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      Access to gender-affirming hormones during adolescence and mental health outcomes among transgender adults

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          Abstract

          Objective

          To examine associations between recalled access to gender-affirming hormones (GAH) during adolescence and mental health outcomes among transgender adults in the U.S.

          Methods

          We conducted a secondary analysis of the 2015 U.S. Transgender Survey, a cross-sectional non-probability sample of 27,715 transgender adults in the U.S. Using multivariable logistic regression adjusting for potential confounders, we examined associations between access to GAH during early adolescence (age 14–15), late adolescence (age 16–17), or adulthood (age ≥18) and adult mental health outcomes, with participants who desired but never accessed GAH as the reference group.

          Results

          21,598 participants (77.9%) reported ever desiring GAH. Of these, 8,860 (41.0%) never accessed GAH, 119 (0.6%) accessed GAH in early adolescence, 362 (1.7%) accessed GAH in late adolescence, and 12,257 (56.8%) accessed GAH in adulthood. After adjusting for potential confounders, accessing GAH during early adolescence (aOR = 0.4, 95% CI = 0.2–0.6, p < .0001), late adolescence (aOR = 0.5, 95% CI = 0.4–0.7, p < .0001), or adulthood (aOR = 0.8, 95% CI = 0.7–0.8, p < .0001) was associated with lower odds of past-year suicidal ideation when compared to desiring but never accessing GAH. In post hoc analyses, access to GAH during adolescence (ages 14–17) was associated with lower odds of past-year suicidal ideation (aOR = 0.7, 95% CI = 0.6–0.9, p = .0007) when compared to accessing GAH during adulthood.

          Conclusion

          Access to GAH during adolescence and adulthood is associated with favorable mental health outcomes compared to desiring but not accessing GAH.

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          Most cited references36

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          Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

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            Information bias in health research: definition, pitfalls, and adjustment methods

            As with other fields, medical sciences are subject to different sources of bias. While understanding sources of bias is a key element for drawing valid conclusions, bias in health research continues to be a very sensitive issue that can affect the focus and outcome of investigations. Information bias, otherwise known as misclassification, is one of the most common sources of bias that affects the validity of health research. It originates from the approach that is utilized to obtain or confirm study measurements. This paper seeks to raise awareness of information bias in observational and experimental research study designs as well as to enrich discussions concerning bias problems. Specifying the types of bias can be essential to limit its effects and, the use of adjustment methods might serve to improve clinical evaluation and health care practice.
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              Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society* Clinical Practice Guideline

              To update the "Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline," published by the Endocrine Society in 2009.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                12 January 2022
                2022
                : 17
                : 1
                : e0261039
                Affiliations
                [1 ] Division of Child & Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California, United States of America
                [2 ] The Fenway Institute, Boston, Massachusetts, United States of America
                [3 ] Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
                [4 ] Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
                [5 ] Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
                [6 ] Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States of America
                [7 ] Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
                Callen-Lorde Community Health Center, UNITED STATES
                Author notes

                Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Dr. Turban reports receiving textbook royalties from Springer Nature and Dr. Keuroghlian reports receiving textbook royalties from McGraw Hill. Dr. Turban has received expert witness payments from the ACLU.

                Author information
                https://orcid.org/0000-0002-4877-254X
                Article
                PONE-D-21-26940
                10.1371/journal.pone.0261039
                8754307
                35020719
                d4cbf418-aa0b-4802-a586-a1990a91c2c9
                © 2022 Turban et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 20 August 2021
                : 16 November 2021
                Page count
                Figures: 0, Tables: 5, Pages: 15
                Funding
                Funded by: The American Academy of Child and Adolescent Psychiatry
                Award ID: Pilot Research Award for General Psychiatry Residents (Supported by Industry Donors including Arbor Pharmaceuticals and Pfizer)
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100000025, National Institute of Mental Health;
                Award ID: MH094612
                Award Recipient :
                Funded by: The Sorensen Foundation
                Award ID: Postdoctoral Research Fellowship
                Award Recipient :
                Funded by: The Health Resources and Services Bureau of Primary Health Care
                Award ID: U30CS22742
                Award Recipient :
                JLT received a pilot research award for general psychiatry residents from The American Academy of Child & Adolescent Psychiatry, supported by Industry Sponsors (Arbor and Pfizer), an award from the National Institute of Mental Health (MH094612), and a fellowship from The Sorensen Foundation. ASK received a grant from Health Resources and Services Administration Bureau of Primary Health Care (U30CS22742). The sponsors of this research did not play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. AACAP: https://www.aacap.org/AACAP/Press/Press_Releases/2019/Jack_Turban_Receives_AACAP_Pilot_Research_Award_for_General_Psychiatry_Residents_Supported_b.aspx#:~:text=Washington%2C%20DC%2C%20September%2030%2C,2019%20Pilot%20Research%20Award%20for NIMH: nimh.nih.gov Sorensen Foundation: https://sorensenfellowship.org/ Health Resources and Services Administration Bureau of Primary Health Care: https://bphc.hrsa.gov/ The funding sources of this study played no role in study design, data collection, data analysis, or data interpretation.
                Categories
                Research Article
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Suicide
                Biology and Life Sciences
                Psychology
                Gender Identity
                Social Sciences
                Psychology
                Gender Identity
                Medicine and Health Sciences
                Mental Health and Psychiatry
                People and Places
                Population Groupings
                Gender Groupings
                Transgender People
                People and Places
                Population Groupings
                Age Groups
                Children
                Adolescents
                People and Places
                Population Groupings
                Families
                Children
                Adolescents
                Social Sciences
                Sociology
                Education
                Educational Attainment
                People and Places
                Population Groupings
                Age Groups
                People and Places
                Population Groupings
                Age Groups
                Adults
                Custom metadata
                Data for this study were obtained via data sharing agreement from The National Center for Transgender Equality. Data requests may be submitted to them online via https://www.ustranssurvey.org/data-requests-general.

                Uncategorized
                Uncategorized

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