientras que en personas no transgénero (n: 4013 fue de 6.2% (247/4013; p:0.0000. El bajo nivel educativo, el consumo de alcohol, el abuso de drogas, los antecedentes de ITS y el trabajo sexual (100% en transgénero y 2.3% en no transgénero fueron más frecuentes en personas transgénero. La prevalencia de sífilis fue del 42% en personas transgénero y del 18% en personas no transgénero. Estos datos demuestran que las personas transgénero que consultan en nuestro centro tienen alta prevalencia de infección por HIV-1 e ITS. Esta información podría contribuir al diseño de estrategias de prevención necesarias en esta población.Few data are available regarding the prevalence of sexually transmitted infections (STI, including HIV-1 infection, and risk behaviors of transgender individuals. Previous reports indicate that this community has a high prevalence of HIV and STIs. Our objective was to compare the prevalence of

  12. Transgender youth: current concepts

    Science.gov (United States)

    2016-01-01

    In many countries throughout the world, increasing numbers of gender nonconforming/transgender youth are seeking medical services to enable the development of physical characteristics consistent with their experienced gender. Such medical services include use of agents to block endogenous puberty at Tanner stage II with subsequent use of cross-sex hormones, and are based on longitudinal studies demonstrating that those individuals who were first identified as gender dysphoric in early or middle childhood and continue to meet the mental health criteria for being transgender at early puberty are likely to be transgender as adults. This review addresses terms and definitions applicable to gender nonconforming youth, studies that shed light on the biologic determinants of gender identity, current clinical practice guidelines for transgender youth, challenges to optimal care, and priorities for research. PMID:28164070

  13. Transgender youth: current concepts

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    Stephen M. Rosenthal

    2016-12-01

    Full Text Available In many countries throughout the world, increasing numbers of gender nonconforming/transgender youth are seeking medical services to enable the development of physical characteristics consistent with their experienced gender. Such medical services include use of agents to block endogenous puberty at Tanner stage II with subsequent use of cross-sex hormones, and are based on longitudinal studies demonstrating that those individuals who were first identified as gender dysphoric in early or middle childhood and continue to meet the mental health criteria for being transgender at early puberty are likely to be transgender as adults. This review addresses terms and definitions applicable to gender nonconforming youth, studies that shed light on the biologic determinants of gender identity, current clinical practice guidelines for transgender youth, challenges to optimal care, and priorities for research.

  14. Terrorist attacks and the male-to-female ratio at birth: The Troubles in Northern Ireland, the Rodney King riots, and the Breivik and Sandy Hook shootings.

    Science.gov (United States)

    Grech, Victor

    2015-12-01

    Males are usually born in excess of females. The ratio is often expressed as M/F (male divided by total births). A wide variety of factors have been shown to influence M/F. Terrorist attacks reduce M/F. This study was carried out in order to ascertain whether individual terrorist attacks influenced M/F in relevant populations. The following events were studied: the Troubles in Northern Ireland, the Los Angeles Riots (the Rodney King affair), the Breivik shooting (Norway), and the Sandy Hook shooting (Connecticut). Northern Ireland M/F was significantly lower during the Troubles (1969-1998) than during the period before (p=0.0006). There was a very sharp dip in 1978 (p≤0.004) during this particular year of renewed violence and heavy civilian attacks. Rodney King riots-late April 1992 M/F dipped significantly in August 1992, 4months after the riots (p=0.044). Breivik Shooting-22/07/2011 M/F dipped significantly in December 2011, 5months after the event (p=0.004). Sandy Hook Shooting-14/12/2012 M/F dipped significantly in April 2013, 4months after the event (p=0.009). M/F dips follow catastrophic or tragic events if these are felt to be momentous enough by a given population. All of the above events caused significant population stress. The M/F dips noted may have been caused by population stress which is known to lead to the culling of frail/small male foetuses. The dips noted are comparable to a substantial proportion of quoted values for perinatal mortality, potentially elevating this a public health issue. 1. The male-to-female ratio at birth is decreased by stressful events. 2. This is due to an excess of male foetal losses in established pregnancies. 3. Such losses in response to acute events are transient. 4. This ratio may be a useful indicator of population stress. RESEARCH DIRECTIONS: 1. Gender ratios in populations could be routinely monitored in order to assess the impact of stressful events that may reduce the male-to-female birth ratio. Copyright

  15. Sex-specific differences in hemodialysis prevalence and practices and the male-to-female mortality rate: the Dialysis Outcomes and Practice Patterns Study (DOPPS.

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    Manfred Hecking

    2014-10-01

    Full Text Available BACKGROUND: A comprehensive analysis of sex-specific differences in the characteristics, treatment, and outcomes of individuals with end-stage renal disease undergoing dialysis might reveal treatment inequalities and targets to improve sex-specific patient care. Here we describe hemodialysis prevalence and patient characteristics by sex, compare the adult male-to-female mortality rate with data from the general population, and evaluate sex interactions with mortality. METHODS AND FINDINGS: We assessed the Human Mortality Database and 206,374 patients receiving hemodialysis from 12 countries (Australia, Belgium, Canada, France, Germany, Italy, Japan, New Zealand, Spain, Sweden, the UK, and the US participating in the international, prospective Dialysis Outcomes and Practice Patterns Study (DOPPS between June 1996 and March 2012. Among 35,964 sampled DOPPS patients with full data collection, we studied patient characteristics (descriptively and mortality (via Cox regression by sex. In all age groups, more men than women were on hemodialysis (59% versus 41% overall, with large differences observed between countries. The average estimated glomerular filtration rate at hemodialysis initiation was higher in men than women. The male-to-female mortality rate ratio in the general population varied from 1.5 to 2.6 for age groups <75 y, but in hemodialysis patients was close to one. Compared to women, men were younger (mean = 61.9 ± standard deviation 14.6 versus 63.1 ± 14.5 y, were less frequently obese, were more frequently married and recipients of a kidney transplant, more frequently had coronary artery disease, and were less frequently depressed. Interaction analyses showed that the mortality risk associated with several comorbidities and hemodialysis catheter use was lower for men (hazard ratio [HR] = 1.11 than women (HR = 1.33, interaction p<0.001. This study is limited by its inability to establish causality for the observed sex

  16. Differences in personality traits between male-to-female and female-to-male gender identity disorder subjects.

    Science.gov (United States)

    Miyajima, Eiichi; Taira, Naoki; Koda, Munenaga; Kondo, Tsuyoshi

    2014-12-15

    The present study aimed to investigate differences in personality traits among male-to-female (MtF), female-to-male (FtM) gender identity disorder (GID) subjects and non-transsexual male (M) and female (F) controls. Subjects were 72 MtF and 187 FtM GID subjects without psychiatric comorbidities together with 184 male and 159 female non-transsexual controls. Personality traits were assessed using a short version of the Temperament and Character Inventory (TCI-125). Group comparisons were made by two-way ANOVA. Statistical significances were observed as follows: 1) lower novelty seeking in FtM than in M or MtF, 2) higher reward dependence in FtM than in M, 3) higher cooperativeness in FtM than in M or MtF, 4) the highest self-transcendence in MtF among all the groups. The highest self-transcendence in MtF subjects may reflect their vulnerable identity and constrained adaptation to society as the minority. Nevertheless, higher reward dependence and cooperativeness in FtM subjects can be related to more determined motivation for the treatments of GID and might promise better social functioning and adjustment than MtF subjects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Transgender Discrimination and the Law

    Science.gov (United States)

    Trotter, Richard

    2010-01-01

    An emerging area of law is developing regarding sex/gender identity discrimination, also referred to as transgender discrimination, as distinguished from discrimination based on sexual orientation. A transgendered individual is defined as "a person who has a gender-identity disorder which is a persistent discomfort about one?s assigned sex or…

  18. Social factors and aromatase gene expression during adult male-to-female sex change in captive leopard grouper Mycteroperca rosacea.

    Science.gov (United States)

    Romo-Mendoza, Daniel; Campos-Ramos, Rafael; Vázquez-Islas, Grecia; Burgos-Aceves, Mario A; Esquivel-Gutiérrez, Edgar R; Guerrero-Tortolero, Danitzia A

    2018-01-25

    Social factors and aromatase gene expression in the leopard grouper Mycteroperca rosacea was studied when captive fish were separated by sex during the reproductive (April-June) and post-reproductive (July-September) seasons. Monosex females, monosex males, and mixed-sex, held in social sextet units were analyzed for sex steroids throughout confinement. At the end of the experiment, the gonad-sex was defined by histology, and gonad and brain aromatase gene expressions were quantified. Only males held in the monosex social units changed sex. Histology showed one male remained unchanged, six were found in a transitional sexual stage, in which two had intersex-predominantly-testes, and four had a more defined intersex ovo-testes pattern, and 11 were immature de novo females (neofemales). Neofemales and most intersex fish did not survive. In spring, 11-ketosterone showed a specific male profile, which suggests that male-to-female sex change was not triggered during the reproductive season. The low steroid levels in summer made it impossible to associate the sex change to a gonad hormonal shift; in September, gonad aromatase gene expression was not significantly different among groups. However, brain aromatase expression in intersex fish was significantly higher than monosex females, mixed-sex females, and neofemale groups. These results suggest that in the absence of female hormonal compounds, and at a time when male gonad steroidogenesis was diminished, the brain mediated male-to-male social-behavioral interactions, including stress, by increasing aromatization, resulting in derived intersex-male, which triggered more aromatization, followed by a sex change. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Neuroimaging differences in spatial cognition between men and male-to-female transsexuals before and during hormone therapy.

    Science.gov (United States)

    Schöning, Sonja; Engelien, Almut; Bauer, Christine; Kugel, Harald; Kersting, Anette; Roestel, Cornelia; Zwitserlood, Pienie; Pyka, Martin; Dannlowski, Udo; Lehmann, Wolfgang; Heindel, Walter; Arolt, Volker; Konrad, Carsten

    2010-05-01

    Neuropsychological abnormalities in transsexual patients have been reported in comparison with subjects without gender identity disorder (GID), suggesting differences in underlying neurobiological processes. However, these results have not consistently been confirmed. Furthermore, studies on cognitive effects of cross-sex hormone therapy also yield heterogeneous results. We hypothesized that untreated transsexual patients differ from men without GID in activation pattern associated with a mental rotation task and that these differences may further increase after commencing of hormonal treatment. The present study investigated 11 male-to-female transsexual (MFTS) patients prior to cross-sex hormone therapy and 11 MFTS patients during hormone therapy in comparison with healthy men without GID. Using functional magnetic resonance imaging at 3-Tesla, a mental rotation paradigm with proven sexual dimorphism was applied to all subjects. Data were analyzed with SPM5. Patterns of brain activation associated with a mental rotation task. The classical mental rotation network was activated in all three groups, but significant differences within this network were observed. Men without GID exhibited significantly greater activation of the left parietal cortex (BA 40), a key region for mental rotation processes. Both transsexual groups revealed stronger activation of temporo-occipital regions in comparison with men without GID. Our results confirmed previously reported deviances of brain activation patterns in transsexual men from men without GID and also corroborated these findings in a group of transsexual patients receiving cross-sex hormone therapy. The present study indicates that there are a priori differences between men and transsexual patients caused by different neurobiological processes or task-solving strategies and that these differences remain stable over the course of hormonal treatment.

  20. A report from a single institute's 14-year experience in treatment of male-to-female transsexuals.

    Science.gov (United States)

    Imbimbo, Ciro; Verze, Paolo; Palmieri, Alessandro; Longo, Nicola; Fusco, Ferdinando; Arcaniolo, Davide; Mirone, Vincenzo

    2009-10-01

    Gender identity disorder or transsexualism is a complex clinical condition, and prevailing social context strongly impacts the form of its manifestations. Sex reassignment surgery (SRS) is the crucial step of a long and complex therapeutic process starting with preliminary psychiatric evaluation and culminating in definitive gender identity conversion. The aim of our study is to arrive at a clinical and psychosocial profile of male-to-female transsexuals in Italy through analysis of their personal and clinical experience and evaluation of their postsurgical satisfaction levels SRS. From January 1992 to September 2006, 163 male patients who had undergone gender-transforming surgery at our institution were requested to complete a patient satisfaction questionnaire. The questionnaire consisted of 38 questions covering nine main topics: general data, employment status, family status, personal relationships, social and cultural aspects, presurgical preparation, surgical procedure, and postsurgical sex life and overall satisfaction. Average age was 31 years old. Seventy-two percent had a high educational level, and 63% were steadily employed. Half of the patients had contemplated suicide at some time in their lives before surgery and 4% had actually attempted suicide. Family and colleague emotional support levels were satisfactory. All patients had been adequately informed of surgical procedure beforehand. Eighty-nine percent engaged in postsurgical sexual activities. Seventy-five percent had a more satisfactory sex life after SRS, with main complications being pain during intercourse and lack of lubrication. Seventy-eight percent were satisfied with their neovagina's esthetic appearance, whereas only 56% were satisfied with depth. Almost all of the patients were satisfied with their new sexual status and expressed no regrets. Our patients' high level of satisfaction was due to a combination of a well-conducted preoperative preparation program, competent surgical skills

  1. HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review

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    Songyuan Tang

    2016-10-01

    Full Text Available Abstract Background Despite global efforts to control HIV among key populations, new infections among men who have sex with men (MSM and transgender (TG individuals are still increasing. The increasing HIV epidemic among MSM/TG in China indicates that more effective services are urgently needed. However, policymakers and program managers must have a clear understanding of MSM/TG sexual health in China to improve service delivery. To meet this need, we undertook a scoping review to summarize HIV epidemiology and responses among MSM and TG individuals in China. Methods We searched MEDLINE, EMBASE and the Cochrane Library for recent studies on MSM/TG HIV epidemiology and responses. We also included supplemental articles, grey literature, government reports, policy documents, and best practice guidelines. Results Overall, HIV prevalence among Chinese MSM was approximately 8 % in 2015 with a higher prevalence observed in Southwest China. TG are not captured in national HIV, STD, or other sexual health surveillance systems. There is limited data sharing between the public health authorities and community-based organizations (CBOs. Like other low and middle income countries, China is challenged by low rates of HIV testing, linkage, and retention. Several pilot interventions have been shown to be effective to increase HIV testing among MSM and TG individuals, but have not been widely scaled up. Data from two randomized controlled trials suggests that crowdsourcing contests can increase HIV testing, creating demand for services while engaging communities. Conclusion Improving HIV surveillance and expanding HIV interventions for Chinese MSM and TG individuals are essential. Further implementation research is needed to ensure high-quality HIV services for MSM and TG individuals in China.

  2. Factors associated with sexual violence against men who have sex with men and transgendered individuals in Karnataka, India.

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    Souradet Y Shaw

    Full Text Available There is a lack of information on sexual violence (SV among men who have sex with men and transgendered individuals (MSM-T in southern India. As SV has been associated with HIV vulnerability, this study examined health related behaviours and practices associated with SV among MSM-T.Data were from cross-sectional surveys from four districts in Karnataka, India.Multivariable logistic regression models were constructed to examine factors related to SV. Multivariable negative binomial regression models examined the association between physician visits and SV.A total of 543 MSM-T were included in the study. Prevalence of SV was 18% in the past year. HIV prevalence among those reporting SV was 20%, compared to 12% among those not reporting SV (p = .104. In multivariable models, and among sex workers, those reporting SV were more likely to report anal sex with 5+ casual sex partners in the past week (AOR: 4.1; 95%CI: 1.2-14.3, p = .029. Increased physician visits among those reporting SV was reported only for those involved in sex work (ARR: 1.7; 95%CI: 1.1-2.7, p = .012.These results demonstrate high levels of SV among MSM-T populations, highlighting the importance of integrating interventions to reduce violence as part of HIV prevention programs and health services.

  3. [Surgery of the breast on transgender persons].

    Science.gov (United States)

    Karhunen-Enckell, Ulla; Kolehmainen, Maija; Kääriäinen, Minna; Suominen, Sinikka

    2015-01-01

    For a female-to-male transgender person, mastectomy is the most important procedure making the social interaction easier. Along with the size of the breasts, the quantity and quality of skin will influence the selection of surgical technique. Although complications are rare, corrective surgery is performed for as many as 40% of the patients. Of male-to-female transsexual persons, 60 to 70% opt for breast enlargement. Breast enlargement can be carried out by using either silicone implants or fat transplantation. Since the surgical procedures on breasts are irreversible, their implementation requires confirmation of the diagnosis of transsexualism by a multidisciplinary team.

  4. Experiences of Transgender-Related Discrimination and Implications for Health: Results From the Virginia Transgender Health Initiative Study

    Science.gov (United States)

    Reisner, Sari L.; Honnold, Julie A.; Xavier, Jessica

    2013-01-01

    Objectives. We examined relationships between social determinants of health and experiences of transgender-related discrimination reported by transgender people in Virginia. Methods. In 2005 through 2006, 387 self-identified transgender people completed a statewide health needs assessment; 350 who completed eligibility questions were included in this examination of factors associated with experiences of discrimination in health care, employment, or housing. We fit multivariate logistic regression models using generalized estimating equations to adjust for survey modality (online vs paper). Results. Of participants, 41% (n = 143) reported experiences of transgender-related discrimination. Factors associated with transgender-related discrimination were geographic context, gender (female-to male spectrum vs male-to-female spectrum), low socioeconomic status, being a racial/ethnic minority, not having health insurance, gender transition indicators (younger age at first transgender awareness), health care needed but unable to be obtained (hormone therapy and mental health services), history of violence (sexual and physical), substance use health behaviors (tobacco and alcohol), and interpersonal factors (family support and community connectedness). Conclusions. Findings suggest that transgender Virginians experience widespread discrimination in health care, employment, and housing. Multilevel interventions are needed for transgender populations, including legal protections and training for health care providers. PMID:23153142

  5. Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study.

    Science.gov (United States)

    Bradford, Judith; Reisner, Sari L; Honnold, Julie A; Xavier, Jessica

    2013-10-01

    We examined relationships between social determinants of health and experiences of transgender-related discrimination reported by transgender people in Virginia. In 2005 through 2006, 387 self-identified transgender people completed a statewide health needs assessment; 350 who completed eligibility questions were included in this examination of factors associated with experiences of discrimination in health care, employment, or housing. We fit multivariate logistic regression models using generalized estimating equations to adjust for survey modality (online vs paper). Of participants, 41% (n = 143) reported experiences of transgender-related discrimination. Factors associated with transgender-related discrimination were geographic context, gender (female-to male spectrum vs male-to-female spectrum), low socioeconomic status, being a racial/ethnic minority, not having health insurance, gender transition indicators (younger age at first transgender awareness), health care needed but unable to be obtained (hormone therapy and mental health services), history of violence (sexual and physical), substance use health behaviors (tobacco and alcohol), and interpersonal factors (family support and community connectedness). Findings suggest that transgender Virginians experience widespread discrimination in health care, employment, and housing. Multilevel interventions are needed for transgender populations, including legal protections and training for health care providers.

  6. Social network characteristics and HIV vulnerability among transgender persons in San Salvador: identifying opportunities for HIV prevention strategies.

    Science.gov (United States)

    Barrington, Clare; Wejnert, Cyprian; Guardado, Maria Elena; Nieto, Ana Isabel; Bailey, Gabriela Paz

    2012-01-01

    The purpose of this study is to improve understanding of HIV vulnerability and opportunities for HIV prevention within the social networks of male-to-female transgender persons in San Salvador, El Salvador. We compare HIV prevalence and behavioral data from a sample of gay-identified men who have sex with men (MSM) (n = 279), heterosexual or bisexual identified MSM (n = 229) and transgender persons (n = 67) recruited using Respondent Driven Sampling. Transgender persons consistently reported higher rates of HIV risk behavior than the rest of the study population and were significantly more likely to be involved in sex work. While transgender persons reported the highest rates of exposure to HIV educational activities they had the lowest levels of HIV-related knowledge. Transgender respondents' social networks were homophilous and efficient at recruiting other transgender persons. Findings suggest that transgender social networks could provide an effective and culturally relevant opportunity for HIV prevention efforts in this vulnerable population.

  7. The Occurrence of Male-to-Female Intimate Partner Violence on Days of Men's Drinking: The Moderating Effects of Antisocial Personality Disorder

    Science.gov (United States)

    Fals-Stewart, William; Leonard, Kenneth E.; Birchler, Gary R.

    2005-01-01

    In this study, the moderating effects of antisocial personality disorder (ASPD) on the day-to-day relationship between male partner alcohol consumption and male-to-female intimate partner violence (IPV) for men entering a domestic violence treatment program (n = 170) or an alcoholism treatment program (n = 169) were examined. For both samples,…

  8. [Psychiatric comorbidities in transsexualism: Study of a Lebanese transgender population].

    Science.gov (United States)

    Ibrahim, C; Haddad, R; Richa, S

    2016-12-01

    The question of whether gender dysphoria is associated with psychiatric comorbidity has been addressed in several studies. Several cohort studies have shown that psychiatric comorbidity is one of the main features of poor prognosis following sex change therapy. Gender dysphoria is rare, with an estimated prevalence of 0.001% to 0.002% globally. The literature shows a high prevalence of psychiatric comorbidities in people with gender dysphoria, and that they are more common in male to female transsexuals. Data on long-term mortality show that transsexuals present a 51 % increase in mortality compared to the general population. This is mainly attributed to a six-fold increase in the number of suicides and a higher rate of psychiatric disorders and risky behaviors leading to HIV infection and substance abuse. Assess psychiatric comorbidity in a population of Lebanese transgender individuals and compare it to the general population. The hypothesis of our study is that the Lebanese transgenders suffer from more psychiatric comorbidities than the general population. Our second objective was to determine the specific mental health needs of this population in order to adapt our services to their medical needs and their specific concerns. Our objective was to acquire 20 transgender participants and 20 control subjects. We chose a snowball sampling method. The evaluation consisted of three questionnaires including a general demographic questionnaire, the MINI 5.0.0 Arabic version for axis I disorders and the SCID-II for axis II disorders. The mean age of both groups was 23.55 years. Fifty-five percent (n=11) transgender participants had active suicidal thoughts against 0 % in controls. Within the group of transgender, 45 % (n=9) had a major depressive episode, 5 % (n=1) had a generalized anxiety disorder, 5 % (n=1) had a posttraumatic stress disorder and 10 % (n=2) had a major depressive episode with comorbid posttraumatic stress disorder. We noted a significant

  9. Wendler glottoplasty and voice-therapy in male-to-female transsexuals: results in pre and post-surgery assessment.

    Science.gov (United States)

    Casado, Juan C; O'Connor, Carlos; Angulo, María S; Adrián, José A

    2016-01-01

    With the development of new ENT techniques, many male transsexuals who wish to become women usually request a surgical procedure to raise the fundamental frequency of the voice (feminization). The ENT specialist and the voice-therapist have to use an interdisciplinary approach to this growing social demand. The aim of this study was to show the results in a group of transsexual patients after Wendler's anterior synechiae, with additional voice-therapy treatment. Ten male transexulas who wish to become women patients who had Wendler glottoplasty and voice-therapy were assessed. The surgical procedure consisted of a de-epithelialization of the anterior third of both vocal folds; this area was sutured and the surface of both vocal folds was vaporised with laser diode. Pre- and postsurgery voice assessment consisted of measuring fundamental frequency (Fo) and maximum phonation time, administering the transgender self-assessment questionnaire (TSEQ) and obtaining perceptual voice assessment by inter-rater agreement. All the male transsexuals who wish to become women patients significantly increased their Fo (106 Hz on average) after the treatment. Furthermore, significant improvements were shown in self-reported satisfaction and in the degree of voice feminization. No improvements in the maximum phonation time were observed. Wendler glottoplasty is a surgical procedure to contribute to feminising the voice, with good medium-term results and without noteworthy medical complications. The increase in vocal tone was observed using several pre- and post-surgery control measures and voice therapy. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  10. Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample.

    Science.gov (United States)

    Diemer, Elizabeth W; White Hughto, Jaclyn M; Gordon, Allegra R; Guss, Carly; Austin, S Bryn; Reisner, Sari L

    2018-01-01

    Purpose: To investigate whether the prevalence of eating disorders (EDs) differs across diverse gender identity groups in a transgender sample. Methods: Secondary analysis of data from Project VOICE, a cross-sectional study of stress and health among 452 transgender adults (ages 18-75 years) residing in Massachusetts. Age-adjusted logistic regression models were fit to compare the prevalence of self-reported lifetime EDs in female-to-male (FTM), male-to-female (MTF), and gender-nonconforming participants assigned male at birth (MBGNC) to gender-nonconforming participants assigned female at birth (FBGNC; referent). Results: The age-adjusted odds of self-reported ED in MTF participants were 0.14 times the odds of self-reported ED in FBGNC participants ( p =0.022). In FTM participants, the age-adjusted odds of self-reported ED were 0.46 times the odds of self-reported ED in FBGNC participants, a marginally significant finding ( p =0.068). No statistically significant differences in ED prevalence were found for MBGNC individuals. Conclusions: Gender nonconforming individuals assigned a female sex at birth appear to have heightened lifetime risk of EDs relative to MTF participants. Further research into specific biologic and psychosocial ED risk factors and gender-responsive intervention strategies are urgently needed. Training clinical providers and ensuring competency of treatment services beyond the gender binary will be vital to addressing this disparity.

  11. Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample

    Science.gov (United States)

    Diemer, Elizabeth W.; White Hughto, Jaclyn M.; Gordon, Allegra R.; Guss, Carly; Austin, S. Bryn; Reisner, Sari L.

    2018-01-01

    Abstract Purpose: To investigate whether the prevalence of eating disorders (EDs) differs across diverse gender identity groups in a transgender sample. Methods: Secondary analysis of data from Project VOICE, a cross-sectional study of stress and health among 452 transgender adults (ages 18–75 years) residing in Massachusetts. Age-adjusted logistic regression models were fit to compare the prevalence of self-reported lifetime EDs in female-to-male (FTM), male-to-female (MTF), and gender-nonconforming participants assigned male at birth (MBGNC) to gender-nonconforming participants assigned female at birth (FBGNC; referent). Results: The age-adjusted odds of self-reported ED in MTF participants were 0.14 times the odds of self-reported ED in FBGNC participants (p=0.022). In FTM participants, the age-adjusted odds of self-reported ED were 0.46 times the odds of self-reported ED in FBGNC participants, a marginally significant finding (p=0.068). No statistically significant differences in ED prevalence were found for MBGNC individuals. Conclusions: Gender nonconforming individuals assigned a female sex at birth appear to have heightened lifetime risk of EDs relative to MTF participants. Further research into specific biologic and psychosocial ED risk factors and gender-responsive intervention strategies are urgently needed. Training clinical providers and ensuring competency of treatment services beyond the gender binary will be vital to addressing this disparity. PMID:29359198

  12. Perioperative Care of the Transgender Patient.

    Science.gov (United States)

    Smith, Francis Duval

    2016-02-01

    Transgender patients are individuals whose gender identity is not related to their biological sex. Assuming a new gender identity that does not conform to societal norms often results in discrimination and barriers to health care. The exact number of transgender patients is unknown; however, these patients are increasingly seen in health care. Transgender individuals may experience provider-generated discrimination in health care facilities, including refusal of service, disrespect, and abuse, which contribute to depression and low self-esteem. Transgender therapies include mental health counseling for depression and low self-esteem, hormone therapy, and sex reassignment surgery. Health care professionals require cultural competence, an understanding of the different forms of patient identification, and adaptive approaches to care for transgender patients. VA (Veterans Affairs) hospitals provide a model for the care for transgender patients and staff. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  13. Development and Validation of the Transgender Inclusive Behavior Scale (TIBS).

    Science.gov (United States)

    Kattari, Shanna K; O'Connor, Ashley A; Kattari, Leonardo

    2018-01-01

    Transgender-inclusive behaviors are actions and communication supporting transgender individuals. Examples include using language not reinforcing the gender binary, asking for and using correct pronouns, creation of spaces that welcome members of the transgender community, and acknowledging cisgender (non-transgender) privilege. A survey was developed measuring this behavior in individuals to examine the impact of transgender-inclusive behavior and the potential effect of interventions on promoting inclusive behavior. Data were collected utilizing an online survey (N = 1,051). The sample was split in half to run two sets of cases in a principal components analysis. Analysis of the full sample showed Cronbach's alpha to be .93 (n = 918). Findings suggest that the Transgender Inclusive Behavior Scale (TIBS) may be a useful instrument for identifying behaviors related to being inclusive of transgender individuals, groups, and communities. It may also be used to measure behavior change before and after transgender-specific educational and behavioral interventions.

  14. Circulating androgens correlate with resting-state MRI in transgender men.

    Science.gov (United States)

    Mueller, Sven C; Wierckx, Katrien; Jackson, Kathryn; T'Sjoen, Guy

    2016-11-01

    Despite mounting evidence regarding the underlying neurobiology in transgender persons, information regarding resting-state activity, particularly after hormonal treatment, is lacking. The present study examined differences between transgender persons on long-term cross-sex hormone therapy and comparisons on two measures of local functional connectivity, intensity of spontaneous resting-state activity (low frequency fluctuations, LFF) and local synchronization of specific brain areas (regional homogeneity, ReHo). Nineteen transgender women (TW, male-to-female), 19 transgender men (TM, female-to-male), 21 non-transgender men (NTM) and 20 non-transgender women (NTW) underwent a resting-state MRI scan. The results showed differences between transgender persons and non-transgender comparisons on both LFF and ReHo measures in the frontal cortex, medial temporal lobe, and cerebellum. More interestingly, circulating androgens correlated for TM in the cerebellum and regions of the frontal cortex, an effect that was associated with treatment duration in the cerebellum. By comparison, no associations were found for TW with estrogens. These data provide first evidence for a potential masculinization of local functional connectivity in hormonally-treated transgender men. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction, and Mental Health in a Cohort of Transgender Individuals.

    Science.gov (United States)

    Owen-Smith, Ashli A; Gerth, Joseph; Sineath, R Craig; Barzilay, Joshua; Becerra-Culqui, Tracy A; Getahun, Darios; Giammattei, Shawn; Hunkeler, Enid; Lash, Timothy L; Millman, Andrea; Nash, Rebecca; Quinn, Virginia P; Robinson, Brandi; Roblin, Douglas; Sanchez, Travis; Silverberg, Michael J; Tangpricha, Vin; Valentine, Cadence; Winter, Savannah; Woodyatt, Cory; Song, Yongjia; Goodman, Michael

    2018-04-01

    Transgender individuals sometimes seek gender confirmation treatments (GCT), including hormone therapy (HT) and/or surgical change of the chest and genitalia ("top" and "bottom" gender confirmation surgeries). These treatments may ameliorate distress resulting from the incongruence between one's physical appearance and gender identity. The aim was to examine the degree to which individuals' body-gender congruence, body image satisfaction, depression, and anxiety differed by GCT groups in cohorts of transmasculine (TM) and transfeminine (TF) individuals. The Study of Transition, Outcomes, and Gender is a cohort study of transgender individuals recruited from 3 health plans located in Georgia, Northern California, and Southern California; cohort members were recruited to complete a survey between 2015-2017. Participants were asked about: history of GCT; body-gender congruence; body image satisfaction; depression; and anxiety. Participants were categorized as having received: (1) no GCT to date; (2) HT only; (3) top surgery; (4) partial bottom surgery; and (5) definitive bottom surgery. Outcomes of interest included body-gender congruence, body image satisfaction, depression, and anxiety. Of the 2,136 individuals invited to participate, 697 subjects (33%) completed the survey, including 347 TM and 350 TF individuals. The proportion of participants with low body-gender congruence scores was significantly higher in the "no treatment" group (prevalence ratio [PR] = 3.96, 95% CI 2.72-5.75) compared to the definitive bottom surgery group. The PR for depression comparing participants who reported no treatment relative to those who had definitive surgery was 1.94 (95% CI 1.42-2.66); the corresponding PR for anxiety was 4.33 (95% CI 1.83-10.54). Withholding or delaying GCT until depression or anxiety have been treated may not be the optimal treatment course given the benefits of reduced levels of distress after undergoing these interventions. Strengths include the well

  16. Provision of Patient-Centered Transgender Care.

    Science.gov (United States)

    Selix, Nancy W; Rowniak, Stefan

    2016-11-01

    Transgender individuals have unique health care needs and experience health disparities. There is an increased need for transgender health care services and primary care for this underserved population. However, provision of appropriate health care services for transgender persons requires cultural competency and skill on the part of the health care provider, and providers need specific skills to address the needs of this population. A review of the literature was performed by accessing CINAHL, PsycINFO, and PubMed databases. Pertinent research was extracted and reviewed for relevance. References in these publications were reviewed to identify additional publications that address primary prevention, secondary prevention, and tertiary care of transgender individuals. Articles that include prevention, screening, and treatment of health problems of transgender persons were identified. Research on the health needs of the transgender population is limited. Whenever available, research findings that address this unique population should be incorporated into clinical practice. When research evidence is not available to address the unique needs of transgender individuals, research and clinical care guidelines from the general population may be applied for health screening and maintenance. This article provides information about primary care services for transgender individuals and seeks to improve awareness of the health disparities this underserved population experiences. Simple solutions to modify clinical settings to enhance care are provided. © 2016 by the American College of Nurse-Midwives.

  17. Prostate Cancer in Transgender Women: Incidence, Etiopathogenesis, and Management Challenges.

    Science.gov (United States)

    Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J

    2017-12-01

    To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of prostate cancer (CaP) in transgender women. In addition, this article aims to present a recent case report of a transgender woman with a unique presentation at the author's institution. An electronic nonsystematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer," "male to female transsexual," "transgender patient," "androgen + prostate cancer," "estrogen therapy + prostate cancer," and "health care barrier." In addition, a clinical case managed at our institution was reviewed and critically discussed. Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective as initially thought. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a nontransgender men. Barriers to care in the transgender female population include accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs pathologizing transgender patients, financial restrictions of the patient, and health system determinants. Although rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development are unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients. Published by Elsevier Inc.

  18. Social Media Use and HIV-Related Risk Behaviors in Young Black and Latino Gay and Bi Men and Transgender Individuals in New York City: Implications for Online Interventions.

    Science.gov (United States)

    Patel, Viraj V; Masyukova, Mariya; Sutton, Desmond; Horvath, Keith J

    2016-04-01

    Urban young men who have sex with men (YMSM) and transgender women continue to experience high rates of new HIV infections in the USA, yet most of this population is not reached by current prevention interventions. The rate of Internet and social media use among youth is high. However, continually updated understanding of the associations between social media access and use and HIV risk behaviors is needed to reach and tailor technology-delivered interventions for those most vulnerable to HIV-racially and ethnically diverse urban YMSM and transgender persons. Thus, we conducted an in-person, venue-based cross-sectional survey among young gay, bisexual, and transgender individuals at locations primarily visited by Black and Latino gay and bisexual and transgender individuals in New York City to understand social media use and how it may relate to HIV risk behaviors to inform social media-based interventions. Among 102 primarily Black and Latino gay and bisexual men (75.5 %) and transgender women (19.6 %), over 90 % were under 30 years of age, 18.6 % reported homelessness in the past 6 months, and 10.8 % reported having HIV. All participants used social media, most accessed these platforms most often via a mobile device (67.6 %) and most logged on multiple times per day (87.3 %). Participants used social media to seek sex partners (56.7 %), exchange sex for money or clothes (19.6 %), and exchange sex for drugs (9.8 %). These results confirm prior studies demonstrating the feasibility of using social media platforms to reach at-risk, urban youth. Of particular concern is the association between recent STI and exchanging sex for money/clothes and drugs. Interventions using social media for young, urban minority MSM and transgender populations should incorporate risk reduction modules addressing exchange partners and promote frequent and regular HIV/STI testing.

  19. Perceptual-Auditory and Acoustical Analysis of the Voices of Transgender Women.

    Science.gov (United States)

    Schwarz, Karine; Fontanari, Anna Martha Vaitses; Costa, Angelo Brandelli; Soll, Bianca Machado Borba; da Silva, Dhiordan Cardoso; de Sá Villas-Bôas, Anna Paula; Cielo, Carla Aparecida; Bastilha, Gabriele Rodrigues; Ribeiro, Vanessa Veis; Dorfman, Maria Elza Kazumi Yamaguti; Lobato, Maria Inês Rodrigues

    2017-09-28

    Voice is an important gender marker in the transition process as a transgender individual accepts a new gender identity. The objectives of this study were to describe and relate aspects of a perceptual-auditory analysis and the fundamental frequency (F0) of male-to-female (MtF) transsexual individuals. A case-control study was carried out with individuals aged 19-52 years who attended the Gender Identity Program of the Hospital de Clínicas of Porto Alegre. Vocal recordings from the MtF transgender and cisgender individuals (vowel /a:/ and six phrases of Consensus Auditory Perceptual Evaluation Voice [CAPE-V]) were edited and randomly coded before storage in a Dropbox folder. The voices (vowel /a:/) were analyzed by consensus on the same day by two judge speech therapists who had more than 10 years of experience in the voice area using the GRBASI perceptual-auditory vocal evaluation scale. Acoustic analysis of the voices was performed using the advanced Multi-Dimensional Voice Program software. The resonance focus and the degrees of masculinity and femininity for each voice recording were determined by listening to the CAPE-V phrases, for the same judges. There were significant differences between the groups regarding a greater frequency of subjects with F0 between 80 and 150 Hz (P = 0.003), and a greater frequency of hypernasal resonant focus (P < 0.001) in the MtF cases and greater frequency of subjects with absence of roughness (P = 0.031) in the control group. The MtF group of individuals showed altered vertical resonant focus, more masculine voices, and lower fundamental frequencies. The control group showed a significant absence of roughness. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. Transgender transitioning and change of self-reported sexual orientation.

    Science.gov (United States)

    Auer, Matthias K; Fuss, Johannes; Höhne, Nina; Stalla, Günter K; Sievers, Caroline

    2014-01-01

    Sexual orientation is usually considered to be determined in early life and stable in the course of adulthood. In contrast, some transgender individuals report a change in sexual orientation. A common reason for this phenomenon is not known. We included 115 transsexual persons (70 male-to-female "MtF" and 45 female-to-male "FtM") patients from our endocrine outpatient clinic, who completed a questionnaire, retrospectively evaluating the history of their gender transition phase. The questionnaire focused on sexual orientation and recalled time points of changes in sexual orientation in the context of transition. Participants were further asked to provide a personal concept for a potential change in sexual orientation. In total, 32.9% (n = 23) MtF reported a change in sexual orientation in contrast to 22.2% (n = 10) FtM transsexual persons (p = 0.132). Out of these patients, 39.1% (MtF) and 60% (FtM) reported a change in sexual orientation before having undergone any sex reassignment surgery. FtM that had initially been sexually oriented towards males ( = androphilic), were significantly more likely to report on a change in sexual orientation than gynephilic, analloerotic or bisexual FtM (p = 0.012). Similarly, gynephilic MtF reported a change in sexual orientation more frequently than androphilic, analloerotic or bisexual MtF transsexual persons (p =0.05). In line with earlier reports, we reveal that a change in self-reported sexual orientation is frequent and does not solely occur in the context of particular transition events. Transsexual persons that are attracted by individuals of the opposite biological sex are more likely to change sexual orientation. Qualitative reports suggest that the individual's biography, autogynephilic and autoandrophilic sexual arousal, confusion before and after transitioning, social and self-acceptance, as well as concept of sexual orientation itself may explain this phenomenon.

  1. Transgender komunita z pohledu sociální práce

    OpenAIRE

    Šlajsová, Kristýna

    2017-01-01

    This bachelor thesis deals with the transgender issue from a social worker perspective, as an assistant profession. The goal of the thesis is to provide a theoretical background for social workers, who work with transgender clients. It focuses on basic information related to classifying transgender individuals and its specifics. Most of my thesis covers the transsexuals, as the most widespread group within transgender category. The thesis shows contemporary trends in field of transgender than...

  2. Comprehensive HIV Prevention for Transgender Persons.

    Science.gov (United States)

    Neumann, Mary Spink; Finlayson, Teresa J; Pitts, Nicole L; Keatley, JoAnne

    2017-02-01

    Transgender persons are at high risk for HIV infection, but prevention efforts specifically targeting these people have been minimal. Part of the challenge of HIV prevention for transgender populations is that numerous individual, interpersonal, social, and structural factors contribute to their risk. By combining HIV prevention services with complementary medical, legal, and psychosocial services, transgender persons' HIV risk behaviors, risk determinants, and overall health can be affected simultaneously. For maximum health impact, comprehensive HIV prevention for transgender persons warrants efforts targeted to various impact levels-socioeconomic factors, decision-making contexts, long-lasting protections, clinical interventions, and counseling and education. We present current HIV prevention efforts that reach transgender persons and present others for future consideration.

  3. Diagnosed HIV Infection in Transgender Adults and Adolescents: Results from the National HIV Surveillance System, 2009-2014.

    Science.gov (United States)

    Clark, Hollie; Babu, Aruna Surendera; Wiewel, Ellen Weiss; Opoku, Jenevieve; Crepaz, Nicole

    2017-09-01

    Publications on diagnosed HIV infection among transgender people have been limited to state- or local-level data. We analyzed data from the National HIV Surveillance System and present results from the first national-level analysis of transgender people with diagnosed HIV infection. From 2009 to 2014, HIV surveillance jurisdictions from 45 states plus the District of Columbia identified and reported at least one case of newly diagnosed HIV infection for transgender people; jurisdictions from 5 states reported no cases for transgender people. Of 2351 transgender people with newly diagnosed HIV infection during 2009-2014, 84.0% were transgender women (male-to-female), 15.4% were transgender men (female-to-male), and 0.7% were additional gender identity (e.g., gender queer, bi-gender). Over half of both transgender women (50.8%; 1002/1974) and men (58.4%; 211/361) with newly diagnosed HIV infection were non-Hispanic black/African American. Improvements in data collection methods and quality are needed to gain a better understanding of HIV burden among transgender people.

  4. Factors influencing health care access perceptions and care-seeking behaviors of immigrant Latino sexual minority men and transgender individuals: baseline findings from the HOLA intervention study.

    Science.gov (United States)

    Tanner, Amanda E; Reboussin, Beth A; Mann, Lilli; Ma, Alice; Song, Eunyoung; Alonzo, Jorge; Rhodes, Scott D

    2014-11-01

    Little is known about immigrant Latino sexual minorities’ health seeking behaviors. This study examined factors associated with perceptions of access and actual care behaviors among this population in North Carolina. A community-based participatory research partnership recruited 180 Latino sexual minority men and transgender individuals within preexisting social networks to participate in a sexual health intervention. Mixed-effects logistic regression models and GIS mapping examined factors influencing health care access perceptions and use of services (HIV testing and routine check-ups). Results indicate that perceptions of access and actual care behaviors are low and affected by individual and structural factors, including: years living in NC, reported poor general health, perceptions of discrimination, micro-, meso-, and macro-level barriers, and residence in a Medically Underserved Area. To improve Latino sexual minority health, focus must be placed on multiple levels, including: individual characteristics (e.g., demographics), clinic factors (e.g., provider competence and clinic environment), and structural factors (e.g., discrimination).

  5. The Role of Discrimination in Care Postponement Among Trans-Feminine Individuals in the U.S. National Transgender Discrimination Survey.

    Science.gov (United States)

    Glick, Jennifer L; Theall, Katherine P; Andrinopoulos, Katherine M; Kendall, Carl

    2018-04-01

    This study examines the associations between discrimination experiences (types and locations) and care postponement among trans-feminine individuals in the United States. This secondary, cross-sectional study utilized a subset of the data from the National Transgender Discrimination Survey (n = 2248), specifically for trans-feminine individuals. In this analysis, we examined the relationship between discrimination and primary care postponement. Twenty-six percent (26.25%) of the study sample reported delaying preventive care due to fear of discrimination; 23.98%-46.66% of respondents reported past experiences of discrimination (setting dependent). Discrimination in health and non-health settings and different types of discrimination-being denied services, verbally harassed, or physically assaulted-were all significantly associated with delaying care; respondents reporting discrimination were up to 20 times more likely to postpone care. While discrimination at a health location had the strongest association with care postponement (adjusted odds ratio = 9.65, confidence interval = 7.60-12.24), discrimination in all non-health-related locations was also important. Individuals reporting discrimination in greater numbers of locations and multiple types of discrimination were more likely to postpone care. To promote preventive care-seeking, these results affirm the importance of interventions that promote discrimination-free environments for gender minorities.

  6. Geographic and Individual Associations with PrEP Stigma: Results from the RADAR Cohort of Diverse Young Men Who have Sex with Men and Transgender Women.

    Science.gov (United States)

    Mustanski, Brian; Ryan, Daniel T; Hayford, Christina; Phillips, Gregory; Newcomb, Michael E; Smith, Justin D

    2018-05-22

    Increasing the uptake of pre-exposure prophylaxis (PrEP) to prevent HIV acquisition among at-risk populations, such as young men who have sex with men (YMSM), is of vital importance to slowing the HIV epidemic. Stigma and negative injunctive norms, such as the so called "Truvada Whore" phenomenon, hamper this effort. We examined the prevalence and types of PrEP stigma and injunctive norm beliefs among YMSM and transgender women and associated individual and geospatial factors. A newly created measure of PrEP Stigma and Positive Attitudes was administered to 620 participants in an ongoing longitudinal cohort study. Results indicated lower stigma among White, compared to Black and Latino participants, and among participants not identifying as male. Prior knowledge about PrEP was associated with lower stigma and higher positive attitudes. PrEP stigma had significant geospatial clustering and hotspots were identified in neighborhoods with high HIV incidence and concentration of racial minorities, whereas coldspots were identified in areas with high HIV incidence and low LGBT stigma. These results provide important information about PrEP attitudes and how PrEP stigma differs between individuals and across communities.

  7. Transgender in China

    Science.gov (United States)

    Jun, Pi

    2010-01-01

    This autobiographical essay of a Chinese transgender who has grown up in a special social background involves the Chinese family, religion, and some social background to demonstrate the current situation of lesbian, gay, bisexual, and transgender groups, especially the condition of female-to-male transgender.

  8. Specific cerebral activation due to visual erotic stimuli in male-to-female transsexuals compared with male and female controls: an fMRI study.

    Science.gov (United States)

    Gizewski, Elke R; Krause, Eva; Schlamann, Marc; Happich, Friederike; Ladd, Mark E; Forsting, Michael; Senf, Wolfgang

    2009-02-01

    Transsexuals harbor the strong feeling of having been born to the wrong sex. There is a continuing controversial discussion of whether or not transsexualism has a biological representation. Differences between males and females in terms of functional imaging during erotic stimuli have been previously described, revealing gender-specific results. Therefore, we postulated that male-to-female (MTF) transsexuals may show specific cerebral activation differing from their biological gender. Cerebral activation patterns during viewing of erotic film excerpts in functional magnetic resonance imaging (fMRI). Twelve male and 12 female heterosexual volunteers and 12 MTF transsexuals before any treatment viewed erotic film excerpts during fMRI. Additionally, subjective rating of sexual arousal was assessed. Statistics were performed using the Statistical Parametric Mapping software. Significantly enhanced activation for men compared with women was revealed in brain areas involved in erotic processing, i.e., the thalamus, the amygdala, and the orbitofrontal and insular cortex, whereas no specific activation for women was found. When comparing MTF transsexuals with male volunteers, activation patterns similar to female volunteers being compared with male volunteers were revealed. Sexual arousal was assessed using standard rating scales and did not differ significantly for the three groups. We revealed a cerebral activation pattern in MTF transsexuals compared with male controls similar to female controls compared with male controls during viewing of erotic stimuli, indicating a tendency of female-like cerebral processing in transsexualism.

  9. Brain Activation in Response to Visually Evoked Sexual Arousal in Male-to-Female Transsexuals: 3.0 Tesla Functional Magnetic Resonance Imaging

    Science.gov (United States)

    Oh, Seok-Kyun; Kim, Gwang-Won; Yang, Jong-Chul; Kim, Seok-Kwun; Kang, Heoung-Keun

    2012-01-01

    Objective This study used functional magnetic resonance imaging (fMRI) to contrast the differential brain activation patterns in response to visual stimulation with both male and female erotic nude pictures in male-to-female (MTF) transsexuals who underwent a sex reassignment surgery. Materials and Methods A total of nine healthy MTF transsexuals after a sex reassignment surgery underwent fMRI on a 3.0 Tesla MR Scanner. The brain activation patterns were induced by visual stimulation with both male and female erotic nude pictures. Results The sex hormone levels of the postoperative MTF transsexuals were in the normal range of healthy heterosexual females. The brain areas, which were activated by viewing male nude pictures when compared with viewing female nude pictures, included predominantly the cerebellum, hippocampus, putamen, anterior cingulate gyrus, head of caudate nucleus, amygdala, midbrain, thalamus, insula, and body of caudate nucleus. On the other hand, brain activation induced by viewing female nude pictures was predominantly observed in the hypothalamus and the septal area. Conclusion Our findings suggest that distinct brain activation patterns associated with visual sexual arousal in postoperative MTF transsexuals reflect their sexual orientation to males. PMID:22563262

  10. Brain Activation in Response to Visually Evoked Sexual Arousal in Male-to-Female Transsexuals: 3.0 Tesla Functional Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Seok Kyun; Kim, Gwang Won; Kang, Heoung Keun; Jeong, Gwang Woo [Chonnam National University, Gwangju (Korea, Republic of); Yang, Jong Chul [Chonbuk National University Medical School, Jeonju (Korea, Republic of); Kim, Seok Kwun [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2012-06-15

    This study used functional magnetic resonance imaging (fMRI) to contrast the differential brain activation patterns in response to visual stimulation with both male and female erotic nude pictures in male-to-female (MTF) transsexuals who underwent a sex reassignment surgery. A total of nine healthy MTF transsexuals after a sex reassignment surgery underwent fMRI on a 3.0 Tesla MR Scanner. The brain activation patterns were induced by visual stimulation with both male and female erotic nude pictures. The sex hormone levels of the postoperative MTF transsexuals were in the normal range of healthy heterosexual females. The brain areas, which were activated by viewing male nude pictures when compared with viewing female nude pictures, included predominantly the cerebellum, hippocampus, putamen, anterior cingulate gyrus, head of caudate nucleus, amygdala, midbrain, thalamus, insula, and body of caudate nucleus. On the other hand, brain activation induced by viewing female nude pictures was predominantly observed in the hypothalamus and the septal area. Our findings suggest that distinct brain activation patterns associated with visual sexual arousal in postoperative MTF transsexuals reflect their sexual orientation to males.

  11. Brain Activation in Response to Visually Evoked Sexual Arousal in Male-to-Female Transsexuals: 3.0 Tesla Functional Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Oh, Seok Kyun; Kim, Gwang Won; Kang, Heoung Keun; Jeong, Gwang Woo; Yang, Jong Chul; Kim, Seok Kwun

    2012-01-01

    This study used functional magnetic resonance imaging (fMRI) to contrast the differential brain activation patterns in response to visual stimulation with both male and female erotic nude pictures in male-to-female (MTF) transsexuals who underwent a sex reassignment surgery. A total of nine healthy MTF transsexuals after a sex reassignment surgery underwent fMRI on a 3.0 Tesla MR Scanner. The brain activation patterns were induced by visual stimulation with both male and female erotic nude pictures. The sex hormone levels of the postoperative MTF transsexuals were in the normal range of healthy heterosexual females. The brain areas, which were activated by viewing male nude pictures when compared with viewing female nude pictures, included predominantly the cerebellum, hippocampus, putamen, anterior cingulate gyrus, head of caudate nucleus, amygdala, midbrain, thalamus, insula, and body of caudate nucleus. On the other hand, brain activation induced by viewing female nude pictures was predominantly observed in the hypothalamus and the septal area. Our findings suggest that distinct brain activation patterns associated with visual sexual arousal in postoperative MTF transsexuals reflect their sexual orientation to males.

