Suchergebnisse

Part IHistory and Backgroundp. 1 --1A History of Transgender and Gender Diverse Health Care: From Medical Mistreatment to Gender-Affirmative Health Carep. 3 /Farah Naz Khan --2Gender Identity: Terminology, Demographics, and Epidemiologyp. 7 /Sari L. Reisner and Alex S. Keuroghlian and Jennifer Potter --3Health Disparitiesp. 16 /Alex McDowell and Carl G. Streed, Jr. --4Harnessing Information Technology to Improve Clinical Carep. 26 /Chris Grasso and Alex S. Keuroghlian --Part IIGender Identity Emergence and Affirmation in Adultsp. 37 --5Gender Identity Emergence and Affirmation in Adultsp. 39 /Meredith Walker and Meghan McGrath --6Behavioral Health Considerations for Transgender and Gender Diverse Peoplep. 51 /Aude Henin and Christine Darsney and Flavia Vaz De Souza and Hilary Goldhammer and Alex S. Keuroghlian --7Gender-Affirming Hormone Therapy for Adultsp. 61 /Julie Thompson --8Nonmedical, Nonsurgical Gender Affirmationp. 74 /Steph DeNormand --9Surgical Gender Affirmationp. 87 /Gaines Blasdel and Lee C. Zhao and Rachel Bluebond-Langner --10Case Studies in Gender Emergence and Affirmationp. 102 /Jennifer Reske-Nielsen --Part IIIPrimary, Preventive, and Specialty Carep. 109 --11Basic Principles of Trauma-Informed and Gender-Affirming Carep. 111 /Samara Grossman and Sarah Berman and Jennifer Potter --12Obtaining a Gender-Affirming Sexual Historyp. 130 /Danielle O'Banion and Sebastian Mitchell Barr --13Performing a Trauma-Informed Physical Examinationp. 143 /Sadie Elisseou and Jennifer Potter --14Recognizing and Addressing Intimate Partner Violencep. 156 /Xavier Quinn --15Eating Disorders, Body Image, and Body Positivityp. 170 /Heidi J. Dalzell and Kayti Protos and Stacy K. Hunt --16Screening and Prevention of HIV and Sexually Transmitted Infectionsp. 183 /Asa Radix and Zil G. Goldstein --17Treatment of HIV and Sexually Transmitted Infectionsp. 192 /Ami Multani --18Screening for Cancer and Cardiovascular Diseasep. 209 /Alex Gonzalez --19Reproductive Health, Obstetric Care, and Family Buildingp. 218 /Mason J. Dunn and Samuel C. Pang and Rebekah P. Vibria --20Case Studies in Transgender and Gender Diverse Primary Carep. 232 /Jennifer Reske-Nielsen --Part IVTransgender and Gender Diverse Populationsp. 237 --21Transgender and Gender Diverse People Who Are Black, Indigenous, and People of Colorp. 239 /Vanessa Warri and Jack Bruno and Jenna J. Rapues and JoAnne Keatley and Jae M. Sevelius --22Health Needs and Service Delivery Models for Transgender Communities in Low-and Middle-Income Countriesp. 247 /S. Wilson Beckham and Eli Sauerwalt and Katherine N. Elfer and Omar Harfouch and Stefan Baral --23Transgender and Gender Diverse People and Incarcerationp. 255 /Jaclyn White Hughto and Kirsty A. Clark --24Caring for Transgender and Gender Diverse Veteransp. 268 /Colleen A. Sloan and Michael R. Kauth and Jillian C. Shipherd --25Affirming Care for People with intersex Traitsp. 276 /Katharine B. Dalke and Niki S. Khanna and Frances W. Grimstad --Part VCommunity-Building, Advocacy, and Partnershipp. 287 --26Community Engagement and Outreachp. 289 /Cei Lambert --27Advocacy for Transgender and Gender Dsverse Patientsp. 299 /Sean Cahill.

