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      Transgender Health Disparities: Comparing Full Cohort and Nested Matched-Pair Study Designs in a Community Health Center.

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          Abstract

          U.S. health surveillance systems infrequently include measures to identify transgender respondents or monitor the health of this underserved and marginalized population.

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          HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention.

          K Clements-Nolle, R Marx, R. Guzman … (2001)
          This study described HIV prevalence, risk behaviors, health care use, and mental health status of male-to-female and female-to-male transgender persons and determined factors associated with HIV. We recruited transgender persons through targeted sampling, respondent-driven sampling, and agency referrals; 392 male-to-female and 123 female-to-male transgender persons were interviewed and tested for HIV. HIV prevalence among male-to-female transgender persons was 35%. African American race (adjusted odds ratio [OR] = 5.81; 95% confidence interval [CI] = 2.82, 11.96), a history of injection drug use (OR = 2.69; 95% CI = 1.56, 4.62), multiple sex partners (adjusted OR = 2.64; 95% CI = 1.50, 4.62), and low education (adjusted OR = 2.08; 95% CI = 1.17, 3.68) were independently associated with HIV. Among female-to-male transgender persons, HIV prevalence (2%) and risk behaviors were much lower. Most male-to-female (78%) and female-to-male (83%) transgender persons had seen a medical provider in the past 6 months. Sixty-two percent of the male-to-female and 55% of the female-to-male transgender persons were depressed; 32% of each population had attempted suicide. High HIV prevalence suggests an urgent need for risk reduction interventions for male-to-female transgender persons. Recent contact with medical providers was observed, suggesting that medical providers could provide an important link to needed prevention, health, and social services.
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            Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study.

            Judith Bradford, Sari Reisner, Julie Honnold … (2013)
            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.
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              Gender Violence

              Emilia L. Lombardi, Riki Wilchins, Dana Priesing … (2002)
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                Author and article information

                Journal
                Journal ID (iso-abbrev): LGBT Health
                Title: LGBT health
                ISSN (Electronic): 2325-8306
                Publication date (Electronic): Sep 1 2014
                Volume: 1
                Issue: 3
                Affiliations
                [1 ] Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA ; The Fenway Institute at Fenway Health, Boston, MA, USA.
                [2 ] The Fenway Institute at Fenway Health, Boston, MA, USA.
                [3 ] Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA ; The Fenway Institute at Fenway Health, Boston, MA, USA ; Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA.
                Article
                Mid ID: NIHMS577059
                DOI: 10.1089/lgbt.2014.0009
                PubMed ID: 25379511
                SO-VID: c4d73238-f5c1-476b-8661-e9e5bbfefa30
                History

                Keywords: Health disparity,gender identity,methods,study design,transgender
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                Keywords: Health disparity, gender identity, methods, study design, transgender

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