  12. Culturally competent substance abuse treatment with transgender persons.

    Science.gov (United States)

    Nuttbrock, Larry A

    2012-01-01

    Transgender individuals are misunderstood and inadequately treated in many conventional substance abuse treatment programs. This article reviews current concepts regarding the definition and diversity of transgenderism and summarizes the existing literature on the prevalence and correlates of substance use in transgendered populations. Examples of culturally competent and gender-sensitive treatment in specialized settings are cited, with a call to extend these initiatives throughout the gamut of service venues that engage transgender individuals. Cultural competence combined with gender sensitivity should improve the effectiveness of substance abuse treatment for transgender individuals and will contribute to the goal of providing effective services in an increasingly diverse society.

  13. Challenges in Transgender Healthcare: The Pathology Perspective.

    Science.gov (United States)

    Gupta, Sarika; Imborek, Katherine L; Krasowski, Matthew D

    2016-08-01

    The transgender community is one of the most marginalized sections of our society. The literature is scarce regarding the pathology and laboratory medicine challenges associated with caring for transgender patients. To summarize the available gender-transitioning options and to discuss healthcare challenges, from a pathology/laboratory medicine perspective, in the care of transgender patients. We reviewed the current terminology and epidemiology relevant to the transgender population in preparing our analysis. The main transgender healthcare challenges in pathology/laboratory medicine practice include the inflexibility of electronic medical records in documenting affirmed gender, unfamiliarity among medical and laboratory professional with the needs of and terminology related to the transgender population, lack of reference ranges for laboratory tests, unclear guidelines regarding gender classification for blood donation eligibility criteria, and paucity of experience in handling and interpreting surgical and cytologic specimens from gender-transitioning individuals. Directed efforts to overcome these shortcomings, coupled with a more welcoming posture, are essential to achieving the highest standards of care for the transgender population. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. An Older Transgender Woman's Quest for Identity.

    Science.gov (United States)

    Walker, Charles A; Cohen, Harriet; Jenkins, David

    2016-02-01

    Despite sensationalized media attention, transgender individuals are the most marginalized and misunderstood group in the lesbian, gay, bisexual, and transgender (LGBT) community. The current article presents a case study of one woman's quest for identity. Narrative inquiry was used to analyze data from interview transcripts and four themes emerged during analysis: (a) naming the ambiguity, (b) revealing-concealing the authentic self, (c) discovering the transgender community, and (d) embracing the "T" identity. Lifespan and empowerment theories were used to harvest meanings from these themes. Implications for nursing practice and research were examined based on study findings. Participatory action research offers an approach for future studies in which researchers advocate for transgender individuals and remove obstacles to their health care access. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 31-38.]. Copyright 2016, SLACK Incorporated.

  15. Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare.

    Science.gov (United States)

    Park, Jason A; Safer, Joshua D

    2018-01-01

    Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. Methods: At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. Results: After completing the elective, students who reported "high" comfort increased from 45% (9/20) to 80% (16/20) ( p =0.04), and students who reported "high" knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) ( p <0.001 ) . Conclusion: Although integrating evidence-based, transgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals.

  16. Community member perspectives from transgender women and men who have sex with men on pre-exposure prophylaxis as an HIV prevention strategy: implications for implementation

    Directory of Open Access Journals (Sweden)

    Galindo Gabriel R

    2012-11-01

    Full Text Available Abstract Background An international randomized clinical trial (RCT on pre-exposure prophylaxis (PrEP as an human immunodeficiency virus (HIV-prevention intervention found that taken on a daily basis, PrEP was safe and effective among men who have sex with men (MSM and male-to-female transgender women. Within the context of the HIV epidemic in the United States (US, MSM and transgender women are the most appropriate groups to target for PrEP implementation at the population level; however, their perspectives on evidenced-based biomedical research and the results of this large trial remain virtually unknown. In this study, we examined the acceptability of individual daily use of PrEP and assessed potential barriers to community uptake. Methods We conducted semi-structured interviews with an ethnoracially diverse sample of thirty HIV-negative and unknown status MSM (n = 24 and transgender women (n = 6 in three California metropolitan areas. Given the burden of disease among ethnoracial minorities in the US, we purposefully oversampled for these groups. Thematic coding and analysis of data was conducted utilizing an approach rooted in grounded theory. Results While participants expressed general interest in PrEP availability, results demonstrate: a lack of community awareness and confusion about PrEP; reservations about PrEP utilization, even when informed of efficacious RCT results; and concerns regarding equity and the manner in which a PrEP intervention could be packaged and marketed in their communities. Conclusions In order to effectively reduce HIV health disparities at the population level, PrEP implementation must take into account the uptake concerns of those groups who would actually access and use this biomedical intervention as a prevention strategy. Recommendations addressing these concerns are provided.

  17. Community member perspectives from transgender women and men who have sex with men on pre-exposure prophylaxis as an HIV prevention strategy: implications for implementation

    Science.gov (United States)

    2012-01-01

    Background An international randomized clinical trial (RCT) on pre-exposure prophylaxis (PrEP) as an human immunodeficiency virus (HIV)-prevention intervention found that taken on a daily basis, PrEP was safe and effective among men who have sex with men (MSM) and male-to-female transgender women. Within the context of the HIV epidemic in the United States (US), MSM and transgender women are the most appropriate groups to target for PrEP implementation at the population level; however, their perspectives on evidenced-based biomedical research and the results of this large trial remain virtually unknown. In this study, we examined the acceptability of individual daily use of PrEP and assessed potential barriers to community uptake. Methods We conducted semi-structured interviews with an ethnoracially diverse sample of thirty HIV-negative and unknown status MSM (n = 24) and transgender women (n = 6) in three California metropolitan areas. Given the burden of disease among ethnoracial minorities in the US, we purposefully oversampled for these groups. Thematic coding and analysis of data was conducted utilizing an approach rooted in grounded theory. Results While participants expressed general interest in PrEP availability, results demonstrate: a lack of community awareness and confusion about PrEP; reservations about PrEP utilization, even when informed of efficacious RCT results; and concerns regarding equity and the manner in which a PrEP intervention could be packaged and marketed in their communities. Conclusions In order to effectively reduce HIV health disparities at the population level, PrEP implementation must take into account the uptake concerns of those groups who would actually access and use this biomedical intervention as a prevention strategy. Recommendations addressing these concerns are provided. PMID:23181780

  18. Individual-level characteristics associated with oral HIV test acceptability among Peruvian men who have sex with men and transgender women: a cross-sectional study.

    Science.gov (United States)

    Flores, Juan A; Brown, Brandon; León, Segundo R; Sánchez, Hugo; Galea, Jerome T

    2018-03-24

    Peruvian men who have sex with men (MSM) and transgender women (TGW) are highly vulnerable to HIV infection (HIV), but stigma, access issues and fear of venipuncture hamper testing. The oral HIV test-which uses oral fluids and provides results in 20 minutes-could reduce these barriers. The objective of this study was to determine the acceptability of the oral HIV test and the individual-level factors associated with its acceptability among MSM and TGW. We conducted a cross-sectional secondary analysis among Peruvian MSM and TGW attending a community-based health centre between February 2012 and February 2013 to determine the individual-level factors associated with oral HIV test acceptability. Of 334 participants, 88% were MSM and 12% TGW. Overall, 85% of participants indicated their acceptability of the oral HIV test. Acceptability was higher in MSM than TGW (85.7% vs 80.0%) but this difference was not significant. Factors associated with acceptability in MSM were: tertiary or higher education (prevalence ratio (PR)=1.18, 95% CI 1.06 to 1.32 and PR=1.16, 95% CI 1.03 to 1.30, respectively); sex with drug use (PR=1.19, 95% CI 1.05 to 1.36); believing that HIV is transmitted by saliva (PR=1.20, 95% CI 1.08 to 1.33); and potential use of the oral test at home (PR=1.56, 95% CI 1.32 to 1.85). The only factor associated with lower acceptability was having had first anal intercourse between 14 and 19 years of age (PR=0.89, 95% CI 0.80 to 0.98). We identified the individual factors associated with oral HIV test acceptability among Peruvian MSM and TGW. Expanded use of the oral HIV test to increase testing rates among Peruvian MSM and TGW is recommended. NCT01387412, post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Caring for transgender patients with epilepsy.

    Science.gov (United States)

    Johnson, Emily L; Kaplan, Peter W

    2017-10-01

    Approximately 25 million individuals older than age 15 identify as transgender, representing about 0.3-0.9% of the world's population. The aim of this paper is to identify and describe important medical and social considerations facing transgender persons with epilepsy. We performed literature searches on the following terms: transgender AND epilepsy, transgender AND neurology, gender dysphoria AND epilepsy, gender dysphoria AND neurology. We also performed literature searches for common feminizing or masculinizing treatment regimens, and searched for interactions of those treatment regimens with antiepileptic drugs (AEDs) and with seizures. There are multiple bidirectional interactions between AEDs and the commonly used treatments for aligning external sex characteristics with identified gender. The scope of the transgender population with epilepsy remains to be elucidated. Transgender patients with epilepsy face significant social and medical challenges. Interactions between medical gender-affirming treatments and AEDs are common, and management must depend on knowledge of these interactions to provide appropriate treatment. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  20. Gender Panics about Transgender Children in Religious Right Discourse

    Science.gov (United States)

    Stone, Amy L.

    2018-01-01

    This paper is a content analysis of political flyers and messages developed by Religious Right campaigns between 1974 and 2013 to fight legislation supportive of lesbian, gay, bisexual, and transgender (LGBT) individuals. The analysis focuses on 16 campaigns in which Religious Right groups made claims about transgender adults and children. In…

  1. Music Teachers' Attitudes toward Transgender Students and Supportive School Practices

    Science.gov (United States)

    Silveira, Jason M.; Goff, Sarah C.

    2016-01-01

    The purpose of this study was to measure music teachers' attitudes toward transgender individuals and toward school practices that support transgender students. Participants (N = 612) included men and women who teach a variety of music subjects in elementary, middle, and high schools, in urban, suburban, and rural areas. An online questionnaire…

  2. Using clinician text notes in electronic medical record data to validate transgender-related diagnosis codes.

    Science.gov (United States)

    Blosnich, John R; Cashy, John; Gordon, Adam J; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Fine, Michael J

    2018-04-04

    Transgender individuals are vulnerable to negative health risks and outcomes, but research remains limited because data sources, such as electronic medical records (EMRs), lack standardized collection of gender identity information. Most EMR do not include the gold standard of self-identified gender identity, but International Classification of Diseases (ICDs) includes diagnostic codes indicating transgender-related clinical services. However, it is unclear if these codes can indicate transgender status. The objective of this study was to determine the extent to which patients' clinician notes in EMR contained transgender-related terms that could corroborate ICD-coded transgender identity. Data are from the US Department of Veterans Affairs Corporate Data Warehouse. Transgender patients were defined by the presence of ICD9 and ICD10 codes associated with transgender-related clinical services, and a 3:1 comparison group of nontransgender patients was drawn. Patients' clinician text notes were extracted and searched for transgender-related words and phrases. Among 7560 patients defined as transgender based on ICD codes, the search algorithm identified 6753 (89.3%) with transgender-related terms. Among 22 072 patients defined as nontransgender without ICD codes, 246 (1.1%) had transgender-related terms; after review, 11 patients were identified as transgender, suggesting a 0.05% false negative rate. Using ICD-defined transgender status can facilitate health services research when self-identified gender identity data are not available in EMR.

  3. Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare

    Science.gov (United States)

    Park, Jason A.; Safer, Joshua D.

    2018-01-01

    Abstract Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. Methods: At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. Results: After completing the elective, students who reported “high” comfort increased from 45% (9/20) to 80% (16/20) (p=0.04), and students who reported “high” knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) (ptransgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals. PMID:29344576

  4. Transgender Dalam Persepsi Masyarakat

    OpenAIRE

    Jasruddin, Jasruddin; Daud, Jasmin

    2015-01-01

    Fenomena transgender dalam masyarakat mendapatkan berbagai macam reaksi. Kasus-kasus pun banyak bermunculan sehingga membutuhkan penanganan. Dalam penelitian ini memfokuskan pada persepsi masyarakat kota Makassar terhadap keberadaan transgender. Untuk menjawabnya peneliti menggunakan pendekatan secara agama dan sosiologi. Adapun jenis penelitian ini adalah kuantitatif deskriptif dengan menggunakan metode survey , yaitu dengan melakukan pendekatan langsung terhadap masyarakat kota Makassar se...

  5. Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions.

    Science.gov (United States)

    White Hughto, Jaclyn M; Reisner, Sari L; Pachankis, John E

    2015-12-01

    Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. This critical review aims to integrate the literature on stigma towards transgender people in the U.S. This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Transgender Stigma and Health: A Critical Review of Stigma Determinants, Mechanisms, and Interventions

    Science.gov (United States)

    White Hughto, Jaclyn M.; Reisner, Sari L.; Pachankis, John E.

    2015-01-01

    Rationale Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. Objective This critical review aims to integrate the literature on stigma towards transgender people in the US. Results This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Conclusion Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. PMID:26599625

  7. Coverage for Gender-Affirming Care: Making Health Insurance Work for Transgender Americans.

    Science.gov (United States)

    Padula, William V; Baker, Kellan

    2017-08-01

    Many transgender Americans continue to remain uninsured or are underinsured because of payers' refusal to cover medically necessary, gender-affirming healthcare services-such as hormone therapy, mental health counseling, and reconstructive surgeries. Coverage refusal results in higher costs and poor health outcomes among transgender people who cannot access gender-affirming care. Research into the value of health insurance coverage for gender-affirming care for transgender individuals shows that the health benefits far outweigh the costs of insuring transition procedures. Although the Affordable Care Act explicitly protects health insurance for transgender individuals, these laws are being threatened; therefore, this article reviews their importance to transgender-inclusive healthcare coverage.

  8. Dyadic effects of gender minority stressors in substance use behaviors among transgender women and their non-transgender male partners

    Science.gov (United States)

    Reisner, Sari L.; Gamarel, Kristi E.; Nemoto, Tooru; Operario, Don

    2014-01-01

    Background Despite evidence that interpersonal processes shape health behaviors, research concerning the dyadic effects of gender minority stressors on substance use behaviors of transgender people is scarce. The objective of this study was to use dyadic analysis to examine whether transgender discrimination was associated with substance use among transgender women and their male partners. Methods Transgender women and their male partners (N=191 couples; N=382 individuals) completed questionnaires. Participants’ mean age was 37.1; 79.1% were racial/ethnic minority; 61.3% earned transgender-related discrimination and past 30-day non-marijuana illicit drug use adjusting for age, relationship length, financial hardship, and depressive distress among partners in these dyads. Results Illicit drug use was reported by 31.4% of transgender women and 25.1% of their male partners. Perceived transgender discrimination was independently associated with increased odds of illicit drug use for transgender women (actor effect) but not for their male partners. Financial hardship statistically predicted drug use for both partners (actor effects). There were no partner effects for financial hardship on drug use. Overall, 34.5% of dyads had discrepant substance use. Discrimination scores of male partners differentiated dyads who reported discrepant substance use. Discussion Gender minority stressors are critical to understanding substance use among transgender women and their male partners. Integrating socioeconomic status into gender minority stress frameworks is essential. Results have implications for substance use prevention and treatment, including the need to incorporate gender minority stressors into interventions. PMID:25642440

  9. Transgender transitioning and change of self-reported sexual orientation.

    Directory of Open Access Journals (Sweden)

    Matthias K Auer

    Full Text Available Sexual orientation is usually considered to be determined in early life and stable in the course of adulthood. In contrast, some transgender individuals report a change in sexual orientation. A common reason for this phenomenon is not known.We included 115 transsexual persons (70 male-to-female "MtF" and 45 female-to-male "FtM" patients from our endocrine outpatient clinic, who completed a questionnaire, retrospectively evaluating the history of their gender transition phase. The questionnaire focused on sexual orientation and recalled time points of changes in sexual orientation in the context of transition. Participants were further asked to provide a personal concept for a potential change in sexual orientation.In total, 32.9% (n = 23 MtF reported a change in sexual orientation in contrast to 22.2% (n = 10 FtM transsexual persons (p = 0.132. Out of these patients, 39.1% (MtF and 60% (FtM reported a change in sexual orientation before having undergone any sex reassignment surgery. FtM that had initially been sexually oriented towards males ( = androphilic, were significantly more likely to report on a change in sexual orientation than gynephilic, analloerotic or bisexual FtM (p = 0.012. Similarly, gynephilic MtF reported a change in sexual orientation more frequently than androphilic, analloerotic or bisexual MtF transsexual persons (p =0.05.In line with earlier reports, we reveal that a change in self-reported sexual orientation is frequent and does not solely occur in the context of particular transition events. Transsexual persons that are attracted by individuals of the opposite biological sex are more likely to change sexual orientation. Qualitative reports suggest that the individual's biography, autogynephilic and autoandrophilic sexual arousal, confusion before and after transitioning, social and self-acceptance, as well as concept of sexual orientation itself may explain this phenomenon.

  10. Cross-sex hormone therapy in transgender persons affects total body weight, body fat and lean body mass: a meta-analysis.

    Science.gov (United States)

    Klaver, M; Dekker, M J H J; de Mutsert, R; Twisk, J W R; den Heijer, M

    2017-06-01

    Weight gain and body fat increase the risk of cardiometabolic disease. Cross-sex hormone therapy in transgender persons leads to changes in body weight and body composition, but it is unclear to what extent. We performed a meta-analysis to investigate the changes in body weight, body fat and lean body mass during cross-sex hormone therapy in transgender persons. We searched the PubMed database for eligible studies until November 2015. Ten studies reporting changes in body weight, body fat or lean mass in hormone naive transgender persons were included, examining 171 male-to-female and 354 female-to-male transgender people. Pooled effect estimates in the male-to-female group were +1.8 kg (95% CI: 0.2;3.4) for body weight, +3.0 kg (2.0;3.9) for body fat and -2.4 kg (-2.8; -2.1) for lean body mass. In the female-to-male group, body weight changed with +1.7 kg (0.7;2.7), body fat with -2.6 kg (-3.9; -1.4) and lean body mass with +3.9 kg (3.2;4.5). Cross-sex hormone therapy increases body weight in both sexes. In the male-to-female group, a gain in body fat and a decline in lean body mass are observed, while the opposite effects are seen in the female-to-male group. Possibly, these changes increase the risk of cardiometabolic disease in the male-to-female group. © 2016 Blackwell Verlag GmbH.

  11. Substance use and treatment of substance use disorders in a community sample of transgender adults.

    Science.gov (United States)

    Keuroghlian, Alex S; Reisner, Sari L; White, Jaclyn M; Weiss, Roger D

    2015-07-01

    Transgender people have elevated substance use prevalence compared with the U.S. general population, however no studies have comprehensively examined the relationship of psychosocial risk factors to substance use and substance use disorder (SUD) treatment among both male-to-female (MTF) and female-to-male (FTM) transgender adults. Secondary data analysis of a 2013 community-based survey of transgender adults in Massachusetts (N=452) was conducted. Adjusted multivariable logistic regression models were fit to examine the relationship of four risk factor domains with SUD treatment history and recent substance use: (1) demographics; (2) gender-related characteristics; (3) mental health; (4) socio-structural factors. Adjusted Odds Ratios (aOR) and 95% Confidence Intervals (95% CI) were estimated. Ten percent of the sample reported lifetime SUD treatment. Factors associated with significant increase in odds of lifetime SUD treatment alongside recent substance use (all pdiscrimination (aOR=1.90; 95% CI=1.22-2.95), unstable housing (aOR=1.80; 95% CI=1.21-2.67), and sex work (aOR=2.48; 95% CI=1.24-4.95). Substance use and SUD treatment among transgender adults are associated with demographic, gender-related, mental health, and socio-structural risk factors. Studies are warranted that identify SUD treatment barriers, and integrate SUD treatment with psychosocial and structural interventions for a diverse spectrum of transgender adults. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Dermatologic care of the transgender patient

    Directory of Open Access Journals (Sweden)

    B.A. Ginsberg, MD

    2017-03-01

    Full Text Available Given the complexities of the transitioning process, transgender individuals may face unique dermatologic needs in addition to routine care. Exogenous hormones affect hair and sebum production, gender-confirming surgeries often require dermatologic pre- and postoperative interventions, and postoperative anatomy may show unique presentations of routine skin conditions. Aesthetic techniques that are often used for rejuvenation may have a role in facial feminization and masculinization and unfortunately are too frequently performed by nonmedical personnel with negative consequences. Ultimately, physicians should strive to make their office a more accommodating environment for transgender individuals.

  13. HPV and genital warts among Peruvian men who have sex with men and transgender people: knowledge, attitudes and treatment experiences.

    Directory of Open Access Journals (Sweden)

    César R Nureña

    Full Text Available BACKGROUND: Several studies have assessed the epidemiology of HPV infection among MSM, but no qualitative studies have specifically assessed how HPV and genital warts (GW affect South American men who have sex with men (MSM and male-to-female transgendered women (TG. This study explored the knowledge, attitudes and experiences of Peruvian MSM and TG regarding HPV and GW. METHODS: We performed a qualitative study consisting of fifteen in-depth interviews and three focus groups carried out in Lima, Peru with diverse MSM and TG groups, including sex workers. Resulting data were analyzed by applying a systematic comparative and descriptive content analysis. RESULTS: While knowledge of HPV was limited, awareness of GW was common, particularly among TG persons and sex workers. Still, few participants recognized that GW are sexually transmitted, and many had problems differentiating between GW and other STI/anogenital conditions. Stigmatizing experiences were common during sexual encounters with people who had visible GW. Shame, emotional and physical troubles, and embarrassing sexual experiences were reported by individuals with GW. Search for treatment was mediated by peers, but stigma and apparent health services' inability to deal with GW limited the access to effective medical care. CONCLUSIONS: In Peru, public health interventions should strengthen services for HPV/GW management and increase accurate knowledge of the transmission, treatment, and sequelae of HPV/GW in MSM and TG populations.

  14. How Good Is Your Rule of Thumb? Validating Male-to-Female Case Ratio as a Proxy for Men Who Have Sex With Men Involvement in N. gonorrhoeae Incidence at the County Level.

    Science.gov (United States)

    Stenger, Mark; Bauer, Heidi; Klingler, Ellen; Bell, Teal; Donnelly, Jennifer; Eaglin, Margaret; Jespersen, Megan; Madera, Robbie; Mattson, Melanie; Torrone, Elizabeth

    2018-03-01

    Lacking information on men who have sex with men (MSM) for most reported cases, sexually transmitted disease (STD) programs in the United States have used crude measures such as male-to-female case ratios (MFCR) as a rule of thumb to gauge MSM involvement at the local level, primarily with respect to syphilis cases in the past. Suitability of this measure for gonorrhea incidence has not previously been investigated. A random sample of gonorrhea cases reported from January 2010 through June 2013 were interviewed in selected counties participating in the STD Surveillance Network to obtain gender of sex partners and history of transactional sex. Weighted estimates of proportion of cases among MSM and proportion reporting transactional sex were developed; correlation between MFCR and proportion MSM was assessed. Male-to-female case ratio ranged from 0.66 to 8.7, and the proportion of cases occurring among MSM varied from 2.5% to 62.3%. The MFCR was strongly correlated with proportion of cases among MSM after controlling for transactional sex (Pearson partial r = 0.754, P < 0.0001). Male-to-female case ratio for gonorrhea at the county level is a reliable proxy measure indicating MSM involvement in gonorrhea case incidence and should be used by STD programs to tailor their programmatic mix to include MSM-specific interventions.

  15. Gender violence: transgender experiences with violence and discrimination.

    Science.gov (United States)

    Lombardi, E L; Wilchins, R A; Priesing, D; Malouf, D

    2001-01-01

    There is a pervasive pattern of discrimination and prejudice against transgendered people within society. Both economic discrimination and experiencing violence could be the result of a larger social climate that severely sanctions people for not conforming to society's norms concerning gender; as such, both would be strongly associated with each other. Questionnaires were distributed to people either through events or through volunteers, and made available upon the World Wide Web. A sample of 402 cases was collected over the span of 12 months (April 1996-April 1997). We found that over half the people within this sample experienced some form of harassment or violence within their lifetime, with a quarter experiencing a violent incident. Further investigation found that experiencing economic discrimination because one is transgendered had the strongest association with experiencing a transgender related violent incident. Economic discrimination was related to transgendered people's experience with violence. Therefore, both hate crimes legislation and employment protections are needed for transgendered individuals.

  16. Transgender Inmates in Prisons.

    Science.gov (United States)

    Routh, Douglas; Abess, Gassan; Makin, David; Stohr, Mary K; Hemmens, Craig; Yoo, Jihye

    2017-05-01

    Transgender inmates provide a conundrum for correctional staff, particularly when it comes to classification, victimization, and medical and health issues. Using LexisNexis and WestLaw and state Department of Corrections (DOC) information, we collected state statutes and DOC policies concerning transgender inmates. We utilized academic legal research with content analysis to determine whether a statute or policy addressed issues concerning classification procedures, access to counseling services, the initiation and continuation of hormone therapy, and sex reassignment surgery. We found that while more states are providing either statutory or policy guidelines for transgender inmates, a number of states are lagging behind and there is a shortage of guidance dealing with the medical issues related to being transgender.

  17. Transgender personen in Nederland

    NARCIS (Netherlands)

    Lisette Kuyper

    2017-01-01

    Verschenen als elektronische publicatie (pdf); niet verkrijgbaar in gedrukte versie. De maatschappelijke en politieke aandacht voor transgender personen heeft de laatste jaren een hoge vlucht genomen. Wetenschappelijke kennis over hun leefsituatie in Nederland blijft hierbij achter. Het Sociaal en

  18. Transgender People (For Parents)

    Science.gov (United States)

    ... best support your child. For people who are transgender, the realization that they feel different from others also can be very difficult. They may face rejection, discrimination, and even anger from people who don't ...

  19. Psychiatrists' and Psychiatry Residents' Attitudes Toward Transgender People.

    Science.gov (United States)

    Ali, Nareesa; Fleisher, William; Erickson, Julie

    2016-04-01

    Gender minority groups, such as transgender individuals, frequently encounter stigma, discrimination, and negative mental health outcomes, which can result in contact with mental health professionals. Recent studies suggest that negative attitudes toward transgender individuals are prevalent and measurable within the general population. The Genderism and Transphobia scale (GTS) measures anti-transgender feelings, thoughts, and behaviors. The purpose of this study was to use the GTS to conduct an investigation of psychiatrists' attitudes toward transgender individuals. A cross-sectional survey of n = 142 faculty members and residents from the Department of Psychiatry at the University of Manitoba was conducted. Respondents completed an online survey consisting of demographic questions and the GTS. Responses were analyzed descriptively and compared to previously published data on the GTS. There was a trend for psychiatrists and psychiatry residents within this sample to endorse less negative attitudes toward transgender people compared to other published data using a sample of undergraduate students. Descriptive analyses suggest that psychiatrists' and psychiatry residents' GTS scores may be related to gender identity, political ideology, religiosity, and levels of both professional and personal contact. These data evoke optimism regarding psychiatrists' and psychiatry residents' attitudes toward transgender individuals. Additional larger-scale studies comparing this medical specialty group with other specialty groups will further elucidate factors that modify physician attitudes toward this patient population. These findings may contribute to the development of educational strategies to ensure that the transgender population receives medical treatment without stigma or attitudinal compromise.

  20. Medical management of transgender children and adolescents.

    Science.gov (United States)

    Castilla-Peón, María Fernanda

    2018-01-01

    Transgender or gender nonconforming (GN) persons identify themselves with a gender which is different from that correspondent to their birth sex. The demand for health services by families with transgender children or adolescents tends to increase. The prevalence of GN in children is unknown; however, it has been estimated to be > 1% in adolescents. Transgender persons are at increased risk of depression, suicide, illicit drug abuse, human immunodeficiency virus infection, and non-accidental injury. The most accepted model for the care of transgender persons assumes that these adverse outcomes are the consequence of social margination rather than the GI condition itself. Social and physical gender transition seem to be effective in increasing the well-being of people with GI and reducing associated health risks. Mental health professionals can support the child in the process of social transition. The pediatric endocrinologist may offer puberty blockade and cross-sex induction of puberty. Surgical sex reassignment interventions are reserved for adults. Gender identity, gender expression and sexual orientation are three relatively independent categories that can take any value, which is not necessarily binary (male/female) or fixed. Health professionals should be familiar with these concepts in order to offer the best resources available to optimize the well-being of each transgender child or adolescent with an individualized approach. Copyright: © 2018 Permanyer.

  1. Judgments toward male and transgendered victims in a depicted stranger rape.

    Science.gov (United States)

    Davies, Michelle; Hudson, Jenefer

    2011-01-01

    There has been an increasing amount of research interest into perceptions of male rape in recent years. However, no research has assessed how people react when a transgendered person is raped. The aim of this study was to investigate the effects of transgendered status and sexuality on victim blame and perceived severity in a depicted rape scenario. The sexuality of the victim was manipulated to include a heterosexual, homosexual, cross-dresser, female-to-male transsexual, and male-to-female transsexual. It was predicted that the heterosexual victims would be judged the most positively and that heterosexual male participants would make the most anti-victim judgments. One hundred thirty-three lesbian, gay male, and heterosexual members of the general population read a scenario depicting a rape and then completed a questionnaire measuring victim blame and perceived severity of the assault. Results conformed to the predictions. Results are discussed in relation to traditional gender roles and homophobia.

  2. Transgender men and pregnancy.

    Science.gov (United States)

    Obedin-Maliver, Juno; Makadon, Harvey J

    2016-03-01

    Transgender people have experienced significant advances in societal acceptance despite experiencing continued stigma and discrimination. While it can still be difficult to access quality health care, and there is a great deal to be done to create affirming health care organizations, there is growing interest around the United States in advancing transgender health. The focus of this commentary is to provide guidance to clinicians caring for transgender men or other gender nonconforming people who are contemplating, carrying, or have completed a pregnancy. Terms transgender and gender nonconforming specifically refer to those whose gender identity (e.g., being a man) differs from their female sex assigned at birth. Many, if not most transgender men retain their female reproductive organs and retain the capacity to have children. Review of their experience demonstrates the need for preconception counseling that includes discussion of stopping testosterone while trying to conceive and during pregnancy, and anticipating increasing experiences of gender dysphoria during and after pregnancy. The clinical aspects of delivery itself fall within the realm of routine obstetrical care, although further research is needed into how mode and environment of delivery may affect gender dysphoria. Postpartum considerations include discussion of options for chest (breast) feeding, and how and when to reinitiate testosterone. A positive perinatal experience begins from the moment transgender men first present for care and depends on comprehensive affirmation of gender diversity.

  3. Dyadic effects of gender minority stressors in substance use behaviors among transgender women and their non-transgender male partners.

    Science.gov (United States)

    Reisner, Sari L; Gamarel, Kristi E; Nemoto, Tooru; Operario, Don

    2014-03-01

    Despite evidence that interpersonal processes shape health behaviors, research concerning the dyadic effects of gender minority stressors on substance use behaviors of transgender people is scarce. The objective of this study was to use dyadic analysis to examine whether transgender discrimination was associated with substance use among transgender women and their male partners. Transgender women and their male partners ( N =191 couples; N =382 individuals) completed questionnaires. Participants' mean age was 37.1; 79.1% were racial/ethnic minority; 61.3% earned discrimination and past 30-day non-marijuana illicit drug use adjusting for age, relationship length, financial hardship, and depressive distress among partners in these dyads. Illicit drug use was reported by 31.4% of transgender women and 25.1% of their male partners. Perceived transgender discrimination was independently associated with increased odds of illicit drug use for transgender women (actor effect) but not for their male partners. Financial hardship statistically predicted drug use for both partners (actor effects). There were no partner effects for financial hardship on drug use. Overall, 34.5% of dyads had discrepant substance use. Discrimination scores of male partners differentiated dyads who reported discrepant substance use. Gender minority stressors are critical to understanding substance use among transgender women and their male partners. Integrating socioeconomic status into gender minority stress frameworks is essential. Results have implications for substance use prevention and treatment, including the need to incorporate gender minority stressors into interventions.

  4. Biotechnologies that empower transgender persons to self-actualize as individuals, partners, spouses, and parents are defining new ways to conceive a child: psychological considerations and ethical issues.

    Science.gov (United States)

    Condat, Agnès; Mendes, Nicolas; Drouineaud, Véronique; Gründler, Nouria; Lagrange, Chrystelle; Chiland, Colette; Wolf, Jean-Philippe; Ansermet, François; Cohen, David

    2018-01-17

    Today, thanks to biomedical technologies advances, some persons with fertility issues can conceive. Transgender persons benefit also from these advances and can not only actualize their self-identified sexual identities but also experience parenthood. Based on clinical multidisciplinary seminars that gathered child psychiatrists and psychoanalysts interested in the fields of assisted reproduction technology (ART) and gender dysphoria, philosophers interested in bioethics, biologists interested in ART, and endocrinologists interested in pubertal suppression, we explore how new biotechnical advances, whether in gender transition or procreation, could create new ways to conceive a child possible. After reviewing the various medical/surgical techniques for physical gender transition and the current ART options, we discuss how these new ways for persons to self-actualize and to experience parenthood can not only improve the condition of transgender persons (and the human condition as a whole through greater equity) but also introduce some elements of change in the habitual patterns of thinking especially in France. Finally, we discuss the ethical issues that accompany the arrival of these children and provide creative solutions to help society handle, accept, and support the advances made in this area.

  5. Sport and Transgender People: A Systematic Review of the Literature Relating to Sport Participation and Competitive Sport Policies

    OpenAIRE

    Jones, Bethany Alice; Arcelus, Jon; Bouman, Walter Pierre; Haycraft, Emma

    2016-01-01

    Background\\ud \\ud Whether transgender people should be able to compete in sport in accordance with their gender identity is a widely contested question within the literature and among sport organisations, fellow competitors and spectators. Owing to concerns surrounding transgender people (especially transgender female individuals) having an athletic advantage, several sport organisations place restrictions on transgender competitors (e.g. must have undergone gender-confirming surgery). In add...

  6. Transgender social inclusion and equality: a pivotal path to development

    Science.gov (United States)

    Divan, Vivek; Cortez, Clifton; Smelyanskaya, Marina; Keatley, JoAnne

    2016-01-01

    Introduction The rights of trans people are protected by a range of international and regional mechanisms. Yet, punitive national laws, policies and practices targeting transgender people, including complex procedures for changing identification documents, strip transgender people of their rights and limit access to justice. This results in gross violations of human rights on the part of state perpetrators and society at large. Transgender people's experience globally is that of extreme social exclusion that translates into increased vulnerability to HIV, other diseases, including mental health conditions, limited access to education and employment, and loss of opportunities for economic and social advancement. In addition, hatred and aggression towards a group of individuals who do not conform to social norms around gender manifest in frequent episodes of extreme violence towards transgender people. This violence often goes unpunished. Discussion The United Nations Development Programme (UNDP) views its work in the area of HIV through the lens of human rights and advances a range of development solutions such as poverty reduction, improved governance, active citizenship, and access to justice. This work directly relates to advancing the rights of transgender people. This manuscript lays out the various aspects of health, human rights, and development that frame transgender people's issues and outlines best practice solutions from transgender communities and governments around the globe on how to address these complex concerns. The examples provided in the manuscript can help guide UN agencies, governments, and transgender activists in achieving better standards of health, access to justice, and social inclusion for transgender communities everywhere. Conclusions The manuscript provides a call to action for countries to urgently address the violations of human rights of transgender people in order to honour international obligations, stem HIV epidemics, promote

  7. Transgender social inclusion and equality: a pivotal path to development.

    Science.gov (United States)

    Divan, Vivek; Cortez, Clifton; Smelyanskaya, Marina; Keatley, JoAnne

    2016-01-01

    The rights of trans people are protected by a range of international and regional mechanisms. Yet, punitive national laws, policies and practices targeting transgender people, including complex procedures for changing identification documents, strip transgender people of their rights and limit access to justice. This results in gross violations of human rights on the part of state perpetrators and society at large. Transgender people's experience globally is that of extreme social exclusion that translates into increased vulnerability to HIV, other diseases, including mental health conditions, limited access to education and employment, and loss of opportunities for economic and social advancement. In addition, hatred and aggression towards a group of individuals who do not conform to social norms around gender manifest in frequent episodes of extreme violence towards transgender people. This violence often goes unpunished. The United Nations Development Programme (UNDP) views its work in the area of HIV through the lens of human rights and advances a range of development solutions such as poverty reduction, improved governance, active citizenship, and access to justice. This work directly relates to advancing the rights of transgender people. This manuscript lays out the various aspects of health, human rights, and development that frame transgender people's issues and outlines best practice solutions from transgender communities and governments around the globe on how to address these complex concerns. The examples provided in the manuscript can help guide UN agencies, governments, and transgender activists in achieving better standards of health, access to justice, and social inclusion for transgender communities everywhere. The manuscript provides a call to action for countries to urgently address the violations of human rights of transgender people in order to honour international obligations, stem HIV epidemics, promote gender equality, strengthen social and

  8. Socialising transgender support in transition

    CERN Document Server

    Kate, Norman

    2017-01-01

    An evaluation of social support to transgender people relating to gender identity, gender transition, discrimination and mental health, leading to consideration of the niche for transgender people in a bi-gendered society, and of the developing socialization of transgender which counter-balances the consequences of its initial medicalization.

  9. Group Work with Transgender Clients

    Science.gov (United States)

    Dickey, Lore M.; Loewy, Michael I.

    2010-01-01

    Drawing on the existing literature, the authors' research and clinical experiences, and the first author's personal journey as a member and leader of the transgender community, this article offers a brief history of group work with transgender clients followed by suggestions for group work with transgender clients from a social justice…

  10. The sensitive period for male-to-female sex reversal begins at the embryonic stage in the Nile tilapia and is associated with the sexual genotype.

    Science.gov (United States)

    Gennotte, Vincent; Mélard, Charles; D'Cotta, Helena; Baroiller, Jean-François; Rougeot, Carole

    2014-12-01

    In this study, we sought to determine the mechanism of early sex reversal in a teleost by applying 4 hr feminization treatments to XY (17α-ethynylestradiol 2000 μg L(-1) ) and YY (6500 μg L(-1) ) Nile tilapia embryos on the first day post-fertilization (dpf). We then searched for changes in the expression profiles of some sex-differentiating genes in the brain (cyp19a1b, foxl2, and amh) and in sex steroids (testosterone, 17β-estradiol, and 11-ketotestosterone) concentrations during embryogenesis and gonad differentiation. No sex reversal was observed in YY individuals, whereas sex-reversal rates in XY progeny ranged from 0-60%. These results, together with the clearance profile of 17α-ethynylestradiol, confirmed the existence of an early sensitive period for sex determination that encompasses embryonic and larval development and is active prior to any sign of gonad differentiation. Estrogen treatment induced elevated expression of cyp19a1b and higher testosterone and 17β-estradiol concentrations at 4 dpf in both XY and YY individuals. foxl2 and amh were repressed at 4 dpf and their expression levels were not different between treated and control groups at 14 dpf, suggesting that foxl2 did not control cyp19a1b in the brains of tilapia embryos. Increased cyp19a1b expression in treated embryos could reflect early brain sexualization, although this difference alone cannot account for the observed sex reversal as the treatment was ineffective in YY individuals. The differential sensitivity of XY and YY genotypes to embryonic induced-feminization suggests that a sex determinant on the sex chromosomes, such as a Y repressor or an X activator, may influence sex reversal during the first steps of tilapia embryogenesis. © 2014 Wiley Periodicals, Inc.

  11. Pharmacotherapy Considerations in the Management of Transgender Patients: A Brief Review.

    Science.gov (United States)

    Bishop, Bryan M

    2015-12-01

    Transgender and transsexual individuals have unique health care needs and risks compared with the population at large. It is estimated that 1 in 100,000 individuals in the United States is a transgender woman and 1 in 400,000 is a transgender man, although these estimates of prevalence are likely conservative. Transgender individuals are at an increased risk of tobacco, alcohol, and substance abuse; they have an increased lifetime suicide attempt risk; and they are more likely to experience significant stressors in their lives. Transgender patients may elect to transition their appearance to the gender with which they identify. Hormone treatment (and possibly sex reassignment surgery) is a significant part of this transition, and pharmacists must understand the pharmacotherapeutic principles involved so they can better recommend therapeutic agents, provide dosing recommendations, and anticipate and manage adverse effects. It is critical to be culturally sensitive when providing care for transgender patients including using their preferred gender identity, preferred names, and preferred pronouns. It is also essential to be able to identify transgender and transsexual patients correctly within electronic health records to ensure that appropriate care and monitoring are provided. For pharmacists, this means they should know the biologic sex for performing calculations such as creatinine clearance and to prevent teratogenic agents from reaching a transgender or transsexual man who could be pregnant or is capable of becoming pregnant. Promoting knowledge of transgender health issues will enable pharmacists to provide better, more holistic care to their transgender patients. © 2015 Pharmacotherapy Publications, Inc.

  12. Social Context of Depressive Distress in Aging Transgender Adults.

    Science.gov (United States)

    White Hughto, Jaclyn M; Reisner, Sari L

    2016-11-01

    This study investigates the relationship between discrimination and mental health in aging transgender adults. Survey responses from 61 transgender adults above 50 ( M age = 57.7, SD = 5.8; 77.1% male-to-female; 78.7% White non-Hispanic) were analyzed. Multivariable logistic regression models examined the relationship between gender- and age-related discrimination, number of everyday discrimination experiences, and past-week depressive distress, adjusting for social support, sociodemographics, and other forms of discrimination. The most commonly attributed reasons for experiencing discrimination were related to gender (80.3%) and age (34.4%). More than half of participants (55.5%) met criteria for past-week depressive distress. In an adjusted multivariable model, gender-related discrimination and a greater number of everyday discrimination experiences were associated with increased odds of past-week depressive distress. Additional research is needed to understand the effects of aging and gender identity on depressive symptoms and develop interventions to safeguard the mental health of this vulnerable aging population.

  13. Social Context of Depressive Distress in Aging Transgender Adults

    Science.gov (United States)

    White Hughto, Jaclyn M.; Reisner, Sari L.

    2016-01-01

    This study investigates the relationship between discrimination and mental health in aging transgender adults. Survey responses from 61 transgender adults above 50 (Mage = 57.7, SD = 5.8; 77.1% male-to-female; 78.7% White non-Hispanic) were analyzed. Multivariable logistic regression models examined the relationship between gender- and age-related discrimination, number of everyday discrimination experiences, and past-week depressive distress, adjusting for social support, sociodemographics, and other forms of discrimination. The most commonly attributed reasons for experiencing discrimination were related to gender (80.3%) and age (34.4%). More than half of participants (55.5%) met criteria for past-week depressive distress. In an adjusted multivariable model, gender-related discrimination and a greater number of everyday discrimination experiences were associated with increased odds of past-week depressive distress. Additional research is needed to understand the effects of aging and gender identity on depressive symptoms and develop interventions to safeguard the mental health of this vulnerable aging population. PMID:28380703

  14. Stigma, Mental Health, and Resilience in an Online Sample of the US Transgender Population

    Science.gov (United States)

    Miner, Michael H.; Swinburne Romine, Rebecca E.; Hamilton, Autumn; Coleman, Eli

    2013-01-01

    Objectives. We assessed the association between minority stress, mental health, and potential ameliorating factors in a large, community-based, geographically diverse sample of the US transgender population. Methods. In 2003, we recruited through the Internet a sample of 1093 male-to-female and female-to-male transgender persons, stratified by gender. Participants completed an online survey that included standardized measures of mental health. Guided by the minority stress model, we evaluated associations between stigma and mental health and tested whether indicators of resilience (family support, peer support, identity pride) moderated these associations. Results. Respondents had a high prevalence of clinical depression (44.1%), anxiety (33.2%), and somatization (27.5%). Social stigma was positively associated with psychological distress. Peer support (from other transgender people) moderated this relationship. We found few differences by gender identity. Conclusions. Our findings support the minority stress model. Prevention needs to confront social structures, norms, and attitudes that produce minority stress for gender-variant people; enhance peer support; and improve access to mental health and social services that affirm transgender identity and promote resilience. PMID:23488522

  15. Self-Reported Discrimination in Health-Care Settings Based on Recognizability as Transgender: A Cross-Sectional Study Among Transgender U.S. Citizens.

    Science.gov (United States)

    Rodriguez, Amanda; Agardh, Anette; Asamoah, Benedict Oppong

    2018-05-01

    Discrimination has long been tied to health inequality. Rejected by families and communities because of their gender identity and gender-role behavior, transgender individuals are often socially marginalized. This study aimed to assess discrimination in health-care settings among persons self-identifying as transgender in the U.S. in relation to their recognizability as transgender, operationalized as how often they experienced that others recognized them as transgender. Data were obtained from the National Transgender Discrimination Survey (n = 6106 participants, assigned sex at birth = 3608 males, 2480 females, respectively). Binary logistic regressions were performed to examine associations between transgender recognizability and discrimination in health-care settings. Being recognized as transgender to any extent had a significant effect on perceived discrimination in health care. Always recognized as transgender showed significant associations with discrimination in a health-care setting (OR 1.48) and the following individualized health-care settings: social service settings (rape crisis and domestic violence centers, OR 5.22) and mental health settings (mental health clinic and drug treatment program, OR 1.87). Sex work and other street economy, which are known experiential factors affected by discrimination, were also significantly associated with discrimination in health-care settings. Discrimination in health-care settings is pervasive for transgender who are recognized as transgender. Public health efforts to improve access to equitable health care for transgender individuals may benefit from consideration of demographic, experiential, and medical risk factors to more fully understand the source of the seemingly excess risk of discrimination among persons recognized by others as being transgender.

  16. Transgender Noninclusive Healthcare and Delaying Care Because of Fear: Connections to General Health and Mental Health Among Transgender Adults

    Science.gov (United States)

    Seelman, Kristie L.; Colón-Diaz, Matthew J.P.; LeCroix, Rebecca H.; Xavier-Brier, Marik; Kattari, Leonardo

    2017-01-01

    Abstract Purpose: There are many barriers to reliable healthcare for transgender people that often contribute to delaying or avoiding needed medical care. Yet, few studies have examined whether noninclusive healthcare and delaying needed medical care because of fear of discrimination are associated with poorer health among transgender adults. This study aims to address these gaps in the knowledge base. Methods: This study analyzed secondary data from a statewide survey of 417 transgender adults in the Rocky Mountain region of the United States. Independent variables included noninclusive healthcare from a primary care provider (PCP) and delay of needed medical care because of fear of discrimination. Dependent variables assessed general health and mental health. Results: Transgender individuals who delayed healthcare because of fear of discrimination had worse general health in the past month than those who did not delay or delayed care for other reasons (B=−0.26, pdiscrimination, having a noninclusive PCP was not significantly associated with either general health or mental health. Conclusion: This study suggests a significant association between delaying healthcare because of fear of discrimination and worse general and mental health among transgender adults. These relationships remain significant even when controlling for provider noninclusivity, suggesting that fear of discrimination and consequent delay of care are at the forefront of health challenges for transgender adults. The lack of statistical significance for noninclusive healthcare may be related to the measurement approach used; future research is needed to develop an improved tool for measuring transgender noninclusive healthcare. PMID:28861545

  17. Assembling Transgender Moments

    Science.gov (United States)

    Greteman, Adam J.

    2017-01-01

    In this article, the author seeks to assemble moments--scholarly, popular, and aesthetic--in order to explore the possibilities that emerge as moments collect in education's encounters with the needs, struggles, and possibilities of transgender lives and practices. Assembling moments, the author argues, illustrates the value of "moments"…

  18. Transgender in Polynesia

    NARCIS (Netherlands)

    Besnier, N.; Whelehan, P.; Bolin, A.

    2015-01-01

    Most societies of Polynesia include a small minority of nonnormatively gendered people. These are highly effeminate men and masculine women, whose gendering also implies an erotic attraction to persons of the same sex who are normatively gendered. The gender crossing that transgender Polynesians

  19. Blatt v. Cabela's Retail, Inc. and a New Path for Transgender Rights

    OpenAIRE

    Levi, Jennifer; Barry, Kevin

    2018-01-01

    Published: Kevin Barry & Jennifer Levi, Blatt v. Cabela's Retail, Inc. and a New Path for Transgender Rights, 127 YALE L.J. F. 373 (2017). Since the Supreme Court recognized marriage equality in Obergefell v. Hodges, civil rights advocates have increasingly set their sights on transgender rights as the next legal frontier. Sex discrimination law, though an essential statutory tool, is not the only potential avenue for securing rights for transgender individuals. Another important federal ...

  20. Retelling Racialized Violence, Remaking White Innocence: The Politics of Interlocking Oppressions in Transgender Day of Remembrance

    OpenAIRE

    Lamble, Sarah

    2008-01-01

    Transgender Day of Remembrance has become a significant political event among those resisting violence against gender-variant persons. Commemorated in more than 250 locations worldwide, this day honors individuals who were killed due to anti-transgender hatred or prejudice. However, by focusing on transphobia as the definitive cause of violence, this ritual potentially obscures the ways in which hierarchies of race, class, and sexuality constitute such acts. Taking the Transgender Day of Reme...

  1. Lesbian, Gay, Bisexual, and Transgender Health

    Science.gov (United States)

    ... Objectives » Lesbian, Gay, Bisexual, and Transgender Health Lesbian, Gay, Bisexual, and Transgender Health Overview (active tab) Objectives National Snapshots Lesbian, Gay, Bisexual, and Transgender Health View HP2020 Data for: ...

  2. Sport and Transgender People: A Systematic Review of the Literature Relating to Sport Participation and Competitive Sport Policies.

    Science.gov (United States)

    Jones, Bethany Alice; Arcelus, Jon; Bouman, Walter Pierre; Haycraft, Emma

    2017-04-01

    Whether transgender people should be able to compete in sport in accordance with their gender identity is a widely contested question within the literature and among sport organisations, fellow competitors and spectators. Owing to concerns surrounding transgender people (especially transgender female individuals) having an athletic advantage, several sport organisations place restrictions on transgender competitors (e.g. must have undergone gender-confirming surgery). In addition, some transgender people who engage in sport, both competitively and for leisure, report discrimination and victimisation. To the authors' knowledge, there has been no systematic review of the literature pertaining to sport participation or competitive sport policies in transgender people. Therefore, this review aimed to address this gap in the literature. Eight research articles and 31 sport policies were reviewed. In relation to sport-related physical activity, this review found the lack of inclusive and comfortable environments to be the primary barrier to participation for transgender people. This review also found transgender people had a mostly negative experience in competitive sports because of the restrictions the sport's policy placed on them. The majority of transgender competitive sport policies that were reviewed were not evidence based. Currently, there is no direct or consistent research suggesting transgender female individuals (or male individuals) have an athletic advantage at any stage of their transition (e.g. cross-sex hormones, gender-confirming surgery) and, therefore, competitive sport policies that place restrictions on transgender people need to be considered and potentially revised.

  3. The role of the illusion in the construction of erotic desire: narratives from heterosexual men who have occasional sex with transgender women.