Objectives. To examine exposure to psychological attempts to change a person's gender identity from transgender to cisgender (PACGI) among transgender people in the United States, lifetime and between the years 2010 and 2015, by US state. Methods. We obtained data from the 2015 US Transgender Survey, a cross-sectional nonprobability sample of 27 716 transgender people in the United States, to estimate the percentage exposed to PACGI in each US state. Results. Overall, 13.5% of the sample indicated lifetime exposure to PACGI, ranging across all US states from 9.4% (South Carolina) to 25.0% (Wyoming). The percentage of transgender adults in the United States reporting exposure to PACGI between 2010 and 2015 was 5% overall, and across all states ranged from 1.2% (Alaska) to 16.3% (South Dakota). Conclusions. Despite major medical organizations identifying PACGI as ineffective and unethical, 13.5% of transgender people in the United States reported lifetime exposure to this practice. Findings suggest that this practice has continued in every US state as recently as the period 2010 to 2015.

IMPORTANCE: Gender identity conversion efforts (GICE) have been widely debated as potentially damaging treatment approaches for transgender persons. The association of GICE with mental health outcomes, however, remains largely unknown. OBJECTIVE: To evaluate associations between recalled exposure to GICE (by a secular or religious professional) and adult mental health outcomes. DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, a survey was distributed through community-based outreach to transgender adults residing in the United States, with representation from all 50 states, the District of Columbia, American Samoa, Guam, Puerto Rico, and US military bases overseas. Data collection occurred during 34 days between August 19 and September 21, 2015. Data analysis was performed from June 8, 2018, to January 2, 2019. EXPOSURE: Recalled exposure to GICE. MAIN OUTCOMES AND MEASURES: Severe psychological distress during the previous month, measured by the Kessler Psychological Distress Scale (defined as a score ≥13). Measures of suicidality during the previous year and lifetime, including ideation, attempts, and attempts requiring inpatient hospitalization. RESULTS: Of 27 715 transgender survey respondents (mean [SD] age, 31.2 [13.5] years), 11 857 (42.8%) were assigned male sex at birth. Among the 19 741 (71.3%) who had ever spoken to a professional about their gender identity, 3869 (19.6%; 95% CI, 18.7%-20.5%) reported exposure to GICE in their lifetime. Recalled lifetime exposure was associated with severe psychological distress during the previous month (adjusted odds ratio [aOR], 1.56; 95% CI, 1.09-2.24; P < .001) compared with non-GICE therapy. Associations were found between recalled lifetime exposure and higher odds of lifetime suicide attempts (aOR, 2.27; 95% CI, 1.60-3.24; P < .001) and recalled exposure before the age of 10 years and increased odds of lifetime suicide attempts (aOR, 4.15; 95% CI, 2.44-7.69; P < .001). No significant differences were found when comparing exposure to ...

BACKGROUND: In recent years, Massachusetts (MA) and Rhode Island (RI) joined a growing list of states allowing residents to easily change the gender marker and name on government-identification (ID) documents. This was an important change for transgender and gender diverse (trans) residents, who face frequent mistreatment and thus for whom legal gender affirmation is critical. Little is known about associations between legal gender affirmation and psychological outcomes. METHODS: We examined associations between legal gender affirmation (i.e., having changed gender marker/name on neither, one, or both a passport and state ID), upsetting responses to gender-based mistreatment, and mental health outcomes in a sample of trans MA and RI residents. Analyses controlled for gender identity, age, race/ethnicity, education, employment, income, and insurance status. FINDINGS: Legal gender affirmation was significantly associated with lower reports of depression, anxiety, somatization, global psychiatric distress, and upsetting responses to gender-based mistreatment. CONCLUSIONS: These data provide corroborate recent studies suggesting having pursued legal gender affirmation may be protective. Findings bolster calls to increase structural support for trans individuals, including enactment of state policies easing legal gender affirmation.