    Science.gov (United States)

    Reback, Cathy J; Kaplan, Rachel L; Bettcher, Talia M; Larkins, Sherry

    2016-08-01

    Little is known about men's sexual desire for and erotic attraction to male-to-female transgender women. To better understand how erotic desire is constructed, this study examined the narratives of a sample of heterosexual men who had had an occasional sexual encounter with a transgender woman. Open-ended qualitative interviews were conducted with 16 heterosexual men who reported at least one sexual encounter with a transgender woman in the previous 12 months. Using principles of Grounded Theory, three themes emerged: (1) the erotic desire that transpired from a transgender woman's construction of her femininity, (2) the sexual act that dictated the specific navigation of a transgender woman's penis and (3) the sexual dissonance that resulted from being a heterosexually identified man having sex with a partner who had a penis. These themes reflected how the participants defined and negotiated their sexual encounters, both psychologically through their understanding of sex with a transgender woman with a penis, and physically through the navigation of specific sex acts. The role of the 'illusion' was central to the meaning and construction of erotic desire. These narratives provided another framework for continuing discourse on the complexity of erotic desire.

  4. Transgender Parenting: A Review of Existing Research

    OpenAIRE

    Stotzer, Rebecca L; Herman, Jody L; Hasenbush, Amira

    2014-01-01

    The authors of this report reviewed 51 studies that analyze data about transgender parents. This report reviews the existing research on the prevalence and characteristics of transgender people who are parents, the quality of relationships between transgender parents and their children, outcomes for children with a transgender parent, and the reported needs of transgender parents. Overall, the authors found that substantial numbers of transgender people are parents, though at rates below the ...

  5. Alcohol-Related Blackouts, Negative Alcohol-Related Consequences, and Motivations for Drinking Reported by Newly Matriculating Transgender College Students.

    Science.gov (United States)

    Tupler, Larry A; Zapp, Daniel; DeJong, William; Ali, Maryam; O'Rourke, Sarah; Looney, John; Swartzwelder, H Scott

    2017-05-01

    Many transgender college students struggle with identity formation and other emotional, social, and developmental challenges associated with emerging adulthood. A potential maladaptive coping strategy employed by such students is heavy drinking. Prior literature has suggested greater consumption and negative alcohol-related consequences (ARCs) in transgender students compared with their cisgender peers, but little is known about their differing experiences with alcohol-related blackouts (ARBs). We examined the level of alcohol consumption, the frequency of ARBs and other ARCs, and motivations for drinking reported by the largest sample of transgender college students to date. A Web survey from an alcohol-prevention program, AlcoholEdu for College™, assessed student demographics and drinking-related behaviors, experiences, and motivations of newly matriculating first-year college students. A self-reported drinking calendar was used to examine each of the following measures over the previous 14 days: number of drinking days, total number of drinks, and maximum number of drinks on any single day. A 7-point Likert scale was used to measure ARCs, ARBs, and drinking motivations. Transgender students of both sexes were compared with their cisgender peers. A total of 989 of 422,906 students (0.2%) identified as transgender. Over a 14-day period, transgender compared with cisgender students were more likely to consume alcohol over more days, more total drinks, and a greater number of maximum drinks on a single day. Transgender students (36%) were more likely to report an ARB than cisgender students (25%) as well as more negative academic, confrontation-related, social, and sexual ARCs. Transgender respondents more often cited stress reduction, social anxiety, self-esteem issues, and the inherent properties of alcohol as motivations for drinking. For nearly all measures, higher values were yielded by male-to-female than female-to-male transgender students. Transgender

  6. Metabolic and functional changes in transgender individuals following cross-sex hormone treatment: Design and methods of the GEnder Dysphoria Treatment in Sweden (GETS study

    Directory of Open Access Journals (Sweden)

    Anna Wiik

    2018-06-01

    Full Text Available Background: Although the divergent male and female differentiation depends on key genes, many biological differences seen in men and women are driven by relative differences in estrogen and testosterone levels. Gender dysphoria denotes the distress that gender incongruence with the assigned sex at birth may cause. Gender-affirming treatment includes medical intervention such as inhibition of endogenous sex hormones and subsequent replacement with cross-sex hormones. The aim of this study is to investigate consequences of an altered sex hormone profile on different tissues and metabolic risk factors. By studying subjects undergoing gender-affirming medical intervention with sex hormones, we have the unique opportunity to distinguish between genetic and hormonal effects. Methods: The study is a single center observational cohort study conducted in Stockholm, Sweden. The subjects are examined at four time points; before initiation of treatment, after endogenous sex hormone inhibition, and three and eleven months following sex hormone treatment. Examinations include blood samples, skeletal muscle-, adipose- and skin tissue biopsies, arteriography, echocardiography, carotid Doppler examination, whole body MRI, CT of muscle and measurements of muscle strength. Results: The primary outcome measure is transcriptomic and epigenomic changes in skeletal muscle. Secondary outcome measures include transcriptomic and epigenomic changes associated with metabolism in adipose and skin, muscle strength, fat cell size and ability to release fatty acids from adipose tissue, cardiovascular function, and body composition. Conclusions: This study will provide novel information on the role of sex hormone treatment in skeletal muscle, adipose and skin, and its relation to cardiovascular and metabolic disease. Keywords: Transgender, Sex hormone, Adipose tissue, Skeletal muscle, Epigenetics, Sex change

  7. Viral hepatitis screening in transgender patients undergoing gender identity hormonal therapy.

    Science.gov (United States)

    Mangla, Neeraj; Mamun, Rifat; Weisberg, Ilan S

    2017-11-01

    Viral hepatitis is a global health issue and can lead to cirrhosis, liver failure, and hepatocellular carcinoma. Guidelines for viral hepatitis screening in the transgender population do not exist. Transgender patients may be at higher risk for contracting viral hepatitis due to socioeconomic and behavioral factors. The aim of this study was to measure the quality of screening, prevalence, and susceptibility of viral hepatitis, and to identify barriers to screening in transgender patients undergoing gender identity hormonal therapy. LGBTQ-friendly clinic visits from transgender patients older than 18 years in New York City from 2012 to 2015 were reviewed. Approximately 13% of patients were screened for any viral hepatitis on initial consultation. Screening rates for hepatitis C virus (HCV), hepatitis B virus (HBV), and hepatitis A virus (HAV) at any point were 27, 22, and 20%. HAV screening was performed in 28% of the female to male (FtM) patients and 16% of male to female (MtF) (P0.05). Prevalence of HCV, HBV, and HIV in FtM was 0, 0, and 0.44% and that in MtF was 1.78, 0.89, and 1.78%, respectively. Percentage of patients immune to hepatitis A in FtM and MtF subgroups were 55 and 47% (P>0.05). Percentage of patients immune to HBV in FtM and MtF subgroups were 54 and 48% (P>0.05). This study indicates a significant lack of hepatitis screening in the transgender population and a concerning proportion of patients susceptible to disease.

  8. Identifying the Transgender Population in the Medicare Program

    Science.gov (United States)

    Proctor, Kimberly; Haffer, Samuel C.; Ewald, Erin; Hodge, Carla; James, Cara V.

    2016-01-01

    Abstract Purpose: To identify and describe the transgender population in the Medicare program using administrative data. Methods: Using a combination of International Classification of Diseases ninth edition (ICD-9) codes relating to transsexualism and gender identity disorder, we analyzed 100% of the 2013 Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service (FFS) “final action” claims from both institutional and noninstitutional providers (∼1 billion claims) to identify individuals who may be transgender Medicare beneficiaries. To confirm, we developed and applied a multistage validation process. Results: Four thousand ninety-eight transgender beneficiaries were identified, of which ∼90% had confirmatory diagnoses, billing codes, or evidence of a hormone prescription. In general, the racial, ethnic, and geographic distribution of the Medicare transgender population tends to reflect the broader Medicare population. However, age, original entitlement status, and disease burden of the transgender population appear substantially different. Conclusions: Using a variety of claims information, ranging from claims history to additional diagnoses, billing modifiers, and hormone prescriptions, we demonstrate that administrative data provide a valuable resource for identifying a lower bound of the Medicare transgender population. In addition, we provide a baseline description of the diversity and disease burden of the population and a framework for future research. PMID:28861539

  9. Recommendations of Transgender Students, Staff, and Faculty in the USA for Improving College Campuses

    Science.gov (United States)

    Seelman, Kristie L.

    2014-01-01

    Research indicates that transgender individuals frequently experience marginalisation and interpersonal victimisation within college and university settings. Missing from the literature is a discussion of what can be done to address such patterns in higher education, based upon empirical data gathered from transgender and gender non-conforming…

  10. Counseling Transgender College Students: Perceptions of College Mental Health Clinicians' Preparedness

    Science.gov (United States)

    Couture, Valerie

    2017-01-01

    The purpose of this study was to assess the perceived preparedness levels of college mental health clinicians to counsel transgender college students. Multicultural counseling competency is required of professional counselors and transgender individuals are considered to be part of the multicultural population. A survey was completed by college…

  11. Trump’s transgender ban reminds us that the US military does not float above politics

    DEFF Research Database (Denmark)

    Crosbie, Thomas Alexander

    2017-01-01

    In July, President Donald Trump announced via Twitter that transgendered individuals would no longer be allowed to serve in the US military. Thomas Crosbie writes that there is no justifiable reason to exclude the transgendered from the military and such an order ignores its tradition...

  12. Addressing Transgender Issues in Schools

    Science.gov (United States)

    Cavanagh, Marian

    2016-01-01

    As mainstream media focus more attention on transgender issues, and as anti-discrimination laws evolve, a shift is taking place on campuses. Many schools now include gender identity and expression in their inclusivity work and seek to establish policies and procedures to support transgender students and their families. It's not an easy task. In…

  13. Neural correlates of ostracism in transgender persons living according to their gender identity: a potential risk marker for psychopathology?

    Science.gov (United States)

    Mueller, Sven C; Wierckx, Katrien; Boccadoro, Sara; T'Sjoen, Guy

    2018-01-15

    Stigmatization in society carries a high risk for development of psychopathology. Transgender persons are at particularly high risk for such stigmatization and social rejection by others. However, the neural correlates of ostracism in this group have not been captured. Twenty transgender men (TM, female-to-male) and 19 transgender women (TW, male-to-female) already living in their gender identity and 20 cisgender men (CM) and 20 cisgender women (CW) completed a cyberball task assessing both exclusion and re-inclusion during functional magnetic resonance imaging (fMRI). During psychosocial stress between-group differences were found in the dorsal and ventral anterior cingulate cortex (ACC) and the inferior frontal gyrus (IFG). Patterns were consistent with sex assigned at birth, i.e. CW showed greater activation in dorsal ACC and IFG relative to CM and TW. During re-inclusion, transgender persons showed greater ventral ACC activity relative to CW, possibly indicating persistent feelings of exclusion. Functional connectivity analyses supported these findings but showed a particularly altered functional connectivity between ACC and lateral prefrontal cortex in TM, which may suggest reduced emotional regulation to the ostracism experience in this group. Depressive symptoms or hormonal levels were not associated with these findings. The results bear implications for the role of social exclusion in development of mental health problems in socially marginalized groups.

  14. Beyond Depression and Suicide: The Mental Health of Transgender College Students

    Directory of Open Access Journals (Sweden)

    Sara B. Oswalt

    2017-02-01

    Full Text Available Research studies examining the mental health of transgender individuals often focus on depression, anxiety, and suicidal ideation through the use of clinic samples. However, little is known about the emerging adult (18–26 years old transgender population and their mental health. The current study seeks to fill that gap by using a national dataset of college students (N = 547,727 to examine how transgender college students (n = 1143 differ from their cisgender peers regarding 12 different mental health conditions. Chi-square and regression analyses were conducted. Results demonstrate that transgender students have approximately twice the risk for most mental health conditions compared to female students. A notable exception is schizophrenia, in which transgender individuals have about seven times the risk compared to females. While these were significant findings, regression analyses indicate that being non-heterosexual is a greater predictor for mental health concerns. Implications for mental health practitioners at colleges and universities are discussed.

  15. Twitter: A Novel Tool for Studying the Health and Social Needs of Transgender Communities.

    Science.gov (United States)

    Krueger, Evan A; Young, Sean D

    2015-01-01

    Limited research has examined the health and social needs of transgender and gender nonconforming populations. Due to high levels of stigma, transgender individuals may avoid disclosing their identities to researchers, hindering this type of work. Further, researchers have traditionally relied on clinic-based sampling methods, which may mask the true heterogeneity of transgender and gender nonconforming communities. Online social networking websites present a novel platform for studying this diverse, difficult-to-reach population. The objective of this study was to attempt to examine the perceived health and social needs of transgender and gender nonconforming communities by examining messages posted to the popular microblogging platform, Twitter. Tweets were collected from 13 transgender-related hashtags on July 11, 2014. They were read and coded according to general themes addressed, and a content analysis was performed. Qualitative and descriptive statistics are presented. There were 1135 tweets that were collected in total. Both "positive" and "negative" events were discussed, in both personal and social contexts. Violence, discrimination, suicide, and sexual risk behavior were discussed. There were 34.36% (390/1135) of tweets that addressed transgender-relevant current events, and 60.79% (690/1135) provided a link to a relevant news article or resource. This study found that transgender individuals and allies use Twitter to discuss health and social needs relevant to the population. Real-time social media sites like Twitter can be used to study issues relevant to transgender communities.

  16. Transgender Veterans' Satisfaction With Care and Unmet Health Needs.

    Science.gov (United States)

    Lehavot, Keren; Katon, Jodie G; Simpson, Tracy L; Shipherd, Jillian C

    2017-09-01

    Transgender individuals are overrepresented among Veterans. However, little is known regarding their satisfaction with Veterans Administration (VA) care and unmet health needs. This study examined transgender Veterans' satisfaction with VA medical and mental health care, prevalence of delaying care, and correlates of these outcomes. We used data from transgender Veterans collected in 2014 through an online, national survey. In total, 298 transgender Veterans living in the United States. We assessed patient satisfaction with VA medical and mental health care and self-reported delays in seeking medical and mental health care in the past year. Potential correlates associated with these 4 outcomes included demographic, health, and health care variables. Over half of the sample used VA (56%) since their military discharge. Among transgender Veterans who had used VA, 79% were satisfied with medical care and 69% with mental health care. Lower income was associated with dissatisfaction with VA medical care, and being a transgender man was associated with dissatisfaction with VA mental health care. A substantial proportion reported delays in seeking medical (46%) or mental (38%) health care in the past year (not specific to VA). Screening positive for depression and/or posttraumatic stress disorder was associated with delays in seeking both types of care. Although the majority of transgender Veterans are satisfied with VA health care, certain subgroups are less likely to be satisfied with care. Further, many report delaying accessing care, particularly those with depression and/or posttraumatic stress disorder symptoms. Adapting health care settings to better engage these vulnerable Veterans may be necessary.

  17. Examining transgender health through the International Classification of Functioning, Disability, and Health's (ICF) Contextual Factors.

    Science.gov (United States)

    Jacob, Melissa; Cox, Steven R

    2017-12-01

    For many transgender individuals, medical intervention is necessary to live as their desired gender. However, little is known about Contextual Factors (i.e., Environmental and Personal) that may act as facilitators and barriers in the health of transgender individuals. Therefore, this paper sought to examine Contextual Factors of the World Health Organization's International Classification of Functioning, Disability, and Health that may facilitate or negatively impact the physical, psychological, and social functioning of transgender individuals. A literature review was conducted to identify Environmental and Personal Factors that may influence transgender individuals' physical, psychological, and social functioning. Seven electronic databases were searched. In total, 154 records were reviewed, and 41 articles and other records met inclusion criteria. Three general themes emerged for Environmental Factors: family and social networks, education, and health care. Three general themes also emerged for Personal Factors: socioeconomic status, race, and age. Transgender individuals benefit from gender-affirming services, improved family and social support systems, and competent provider care. Educational training programs, including medical curricula or workshops, might provide the greatest benefit in improving transgender health by increasing the knowledge and cultural competency of health professionals working with this population. Given the diversity of gender expression, differences in lived experiences, and potential for enduring persistent "double discrimination" due to the intersectional relationships between socioeconomic status, race, and/or age, health professionals must approach transgender health using a holistic lens such as the World Health Organization's International Classification of Functioning, Disability, and Health.

  18. Transgender health care: improving medical students' and residents' training and awareness

    Directory of Open Access Journals (Sweden)

    Dubin SN

    2018-05-01

    Full Text Available Samuel N Dubin,1,* Ian T Nolan,1,* Carl G Streed Jr,2 Richard E Greene,3 Asa E Radix,4 Shane D Morrison5 1NYU School of Medicine, New York, NY, 2Department of Medicine, Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, 3Department of Internal Medicine, NYU School of Medicine, 4Callen-Lorde Community Health Center, New York, NY, 5Department of Surgery, Division of Plastic Surgery, University of Washington School of Medicine, Seattle, WA, USA *These authors contributed equally to this work Background: A growing body of research continues to elucidate health inequities experienced by transgender individuals and further underscores the need for medical providers to be appropriately trained to deliver care to this population. Medical education in transgender health can empower physicians to identify and change the systemic barriers to care that cause transgender health inequities as well as improve knowledge about transgender-specific care. Methods: We conducted structured searches of five databases to identify literature related to medical education and transgender health. Of the 1272 papers reviewed, 119 papers were deemed relevant to predefined criteria, medical education, and transgender health topics. Citation tracking was conducted on the 119 papers using Scopus to identify an additional 12 relevant citations (a total of 131 papers. Searches were completed on October 15, 2017 and updated on December 11, 2017. Results: Transgender health has yet to gain widespread curricular exposure, but efforts toward incorporating transgender health into both undergraduate and graduate medical educations are nascent. There is no consensus on the exact educational interventions that should be used to address transgender health. Barriers to increased transgender health exposure include limited curricular time, lack of topic-specific competency among faculty, and underwhelming institutional support. All published

  19. The Social Costs of Gender Nonconformity for Transgender Adults: Implications for Discrimination and Health.

    Science.gov (United States)

    Miller, Lisa R; Grollman, Eric Anthony

    2015-09-01

    Research suggests that transgender people face high levels of discrimination in society, which may contribute to their disproportionate risk for poor health. However, little is known about whether gender nonconformity, as a visible marker of one's stigmatized status as a transgender individual, heightens trans people's experiences with discrimination and, in turn, their health. Using data from the largest survey of transgender adults in the United States, the National Transgender Discrimination Survey (N = 4,115), we examine the associations among gender nonconformity, transphobic discrimination, and health-harming behaviors (i.e., attempted suicide, drug/alcohol abuse, and smoking). The results suggest that gender nonconforming trans people face more discrimination and, in turn, are more likely to engage in health-harming behaviors than trans people who are gender conforming. Our findings highlight the important role of gender nonconformity in the social experiences and well-being of transgender people.

  20. Gender cognition in transgender children.

    Science.gov (United States)

    Olson, Kristina R; Key, Aidan C; Eaton, Nicholas R

    2015-04-01

    A visible and growing cohort of transgender children in North America live according to their expressed gender rather than their natal sex, yet scientific research has largely ignored this population. In the current study, we adopted methodological advances from social-cognition research to investigate whether 5- to 12-year-old prepubescent transgender children (N = 32), who were presenting themselves according to their gender identity in everyday life, showed patterns of gender cognition more consistent with their expressed gender or their natal sex, or instead appeared to be confused about their gender identity. Using implicit and explicit measures, we found that transgender children showed a clear pattern: They viewed themselves in terms of their expressed gender and showed preferences for their expressed gender, with response patterns mirroring those of two cisgender (nontransgender) control groups. These results provide evidence that, early in development, transgender youth are statistically indistinguishable from cisgender children of the same gender identity. © The Author(s) 2015.

  1. The Sexual Health of Transgender Men: A Scoping Review.

    Science.gov (United States)

    Stephenson, Rob; Riley, Erin; Rogers, Erin; Suarez, Nicolas; Metheny, Nick; Senda, Jonathan; Saylor, Kate M; Bauermeister, José A

    There is a general paucity of research concerning the sexual health of transgender individuals, and most existing research focuses on transgender women. A scoping review concerning the sexual health of transgender men was conducted to identify gaps in the literature and to highlight opportunities for future research and intervention. A comprehensive search of seven databases was conducted. The Joanna Briggs Institute Reviewers' Manual was used as a framework. Some 7,485 articles were initially identified using a search strategy applied to seven online databases: 54 articles were identified as relevant to the research questions and reviewed in detail; of those, 33 were included in the final analysis. Studies were conceptualized into four broad themes: sexual behaviors, sexual identity, sexual pleasure and sexual function, and transactional sex. Besides an overall lack of research, existing studies were often characterized by small convenience samples that do not allow for generalization to the larger population of transgender men. Significant gaps in the literature regarding sexual coercion, sexual and intimate partner violence, and relationship quality and functioning among transgender men exist. There is a need to improve the scope and depth of research examining the sexual health of this population, especially concerning sexual risk behaviors and structural barriers to sexual health care access.

  2. Video gaming and gaming addiction in transgender people: An exploratory study.

    Science.gov (United States)

    Arcelus, Jon; Bouman, Walter Pierre; Jones, Bethany Alice; Richards, Christina; Jimenez-Murcia, Susana; Griffiths, Mark D

    2017-03-01

    Background There is anecdotal clinical evidence that transgender people use the online world - such as forums and online video gaming - for the purpose of experiencing their gender identity in a safe, non-threatening, non-alienating, non-stigmatizing, and non-critical environment. Aims To describe gaming behavior, degree of problematic gaming behavior and associated factors with problematic gaming in a comparatively large group of transgender people accessing transgender health services. Methods Every individual referred to a national transgender health service in the United Kingdom during a 12-month period was invited to complete a series of questionnaires to measure gaming behavior, interpersonal functioning, severity of autistic features, and anxiety and depressive symptoms. Results A total of 245 people agreed to participate in the study with 154 (62.9%) describing themselves as current gamers. Gaming behavior in the transgender population attending transgender health services was prevalent, but less than 1% of them presented with clinical scores for Internet Gaming Disorder, with no differences according to gender. Problematic gaming behavior was associated with general interpersonal problems, depression, and young age. Discussion and conclusions Transgender people who engage in problematic gaming behavior are younger, and present with high interpersonal problems, and depression, which can affect a successful transition. In view of the high levels of gaming activity in this population games that are designed to address these psychological problems may be well received by transgender people.

  3. Fertility Preservation for Transgender Adolescents.

    Science.gov (United States)

    Chen, Diane; Simons, Lisa; Johnson, Emilie K; Lockart, Barbara A; Finlayson, Courtney

    2017-07-01

    To describe fertility preservation (FP) utilization by transgender adolescents within a pediatric gender clinic between July 2013 and July 2016. A retrospective chart review was conducted to abstract demographic and clinical information among adolescents initiating gender-affirming hormones, including patient age at initial FP consultation, birth-assigned sex, race/ethnicity, and outcome of FP consultation. In our sample of 105 transgender adolescents, a total of 13 (seven transgender men and six transgender women) between the age of 14.2 and 20.6 years were seen in formal consultation for FP before initiating hormones. Of these adolescents, four completed sperm cryopreservation and one completed oocyte cryopreservation. Rates of FP utilization among transgender youth were low, which is consistent with a recently published report of FP utilization among transgender youth at another pediatric institution. Identified barriers to FP in our sample included cost, invasiveness of procedures, and desire not to delay medical transition. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  4. Statement on gender-affirmative approach to care from the pediatric endocrine society special interest group on transgender health.

    Science.gov (United States)

    Lopez, Ximena; Marinkovic, Maja; Eimicke, Toni; Rosenthal, Stephen M; Olshan, Jerrold S

    2017-08-01

    The purpose of this Position Statement is to emphasize the importance of an affirmative approach to the health care of transgender individuals, as well as to improve the understanding of the rights of transgender youth. Transgender youth have optimal outcomes when affirmed in their gender identity, through support by their families and their environment, as well as appropriate mental health and medical care. The Pediatric Endocrine Society Special Interest Group on Transgender Health joins other academic societies involved in the care of children and adolescents in supporting policies that promote a safe and accepting environment for gender nonconforming/transgender youth, as well as adequate mental health and medical care. This document provides a summary of relevant definitions, information and current literature on which the medical management and affirmative approach to care of transgender youth are based.

  5. Global Epidemiology of HIV Infection and Related Syndemics Affecting Transgender People

    Science.gov (United States)

    Scheim, Ayden; Xavier, Jessica; Reisner, Sari; Baral, Stefan

    2016-01-01

    Introduction: Transgender populations have been underrepresented in HIV epidemiologic studies and consequently in HIV prevention, care, and treatment programs. Since 2012, there has been a dramatic increase in research focused on transgender people. Studies highlight the burden of HIV and risk determinants, including intersecting stigmas, as drivers of syndemics among transgender populations. This review synthesizes the most recent global epidemiology of HIV infection and describes current gaps in research and interventions to inform prioritization of HIV research for transgender populations. Methods: A systematic review was conducted of the medical literature published between January 1, 2012 and November 30, 2015. The data focused on HIV prevalence, determinants of risk, and syndemics among transgender populations. Results: Estimates varied dramatically by location and subpopulation. Transfeminine individuals have some of the highest concentrated HIV epidemics in the world with laboratory-confirmed prevalence up to 40%. Data were sparse among trans masculine individuals; however, they suggest potential increased risk for trans masculine men who have sex with men (MSM). No prevalence data were available for transgender people across Sub-Saharan Africa or Eastern Europe/Central Asia. Emerging data consistently support the association of syndemic conditions with HIV risk in transgender populations. Discussion: Addressing syndemic conditions and gender-specific challenges is critical to ensure engagement and retention in HIV prevention by transgender populations. Future research should prioritize: filling knowledge gaps in HIV epidemiology; elucidating how stigma shapes syndemic factors to produce HIV and other deleterious effects on transgender health; and understanding how to effectively implement HIV interventions for transgender people. PMID:27429185

  6. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding

    National Research Council Canada - National Science Library

    Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities; Board on the Health of Select Populations; Institute of Medicine

    2011-01-01

    At a time when lesbian, gay, bisexual, and transgender individuals--often referred to under the umbrella acronym LGBT--are becoming more visible in society and more socially acknowledged, clinicians...

  7. Toward Transgender Affirmative Social Work Education

    Science.gov (United States)

    Austin, Ashley; Craig, Shelley L.; McInroy, Lauren B.

    2016-01-01

    Social work has professional and academic standards consistent with transgender affirmative education and practice. Nevertheless, a growing body of research suggests that transgender issues are largely absent from social work education, resulting in practitioners who are uninformed or biased against transgender issues. The present study expands…

  8. Research Priorities for Gender Nonconforming/Transgender Youth: Gender Identity Development and Biopsychosocial Outcomes

    Science.gov (United States)

    Olson-Kennedy, J; Cohen-Kettenis, P. T.; Kreukels, B.P.C; Meyer-Bahlburg, H.F.L; Garofalo, R; Meyer, W; Rosenthal, S.M.

    2016-01-01

    This review summarizes relevant research focused on prevalence and natural history of gender non-conforming / transgender youth, and outcomes of currently recommended clinical practice guidelines. This review identifies gaps in knowledge, and provides recommendations foci for future research. Recent findings Increasing numbers of gender nonconforming youth are presenting for care. Clinically useful information for predicting individual psychosexual development pathways is lacking. Transgender youth are at high risk for poor medical and psychosocial outcomes. Longitudinal data examining the impact of early social transition and medical interventions are sparse. Existing tools to understand gender identity and quantify gender dysphoria need to be reconfigured in order to study a more diverse cohort of transgender individuals. Increasingly, biomedical data are beginning to change the trajectory of scientific investigation. Summary Extensive research is needed to improve understanding of gender dysphoria, and transgender experience, particularly among youth. Recommendations include identification of predictors of persistence of gender dysphoria from childhood into adolescence, and a thorough investigation into the impact of interventions for transgender youth. Finally, examining the social environments of transgender youth is critical for the development of appropriate interventions necessary to improve the lives of transgender people. PMID:26825472

  9. Research priorities for gender nonconforming/transgender youth: gender identity development and biopsychosocial outcomes.

    Science.gov (United States)

    Olson-Kennedy, Johanna; Cohen-Kettenis, Peggy T; Kreukels, Baudewijntje P C; Meyer-Bahlburg, Heino F L; Garofalo, Robert; Meyer, Walter; Rosenthal, Stephen M

    2016-04-01

    The review summarizes relevant research focused on prevalence and natural history of gender nonconforming/transgender youth, and outcomes of currently recommended clinical practice guidelines. This review identifies gaps in knowledge, and provides recommendations foci for future research. Increasing numbers of gender nonconforming youth are presenting for care. Clinically useful information for predicting individual psychosexual development pathways is lacking. Transgender youth are at high risk for poor medical and psychosocial outcomes. Longitudinal data examining the impact of early social transition and medical interventions are sparse. Existing tools to understand gender identity and quantify gender dysphoria need to be reconfigured to study a more diverse cohort of transgender individuals. Increasingly, biomedical data are beginning to change the trajectory of scientific investigation. Extensive research is needed to improve understanding of gender dysphoria, and transgender experience, particularly among youth. Recommendations include identification of predictors of persistence of gender dysphoria from childhood into adolescence, and a thorough investigation into the impact of interventions for transgender youth. Finally, examining the social environments of transgender youth is critical for the development of appropriate interventions necessary to improve the lives of transgender people.

  10. Bending gender, ending gender: theoretical foundations for social work practice with the transgender community.

    Science.gov (United States)

    Burdge, Barb J

    2007-07-01

    Gender is a ubiquitous social construct that wields power over every individual in our society. The traditional dichotomous gender paradigm is oppressive, especially for transgendered people whose sense of themselves as gendered people is incongruent with the gender they were assigned at birth. Transgendered individuals are targeted for mistreatment when others attempt to enforce conventional gender boundaries. This article discusses gender-based oppression and the resulting psychosocial difficulties experienced by many transgendered individuals. The discussion advances a critical analysis of the dominant gender paradigm using two alternative theoretical perspectives on gender--queer theory and social constructionism. The article argues that the transgender community is an at-risk population and that empowering practice with this population calls on social workers to target society's traditional gender dichotomy for change. An overview of practice implications and research needs is provided.

  11. Differences Across Age Groups in Transgender and Gender Non-Conforming People's Experiences of Health Care Discrimination, Harassment, and Victimization.

    Science.gov (United States)

    Kattari, Shanna K; Hasche, Leslie

    2016-03-01

    Given the increasing diversity among older adults and changes in health policy, knowledge is needed on potential barriers to health care for transgender and gender non-conforming (GNC) individuals. Using the 2010 National Transgender Discrimination Survey (NTDS), logistic regression models test differences between age groups (below 35, 35-49, 50-64, and 65 and above) in lifetime experience of anti-transgender discrimination, harassment, and victimization within health care settings while considering the influences of insurance status, level of passing, time of transition, and other socio-demographic factors. Although more than one fifth of transgender and GNC individuals of all ages reported health discrimination, harassment, or victimization, significant age differences were found. Insurance status and level of passing were also influential. Medicare policy changes and this study's findings prompt further consideration for revising other health insurance policies. In addition, expanded cultural competency trainings that are specific to transgender and GNC individuals are crucial. © The Author(s) 2015.

  12. Fertility treatment for the transgender community: a public opinion study.

    Science.gov (United States)

    Goldman, Randi H; Kaser, Daniel J; Missmer, Stacey A; Farland, Leslie V; Scout; Ashby, Rachel K; Ginsburg, Elizabeth S

    2017-11-01

    The purposes of this study were to evaluate public opinion regarding fertility treatment and gamete cryopreservation for transgender individuals and identify how support varies by demographic characteristics. This is a cross-sectional web-based survey study completed by a representative sample of 1111 US residents aged 18-75 years. Logistic regression was used to calculate odd ratios (ORs) and 95% confidence intervals (CIs) of support for/opposition to fertility treatments for transgender people by demographic characteristics, adjusting a priori for age, gender, race, and having a biological child. Of 1336 people recruited, 1111 (83.2%) agreed to participate, and 986 (88.7%) completed the survey. Most respondents (76.2%) agreed that "Doctors should be able to help transgender people have biological children." Atheists/agnostics were more likely to be in support (88.5%) than Christian-Protestants (72.4%; OR = 3.10, CI = 1.37-7.02), as were younger respondents, sexual minorities, those divorced/widowed, Democrats, and non-parents. Respondents who did not know a gay person (10.0%; OR = 0.20, CI = 0.09-0.42) or only knew a gay person without children (41.4%; OR = 0.29, CI = 0.17-0.50) were more often opposed than those who knew a gay parent (48.7%). No differences in gender, geography, education, or income were observed. A smaller majority of respondents supported doctors helping transgender minors preserve gametes before transitioning (60.6%) or helping transgender men carry pregnancies (60.1%). Most respondents who support assisted and third-party reproduction also support such interventions to help transgender people have children.

  13. Aktualisasi Transgender di Kabupaten Jombang

    Directory of Open Access Journals (Sweden)

    Wening Purbatin Palupi Soenjoto

    2016-12-01

    Full Text Available Transgender phenomena in the community get a variety of reactions. Many cases have sprung up that need to be addressed. In this study focused on the opinions and forms of social action carried out by a student against transgender existence. To answer the researchers used the theory of social action, Max Weber. Snowball is a technique used to determine the informant with the help to the informant. This research was conducted by means of qualitative description and choose a location in the area of Jombang, East Java. Data collected by means of in-depth interviews were then analyzed inductively. Based on the results of the study, presented on the causes being a transgender. Researchers found a uniform answer as to the cause of both informants about being transgender subjectively. It can be seen that transgender is a person were has a biological disorder for example born with two genitals and some were caused by some external factors as the influence of the social environment. In addition there are internal factors that have an instinct that is different from the original gender.

  14. Barriers to Care for Transgender People: A Conversation With Dana Hines, PhD, MSN, RN.

    Science.gov (United States)

    Biederman, Donna J; Hines, Dana

    2016-05-01

    A public health nurse talks about her career trajectory, her entry into nursing research, and her research career in transgender health. Transgender people encounter many health and social disparities, yet medical and nursing professionals are often ill-prepared to care for this population of individuals. The nursing profession is well known for its contributions to population health and for developing nursing-led interventions to improve the health outcomes of marginalized populations. Hines urges nursing to take a more active stance in transgender health and is leading this effort by example.

  15. Transgender at Work: Livelihoods for Transgender People in Vietnam

    NARCIS (Netherlands)

    Hoang, T.A.; Oosterhoff, P.

    2016-01-01

    The laws in the Socialist Republic of Vietnam promote equality for all citizens and refer to ‘persons’ rather than ‘men’ or ‘women’. However, because of traditional gender norms, transgender people in Vietnam are facing severe stigma and discrimination in public, in schools, at home and in the

  16. HIV Risk Behaviors in the U.S. Transgender Population: Prevalence and Predictors in a Large Internet Sample

    Science.gov (United States)

    Feldman, Jamie; Romine, Rebecca Swinburne; Bockting, Walter O.

    2014-01-01

    To study the influence of gender on HIV risk, a sample of the U.S. transgender population (N = 1,229) was recruited via the Internet. HIV risk and prevalence were lower than reported in prior studies of localized, urban samples, but higher than the overall U.S. population. Findings suggest that gender nonconformity alone does not itself result in markedly higher HIV risk. Sex with nontransgender men emerged as the strongest independent predictor of unsafe sex for both male-to-female (MtF) and female-to-male (FtM) participants. These sexual relationships constitute a process that may either affirm or problematize gender identity and sexual orientation, with different emphases for MtFs and FtMs, respectively. PMID:25022491

  17. The Schools Transgender Students Need

    Science.gov (United States)

    Kahn, Ellen

    2016-01-01

    In May 2016, the U.S. Department of Justice and the U.S. Department of Education issued guidance to schools intended to provide transgender students with safe and inclusive learning environments. On the heels of this guidance, Ellen Kahn, the Human Rights Campaign's director of Children, Youth, and Families Program, offers advice for educators…

  18. Transgender Research in the 21st Century: A Selective Critical Review From a Neurocognitive Perspective.

    Science.gov (United States)

    Mueller, Sven C; De Cuypere, Griet; T'Sjoen, Guy

    2017-12-01

    Gender dysphoria describes the psychological distress caused by identifying with the sex opposite to the one assigned at birth. In recent years, much progress has been made in characterizing the needs of transgender persons wishing to transition to their preferred gender, thus helping to optimize care. This critical review of the literature examines their common mental health issues, several individual risk factors for psychiatric comorbidity, and current research on the underlying neurobiology. Prevalence rates of persons identifying as transgender and seeking help with transition have been rising steeply since 2000 across Western countries; the current U.S. estimate is 0.6%. Anxiety and depression are frequently observed both before and after transition, although there is some decrease afterward. Recent research has identified autistic traits in some transgender persons. Forty percent of transgender persons endorse suicidality, and the rate of self-injurious behavior and suicide are markedly higher than in the general population. Individual factors contributing to mental health in transgender persons include community attitudes, societal acceptance, and posttransition physical attractiveness. Neurobiologically, whereas structural MRI data are thus far inconsistent, functional MRI evidence in trans persons suggests changes in some brain areas concerned with olfaction and voice perception consistent with sexual identification, but here too, a definitive picture has yet to emerge. Mental health clinicians, together with other health specialists, have an increasing role in the assessment and treatment of gender dysphoria in transgender individuals.

  19. A Literature Review of Cervical Cancer Screening in Transgender Men.

    Science.gov (United States)

    Gatos, Kayla C

    2018-02-01

    Most female-to-male (FTM) transgender men retain their cervixes and need comprehensive sexual health care, including cervical cancer screening. According to the literature, FTM individuals obtain cervical cancer screening less frequently and are less likely to be up to date on their Pap tests compared with cisgender women. Misinformation related to human papillomavirus and cervical cancer risk was noted for health care providers and FTM individuals. Absence of transgender-specific guidelines or trained health care providers presents barriers to cervical cancer screening for FTM individuals, and further research is indicated to develop comprehensive guidelines unique to the needs and experiences of this population. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  20. Using a Two-Step Method to Measure Transgender Identity in Latin America/the Caribbean, Portugal, and Spain

    Science.gov (United States)

    Reisner, Sari L.; Biello, Katie; Rosenberger, Joshua G.; Austin, S. Bryn; Haneuse, Sebastien; Perez-Brumer, Amaya; Novak, David S.; Mimiaga, Matthew J.

    2014-01-01

    Few comparative data are available internationally to examine health differences by transgender identity. A barrier to monitoring the health and well-being of transgender people is the lack of inclusion of measures to assess natal sex/gender identity status in surveys. Data were from a cross-sectional anonymous online survey of members (n > 36,000) of a sexual networking website targeting men who have sex with men in Spanish- and Portuguese-speaking countries/ territories in Latin America/the Caribbean, Portugal, and Spain. Natal sex/gender identity status was assessed using a two-step method (Step 1: assigned birth sex, Step 2: current gender identity). Male-to-female (MTF) and female-to-male (FTM) participants were compared to non-transgender males in age-adjusted regression models on socioeconomic status (SES) (education, income, sex work), masculine gender conformity, psychological health and well-being (lifetime suicidality, past-week depressive distress, positive self-worth, general self-rated health, gender related stressors), and sexual health (HIV-infection, past-year STIs, past-3 month unprotected anal or vaginal sex). The two-step method identified 190 transgender participants (0.54%; 158 MTF, 32 FTM). Of the 12 health-related variables, six showed significant differences between the three groups: SES, masculine gender conformity, lifetime suicidality, depressive distress, positive self-worth, and past-year genital herpes. A two-step approach is recommended for health surveillance efforts to assess natal sex/gender identity status. Cognitive testing to formally validate assigned birth sex and current gender identity survey items in Spanish and Portuguese is encouraged. PMID:25030120

  1. Screening for Spiritual Struggle in an Adolescent Transgender Clinic: Feasibility and Acceptability.

    Science.gov (United States)

    Grossoehme, Daniel H; Teeters, Alexis; Jelinek, Sue; Dimitriou, Sophia M; Conard, Lee Ann E

    2016-01-01

    Spiritual struggles are associated with poorer health outcomes, including depression, which has higher prevalence among transgender individuals than the general population. This study's objective was to improve the quality of care in an outpatient transgender clinic by screening patients and caregivers for spiritual struggle and future intervention. The quality improvement questions addressed were whether screening for spiritual struggle was feasible and acceptable; and whether the sensitivity and specificity of the Rush Protocol were acceptable. Revision of the screening was based on cognitive interviews with the 115 adolescents and caregivers who were screened. Prevalence of spiritual struggle was 38-47%. Compared to the Negative R-COPE, the Rush Protocol screener had sensitivities of 44-80% and specificities of 60-74%. The Rush Protocol was acceptable to adolescents seen in a transgender clinic, caregivers, and clinic staff; was feasible to deliver during outpatient clinic visits, and offers a straightforward means of identifying transgender persons and caregivers experiencing spiritual struggle.

  2. Sexual Preferences and Partnerships of Transgender Persons Mid- or Post-Transition.

    Science.gov (United States)

    Fein, Lydia A; Salgado, Christopher J; Sputova, Klara; Estes, Christopher M; Medina, Carlos A

    2018-01-01

    The process of gender transition has varying effects on various aspects of sexuality. The purpose of this study was to investigate the effects of transitioning on transgender persons' sexual preferences and partnerships. Data were collected through an anonymous online survey. Questions focused on timing of gender transition in relation to change in sexual preference. Transgender individuals have a variety of sexual partners, predominantly cisgender, and may change sexual preference when they transition. Transitioning can be associated with having no primary sexual partner, despite past sexual partnerships. Length of time between identifying as transgender and starting the transition might be associated with changing sexual partner preference, particularly in transgender women. The emerging trends of sexual partnerships and changing sexual preferences related to the transition in this study warrant further investigation. These data provide more understanding of the relationship between transitioning and sexual preferences and partnerships.

  3. Transgender, Mental Health, and Older People: An Appreciative Approach Towards Working Together.

    Science.gov (United States)

    Page, Sean; Burgess, Jenny; Davies-Abbott, Ian; Roberts, Debbie; Molderson, Jaanika

    2016-12-01

    It cannot be assumed by healthcare providers that transgender people routinely receive care and treatment that is of the quality and sensitivity that should be expected. In particular there are concerns from within the transgender community that they experience discrimination and disrespect from both individual practitioners and the healthcare system as a whole. This causes an avoidance of contact that is undesirable for both users and providers of healthcare services. Older transgender people are vulnerable to a range of mental health problems and, like all elderly, increasingly to dementia; failure to access specialist services in a timely manner may result in unnecessary distress and potentially to crisis. This paper reports on the use of an appreciative inquiry approach towards identifying the opportunities for one health board in North Wales to work more closely with older members of the transgender community it serves.

  4. Gender Affirmation and Body Modification Among Transgender Persons in Bogotá, Colombia.

    Science.gov (United States)

    Aguayo-Romero, Rodrigo A; Reisen, Carol A; Zea, Maria Cecilia; Bianchi, Fernanda T; Poppen, Paul J

    This paper examined structural, social, and personal characteristics that shape the processes of gender affirmation and body modification among transgender persons (assigned male at birth) in Bogotá, Colombia. Qualitative data from life-history interviews (N=14) and a focus group (N=11) explored research questions concerning the ways in which the internal psychological and external contextual processes influence individuals' decisions and behaviors concerning hormonal treatment, injections, or surgery. Research questions concerning practices and consequences of treatment performed without medical supervision were addressed through qualitative data, as well as quantitative data from 58 transgender participants. Findings indicated variation in ways participants conceptualized gender (e.g., binary or fluid), but an increased feminine presentation was a strong personal desire expressed by many and often encouraged by romantic partners and transgender friends. Transgender individuals within participants' social networks were frequently instrumental not only in providing information about hormones and contouring injections, but also in carrying out procedures-sometimes with negative consequences. Body modification procedures occurred primarily outside the health care system, due to limited access to or awareness of medical care, societal stigma, social norms within the transgender community, and personal decision-making. Public health approaches to protect the health of transgender persons undergoing body modification were suggested.

  5. Development and Validation of the Transgender Attitudes and Beliefs Scale.

    Science.gov (United States)

    Kanamori, Yasuko; Cornelius-White, Jeffrey H D; Pegors, Teresa K; Daniel, Todd; Hulgus, Joseph

    2017-07-01

    In recent years, issues surrounding transgender have garnered media and legal attention, contributing to rapidly shifting views on gender in the U.S. Yet, there is a paucity of data-driven studies on the public's views of transgender identity. This study reports the development and validation of the Transgender Attitudes and Beliefs Scale (TABS). After constructing an initial 96-item pool from consulting experts and existing scales, Phase 1 of the study was launched, involving an exploratory factor analysis of 48 items. The initial factor analysis with 295 participants revealed three factors across 33 items-16 items on interpersonal comfort, 11 on sex/gender beliefs, and 6 on human value. The internal consistency of each factor was high-α = .97 for Factor 1, α = .95 for Factor 2, and α = .94 for Factor 3. A confirmatory factor analysis was conducted in the second phase with an independent sample consisting of 238 participants. The Attitudes Toward Transgender Individual Scale and the Genderism and Transphobia Scale were also included to test for convergent validity, and the Rosenberg Self-Esteem Scale and the short form of the Marlowe-Crowne Social Desirability Scale were utilized to test discriminant validity. Both of the data collection phases employed MTurk, a form of online sampling with increased diversity compared to college student samples and more generalizability to the general U.S. TABS represents an addition to the literature in its ability to capture a more nuanced conceptualization of transgender attitude not found in previous scales.

  6. Mental Health Concerns and Insurance Denials Among Transgender Adolescents.

    Science.gov (United States)

    Nahata, Leena; Quinn, Gwendolyn P; Caltabellotta, Nicole M; Tishelman, Amy C

    2017-06-01

    Transgender youth are at high risk for mental health morbidities. Based on treatment guidelines, puberty blockers and gender-affirming hormone therapy should be considered to alleviate distress due to discordance between an individual's assigned sex and gender identity. The goals of this study were to examine the: (1) prevalence of mental health diagnoses, self-injurious behaviors, and school victimization and (2) rates of insurance coverage for hormone therapy, among a cohort of transgender adolescents at a large pediatric gender program, to understand access to recommended therapy. An IRB-approved retrospective medical record review (2014-2016) was conducted of patients with ICD 9/10 codes for gender dysphoria referred to pediatric endocrinology within a large multidisciplinary gender program. Researchers extracted the following details: demographics, age, assigned sex, identified gender, insurance provider/coverage, mental health diagnoses, self-injurious behavior, and school victimization. Seventy-nine records (51 transgender males, 28 transgender females) met inclusion criteria (median age: 15 years, range: 9-18). Seventy-three subjects (92.4%) were diagnosed with one or more of the following conditions: depression, anxiety, post-traumatic stress disorder, eating disorders, autism spectrum disorder, and bipolar disorder. Fifty-nine (74.7%) reported suicidal ideation, 44 (55.7%) exhibited self-harm, and 24 (30.4%) had one or more suicide attempts. Forty-six (58.2%) subjects reported school victimization. Of the 27 patients prescribed gonadotropin-releasing hormone analogues, only 8 (29.6%) received insurance coverage. Transgender youth face significant barriers in accessing appropriate hormone therapy. Given the high rates of mental health concerns, self-injurious behavior, and school victimization among this vulnerable population, healthcare professionals must work alongside policy makers toward insurance coverage reform.

  7. Transgender, aging and old age - Do transgender people get old?

    Directory of Open Access Journals (Sweden)

    Pedro Paulo Sammarco Antunes

    2013-12-01

    Full Text Available This study is aimed to understand transgender aging context in Brazil. Normal and abnormal were especially created by biological sciences. For being considered deviants, transgender people are not seen as human beings. They end up living in violent environments. Their life expectancy is low. Many of them do not believe to reach old age. They face a lot of prejudice and death threat. Those who get to what we call old age are considered survivals. This investigation was able to show satisfactorily their demands and needs. To be considered visible, they have to count on public policies to give them existence since their childhood. That way, we believe they will reach what we call old age with respect and dignity, already assured by the Universal Human Rights.

  8. Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care.

    Science.gov (United States)

    Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J

    2017-09-01

    Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.

  9. Do transgender people get old?

    Directory of Open Access Journals (Sweden)

    Pedro Paulo Sammarco Antunes

    2012-06-01

    Full Text Available This study is aimed to understand transgender aging context in Brazil. Normal and abnormal were especially created by biological sciences. For being considered deviants, transgender people are not seen as human beings. They end up living in violent environments. Their life expectancy is low. Many of them do not believe to reach old age. They face a lot of prejudice and death threat. Those who get to what we call old age are considered survivals. This investigation was able to show satisfactorily their demands and needs. To be considered visible, they have to count on public policies to give them existence since their childhood. That way, we believe they will reach what we call old age with respect and dignity, already assured by theUniversal Human Rights.

  10. Structural Connectivity Networks of Transgender People

    NARCIS (Netherlands)

    Hahn, Andreas; Kranz, Georg S.; Küblböck, Martin; Kaufmann, Ulrike; Ganger, Sebastian; Hummer, Allan; Seiger, Rene; Spies, Marie; Winkler, Dietmar; Kasper, Siegfried; Windischberger, Christian; Swaab, Dick F.; Lanzenberger, Rupert

    2015-01-01

    Although previous investigations of transsexual people have focused on regional brain alterations, evaluations on a network level, especially those structural in nature, are largely missing. Therefore, we investigated the structural connectome of 23 female-to-male (FtM) and 21 male-to-female (MtF)

  11. Levels of depression in transgender people and its predictors: Results of a large matched control study with transgender people accessing clinical services.

    Science.gov (United States)

    Witcomb, Gemma L; Bouman, Walter Pierre; Claes, Laurence; Brewin, Nicola; Crawford, John R; Arcelus, Jon

    2018-02-17

    Depression is a serious disorder which significantly impacts wellbeing and quality of life. Studies exploring mental wellbeing in the transgender population are mostly limited by small, non-homogenous samples and lack of matched controls. This study aimed to address these limitations and explore depression rates in a large sample of transgender people, compared with matched controls from the general population, as well as factors predicting depression in those taking cross-sex hormone treatment (CHT) compared to those not. Transgender individuals (n = 913) completed a measure of depression, measures which predict psychopathology (self-esteem, victimization, social support, interpersonal problems), and information regarding CHT use. Participants were matched by age and experienced gender with adults from the general population who had completed the measure of depression. Individuals were categorized as having no, possible or probable depressive disorder. Transgender individuals not on CHT had a nearly four-fold increased risk of probable depressive disorder, compared to controls. Older age, lower self-esteem, poorer interpersonal function and less social support predicted depressive disorder. Use of CHT was associated with less depression. Participants were attending a national gender identity service and therefore represent only a sub-group of transgender people. Due to the cross-sectional design, longitudinal research is required to fully confirm the finding that CHT use reduces depression. This study confirms that non-treated transgender individuals have an increased risk of a depressive disorder. Interventions offered alongside gender affirming treatment to develop interpersonal skills, increase self-esteem and improve social support may reduce depression and prepare individuals for a more successful transition. Copyright © 2018. Published by Elsevier B.V.

  12. Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India.

    Science.gov (United States)

    Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

    2016-01-01

    Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, pgender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains.

  13. Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India

    Science.gov (United States)

    Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

    2016-01-01

    Introduction Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. Methods We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. Results There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, pgender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains. PMID:27431474

  14. Re-writing the Script: Representations of Transgender Creativity in Contemporary Young Adult Fiction and Television

    Directory of Open Access Journals (Sweden)

    Norbury, Kate

    2014-12-01

    Full Text Available The transgender, gender-atypical or intersex protagonist challenges normative assumptions and expectations about gender, identity and sexuality. This article argues that contemporary transgender-themed young adult fiction and television uses the theme of creativity or the creative achievement script to override previously negative representations of adolescent transgender subjectivities. I consider three English-language novels and one television series for young adults and use script theory to analyse these four texts, each of which has an optimistic ending. The television series, Glee (2009- , is now in its sixth season and therefore has not yet formally concluded. This more recent selection of texts which date from 2011 validate young adult transgender experience and model diversity and acceptance. Cris Beam’s I Am J (2011 and Kirstin Cronn-Mills’ Beautiful Music for Ugly Children (2012, both originally published in the United States, depict female to male transitions. Alyssa Brugman’s Alex as Well (2013, originally published in Australia, foregrounds the experience of an intersex teenager, Alex, raised as a boy, but who, at the age of fourteen, decides she is female. Glee introduced the transgender character Unique in 2012, and she continues to be a central member of the New Directions choir. The Swedish graphic novel, Elias Ericson’s Åror (2013, includes two transgender characters who enact the creative achievement script and fall in love with each other. In other words, Ericson’s graphic novel goes further than the English-language texts to date. Collectively, these transgender, gender-atypical or intersex protagonists and central characters assert their individual agency and creative sense of self. The transgender character’s particular creativity ultimately secures a positive sense of self.

  15. It's Not All Darkness: Robustness, Resilience, and Successful Transgender Aging.

    Science.gov (United States)

    Witten, Tarynn M

    2014-03-01

    We review the recent psychosocial literature on transgender aging. We also report relevant in-press results from the Trans MetLife Survey on Later-Life Preparedness and Perceptions in Transgender-Identified Individuals (TMLS) on end-of-life and later-life trans-aging. To obtain relevant literature, we employed the search engines Google Scholar, Stanford Highwire, and PubMed/Medline. Databases searched included Web of Science, Cinhal, PsyINFO, Gender Studies Database, Sociological Abstracts, and Social Services Abstracts. Keyword searches included "transgender" and "transsexual." Key phrases included "transgender aging," "transsexual aging," and "LGBT aging." Years searched were from January 1, 2011, through April 26, 2013. We found two types of articles: LGBT aging-related (or lumped aging) articles and articles that focused specifically on transgender aging, or trans-aging. We found that the articles spoke of concerns and fears regarding discrimination, potential abuse at the hands of caregivers, inability to live out their lives in their true identities, risk of becoming homeless, loss of independence, and dementia, among other concerns. We note that the elder trans-identified population is significantly ill-prepared for the major legal issues that arise and events that occur in the later-life to end-of-life time periods. Despite these difficulties, a few articles spoke of resilience and successful aging in the population. Some TMLS respondents indicated that they were considering either "detransitioning," that is, changing social presentation to the pretransition gender identity, or suicide (which some referred to as euthanasia) as means of managing the severe problems they expected to encounter later in the aging process. A number of potentially modifiable risk factors exist within this population. Modification strategies include increasing the population awareness of the need for end-of-life legal preparations for members of the trans-identified community as

  16. Creating Spaces to Support Transgender Youth

    Science.gov (United States)

    McGuire, Jenifer K.; Conover-Williams, Meredith

    2010-01-01

    This article explores the opportunity to create spaces within the family, school, and community that specifically promote the well-being of transgender adolescents and young adults. When social contexts are supportive, transgender youth report significantly less risk. Supportive home and school environments have been linked to better outcomes…

  17. Supporting the Health and Well-Being of Transgender Students

    Science.gov (United States)

    Cicero, Ethan C.; Wesp, Linda M.

    2017-01-01

    Throughout the United States, there has been a rise in public discourse about transgender people and transgender issues. Much of this attention stems from passed and proposed anti-LGBTQ (lesbian, gay, bisexual, transgender, queer or questioning) legislation, including "bathroom bills" that would require transgender people to use public…

  18. Integrated and Gender-Affirming Transgender Clinical Care and Research

    Science.gov (United States)

    Radix, Asa; Deutsch, Madeline B.

    2016-01-01

    Abstract: Transgender (trans) communities worldwide, particularly those on the trans feminine spectrum, are disproportionately burdened by HIV infection and at risk for HIV acquisition/transmission. Trans individuals represent an underserved, highly stigmatized, and under-resourced population not only in HIV prevention efforts but also in delivery of general primary medical and clinical care that is gender affirming. We offer a model of gender-affirmative integrated clinical care and community research to address and intervene on disparities in HIV infection for transgender people. We define trans terminology, briefly review the social epidemiology of HIV infection among trans individuals, highlight gender affirmation as a key social determinant of health, describe exemplar models of gender-affirmative clinical care in Boston MA, New York, NY, and San Francisco, CA, and offer suggested “best practices” for how to integrate clinical care and research for the field of HIV prevention. Holistic and culturally responsive HIV prevention interventions must be grounded in the lived realities the trans community faces to reduce disparities in HIV infection. HIV prevention interventions will be most effective if they use a structural approach and integrate primary concerns of transgender people (eg, gender-affirmative care and management of gender transition) alongside delivery of HIV-related services (eg, biobehavioral prevention, HIV testing, linkage to care, and treatment). PMID:27429189

  19. Elder transgender lesbians: exploring the intersection of age, lesbian sexual identity, and transgender identity.

    Science.gov (United States)

    Witten, Tarynn M

    2015-01-01

    This study is the first to examine the experiences and needs of an international sample of current, English-speaking, lesbian, transgender-identified (trans-lesbian) adults around a number of later life and end-of-life perceptions, preparations, and concerns. I analyzed a subset (n = 276) of the cross-sectional data collected from the online Trans MetLife Survey on Later-Life Preparedness and Perceptions in Transgender-Identified Individuals (N = 1,963). I assessed perceptions and fears around aging, preparation for later life, and end-of-life as well as numerous demographic and psycho-social variables. Despite the overall feeling that they have aged successfully, the respondent trans-lesbian population harbors significant fears about later life. I found that this population, while better-prepared than the overall respondent trans-identified population, is still ill-prepared for the major legalities and events that occur in the later to end-of-life time periods.

  20. An Overview of Depression among Transgender Women

    Directory of Open Access Journals (Sweden)

    Beth Hoffman

    2014-01-01

    Full Text Available Rates of depression are higher in transgender women than in the general population, warranting an understanding of the variables related to depression in this group. Results of the literature review of depression in transgender women reveal several variables influencing depression, including social support, violence, sex work, and gender identity. The theoretical constructs of minority stress, coping, and identity control theory are explored in terms of how they may predict depression in transgender women. Depression and depressive symptoms have been used to predict high-risk sexual behaviors with mixed results. The implications of the findings on treating depression in transgender women include taking into account the stress of transition and the importance of supportive peers and family. Future studies should explore a model of depression and high-risk behaviors in transgender women.

  1. A potential role for the dermatologist in the physical transformation of transgender people: A survey of attitudes and practices within the transgender community.

    Science.gov (United States)

    Ginsberg, Brian A; Calderon, Marcus; Seminara, Nicole M; Day, Doris

    2016-02-01

    There are an estimated 700,000 or more transgender people in the United States, however their dermatologic needs are not fully established in the medical literature. Unique needs relate to hormone therapy, prior surgeries, and other aspects of physical transitioning. By examining attitudes and practices of transgender individuals, we aimed to identify areas for which dermatologists could contribute to their physical transformation. This cross-sectional study used an anonymous online survey, distributed via lesbian, gay, bisexual, and transgender organizations; social media; and at targeted locations and events. A total of 327 people completed the survey (63% men, 29% women, 9% other). Most transgender women indicated that their face was most imperative to have changed, whereas men noted their chest, in turn influencing procedures. Of women's facial procedures, hair removal predominated, followed by surgery then injectables, mostly performed by plastic surgeons. Hormone-induced facial effects varied, usually taking over 2 years for maximal effect. When choosing procedures, money was the major barrier and good aesthetic outcome the primary concern. Participants did not think that facial procedures necessitate the currently accepted prerequisites for chest and genital surgery. This study has limited size and convenience sampling. Dermatologists could contribute to the physical transformation of transgender patients through noninvasive procedures. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  2. HIV risk and preventive interventions in transgender women sex workers

    Science.gov (United States)

    Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

    2015-01-01

    Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

  3. Mental Health Disparities Among Canadian Transgender Youth.

    Science.gov (United States)

    Veale, Jaimie F; Watson, Ryan J; Peter, Tracey; Saewyc, Elizabeth M

    2017-01-01

    This study documented the prevalence of mental health problems among transgender youth in Canada and made comparisons with population-based studies. This study also compared gender identity subgroups and age subgroups (14-18 and 19-25). A nonprobability sample of 923 transgender youth from Canada completed an online survey. Participants were recruited through community organizations, health care settings, social media, and researchers' networks. Mental health measures were drawn from the British Columbia Adolescent Health Survey and the Canadian Community Health Survey. Transgender youth had a higher risk of reporting psychological distress, self-harm, major depressive episodes, and suicide. For example, 65% of transgender 14- to 18-year olds seriously considered suicide in the past year compared with 13% in the British Columbia Adolescent Health Survey, and only a quarter of participants reported their mental health was good or excellent. Transgender boys/men and nonbinary youth were most likely to report self-harm and overall mental health remained stable across age subgroups. Although a notable minority of transgender youth did not report negative health outcomes, this study shows the mental health disparities faced by transgender youth in Canada are considerable. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  4. 'They wrote "gay" on her file': transgender Ugandans in HIV prevention and treatment.

    Science.gov (United States)

    Minor Peters, Melissa

    2016-01-01

    This paper examines the ways in which HIV-related programmes for heterosexual Ugandans and also for men who have sex with men work to deny healthcare services to transgender people in Uganda. Contrary to current conventional wisdom, the study found that the widespread use of the term 'men who have sex with men' produces greater barriers to healthcare for queer Ugandans than identity categories such as 'lesbian' or 'transgender'. Interventions for men who have sex with men assume a male-identified sexual subject with agency over sexual practices, such as frequency of condom use. Based on two years of ethnographic research in Kampala, I suggest that the focus on individual sexual practices harms transgender people in two ways. First, current HIV prevention and treatment programmes fail to account for risk factors that accrue to both male and female transgender Ugandans due to the social enforcement of gender norms. Second, the term men who have sex with men directs attention towards stigmatised sexual practices, producing the neglect and abuse of non-heteronormative individuals. In the context of Ugandan healthcare, terms such as 'transgender' and kuchu instead focus attention on the dignity and humanity of the rights-bearing person. These findings emphasise how health practitioners must pay attention to emic categories in order to address the ways in which vulnerability is distributed along social vectors of difference.

  5. Attitudes Toward Transgender Men and Women: Development and Validation of a New Measure

    Directory of Open Access Journals (Sweden)

    Thomas J Billard

    2018-04-01

    Full Text Available A series of three studies were conducted to generate, develop, and validate the Attitudes toward Transgender Men and Women (ATTMW scale. In Study 1, 120 American adults responded to an open-ended questionnaire probing various dimensions of their perceptions of transgender individuals and identity. Qualitative thematic analysis generated 200 items based on their responses. In Study 2, 238 American adults completed a questionnaire consisting of the generated items. Exploratory factor analysis (EFA revealed two non-identical 12-item subscales (ATTM and ATTW of the full 24-item scale. In Study 3, 150 undergraduate students completed a survey containing the ATTMW and a number of validity-testing variables. Confirmatory factor analysis (CFA verified the single-factor structures of the ATTM and ATTW subscales, and the convergent, discriminant, predictive, and concurrent validities of the ATTMW were also established. Together, our results demonstrate that the ATTMW is a reliable and valid measure of attitudes toward transgender individuals.

  6. Youth and Caregiver Perspectives on Barriers to Gender-Affirming Health Care for Transgender Youth.

    Science.gov (United States)

    Gridley, Samantha J; Crouch, Julia M; Evans, Yolanda; Eng, Whitney; Antoon, Emily; Lyapustina, Melissa; Schimmel-Bristow, Allison; Woodward, Jake; Dundon, Kelly; Schaff, RaNette; McCarty, Carolyn; Ahrens, Kym; Breland, David J

    2016-09-01

    Few transgender youth eligible for gender-affirming treatments actually receive them. Multidisciplinary gender clinics improve access and care coordination but are rare. Although experts support use of pubertal blockers and cross-sex hormones for youth who meet criteria, these are uncommonly offered. This study's aim was to understand barriers that transgender youth and their caregivers face in accessing gender-affirming health care. Transgender youth (age 14-22 years) and caregivers of transgender youth were recruited from Seattle-based clinics, and readerships from a blog and support group listserv. Through individual interviews, focus groups, or an online survey, participants described their experiences accessing gender-affirming health care. We then used theoretical thematic analysis to analyze data. Sixty-five participants (15 youth, 50 caregivers) described barriers spanning six themes: (1) few accessible pediatric providers are trained in gender-affirming health care; (2) lack of consistently applied protocols; (3) inconsistent use of chosen name/pronoun; (4) uncoordinated care and gatekeeping; (5) limited/delayed access to pubertal blockers and cross-sex hormones; and (6) insurance exclusions. This is the first study aimed at understanding perceived barriers to care among transgender youth and their caregivers. Themed barriers to care led to the following recommendations: (1) mandatory training on gender-affirming health care and cultural humility for providers/staff; (2) development of protocols for the care of young transgender patients, as well as roadmaps for families; (3) asking and recording of chosen name/pronoun; (4) increased number of multidisciplinary gender clinics; (5) providing cross-sex hormones at an age that permits peer-congruent development; and (6) designating a navigator for transgender patients in clinics. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  7. Outcome and Impact Evaluation of a Transgender Health Course for Health Profession Students.

    Science.gov (United States)

    Braun, Hannan M; Garcia-Grossman, Ilana R; Quiñones-Rivera, Andrea; Deutsch, Madeline B

    2017-02-01

    Being transgender is associated with numerous health disparities, and transgender individuals face mistreatment and discrimination in healthcare settings. At the same time, healthcare professionals report inadequate preparation to care for transgender people, and patients often have to teach their own medical providers about transgender care. Our study aimed to evaluate the impact of an elective course for health profession students in transgender health that was implemented to address these gaps in provider knowledge. Students participated in a 10-session, lunch-hour elective course during the spring of 2015. To evaluate impact, course participants completed pre-, immediately post-, and 3-month postcourse questionnaires, including a previously validated nine-item transphobia scale, to determine the course's effect on knowledge, attitudes, and beliefs about transgender health. Forty-six students completed the pre- and immediately postelective questionnaire (74% response rate). Compared with pre-elective surveys, immediately postelective scores demonstrated increased knowledge in most domains and reduced transphobia. Specific knowledge domains with improvements included terminology, best practices for collecting gender identity, awareness of the DSM-V gender dysphoria diagnosis, medications used for gender affirmation, and relevant federal policies. A previously validated transphobia scale was found to have good reliability in the current sample. This elective course led to positive short-term changes in measures of multiple knowledge domains and reduced measures of transphobia among health profession students. Further study is needed to assess the long-term impact. Our methods and findings, including the demonstration of reliability of a previously validated nine-item transphobia scale, serve as formative data for the future development of theory-based transgender medicine curricula and measures.

  8. Family Rejection as a Predictor of Suicide Attempts and Substance Misuse Among Transgender and Gender Nonconforming Adults.

    Science.gov (United States)

    Klein, Augustus; Golub, Sarit A

    2016-06-01

    We examined associations between family rejection and risk of suicide attempts and substance misuse among a national sample of transgender and gender nonconforming adults. Data were drawn from the National Transgender Discrimination Survey (N = 6456). This secondary analysis was restricted to 3458 individuals who self-identified as transgender or gender nonconforming and provided complete data on study variables. We used multivariable logistic regression to examine health risks by level of reported family rejection (low/moderate/high), controlling for relevant sociodemographic characteristics. Overall, 42.3% of the sample reported a suicide attempt and 26.3% reported misusing drugs or alcohol to cope with transgender-related discrimination. After controlling for age, race/ethnicity, sex assigned at birth, binary gender identity, income, education, and employment status, family rejection was associated with increased odds of both behaviors. Odds increased significantly with increasing levels of family rejection. Family rejection related to gender identity is an understudied interpersonal stressor that may negatively affect health outcomes for transgender and gender nonconforming individuals. A better understanding of the role of close relationships in both risk and resilience for transgender individuals is critical in the development of effective public health interventions for this community.

  9. Transgender men's experiences of fertility preservation: a qualitative study.

    Science.gov (United States)

    Armuand, G; Dhejne, C; Olofsson, J I; Rodriguez-Wallberg, K A

    2017-02-01

    How do transgender men experience fertility preservation (FP) by cryopreservation of oocytes? The procedures required prior to oocyte cryopreservation, such as hormonal ovarian stimulation and transvaginal ultrasound (TVS), have a negative impact on gender dysphoria as they are closely linked to the men's female assigned sex at birth, which is incompatible with their current status. Transgender persons often have high dissatisfaction with assigned sex-specific body features, such as the genital organs and androgen/oestrogen-responsive features. Thus, undergoing FP that requires genital-specific examinations, aimed at obtaining oocytes to cryopreserve, could be distressing. As no previous studies have investigated transgender men's experiences of FP involving cryopreservation of oocytes, little is known about their experience of the procedures. This is a prospective study among adult transgender men referred for FP between March 2014 and December 2015. Individual in-depth qualitative interviews were conducted shortly after FP treatment. The interviews lasted between 62 and 111 min (mean 81 min) and were digitally recorded and transcribed verbatim. Participants were recruited on their first visit to the assisted reproduction clinic for reproductive counseling. There were 15 men, scheduled for FP, who chose to participate in the study (age 19-35); none had given birth and eight had a partner. Data were analyzed by thematic content analysis. The analysis resulted in three main categories: the journey to FP, reactions to the FP proceedings and strategies for coping. The referral for FP was an important part of the assessment and diagnosis and sometimes lined with frustrating waits and doubts. The reaction to the FP proceedings revealed that the genital examinations and the physical changes associated with discontinuation of testosterone or hormonal stimulation treatment triggered gender incongruence and dysphoria. However, for some, the negative expectations were not

  10. Transgender Population Size in the United States: a Meta-Regression of Population-Based Probability Samples

    Science.gov (United States)

    Sevelius, Jae M.

    2017-01-01

    Background. Transgender individuals have a gender identity that differs from the sex they were assigned at birth. The population size of transgender individuals in the United States is not well-known, in part because official records, including the US Census, do not include data on gender identity. Population surveys today more often collect transgender-inclusive gender-identity data, and secular trends in culture and the media have created a somewhat more favorable environment for transgender people. Objectives. To estimate the current population size of transgender individuals in the United States and evaluate any trend over time. Search methods. In June and July 2016, we searched PubMed, Cumulative Index to Nursing and Allied Health Literature, and Web of Science for national surveys, as well as “gray” literature, through an Internet search. We limited the search to 2006 through 2016. Selection criteria. We selected population-based surveys that used probability sampling and included self-reported transgender-identity data. Data collection and analysis. We used random-effects meta-analysis to pool eligible surveys and used meta-regression to address our hypothesis that the transgender population size estimate would increase over time. We used subsample and leave-one-out analysis to assess for bias. Main results. Our meta-regression model, based on 12 surveys covering 2007 to 2015, explained 62.5% of model heterogeneity, with a significant effect for each unit increase in survey year (F = 17.122; df = 1,10; b = 0.026%; P = .002). Extrapolating these results to 2016 suggested a current US population size of 390 adults per 100 000, or almost 1 million adults nationally. This estimate may be more indicative for younger adults, who represented more than 50% of the respondents in our analysis. Authors’ conclusions. Future national surveys are likely to observe higher numbers of transgender people. The large variety in questions used to ask

  11. Development, risk, and resilience of transgender youth.

    Science.gov (United States)

    Stieglitz, Kimberly A

    2010-01-01

    Transgender youth face unique and complex issues as they confront cultural expectations of gender expression and how these fit with what is natural for them. Striving for balance, learning to cope, questioning, and eventually becoming comfortable with one's gender identity and sexual orientation are of paramount importance for healthy growth and development. Ineffective management of intense challenges over time without adequate social support places youth at risk for a number of unhealthy behaviors, including risk behaviors associated with acquiring HIV. This article explores early foundations of gender identity development, challenges in the development of transgender youth, and the limited data that exist on transgender youth and HIV risks. The concept of resilience is introduced as a counterbalancing area for assessment and intervention in practice and future research with transgender youth.

  12. Education Creates Welcoming Environment for Transgender Patients.

    Science.gov (United States)

    Ehrenfeld, Jesse; Gridley, Samantha

    2016-08-01

    The ED often is the access point of choice for transgender patients who may be reluctant to interact with providers. Experts say there is a need for training and education of how to present a gender-affirming healthcare environment. Recommended steps include a review of policies, along with corresponding changes to electronic and paper intake forms to ensure that the language used is inclusive of all genders. While blanket discrimination may be declining, experts note that some providers are uncertain about how to interact with a transgender patient. It's always best to ask patients for their preferred name and pronoun and to repeat this exercise every three to six months for return patients, as gender identify can be fluid. To ease anxiety for transgender patients, consider developing a navigator program that will pair any transgender patient who requests the service with a trained advocate who can support and guide the patient through the system.

  13. School climate for transgender youth: a mixed method investigation of student experiences and school responses.

    Science.gov (United States)

    McGuire, Jenifer K; Anderson, Charles R; Toomey, Russell B; Russell, Stephen T

    2010-10-01

    Transgender youth experience negative school environments and may not benefit directly from interventions defined to support Lesbian, Gay and Bisexual (LGB) youth. This study utilized a multi-method approach to consider the issues that transgender students encounter in school environments. Using data from two studies, survey data (total n = 2260, 68 transgender youth) from study 1 and focus groups (n = 35) from study 2, we examine transgender youth's experience of school harassment, school strategies implemented to reduce harassment, the protective role of supportive school personnel, and individual responses to harassment, including dropping out and changing schools. In both studies, we found that school harassment due to transgender identity was pervasive, and this harassment was negatively associated with feelings of safety. When schools took action to reduce harassment, students reported greater connections to school personnel. Those connections were associated with greater feelings of safety. The indirect effects of school strategies to reduce harassment on feelings of safety through connection to adults were also significant. Focus group data illuminate specific processes schools can engage in to benefit youth, and how the youth experience those interventions.

  14. The role of gender affirmation in psychological well-being among transgender women.

    Science.gov (United States)

    Glynn, Tiffany R; Gamarel, Kristi E; Kahler, Christopher W; Iwamoto, Mariko; Operario, Don; Nemoto, Tooru

    2016-09-01

    High prevalence of psychological distress, including greater depression, lower self-esteem, and suicidal ideation, has been documented across numerous samples of transgender women and has been attributed to high rates of discrimination and violence. According to the gender affirmation framework (Sevelius, 2013), access to sources of gender-affirmative support can offset such negative psychological effects of social oppression. However, critical questions remain unanswered in regards to how and which aspects of gender affirmation are related to psychological well-being. The aims of this study were to investigate the associations between three discrete areas of gender affirmation (psychological, medical, and social) and participants' reports of psychological well-being. A community sample of 573 transgender women with a history of sex work completed a one-time self-report survey that assessed demographic characteristics, gender affirmation, and mental health outcomes. In multivariate models, we found that social, psychological, and medical gender affirmation were significant predictors of lower depression and higher self-esteem while no domains of affirmation were significantly associated with suicidal ideation. Findings support the need for accessible and affordable transitioning resources for transgender women in order to promote better quality of life among an already vulnerable population. As the gender affirmation framework posits, the personal experience of feeling affirmed as a transgender person results from individuals' subjective perceptions of need along multiple dimensions of gender affirmation. Personalized assessment of gender affirmation may thus be a useful component of counseling and service provision for transgender women.

  15. Suicide and Suicidal Behavior among Transgender Persons.

    Science.gov (United States)

    Virupaksha, H G; Muralidhar, Daliboyina; Ramakrishna, Jayashree

    2016-01-01

    Suicide rate and suicidal tendencies among transgender persons are considerably high compared to general population. Hence, this review is an attempt to understand the issues around the suicide and suicidal behavior among transgender persons. The literature search conducted using three sources, i.e., electronic databases (PubMed, ProQuest, Google Scholar, PsycInfo), manual search (library catalog), and gray literature (consultation with experts). The suicide attempt rate among transgender persons ranges from 32% to 50% across the countries. Gender-based victimization, discrimination, bullying, violence, being rejected by the family, friends, and community; harassment by intimate partner, family members, police and public; discrimination and ill treatment at health-care system are the major risk factors that influence the suicidal behavior among transgender persons. In spite of facing a number of hardships in their day-to-day life, the transgender community holds a number of resiliency factors. Further, this community needs to be supported to strengthen their resiliency factors and draw culturally sensitive and transgender-inclusive suicide prevention strategies and increase protective factors to tackle this high rate of suicidality.

  16. The threat of male-to-female erotic transference.

    Science.gov (United States)

    Celenza, Andrea

    2006-01-01

    Vignettes from an ongoing psychoanalysis with a patient, Michael, are presented to illustrate the various dimensions of the erotic transference at different phases of the treatment. The relation to power, the experience and expression of aggression, how these may be organized by gender, and the female analyst's countertransference are discussed as potentially fostering or inhibitory in the development of an erotic transference. Traditional sociocultural gender stereotypes kept alive in fantasy can cause female analysts to subtly foreclose the impending threat of an intense erotic transference with male analysands due to a fear of outwardly directed male aggression. It is suggested that the maternal/containing transference can be unconsciously fostered by both analyst and analysand to defensively avoid expression of the aggressivized erotic transference in its full intensity. Similarities and differences in cases of sexual boundary violations with opposite-gender pairings are discussed.

  17. High heterogeneity of HIV-related sexual risk among transgender people in Ontario, Canada: a province-wide respondent-driven sampling survey

    Directory of Open Access Journals (Sweden)

    Bauer Greta R

    2012-04-01

    Full Text Available Abstract Background Studies of HIV-related risk in trans (transgender, transsexual, or transitioned people have most often involved urban convenience samples of those on the male-to-female (MTF spectrum. Studies have detected high prevalences of HIV-related risk behaviours, self-reported HIV, and HIV seropositivity. Methods The Trans PULSE Project conducted a multi-mode survey using respondent-driven sampling to recruit 433 trans people in Ontario, Canada. Weighted estimates were calculated for HIV-related risk behaviours, HIV testing and self-reported HIV, including subgroup estimates for gender spectrum and ethno-racial groups. Results Trans people in Ontario report a wide range of sexual behaviours with a full range of partner types. High proportions – 25% of female-to-male (FTM and 51% of MTF individuals – had not had a sex partner within the past year. Of MTFs, 19% had a past-year high-risk sexual experience, versus 7% of FTMs. The largest behavioural contributors to HIV risk were sexual behaviours some may assume trans people do not engage in: unprotected receptive genital sex for FTMs and insertive genital sex for MTFs. Overall, 46% had never been tested for HIV; lifetime testing was highest in Aboriginal trans people and lowest among non-Aboriginal racialized people. Approximately 15% of both FTM and MTF participants had engaged in sex work or exchange sex and about 2% currently work in the sex trade. Self-report of HIV prevalence was 10 times the estimated baseline prevalence for Ontario. However, given wide confidence intervals and the high proportion of trans people who had never been tested for HIV, estimating the actual prevalence was not possible. Conclusions Results suggest potentially higher than baseline levels of HIV; however low testing rates were observed and self-reported prevalences likely underestimate seroprevalence. Explicit inclusion of trans people in epidemiological surveillance statistics would provide much

  18. Queer periods: attitudes toward and experiences with menstruation in the masculine of centre and transgender community.

    Science.gov (United States)

    Chrisler, Joan C; Gorman, Jennifer A; Manion, Jen; Murgo, Michael; Barney, Angela; Adams-Clark, Alexis; Newton, Jessica R; McGrath, Meaghan

    2016-11-01

    Menstruation has long been viewed as an important aspect of women's health. However, scholars and healthcare providers have only recently begun to recognise that transgender men and people with masculine gender identities also menstruate, thus little is known about their attitudes toward and experiences with menstruation. A sample of masculine of centre and transgender individuals with a mean age of 30 years was recruited online to complete measures of attitudes toward menstruation and menstrual suppression and to answer exploratory questions about their experiences managing menstruation. Participants reported mixed attitudes toward menstruation, but generally positive attitudes toward menstrual suppression. Many participants said that they try to avoid public restrooms during menstruation because of practical and psychological concerns. Implications of our findings for the transgender health are discussed.

  19. Gender Affirmation: A Framework for Conceptualizing Risk Behavior among Transgender Women of Color.

    Science.gov (United States)

    Sevelius, Jae M

    2013-06-01

    Experiences of stigma, discrimination, and violence as well as extreme health disparities and high rates of sexual risk behavior and substance use have been well-documented among transgender women of color. Using an intersectional approach and integrating prominent theories from stigma, eating disorders, and HIV-related research, this article offers a new framework for conceptualizing risk behavior among transgender women of color, specifically sexual risk behavior and risky body modification practices. This framework is centered on the concept of 'gender affirmation,' the process by which individuals are affirmed in their gender identity through social interactions. Qualitative data from 22 interviews with transgender women of color from the San Francisco Bay Area in the United States are analyzed and discussed in the context of the gender affirmation framework.

  20. Sexual health service providers' perceptions of transgender youth in England.

    Science.gov (United States)

    Lefkowitz, Ayla R F; Mannell, Jenevieve

    2017-05-01

    Transgender youth often face difficulties when accessing sexual health services. However, few studies investigate health service providers' perceptions of transgender youth, and fewer focus on sexual health. To fill this gap, our study draws on social representations theory to examine sexual health service providers' perceptions of transgender youth and how this influences the provision of health services for this marginalised population in England. A thematic analysis of 20 semi-structured interviews with service providers, conducted between March and June 2014, resulted in five main themes centred on: binary representations of transgender; transgender as homosexuality; uncertain bodies; unstable mental states; and too young to know. Of the service providers interviewed, many understood transgender within a male/female binary, and perceived being transgender to be synonymous with being gay. There was confusion among service providers regarding transgender youths' sexual organs, and most of those interviewed saw transgender youth as mentally unstable and confused. Finally, many service providers perceived that transgender youth are too young to know that they are transgender and make decisions about their body. Some of these representations were potentially stigmatising and many conflicted with transgender youths' representations of themselves. Training by transgender people is recommended to help address these misunderstandings. © 2017 John Wiley & Sons Ltd.

  1. Voices in Transition: Testosterone, Transmasculinity, and the Gendered Voice among Female-to-Male Transgender People

    Science.gov (United States)

    Zimman, Lal

    2012-01-01

    This dissertation is based on a long-term ethnographic and sociophonetic study of 15 transgender people on the female-to-male (or "transmasculine") identity spectrum. The focus of the study is the way these individuals' voices change during the first 1-2 years of masculinizing hormone therapy, which brings about a drop in vocal…

  2. Access to fertility services by transgender persons: an Ethics Committee opinion.

    Science.gov (United States)

    2015-11-01

    This statement explores the ethical considerations surrounding the provision of fertility services to transgender individuals and concludes that denial of access to fertility services is not justified. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Experience of Career-Related Discrimination for Female-to-Male Transgender Persons: A Qualitative Study

    Science.gov (United States)

    Dispenza, Franco; Watson, Laurel B.; Chung, Y. Barry; Brack, Greg

    2012-01-01

    In this qualitative study, the authors examined the experience of discrimination and its relationship to the career development trajectory of 9 female-to-male transgender persons. Participants were between 21 and 48 years old and had a variety of vocational experiences. Individual semistructured interviews were conducted via telephone and analyzed…

  4. Lesbian, Gay, Bisexual, and Transgender-Identified School Psychologists: A Qualitative Study of Their Professional Experiences

    Science.gov (United States)

    Sowden, Beth; Fleming, Julia; Savage, Todd A.; Woitaszewski, Scott A.

    2016-01-01

    Despite recent socially positive progression in the view and treatment of lesbian, gay, bisexual, and transgender (LGBT) individuals in the USA, the LGBT population continues to face complicated circumstances and significant hindrances in many societal institutions. One of the most challenging and complex arena is the educational system (Biegel…

  5. Lesbian, Gay, Bisexual, and Transgender Persons and Tobacco Use

    Science.gov (United States)

    ... Division of Reproductive Health More CDC Sites Lesbian, Gay, Bisexual, and Transgender Persons and Tobacco Use Recommend ... and Influence Resources References People who are lesbian, gay, bisexual, or transgender (LGBT) include all races and ...

  6. Transform Health Arkansas: A Transgender-Led Partnership Engaging Transgender/Non-Binary Arkansans in Defining Health Research Priorities.

    Science.gov (United States)

    Stewart, M Kathryn; Archie, Dani Smith; Marshall, S Alexandra; Allison, M Kathryn; Robinson, Colin

    2017-01-01

    Transgender/non-binary (trans/NB) individuals face major challenges, including within health care. Transform Health Arkansas (THA) engaged trans/ NB Arkansans in defining their greatest health-related concerns to inform responsive, partnered, participatory research. The THA partnership engaged trans/NB individuals through an interactive, trans/NB-led process in nine summits across the state and collected surveys on research interests. Descriptive analysis examined respondent characteristics by gender identity, mode of survey completion, and most pressing concerns. The summits, attended by 54 trans/NB and 29 cisgender individuals, received positive evaluations. The top five priorities among 140 survey respondents included (1) transition-related insurance coverage, (2) access to transition care, (3) education of health care providers, (4) public education, and (5) supportive health care systems. The THA has also led to trans/NB individuals educating a range of audiences about transgender issues. Next steps include dissemination, identification of evidence-based interventions addressing prioritized issues, and joint development of a research agenda.

  7. Interactions of Transgender Latina Women with Law Enforcement

    OpenAIRE

    Galvan, Frank H.; Bazargan, Mohzen

    2012-01-01

    A new report, funded by the Williams Institute, reveals high levels of reported harassment and assault of Latina transgender women by law enforcement agencies and highlights steps that police departments should take to improve relations with the transgender community.    The report, “Interactions of Latina Transgender Women with Law Enforcement” is based on interviews with 220 Latina transgender women from the Los Angeles area. BIENESTAR, a non-profit social service organization comm...

  8. Transgender and Gender Nonconforming Adolescent Care: Psychosocial and Medical Considerations

    Science.gov (United States)

    Guss, Carly; Shumer, Daniel; Katz-Wise, Sabra L.

    2015-01-01

    Purpose of review Transgender individuals display incongruence between their assigned birth sex and their current gender identity, and may identify as male, female or elsewhere on the gender spectrum. Gender nonconformity describes an individual whose gender identity, role, or expression are not typical for individuals in a given assigned sex category. This update highlights recent literature pertaining to the psychosocial and medical care of transgender and gender nonconforming (TGN) adolescents with applications for the general practitioner. Recent findings The psychological risks and outcomes of TGN adolescents are being more widely recognized. Moreover, there is increasing evidence that social and medical gender transition reduces gender dysphoria, defined as distress that accompanies the incongruence between one’s birth sex and identified gender. Unfortunately, lack of education about TGN adolescents in medical training persists. Summary Recent literature highlights increased health risks in TGN adolescents and improved outcomes following gender dysphoria treatment. It is important for clinicians to become familiar with the range of treatment options and referral resources available to TGN adolescents in order to provide optimal and welcoming care to all adolescents. PMID:26087416

  9. Transgender and gender nonconforming adolescent care: psychosocial and medical considerations.

    Science.gov (United States)

    Guss, Carly; Shumer, Daniel; Katz-Wise, Sabra L

    2015-08-01

    Transgender individuals display incongruence between their assigned birth sex and their current gender identity, and may identify as male, female, or being elsewhere on the gender spectrum. Gender nonconformity describes an individual whose gender identity, role, or expression is not typical for individuals in a given assigned sex category. This update highlights recent literature pertaining to the psychosocial and medical care of transgender and gender nonconforming (TGN) adolescents with applications for the general practitioner. The psychological risks and outcomes of TGN adolescents are being more widely recognized. Moreover, there is increasing evidence that social and medical gender transition reduces gender dysphoria, defined as distress that accompanies the incongruence between one's birth sex and identified gender. Unfortunately, lack of education about TGN adolescents in medical training persists. Recent literature highlights increased health risks in TGN adolescents and improved outcomes following gender dysphoria treatment. It is important for clinicians to become familiar with the range of treatment options and referral resources available to TGN adolescents in order to provide optimal and welcoming care to all adolescents.

  10. Avenue T: Using Film as "Entree" in Teaching about Transgender

    Science.gov (United States)

    Walters, Andrew S.; Rehma, Kae

    2013-01-01

    Educators from a variety of disciplines include the concept of transgender and multiple gender identities in course curricula. The "T" (denoting the specific inclusion of transgender) in the popular acronym LGBT (lesbian, gay, bisexual, transgender) often is given less pedagogical attention than is sexual orientation, and the transgender…

  11. Assessing the Implications of Allowing Transgender Personnel to Serve Openly

    Science.gov (United States)

    2016-01-01

    Openly? There are 18 countries that allow transgender personnel to serve openly in their mili- taries: Australia, Austria, Belgium, Bolivia , Canada...clinical and cultural competence for the proper care of transgender patients. Surgical procedures quite similar to those used for gender transition...tries that allow transgender personnel to serve openly in their militaries: Austra- lia, Austria, Belgium, Bolivia , Canada, Czech Republic, Denmark

  12. When Gender Identity Doesn't Equal Sex Recorded at Birth: The Role of the Laboratory in Providing Effective Healthcare to the Transgender Community.

    Science.gov (United States)

    Goldstein, Zil; Corneil, Trevor A; Greene, Dina N

    2017-08-01

    Transgender is an umbrella term used to describe individuals who identify with a gender incongruent to or variant from their sex recorded at birth. Affirming gender identity through a variety of social, medical, and surgical interventions is critical to the mental health of transgender individuals. In recent years, awareness surrounding transgender identities has increased, which has highlighted the health disparities that parallel this demographic. These disparities are reflected in the experience of transgender patients and their providers when seeking clinical laboratory services. Little is known about the effect of gender-affirming hormone therapy and surgery on optimal laboratory test interpretation. Efforts to diminish health disparities encountered by transgender individuals and their providers can be accomplished by increasing social and clinical awareness regarding sex/gender incongruence and gaining insight into the physiological manifestations and laboratory interpretations of gender-affirming strategies. This review summarizes knowledge required to understand transgender healthcare including current clinical interventions for gender dysphoria. Particular attention is paid to the subsequent impact of these interventions on laboratory test utilization and interpretation. Common nomenclature and system barriers are also discussed. Understanding gender incongruence, the clinical changes associated with gender transition, and systemic barriers that maintain a gender/sex binary are key to providing adequate healthcare to transgender community. Transgender appropriate reference interval studies are virtually absent within the medical literature and should be explored. The laboratory has an important role in improving the physiological understanding, electronic medical system recognition, and overall social awareness of the transgender community. © 2017 American Association for Clinical Chemistry.

  13. The Intersection of Gender Identity and Violence: Victimization Experienced by Transgender College Students.

    Science.gov (United States)

    Griner, Stacey B; Vamos, Cheryl A; Thompson, Erika L; Logan, Rachel; Vázquez-Otero, Coralia; Daley, Ellen M

    2017-08-01

    College students disproportionately experience victimization, stalking, and relationship violence when compared with other groups. Few studies explore victimization by the gender identity of college students, including those who identify as transgender. The purpose of this study is to explore the rates of violence experienced by transgender students compared with male and female college students. This study utilized the National College Health Assessment-II (NCHA-II) and included data from students ( n = 82,538) across fall 2011, 2012, and 2013. Bivariate statistics and binary logistic regression were conducted to test the relationships between gender identity and victimization. Transgender students ( n = 204) were compared with male ( n = 27,322) and female ( n = 55,012) students. After adjusting for individual factors, transgender students had higher odds of experiencing all nine types of violence when compared with males and higher odds of experiencing eight types of violence than females. Transgender students experienced the highest odds in crimes involving sexual victimization, including attempted sexual penetration (adjusted odds ratio [aOR]: 9.49, 95% confidence interval [CI] = [6.17, 14.59], d = 1.00), sexual penetration without consent (aOR: 9.06, 95% CI = [5.64, 14.53], d = 0.94), and being in a sexually abusive relationship (aOR: 6.48, 95% CI = [4.01, 10.49], d = 0.48), than did male students. Findings reveal increased odds of victimization among transgender students when compared with male and female students. Results demonstrate the need for more comprehensive violence prevention efforts in college settings.

  14. An Exploratory Study of Transgender New Yorkers' Use of Sexual Health Services and Interest in Receiving Services at Planned Parenthood of New York City.

    Science.gov (United States)

    Porsch, Lauren M; Dayananda, Ila; Dean, Gillian

    2016-01-01

    Purpose: Transgender individuals experience barriers to healthcare, including discrimination in care provision and lack of knowledge about transgender health. We assessed New York City (NYC) transgender and gender nonconforming individuals' sexual and reproductive health (SRH) needs, access to services, and interest in receiving services from Planned Parenthood of NYC (PPNYC). Methods: We conducted an anonymous Internet-based survey of transgender individuals residing in NYC from September to December 2014 by using snowball sampling. Results: Data were analyzed from 113 surveys. Although 74% (71/96) of respondents avoided or delayed healthcare in the past year, most respondents adhered to medically indicated SRH screenings. In the past year, 64% (45/70) and 67% (46/69) of respondents were tested for HIV and other sexually transmitted infections, respectively. In the past 3 years, 80% (39/49) of respondents received clinical breast/chest examinations and 83% (35/42) of eligible individuals received Pap tests. Respondents most often received care at LGBT specialty clinics (35% [37/105]) or at private doctors' offices (31% [32/105]). Eighteen percent (19/107) had ever been to a Planned Parenthood health center. On a four-point scale, respondents rated the following factors as most influential on whether they would seek care at PPNYC: assurance that staff received transsensitivity training (mean 3.8), the existence of gender identity nondiscrimination policies (mean 3.7), and the availability of transgender-specific services, such as hormone therapy (mean 3.7). Conclusions: Although the majority of transgender individuals in our sample received recommended SRH screenings, respondents reported barriers to accessing needed medical care. Healthcare organizations interested in better serving the transgender community should ensure a high level of training around transsensitivity and explore the provision of transgender-specific services.

  15. Survey of community pharmacy residents' perceptions of transgender health management.

    Science.gov (United States)

    Leach, Caitlin; Layson-Wolf, Cherokee

    2016-01-01

    1) To measure the general perceptions and attitudes of community pharmacy residents toward transgender patients and health; 2) to identify gaps in didactic education regarding transgender health care among residents; and 3) to evaluate residents' level of support for pharmacists receiving education in transgender health care. This study was a cross-sectional survey delivered online. Community residency directors were e-mailed a cover letter and a 34-question online survey. The directors were asked to forward the survey to their residents for completion within 4 weeks. Responses were anonymous with no identifiers collected on the survey. Survey responses used a combination of open-response, multiple-choice, and Likert-scale questions aimed at gathering respondents' demographic information, perceptions of managing transgender patients and the need for receiving additional education in transgender health care. Overall, the results of the survey indicated that community pharmacy residents support integrating transgender health management into pharmacy education and recognize that the overwhelming barriers to care for these patients include discrimination and lack of provider knowledge. Significant findings include: 82.7% of community residents think that community pharmacists play an important role in providing care for transgender patients; 98.2% think that they have a responsibility to treat transgender patients; and 71.4% were not educated about transgender patient issues in pharmacy school. Only 36.2% of community residents felt confident in their ability to treat transgender patients. Community pharmacy residents list discrimination and lack of provider knowledge as the major barriers to care for transgender patients. Residents do not feel confident in their ability to treat and manage transgender patients. The majority of residents were not educated about transgender patient issues while in pharmacy school and think that community pharmacists need more education

  16. Lesbian, gay, bisexual, transgendered, or intersexed content for nursing curricula.

    Science.gov (United States)

    Brennan, Ann Marie Walsh; Barnsteiner, Jane; Siantz, Mary Lou de Leon; Cotter, Valeri T; Everett, Janine

    2012-01-01

    There has been limited identification of core lesbian, gay, bisexual, transgendered, or intersexed (LGBTI) experience concepts that should be included in the nursing curricula. This article addresses the gap in the literature. To move nursing toward the goals of health equity and cultural humility in practice, education, and research, nursing curricula must integrate core LGBTI concepts, experiences, and needs related to health and illness. This article reviews LGBTI health care literature to address the attitudes, knowledge, and skills needed to address curricular gaps and provide content suggestions for inclusion in nursing curricula. Also considered is the need to expand nursing students' definition of diversity before discussing the interplay between nurses' attitudes and culturally competent care provided to persons who are LGBTI. Knowledge needed includes a life span perspective that addresses developmental needs and their impact on health concerns throughout the life course; health promotion and disease prevention with an articulation of unique health issues for this population; mental health concerns; specific health needs of transgender and intersex individuals; barriers to health care; interventions and resources including Internet sites; and legal and policy issues. Particular assessment and communication skills for LGBTI patients are identified. Finally, there is a discussion of didactic, simulation, and clinical strategies for incorporating this content into nursing curricula at the undergraduate and graduate levels. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Care of the transgender patient: the role of the gynecologist.

    Science.gov (United States)

    Unger, Cécile A

    2014-01-01

    Gender dysphoria refers to distress that is caused by a sense of incongruity between an individual's self-identified gender and natal sex. Diagnosis is made in accordance with the Diagnostic and Statistical Manual of Mental Disorders and treatment first involves psychiatric therapy, which can help determine a patient's true goals in regards to achieving gender identity. Patients who wish to transition to the opposite sex must undergo a supervised real-life test and often are treated with hormonal therapy to develop physical characteristics consistent with their gender identity. Sex reassignment surgery is an option for patients who wish to transition completely. Transpatients face many barriers when it comes to basic health needs including education, housing, and health care. This is a result of long-standing marginalization and discrimination against this community. Because of these barriers, many patients do not receive the proper health care that they need. Additionally, because of certain high-risk behaviors as well as long-term hormonal therapy, transpatients have different routine health care needs that should be addressed in the primary care setting. Gynecologists play an important role in caring for transgender patients and should be knowledgeable about the general principles of transgender health. Copyright © 2014 Mosby, Inc. All rights reserved.

  18. Prevalence of Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Infections Among Transgender Persons Referred to an Italian Center for Total Sex Reassignment Surgery.

    Science.gov (United States)

    Luzzati, Roberto; Zatta, Marta; Pavan, Nicola; Serafin, Maurizia; Maurel, Cristina; Trombetta, Carlo; Barbone, Fabio

    2016-07-01

    The burden of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in transgender population is an underestimated issue. We performed a study to evaluate the prevalence of such infections in transgender persons addressed our center for total sex reassignment surgery (SRS). All transgender persons undergoing SRS from 2000 to 2014 were evaluated retrospectively. Participant characteristics and results of HIV, HBV, and HCV testing were collected. Exact Fisher test, Cochran-Armitage tests for trend and correct prevalence ratios were estimated. Among 498 transgender persons, 243 had confirmed serological data. Of them, 25 were female-to-male and 218 male-to-female (MtF) subjects. The prevalence of HIV, HBV and HCV infections was 0%, 4.0%, and 8.0% in female-to-male, and 12.1%, 4.6%, and 3.7% in MtF. Among MtF, younger age and earlier year of SRS were associated with lower HIV prevalence. From the multivariate model, the mutually adjustment prevalence ratios were 1.9 (95% confidence interval [95% CI], 1.2-3.1) for SRS in 2005-2010 and 3.6 (95% CI, 1.3-9.4) in 2010-2014, as compared with SRS in 2000-2004; and 4.7 (95% CI, 2.4-9.4) for South Americans as compared with others. Among the HCV-positive MtF, 57.1% were also HIV-positive. Regarding HBV, the immunity was 38.5% and, after mutual adjustment, the prevalence ratios were 2.1 (95% CI, 1.3-3.4) for South Americans versus others and 2.2 (95% CI, 1.6-3.1) for year of birth ≥ 1980. The prevalence of HBV and HCV infections among our transgender persons overlaps that reported in the general population, but HCV prevalence was much higher in HIV-infected MtF. The high burden of HIV infection among MtF and its recent incremented prevalence points out that social and medical support should be strongly promoted in such population.

  19. Speech-Language Pathologists' Knowledge and Attitudes Regarding Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Populations.

    Science.gov (United States)

    Hancock, Adrienne; Haskin, Gregory

    2015-05-01

    The cultures and service needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) minority groups are relevant to speech-language pathologists (SLPs). In particular, transgender individuals seeking communication services from SLPs in order to improve quality of life require culturally and clinically competent clinicians. Knowledge and attitudes regarding a population are foundational stages toward cultural competency (Turner, Wilson, & Shirah, 2006). The purpose of this research is to assess LGBTQ knowledge and attitudes among aspiring and practicing SLPs. An online survey was completed by 279 SLPs from 4 countries. Mean accuracy scores on LGBTQ culture questions were near 50%. Self-ratings indicated more comfort than knowledge, with generally positive feelings toward LGBTQ subgroups. Transgender communication is within SLPs' scope of practice, yet 47% indicated such services were not addressed in their master's curriculum, and 51% did not know how to describe transgender communication therapy. When respondents were asked to indicate priority of 10 LGBTQ topics for a continuing education seminar, communication masculinization/feminization best practice and case examples had the highest mean priority scores. There is a need to promote LGBTQ cultural competence within speech-language pathology. This study provides direction for improving LGBTQ cultural competence among SLPs.

  20. Transforming Attitudes about Transgender Employee Rights

    Science.gov (United States)

    Rudin, Joel; Yang, Yang; Ruane, Sinead; Ross, Linda; Farro, Andrea; Billing, Tejinder

    2016-01-01

    Transgender employees may suffer from discrimination due to transphobia. This article evaluates a pedagogical intervention designed to reduce the transphobia of North American undergraduate business students. Participants were enrolled in an organizational behavior course. They resolved a simulated dispute between coworkers over accommodating the…

  1. Sex and gender diversity among transgender persons in Ontario, Canada: results from a respondent-driven sampling survey.

    Science.gov (United States)

    Scheim, Ayden I; Bauer, Greta R

    2015-01-01

    Recent estimates suggest that as many as 1 in 200 adults may be trans (transgender, transsexual, or transitioned). Knowledge about dimensions of sex and gender in trans populations is crucial to development of inclusive policy, practice, and research, but limited data have been available, particularly from probability samples. The Trans PULSE community-based research project surveyed trans Ontarians (n=433) in 2009-2010 using respondent-driven sampling. Frequencies were weighted by recruitment probability to produce estimates for the networked Ontario trans population. An estimated 30% of trans Ontarians were living their day-to-day lives in their birth gender, and 23% were living in their felt gender with no medical intervention. In all, 42% were using hormones, while 15% of male-to-female spectrum persons had undergone vaginoplasty and 0.4% of female-to-male spectrum persons had had phalloplasty. Of those living in their felt gender, 59% had begun to do so within the past four years. A minority of trans Ontarians reported a linear transition from one sex to another, yet such a trajectory is often assumed to be the norm. Accounting for this observed diversity, we recommend policy and practice changes to increase social inclusion and service access for trans persons, regardless of transition status.

  2. Sex and Gender Diversity Among Transgender Persons in Ontario, Canada: Results From a Respondent-Driven Sampling Survey

    Science.gov (United States)

    Scheim, Ayden I.; Bauer, Greta R.

    2015-01-01

    Recent estimates suggest that as many as 1 in 200 adults may be trans (transgender, transsexual, or transitioned). Knowledge about dimensions of sex and gender in trans populations is crucial to development of inclusive policy, practice, and research, but limited data have been available, particularly from probability samples. The Trans PULSE community-based research project surveyed trans Ontarians (n = 433) in 2009–2010 using respondent-driven sampling. Frequencies were weighted by recruitment probability to produce estimates for the networked Ontario trans population. An estimated 30% of trans Ontarians were living their day-to-day lives in their birth gender, and 23% were living in their felt gender with no medical intervention. In all, 42% were using hormones, while 15% of male-to-female spectrum persons had undergone vaginoplasty and 0.4% of female-to-male spectrum persons had had phalloplasty. Of those living in their felt gender, 59% had begun to do so within the past four years. A minority of trans Ontarians reported a linear transition from one sex to another, yet such a trajectory is often assumed to be the norm. Accounting for this observed diversity, we recommend policy and practice changes to increase social inclusion and service access for trans persons, regardless of transition status. PMID:24750105

  3. Supporting the Health and Well-Being of Transgender Students.

    Science.gov (United States)

    Cicero, Ethan C; Wesp, Linda M

    2017-04-01

    Throughout the United States, there has been a rise in public discourse about transgender people and transgender issues. Much of this attention stems from passed and proposed anti-LGBTQ (lesbian, gay, bisexual, transgender, queer or questioning) legislation, including "bathroom bills" that would require transgender people to use public facilities corresponding with the sex designated on their birth certificates. With the recent discussion and legislation impacting school-aged children and adolescents, what does this mean for school nurses and how can they care and advocate for their transgender students? In this article, we aim to empower school nurses to join the discussion, advocate for inclusive and equitable school policies, and deliver gender-affirming care to transgender students. We will explain transgender identities; transgender-related stigma, prejudice, discrimination, and health concerns; gender-affirming approaches in caring for transgender youth; and implications for school nurses. School nurses play a key role in creating a space that is welcoming and affirming where transgender students can thrive.

  4. Balancing benefits and harm: chemical use and bodily transformation among Indonesia's transgender waria.

    Science.gov (United States)

    Idrus, Nurul Ilmi; Hymans, Takeo David

    2014-07-01

    Members of Indonesia's diverse male-to-female transgender community often describe themselves as waria. Waria do not equate being feminine with being female. They do not want to be women; they aspire to be like women. It entails cultivating mannerisms and wearing make-up and women's clothes, shaving one's legs and styling one's hair. But some go further in their practices of self-administered, chemically assisted bodily transformation. Field research took place in Makassar, the capital city of South Sulawesi; in a smaller town in the regency of Bulukumba on the south coast of Sulawesi; and in the special region of Yogyakarta in Java. Data were collected through repeated in-depth interviews with ten waria youths aged between 18 and 26 in each site; interviews with pharmacists, drug and cosmetics store clerks; three focus group discussions at each site; and participant observation. Our respondents saw their bodies as 'projects' they can manipulate with pharmaceutical products and cosmetics. To lighten their skin, they experimented with different brands of exfoliating liquid, whitening cream, powder, foundation, face soap and skin scrub. To grow breasts and reduce muscle mass, they experimented with different brands and dosages of contraceptive pills and injections in order to get faster, better and longer-lasting results. Harm reduction programs often neglect chemicals that are not narcotics, not related to sexually transmitted infections, and which are legally and freely available. Safety issues arise when otherwise safe products are used off-label in large quantities. Drug policy-makers are paying insufficient attention to the safety of cosmetics. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  5. HIV, HBV, and HCV molecular epidemiology among trans (transvestites, transsexuals, and transgender) sex workers in Argentina.

    Science.gov (United States)

    Carobene, Mauricio; Bolcic, Federico; Farías, María Sol Dos Ramos; Quarleri, Jorge; Avila, María Mercedes

    2014-01-01

    Commercial sex work is frequent among male-to-female transvestites, transsexuals and transgenders in Argentina, leading to high susceptibility to HIV, HBV, and HCV among other sexually transmitted infections. In a global context of scarce data on the trans sex workers population, this study was aimed to study the genomic characterization of these viruses. Plasma presence of HIV, HBV, and HCV genomic material was evaluated in samples from 273 trans sex workers. Genomic sequences of HIV-gag, pol, and vif-vpu genes, HBV-S gene, and HCV-5'UT and NS5B genes were obtained. Molecular characterization involved phylogenetic analysis and several in silico tools. Resistance-associated mutations in HIV and HBV pol genes were also analyzed. The HIV genomic characterization in 62 trans sex workers samples showed that 54.8% of the isolates corresponded to BF intersubtype recombinants, and 38.7% to subtype B. The remaining were classified as subtypes C (4.8%) and A (1.6%). HBV and HCV co-infection prevalence among HIV positive trans sex workers yielded rates of 3.2% and 6.5% respectively. Drug resistance-associated mutations were found in 12/62 (19%) HIV pol sequences, but none among HBV. Based on phylogenetic relationships, HIV isolates characterized as subtypes BF and B appeared intermingled with those from other high-risk groups. Despite trans sex workers declared not to have received antiviral treatment, complex drug resistance-associated mutation patterns were found in several HIV isolates. Planned prevention, screening, and treatment are needed to reduce further transmission and morbidity. © 2013 Wiley Periodicals, Inc.

  6. Resilience to Discrimination and Rejection Among Young Sexual Minority Males and Transgender Females: A Qualitative Study on Coping With Minority Stress.

    Science.gov (United States)

    Bry, Laura Jane; Mustanski, Brian; Garofalo, Robert; Burns, Michelle Nicole

    2017-09-13

    Sexual minority and transgender status is associated with mental health disparities, which have been empirically and theoretically linked to stressors related to social stigma. Despite exposure to these unique stressors, many sexual minority and transgender individuals will not experience mental health disorders in their lifetime. Little is known about the specific processes that sexual minority and transgender youth use to maintain their wellbeing in the presence of discrimination and rejection. Semistructured interviews were conducted with 10 sexual minority males and transgender females aged 18-22 years, who currently met criteria for an operationalized definition of resilience to depression and anxiety. Data were analyzed qualitatively, yielding information related to a wide variety of problem-solving, support-seeking, and accommodative coping strategies employed by youth in the face of social stigma. Results are discussed in light of their clinical implications.

  7. Risk Factors for Eating Disorder Psychopathology within the Treatment Seeking Transgender Population: The Role of Cross-Sex Hormone Treatment.

    Science.gov (United States)

    Jones, Bethany Alice; Haycraft, Emma; Bouman, Walter Pierre; Brewin, Nicola; Claes, Laurence; Arcelus, Jon

    2018-03-01

    Many transgender people experience high levels of body dissatisfaction, which is one of the numerous factors known to increase vulnerability to eating disorder symptoms in the cisgender (non-trans) population. Cross-sex hormones can alleviate body dissatisfaction so might also alleviate eating disorder symptoms. This study aimed to explore risk factors for eating disorder symptoms in transgender people and the role of cross-sex hormones. Individuals assessed at a national transgender health service were invited to participate (N = 563). Transgender people not on cross-sex hormones reported higher levels of eating disorder psychopathology than people who were. High body dissatisfaction, perfectionism, anxiety symptoms, and low self-esteem were risk factors for eating psychopathology, but, after controlling for these, significant differences in eating psychopathology between people who were and were not on cross-sex hormones disappeared. Cross-sex hormones may alleviate eating disorder psychopathology. Given the high prevalence of transgender identities, clinicians at eating disorder services should assess for gender identity issues. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

  8. Interdisciplinary Transgender Veteran Care: Development of a Core Curriculum for VHA Providers

    Science.gov (United States)

    Shipherd, Jillian C.; Kauth, Michael R.; Firek, Anthony F.; Garcia, Ranya; Mejia, Susan; Laski, Sandra; Walden, Brent; Perez-Padilla, Sonia; Lindsay, Jan A.; Brown, George; Roybal, Lisa; Keo-Meier, Colton L.; Knapp, Herschel; Johnson, Laura; Reese, Rebecca L.; Byne, William

    2016-01-01

    Abstract Purpose: The Veteran's Health Administration (VHA) has created a training program for interdisciplinary teams of providers on the unique treatment needs of transgender veterans. An overview of this program's structure and content is described along with an evaluation of each session and the program overall. Methods: A specialty care team delivered 14 didactic courses supplemented with case consultation twice per month over the course of 7 months through video teleconferencing to 16 teams of learners. Each team, consisting of at least one mental health provider (e.g., social worker, psychologist, or psychiatrist) and one medical provider (e.g., physician, nurse, physician assistant, advanced practice nurse, or pharmacist), received training and consultation on transgender veteran care. Results: In the first three waves of learners, 111 providers across a variety of disciplines attended the sessions and received training. Didactic topics included hormone therapy initiation and adjustments, primary care issues, advocacy within the system, and psychotherapy issues. Responses were provided to 39 veteran-specific consult questions to augment learning. Learners reported an increase in knowledge plus an increase in team cohesion and functioning. As a result, learners anticipated treating more transgender veterans in the future. Conclusion: VHA providers are learning about the unique healthcare needs of transgender veterans and benefitting from the training opportunity offered through the Transgender Specialty Care Access Network–Extension of Community Healthcare Outcomes program. The success of this program in training interdisciplinary teams of providers suggests that it might serve as a model for other large healthcare systems. In addition, it provides a path forward for individual learners (both within VHA and in the community) who wish to increase their knowledge. PMID:29159298

  9. EXOGENOUS TESTOSTERONE DOES NOT INDUCE OR EXACERBATE THE METABOLIC FEATURES ASSOCIATED WITH PCOS AMONG TRANSGENDER MEN.

    Science.gov (United States)

    Chan, Kelly J; Liang, Jennifer J; Jolly, Divya; Weinand, Jamie D; Safer, Joshua D

    2018-04-06

    Polycystic ovarian syndrome (PCOS) is a complex condition which can include menstrual irregularity, metabolic derangement, and increased androgen levels. The mechanism of PCOS is unknown. Some suggest that excess production of androgens by the ovaries may cause or exacerbate the metabolic findings. The purpose of this study was to assess the role of increased testosterone on metabolic parameters on individuals presumed to be chromosomally female by examination of these parameters in hormone-treated transgender men. In 2015 and 2016, we asked all transgender men who visited the Endocrinology Clinic at Boston Medical Center treated with testosterone for consent for a retrospective anonymous chart review. Of the 36 men, 34 agreed (94%). Serum metabolic factors and body mass index levels for each patient were graphed over time, from initiation of therapy through 6 years of treatment. Bivariate analyses were conducted to analyze the impact of added testosterone. Regressions measuring the impact of testosterone demonstrated no significant change in levels of glycosylated hemoglobin, triglycerides, or low density lipoprotein cholesterol. There was a statistically significant decrease in BMI with increasing testosterone. There was also a statistically significant decrease in high density lipoprotein levels upon initiation of testosterone therapy. Testosterone therapy in transgender men across a wide range of doses and over many years did not result in the abnormalities in HbA1c or dyslipidemia seen with PCOS. Instead, treatment of transgender men with testosterone resulted only in a shift of metabolic biomarkers toward the average physiologic male body. This retrospective chart review of 34 transgender men found that testosterone therapy does not induce or exacerbate the metabolic features associated with PCOS.

  10. Generational Differences in Internalized Transnegativity and Psychological Distress Among Feminine Spectrum Transgender People.

    Science.gov (United States)

    Jackman, Kasey B; Dolezal, Curtis; Bockting, Walter O

    2018-01-01

    This study examined internalized transnegativity and psychological distress in two age groups of transgender individuals who identified their gender identity on the feminine spectrum (rather than congruent with their male sex assigned at birth). Due to greater visibility and acceptance of gender diversity in the United States, we hypothesized that internalized transnegativity would be lower in the younger compared with the older group, and that the younger generation would, therefore, report lower levels of psychological distress than the older generation. The study sample consisted of trans-feminine individuals (N = 440) who completed a online survey of the U.S. transgender population and comprised a younger group aged 18-24 years (n = 133) and an older group aged 40 years and older (n = 307). Internalized transnegativity was assessed using the Transgender Identity Survey, and psychological distress was assessed with the Brief Symptom Inventory 18. We used regression and mediation analysis to examine differences between the two groups. Contrary to our expectations, the older group reported significantly lower levels of both internalized transnegativity and psychological distress compared with the younger group. Internalized transnegativity partially mediated the relationship between age group and psychological distress. Despite greater visibility of transgender people and increasing acceptance of gender diversity in the United States, the younger trans-feminine individuals reported more psychological distress than the older transfeminine individuals, which was, in part, related to internalized transnegativity. Trans-feminine individuals may benefit from culturally sensitive and clinically competent mental health services to alleviate internalized transnegativity and psychological distress.

  11. The Cost of Employment Discrimination against Transgender Residents of Massachusetts

    OpenAIRE

    Herman, Jody L.

    2011-01-01

    Transgender residents of Massachusetts have reported experiencing discrimination in employment. Loss of employment due to anti-transgender bias often means lost wages, lost health insurance coverage, and housing instability. Therefore, employment discrimination might affect the budget of the Commonwealth of Massachusetts in several ways: reduced income tax revenues, higher public assistance expenditures, and other costs. For instance, if a worker is fired for being transgender and loses wages...

  12. The Cost of Employment Discrimination against Transgender Residents of Florida

    OpenAIRE

    Brown, Taylor NT; Herman, Jody L

    2015-01-01

    The State of Florida spends more than a half million dollars each year as the result of employment discrimination against transgender residents. Currently, 10 counties and 14 cities in Florida have ordinances prohibiting discrimination based on gender identity in public and private sector employment, but nearly 22,000 transgender adult residents are not covered by these laws. Employment discrimination against transgender adults in Florida costs the state an estimated $570,000 annually in stat...

  13. The role of religiosity, social support, and stress-related growth in protecting against HIV risk among transgender women.

    Science.gov (United States)

    Golub, Sarit A; Walker, Ja'nina J; Longmire-Avital, Buffie; Bimbi, David S; Parsons, Jeffrey T

    2010-11-01

    Transgender women completed questionnaires of religiosity, social support, stigma, stress-related growth, and sexual risk behavior. In a multivariate model, both social support and religious stress-related growth were significant negative predictors of unprotected anal sex, but religious behaviors and beliefs emerged as a significant positive predictor. The interaction between religious behaviors and beliefs and social support was also significant, and post-hoc analyses indicated that high-risk sex was least likely among individuals with high-levels of social support but low levels of religious behaviors and beliefs. These data have important implications for understanding factors that might protect against HIV risk for transgender women.

  14. Providing Competent and Affirming Services for Transgender and Gender Nonconforming Older Adults.

    Science.gov (United States)

    Porter, Kristen E; Brennan-Ing, Mark; Chang, Sand C; Dickey, Lore M; Singh, Anneliese A; Bower, Kyle L; Witten, Tarynn M

    2016-01-01

    Despite the growing visibility and acceptance of transgender and gender nonconforming (TGNC) individuals, TGNC older adults experience many barriers in accessing competent and affirming health and social services due to anti-TGNC prejudice, discrimination, and lack of competent healthcare training on the part of healthcare workers. Clinical gerontologists and geriatricians will likely encounter TGNC adults in their practice given population aging and greater numbers of TGNC people who are living in their affirmed gender identities. The American Psychological Association recently published its Guidelines for Psychological Practice with Transgender and Gender Nonconforming People, which document the unique needs of TGNC individuals and outlines approaches for competent and affirming service provision (APA, 2015). We interpret these Guidelines using a gerontological lens to elucidate specific issues faced by the TGNC older adult along with the practice and policy implications for this population.

  15. Negative and Positive Factors Associated with the Well-Being of Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning (LGBTQ) Youth

    Science.gov (United States)

    Higa, Darrel; Hoppe, Marilyn J.; Lindhorst, Taryn; Mincer, Shawn; Beadnell, Blair; Morrison, Diane M.; Wells, Elizabeth A.; Todd, Avry; Mountz, Sarah

    2014-01-01

    Factors associated with the well-being of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth were qualitatively examined to better understand how these factors are experienced from the youths' perspectives. Largely recruited from LGBTQ youth groups, 68 youth participated in focus groups (n = 63) or individual interviews (n =…

  16. Discourses Governing Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual Teachers' Disclosure of Sexual Orientation and Gender History

    Science.gov (United States)

    Bower-Phipps, Laura

    2017-01-01

    Significant progress has been made in equal rights for lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) individuals, yet schools remain institutions where sexual and gender diversity are marginalized and/or silenced. Queer theory, a non-linear theory that disrupts dominant beliefs about gender and sexuality and what…

  17. Are Lesbian, Gay, Bisexual and Transgender (LGBT) persons protected against discrimination and hate crime in Georgia?

    OpenAIRE

    Japaridze, Sophio

    2012-01-01

    This article discusses whether lesbian, gay, bisexual and transgender (LGBT) people are protected against discrimination and hate crime in Georgia. Georgia is dominated by deeply rooted traditions, history and religion which promote stigmatisation and enhance existing negative stereotypes of the LGBT community. This is aggravated by state practice and poor legislation which fail to ensure adequate protection of LGBT individuals against discrimination and hate crime. Even though homosexuality ...

  18. Perception of Community Tolerance and Prevalence of Depression among Transgender Persons.

    Science.gov (United States)

    Owen-Smith, Ashli A; Sineath, Craig; Sanchez, Travis; Dea, Robin; Giammattei, Shawn; Gillespie, Theresa; Helms, Monica F; Hunkeler, Enid M; Quinn, Virginia P; Roblin, Douglas; Slovis, Jennifer; Stephenson, Robert; Sullivan, Patrick S; Tangpricha, Vin; Woodyatt, Cory; Goodman, Michael

    2017-01-01

    The goal of the study was to examine the association between depression and perceived community tolerance after controlling for various demographic and personal characteristics, treatment receipt, and past experiences with abuse or discrimination. An on-line survey assessed depressive symptoms among transgender and gender non-conforming individuals. Depression was assessed using the 7-item Beck Depression Inventory for Primary Care (BDI-PC) and the 10-item Center for Epidemiologic Studies Depression (CESD-10) scale. The prevalence ratios (95% confidence intervals) comparing depression in persons who did and did not perceive their area as tolerant were 0.33 (0.20-0.54) for BD-PC and 0.66 (0.49-0.89) for CESD-10. Other factors associated with depression were experience with abuse or discrimination, lower education, and unfulfilled desire to receive hormonal therapy. Depression was common in this sample of transgender and gender non-conforming individuals and was strongly and consistently associated with participants' perceptions of community tolerance, even after adjusting for possible confounding. The association between desire to receive hormonal therapy and depression is a finding that warrants further exploration. Future research should also assess depression and changes in perception of community tolerance in transgender individuals before and after initiation of gender confirmation treatment.

  19. Sexual Behavior of Gender-Dysphoric Individuals Before Gender-Confirming Interventions: A European Multicenter Study

    NARCIS (Netherlands)

    Cerwenka, S.; Nieder, T.O.; Cohen-Kettenis, P.T.; De Cuypere, G.; Haraldsen, I.R.H.; Kreukels, B.P.C.; Richter-Appelt, H.

    2014-01-01

    A transsexual course of development that starts before puberty (early onset) or during or after puberty, respectively (late onset), may lead to diverse challenges in coping with sexual activity. The authors explored the sexual behavior of 380 adult male-to-female and female-to-male individuals

  20. Epidemiology of gender dysphoria and transgender identity.

    Science.gov (United States)

    Zucker, Kenneth J

    2017-10-01

    This review provides an update on the epidemiology of gender dysphoria and transgender identity in children, adolescents and adults. Although the prevalence of gender dysphoria, as it is operationalised in the fifth edtion of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), remains a relatively 'rare' or 'uncommon' diagnosis, there is evidence that it has increased in the past couple of decades, perhaps reflected in the large increase in referral rates to specialised gender identity clinics. In childhood, the sex ratio continues to favour birth-assigned males, but in adolescents, there has been a recent inversion in the sex ratio from one favouring birth-assigned males to one favouring birth-assigned females. In both adolescents and adults, patterns of sexual orientation vary as a function of birth-assigned sex. Recent studies suggest that the prevalence of a self-reported transgender identity in children, adolescents and adults ranges from 0.5 to 1.3%, markedly higher than prevalence rates based on clinic-referred samples of adults. The stability of a self-reported transgender identity or a gender identity that departs from the traditional male-female binary among non-clinic-based populations remains unknown and requires further study.

  1. Mental Health and the Transgender Population.

    Science.gov (United States)

    Carmel, Tamar C; Erickson-Schroth, Laura

    2016-12-01

    Although research into the physical and mental health disparities faced by transgender and gender nonconforming (TGNC) populations is becoming more popular, historically it has been limited. It is now recognized that TGNC people experience disproportionate rates of negative mental health outcomes relative to both their gender-normative, heterosexual peers, as well as their gender-normative lesbian, gay, and bisexual (LGB) peers. The theoretical basis of current transgender mental health research is rooted in the Minority Stress Model, which postulates that we live in a hetero-centric, gender-normative society that stigmatizes and discriminates against lesbian, gay, bisexual, and transgender (LGBT) people, subjecting them to chronic stress (Hendricks & Testa, 2012; Meyer, 1995). This chronic, potentially compounding stress, is responsible for the increased risk of negative mental health outcomes in LGBT populations. TGNC people, in particular, may experience more adverse outcomes than their LGB peers due to rejection and discrimination within society at large as well as within the LGB community. [Journal of Psychosocial Nursing and Mental Health Services, 54(12), 44-48.]. Copyright 2016, SLACK Incorporated.

  2. Prospective Evaluation of Self-Reported Aggression in Transgender Persons.

    Science.gov (United States)

    Defreyne, Justine; T'Sjoen, Guy; Bouman, Walter Pierre; Brewin, Nicola; Arcelus, Jon

    2018-05-01

    Although research on the relation between testosterone and aggression in humans is inconclusive, guidelines (including the World Professional Association for Transgender Health Standards of Care, edition 7) have warned for an increase in aggression in transgender men taking testosterone treatment. To investigate the association between levels of testosterone and aggression in treatment-seeking transgender people and explore the role of mental health psychopathology (anxiety and depressive symptoms) and social support in aggression in this population. Every transgender person invited for assessment at a national transgender health clinic in the United Kingdom during a 3-year period (2012-2015) completed self-report measures for interpersonal problems, including levels of aggression (Inventory of Interpersonal Problems [IIP-32]), symptoms of anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), social support (Multidimensional Scale of Perceived Social Support), and experiences of transphobia before and 1 year after the initiation of gender-affirming hormonal therapy. Correlations between prospective scores for the IIP-32 factor "too aggressive" and prospective levels of sex steroids, prospective psychological (HADS), and baseline psychosocial measurements were tested. Prospective scores for the factor "too aggressive" were not correlated to prospective serum testosterone levels. Results of 140 people (56 transgender men, 84 transgender women) were analyzed. A prospective increase in scores for the factor "too aggressive" of the IIP-32 in transgender men 1 year after being treated with testosterone treatment or a decrease of the IIP-32 aggression scores in transgender women 1 year after gender-affirming hormonal therapy was not found. However, a positive correlation was found between increasing HADS anxiety scores and increasing scores for the IIP-32 "too aggressive" score in the entire study population and a positive correlation with lower support

  3. 7 Reasons for Accommodating Transgender Students at School

    Science.gov (United States)

    Arenas, Alberto; Gunckel, Kristin L.; Smith, William L.

    2016-01-01

    Schools have become ground zero for clashes over transgender rights, and critics are denouncing academic institutions--and more recently, the Obama administration--for supporting transgender students in their right to use restrooms and locker rooms that match their gender identity. This article responds to the seven most common claims made by…

  4. School Experiences of Transgender and Gender Diverse Students in Australia

    Science.gov (United States)

    Jones, Tiffany; Smith, Elizabeth; Ward, Roz; Dixon, Jennifer; Hillier, Lynne; Mitchell, Anne

    2016-01-01

    Over the last decade, there has been an increase in global and local policy protections on the basis of gender identity and expression in education and a recent spate of coverage of transgender students on Australian television and news media. This paper explores the school experiences of Australian transgender and gender diverse students, with…

  5. Parents of Youth Who Identify as Transgender: An Exploratory Study

    Science.gov (United States)

    Johnson, Danielle; Sikorski, Jonathon; Savage, Todd A.; Woitaszewski, Scott A.

    2014-01-01

    This article explores the experiences, perceptions, support systems, and coping strategies on which parents of youth who identify as transgender rely. Based on data gathered via interviews with parents of youth who identify as transgender and analyzed using the consensual qualitative research method, parental challenges and concerns about their…

  6. Examining Victimization and Psychological Distress in Transgender College Students

    Science.gov (United States)

    Effrig, Jessica C.; Bieschke, Kathleen J.; Locke, Benjamin D.

    2011-01-01

    Treatment-seeking and non-treatment-seeking transgender college students were examined with regard to victimization and psychological distress. Findings showed that transgender college students had elevated rates of distress as compared with college students who identified as men or women. Results indicated that treatment-seeking and non-treatment…

  7. Transgender across the Curriculum: A Psychology for Inclusion

    Science.gov (United States)

    Case, Kim A.; Stewart, Briana; Tittsworth, Josephine

    2009-01-01

    Neumann (2005) called for an analysis of marginalization and inclusion of lesbian, gay, and bisexual students in psychology. As psychology instructors begin to infuse such content, the curriculum still overwhelmingly neglects the transgender community. This invisibility of transgender people within psychology courses allows for perpetuation of…

  8. The Experiences and Needs of Transgender Community College Students

    Science.gov (United States)

    Beemyn, Genny

    2012-01-01

    The experiences and needs of college students who identify on the transgender spectrum (androgynous, gender nonconforming, genderqueer, transfeminine, transmaculine, transgender, etc.) have begun to be explored in recent years, but this work has largely been limited to four-year colleges and universities. Virtually no research has considered the…

  9. Gender Variance on Campus: A Critical Analysis of Transgender Voices

    Science.gov (United States)

    Mintz, Lee M.

    2011-01-01

    Transgender college students face discrimination, harassment, and oppression on college and university campuses; consequently leading to limited academic and social success. Current literature is focused on describing the experiences of transgender students and the practical implications associated with attempting to meet their needs (Beemyn,…

  10. Street and State Discrimination: Thai Transgender Women in Europe

    NARCIS (Netherlands)

    Pravattiyagul, Jutathorn

    2018-01-01

    The large number of Thai transgender women (Kathoey) in Thailand and their visible roles in society often lead casual visitors to believe that Thailand is open and accepting of LGBT (Lesbian, Gay, Bisexual, Transgender) culture. Hence, it is common to hear Thailand described as gender tolerant and

  11. Considering Transgender People in Education: A Gender-Complex Approach

    Science.gov (United States)

    Rands, Kathleen E.

    2009-01-01

    Schools serve as a setting in which students come to understand gender, but transgender students (those who transgress societal gender norms) are largely left out of discussions of education. The high level of harassment that transgender students face poses sizable obstacles to school success. If the field of education is committed to equity and…

  12. Transgender people: health at the margins of society.

    Science.gov (United States)

    Winter, Sam; Diamond, Milton; Green, Jamison; Karasic, Dan; Reed, Terry; Whittle, Stephen; Wylie, Kevan

    2016-07-23

    In this paper we examine the social and legal conditions in which many transgender people (often called trans people) live, and the medical perspectives that frame the provision of health care for transgender people across much of the world. Modern research shows much higher numbers of transgender people than were apparent in earlier clinic-based studies, as well as biological factors associated with gender incongruence. We examine research showing that many transgender people live on the margins of society, facing stigma, discrimination, exclusion, violence, and poor health. They often experience difficulties accessing appropriate health care, whether specific to their gender needs or more general in nature. Some governments are taking steps to address human rights issues and provide better legal protection for transgender people, but this action is by no means universal. The mental illness perspective that currently frames health-care provision for transgender people across much of the world is under scrutiny. The WHO diagnostic manual may soon abandon its current classification of transgender people as mentally disordered. Debate exists as to whether there should be a diagnosis of any sort for transgender children below the age of puberty. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Low Fertility Preservation Utilization Among Transgender Youth.

    Science.gov (United States)

    Nahata, Leena; Tishelman, Amy C; Caltabellotta, Nicole M; Quinn, Gwendolyn P

    2017-07-01

    Research demonstrates a negative psychosocial impact of infertility among otherwise healthy adults, and distress among adolescents facing the prospect of future infertility due to various medical conditions and treatments that impair reproductive health. Guidelines state that providers should counsel transgender youth about potential infertility and fertility preservation (FP) options prior to initiation of hormone therapy. The purpose of this study was to examine the rates of fertility counseling and utilization of FP among a cohort of adolescents with gender dysphoria seen at a large gender clinic. An Institutional Review Board-approved retrospective review of electronic medical records was conducted of all patients with ICD-9/10 codes for gender dysphoria referred to Pediatric Endocrinology for hormone therapy (puberty suppression and/or cross-sex hormones) from January 2014 to August 2016. Seventy-eight patients met inclusion criteria. Five children were prepubertal, no hormone therapy was considered, and they were therefore excluded. Of the remaining 73 patients, 72 had documented fertility counseling prior to initiation of hormone therapy and 2 subjects attempted FP; 45% of subjects mentioned a desire or plan to adopt, and 21% said they had never wanted to have children. Utilization rates of FP are low among transgender adolescents. More research is needed to understand parenthood goals among transgender youth at different ages and developmental stages and to explore the impact of gender dysphoria on decision-making about FP and parenthood. Discussions about infertility risk, FP, and other family building options should be prioritized in this vulnerable adolescent population. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. A cross-sectional study of low HIV testing frequency and high-risk behaviour among men who have sex with men and transgender women in Lima, Peru.

    Science.gov (United States)

    Lee, Sky W; Deiss, Robert G; Segura, Eddy R; Clark, Jesse L; Lake, Jordan E; Konda, Kelika A; Coates, Thomas J; Caceres, Carlos F

    2015-04-21

    Increased HIV testing frequency among high-risk populations such as men who have sex with men (MSM) and male-to-female transgender women (TW) can lead to earlier treatment and potentially reduce HIV transmission. We analyzed baseline survey data from 718 high-risk, young (median age 29 [interquartile range 23-35]) MSM/TW enrolled in a community-based HIV prevention trial between 2008-2009. Participants were recruited from 24 neighborhoods in and around Lima, Peru. We assessed HIV testing frequency, testing behaviour, and motivations and barriers to testing. Multivariate analysis identified correlates to prior HIV testing. Overall, 79.6% reported HIV testing within their lifetimes, however, only 6.2% reported an average of two tests per year, as per Peruvian Ministry of Health guidelines. The most commonly reported motivators for testing were to check one's health (23.3%), lack of condom use (19.7%), and availability of free testing (14.0%), while low self-perceived risk for HIV (46.9%), fear of a positive result (42.0%), and lack of access to testing services (35.7%) were the most frequently reported barriers. In multivariate analysis, factors independently associated with HIV testing included age [adjusted prevalence ratio (APR) 1.00, 95% CI (1.00-1.01)], transgender-identification vs. gay-identification [APR 1.11, 95% CI (1.03-1.20)], history of transactional sex [APR 1.16, 95% CI (1.07-1.27)], and prior sexually transmitted infection diagnosis [APR 1.15, 95% CI (1.07-1.24)]. An overwhelming majority of participants did not meet the standard-of-care for testing frequency. The reported motivations and barriers to testing highlight issues of risk perception and accessibility. Our findings suggest utilizing non-traditional outreach methods and promoting HIV testing as a routine part of healthcare in Peru to encourage testing and knowledge of HIV serostatus.

  15. Sex work among men who have sex with men and transgender women in Bogotá.

    Science.gov (United States)

    Bianchi, Fernanda T; Reisen, Carol A; Zea, Maria Cecilia; Vidal-Ortiz, Salvador; Gonzales, Felisa A; Betancourt, Fabián; Aguilar, Marcela; Poppen, Paul J

    2014-11-01

    This qualitative study examined sex work among internally displaced male and transgender female sex workers in Bogotá, Colombia. Internal displacement has occurred in Colombia as a result of decades of conflict among armed groups and has created large-scale migration from rural to urban areas. Informed by the polymorphous model of sex work, which posits that contextual conditions shape the experience of sex work, we examined three main research questions. The first dealt with how internal displacement was related to the initiation of sex work; the second concerned the effect of agency on sex worker satisfaction; and the third examined how sex work in this context was related to HIV and other risks. Life history interviews were conducted with 26 displaced individuals who had done sex work: 14 were men who have sex with men and 12 were transgender women (natal males). Findings revealed that many participants began doing sex work in the period immediately after displacement, because of a lack of money, housing, and social support. HIV risk was greater during this time due to limited knowledge of HIV and inexperience negotiating safer sex with clients. Other findings indicated that sex workers who exerted more control and choice in the circumstances of their work reported greater satisfaction. In addition, we found that although many sex workers insisted on condom use with clients, several noted that they would sometimes have unprotected sex for additional money. Specific characteristics affecting the experience of sex work among the transgender women were also discussed.

  16. Researching and Working for Transgender Youth: Contexts, Problems and Solutions

    Directory of Open Access Journals (Sweden)

    Tiffany Jones

    2016-08-01

    Full Text Available In May 2016, two events epitomized the complexities of working for global transgender youth rights. First, United Nations Educational Scientific and Cultural Organisation (UNESCO hosted a ministerial event in which education ministers from around the world released a call to action for protection of students on the basis of their gender identity and expression in schools. Second, the United Nations (UN hosted an event celebrating the family, attended by conservative ministers and activists who mobilized family protectionist discourse against transgender students. This article contemplates, in light of transgender activist Raewyn Connell’s Southern Theory contributions, the complexity of global research and work for transgender youth. It considers key informant interviews with 50 stakeholders in the global push for transgender student rights in education, including members of government and non-government organisations, and academics from Northern and Southern countries. Problems in aiding transgender youth at the global level included safety concerns, the impacts of conservative advocates and media backlash (within family and national protectionist discourses, cultural complexities hampering engagement and translation, dissemination hindrances pertaining to established publishing biases, and financial and collaboration barriers. Solutions including virtual work; multi-level leadership; alliance-building; representation; visibility of transgender youth citizenship and family membership; and legal, financial and capacity-building aid are considered.

  17. Improving Transgender Healthcare in the New York City Correctional System.

    Science.gov (United States)

    Jaffer, Mohamed; Ayad, John; Tungol, Jose Gabriel; MacDonald, Ross; Dickey, Nathaniel; Venters, Homer

    2016-04-01

    Correctional settings create unique challenges for patients with special needs, including transgender patients, who have an increased rate of overall discrimination, sexual abuse, healthcare disparities, and improper housing. As part of our correctional health quality improvement process, we sought to review and evaluate the adequacy of care for transgender patients in the New York City jail system. Using correctional pharmacy records, transgender patients receiving hormonal treatment were identified. A brief in-person survey was conducted to evaluate their care in the community before incarceration, medical care in jail, and experience in the jail environment. Survey findings and analysis of transgender patient healthcare-related complaints revealed opportunities for improvements in the provision of care and staff understanding of this population. Utilizing these findings, we conducted lesbian, gay, bisexual, and transgender (LGBT) trainings in all 12 jail clinics for medical, nursing, and mental health staff. Three months after LGBT training, patient complaints dropped by over 50%. After the development and implementation of a newly revised transgender healthcare policy, complaints dropped to zero within 6 months. Our efforts to assess the quality of care provided to transgender patients revealed significant areas for improvement. Although we have made important gains in providing quality care through the implementation of policies and procedures rooted in community standards and the express wishes of our patients, we continue to engage this patient population to identify other issues that impact their health and well-being in the jail environment.

  18. Body Image and Eating Disorders Among Lesbian, Gay, Bisexual, and Transgender Youth.

    Science.gov (United States)

    McClain, Zachary; Peebles, Rebecka

    2016-12-01

    Adolescence is a crucial period for emerging sexual orientation and gender identity and also body image disturbance and disordered eating. Body image distortion and disordered eating are important pediatric problems affecting individuals along the sexual orientation and gender identity spectrum. Lesbian, gay, bisexual, transgender (LGBT) youth are at risk for eating disorders and body dissatisfaction. Disordered eating in LGBT and gender variant youth may be associated with poorer quality of life and mental health outcomes. Pediatricians should know that these problems occur more frequently in LGBT youth. There is evidence that newer treatment paradigms involving family support are more effective than individual models of care. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. No One Expects a Transgender Jew: Religious, Sexual and Gendered Intersections in the Evaluation of Religious and Nonreligious Others

    Directory of Open Access Journals (Sweden)

    Ryan Cragun

    2017-01-01

    Full Text Available While a large body of research has established that there is substantial prejudice against atheists and nonreligious individuals, both in the US and in other countries where nonreligious people are minorities, to date very little research has looked beyond attitudes toward solitary identities (e.g., “atheists” vs. “gay atheists”. Given the growing recognition of the importance of intersectionality in understanding the experiences of minorities, in this article we examined attitudes toward intersected identities, combining five (nonreligious identities (i.e., Christian, Jewish, Muslim, atheist, and nonreligious with four sexual/gender identities (i.e., heterosexual, homosexual, bisexual, and transgender using a 100-point thermometer scale (N = 618. We found that sexual/gender identities were more influential in ordering the results than were religious identities, with heterosexual individuals being rated most positively, followed for the most part by: homosexual, bisexual, and then transgender individuals. However, within the sexual/gender identities, (nonreligion ordered the results; Christians and Jewish individuals rated most highly among heterosexuals while nonreligious and atheist individuals rated most highly among transgender individuals. We suggest these results indicate that people believe minority sexual/gender identities “taint” or “pollute” religious identities, unless those religious identities are already perceived as tainted, as is the case for atheists and the nonreligious.

  20. Affirmative Cognitive Behavior Therapy with Transgender and Gender Nonconforming Adults.

    Science.gov (United States)

    Austin, Ashley; Craig, Shelley L; Alessi, Edward J

    2017-03-01

    Although there is growing awareness in contemporary society regarding transgender and gender nonconforming (TGNC) identities, transgender people continue to be highly marginalized and subject to transphobic discrimination and victimization. As a result, authentically expressing and navigating a TGNC identity can be difficult. Psychiatrists and other mental health professionals can play a key role in supporting TGNC client health and well-being through the use of trans-affirmative approaches. Trans-affirmative practice recognizes all experiences of gender as equally healthy and valuable This article focuses on transgender affirmative cognitive behavior therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Barriers to Care Among Transgender and Gender Nonconforming Adults.

    Science.gov (United States)

    Gonzales, Gilbert; Henning-Smith, Carrie

    2017-12-01

    Policy Points: Transgender and gender nonconforming (GNC) adults may experience barriers to care for a variety of reasons, including discrimination and lack of awareness by providers in health care settings. In our analysis of a large, population-based sample, we found transgender and GNC adults were more likely to be uninsured and have unmet health care needs, and were less likely to have routine care, compared to cisgender (nontransgender) women. Our findings varied by gender identity. More research is needed on transgender and GNC populations, including on how public policy and provider awareness affects health care access and health outcomes differentially by gender identity. Very little population-based research has examined health and access to care among transgender populations. This study compared barriers to care between cisgender, transgender, and gender nonconforming (GNC) adults using data from a large, multistate sample. We used data from the 2014-2015 Behavioral Risk Factor Surveillance System to estimate the prevalence of having no health insurance, unmet medical care needs due to cost, no routine checkup, and no usual source of care for cisgender women (n = 183,370), cisgender men (n = 131,080), transgender women (n = 724), transgender men (n = 449), and GNC adults (n = 270). Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for each barrier to care while adjusting for sociodemographic characteristics. Transgender and GNC adults were more likely to be nonwhite, sexual minority, and socioeconomically disadvantaged compared to cisgender adults. After controlling for sociodemographic characteristics, transgender women were more likely to have no health insurance (OR = 1.60; 95% CI = 1.07-2.40) compared to cisgender women; transgender men were more likely to have no health insurance (OR = 2.02; 95% CI = 1.25-3.25) and no usual source of care (OR = 1.84; 95% CI = 1.18-2.88); and GNC

  2. Transactional Pathways of Transgender Identity Development in Transgender and Gender Nonconforming Youth and Caregivers from the Trans Youth Family Study

    Science.gov (United States)

    Katz-Wise, Sabra L.; Budge, Stephanie L.; Fugate, Ellen; Flanagan, Kaleigh; Touloumtzis, Currie; Rood, Brian; Perez-Brumer, Amaya; Leibowitz, Scott

    2017-01-01

    Background A growing body of research has examined transgender identity development, but no studies have investigated developmental pathways as a transactional process between youth and caregivers, incorporating perspectives from multiple family members. The aim of this study was to conceptualize pathways of transgender identity development using narratives from both transgender and gender nonconforming (TGN) youth and their cisgender (non-transgender) caregivers. Methods The sample included 16 families, with 16 TGN youth, ages 7–18 years, and 29 cisgender caregivers (N = 45 family members). TGN youth represented multiple gender identities, including trans boy (n = 9), trans girl (n = 5), gender fluid boy (n = 1), and girlish boy (n = 1). Caregivers included mothers (n = 17), fathers (n = 11), and one grandmother. Participants were recruited from LGBTQ community organizations and support networks for families with transgender youth in the Midwest, Northeast, and South regions of the United States. Each family member completed a one-time in-person semi-structured qualitative interview that included questions about transgender identity development. Results Analyses revealed seven overarching themes of transgender identity development, which were organized into a conceptual model: Trans identity development, sociocultural influences/societal discourse, biological influences, family adjustment/impact, stigma/cisnormativity, support/resources, and gender affirmation/actualization. Conclusions Findings underscore the importance of assessing developmental processes among TGN youth as transactional, impacting both youth and their caregivers. PMID:29527139

  3. Prolactin levels during short- and long-term cross-sex hormone treatment: an observational study in transgender persons.

    Science.gov (United States)

    Nota, N M; Dekker, M J H J; Klaver, M; Wiepjes, C M; van Trotsenburg, M A; Heijboer, A C; den Heijer, M

    2017-08-01

    The cause of prolactin alterations in transgender persons is often assigned to oestrogens, but the precise cause and time course during different phases of cross-sex hormone treatment (CHT) remain unclear. In this study, we prospectively examined prolactin levels in 55 female-to-males (FtMs) and 61 male-to-females (MtFs) during the first year of CHT. Because long-term prolactin data were not available in this population, we studied these levels in a retrospective population of 25 FtMs and 38 MtFs who underwent gonadectomy. FtMs were treated with testosterone and MtFs with estradiol, with or without the anti-androgen cyproterone acetate (CPA) (after gonadectomy CPA is cessated). During the first year of CHT, prolactin decreased with 25% (95CI: -33%, -12%) in FtMs and increased with 193% (95CI: 156%, 219%) in MtFs. Eighteen MtFs developed hyperprolactinemia (≥0.6 IU L -1 ). In the retrospective population, post-gonadectomy levels in FtMs were lower than baseline levels (-39%; 95CI: -51%, -20%) while in MtFs post-gonadectomy levels and baseline levels were comparable (-6%; 95CI: -24%, 15%). No hyperprolactinemia was found after gonadectomy. In conclusion, in FtMs, prolactin decreased consistently during CHT and in MtFs, prolactin increased during pre-surgical CHT but normalised after gonadectomy. It is likely that CPA induces increasing prolactin levels in MtFs. © 2016 Blackwell Verlag GmbH.

  4. Pathological, Disabled, Transgender: The Ethics, History, Laws, and Contradictions in Models that Best Serve Transgender Rights.

    Science.gov (United States)

    Wahlert, Lance; Gill, Sabrina

    This article addresses the precarious place of transgender and gender non-cis persons in relation to their discrimination-protections in recent legal, medical, and ethical policies in the United States. At present, there exists a contradiction such that trans persons are considered "pathological" enough that they are included in the latest iteration of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-V) as "gender dysphoric," but they are not included in the category of "disabled" under the Americans with Disabilities Act (ADA). As such, trans persons in America are subject to the stigma of pathology (albeit with medical treatment) without the full protections of the ADA. By contrast, transgender and non-cis-gender Americans find their queer cohorts who are HIV-positive to be fully protected by the ADA. We ask whether transgender and non-cis-gender persons should embrace their (already pathologized) personhood as a disability. Sometimes "choosing disability" affords more rights than it deploys stigma.

  5. Transgender women and the sex work industry: roots in systemic, institutional, and interpersonal discrimination.

    Science.gov (United States)

    Nadal, Kevin L; Davidoff, Kristin C; Fujii-Doe, Whitney

    2014-01-01

    Because transgender people face discrimination on systemic, institutional, and interpersonal levels, the previous literature has supported that many transgender women view the sex work industry as their only viable career option. The current article reviews the literature on discrimination against transgender people, explores how discrimination influences their participation in sex work, and discusses how institutional discrimination against transgender women manifests within the criminal justice system. Furthermore, recommendations are provided for advocating for the rights of transgender people while promoting healthy behaviors and higher quality of life. Throughout the article, quotes from previous qualitative research are used to illustrate the experiences of transgender women through their own voices and perspectives.

  6. Medication adherence among transgender women living with HIV

    OpenAIRE

    Baguso, Glenda N.; Gay, Caryl L.; Lee, Kathryn A.

    2016-01-01

    Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the U.S. report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transg...

  7. Lesbian, Gay, Bisexual, and Transgender (LGBT) Survivorship.

    Science.gov (United States)

    Kamen, Charles

    2018-02-01

    To discuss lesbian, gay, bisexual, and transgender (LGBT)-specific survivorship issues including: integrating sexual and gender minority identities with cancer survivor identities; coordinating medical care and disclosing identities to health care providers; dealing with late effects of treatment; and addressing LGBT family and relationship issues. Published articles, quotes from an online survey of 311 LGBT survivors. The transition from active cancer treatment to survivorship presents challenges, and LGBT cancer survivors may face additional challenges as they enter the survivorship phase. Oncology nurses can improve the quality of survivorship care delivered to LGBT survivors and their caregivers by addressing the disparities and gaps in health care. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

    OpenAIRE

    Lelutiu-Weinberger, Corina; Pachankis, John E.

    2017-01-01

    Purpose: Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills.

  9. [Violence and social distress among transgender persons in Santa Maria, Rio Grande do Sul State, Brazil].

    Science.gov (United States)

    Souza, Martha Helena Teixeira de; Malvasi, Paulo; Signorelli, Marcos Claudio; Pereira, Pedro Paulo Gomes

    2015-04-01

    The authors conducted an ethnographic research with transgender persons in Santa Maria, Rio Grande do Sul State, Brazil, in 2012, using participant observation, semi-structured interviews, and following their everyday lives. These individuals invariably experienced physical and symbolic violence and the resulting distress, a condition they had to deal with in their careers and daily practices and tasks. The article discusses the violence experienced by transvestites (in the family, school, police precincts, and health services), specifically seeking to understand how such violence relates to their experiences with health services and how the latter respond.

  10. Characteristics of Transgender Women Living with HIV Receiving Medical Care in the United States.

    Science.gov (United States)

    Mizuno, Yuko; Frazier, Emma L; Huang, Ping; Skarbinski, Jacek

    2015-09-01

    Little has been reported from population-based surveys on the characteristics of transgender persons living with HIV. Using Medical Monitoring Project (MMP) data, we describe the characteristics of HIV-infected transgender women and examine their care and treatment needs. We used combined data from the 2009 to 2011 cycles of MMP, an HIV surveillance system designed to produce nationally representative estimates of the characteristics of HIV-infected adults receiving medical care in the United States, to compare demographic, behavioral, and clinical characteristics, and met and unmet needs for supportive services of transgender women with those of non-transgender persons using Rao-Scott chi-square tests. An estimated 1.3% of HIV-infected persons receiving care in the United States self-identified as transgender women. Transgender women were socioeconomically more marginalized than non-transgender men and women. We found no differences between transgender women and non-transgender men and women in the percentages prescribed antiretroviral therapy (ART). However, a significantly lower percentage of transgender women compared to non-transgender men had 100% ART dose adherence (78.4% vs. 87.4%) and durable viral suppression (50.8% vs. 61.4%). Higher percentages of transgender women needed supportive services. No differences were observed in receipt of most of supportive services, but transgender women had higher unmet needs than non-transgender men for basic services such as food and housing. We found little difference between transgender women and non-transgender persons in regards to receipt of care, treatment, and most of supportive services. However, the noted disparities in durable viral suppression and unmet needs for basic services should be explored further.

  11. Measuring the Health of an Invisible Population: Lessons from the Colorado Transgender Health Survey.

    Science.gov (United States)

    Christian, Robin; Mellies, Amy Anderson; Bui, Alison Grace; Lee, Rita; Kattari, Leo; Gray, Courtney

    2018-05-15

    Transgender people, those whose gender identity does not match their sex assigned at birth, face barriers to receiving health care. These include discrimination, prohibitive cost, and difficulty finding transgender-inclusive providers. As transgender identities are not typically recognized in public health research, the ability to compare the health of the transgender population to the overall population is limited. The Colorado Transgender Health Survey sought to explore current disparities and their effects on the health of transgender people in Colorado. The Colorado Transgender Health Survey, based on the Behavioral Risk Factor Surveillance System (BRFSS), was developed by the Colorado Department of Public Health and Environment, transgender advocates, and transgender community members. Outreach was targeted to transgender-inclusive events and organizations. Responses to the 2014 Colorado Transgender Health Survey were compared side by side to Colorado 2014 BRFSS data. Results from 406 transgender or gender-nonconforming adults who live in Colorado were included in the analysis. Forty percent of respondents report delaying medical care due to cost, inadequate insurance, and/or fear of discrimination. Respondents report significant mental health concerns, with 43% reporting depression, 36% reporting suicidal thoughts, and 10% attempting suicide in the past year. Respondents with a transgender-inclusive provider were more likely to receive wellness exams (76 versus 48%), less likely to delay care due to discrimination (24 versus 42%), less depressed (38 versus 54%), and less likely to attempt suicide (7 versus 15%) than those without. The transgender community in Colorado faces significant disparities, especially around mental health. However, a transgender-inclusive provider is associated with improved mental and physical health and health behaviors. Further population-level research and provider education on transgender health should to be incorporated into

  12. Beyond the Gender Binary: A Case Study of Two Transgender Students at a Midwestern Research University

    Science.gov (United States)

    Bilodeau, Brent

    2005-01-01

    Few non-pathologizing models of transgender identity development currently exist. This study uses an adaptation of the D'Augelli (1994) lifespan model of sexual orientation identity development to consider the lives of transgender college students. Interviews with two transgender-identified students find that they have developmental experiences in…

  13. Supporting Transgender College Students: Implications for Clinical Intervention and Campus Prevention

    Science.gov (United States)

    Swanbrow Becker, Martin A.; Nemeth Roberts, Stacey F.; Ritts, Sam M.; Branagan, William Tyler; Warner, Alia R.; Clark, Sheri L.

    2017-01-01

    This study examines the experiences of transgender college students in coping with stress in comparison to their cisgender peers. Undergraduate and graduate students from 73 colleges, totaling 26,292 participants, of which 47 identified as transgender completed an online survey. Transgender students reported greater exposure to trauma and higher…

  14. 77 FR 33599 - Lesbian, Gay, Bisexual, and Transgender Pride Month, 2012

    Science.gov (United States)

    2012-06-07

    ..., Gay, Bisexual, and Transgender Pride Month, 2012 By the President of the United States of America A... live and love as we see fit. The lesbian, gay, bisexual, and transgender (LGBT) community has written a... coverage to someone just because they are lesbian, gay, bisexual, or transgender. Because we understand...

  15. Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia

    OpenAIRE

    Vijay, Aishwarya; Earnshaw, Valerie A.; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M.; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L.; Wickersham, Jeffrey A.

    2018-01-01

    Purpose: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia.

  16. Putting the "T" in "Resource": The Benefits of LGBT-Related School Resources for Transgender Youth

    Science.gov (United States)

    Greytak, Emily A.; Kosciw, Joseph G.; Boesen, Madelyn J.

    2013-01-01

    This study examines the availability and effectiveness of lesbian, gay, bisexual, and transgender (LGBT)-related school resources for a national sample of transgender youth (N = 409), as compared to a national sample of LGB cisgender (non-transgender) youth (N = 6,444). All four examined resources--gay-straight alliances (GSAs), supportive…

  17. A lesbian, gay, bisexual and transgender dedicated inpatient psychiatric unit in rural New England: a descriptive analysis in demographics, service utilisation and needs.

    Science.gov (United States)

    Klotzbaugh, Ralph; Glover, Eileen

    2016-12-01

    To develop an understanding of lesbian-, gay-, bisexual-, transgender-specific mental health and substance abuse needs in rural populations and to improve data about sexual orientation and gender identity. Existing literature on mental health needs for lesbian, gay, bisexual and transgender populations has continued to reveal higher levels of need. Research has also demonstrated that few mental health providers have expertise or comfort in treating lesbian, gay, bisexual and transgender clients. Descriptive correlational study. A sample (n = 456) of patient records admitted to a rural lesbian, gay, bisexual and transgender inpatient psychiatric clinic over 12 months were examined using descriptive statistics. Patient zip code information was used to determine the levels of rurality. Chi-square analysis was used to determine relationships between sexual orientation, rural/urban distinctions and concomitant drug use. Unexpectedly, those who identified as heterosexual were significantly more likely to concomitantly abuse alcohol and heroin than those who identified as lesbian, gay, bisexual and transgender. Patients residing in small or isolated rural areas were more likely to abuse alcohol or synthetics than those residing in urban or micropolitan areas. Results of this study concerning substance abuse among lesbian, gay, bisexual and transgender individuals are not reflective of prior studies. LGBT patients did not demonstrate a higher proportion of substance abuse compared with those identifying as heterosexual. Increased substance abuse among those from rural isolated areas does support prior studies. The context of gathering demographic information on sexual orientation was thought by staff to increase the number of those identifying as heterosexual. Context in which sensitive questions are asked may affect the accuracy of demographic data. Lack of information regarding patients' sexual orientation or gender identity may impact perceived need for

  18. [Quality development within interdisciplinary transgender healthcare : Results and implications of a participatory research project].

    Science.gov (United States)

    Nieder, Timo O; Köhler, Andreas; Eyssel, Jana; Briken, Peer

    2017-09-01

    Both internationally and nationally, the objective has been set to offer specialized, coordinated, and interdisciplinary treatment to individuals with rare clinical needs, such as trans individuals (e. g., transsexual, transgender). The Interdisciplinary Transgender Health Care Center Hamburg (ITHCCH) is the first and only center in Germany to integrate all disciplines relevant to trans healthcare (THC).The research project seeks to generate valid information to support quality development and assure high-quality treatment at the ITHCCH. This was done by (a) investigating needs and concerns of trans individuals regarding interdisciplinary THC, and (b) analyzing attitudes and interests of key stakeholders.Using a participatory approach involving a work group (representatives of trans support groups and local THC professionals), researchers developed an online survey focusing on trans individuals' needs and concerns. Data from N = 415 trans-identified participants were analyzed using quantitative and qualitative methods. In addition, a short survey was used to record key stakeholders' attitudes and interests towards the ITHCCH.Healthcare offers accessed by trans individuals as part of transition related treatment vary in focus and number. For example, take-up numbers of genital surgery differ between binary and non-binary trans individuals. Crucial aspects impacting on THC quality are structural characteristics, communication/social aspects, individuality, and professionalism/quality.To ensure successful, high-quality interdisciplinary THC, feedback from (potential) patients and stakeholders is crucial. In addition, both structural development and optimizing individuality and flexibility throughout the treatment process are key. This poses a considerable challenge to the sector of THC provision.

  19. Meeting the substance abuse treatment needs of lesbian, bisexual and transgender women: implications from research to practice

    Directory of Open Access Journals (Sweden)

    Stevens S

    2012-02-01

    Full Text Available Sally StevensSouthwest Institute for Research on Women (SIROW and Department of Gender and Women’s Studies (GWS, University of Arizona, Tucson, AZ, USAAbstract: Research on the incidence, etiology and substance abuse treatment needs of lesbian, bisexual and transgender (LBT women is limited. Most research indicates higher levels of alcohol and drug abuse among these populations compared to their heterosexual counterparts, with recent research indicating that substance abuse is a particular concern for transgender individuals and an increasing problem among younger LBT individuals. Risk factors and reasons for substance abuse among sexual minority women are similar to those of heterosexual women, yet are substantially complicated by issues of family rejection and lack of social support, stigma and minority stress, as well as abuse and harassment. Historically, substance abuse prevention, early intervention, and clinical treatment programs were designed to meet the needs of the sexual majority population with relatively few programs designed to incorporate the specific needs of sexual minorities. This article reviews findings from previous studies and utilizes new data collected from community-based and residential substance abuse treatment programs to (1 examine issues relevant to LBT women and substance use, and (2 make recommendations for tailoring substance abuse treatment programs to meet the needs of these populations.Keywords: lesbian, bisexual, transgender, substance abuse, family rejection, social support, stigma, minority stress, abuse, harassment

  20. Prevalence and Correlates of Lifetime Suicide Attempts Among Transgender Persons in Argentina.

    Science.gov (United States)

    Marshall, Brandon D L; Socías, María Eugenia; Kerr, Thomas; Zalazar, Virginia; Sued, Omar; Arístegui, Inés

    2016-07-01

    This study examined the lifetime prevalence and correlates of attempted suicide among transgender persons in Argentina. Data were derived from a nation-wide, cross-sectional survey conducted in 2013. We assessed individual, social, and structural correlates of reporting a history of attempting suicide using logistic regression. Among 482 participants, the median age was 30, 91% identified as transwomen, and 32% resided in the Buenos Aires metropolitan area. A lifetime suicide attempt was reported by 159 (33%), among whom the median age at first attempt was 17. In a multivariate model, internalized stigma was positively associated with a history of suicidal behavior, while participants with stable housing had reduced odds of prior suicide attempt(s). These findings suggest that reducing stigma and mitigating structural vulnerabilities (through, for example, the enactment and enforcement of laws that prohibit discrimination based on gender identity to ensure equitable access to housing) could be effective targets for intervention to reduce suicide attempts among transgender individuals in Argentina.

  1. Advances in the Care of Transgender Children and Adolescents

    Science.gov (United States)

    Shumer, Daniel E; Nokoff, Natalie J; Spack, Norman P

    2016-01-01

    Children and adolescents with gender dysphoria are presenting for medical attention at increasing rates. Standards of Care have been developed which outline appropriate mental health support and hormonal interventions for transgender youth. This article defines terminology related to gender identity, reviews the history of medical interventions for transgender persons, outlines what is known about gender identity development, and reviews mental health disparities faced by this patient population. We provide an overview of medical management options for transgender adolescents meeting diagnostic criteria for gender dysphoria including pubertal suppression, cross-sex hormones, longitudinal screening and anticipatory guidance. We describe current challenges in the field and provide information about how care is currently being provided in the US and Canada. We conclude with 5 brief case examples. PMID:27426896

  2. Social Networks of Lesbian, Gay, Bisexual, and Transgender Older Adults

    Science.gov (United States)

    Erosheva, Elena A.; Kim, Hyun-Jun; Emlet, Charles; Fredriksen-Goldsen, Karen I.

    2015-01-01

    Purpose This study examines global social networks—including friendship, support, and acquaintance networks—of lesbian, gay, bisexual, and transgender (LGBT) older adults. Design and Methods Utilizing data from a large community-based study, we employ multiple regression analyses to examine correlates of social network size and diversity. Results Controlling for background characteristics, network size was positively associated with being female, transgender identity, employment, higher income, having a partner or a child, identity disclosure to a neighbor, engagement in religious activities, and service use. Controlling in addition for network size, network diversity was positively associated with younger age, being female, transgender identity, identity disclosure to a friend, religious activity, and service use. Implications According to social capital theory, social networks provide a vehicle for social resources that can be beneficial for successful aging and well-being. This study is a first step at understanding the correlates of social network size and diversity among LGBT older adults. PMID:25882129

  3. Social Networks of Lesbian, Gay, Bisexual, and Transgender Older Adults.

    Science.gov (United States)

    Erosheva, Elena A; Kim, Hyun-Jun; Emlet, Charles; Fredriksen-Goldsen, Karen I

    2016-01-01

    This study examines global social networks-including friendship, support, and acquaintance networks-of lesbian, gay, bisexual, and transgender (LGBT) older adults. Utilizing data from a large community-based study, we employ multiple regression analyses to examine correlates of social network size and diversity. Controlling for background characteristics, network size was positively associated with being female, transgender identity, employment, higher income, having a partner or a child, identity disclosure to a neighbor, engagement in religious activities, and service use. Controlling in addition for network size, network diversity was positively associated with younger age, being female, transgender identity, identity disclosure to a friend, religious activity, and service use. According to social capital theory, social networks provide a vehicle for social resources that can be beneficial for successful aging and well-being. This study is a first step at understanding the correlates of social network size and diversity among LGBT older adults. © The Author(s) 2015.

  4. Transgender HIV prevention: implementation and evaluation of a workshop.

    Science.gov (United States)

    Bockting, W O; Rosser, B R; Scheltema, K

    1999-04-01

    Virtually no HIV prevention education has specifically targeted the transgender community. To fill this void, a transgender HIV prevention workshop was developed, implemented and evaluated. A 4 h workshop, grounded in the Health Belief Model and the Eroticizing Safer Sex approach, combined lectures, videos, a panel, discussion, roleplay and exercises. Evaluation using a pre-, post- and follow-up test design showed an increase in knowledge and an initial increase in positive attitudes that diminished over time. Due to the small sample size (N = 59) and limited frequency of risk behavior, a significant decrease in unsafe sexual or needle practices could not be demonstrated. However, findings suggested an increase in safer sexual behaviors such as (mutual) masturbation. Peer support improved significantly. Future prevention education should make special efforts to target the more difficult-to-reach, high-risk subgroups of the transgender population.

  5. Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia

    Science.gov (United States)

    Vijay, Aishwarya; Earnshaw, Valerie A.; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M.; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L.

    2018-01-01

    Abstract Purpose: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia. Methods: A total of 436 physicians at two major university medical centers in Kuala Lumpur, Malaysia, completed an online survey. Sociodemographic characteristics, stigma-related constructs, and intentions to discriminate against transgender people were measured. Bivariate and multivariate linear regression were used to evaluate independent covariates of discrimination intent. Results: Medical doctors who felt more fearful of transgender people and more personal shame associated with transgender people expressed greater intention to discriminate against transgender people, whereas doctors who endorsed the belief that transgender people deserve good care reported lower discrimination intent. Stigma-related constructs accounted for 42% of the variance and 8% was accounted for by sociodemographic characteristics. Conclusions: Constructs associated with transgender stigma play an important role in medical doctors' intentions to discriminate against transgender patients. Development of interventions to improve medical doctors' knowledge about and attitudes toward transgender people are necessary to reduce discriminatory intent in healthcare settings. PMID:29227183

  6. Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Vijay, Aishwarya; Earnshaw, Valerie A; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L; Wickersham, Jeffrey A

    2018-01-01

    Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia. A total of 436 physicians at two major university medical centers in Kuala Lumpur, Malaysia, completed an online survey. Sociodemographic characteristics, stigma-related constructs, and intentions to discriminate against transgender people were measured. Bivariate and multivariate linear regression were used to evaluate independent covariates of discrimination intent. Medical doctors who felt more fearful of transgender people and more personal shame associated with transgender people expressed greater intention to discriminate against transgender people, whereas doctors who endorsed the belief that transgender people deserve good care reported lower discrimination intent. Stigma-related constructs accounted for 42% of the variance and 8% was accounted for by sociodemographic characteristics. Constructs associated with transgender stigma play an important role in medical doctors' intentions to discriminate against transgender patients. Development of interventions to improve medical doctors' knowledge about and attitudes toward transgender people are necessary to reduce discriminatory intent in healthcare settings.

  7. HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action.

    Science.gov (United States)

    Poteat, Tonia; Malik, Mannat; Scheim, Ayden; Elliott, Ayana

    2017-08-01

    The purpose of this review is to summarize the available evidence-based HIV prevention interventions tailored for transgender people. A limited number of evidence-based HIV prevention interventions have been tested with transgender populations. Most existing interventions target behavior change among transgender women, with only one HIV prevention program evaluated for transgender men. Studies addressing biomedical interventions for transgender women are ongoing. Few interventions address social and structural barriers to HIV prevention, such as stigma, discrimination, and poverty. Evidence-based multi-level interventions that address the structural, biomedical, and behavioral risks for HIV among transgender populations, including transgender men, are needed to address disparities in HIV prevalence. Future research should address not only pre-exposure prophylaxis uptake and condom use but also structural barriers that limit access to these prevention strategies.

  8. Affirmative Psychological Testing and Neurocognitive Assessment with Transgender Adults.

    Science.gov (United States)

    Keo-Meier, Colton L; Fitzgerald, Kara M

    2017-03-01

    Neither consensus on best practice nor validated neuropsychological, intelligence, or personality testing batteries exist for assessment and psychological testing on the transgender population. Historically, assessment has been used in a gate-keeping fashion with transgender clients. There are no firm standards of care when considering the content and appropriateness of evaluations conducted presurgically. These evaluations are discussed in the setting of other presurgical evaluations, with a recommendation to move toward a competency to make a medical decisions model. Additional considerations are discussed, such as effects of transition on mood and how to interpret scores in a field where normative data are often gender stratified. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Transgender female sex workers’ HIV knowledge, experienced stigma, and condom use in the Dominican Republic

    Science.gov (United States)

    Hasbun, Julia; Charow, Rebecca; Rosario, Santo; Tillotson, Louise; McGlaughlin, Elaine; Waters, John

    2017-01-01

    was considerably lower than condom use reported with coercive partners (92.96%) and clients (91.78%). Bivariate analyses revealed two trends: experienced stigma was associated with lower rates of condom use, and lower HIV knowledge was associated with lower rates of condom use. The former provides additional evidence that experienced stigma may become internalized, affecting individual-level behaviors—lowering self-confidence and resilience—making it more difficult to negotiate condom use due to lack of self-efficacy and desire to show trust in one’s partner. The latter supports public health research that suggests gaps in HIV knowledge persist and are pronounced in highly stigmatized populations. Discussion The vulnerabilities experienced by transgender persons, particularly in environments that vehemently adhere to conservative ideologies related to sex and gender, are significant and harm this population. These vulnerabilities could potentially be addressed through critically examining of impact of policies that indirectly promote or allow victimization of transgender citizens and subsequently diminish the effectiveness of public health and educational interventions. By taking action through the revocation of such laws, the Dominican Republic has the opportunity to improve overall population health, to protect some of its most stigmatized citizens, and to become the flag bearer of enhanced human rights in the Caribbean and Latin America. PMID:29095843

  10. Transgender female sex workers' HIV knowledge, experienced stigma, and condom use in the Dominican Republic.

    Science.gov (United States)

    Budhwani, Henna; Hearld, Kristine R; Hasbun, Julia; Charow, Rebecca; Rosario, Santo; Tillotson, Louise; McGlaughlin, Elaine; Waters, John

    2017-01-01

    condom use reported with coercive partners (92.96%) and clients (91.78%). Bivariate analyses revealed two trends: experienced stigma was associated with lower rates of condom use, and lower HIV knowledge was associated with lower rates of condom use. The former provides additional evidence that experienced stigma may become internalized, affecting individual-level behaviors-lowering self-confidence and resilience-making it more difficult to negotiate condom use due to lack of self-efficacy and desire to show trust in one's partner. The latter supports public health research that suggests gaps in HIV knowledge persist and are pronounced in highly stigmatized populations. The vulnerabilities experienced by transgender persons, particularly in environments that vehemently adhere to conservative ideologies related to sex and gender, are significant and harm this population. These vulnerabilities could potentially be addressed through critically examining of impact of policies that indirectly promote or allow victimization of transgender citizens and subsequently diminish the effectiveness of public health and educational interventions. By taking action through the revocation of such laws, the Dominican Republic has the opportunity to improve overall population health, to protect some of its most stigmatized citizens, and to become the flag bearer of enhanced human rights in the Caribbean and Latin America.

  11. Preservation of Fertility Potential for Gender and Sex Diverse Individuals.

    Science.gov (United States)

    Johnson, Emilie K; Finlayson, Courtney

    2016-01-01

    Gender and sex diverse individuals-transgender individuals and those with disorders of sex development (DSD)-both face medical treatments that may impair biological fertility potential. Young DSD patients also often have abnormal gonadal development. Fertility preservation for these populations has historically been poorly understood and rarely addressed. Future fertility should be discussed with gender and sex diverse individuals, particularly given recent advances in fertility preservation technologies and evolving views of fertility potential. Key ethical issues include parental proxy decision-making and uncertainty regarding prepubertal fertility preservation technologies. Many opportunities exist for advancing fertility-related care and research for transgender and DSD patients.

  12. Physical victimization, gender identity and suicide risk among transgender men and women

    Directory of Open Access Journals (Sweden)

    Gia Elise Barboza, PhD

    2016-12-01

    Full Text Available We investigated whether being attacked physically due to one's gender identity or expression was associated with suicide risk among trans men and women living in Virginia. The sample consisted of 350 transgender men and women who participated in the Virginia Transgender Health Initiative Survey (THIS. Multivariate multinomial logistic regression was used to explore the competing outcomes associated with suicidal risk. Thirty-seven percent of trans men and women experienced at least one physical attack since the age of 13. On average, individuals experienced 3.97 (SD = 2.86 physical attacks; among these about half were attributed to one's gender identity or expression (mean = 2.08, SD = 1.96. In the multivariate multinomial regression, compared to those with no risk, being physically attacked increased the odds of both attempting and contemplating suicide regardless of gender attribution. Nevertheless, the relative impact of physical victimization on suicidal behavior was higher among those who were targeted on the basis of their gender identity or expression. Finally, no significant association was found between multiple measures of institutional discrimination and suicide risk once discriminatory and non-discriminatory physical victimization was taken into account. Trans men and women experience high levels of physical abuse and face multiple forms of discrimination. They are also at an increased risk for suicidal tendencies. Interventions that help transindividuals cope with discrimination and physical victimization simultaneously may be more effective in saving lives.

  13. Physical victimization, gender identity and suicide risk among transgender men and women.

    Science.gov (United States)

    Barboza, Gia Elise; Dominguez, Silvia; Chance, Elena

    2016-12-01

    We investigated whether being attacked physically due to one's gender identity or expression was associated with suicide risk among trans men and women living in Virginia. The sample consisted of 350 transgender men and women who participated in the Virginia Transgender Health Initiative Survey (THIS). Multivariate multinomial logistic regression was used to explore the competing outcomes associated with suicidal risk. Thirty-seven percent of trans men and women experienced at least one physical attack since the age of 13. On average, individuals experienced 3.97 (SD = 2.86) physical attacks; among these about half were attributed to one's gender identity or expression (mean = 2.08, SD = 1.96). In the multivariate multinomial regression, compared to those with no risk, being physically attacked increased the odds of both attempting and contemplating suicide regardless of gender attribution. Nevertheless, the relative impact of physical victimization on suicidal behavior was higher among those who were targeted on the basis of their gender identity or expression. Finally, no significant association was found between multiple measures of institutional discrimination and suicide risk once discriminatory and non-discriminatory physical victimization was taken into account. Trans men and women experience high levels of physical abuse and face multiple forms of discrimination. They are also at an increased risk for suicidal tendencies. Interventions that help transindividuals cope with discrimination and physical victimization simultaneously may be more effective in saving lives.

  14. Resources to cope with stigma related to HIV status, gender identity, and sexual orientation in gay men and transgender women.

    Science.gov (United States)

    Arístegui, Inés; Radusky, Pablo D; Zalazar, Virginia; Lucas, Mar; Sued, Omar

    2018-02-01

    The stigma related to HIV status, gender identity, and sexual orientation has negative implications for the quality of life of individuals. A qualitative study was conducted to explore the resources that these stigmatized groups recognize as tools to cope with stigma and maintain their psychological well-being. Four focus groups were conducted with gay men and transgender women divided by HIV status. A thematic analysis revealed that individual, interpersonal, and institutional resources are commonly recognized as coping resources. This article discusses the importance of enhancing self-acceptance, social support, and a legal framework that legitimizes these groups as right holders.

  15. HIV self-testing in Peru: questionable availability, high acceptability but potential low linkage to care among men who have sex with men and transgender women.

    Science.gov (United States)

    Bustamante, Maria Jose; Konda, Kelika A; Joseph Davey, Dvora; León, Segundo R; Calvo, Gino M; Salvatierra, Javier; Brown, Brandon; Caceres, Carlos F; Klausner, Jeffrey D

    2017-02-01

    HIV status awareness is key to prevention, linkage-to-care and treatment. Our study evaluated the accessibility and potential willingness of HIV self-testing among men who have sex with men (MSM) and transgender women in Peru. We surveyed four pharmacy chains in Peru to ascertain the commercial availability of the oral HIV self-test. The pharmacies surveyed confirmed that HIV self-test kits were available; however, those available were not intended for individual use, but for clinician use. We interviewed 147 MSM and 45 transgender women; nearly all (82%) reported willingness to perform the oral HIV self-test. However, only 55% of participants would definitely seek a confirmatory test in a clinic after an HIV-positive test result. Further, price may be a barrier, as HIV self-test kits were available for 18 USD, and MSM and transgender women were only willing to pay an average of 5 USD. HIV self-testing may facilitate increased access to HIV testing among some MSM/transgender women in Peru. However, price may prevent use, and poor uptake of confirmatory testing may limit linkage to HIV treatment and care.

  16. Gender on the edge: transgender, gay, and other Pacific Islanders

    NARCIS (Netherlands)

    Besnier, N.; Alexeyeff, K.

    2014-01-01

    Transgender identities and other forms of gender and sexuality that transcend the normative pose important questions about society, culture, politics, and history. They force us to question, for example, the forces that divide humanity into two gender categories and render them necessary,

  17. [Transgender] Young Men: Gendered Subjectivities and the Physically Active Body

    Science.gov (United States)

    Caudwell, Jayne

    2014-01-01

    In this paper, I discuss [transgender] young men's social, physical and embodied experiences of sport. These discussions draw from interview research with two young people who prefer to self-identify as "male" and not as "trans men", although they do make use of this term. Finn and Ed volunteered to take part in the research…

  18. Transgender Policy: What is Fair for All Students?

    Science.gov (United States)

    Kaiser, Matthew M.; Seitz, Keshia M.; Walters, Elizabeth A.

    2014-01-01

    Ritha Smith, assistant superintendent, and Seth Hanson, principal, are faced with a difficult decision. Taylor Harper is a transgender student who identifies as male and is openly attracted to females. Taylor's parents, Lane and Morgan Harper, are lesbians; they are fully supportive of their child's identification and are well versed in their…

  19. Security for women and the lesbian, gay, bisexual, transgender and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Security for women and the lesbian, gay, bisexual, transgender and intersex people in the conflict-affected regions in Colombia. Colombia is currently in the process of concluding peace negotiations with the guerrilla group Colombian Revolutionary Armed Forces (FARC). One of the principal expectations generated by the ...

  20. Thinking about the Unthinkable: Transgender in an Immutable Binary World

    Science.gov (United States)

    Cook-Daniels, Loree

    2010-01-01

    This essay discusses ways in which people attempt to reconcile or resolve their own cognitive dissonance engendered by transgender people in a society in which gender is perceived as both binary (male OR female) and immutable (an unalterable state or condition). The author suggests these cognitive dissonance reduction methods may be utilized in…

  1. Barriers to quality health care for the transgender population.

    Science.gov (United States)

    Roberts, Tiffany K; Fantz, Corinne R

    2014-07-01

    The transgender community is arguably the most marginalized and underserved population in medicine. A special issue focusing on men's health would be incomplete without mention of this vulnerable population, which includes those transitioning to and from the male gender. Transgender patients face many barriers in their access to healthcare including historical stigmatization, both structural and financial barriers, and even a lack of healthcare provider experience in treating this unique population. Historical stigmatization fosters a reluctance to disclose gender identity, which can have dire consequences for long-term outcomes due to a lack of appropriate medical history including transition-related care. Even if a patient is willing to disclose their gender identity and transition history, structural barriers in current healthcare settings lack the mechanisms necessary to collect and track this information. Moreover, healthcare providers acknowledge that information is lacking regarding the unique needs and long-term outcomes for transgender patients, which contributes to the inability to provide appropriate care. All of these barriers must be recognized and addressed in order to elevate the quality of healthcare delivered to the transgender community to a level commensurate with the general population. Overcoming these barriers will require redefinition of our current system such that the care a patient receives is not exclusively linked to their sex but also considers gender identity. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  2. Examples of Policies and Emerging Practices for Supporting Transgender Students

    Science.gov (United States)

    Office of Safe and Healthy Students, US Department of Education, 2016

    2016-01-01

    It has come to the Department of Education's (ED's) attention that many transgender students (i.e., students whose gender identity is different from the sex they were assigned at birth) report feeling unsafe and experiencing verbal and physical harassment or assault in school, and that these students may perform worse academically when they are…

  3. Shimmering images: on transgender embodiment and cinematic aesthetics

    NARCIS (Netherlands)

    Steinbock, E.A.

    2011-01-01

    Eliza Steinbock toont aan dat transgender belichaming en filmbeelden mogelijkerwijs een eigenschap met elkaar gemeen hebben. Zij beschrijft die als glinsterend. ‘Glinstering’ is het heen en weer te gaan tussen transseksuele lichamelijkheid aan de ene kant en het medium film aan de andere, en tussen

  4. Informal Mentoring for Lesbian, Gay, Bisexual, and Transgender Students

    Science.gov (United States)

    Mulcahy, Molly; Dalton, Sarah; Kolbert, Jered; Crothers, Laura

    2016-01-01

    The authors identified the process that 10 lesbian, gay, bisexual, and transgender (LGBT) high school students used to establish an informal adult-mentor relationship with a school personnel member. Five major themes emerged: (a) how LGBT students determined whether this person would be a safe mentor, (b) a listing of the important qualities of…

  5. Barriers and facilitators to HIV testing among young men who have sex with men and transgender women in Kingston, Jamaica: a qualitative study.

    Science.gov (United States)

    Logie, Carmen H; Lacombe-Duncan, Ashley; Brien, Natasha; Jones, Nicolette; Lee-Foon, Nakia; Levermore, Kandasi; Marshall, Annecka; Nyblade, Laura; Newman, Peter A

    2017-04-04

    Young men who have sex with men (MSM) in Jamaica have the highest HIV prevalence in the Caribbean. There is little information about HIV among transgender women in Jamaica, who are also overrepresented in the Caribbean epidemic. HIV-related stigma is a barrier to HIV testing among Jamaica's general population, yet little is known of MSM and transgender women's HIV testing experiences in Jamaica. We explored perceived barriers and facilitators to HIV testing among young MSM and transgender women in Kingston, Jamaica. We implemented a community-based research project in collaboration with HIV and lesbian, gay, bisexual and transgender (LGBT) agencies in Kingston. We held two focus groups, one with young (aged 18-30 years) transgender women (n = 8) and one with young MSM (n = 10). We conducted 53 in-depth individual semi-structured interviews focused on HIV testing experiences with young MSM (n = 20), transgender women (n = 20), and community-based key informants (n = 13). We conducted thematic analysis to identify, analyze, and report themes. Participant narratives revealed social-ecological barriers and facilitators to HIV testing. Barriers included healthcare provider mistreatment, confidentiality breaches, and HIV-related stigma: these spanned interpersonal, community and structural levels. Healthcare provider discrimination and judgment in HIV testing provision presented barriers to accessing HIV services (e.g. treatment), and resulted in participants hiding their sexual orientation and/or gender identity. Confidentiality concerns included: clinic physical arrangements that segregated HIV testing from other health services, fear that healthcare providers would publicly disclose their status, and concerns at LGBT-friendly clinics that peers would discover they were getting tested. HIV-related stigma contributed to fear of testing HIV-positive; this intersected with the stigma of HIV as a "gay" disease. Participants also anticipated healthcare provider

  6. Disparities in Exposure to Intimate Partner Violence Among Transgender/Gender Nonconforming and Sexual Minority Primary Care Patients.

    Science.gov (United States)

    Valentine, Sarah E; Peitzmeier, Sarah M; King, Dana S; O'Cleirigh, Conall; Marquez, Samantha M; Presley, Cara; Potter, Jennifer

    2017-08-01

    We investigated the odds of intimate partner violence (IPV) among primary care patients across subgroups of transgender and gender nonconforming (TGNC) individuals relative to cisgender women, and cisgender sexual minority men and women relative to cisgender heterosexual men and women. Participants completed an IPV screener as part of routine primary care visits at an urban community health center (N = 7572). Electronic medical record data were pooled for all patients who received the IPV screener January 1 to December 31, 2014. Overall, 3.6% of the sample reported experiencing physical or sexual IPV in the past year. Compared to cisgender women (past-year prevalence 2.7%), all TGNC subgroups reported elevated odds of physical or sexual IPV, including transgender women (past-year prevalence 12.1%; adjusted odds ratio [AOR] = 5.0, 95% confidence interval [CI] = 2.9-8.6), transgender men (6.6%; AOR = 2.4, 95% CI: 1.2-4.6), gender non-binary individuals (8.2%, AOR = 3.1, 95% CI = 1.7-5.4), and TGNC individuals who did not report their gender identity (9.1%; AOR = 3.7, 95% CI = 2.2-6.3). The prevalence of isolation-related IPV and controlling behaviors was also high in some TGNC groups. Our findings support that IPV is prevalent across genders and sexual orientations. Clinical guidelines for IPV screening should be expanded to include TGNC individuals and not just cisgender women. Future research could explore the complex patterns by which individuals of different genders are at increased risk for different types of IPV, and investigate the best ways to screen TGNC patients and support TGNC survivors.

  7. Health care providers' comfort with and barriers to care of transgender youth.

    Science.gov (United States)

    Vance, Stanley R; Halpern-Felsher, Bonnie L; Rosenthal, Stephen M

    2015-02-01

    To explore providers' clinical experiences, comfort, and confidence with and barriers to providing care to transgender youth. An online survey was administered to members of the Society for Adolescent Health and Medicine and the Pediatric Endocrine Society with items querying about clinical exposure to transgender youth, familiarity with and adherence to existing clinical practice guidelines, perceived barriers to providing transgender-related care, and comfort and confidence with providing transgender-related care. The response rate was 21.9% (n = 475). Of the respondents, 66.5% had provided care to transgender youth, 62.4% felt comfortable with providing transgender medical therapy, and 47.1% felt confident in doing so. Principal barriers to provision of transgender-related care were lack of the following: training, exposure to transgender patients, available qualified mental health providers, and insurance reimbursement. This study suggests that more training in transgender-related care, available qualified mental health providers, and insurance reimbursement for transgender-related care are needed. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  8. Reported emergency department avoidance, use, and experiences of transgender persons in Ontario, Canada: results from a respondent-driven sampling survey.

    Science.gov (United States)

    Bauer, Greta R; Scheim, Ayden I; Deutsch, Madeline B; Massarella, Carys

    2014-06-01

    Transgender, transsexual, or transitioned (trans) people have reported avoiding medical care because of negative experiences or fear of such experiences. The extent of trans-specific negative emergency department (ED) experiences, and of ED avoidance, has not been documented. The Trans PULSE Project conducted a survey of trans people in Ontario, Canada (n=433) in 2009 to 2010, using respondent-driven sampling, a tracked network-based method for studying hidden populations. Weighted frequencies and bootstrapped 95% confidence intervals (CIs) were estimated for the trans population in Ontario and for the subgroup (n=167) reporting ED use in their felt gender. Four hundred eight participants completed the ED experience items. Trans people were young (34% aged 16 to 24 years and only 10% >55 years); approximately half were female-to-male and half male-to-female. Medically supervised hormones were used by 37% (95% CI 30% to 46%), and 27% (95% CI 20% to 35%) had at least 1 transition-related surgery. Past-year ED need was reported by 33% (95% CI 26% to 40%) of trans Ontarians, though only 71% (95% CI 40% to 91%) of those with self-reported need indicated that they were able to obtain care. An estimated 21% (95% CI 14% to 25%) reported ever avoiding ED care because of a perception that their trans status would negatively affect such an encounter. Trans-specific negative ED experiences were reported by 52% (95% CI 34% to 72%) of users presenting in their felt gender. This first exploratory analysis of ED avoidance, utilization, and experiences by trans persons documented ED avoidance and possible unmet need for emergency care among trans Ontarians. Additional research, including validation of measures, is needed. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  9. Suicides among lesbian, gay, bisexual, and transgender populations in Australia: an analysis of the Queensland Suicide Register.

    Science.gov (United States)

    Skerrett, Delaney Michael; Kõlves, Kairi; De Leo, Diego

    2014-12-01

    Sexual orientation is seldom recorded at death in Australia, and to date there have been no studies on the relationship between those that have died by suicide and sexuality or minority gender identity in Australia. The aim of the present study is to determine whether or not lesbian, gay, bisexual, transgender (LGBT), and intersex individuals who die by suicide constitute a unique subpopulation of those who die by suicide, when compared with non-lesbian, gay, bisexual, transgender, and intersex suicide deaths. The Queensland Suicide Register holds records of all suicides in Queensland since 1990. All cases from 2000 to 2009 (inclusive; a total of 5,966 cases) were checked for potential indicators of individuals' sexual orientation and gender identification. A total of 35 lesbian (n = 10), gay (n = 22), bisexual (n = 2), and transgender (n = 1) suicide cases were identified. Three comparison cases of non-LGBT suicides for each LGBT suicide were then located, matched by age and gender. Conditional logistic regression was used to calculate odds ratios with 95% confidence intervals. It was significantly more likely that depression was mentioned in the cases of LGBT suicides than in non-LGBT cases. While 12.4% of the comparison group had been diagnosed with psychotic disorders, there were no such diagnoses among LGBT individuals. LGBT individuals experienced relationship problems more often, with relationship conflict also being more frequent than in non-LGBT cases. Despite its limitations, this study - the first of its kind in Australia - seems to indicate that LGBT people would require targeted approaches in mental and general health services. © 2014 Wiley Publishing Asia Pty Ltd.

  10. Expanding on the Experiences of Transgender Nonreligious People: An Exploratory Analysis

    Directory of Open Access Journals (Sweden)

    Lain A.B. Mathers

    2017-01-01

    Full Text Available Building on research that points out the specific forms of marginalization that transgender and nonreligious people face in contemporary U.S. society, this exploratory analysis focuses on the experiences of transgender nonreligious people who were raised in religious households. Utilizing interviews with eleven formerly religious, now nonreligious, transgender people I draw out some of the future pathways scholars of nonreligion should take to better account for the lives of transgender nonreligious people in scholarship on nonreligion. Specifically, scholars of nonreligion should begin analyzing transgender nonreligious people’s experiences in religious settings, with family, and with organizations and networks outside of religion. I conclude by discussing the ways this study can shed light on the broader processes by which inequality is reproduced and make suggestions for nonreligious leaders to make room for and listen to transgender people in nonreligious spaces.

  11. Conducting Internet Research With the Transgender Population: Reaching Broad Samples and Collecting Valid Data

    OpenAIRE

    Miner, Michael H.; Bockting, Walter O.; Romine, Rebecca Swinburne; Raman, Sivakumaran

    2011-01-01

    Health research on transgender people has been hampered by the challenges inherent in studying a hard-to-reach, relatively small, and geographically dispersed population. The Internet has the potential to facilitate access to transgender samples large enough to permit examination of the diversity and syndemic health disparities found among this population. In this article, we describe the experiences of a team of investigators using the Internet to study HIV risk behaviors of transgender peop...

  12. Video gaming and gaming addiction in transgender people: An exploratory study

    OpenAIRE

    Arcelus, Jon; Bouman, Walter Pierre; Jones, Bethany Alice; Richards, Christina; Jimenez-Murcia, Susana; Griffiths, Mark D.

    2017-01-01

    Background: There is anecdotal clinical evidence that transgender people use the online world – such as forums and online video gaming – for the purpose of experiencing their gender identity in a safe, non-threatening, non alienating, nonstigmatizing, and non-critical environment.\\ud Aims: To describe the type and degree of gaming behaviour in a comparatively large group of transgender people accessing transgender health services, and to investigate the main predictors of problematic gaming b...

  13. Policing Diversity: Examining Police Resistance to Training Reforms for Transgender People in Australia.

    Science.gov (United States)

    Miles-Johnson, Toby

    2016-01-01

    Using field notes collected from participant observation of Australian police officers training to work with the transgender community, the current research builds on previous work examining social identity theory (Tajfel, 2010) to explain how one training program implemented to educate police about transgender people challenges police culture. This research determines that police culture, training procedures, and stereotypes of gender are equally influential on police perceptions of all transgender people. Overall, the results indicate that negative police perceptions toward police training reforms strengthen in-group identity of police, and negative out-group perceptions of transgender people.

  14. HIV Risk Perception, HIV Knowledge, and Sexual Risk Behaviors among Transgender Women in South Florida.

    Science.gov (United States)

    De Santis, Joseph P; Hauglum, Shayne D; Deleon, Diego A; Provencio-Vasquez, Elias; Rodriguez, Allan E

    2017-05-01

    Transgender women experience a variety of factors that may contribute to HIV risk. The purpose of this study was to explore links among HIV risk perception, knowledge, and sexual risk behaviors of transgender women. A descriptive, correlational study design was used. Fifty transgender women from the South Florida area were enrolled in the study. Transgender women completed a demographic questionnaire and standardized instruments measuring HIV risk perception, knowledge, and sexual risk behaviors. Transgender women reported low levels of HIV risk perception, and had knowledge deficits regarding HIV risk/transmission. Some participants engaged in high-risk sexual behaviors. Predictors of sexual risk behaviors among transgender women were identified. More research is needed with a larger sample size to continue studying factors that contribute to sexual risk behaviors in the understudied population of transgender women. Evidence-based guidelines are available to assist public health nurses in providing care for transgender women. Nurses must assess HIV perception risk and HIV knowledge and provide relevant education to transgender women on ways to minimize sexual risk. © 2016 Wiley Periodicals, Inc.

  15. Pathways to HIV risk and vulnerability among lesbian, gay, bisexual, and transgendered methamphetamine users: a multi-cohort gender-based analysis

    OpenAIRE

    Patterson Thomas L; Shoveller Jean A; Wood Evan; Marshall Brandon DL; Montaner Julio SG; Kerr Thomas

    2011-01-01

    Abstract Background Methamphetamine (MA) use continues to be a major public health concern in many urban settings. We sought to assess potential relationships between MA use and individual, social, and structural HIV vulnerabilities among sexual minority (lesbian, gay, bisexual or transgendered) drug users. Methods Beginning in 2005 and ending in 2008, 2109 drug users were enroled into one of three cohort studies in Vancouver, Canada. We analysed longitudinal data from all self-identified sex...

  16. Examination of Lesbian, Gay, Bisexual, and Transgender Health Care Content in North Carolina Schools of Nursing.

    Science.gov (United States)

    Cornelius, Judith B; Enweana, Ijeoma; Alston, Celeste Kaysha; Baldwin, Dee M

    2017-04-01

    Nursing students require academic and clinical training in preparation for the increased demand for culturally competent care. One group that is in need of culturally knowledgeable health care providers is lesbian, gay, bisexual, and transgender (LGBT) individuals. The purpose of this study was to examine how LGBT health care content is integrated into North Carolina schools of nursing curricula and to examine the existence of specific LGBT policies. A survey was mailed to 70 deans and directors of RN programs in North Carolina. Over 90% of the schools indicated that LGBT health care issues were taught in the curricula. The majority of the content was taught as an "other" course (37%). More than two thirds of the schools devoted less than 5 hours teaching LGBT content. LGBT health care content is being taught, yet the presence of specific LGBT practice policies is basically nonexistent. [J Nurs Educ. 2017;56(4):223-226.]. Copyright 2017, SLACK Incorporated.

  17. Guidelines for psychological practice with transgender and gender nonconforming people.

    Science.gov (United States)

    2015-12-01

    In 2015, the American Psychological Association adopted Guidelines for Psychological Practice with Transgender and Gender Nonconforming Clients in order to describe affirmative psychological practice with transgender and gender nonconforming (TGNC) clients. There are 16 guidelines in this document that guide TGNC-affirmative psychological practice across the lifespan, from TGNC children to older adults. The Guidelines are organized into five clusters: (a) foundational knowledge and awareness; (b) stigma, discrimination, and barriers to care; (c) lifespan development; (d) assessment, therapy, and intervention; and (e) research, education, and training. In addition, the guidelines provide attention to TGNC people across a range of gender and racial/ethnic identities. The psychological practice guidelines also attend to issues of research and how psychologists may address the many social inequities TGNC people experience. (c) 2015 APA, all rights reserved).

  18. Transgender Voice and Communication Treatment: A Retrospective Chart Review of 25 Cases

    Science.gov (United States)

    Hancock, Adrienne B.; Garabedian, Laura M.

    2013-01-01

    Background: People transitioning from male to female (MTF) gender seek speech-language pathology services when they feel their voice is betraying their genuine self or perhaps is the last obstacle to representing their authentic gender. Speaking fundamental frequency (pitch) and resonance are most often targets in treatment because the combination…

  19. Transgender women of color: discrimination and depression symptoms

    Science.gov (United States)

    Jefferson, Kevin; Neilands, Torsten B.; Sevelius, Jae

    2014-01-01

    Purpose Trans women of color contend with multiple marginalizations; the purpose of this study is to examine associations between experiencing discriminatory (racist/transphobic) events and depression symptoms. It uses a categorical measure of combined discrimination, and examines a protective association of transgender identity on depression symptoms. Design/methodology/approach Data from a subset of trans women of color participants in the Sheroes study were analyzed with linear and logistic regression. Associations of depression symptoms with racist and transphobic events, combined discrimination, coping self-efficacy, and transgender identity were assessed with odds ratios. Findings Exposure to discriminatory events and combined discrimination positively associated with depression symptom odds. Increased transgender identity associated with increased coping self-efficacy, which negatively associated with depression symptom odds. Research limitations/implications Cross-sectional study data prohibits inferring causality; results support conducting longitudinal research on discrimination’s health effects, and research on transgender identity. Results also support operationalizing intersectionality in health research. The study’s categorical approach to combined discrimination may be replicable in studies with hard to reach populations and small sample sizes. Practical implications Health programs could pursue psychosocial interventions and anti-discrimination campaigns. Interventions might advocate increasing participants’ coping self-efficacy while providing space to explore and develop social identity. Social implications There is a need for policy and health programs to center trans women of color concerns. Originality/value This study examines combined discrimination and identity in relation to depression symptoms among trans women of color, an underserved population. Paper type Research paper PMID:25346778

  20. The mental health of Canadian transgender youth compared with the Canadian population

    Science.gov (United States)

    Veale, Jaimie F.; Watson, Ryan J.; Peter, Tracey; Saewyc, Elizabeth M.

    2017-01-01

    Objectives This study documents the prevalence of mental health concerns among Canadian transgender youth and makes comparisons with cisgender or mostly-cisgender population-based studies. This study also compares gender identity subgroups (transgender girls/women, boys/men, and non-binary) and age subgroups (14–18 year olds and 19–25 year olds) on mental health outcomes. Methods A nonprobability sample of 923 transgender youth from across Canada completed a bilingual online survey. Participants were recruited through community organizations, healthcare settings, social media, and the researchers’ networks. Mental health measures were drawn from the British Columbia Adolescent Health Survey and the Canadian Community Health Survey. Results Transgender youth had a higher risk of reporting psychological distress, self-harm, major depressive episode, suicidal ideation, and suicide attempts. Risk ratios ranged from 3.8 to 16.1. Transgender boys/men and non-binary youth were most likely to report self-harm and non-binary youth also reported lower overall mental health. Rates of self-harm and suicide were lower in the 19–25 age group than the 14–18 age group, but reported overall mental health was the same across these age groups. Conclusions Although a notable minority of transgender youth reported good mental health, this study shows the mental health disparities faced by transgender youth in Canada are considerable. Policy Implications These findings underscore the need for policies and laws protecting transgender people from discrimination, training for transgender competency for mental healthcare providers, providers, and further development of transgender-specific interventions to promote positive mental health and reduce mental health problems among transgender youth. PMID:28007056

  1. HIV-related needs for safety among male-to-female transsexuals (mak nyah) in Malaysia.

    Science.gov (United States)

    Koon Teh, Yik

    2008-12-01

    This research, commissioned by the Malaysian AIDS Council in 2007, is qualitative and descriptive in nature. In depth face-to-face interviews were carried out with 15 mak nyah respondents from five major towns. The interviews were guided by an interview schedule that had seven main topics: brief background; hormone-taking behaviour; safe sex; health care; substance abuse; harassment from authorities; and HIV prevention. The HIV problem among the mak nyah, mak nyah sex workers and their clients is critical. Many do not have in-depth HIV/AIDS knowledge and do not practise safe sex. The problem gets worse when most mak nyah do not consider HIV/AIDS as a primary concern because of other pressing problems like employment and discrimination. There are also no HIV prevention activities in many parts of Malaysia. Mak nyah also face constant harassment from enforcement authorities for prostitution. This hampers HIV prevention work.

  2. Neuropeptides affecting the transfer of juvenile hormones from males to females during mating in Spodoptera frugiperda.

    Science.gov (United States)

    Hassanien, Intisar T E; Grötzner, Manuela; Meyering-Vos, Martina; Hoffmann, Klaus H

    2014-07-01

    In the polyandric moth, Spodopterafrugiperda, juvenile hormone (JH) is transferred from the male accessory reproductive glands (AG) to the female bursa copulatrix (BC) during copulation (see Hassanien et al., 2014). Here we used the RNA interference technique to study the role of allatoregulating neuropeptides in controlling the synthesis and transfer of JH during mating. Knockdown of S. frugiperda allatostatin C (Spofr-AS type C) in freshly emerged males leads to an accumulation of JH in the AG beyond that in the control and mating results in a higher transport of JH I and JH II into the female BC. Knockdown of S. frugiperda allatotropin 2 (Spofr-AT2) significantly reduces the amount of JH in the AG as well as its transfer into the female BC during copulation. Knockdown of S. frugiperda allatostatin A (Spofr-AS type A) and S. frugiperda allatotropin (Spofr-AT; Hassanien et al., 2014) only slightly affects the accumulation of JH in the AG and its transfer from the male to the female. We conclude that Spofr-AS type C and Spofr-AT2 act as true allatostatin and true allatotropin, respectively, on the synthesis of JH I and JH II in the male AG. Moreover, both peptides seem to control the synthesis of JH III in the corpora allata of adult males and its release into the hemolymph. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. A dangerous boomerang: Injunctive norms, hostile sexist attitudes, and male-to-female sexual aggression.

    Science.gov (United States)

    Bosson, Jennifer K; Parrott, Dominic J; Swan, Suzanne C; Kuchynka, Sophie L; Schramm, Andrew T

    2015-01-01

    This study examined the interactive effects of injunctive norm exposure and hostile and benevolent sexist attitudes on men's sexually aggressive responses during a behavioral analogue paradigm in which they interacted online with a bogus female partner. Heterosexual adult men (n = 201), recruited from an online sample, read fictional information regarding other men's approval of misogynistic, paternalistic, or egalitarian treatment of women, or non-gender-relevant control information. Through a media preference survey, men then learned that their female partner disliked sexual content in films, after which they had an opportunity to send her up to 120 sec' worth of either a sexually explicit or nonsexual film clip. Validating the online sexual aggression paradigm, men with a 1-year history of sexual assault exhibited more sexually aggressive responding during the film selection paradigm. Moreover, exposure to injunctive norm information produced a boomerang effect, such that men high in hostile sexist attitudes showed an increase in sexual aggression when confronted with paternalism and gender equality norms. Conversely, exposure to paternalism and gender equality norms suppressed the otherwise protective function of high benevolent sexism in reducing men's sexually aggressive tendencies. The implications of these results for social norms interventions are discussed. © 2015 Wiley Periodicals, Inc.

  4. The Chernobyl accident, the male to female ratio at birth and birth rates.

    Science.gov (United States)

    Grech, Victor

    2014-01-01

    The male:female ratio at birth (male births divided by total live births - M/T) has been shown to increase in response to ionizing radiation due to gender-biased fetal loss, with excess female loss. M/T rose sharply in 1987 in central-eastern European countries following the Chernobyl accident in 1986. This study analyses M/T and births for the former Soviet Republics and for the countries most contaminated by the event. Annual birth data was obtained from the World Health Organisation. The countries with the highest exposure levels (by ¹³⁷Cs) were identified from an official publication of the International Atomic Energy Agency. All of the former Soviet states were also analysed and the periods before and after 1986 were compared. Except for the Baltic States, all regions in the former USSR showed a significant rise in M/T from 1986. There were significant rises in M/T in the three most exposed (Belarus, Ukraine and the Russian Federation). The birth deficit in the post-Soviet states for the ten years following Chernobyl was estimated at 2,072,666, of which 1,087,924 are accounted by Belarus and Ukraine alone. Chernobyl has resulted in the loss of millions of births, a process that has involved female even more than male fetuses. This is another and oft neglected consequence of widespread population radiation contamination.

  5. THE CHERNOBYL ACCIDENT, THE MALE TO FEMALE RATIO AT BIRTH AND BIRTH RATES

    Directory of Open Access Journals (Sweden)

    Victor Grech

    2014-01-01

    Full Text Available Introduction: The male:female ratio at birth (male births divided by total live births – M/T has been shown to increase in response to ionizing radiation due to gender-biased fetal loss, with excess female loss. M/T rose sharply in 1987 in central-eastern European countries following the Chernobyl accident in 1986. This study analyses M/T and births for the former Soviet Republics and for the countries most contaminated by the event. Methods: Annual birth data was obtained from the World Health Organisation. The countries with the highest exposure levels (by 137Cs were identified from an official publication of the International Atomic Energy Agency. All of the former Soviet states were also analysed and the periods before and after 1986 were compared. Results: Except for the Baltic States, all regions in the former USSR showed a significant rise in M/T from 1986. There were significant rises in M/T in the three most exposed (Belarus, Ukraine and the Russian Federation. The birth deficit in the post-Soviet states for the ten years following Chernobyl was estimated at 2,072,666, of which 1,087,924 are accounted by Belarus and Ukraine alone. Discussion: Chernobyl has resulted in the loss of millions of births, a process that has involved female even more than male fetuses. This is another and oft neglected consequence of widespread population radiation contamination.

  6. HIV-related needs for safety among male-to-female transsexuals ...

    African Journals Online (AJOL)

    This research, commissioned by the Malaysian AIDS Council in 2007, is qualitative and descriptive in nature. In depth face-to-face interviews were carried out with 15 mak nyah respondents from five major towns. The interviews were guided by an interview schedule that had seven main topics: brief background; ...

  7. The President Kennedy assassination and the male to female birth ratio.

    Science.gov (United States)

    Grech, Victor; Zammit, Dorota

    2016-12-01

    Male live births occur slightly in excess of female. This ratio is expressed as M/F. Terrorist attacks induce stress which transiently lowers M/F three to five months later due to increased male foetal losses. A previous study had shown that the assassination of President John F. Kennedy in November 1963 was associated with a significant dip in M/F in the United States for 1964 due to a dip confined to March 1964. This study was carried out in order to ascertain whether the assassination influenced M/F in the rest of the world. Annual male and female live births were obtained from a World Health Organisation Mortality database for all countries reporting. Comparisons were made between 1964, the year after the assassination, and the preceding five years (1959-1963) and following five years (1965-1969). Monthly data was only available for Malta, for the period 1958-1968. There were 159,339,564 live births (82,066,005 males, 77,273,559 females, M/F 0.5150; 95% CI 0.5150-0.5151). No dip was present for 1964 for any country, nor for the amalgamation of European countries, for the Far East, the North American continent, or for the amalgamation of the total. Data for Malta showed a significant decline in March 1964 (M/F 0.4661, p=0.0175), translating to a loss of 56 boys (estimated at 6.3/1000 births). These findings replicate the findings for the United States following the assassination of President Kennedy. The March M/F dip transiently exceeded the modern expected rate for perinatal mortality, making terrorist attacks Public Health issues. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Gender, Sexuality, and Cosplay: A Case Study of Male-to-Female Crossplay

    OpenAIRE

    Leng, Rachel Hui Ying

    2014-01-01

    In recent years, cosplay fans gathering at anime conventions and events all over North America have attracted much public attention and media coverage. These fans, who often refer to themselves as otaku, 1 wear elaborate costumes and makeup to embody various anime, manga, and related video game characters (Cooper-Chen, 2010; Eng, 2012a). The essence of cosplay, or costume-play, involves affective labor where fans transform themselves into chosen anime characters by constructing and wearing co...

  9. Career Development with Transgender College Students: Implications for Career and Employment Counselors

    Science.gov (United States)

    Scott, David A.; Belke, Stephanie L.; Barfield, Hannah G.

    2011-01-01

    The number of transgender college students continues to increase every year. These students face unique challenges that many college and university career centers are not prepared to handle. This article describes some of the challenges facing transgender students and college career centers. A professional development design is proposed to assist…

  10. Characteristics of HIV-Positive Transgender Men Receiving Medical Care: United States, 2009-2014.

    Science.gov (United States)

    Lemons, Ansley; Beer, Linda; Finlayson, Teresa; McCree, Donna Hubbard; Lentine, Daniel; Shouse, R Luke

    2018-01-01

    To present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States. This analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology. Transgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months. Although they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons.

  11. Selection, Inclusion, Evaluation and Defense of Transgender-Inclusive Fiction for Young Adults: A Resource Guide

    Science.gov (United States)

    Rockefeller, Elsworth I.

    2009-01-01

    An increasingly visible youth transgender population is emerging and the number of transgender-inclusive fiction texts for young adults is growing. Adults serving teens in schools, libraries, and community agencies must begin actively pursuing, utilizing, and incorporating these texts into resource collections. This article provides an overview of…

  12. The Role of School Counsellors and Psychologists in Supporting Transgender People

    Science.gov (United States)

    Riggs, Damien W.; Bartholomaeus, Clare

    2015-01-01

    As growing numbers of transgender people--including students, parents, and educators--become visible within schools, so comes with this the requirement that schools ensure their full inclusion. This article suggests that school counsellors and psychologists have an important role to play in supporting transgender people within schools. As an…

  13. A Mixed Methods Examination of Structural Bigenderism and the Consequences for Transgender and Gender Variant People

    Science.gov (United States)

    Seelman, Kristie L.

    2013-01-01

    For years, transgender activists and their allies have spoken out about the oppression that transgender and gender non-conforming people experience in relation to societal systems and institutions, due to policies and practices that do not acknowledge non-binary experiences of gender, that do not recognize that one's gender may change over time or…

  14. Transgender College Students: An Exploratory Study of Perceptions, Engagement, and Educational Outcomes

    Science.gov (United States)

    Dugan, John P.; Kusel, Michelle L.; Simounet, Dawn M.

    2012-01-01

    We explored transgender students' perceptions, engagement, and educational outcomes across 17 dimensions of the collegiate experience. Data were collected as part of a national study and represent a total of 91 transgender-identified college students as well as matching samples of nontransgender LGB and heterosexual peers for comparative purposes.…

  15. Leadership Styles of College and University Athletic Directors and the Presence of NCAA Transgender Policy

    Science.gov (United States)

    Bowden, Randall; McCauley, Kayleigh

    2016-01-01

    In September 2011, the National Collegiate Athletic Association (NCAA) announced the "Policy on Transgender Inclusion." It provides guidelines for transgender student athletes to participate in sex-separated athletic teams according to their gender identity. The "2012 LGBTQ National College Athlete Report," the first of its…

  16. Anti-Transgender Prejudice: A Structural Equation Model of Associated Constructs

    Science.gov (United States)

    Tebbe, Esther N.; Moradi, Bonnie

    2012-01-01

    This study aimed to identify theoretically relevant key correlates of anti-transgender prejudice. Specifically, structural equation modeling was used to test the unique relations of anti-lesbian, gay, and bisexual (LGB) prejudice; traditional gender role attitudes; need for closure; and social dominance orientation with anti-transgender prejudice.…

  17. Transgender People at Four Big Ten Campuses: A Policy Discourse Analysis

    Science.gov (United States)

    Dirks, Doris Andrea

    2016-01-01

    This article examines the language used to discuss transgender people on university campuses. This study asks how, despite seemingly benefitting transgender people, the discourses carried by the documents that discuss trans people may actually undermine the intended goals of policy initiatives. For example, a report on the status of transgender…

  18. 78 FR 33957 - Lesbian, Gay, Bisexual, and Transgender Pride Month, 2013

    Science.gov (United States)

    2013-06-06

    ..., Gay, Bisexual, and Transgender Pride Month, 2013 By the President of the United States of America A... equality from founding promise into lasting reality. Lesbian, gay, bisexual, and transgender (LGBT... Constitution and the laws of the United States, do hereby proclaim June 2013 as Lesbian, Gay, Bisexual, and...

  19. 76 FR 32853 - Lesbian, Gay, Bisexual, And Transgender Pride Month, 2011

    Science.gov (United States)

    2011-06-07

    ..., Gay, Bisexual, And Transgender Pride Month, 2011 By the President of the United States of America A Proclamation The story of America's Lesbian, Gay, Bisexual, and Transgender (LGBT) community is the story of..., Don't Tell'' policy. With this repeal, gay and lesbian Americans will be able to serve openly in our...

  20. 75 FR 32079 - Lesbian, Gay, Bisexual, and Transgender Pride Month, 2010

    Science.gov (United States)

    2010-06-07

    ..., Gay, Bisexual, and Transgender Pride Month, 2010 By the President of the United States of America A... equality on behalf of the lesbian, gay, bisexual, and transgender (LGBT) community. This month, as we.... That is why we must give committed gay couples the same rights and responsibilities afforded to any...

  1. The Experiences of Incoming Transgender College Students: New Data on Gender Identity

    Science.gov (United States)

    Stolzenberg, Ellen Bara; Hughes, Bryce

    2017-01-01

    According to the National Transgender Discrimination Survey, transgender students in K-12 settings experience high rates of harassment (78 percent), physical assault (35 percent), and even sexual violence (12 percent). In response to the mounting evidence of discrimination, the Obama administration in May 2016 issued a "Dear Colleague"…

  2. Defense.gov Special Report: Lesbian, Gay, Bisexual, and Transgender (LGBT)

    Science.gov (United States)

    , and Transgender (LGBT) Pride Month Social Media Facebook Twitter Instagram 2015 Pride Month Poster transgender environment at the Defense Department over the past 20 years. Carter: Diversity, Inclusion Critical to Force of Future Embracing diversity and inclusion is critical to recruiting and retaining the

  3. Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

    NARCIS (Netherlands)

    Coleman, E.; Bockting, W.; Botzer, M.; Cohen-Kettenis, P.T.; DeCuypere, G.; Feldman, J.; Fraser, L.; Green, J.; Knudson, G.; Meyer, W.J.; Monstrey, S.; Adler, R.K.; Brown, G.R.; Devor, A.H.; Ehrbar, R.; Ettner, R.; Eyler, E.; Garofalo, R.; Karasic, D.H.; Lev, A.I.; Mayer, G.; Meyer-Bahlburg, H.; Hall, B.P.; Pfaefflin, F.; Rachlin, K.; Robinson, B.; Schechter, L.S.; Tangpricha, V.; van Trotsenburg, M.A.A.; Vitale, A.; Winter, S.; Whittle, S.; Wylie, K.R.; Zucker, K.J.

    2012-01-01

    The Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People is a publication of the World Professional Association for Transgender Health (WPATH). The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual,

  4. Review of the Transgender Literature: Where Do We Go from Here?

    Science.gov (United States)

    Wanta, Jonathon W; Unger, Cecile A

    2017-01-01

    Purpose: The "transgender tipping point" has brought transgender social and health issues to the forefront of American culture. However, medical professionals have been lagging in academic research with a transgender-specific focus resulting in significant knowledge gaps in dealing with the care of our transgender patients. The aim of this article is to analyze all published Medline-available transgender-specific articles, identify these knowledge gaps, and direct future research to where it is most needed. Methods: We surveyed all Medline-available articles up to June 2016 using a combination of medical subject headings and keywords in titles and abstracts. Articles meeting inclusion criteria were reviewed, categorized, and analyzed for content and study design. Results: In our review of the literature, we identified 2405 articles published from January 1950 to June 2016 that focused on transgender health, primarily in the fields of surgery, mental health, and endocrinology. Conclusion: Significant knowledge gaps were found across the subspecialties, and there was a lack of prospective robust research and representation of transgender-specific data in the core medical journals. More data and research are needed to bridge the knowledge gaps that currently exist and improve the care of the transgender community.

  5. The Impact of Social Connectedness and Internalized Transphobic Stigma on Self-Esteem Among Transgender and Gender Non-Conforming Adults.

    Science.gov (United States)

    Austin, Ashley; Goodman, Revital

    2017-01-01

    The transgender and gender non-conforming (TGNC) community continues to represent a notably marginalized population exposed to pervasive discrimination, microaggressions, and victimization. Congruent with the minority stress model, TGNC individuals persistently experience barriers to wellbeing in contemporary society; however, research uncovering resilience-based pathways to health among this population is sparse. This study aimed to explore the impact and interaction between internalized transphobic stigma and a potential buffer against minority stress-social connectedness-on the self-esteem of TGNC identified adults. Data were collected from 65 TGNC identified adults during a national transgender conference. Multiple regression analysis reveals that self-esteem is negatively impacted by internalized transphobia and positively impacted by social connectedness. Social connectedness did not significantly moderate the relationship between internalized transphobia and self-esteem. Micro and macro interventions aimed at increasing social connectedness and decreasing internalized transphobic stigma may be paramount for enhancing resiliency and wellbeing in the TGNC community.

  6. Factors associated with sex work involvement among transgender women in Jamaica: a cross-sectional study.

    Science.gov (United States)

    Logie, Carmen H; Wang, Ying; Lacombe-Duncan, Ashley; Jones, Nicolette; Ahmed, Uzma; Levermore, Kandasi; Neil, Ava; Ellis, Tyrone; Bryan, Nicolette; Marshall, Annecka; Newman, Peter A

    2017-04-06

    Transgender women are disproportionately impacted by HIV. Transgender women involved in sex work may experience exacerbated violence, social exclusion, and HIV vulnerabilities, in comparison with non-sex work-involved transgender women. Scant research has investigated sex work among transgender women in the Caribbean, including Jamaica, where transgender women report pervasive violence. The study objective was to examine factors associated with sex work involvement among transgender women in Jamaica. In 2015, we implemented a cross-sectional survey using modified peer-driven recruitment with transgender women in Kingston and Ocho Rios, Jamaica, in collaboration with a local community-based AIDS service organization. We conducted multivariable logistic regression analyses to identify factors associated with paid sex and transactional sex. Exchanging oral, anal or vaginal sex for money only was categorized as paid sex. Exchanging sex for survival needs (food, accommodation, transportation), drugs or alcohol, or for money along with survival needs and/or drugs/alcohol, was categorized as transactional sex. Among 137 transgender women (mean age: 24.0 [SD: 4.5]), two-thirds reported living in the Kingston area. Overall, 25.2% reported being HIV-positive. Approximately half (n = 71; 51.82%) reported any sex work involvement, this included sex in exchange for: money (n = 64; 47.06%); survival needs (n = 27; 19.85%); and drugs/alcohol (n = 6; 4.41%). In multivariable analyses, paid sex and transactional sex were both associated with: intrapersonal (depression), interpersonal (lower social support, forced sex, childhood sexual abuse, intimate partner violence, multiple partners/polyamory), and structural (transgender stigma, unemployment) factors. Participants reporting transactional sex also reported increased odds of incarceration perceived to be due to transgender identity, forced sex, homelessness, and lower resilience, in comparison with participants reporting

  7. Lesbian, Gay, Bisexual, and Transgender Patient Care: Medical Students' Preparedness and Comfort.

    Science.gov (United States)

    White, William; Brenman, Stephanie; Paradis, Elise; Goldsmith, Elizabeth S; Lunn, Mitchell R; Obedin-Maliver, Juno; Stewart, Leslie; Tran, Eric; Wells, Maggie; Chamberlain, Lisa J; Fetterman, David M; Garcia, Gabriel

    2015-01-01

    Phenomenon: Lesbian, gay, bisexual, and transgender (LGBT) individuals face significant barriers in accessing appropriate and comprehensive medical care. Medical students' level of preparedness and comfort caring for LGBT patients is unknown. An online questionnaire (2009-2010) was distributed to students (n = 9,522) at 176 allopathic and osteopathic medical schools in Canada and the United States, followed by focus groups (2010) with students (n = 35) at five medical schools. The objective of this study was to characterize LGBT-related medical curricula, to determine medical students' assessments of their institutions' LGBT-related curricular content, and to evaluate their comfort and preparedness in caring for LGBT patients. Of 9,522 survey respondents, 4,262 from 170 schools were included in the final analysis. Most medical students (2,866/4,262; 67.3%) evaluated their LGBT-related curriculum as "fair" or worse. Students most often felt prepared addressing human immunodeficiency virus (HIV; 3,254/4,147; 78.5%) and non-HIV sexually transmitted infections (2,851/4,136; 68.9%). They felt least prepared discussing sex reassignment surgery (1,061/4,070; 26.1%) and gender transitioning (1,141/4,068; 28.0%). Medical education helped 62.6% (2,669/4,262) of students feel "more prepared" and 46.3% (1,972/4,262) of students feel "more comfortable" to care for LGBT patients. Four focus group sessions with 29 students were transcribed and analyzed. Qualitative analysis suggested students have significant concerns in addressing certain aspects of LGBT health, specifically with transgender patients. Insights: Medical students thought LGBT-specific curricula could be improved, consistent with the findings from a survey of deans of medical education. They felt comfortable, but not fully prepared, to care for LGBT patients. Increasing curricular coverage of LGBT-related topics is indicated with emphasis on exposing students to LGBT patients in clinical settings.

  8. Drug use among transgender people in Ontario, Canada: Disparities and associations with social exclusion.

    Science.gov (United States)

    Scheim, Ayden I; Bauer, Greta R; Shokoohi, Mostafa

    2017-09-01

    We identified the prevalence and correlates of past-year illicit drug use among transgender people in Ontario, Canada, and disparities with the age-standardized non-transgender population. Data on transgender persons aged 16+ (n=406) were obtained from Trans PULSE, a respondent-driven sampling (RDS) survey (2009-2010). Overall and sex-specific estimates of past-year drug use (cocaine and amphetamines, based on data availability) in the reference population were obtained from Ontario residents aged 16+ (n=39, 980) in the Canadian Community Health Survey (2009-2010), and standardized to the overall and gender-specific transgender age distributions. For regression analyses with Trans PULSE data, past-year drug use included drug types associated with high risk of physical, psychological, and social harm to the user, and RDS-II weights were applied to frequencies and prevalence ratios (PR) derived from blockwise logistic regression models. An estimated 12.3% (95% CI: 7.7, 17.0) of transgender Ontarians had used at least one of the specified drugs in the past year, with no significant difference by gender identity. Transgender Ontarians were more likely to use both cocaine (standardized prevalence difference; SPD=6.8%; 95% CI=1.6, 10.9) and amphetamines (SPD=SPD=1.3%, 95% CI=0.2, 3.1) as compared to the age-standardized non-transgender population. History of transphobic assault, homelessness or underhousing, and sex work were associated with greater drug use among transgender persons. The prevalence of cocaine and amphetamine use among transgender people in Ontario, Canada was higher than in the age-standardized reference population. Social exclusion predicted within-group variation in drug use among transgender persons. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Transgender Health in Endocrinology: Current Status of Endocrinology Fellowship Programs and Practicing Clinicians.

    Science.gov (United States)

    Davidge-Pitts, Caroline; Nippoldt, Todd B; Danoff, Ann; Radziejewski, Lauren; Natt, Neena

    2017-04-01

    The transgender population continues to face challenges in accessing appropriate health care. Adequate training of endocrinologists in this area is a priority. Assess the status of transgender health care education in US endocrinology fellowship training programs and assess knowledge and practice of transgender health among practicing US endocrinologists. Mayo Clinic and the Endocrine Society developed and administered a Web-based anonymous survey to 104 endocrinology fellowship program directors (PDs; members of the Association of Program Directors in Endocrinology, Diabetes and Metabolism) and 6992 US medical doctor members of Endocrine Society. There were 54 total responses from 104 PDs (51.9%). Thirty-five of these 54 programs (72.2%) provide teaching on transgender health topics; however, 93.8% respondents indicated that fellowship training in this area is important. Barriers to provision of education included lack of faculty interest or experience. The most desired strategies to increase transgender-specific content included online training modules for trainees and faculty. Of 411 practicing clinician responders, almost 80% have treated a transgender patient, but 80.6% have never received training on care of transgender patients. Clinicians were very or somewhat confident in terms of definitions (77.1%), taking a history (63.3%), and prescribing hormones (64.8%); however, low confidence was reported outside of the hormonal realm. The most requested methods of education included online training modules and presentation of transgender topics at meetings. Confidence and competence in transgender health needs to increase among endocrinologists. Strategies include the development of online training modules, expansion of formal transgender curricula in fellowship programs, and presentations at national and international meetings. Copyright © 2017 by the Endocrine Society

  10. Mental Health and Self-Worth in Socially Transitioned Transgender Youth.

    Science.gov (United States)

    Durwood, Lily; McLaughlin, Katie A; Olson, Kristina R

    2017-02-01

    Social transitions are increasingly common for transgender children. A social transition involves a child presenting to other people as a member of the "opposite" gender in all contexts (e.g., wearing clothes and using pronouns of that gender). Little is known about the well-being of socially transitioned transgender children. This study examined self-reported depression, anxiety, and self-worth in socially transitioned transgender children compared with 2 control groups: age- and gender-matched controls and siblings of transgender children. As part of a longitudinal study (TransYouth Project), children (9-14 years old) and their parents completed measurements of depression and anxiety (n = 63 transgender children, n = 63 controls, n = 38 siblings). Children (6-14 years old; n = 116 transgender children, n = 122 controls, n = 72 siblings) also reported on their self-worth. Mental health and self-worth were compared across groups. Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096). Parents similarly reported that their transgender children experienced more anxiety than children in the control groups (p = .002) and rated their transgender children as having equivalent levels of depression (p = .728). These findings are in striking contrast to previous work with gender-nonconforming children who had not socially transitioned, which found very high rates of depression and anxiety. These findings lessen concerns from previous work that parents of socially transitioned children could be systematically underreporting mental health problems. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  11. Discrimination and Delayed Health Care Among Transgender Women and Men: Implications for Improving Medical Education and Health Care Delivery.

    Science.gov (United States)

    Jaffee, Kim D; Shires, Deirdre A; Stroumsa, Daphna

    2016-11-01

    The transgender community experiences health care discrimination and approximately 1 in 4 transgender people were denied equal treatment in health care settings. Discrimination is one of the many factors significantly associated with health care utilization and delayed care. We assessed factors associated with delayed medical care due to discrimination among transgender patients, and evaluated the relationship between perceived provider knowledge and delayed care using Anderson's behavioral model of health services utilization. Multivariable logistic regression analysis was used to test whether predisposing, enabling, and health system factors were associated with delaying needed care for transgender women and transgender men. A sample of 3486 transgender participants who took part in the National Transgender Discrimination Survey in 2008 and 2009. Predisposing, enabling, and health system environment factors, and delayed needed health care. Overall, 30.8% of transgender participants delayed or did not seek needed health care due to discrimination. Respondents who had to teach health care providers about transgender people were 4 times more likely to delay needed health care due to discrimination. Transgender patients who need to teach their providers about transgender people are significantly more likely to postpone or not seek needed care. Systemic changes in provider education and training, along with health care system adaptations to ensure appropriate, safe, and respectful care, are necessary to close the knowledge and treatment gaps and prevent delayed care with its ensuing long-term health implications.

  12. Challenging and Preventing Policies That Prohibit Local Civil Rights Protections for Lesbian, Gay, Bisexual, Transgender, and Queer People.

    Science.gov (United States)

    Pomeranz, Jennifer L

    2018-01-01

    Discrimination causes health inequities for stigmatized groups. Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals, in particular, are at significantly increased risk for disparate health outcomes when they reside in states that fail to extend equal protections to them or that actively deprive equal rights to them. Several states and the federal government have proposed or enacted laws that permit residents to discriminate against LGBTQ individuals. One such law, Arkansas's Intrastate Commerce Improvement Act of 2015, preempts or prohibits local governments from enacting civil rights protections for LGBTQ individuals that are also lacking at the state level. State laws such as Arkansas's undermine local control, damage the economy, and create injustices that harm LGBTQ people. I set forth 2 constitutional arguments to challenge such laws, and I provide information to help advocates support evidence-based policymaking and prevent the passage of similar laws in their states.

  13. TRANSGENDER COMMUNITY ACTIVITIES AND THEIR MARRIAGE CONCEPT IN YOGYAKARTA

    Directory of Open Access Journals (Sweden)

    Muta’Ali Rauf

    2016-05-01

    Full Text Available Transgender have been considered as someone who always marginalized in their life, so they always get moral discrimination, social and even religion. Development of the transgender community in Yogyakarta is currently getting a response from various groups, namely the general public, religious leaders, sociologists and psychologists. As for job transsexual Kebaya NGOs joined in Yogyakarta, located in very small scope, include: ngamen, nyebong, salon and sewing. It was done since the transvestites are out of work in the formal sector. The concept of marriage in transgender community in Kebaya NGOs does not have clear rules because there is no basis or guidelines. Same-sex marriage in Indonesia is not recognized legally as well as normative, so the concept of transsexual marriage does not exist according to Islamic law. Kebaya NGOs consider that the rules about marriage in Indonesia violate the human rights, because it does not facilitate and accommodate the same-sex marriage. [Waria selama ini dianggap sebagai sosok yang selalu termarginalkan di dalam kehidupannya, sehingga mereka selalu mendapatkan diskriminasi baik moral, sosial, maupun agama. Perkembangan komunitas waria di Yogyakarta saat ini mendapat respon dari berbagai kalangan, yaitu masyarakat umum, tokoh Agama, Sosiolog, dan Psikolog. Adapun pekerjaan Waria Yogyakarta yang tergabung dalam LSM Kebaya, berada dalam skala yang sangat kecil meliputi : Ngamen, Nyebong, salon dan menjahit. Hal itu dikerjakan semenjak waria tidak mendapat pekerjaan dalam sektor formal. Konsep perkawinan dalam komunitas waria di LSM Kebaya belum mempunyai aturan yang jelas karena tidak ada landasan atau pedomannya. Perkawinan sesama jenis di Indonesia tidak mendapatkan pengakuan secara yuridis maupun normatif, sehingga konsep perkawinan waria tidak eksis menurut Hukum Islam. LSM Kebaya menganggap bahwa peraturan tentang perkawinan di Indonesia melanggar hak asasi manusia, karena tidak memfasilitasi perkawinan

  14. A social ecology of rectal microbicide acceptability among young men who have sex with men and transgender women in Thailand.

    Science.gov (United States)

    Newman, Peter A; Roungprakhon, Surachet; Tepjan, Suchon

    2013-08-01

    With HIV-incidence among men who have sex with men (MSM) in Bangkok among the highest in the world, a topical rectal microbicide would be a tremendous asset to prevention. Nevertheless, ubiquitous gaps between clinical trial efficacy and real-world effectiveness of existing HIV preventive interventions highlight the need to address multi-level factors that may impact on rectal microbicide implementation. We explored the social ecology of rectal microbicide acceptability among MSM and transgender women in Chiang Mai and Pattaya, Thailand. We used a qualitative approach guided by a social ecological model. Five focus groups were conducted in Thai using a semi-structured interview guide. All interviews were digitally recorded, transcribed verbatim in Thai and translated into English. We conducted thematic analysis using line-by-line and axial coding and a constant comparative method. Transcripts and codes were uploaded into a customized database programmed in Microsoft Access. We then used content analysis to calculate theme frequencies by group, and Chi-square tests and Fisher's exact test to compare themes by sexual orientation/gender expression and age. Participant's (n=37) mean age was 24.8 years (SD=4.2). The majority (70.3%) self-identified as gay, 24.3% transgender women. Product-level themes (side effects, formulation, efficacy, scent, etc.) accounted for 42%, individual (increased sexual risk, packaging/portability, timing/duration of protection) 29%, interpersonal (trust/communication, power/negotiation, stealth) 8% and social-structural (cost, access, community influence, stigma) 21% of total codes, with significant differences by sexual orientation/gender identity. The intersections of multi-level influences included product formulation and timing of use preferences contingent on interpersonal communication and partner type, in the context of constraints posed by stigma, venues for access and cost. The intersecting influence of multi-level factors on

  15. LESBIAN, GAY, BISEXUAL, TRANSGENDER AGEING AND CARE: A LITERATURE STUDY

    Directory of Open Access Journals (Sweden)

    Henderson, Neil

    2016-08-01

    Full Text Available There is an increasing body of research on ageing and end-of-life care (EOLC of lesbian, gay, bisexual and transgender (LGBT older people in the UK, USA and Australia. In contrast, in South Africa, despite progressive legislation to protect LGBT rights, there has been minimal research in this area. This article reports on a critical review of literature on ageing of the LGBT community. Key themes identified include discrimination by health care workers and health risks for LGBT older people alongside the need for training of health professionals. The article concludes with consideration of the needs of LGBT persons in South Africa

  16. Bullying Among Lesbian, Gay, Bisexual, and Transgender Youth.

    Science.gov (United States)

    Earnshaw, Valerie A; Bogart, Laura M; Poteat, V Paul; Reisner, Sari L; Schuster, Mark A

    2016-12-01

    Bullying of lesbian, gay, bisexual, and transgender (LGBT) youth is prevalent in the United States, and represents LGBT stigma when tied to sexual orientation and/or gender identity or expression. LGBT youth commonly report verbal, relational, and physical bullying, and damage to property. Bullying undermines the well-being of LGBT youth, with implications for risky health behaviors, poor mental health, and poor physical health that may last into adulthood. Pediatricians can play a vital role in preventing and identifying bullying, providing counseling to youth and their parents, and advocating for programs and policies to address LGBT bullying. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Positive aspects of being a heterosexual ally to lesbian, gay, bisexual and transgender (LGBT) people.

    Science.gov (United States)

    Rostosky, Sharon S; Black, Whitney W; Riggle, Ellen D B; Rosenkrantz, Dani

    2015-07-01

    Research on heterosexual allies has focused on heterosexual identity development models and pathways to ally activism. The positive aspects or positive experiences of identifying as an ally to lesbian, gay, bisexual, and transgender (LGBT) identified individuals and communities have received little attention. Using an online survey of participants recruited from LGBT ally related social media, we collected open-ended responses to a question about the positive aspects of self-identifying as a heterosexual ally. A final analytic sample of 292 self-identified male and female heterosexual adults (age 18-71, M = 33.47, SD = 13.32) provided responses that generated 8 themes. Positive aspects of being a heterosexual ally were: (a) increased knowledge and awareness, (b) upholding values of justice, (c) beneficial individual relationships, (d) community belonging, (e) educating others, (f) being a role model, (g) using social privilege, and (h) speaking out and taking a stand. The findings suggest that being a heterosexual ally is rewarding and may enhance individual well-being. These findings provide information that may contribute to effective ally development efforts. (c) 2015 APA, all rights reserved).

  18. Psychosocial Effects of Health Disparities of Lesbian, Gay, Bisexual, and Transgender Older Adults.

    Science.gov (United States)

    Zelle, Andraya; Arms, Tamatha

    2015-07-01

    The 1.5 million older adults who self-identify as lesbian, gay, bisexual, and transgender (LGBT) are expected to double in number by 2030. Research suggests that health disparities are closely linked with societal stigma, discrimination, and denial of civil and human rights. More LGBT older adults struggle with depression, substance abuse, social isolation, and acceptance compared to their heterosexual counterparts. Despite individual preferences, most health care providers recognize the right of any individual to have access to basic medical services. The U.S. Department of Health and Human Services requires that all hospitals receiving funds from Medicare and Medicaid respect visitation and medical decision-making rights to all individuals identifying as LGBT. The Joint Commission also requires a non-discrimination statement for accreditation. The current literature review examines LGBT health disparities and the consequential psychosocial impact on LGBT older adults as well as brings awareness to the needs of this underserved and underrepresented population. Copyright 2015, SLACK Incorporated.

  19. Barriers and Facilitators to Oral PrEP Use Among Transgender Women in New York City.

    Science.gov (United States)

    Rael, Christine Tagliaferri; Martinez, Michelle; Giguere, Rebecca; Bockting, Walter; MacCrate, Caitlin; Mellman, Will; Valente, Pablo; Greene, George J; Sherman, Susan; Footer, Katherine H A; D'Aquila, Richard T; Carballo-Diéguez, Alex

    2018-03-27

    Transgender women may face a disparate risk for HIV/AIDS compared to other groups. In 2012, Truvada was approved for daily use as HIV pre-exposure prophylaxis (PrEP). However, there is a dearth of research about barriers and facilitators to PrEP in transgender women. This paper will shed light on transgender women living in New York City's perceived and actual challenges to using PrEP and potential strategies to overcome them. After completing an initial screening process, four 90-min focus groups were completed with n = 18 transgender women. Participants were asked what they like and dislike about PrEP. Participants identified the following barriers: uncomfortable side effects, difficulty taking pills, stigma, exclusion of transgender women in advertising, and lack of research on transgender women and PrEP. Facilitators included: reducing pill size, increasing the types of available HIV prevention products, and conducting scientific studies to evaluate PrEP in transgender women.

  20. Gender identity and the management of the transgender patient: a guide for non-specialists.

    Science.gov (United States)

    Joseph, Albert; Cliffe, Charlotte; Hillyard, Miriam; Majeed, Azeem

    2017-04-01

    In this review, we introduce the topic of transgender medicine, aimed at the non-specialist clinician working in the UK. Appropriate terminology is provided alongside practical advice on how to appropriately care for transgender people. We offer a brief theoretical discussion on transgenderism and consider how it relates to broader understandings of both gender and disease. In respect to epidemiology, while it is difficult to assess the exact size of the transgender population in the UK, population surveys suggest a prevalence of between 0.2 and 0.6% in adults, with rates of referrals to gender identity clinics in the UK increasing yearly. We outline the legal framework that protects the rights of transgender people, showing that is not legal for physicians to deny transgender people access to services based on their personal beliefs. Being transgender is often, although not always, associated with gender dysphoria, a potentially disabling condition in which the discordance between a person's natal sex (that assigned to them at birth) and gender identity results in distress, with high associated rates of self-harm, suicidality and functional impairment. We show that gender reassignment can be a safe and effective treatment for gender dysphoria with counselling, exogenous hormones and surgery being the mainstay of treatment. The role of the general practitioner in the management of transgender patients is discussed and we consider whether hormone therapy should be initiated in primary care in the absence of specialist advice, as is suggested by recent General Medical Council guidance.

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

    Science.gov (United States)

    Streed, Carl G; Harfouch, Omar; Marvel, Francoise; Blumenthal, Roger S; Martin, Seth S; Mukherjee, Monica

    2017-08-15

    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.

  2. Managing uncertainty: a grounded theory of stigma in transgender health care encounters.

    Science.gov (United States)

    Poteat, Tonia; German, Danielle; Kerrigan, Deanna

    2013-05-01

    A growing body of literature supports stigma and discrimination as fundamental causes of health disparities. Stigma and discrimination experienced by transgender people have been associated with increased risk for depression, suicide, and HIV. Transgender stigma and discrimination experienced in health care influence transgender people's health care access and utilization. Thus, understanding how stigma and discrimination manifest and function in health care encounters is critical to addressing health disparities for transgender people. A qualitative, grounded theory approach was taken to this study of stigma in health care interactions. Between January and July 2011, fifty-five transgender people and twelve medical providers participated in one-time in-depth interviews about stigma, discrimination, and health care interactions between providers and transgender patients. Due to the social and institutional stigma against transgender people, their care is excluded from medical training. Therefore, providers approach medical encounters with transgender patients with ambivalence and uncertainty. Transgender people anticipate that providers will not know how to meet their needs. This uncertainty and ambivalence in the medical encounter upsets the normal balance of power in provider-patient relationships. Interpersonal stigma functions to reinforce the power and authority of the medical provider during these interactions. Functional theories of stigma posit that we hold stigmatizing attitudes because they serve specific psychological functions. However, these theories ignore how hierarchies of power in social relationships serve to maintain and reinforce inequalities. The findings of this study suggest that interpersonal stigma also functions to reinforce medical power and authority in the face of provider uncertainty. Within functional theories of stigma, it is important to acknowledge the role of power and to understand how stigmatizing attitudes function to maintain

  3. The Role of Distal Minority Stress and Internalized Transnegativity in Suicidal Ideation and Nonsuicidal Self-Injury Among Transgender Adults.

    Science.gov (United States)

    Staples, Jennifer M; Neilson, Elizabeth C; Bryan, Amanda E B; George, William H

    Transgender people are at elevated risk for nonsuicidal self-injury (NSSI) and suicidal ideation compared to the general population. Transgender (trans) refers to a diverse group of people who experience incongruence between their gender identity and sex assigned at birth. The present study is guided by the minority stress model and the psychological mediation framework, which postulate that sexual minority groups experience elevated stress as a result of anti-minority prejudice, contributing to negative mental health outcomes. This study utilized these theories to investigate the role of internalized transnegativity-internalization of negative societal attitudes about one's trans identity-in the relationships of distal trans stress to suicidal ideation and NSSI. A U.S. national sample of trans adults (N = 237) completed a battery of online measures. Structural equation modeling (SEM) was used to compare models with mediation and moderation effects. Results suggested that internalized transnegativity acts as both a mediator and a moderator in the relationship between distal trans stress and suicidal ideation. Log likelihood comparisons suggested moderation models had the superior fit for these data. Results suggest that clinical interventions should directly target individuals' internalized transnegativity as well as societal-level transnegativity.

  4. Novel approaches to HIV prevention and sexual health promotion among Guatemalan gay and bisexual men, MSM, and transgender persons.

    Science.gov (United States)

    Rhodes, Scott D; Alonzo, Jorge; Mann, Lilli; Downs, Mario; Simán, Florence M; Andrade, Mario; Martinez, Omar; Abraham, Claire; Villatoro, Guillermo R; Bachmann, Laura H

    2014-08-01

    The burden of HIV is disproportionate for Guatemalan sexual minorities (e.g., gay and bisexual men, men who have sex with men [MSM], and transgender persons). Our bi-national partnership used authentic approaches to community-based participatory research (CBPR) to identify characteristics of potentially successful programs to prevent HIV and promote sexual health among Guatemalan sexual minorities. Our partnership conducted Spanish-language focus groups with 87 participants who self-identified as male (n=64) or transgender (n=23) and individual in-depth interviews with ten formal and informal gay community leaders. Using constant comparison, an approach to grounded theory, we identified 20 characteristics of potentially successful programs to reduce HIV risk, including providing guidance on accessing limited resources; offering supportive dialogue around issues of masculinity, socio-cultural expectations, love, and intimacy; using Mayan values and images; harnessing technology; increasing leadership and advocacy skills; and mobilizing social networks. More research is clearly needed, but participants reported needing and wanting programming and had innovative ideas to prevent HIV exposure and transmission.

  5. Impact of Anticipated Bias from Healthcare Professionals on Perceived Successful Aging Among Transgender and Gender Nonconforming Older Adults.

    Science.gov (United States)

    Walker, Ruth V; Powers, Sara M; Witten, Tarynn M

    2017-12-01

    Transgender and gender nonconforming (TGNC) persons have routinely experienced high rates of violence and discrimination. Discrimination in healthcare can affect the ability of TGNC persons to age successfully as it often deters them from seeking care. The purpose of this study was to determine if anticipation of bias from healthcare professionals, as well as other variables, predicted perceived successful aging in a sample of TGNC adults. A total of 384 (of the original 1963) participants older than 50 years completed the relevant parts of an 83-item online survey as part of the Trans MetLife Survey on Later-Life Preparedness and Perceptions in Transgender-Identified Individuals. Larger social support networks and higher levels of confidence that a healthcare professional will treat them with dignity and respect as a TGNC person at the end of their life were associated with increased odds of perceiving that they were aging successfully. With high rates of discrimination and prejudice toward TGNC persons in various contexts (e.g., healthcare, education, and housing), it is imperative that practitioners, researchers, policymakers, and institutions work together to eradicate healthcare disparities, promote social change, and support an environment that encourages successful aging. This calls for a coordinated, proactive outreach effort to put trust back into a system that has historically let down an entire subset of the population.

  6. Health Care Use and HIV-Related Behaviors of Black and Latina Transgender Women in 3 US Metropolitan Areas: Results From the Transgender HIV Behavioral Survey.

    Science.gov (United States)

    Denson, Damian J; Padgett, Paige M; Pitts, Nicole; Paz-Bailey, Gabriela; Bingham, Trista; Carlos, Juli-Ann; McCann, Pamela; Prachand, Nikhil; Risser, Jan; Finlayson, Teresa

    2017-07-01

    HIV prevalence estimates among transgender women in the United States are high, particularly among racial/ethnic minorities. Despite increased HIV risk and evidence of racial disparities in HIV prevalence among transgender women, few data are available to inform HIV prevention efforts. A transgender HIV-related behavioral survey conducted in 2009 in 3 US metropolitan areas (Chicago, Houston, and Los Angeles County), used respondent-driven sampling to recruit 227 black (n = 139) and Latina (n = 88) transgender women. We present descriptive statistics on sociodemographic, health care, and HIV-risk behaviors. Of 227 transgender women enrolled, most were economically and socially disadvantaged: 73% had an annual income of less than $15,000; 62% lacked health insurance; 61% were unemployed; and 46% reported being homeless in the past 12 months. Most (80%) had visited a health care provider and over half (58%) had tested for HIV in the past 12 months. Twenty-nine percent of those who reported having an HIV test in the past 24 months self-reported being HIV positive. Most of the sample reported hormone use (67%) in the past 12 months and most hormone use was under clinical supervision (70%). Forty-nine percent reported condomless anal sex in the past 12 months and 16% reported ever injecting drugs. These findings reveal the socioeconomic challenges and behavioral risks often associated with high HIV risk reported by black and Latina transgender women. Despite low health insurance coverage, the results suggest opportunities to engage transgender women in HIV prevention and care given their high reported frequency of accessing health care providers.

  7. Transgender Associations and Possible Etiology: A Literature Review.

    Science.gov (United States)

    Saleem, Fatima; Rizvi, Syed W

    2017-12-24

    Transgender or gender dysphoria has been defined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), as distress resulting from the incongruence between one's experienced gender and one's assigned gender, along with a persistent and strong desire to be of another gender, and accompanied by clinically significant distress. Adolescents referred for evaluation often want hormonal therapy and several among them also express a desire for gender reassignment surgery. Furthermore, evidence shows that adolescents and adults with gender dysphoria without a sex development disorder, before gender reassignments, are at increased risk for suicide. For this review, a search of the English language scientific literature was conducted using the PubMed database. This summary discusses the associations and comorbidities of gender dysphoria and reiterates the evidence that its etiology is multifactorial. Transsexualism involves prenatal neuroanatomical changes, has a psychiatric association, and is found to be more prevalent in conjunction with schizophrenia and autism spectrum disorders. Childhood adversities and neglect are also linked to having a transgender identity. Moreover, the evidence favors a genetic predisposition. Likewise, there seems to be a growing concern with regards to the relationship between endocrine disruptors and transsexuals as well as other gender minority populations. More research needs to be done to understand the exact pathways.

  8. Gender Creative or Transgender Youth and Advanced Nursing Practice.

    Science.gov (United States)

    Kirouac, Nicole; Tan, Mabel

    2017-06-01

    The World Professional Association for Transgender Health (WPATH) defines gender dysphoria as "Discomfort or distress that is caused by a discrepancy between a person's gender identity and that person's sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics)" (WPATH, 2016). Gender creative (GC) and transgender (TG) youth are at high risk for severe mental health disparities if they don't receive competent and timely gender transitioning care. Although awareness and early care of TG youth in specialty clinics is improving and increasing, there is still much effort that is required to eliminate barriers to care at many levels and thus improve outcomes. Nurses, particularly advanced practice nurses, are poised to lead the way in creating safe, inclusive, family centered spaces for TG and GC children, youth and their families as well as acting as vital mentors for other nurses. The purpose of this paper is to discuss the increasing prevalence of GC and TG youth, the significance of inclusive care for GC and TG youth, treatment guidelines, and the impact parents and advanced practice nurses can have on the journey of these youth as they explore and find their place on the gender spectrum. Copyright© of YS Medical Media ltd.

  9. Dating violence experiences of lesbian, gay, bisexual, and transgender youth.

    Science.gov (United States)

    Dank, Meredith; Lachman, Pamela; Zweig, Janine M; Yahner, Jennifer

    2014-05-01

    Media attention and the literature on lesbian, gay, and bisexual youth overwhelmingly focus on violence involving hate crimes and bullying, while ignoring the fact that vulnerable youth also may be at increased risk of violence in their dating relationships. In this study, we examine physical, psychological, sexual, and cyber dating violence experiences among lesbian, gay, and bisexual youth--as compared to those of heterosexual youth, and we explore variations in the likelihood of help-seeking behavior and the presence of particular risk factors among both types of dating violence victims. A total of 5,647 youth (51 % female, 74 % White) from 10 schools participated in a cross-sectional anonymous survey, of which 3,745 reported currently being in a dating relationship or having been in one during the prior year. Results indicated that lesbian, gay, and bisexual youth are at higher risk for all types of dating violence victimization (and nearly all types of dating violence perpetration), compared to heterosexual youth. Further, when looking at gender identity, transgender and female youth are at highest risk of most types of victimization, and are the most likely perpetrators of all forms of dating violence but sexual coercion, which begs further exploration. The findings support the development of dating violence prevention programs that specifically target the needs and vulnerabilities of lesbian, gay, and bisexual youth, in addition to those of female and transgender youth.

  10. The interaction of drug use, sex work, and HIV among transgender women.

    Science.gov (United States)

    Hoffman, Beth R

    2014-06-01

    Transgender women have a higher prevalence of drug use, HIV, drug use, and sex work than the general population. This article explores the interaction of these variables and discusses how sex work and drug use behaviors contribute to the high rates of HIV. A model predicting HIV rates with sex work and drug use as well as these behaviors in the transgender woman's social network is presented. Challenges to intervening with transgender women, as well as suggestions and criteria for successful interventions, are discussed.

  11. Increase in condom use and decline in prevalence of sexually transmitted infections among high-risk men who have sex with men and transgender persons in Maharashtra, India: Avahan, the India AIDS Initiative.

    Science.gov (United States)

    Ramanathan, Shreena; Deshpande, Sucheta; Gautam, Abhishek; Pardeshi, Dilip B; Ramakrishnan, Lakshmi; Goswami, Prabuddhagopal; Adhikary, Rajatashuvra; George, Bitra; Paranjape, Ramesh S; Mainkar, Mandar M

    2014-08-03

    The present study assessed coverage, changes in condom use, and prevalence of HIV and other STIs among high-risk men who have sex with men (HR-MSM; highly visible, recruited from cruising sites/sex venues) and transgender (TG; male-to-female transgender persons, also called hijras) in the Indian state of Maharashtra. Data from Avahan's computerized management information system; two rounds of integrated behavioral and biological assessment (IBBA) surveys (Round 1 with 653 HR-MSM/TG and Round 2 with 652 HR-MSM/TG); and project-supported condom social marketing was used for the present analysis. Logistic regression models were used to assess changes in key indicators over these two rounds and to explore the association between exposure to Avahan interventions and condom use and STI prevalence in HR-MSM/TG. By December 2007, Avahan had reached about 90% of the estimated HR-MSM/TG population, and 83% of the estimated total population had visited STI clinics by March 2009. Free direct condom distribution by Avahan program NGOs and social marketing outlets in Maharashtra increased from about 2.7 million condoms in 2004 to 15.4 million in 2008. HR-MSM/TG were more likely to report higher consistent condom use (adjusted odds ratio [AOR]: 1.90; 95% confidence interval [CI] 1.01-3.58) with regular male partners (spouse/lover/boyfriend) in Round 2 of IBBA, compared to Round 1. HR-MSM/TG exposed to Avahan interventions were more likely to report consistent condom use with regular male partners (AOR: 2.46; CI 1.34-4.52) than those who were unexposed. Prevalence of reactive syphilis serology declined significantly from 8.8% in Round 1 to 1.1% in Round 2 (p = 0.001), while the observed change HIV prevalence (12.3% to 6.3%, p = 0.16) was insignificant. The current evaluation provides evidence for successful scale up and coverage of target population by Avahan interventions in Maharashtra. The assessment findings showed improved accessibility to condoms and reduced risk

  12. Mental health promotion for gay, lesbian, bisexual, transgender and intersex New Zealanders

    Directory of Open Access Journals (Sweden)

    Adams J

    2013-06-01

    Full Text Available INTRODUCTION: A number of studies have identified that gay, lesbian, bisexual, transgender, and intersex (GLBTI people have poorer mental health than the general population. This article describes current mental health promotion and service provision for GLBTI people in New Zealand, and the views of stakeholders on current service delivery and concerns facing the sector. METHODS: An email survey of service providers gathered descriptive data about mental health promotion and services provided for GLBTI people. Data obtained from interviews with key informants and online submissions completed by GLBTI individuals were analysed thematically. FINDINGS: Five organisations provide clear, specific and utilised services and programmes to some or all of the GLBTI populations. Twelve GLBTI-focused mental health promotion resources are identified. The analysis of data from key informants and GLBTI respondents identified factors affecting mental health for these populations occurring at three levels-macro-social environment, social acceptance and connection, and services and support. CONCLUSION: While GLBTI individuals have the same basic mental health promotion and service provision needs as members of the general population, they have additional unique issues. To enhance the mental health of GLBTI New Zealanders, a number of actions are recommended, including building sector capacity, allocating sufficient funding, ensuring adequate research and information is available, and reducing stigma, enhancing young people's safety, and supporting practitioners through training and resources. An important role for government, alongside GLBTI input, for improving mental health is noted.

  13. Enhancing dental and dental hygiene student awareness of the lesbian, gay, bisexual and transgender population.

    Science.gov (United States)

    Aguilar, Elizabeth; Fried, Jacquelyn

    2015-02-01

    Although cultural competence education is being incorporated into most health care curricula, content addressing sexual minorities is lacking or, if present, inadequate. This void can result in compromised health care and can contribute to the social stigma surrounding the lesbian, gay, bisexual and transgender (LGBT) community. Increasing the knowledge and demystifying sexual minority issues can enhance the confidence and attitudes of health care workers when treating LGBT individuals. Suggestions for creating a more welcoming health care environment for LGBT individuals in different health care settings such as private clinics, public health settings and school based programs are offered. The purpose of this literature review was to systematically review available literature on health care providers' delivery of culturally competent care to the LGBT community. The investigators searched electronic databases that included Medline (Ovid), Eric and PubMed with consultation from information specialists at the Health Sciences and Human Services Library at the University of Maryland. The information was categorized into content areas. Discussion of the findings and future directions regarding health care delivery for the LGBT community are provided. Copyright © 2015 The American Dental Hygienists’ Association.

  14. Social Branding to Decrease Lesbian, Gay, Bisexual, and Transgender Young Adult Smoking

    Science.gov (United States)

    Fallin, Amanda; Neilands, Torsten B.; Jordan, Jeffrey W.

    2015-01-01

    Introduction: Lesbian, gay, bisexual, and transgender (LGBT) individuals are more likely to smoke than the general population. This study evaluated a Social Branding intervention, CRUSH, which included an aspirational brand, social events, and targeted media to discourage smoking among LGBT young adults in Las Vegas, NV. Methods: Cross-sectional surveys (N = 2,395) were collected in Las Vegas LGBT bars at 2 time points 1 year apart. Multivariate logistic regressions examined associations between campaign exposure, message understanding, and current (past 30 days) smoking, controlling for demographics. Results: LGBT individuals were significantly more likely to report current (past 30 day) smoking than heterosexual/straight, gender-conforming participants. Overall, 53% of respondents reported exposure to CRUSH; of those exposed, 60% liked the campaign, 60.3% reported they would attend a CRUSH event on a night when they usually went somewhere else, and 86.3% correctly identified that the campaign was about “partying fresh and smokefree.” Current smoking was reported by 47% of respondents at Time 1 and 39.6% at Time 2. There were significant interactions between time and campaign exposure and campaign exposure and understanding the message. Among those who understood the CRUSH smokefree message, the highest level of campaign exposure was significantly associated with 37%–48% lower odds for current smoking. Conclusions: While longitudinal studies would better assess the impact of this intervention, CRUSH shows promise to reduce tobacco use among LGBT bar patrons. PMID:26180223

  15. Sociodemographic Study of Danish Individuals Diagnosed with Transsexualism

    DEFF Research Database (Denmark)

    Simonsen, Rikke; Hald, Gert Martin; Giraldi, Annamaria

    2015-01-01

    INTRODUCTION: Male-to-female (MtF) and female-to-male (FtM) individuals with transsexualism (International Classification of Diseases-10) may differ in core clinical and sociodemographic variables such as age, sexual orientation, marriage and parenthood, school, educational level, and employment......F individuals. Compared with MtF, FtM had a significantly lower onset age (before 12 years of age) and lower age when permission for SRS was granted. Further, FtM individuals were significantly more often gynephilic (sexually attracted to females) during research period and less likely to start self......-initiated hormonal sex reassignment (SR) (treatment with cross-sex hormones). The MtF and FtM groups did not differ in years of school, educational level, employment, or engagement in marriage and cohabitation. CONCLUSIONS: As approximately half of MtF started cross-sex hormonal SR without attending a gender unit...

  16. Experiences of Violence Among Transgender Women in Puerto Rico: An Underestimated Problem.

    Science.gov (United States)

    Rodríguez-Madera, Sheilla L; Padilla, Mark; Varas-Díaz, Nelson; Neilands, Torsten; Vasques Guzzi, Ana C; Florenciani, Ericka J; Ramos-Pibernus, Alíxida

    2017-01-01

    Violence is a public health concern faced on a daily basis by transgender women. Literature has documented how it adversely affects quality of life and health and in some instances leads to homicide. Considering the lack of research documenting the experiences of violence among transgender women, the objective of this article was to explore manifestations of violence among this population in Puerto Rico. The data presented in this article are part of a larger study on transgender/transsexual health in Puerto Rico. For the purpose of this article we focus on the quantitative data analysis. Participants (N = 59 transgender women) were recruited via respondent driven sampling. Implications and specific recommendations are discussed in light of these findings.

  17. Stigmatization and Mental Health in a Diverse Sample of Transgender Women.

    Science.gov (United States)

    Yang, Mei-Fen; Manning, David; van den Berg, Jacob J; Operario, Don

    2015-12-01

    Previous research indicates elevated risk for psychological distress in sexual and gender minority populations, and some research suggests that stigma contributes to elevated psychological distress among members of these groups. This study examined the hypothesis that exposure to transgender-related stigma (TRS) is associated with both higher levels of depression and anxiety among transgender women. We analyzed data from a diverse sample of 191 adult transgender women living or working in the San Francisco Bay area who were recruited using purposive sampling methods to participate in a cross-sectional survey, which included measures of stigmatization, depression, and anxiety. Higher levels of exposure to TRS were independently associated with higher levels of depression (β=0.31, Ptransgender women. This research further highlights the need to develop a stronger evidence base on effective counseling approaches to improve the mental health of transgender women.

  18. HIV Testing Among Transgender Women and Men - 27 States and Guam, 2014-2015.

    Science.gov (United States)

    Pitasi, Marc A; Oraka, Emeka; Clark, Hollie; Town, Machell; DiNenno, Elizabeth A

    2017-08-25

    Transgender persons are at high risk for human immunodeficiency virus (HIV) infection; in a recent analysis of the results of over nine million CDC funded HIV tests, transgender women* had the highest percentage of confirmed positive results (2.7%) of any gender category (1). Transgender men, † particularly those who have sex with cisgender § men, are also at high risk for infection (2). HIV testing is critical for detecting and treating persons who are infected and delivering preventive services to those who are uninfected. CDC recommends that persons at high risk for HIV infection be screened for HIV at least annually, although transgender persons are not specified in the current recommendations. CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) to describe HIV testing among transgender women and men and two cisgender comparison groups in 27 states and Guam. After adjusting for demographic characteristics, transgender women and men had a lower prevalence of ever testing and past year testing for HIV (35.6% and 31.6% ever, and 10.0% and 10.2% past year, respectively) compared with cisgender gay and bisexual men (61.8% ever and 21.6% past year) and instead reported testing at levels comparable to cisgender heterosexual men and women (35.2% ever, and 8.6% past year). This finding suggests that transgender women and men might not be sufficiently reached by current HIV testing measures. Tailoring HIV testing activities to overcome the unique barriers faced by transgender women and men might increase rates of testing among these populations.

  19. Preferences for HIV test characteristics among young, Black Men Who Have Sex With Men (MSM) and transgender women: Implications for consistent HIV testing

    Science.gov (United States)

    Frye, Victoria; Hirshfield, Sabina; Chiasson, Mary Ann; Lucy, Debbie; Usher, DaShawn; McCrossin, Jermaine; Greene, Emily; Koblin, Beryl

    2018-01-01

    Background Promoting consistent HIV testing is critical among young, Black Men Who Have Sex With Men (MSM) and transgender women who are overrepresented among new HIV cases in the United States. New HIV test options are available, including mobile unit testing, one-minute testing, at home or self-testing and couples HIV testing and counseling (CHTC). In the context of these newer options, the objective of this study was to explore whether and how preferences for specific characteristics of the tests acted as barriers to and/or facilitators of testing in general and consistent testing specifically among young Black MSM and transgender women aged 16 to 29. Methods We conducted 30 qualitative, semi-structured, in-depth interviews with young, Black, gay, bisexual or MSM and transgender women in the New York City metropolitan area to identify preferences for specific HIV tests and aspects of HIV testing options. Participants were primarily recruited from online and mobile sites, followed by community-based, face-to-face recruitment strategies to specifically reach younger participants. Thematic coding was utilized to analyze the qualitative data based on a grounded theoretical approach. Results We identified how past experiences, perceived test characteristics (e.g., accuracy, cost, etc.) and beliefs about the “fit” between the individual, and the test relate to preferred testing methods and consistent testing. Three major themes emerged as important to preferences for HIV testing methods: the perceived accuracy of the test method, venue characteristics, and lack of knowledge or experience with the newer testing options, including self-testing and CHTC. Conclusions These findings suggest that increasing awareness of and access to newer HIV testing options (e.g., free or reduced price on home or self-tests or CHTC available at all testing venues) is critical if these new options are to facilitate increased levels of consistent testing among young, Black MSM and

  20. Preferences for HIV test characteristics among young, Black Men Who Have Sex With Men (MSM) and transgender women: Implications for consistent HIV testing.

    Science.gov (United States)

    Frye, Victoria; Wilton, Leo; Hirshfield, Sabina; Chiasson, Mary Ann; Lucy, Debbie; Usher, DaShawn; McCrossin, Jermaine; Greene, Emily; Koblin, Beryl

    2018-01-01

    Promoting consistent HIV testing is critical among young, Black Men Who Have Sex With Men (MSM) and transgender women who are overrepresented among new HIV cases in the United States. New HIV test options are available, including mobile unit testing, one-minute testing, at home or self-testing and couples HIV testing and counseling (CHTC). In the context of these newer options, the objective of this study was to explore whether and how preferences for specific characteristics of the tests acted as barriers to and/or facilitators of testing in general and consistent testing specifically among young Black MSM and transgender women aged 16 to 29. We conducted 30 qualitative, semi-structured, in-depth interviews with young, Black, gay, bisexual or MSM and transgender women in the New York City metropolitan area to identify preferences for specific HIV tests and aspects of HIV testing options. Participants were primarily recruited from online and mobile sites, followed by community-based, face-to-face recruitment strategies to specifically reach younger participants. Thematic coding was utilized to analyze the qualitative data based on a grounded theoretical approach. We identified how past experiences, perceived test characteristics (e.g., accuracy, cost, etc.) and beliefs about the "fit" between the individual, and the test relate to preferred testing methods and consistent testing. Three major themes emerged as important to preferences for HIV testing methods: the perceived accuracy of the test method, venue characteristics, and lack of knowledge or experience with the newer testing options, including self-testing and CHTC. These findings suggest that increasing awareness of and access to newer HIV testing options (e.g., free or reduced price on home or self-tests or CHTC available at all testing venues) is critical if these new options are to facilitate increased levels of consistent testing among young, Black MSM and transgender women. Addressing perceptions of

  1. Preferences for HIV test characteristics among young, Black Men Who Have Sex With Men (MSM and transgender women: Implications for consistent HIV testing.

    Directory of Open Access Journals (Sweden)

    Victoria Frye

    Full Text Available Promoting consistent HIV testing is critical among young, Black Men Who Have Sex With Men (MSM and transgender women who are overrepresented among new HIV cases in the United States. New HIV test options are available, including mobile unit testing, one-minute testing, at home or self-testing and couples HIV testing and counseling (CHTC. In the context of these newer options, the objective of this study was to explore whether and how preferences for specific characteristics of the tests acted as barriers to and/or facilitators of testing in general and consistent testing specifically among young Black MSM and transgender women aged 16 to 29.We conducted 30 qualitative, semi-structured, in-depth interviews with young, Black, gay, bisexual or MSM and transgender women in the New York City metropolitan area to identify preferences for specific HIV tests and aspects of HIV testing options. Participants were primarily recruited from online and mobile sites, followed by community-based, face-to-face recruitment strategies to specifically reach younger participants. Thematic coding was utilized to analyze the qualitative data based on a grounded theoretical approach.We identified how past experiences, perceived test characteristics (e.g., accuracy, cost, etc. and beliefs about the "fit" between the individual, and the test relate to preferred testing methods and consistent testing. Three major themes emerged as important to preferences for HIV testing methods: the perceived accuracy of the test method, venue characteristics, and lack of knowledge or experience with the newer testing options, including self-testing and CHTC.These findings suggest that increasing awareness of and access to newer HIV testing options (e.g., free or reduced price on home or self-tests or CHTC available at all testing venues is critical if these new options are to facilitate increased levels of consistent testing among young, Black MSM and transgender women. Addressing

  2. HIV prevalence, risky behaviors, and discrimination experiences among transgender women in Cambodia: descriptive findings from a national integrated biological and behavioral survey.

    Science.gov (United States)

    Yi, Siyan; Ngin, Chanrith; Tuot, Sovannary; Chhoun, Pheak; Chhim, Srean; Pal, Khuondyla; Mun, Phalkun; Mburu, Gitau

    2017-05-23

    of HIV, STI, and related risk behaviors among transgender women in Cambodia is of great concern, suggesting an urgent need to further expand tailored prevention interventions for this key population focusing on individual, social, and structural drivers of HIV. HIV self-test and PrEP should be explored as a priority.

  3. Is Type 1 Diabetes Mellitus More Prevalent Than Expected in Transgender Persons? A Local Observation.

    Science.gov (United States)

    Defreyne, Justine; De Bacquer, Dirk; Shadid, Samyah; Lapauw, Bruno; T'Sjoen, Guy

    2017-09-01

    The International Diabetes Federation estimates that approximately 0.4% of the Belgian population is diagnosed with type 1 diabetes mellitus, which is similar to other industrialized countries. The prevalence of transgenderism is estimated at 0.6% to 0.7% of all adults in Western populations. In this study, we evaluated whether there was an increased prevalence of type 1 diabetes mellitus in transgender people in the local cohort. Medical records of transgender patients were analyzed retrospectively. From January 1, 2007 until October 10, 2016, 1,081 transgender patients presented at a tertiary reference center to start hormonal treatment. Nine of these 1,081 patients were previously diagnosed with type 1 diabetes mellitus and 1 was diagnosed with latent autoimmune diabetes in adults. A 2.3-fold higher prevalence of type 1 diabetes mellitus was observed in transgender patients. We concluded that type 1 diabetes mellitus was more prevalent in transgender patients than one would expect from population prevalences. This could be a spurious result in a local cohort, because a causal relation seems unlikely, but our finding might encourage other centers to investigate this putative association. Defreyne J, De Bacquer D, Shadid S, et al. Is Type 1 Diabetes Mellitus More Prevalent Than Expected in Transgender Persons? A Local Observation. Sex Med 2017;5:e215-e218. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Barriers in the social and healthcare assistance for transgender persons: A systematic review of qualitative studies.

    Science.gov (United States)

    Aylagas-Crespillo, Marina; García-Barbero, Óscar; Rodríguez-Martín, Beatriz

    2017-11-01

    To explore the barriers to requesting social and healthcare assistance perceived by transgender persons and professionals involved in the assistance. A meta-study, qualitative systematic review, of studies published in English or Spanish, exploring the barriers, perceived by transgender persons and social and healthcare professionals, that transgender persons have when they seek social and healthcare assistance was carried out in the following databases Medline (PubMed), Scopus, Web of Science, Spanish National Research Council, CUIDEN, ProQuest, PsycINFO and CINAHL. Two thousand two hundred and sixty-one articles were found in the databases searched. Seven articles met all inclusion criteria and were included in this review. The professionals highlight the uncertainty when treating transgender persons and their lack of training. Transgender persons highlight the lack of information and the sense of helplessness it creates. Perceptions of transphobia, the fragmentation of services, administrative barriers, the lack of cultural sensitivity and professional training are also considered barriers to assistance. The findings of this study provide key information for the design of plans and programmes to improve the quality of social and health care for transgender persons. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. Sexual HIV risk among gay, bisexual and queer transgender men: findings from interviews in Vancouver, Canada.

    Science.gov (United States)

    Rich, Ashleigh; Scott, Kai; Johnston, Caitlin; Blackwell, Everett; Lachowsky, Nathan; Cui, Zishan; Sereda, Paul; Moore, David; Hogg, Robert; Roth, Eric

    2017-11-01

    Gay, bisexual, queer and other men who have sex with men are disproportionately affected by HIV in Canada. While up to 63% of transgender men identify as gay, bisexual or queer and report a variety of HIV sexual risk behaviours, transgender men are often overlooked within epidemiological HIV surveillance and research. While a growing body of research has begun to examine sexual risk for transgender gay, bisexual and queer men, most studies have been conducted in the USA. This study explored sexual HIV risk for this population in the Canadian context, specifically in British Columbia, in an environment of publically funded universal access to healthcare, including HIV testing and treatment. We conducted interviews with 11 gay, bisexual and queer transgender men. Participants' narratives suggest that HIV risk for these transgender men is shaped by a diversity of sexual behaviours, including inconsistent condom use, seeking partners online for greater safety and accessing HIV/STI testing and other healthcare services despite facing transition-related barriers. Public health prevention and health education must recognise the presence of transgender men and ensure health services and broader population health promotion meet the unique sexual health needs of this sub-population of gay, bisexual and queer men.

  6. Transgender inclusion in state non-discrimination policies: The democratic deficit and political powerlessness

    Directory of Open Access Journals (Sweden)

    Andrew R Flores

    2015-10-01

    Full Text Available Transgender people—people whose gender identity or expression is different from their assigned sex at birth—and their allies advocate for the inclusion of gender identity or transgender in state non-discrimination policies. These policies generally proscribe discrimination in employment, housing, and public accommodations. Courts and administrative agencies have determined discrimination against transgender people is a violation of existing statutes, but there remain efforts by advocates to seek policies that explicitly prohibit discrimination on the basis of transgender status, which are often the result of legislation going through the political process. A pluralist understanding of the political process theorizes that a majority coalition of minorities can offer social groups policies they support. This rests on the presumption that a majority coalition of minorities should rule. Any indication to the contrary may suggest a democratic deficit, whereby more than a majority is necessary for policy introduction. We find that there is a substantial democratic deficit regarding the inclusion of gender identity or transgender in employment non-discrimination policies. On average, state support for the policy must be 81% in order for the state to have a policy reflecting such sentiment. This leaves substantial implications for the political powerlessness of transgender people in the political process.

  7. Transgender Health Care for Nurses: An Innovative Approach to Diversifying Nursing Curricula to Address Health Inequities.

    Science.gov (United States)

    McDowell, Alex; Bower, Kelly M

    2016-08-01

    Transgender people experience high rates of discrimination in health care settings, which is linked to decreases in physical and mental wellness. By increasing the number of nurses who are trained to deliver high-quality care to transgender patients, health inequities associated with provider discrimination can be mitigated. At present, baccalaureate nursing curricula do not adequately prepare nurses to care for transgender people, which is a shortcoming that has been attributed to limited teaching time and lack of guidance regarding new topics. We developed transgender health content for students in a baccalaureate nursing program and used a student-faculty partnership model to integrate new content into the curriculum. We incorporated new transgender health content into five required courses over three semesters. We mitigated common barriers to developing and integrating new, diversity-related topics into a baccalaureate nursing curriculum. Added transgender health content was well received by students and faculty. [J Nurs Educ. 2016;55(8):476-479.]. Copyright 2016, SLACK Incorporated.

  8. LGB within the T: Sexual Orientation in the National Transgender Discrimination Survey and Implications for Public Policy

    OpenAIRE

    Herman, Jody

    2016-01-01

    This book chapter examines sexual orientation and discrimination experienced by transgender people, using data from the National Transgender Discrimination Survey. This study explores how respondents to the NTDS identified their sexual orientation, how those responses differ based on demographic variables (e.g. age, race, and gender), and how respondents’ experiences of discrimination and outcomes differ based on sexual orientation. The study finds that only 22% of transgender respondents ide...

  9. Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth

    Science.gov (United States)

    Russell, Stephen T.; Fish, Jessica N.

    2016-01-01

    Today’s lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be at high risk for compromised mental health? We provide an overview of the contemporary context for LGBT youth, followed by a review of current science on LGBT youth mental health. Research in the past decade has identified risk and protective factors for mental health, which point to promising directions for prevention, intervention, and treatment. Legal and policy successes have set the stage for advances in programs and practices that may foster LGBT youth mental health. Implications for clinical care are discussed, and important areas for new research and practice are identified. PMID:26772206

  10. Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth.

    Science.gov (United States)

    Russell, Stephen T; Fish, Jessica N

    2016-01-01

    Today's lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be at high risk for compromised mental health? We provide an overview of the contemporary context for LGBT youth, followed by a review of current science on LGBT youth mental health. Research in the past decade has identified risk and protective factors for mental health, which point to promising directions for prevention, intervention, and treatment. Legal and policy successes have set the stage for advances in programs and practices that may foster LGBT youth mental health. Implications for clinical care are discussed, and important areas for new research and practice are identified.

  11. Exploring transgender legal name change as a potential structural intervention for mitigating social determinants of health among transgender women of color.

    Science.gov (United States)

    Hill, Brandon J; Crosby, Richard; Bouris, Alida; Brown, Rayna; Bak, Trevor; Rosentel, Kris; VandeVusse, Alicia; Silverman, Michael; Salazar, Laura

    2018-03-01

    The purpose of this exploratory study was to examine the effects of legal name change on socioeconomic factors, general and transgender-related healthcare access and utilization, and transgender-related victimization in a sample of young transgender women (transwomen) of color. A cross-sectional group comparison approach was used to assess the potential effects of legal name change. A convenience sample of young transwomen enrolled in a no-cost legal name change clinic were recruited to complete a 30-minute interviewer-guided telephone survey including sociodemographic and socioeconomic factors, health and well-being, health care utilization, transgender transition-related health care, and transgender-related victimization. Sixty-five transgender women of color (37 = pre-name change group; 28 = post-name change group) completed the survey. Results indicated that the transwomen in the post-name change group were significantly older than the pre-name change group. In age-adjusted analyses, the post-name change group was significantly more likely to have a higher monthly income and stable housing than the pre-name change group. No significant differences were observed for general healthcare utilization; however, a significantly greater percentage of transwomen in the pre-name change group reported postponing medical care due to their gender identity. In addition, a significantly larger proportion of transwomen in the pre-name change group reported using non-prescribed hormones injected by friends and experiencing verbal harassment by family and friends compared to transwomen in the post-name change group. Findings suggest that legal name change may be an important structural intervention for low-income transwomen of color, providing increased socioeconomic stability and improved access to primary and transition-related health care.

  12. The Levels and Predictors of Physical Activity Engagement Within the Treatment-Seeking Transgender Population: A Matched Control Study.

    Science.gov (United States)

    Jones, Bethany Alice; Haycraft, Emma; Bouman, Walter Pierre; Arcelus, Jon

    2018-02-01

    Physical activity has been found to alleviate mental health problems and could be beneficial for at-risk populations, such as transgender people. This study had 3 aims. First, to explore the amount of physical activity that treatment-seeking transgender people engage in and to compare this to matched cisgender people. Second, to determine whether there was a difference in physical activity depending on cross-sex hormone use. Third, to determine factors that predict physical activity among treatment-seeking transgender people. Transgender (n = 360) and cisgender people (n = 314) were recruited from the United Kingdom. Participants were asked to complete questionnaires about physical activity, symptoms of anxiety and depression, self-esteem, body satisfaction, and transphobia. Transgender people engaged in less physical activity than cisgender people. Transgender people who were on cross-sex hormone treatment engaged in more physical activity than transgender people who were not. In transgender people on cross-sex hormones, high body satisfaction was the best statistical predictor of physical activity, whereas high self-esteem was the best statistical predictor in people who were not. Transgender people are less active than cisgender people. Cross-sex hormone treatment appears to be able to indirectly increase physical activity within this population, which may be beneficial for mental well-being.

  13. Latino men who have sex with transgender women: the influence of heteronormativity, homonegativity and transphobia on gender and sexual scripts.

    Science.gov (United States)

    Muñoz-Laboy, Miguel; Severson, Nicolette; Levine, Ethan; Martínez, Omar

    2017-09-01

    Latino men who have sex with transgender women make up an overlooked sector of the population that requires more attention than is currently given in sexuality and gender studies, particularly in regard to their non-commercial, long-term sexual and romantic relationships with transgender women. Sixty-one sexual histories were selected for this qualitative analysis from a larger study on Latino male bisexuality in the New York City metropolitan area. Findings suggest that participants' sexual and gender scripts with transgender women are strongly regulated by heteronormativity. Furthermore, homonegativity and transphobia often intersect in the lived experiences of men who have sex with transgender women, resulting in relationship conflicts over the control of transgender women's bodies, sexual behaviours and gender performance both in public and in private. Findings also suggest that low relationship conflict is more common among men who have sex with transgender women who exhibit diverse sexual roles (being both insertive and receptive during anal sex), or transgress heteronormative scripts through dialogue of desires and/or by embracing transgender women as human beings and not as hyperfeminised objects of desire. Stigma reduction and alternatives to heteronormative interventions are needed to improve relationship dynamics and potentially positively impact on the sexual health and overall wellbeing of Latino men who have sex with transgender women and their transgender partners.

  14. Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death

    Directory of Open Access Journals (Sweden)

    Rikke Kildevæld Simonsen, MA

    2016-03-01

    Conclusion: Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality.

  15. Stigma and Minority Stress as Social Determinants of Health Among Lesbian, Gay, Bisexual, and Transgender Youth: Research Evidence and Clinical Implications.

    Science.gov (United States)

    Hatzenbuehler, Mark L; Pachankis, John E

    2016-12-01

    In this article, we review theory and evidence on stigma and minority stress as social/structural determinants of health among lesbian, gay, bisexual, and transgender (LGBT) youth. We discuss different forms of stigma at individual (eg, identity concealment), interpersonal (eg, victimization), and structural (eg, laws and social norms) levels, as well as the mechanisms linking stigma to adverse health outcomes among LGBT youth. Finally, we discuss clinical (eg, cognitive behavioral therapy) and public health (eg, antibullying policies) interventions that effectively target stigma-inducing mechanisms to improve the health of LGBT youth. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. The conflation of gender and sex: Gaps and opportunities in HIV data among transgender women and MSM.

    Science.gov (United States)

    Poteat, Tonia; German, Danielle; Flynn, Colin

    2016-01-01

    Historically, HIV studies have conflated men who have sex with men (MSM) with transgender (trans) women, explicitly excluded trans individuals, or included sample sizes of trans people that are too small to reach meaningful conclusions. Despite the heavy burden of HIV among trans women, conflation of this population with MSM has limited the information available on the social and behavioural factors that increase HIV vulnerability among trans women and how these factors may differ from MSM. Using data sets from quantitative studies among MSM (n = 645) and trans women (n = 89), as well as qualitative in-depth interviews with 30 trans women in Baltimore, we explore what these data tell us about similarities and differences in HIV vulnerability between the two groups and where they leave gaps in our understanding. We conclude with implications for data collection and intervention development.

  17. Keeping the Community Posted: Lesbian, Gay, Bisexual, and Transgender Blogs and the Tobacco Epidemic.

    Science.gov (United States)

    Lee, Joseph G L

    2014-06-01

    Lesbian, gay, bisexual, and transgender (LGBT) people are more likely to use tobacco products than heterosexual people. This results in disproportionate death and disability for LGBT communities. Yet, addressing the tobacco epidemic is generally low on the agenda of LGBT community organizations, and LGBT individuals report lower levels of support for some evidence-based tobacco prevention and control policies than heterosexuals. Informed by agenda-setting theory, this study investigated coverage of the tobacco epidemic in LGBT news blogs. Sixteen blogs and 105 tobacco-related posts from 2003 to March 9, 2013, were identified, and a quantitative content analysis was conducted. Coverage of the tobacco epidemic was primarily concentrated in four blogs and focused on the epidemiology of the epidemic and on tobacco-related policies. Little coverage focused on the tobacco industry, addiction, or health effects. A substantial minority of coverage focused on socially conservative arguments comparing smoking to homosexuality as a lifestyle choice. Thirty-three organizations working on LGBT tobacco prevention and control were present in blog posts. LGBT news blogs have a potentially important and mostly untapped role in tobacco-related media advocacy. LGBT health advocates would do well to cultivate relationships with LGBT bloggers as well as include bloggers in dissemination and media strategy efforts.

  18. Lesbian, gay, bisexual, and transgender (LGBT) physicians' experiences in the workplace.

    Science.gov (United States)

    Eliason, Michele J; Dibble, Suzanne L; Robertson, Patricia A

    2011-01-01

    Little is known about the experiences of lesbian, gay, bisexual, and transgender (LGBT) physicians in the workplace. There is little formal education in medical school about LGBT issues, and some heterosexual physicians have negative attitudes about caring for LGBT patients or working with LGBT coworkers, setting the stage for an exclusive and unwelcoming workplace. The current study used an online survey to assess a convenience sample of 427 LGBT physicians from a database of a national LGBT healthcare organization, as well as a snowball sample generated from the members of the database. Although rates of discriminatory behaviors had decreased since earlier reports, 10% reported that they were denied referrals from heterosexual colleagues, 15% had been harassed by a colleague, 22% had been socially ostracized, 65% had heard derogatory comments about LGBT individuals, 34% had witnessed discriminatory care of an LGBT patient, 36% had witnessed disrespect toward an LGBT patient's partner, and 27% had witnessed discriminatory treatment of an LGBT coworker. Few had received any formal education on LGBT issues in medical school or residency. It appears that medical schools and health care workplaces continue to ignore LGBT issues and operate in discriminatory fashion far too often.

  19. Health Concerns of Transgender and Gender Nonconforming Youth and Their Parents Upon Presentation to a Transgender Clinic.

    Science.gov (United States)

    Lawlis, Shauna M; Donkin, Hillary R; Bates, Justin R; Britto, Maria T; Conard, Lee Ann E

    2017-11-01

    The purpose of the study was to determine the frequency of specific health concerns identified by transgender and gender nonconforming patients and their parents at initial clinic visit. Checklists were developed in an iterative process and distributed to both patients and parents at their initial visit to a transgender clinic. Retrospective chart review and secondary data analyses were performed to determine the number of items endorsed, frequency with which each item was endorsed, and provider domain of each item endorsed: physician, social work, or both physician and social work. Checklists were collected from 118 patients and 103 parents. Patients endorsed a mean of 8.4 concerns (range 0-22) and parents 7.9 concerns (range 0-20). The most commonly endorsed patient concerns included use of gender-affirming hormones, steps for transition, gender-affirming surgery, restroom/dressing room use, and legal issues. Common parent concerns included general resources, child safety at school, acute mental health concerns, restroom/dressing room use, and steps for transition. Of the concerns endorsed by patients, 44% were in the social work domain, 37% in the physician domain, and 19% in both the social work and physician domain. Of the concerns endorsed by parents, 40% were in the social work domain, 31% in the physician domain, and 29% in the social work and physician domain. Although patients and parents had similar numbers of concerns, they primarily focused on different topics. Youth were more interested in hormones and transition, while parents were more interested with transition and acceptance. Many concerns for both patients and parents fell within the social work domain. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Implementation and Evaluation of a Pilot Training to Improve Transgender Competency Among Medical Staff in an Urban Clinic.

    Science.gov (United States)

    Lelutiu-Weinberger, Corina; Pollard-Thomas, Paula; Pagano, William; Levitt, Nathan; Lopez, Evelyn I; Golub, Sarit A; Radix, Asa E

    2016-01-01

    Purpose: Transgender individuals (TGI), who identify their gender as different from their sex assigned at birth, continue facing widespread discrimination and mistreatment within the healthcare system. Providers often lack expertise in adequate transgender (TG) care due to limited specialized training. In response to these inadequacies, and to increase evidence-based interventions effecting TG-affirmative healthcare, we implemented and evaluated a structural-level intervention in the form of a comprehensive Provider Training Program (PTP) in TG health within a New York City-based outpatient clinic serving primarily individuals of color and of low socioeconomic status. This pilot intervention aimed to increase medical staff knowledge of TG health and needs, and to support positive attitudes toward TGI. Methods: Three 2-h training sessions were delivered to 35 clinic staff across 4 months by two of the authors experienced in TG competency training; the training sessions included TG-related identity and barriers to healthcare issues, TG-specialized care, and creating TG-affirmative environments, medical forms, and billing procedures. We evaluated changes through pre-post intervention surveys by trainees. Results: Compared to pre-training scores, post-training scores indicated significant (1) decreases in negative attitudes toward TGI and increases in TG-related clinical skills, (2) increases in staff's awareness of transphobic practices, and (3) increases in self-reported readiness to serve TGI. The clinic increased its representation of general LGBT-related images in the waiting areas, and the staff provided highly positive training evaluations. Conclusion: This PTP in TG health shows promise in leading to changes in provider attitudes and competence, as well as clinic systems, especially with its incorporation in continuing education endeavors, which can, in turn, contribute to health disparities reductions among TG groups.

  1. Sex Partnership and Self-Efficacy Influence Depression in Chinese Transgender Women: A Cross-Sectional Study.

    Science.gov (United States)

    Yang, Xiaoshi; Wang, Lie; Hao, Chun; Gu, Yuan; Song, Wei; Wang, Jian; Chang, Margaret M; Zhao, Qun

    2015-01-01

    Transgender women often suffer from transition-related discrimination and loss of social support due to their gender transition, which may pose considerable psychological challenges and may lead to a high prevalence of depression in this population. Increased self-efficacy may combat the adverse effects of gender transition on depression. However, few available studies have investigated the protective effect of self-efficacy on depression among transgender women, and there is a scarcity of research describing the mental health of Chinese transgender women. This study aims to describe the prevalence of depression among Chinese transgender women and to explore the associated factors. A cross-sectional study was conducted in Shenyang, Liaoning Province of China by convenience sampling from January 2014 to July 2014. Two hundred and nine Chinese transgender women were interviewed face-to-face with questionnaires that covered topics including the Zung Self-Rating Depression Scale (SDS), demographic characteristics, transition status, sex partnership, perceived transgender-related discrimination, the Multidimensional Scale of Perceived Social Support (MSPSS) and the adapted General Self-efficacy Scale (GSES). A hierarchical multiple regression analysis was performed to explore the factors associated with SDS scores. The prevalence of depression among transgender women was 45.35%. Transgender women with regular partners or casual partners exhibited higher SDS scores than those without regular partners or casual partners. Regression analyses showed that sex partnership explained most (16.6%) of the total variance in depression scores. Self-efficacy was negatively associated with depression. Chinese transgender women experienced high levels of depression. Depression was best predicted by whether transgender women had a regular partner or a casual partner rather than transgender-related discrimination and transition status. Moreover, self-efficacy had positive effects on

  2. Transgender women in Malaysia, in the context of HIV and Islam: a qualitative study of stakeholders' perceptions.

    Science.gov (United States)

    Barmania, Sima; Aljunid, Syed Mohamed

    2017-10-18

    Globally, one of the key groups considered to be at high risk of acquiring HIV are transgender women, often a marginalised group. In the Malaysian context there has been a scarcity of published research relating to transgender women, a sensitive issue in a Muslim majority country, where Islam plays an influential role in society. Furthermore, there has been a paucity of research relating to how such issues relate to HIV prevention in transgender women in Malaysia. Thus, the aim of this study is to explore the attitudes of stakeholders involved in HIV prevention policy in Malaysia towards transgender women, given the Islamic context. In-depth interviews were undertaken with stakeholders involved in HIV prevention, Ministry of Health, Religious Leaders and People Living with HIV, including transgender women. Thirty five participants were recruited using purposive sampling from June to December 2013 within Kuala Lumpur and surrounding vicinities. Interviews were in person, audiotaped, transcribed verbatim and used a framework analysis. Five central themes emerged from the qualitative data; Perceptions of Transgender women and their place in Society; Reaching out to Transgender Women; Islamic doctrine; 'Cure', 'Correction' and finally, Stigma and Discrimination. Islamic rulings about transgenderism were often the justification given by participants chastising transgender women, whilst there were also more progressive attitudes and room for debate. Pervasive negative attitudes and stigma and discrimination created a climate where transgender women often felt more comfortable with non-governmental organisations. The situation of transgender women in Malaysia and HIV prevention is a highly sensitive and challenging environment for all stakeholders, given the Muslim context and current legal system. Despite this apparent impasse, there are practically achievable areas that can be improved upon to optimise HIV prevention services and the environment for transgender women in

  3. An Invaluable Resource for Supporting Transgender, Transsexual, and Gender-Nonconforming Students in School Communities: A Review of "Supporting Transgender and Transsexual Students in K-12 Schools"

    Science.gov (United States)

    Martino, Wayne

    2013-01-01

    This essay provides a review of a resource guide written by Kristopher Wells, Gayle Roberts, and Carol Allan (2012) titled "Supporting Transgender and Transsexual Students in K-12 Schools: A Guide for Educators". The guide is an invaluable resource for educators in schools and teacher education programs.

  4. Testosterone treatment and MMPI-2 improvement in transgender men: a prospective controlled study.

    Science.gov (United States)

    Keo-Meier, Colton L; Herman, Levi I; Reisner, Sari L; Pardo, Seth T; Sharp, Carla; Babcock, Julia C

    2015-02-01

    Most transgender men desire to receive testosterone treatment in order to masculinize their bodies. In this study, we aimed to investigate the short-term effects of testosterone treatment on psychological functioning in transgender men. This is the 1st controlled prospective follow-up study to examine such effects. We examined a sample of transgender men (n = 48) and nontransgender male (n = 53) and female (n = 62) matched controls (mean age = 26.6 years; 74% White). We asked participants to complete the Minnesota Multiphasic Personality Inventory (2nd ed., or MMPI-2; Butcher, Graham, Tellegen, Dahlstrom, & Kaemmer, 2001) to assess psychological functioning at baseline and at the acute posttreatment follow-up (3 months after testosterone initiation). Regression models tested (a) Gender × Time interaction effects comparing divergent mean response profiles across measurements by gender identity; (b) changes in psychological functioning scores for acute postintervention measurements, adjusting for baseline measures, comparing transgender men with their matched nontransgender male and female controls and adjusting for baseline scores; and (c) changes in meeting clinical psychopathological thresholds. Statistically significant changes in MMPI-2 scale scores were found at 3-month follow-up after initiating testosterone treatment relative to baseline for transgender men compared with female controls (female template): reductions in Hypochondria (p < .05), Depression (p < .05), Hysteria (p < .05), and Paranoia (p < .01); and increases in Masculinity-Femininity scores (p < .01). Gender × Time interaction effects were found for Hysteria (p < .05) and Paranoia (p < .01) relative to female controls (female template) and for Hypochondria (p < .05), Depression (p < .01), Hysteria (p < .01), Psychopathic Deviate (p < .05), Paranoia (p < .01), Psychasthenia (p < .01), and Schizophrenia (p < .01) compared with male controls (male template). In addition, the proportion of

  5. Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons.

    Science.gov (United States)

    Burgess, Diana; Tran, Alisia; Lee, Richard; van Ryn, Michelle

    2007-01-01

    Previous research has found that lesbian, gay, bisexual and transgender (LGBT) individuals are at risk for a variety of mental health disorders. We examined the extent to which a recent experience of a major discriminatory event may contribute to poor mental health among LGBT persons. Data were derived from a cross-sectional strata-cluster survey of adults in Hennepin County, Minnesota, who identified as LGBT (n=472) or heterosexual (n=7,412). Compared to heterosexuals, LGBT individuals had poorer mental health (higher levels of psychological distress, greater likelihood of having a diagnosis of depression or anxiety, greater perceived mental health needs, and greater use of mental health services), more substance use (higher levels of binge drinking, greater likelihood of being a smoker and greater number of cigarettes smoked per day), and were more likely to report unmet mental healthcare needs. LGBT individuals were also more likely to report having experienced a major incident of discrimination over the past year than heterosexual individuals. Although perceived discrimination was associated with almost all of the indicators of mental health and utilization of mental health care that we examined, adjusting for discrimination did not significantly reduce mental health disparities between heterosexual and LGBT persons. LGBT individuals experienced more major discrimination and reported worse mental health than heterosexuals, but discrimination did not account for this disparity. Future research should explore additional forms of discrimination and additional stressors associated with minority sexual orientation that may account for these disparities.

  6. Supporting and caring for transgender and gender nonconforming youth in the urology practice.

    Science.gov (United States)

    Conard, L E

    2017-06-01

    Gender identity is a person's internal sense of gender, which may be different than the sex they were assigned at birth. Pediatric urologists are starting to see more transgender and gender non-conforming (TGN) youth and need to be able to provide culturally competent and appropriate care for these patients and their caregivers. This review will discuss common transgender terminology, specific health concerns and treatment options. A systematic literature review was performed on Medline ® , PubMed ® , and Google Scholar™ for key words transgender, gender dysphoria and gender identity disorder. Original research articles and relevant reviews were examined as well as transgender treatment guidelines from several organizations. These studies and expert opinion are summarized in this review. In this rapidly growing area of medicine, there is very little literature and few evidence-based studies. Treatment guidelines are based on small studies and expert opinion. Transgender and gender nonconforming youth are at high risk for mental health concerns and other health disparities based on their gender identity. Pediatric urologists can create a safe and welcoming environment for these patients and their caregivers to discuss these matters. Providers who are able to provide competent care for TGN youth can improve outcomes for this group. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  7. Insuring Care: Paperwork, Insurance Rules, and Clinical Labor at a U.S. Transgender Clinic.

    Science.gov (United States)

    van Eijk, Marieke

    2017-12-01

    What is a clinician to do when people needing medical care do not have access to consistent or sufficient health insurance coverage and cannot pay for care privately? Analyzing ethnographically how clinicians at a university-based transgender clinic in the United States responded to this challenge, I examine the U.S. health insurance system, insurance paperwork, and administrative procedures that shape transgender care delivery. To buffer the impact of the system's failure to provide sufficient health insurance coverage for transgender care, clinicians blended administrative routines with psychological therapy, counseled people's minds and finances, and leveraged the prestige of their clinic in attempts to create space for gender nonconforming embodiments in gender conservative insurance policies. My analysis demonstrates that in a market-based health insurance system with multiple payers and gender binary insurance rules, health care may be unaffordable, or remain financially challenging, even for transgender people with health insurance. Moreover, insurance carriers' "reliance" on clinicians' insurance-related labor is problematic as it exacerbates existing insurance barriers to the accessibility and affordability of transgender care and obscures the workings of a financial payment model that prioritizes economic expediency over gender nonconforming health.

  8. Adult Development and Quality of Life of Transgender and Gender Nonconforming People

    Science.gov (United States)

    Bockting, Walter; Coleman, Eli; Deutsch, Madeline B.; Guillamon, Antonio; Meyer, Ilan; Meyer, Walter; Reisner, Sari; Sevelius, Jae; Ettner, Randi

    2016-01-01

    Purpose of review Research on the health of transgender and gender nonconforming people has been limited with most of the work focusing on transition-related care and HIV. This review summarizes research to date on the overall development and quality of life of transgender and gender nonconforming adults, and makes recommendations for future research. Recent findings Pervasive stigma and discrimination attached to gender nonconformity affect the health of transgender people across the lifespan, particularly when it comes to mental health and wellbeing. Despite the related challenges, transgender and gender nonconforming people may develop resilience over time. Social support and affirmation of gender identity play herein a critical role. While there is a growing awareness of diversity in gender identity and expression among this population, a comprehensive understanding of biopsychosocial development beyond the gender binary and beyond transition is lacking. Summary Greater visibility of transgender people in society has revealed the need to understand and promote their health and quality of life broadly, including but not limited to gender dysphoria and HIV. This means addressing their needs in context of their families and communities, sexual and reproductive health, and successful aging. Research is needed to better understand what factors are associated with resilience and how it can be effectively promoted. PMID:26835800

  9. Contesting heteronormativity: the fight for lesbian, gay, bisexual and transgender recognition in India and Vietnam.

    Science.gov (United States)

    Horton, Paul; Rydstrøm, Helle; Tonini, Maria

    2015-01-01

    Recent public debates about sexuality in India and Vietnam have brought the rights of lesbian, gay, bisexual and transgender people sharply into focus. Drawing on legal documents, secondary sources and ethnographic fieldwork conducted in the urban centres of Delhi and Hanoi, this article shows how the efforts of civil society organisations dedicated to the fight for lesbian, gay, bisexual and transgender rights have had different consequences in these two Asian contexts. The paper considers how these organisations navigated government regulations about their formation and activities, as well as the funding priorities of national and international agencies. The HIV epidemic has had devastating consequences for gay men and other men who have sex with men, and has been highly stigmatising. As a sad irony, the epidemic has provided at the same time a strategic entry point for organisations to struggle for lesbian, gay, bisexual and transgender recognition. This paper examines how the fight for lesbian, gay, bisexual and transgender recognition has been doubly framed through health-based and rights-based approaches and how the struggle for recognition has positioned lesbian, gay, bisexual and transgender people in India and Vietnam differently.

  10. ENAM KONTINUM DALAM KONSELING TRANSGENDER SEBAGAI ALTERNATIF SOLUSI UNTUK KONSELI LGBT

    Directory of Open Access Journals (Sweden)

    Khilman Rofi Azmi

    2015-06-01

    Full Text Available ABSTRACT Globalization caused by modern and dynamic society, creates several kinds of concepts, terms, and new theories today. The development in psychological science, and guidance and counseling are indicators of science development. Society problems come from the result of the change from that society, for example modern lifestyle that gives positive and negative impact. Transgender, gay, and lesbian phenomenon is one of the alternative lifestyle that spreads in Indonesia which is experienced by teenagers. It creates new problem for teenagers, their family, and their surroundings. The biggest problem in this case is there’s no specific step for counselor and psychiatrist to help transgender, gay, or lesbian counselee. The new concept that offered in this article is  Six Continuum of Transgender Counseling. Six continuum are aimed to give direction for counselor  that may help gay, lesbian, and transgender counselee by doing counseling. Six continuum that have to be passed by counselor are (1 self, (2 relationship, (3 differential of feeling, (4 spiritual intervention, (5 acceptance of environment. Researchers are using literature study as their research method, by explored and examined some literatures: books, journal, dissertation, e-book, and some cases that happened in our society. This article especially developed and inspired by previous article. The article’s tittle is Transgender Counseling Through (Wisdom-Oriented Counseling Approach.

  11. Dinner and a Conversation: Transgender Integration at West Point and Beyond

    Directory of Open Access Journals (Sweden)

    Morten G. Ender

    2017-03-01

    Full Text Available In 2016, the United States military lifted the ban on transgender members serving and are expected to begin accessions of transgender service members in 2017. A paucity of research exists on transgender matters in the military, especially on attitudes towards cisgender service members. This study deploys a qualitative methodology, comprised of 21 focus groups of undergraduate cadets and advanced schooled Army officers (N = 110, at the United States Military Academy at West Point, New York, using a semi-structured interview protocol. Overall, a diversity of experiences and familiarity with transgender people surfaced among cadets and officers. We distinguish between experiences and familiarity on a spectrum by introducing notions of transgender tourism and cosmopolitanism. Major concerns associated with (uncomfortableness emerged from the focus groups including privacy, physical standards, well-being, and costs. Interventions are offered by the participants based on their major concerns. We recommend education, increased cosmopolitism, privacy considerations, narrowing the civil-military propinquity gap, and more studies of diversity and inclusion issues in the military.

  12. Adult development and quality of life of transgender and gender nonconforming people.

    Science.gov (United States)

    Bockting, Walter; Coleman, Eli; Deutsch, Madeline B; Guillamon, Antonio; Meyer, Ilan; Meyer, Walter; Reisner, Sari; Sevelius, Jae; Ettner, Randi

    2016-04-01

    Research on the health of transgender and gender nonconforming people has been limited with most of the work focusing on transition-related care and HIV. The present review summarizes research to date on the overall development and quality of life of transgender and gender nonconforming adults, and makes recommendations for future research. Pervasive stigma and discrimination attached to gender nonconformity affect the health of transgender people across the lifespan, particularly when it comes to mental health and well-being. Despite the related challenges, transgender and gender nonconforming people may develop resilience over time. Social support and affirmation of gender identity play herein a critical role. Although there is a growing awareness of diversity in gender identity and expression among this population, a comprehensive understanding of biopsychosocial development beyond the gender binary and beyond transition is lacking. Greater visibility of transgender people in society has revealed the need to understand and promote their health and quality of life broadly, including but not limited to gender dysphoria and HIV. This means addressing their needs in context of their families and communities, sexual and reproductive health, and successful aging. Research is needed to better understand what factors are associated with resilience and how it can be effectively promoted.

  13. Life skills: evaluation of a theory-driven behavioral HIV prevention intervention for young transgender women.

    Science.gov (United States)

    Garofalo, Robert; Johnson, Amy K; Kuhns, Lisa M; Cotten, Christopher; Joseph, Heather; Margolis, Andrew

    2012-06-01

    Young transgender women are at increased risk for HIV infection due to factors related to stigma/marginalization and participation in risky sexual behaviors. To date, no HIV prevention interventions have been developed or proven successful with young transgender women. To address this gap, we developed and pilot tested a homegrown intervention "Life Skills," addressing the unique HIV prevention needs of young transgender women aged 16-24 years. Study aims included assessing the feasibility of a small group-based intervention with the study population and examining participant's engagement in HIV-related risk behaviors pre- and 3-months-post-intervention. Fifty-one (N = 51) young transgender women enrolled in the study. Our overall attendance and retention rates demonstrate that small group-based HIV prevention programs for young transgender women are both feasible and acceptable. Trends in outcome measures suggest that participation in the intervention may reduce HIV-related risk behaviors. Further testing of the intervention with a control group is warranted.

  14. Transgender identity and health care: implications for psychosocial and physical evaluation.

    Science.gov (United States)

    Alegria, Christine Aramburu

    2011-04-01

    The purpose of this article is to educate nurse practitioners (NPs) regarding: (a) the definition and range of transgenderism, (b) social influences on transgender persons, and (c) health care for transgender persons. Data sources include review of the literature in the areas of gender, gender identity, marginalized populations, and gender transition. Personal communication was also utilized. Transgender persons remain marginalized and may remain closeted and at risk for negative psychosocial consequences. For those that do come out, other issues present, including the navigation of gender transition and psychosocial and physical changes that may be positive and/or negative. Examples of positive effects may include satisfaction of living authentically and decrease in depression. Negative effects may include social discrimination and loss of relationships. To provide holistic care, NPs need to be aware of transgender lives in social context and of their healthcare needs. Suggestions for cultivating a supportive healthcare environment include the usage of sensitive language and an appropriate health history and physical examination. Further, to help rectify the knowledge deficit regarding transgender care among healthcare providers, NP educators and preceptors may utilize this article as a resource in their work with students. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

  15. Abjection and Alterity in the Imagining of Transgender in Physical Education and Sport: A Pedagogical Approach in Higher Education

    Science.gov (United States)

    Pérez-Samaniego, Víctor; Fuentes-Miguel, Jorge; Pereira-García, Sofía; Devís-Devís, José

    2016-01-01

    In physical education (PE) and sports there is little theoretical and empirical knowledge about transgender people, and particularly, on how they are and can be imagined within this context. In this paper, we present and analyze a pedagogical activity based on the reading and discussion of a fictional representation of a transgender person within…

  16. Missives from the Adult World to LGBTQ Youth: A Review of "Gallup's Guide to Modern Gay, Lesbian, and Transgender Lifestyle"

    Science.gov (United States)

    Taylor, Catherine G.

    2012-01-01

    "Gallup's Guide to Modern Gay, Lesbian, and Transgender Lifestyle" is a set of 15 volumes addressing lesbian, gay, transgender, queer, and questioning (LGTQ) topics of concern to young LGTQ readers. Each volume is attractively produced, is well presented, and answers questions systematically avoided in most school curricula. It would be a valuable…

  17. 3 CFR 8387 - Proclamation 8387 of June 1, 2009. Lesbian, Gay, Bisexual, and Transgender Pride Month, 2009

    Science.gov (United States)

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Proclamation 8387 of June 1, 2009. Lesbian, Gay... Proclamation 8387 of June 1, 2009 Proc. 8387 Lesbian, Gay, Bisexual, and Transgender Pride Month, 2009By the... lesbian, gay, bisexual, and transgender (LGBT) community. Out of this resistance, the LGBT rights movement...

  18. Contextual, experiential, and behavioral risk factors associated with HIV status: a descriptive analysis of transgender women residing in Atlanta, Georgia.

    Science.gov (United States)

    Salazar, Laura F; Crosby, Richard A; Jones, Jamal; Kota, Krishna; Hill, Brandon; Masyn, Katherine E

    2017-10-01

    This study assessed the prevalence of self-reported HIV infection among a community sample of transgender women and identified associated contextual, experiential, and behavioral factors. Ninety-two transgender women completed a self-administered interview. Recruitment occurred through an LGBT service organization, a transgender support group, transgender advocates, and informal communications. Eighty-two percent were African American/Black. Of 83 who knew their status, 60% reported being HIV infected. High rates of childhood sexual abuse (52%), rape (53%), intimate partner violence (56%), and incarceration (57%) were reported. Many did not have health insurance (53%), were not employed full-time nor in school (63%) and had been recently homeless (49%). HIV-infected transgender women as compared to HIV-uninfected transgender women were more likely to be African American/Black ( P = 0.04), and older than 34 years ( P = 0.01), unemployed/not in school ( P transgender women also experienced less trans-related discrimination ( P = 0.03), perceived less negative psychosocial impact due to trans status ( P = 0.04) and had greater happiness with their physical appearance ( P = 0.01). HIV-infected transgender women may experience relatively less trans-related stress compared to their HIV-uninfected counterparts. High rates of HIV, trauma, and social marginalization raise concerns for this population and warrant the development of structural and policy-informed interventions.

  19. Advancement Staff and Alumni Advocates: Cultivating LGBTQ Alumni by Promoting Individual and Community Uplift

    Science.gov (United States)

    Garvey, Jason C.; Drezner, Noah D.

    2013-01-01

    Using a constructivist case-study analysis, we explore philanthropy toward higher education among lesbian, gay, bisexual, transgender, and queer (LGBTQ) alumni, examining the role of advancement staff and alumni advocates in engaging LGBTQ alumni to promote individual and community uplift. Data come from focus groups with 37 advancement staff and…

  20. Social Branding to Decrease Lesbian, Gay, Bisexual, and Transgender Young Adult Smoking.

    Science.gov (United States)

    Fallin, Amanda; Neilands, Torsten B; Jordan, Jeffrey W; Ling, Pamela M

    2015-08-01

    Lesbian, gay, bisexual, and transgender (LGBT) individuals are more likely to smoke than the general population. This study evaluated a Social Branding intervention, CRUSH, which included an aspirational brand, social events, and targeted media to discourage smoking among LGBT young adults in Las Vegas, NV. Cross-sectional surveys (N = 2,395) were collected in Las Vegas LGBT bars at 2 time points 1 year apart. Multivariate logistic regressions examined associations between campaign exposure, message understanding, and current (past 30 days) smoking, controlling for demographics. LGBT individuals were significantly more likely to report current (past 30 day) smoking than heterosexual/straight, gender-conforming participants. Overall, 53% of respondents reported exposure to CRUSH; of those exposed, 60% liked the campaign, 60.3% reported they would attend a CRUSH event on a night when they usually went somewhere else, and 86.3% correctly identified that the campaign was about "partying fresh and smokefree." Current smoking was reported by 47% of respondents at Time 1 and 39.6% at Time 2. There were significant interactions between time and campaign exposure and campaign exposure and understanding the message. Among those who understood the CRUSH smokefree message, the highest level of campaign exposure was significantly associated with 37%-48% lower odds for current smoking. While longitudinal studies would better assess the impact of this intervention, CRUSH shows promise to reduce tobacco use among LGBT bar patrons. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.