Confronting High HIV Rates Among Transgender Women With Empowerment and Gender Affirmation

JAMA ◽  
2021 ◽  
Author(s):  
Bridget M. Kuehn
Keyword(s):  
Transgender Women ◽  
Gender Affirmation ◽  
And Gender

scholarly journals Measuring Satisfaction and Comfort with Gender Identity and Gender Expression among Transgender Women: Development and Validation of the Psychological Gender Affirmation Scale

2021 ◽  
Vol 18 (6) ◽  
pp. 3298
Author(s):  
Jae M. Sevelius ◽  
Deepalika Chakravarty ◽  
Samantha E. Dilworth ◽  
Greg Rebchook ◽  
Torsten B. Neilands
Keyword(s):  
Factor Analysis ◽  
Gender Identity ◽  
High Reliability ◽  
Well Being ◽  
Transgender Women ◽  
Gender Expression ◽  
Gender Diverse ◽  
Gender Affirmation ◽  
Psychological Gender ◽  
And Gender

Among transgender and gender diverse people, psychological gender affirmation is an internal sense of valuing oneself as a transgender or gender diverse person, being comfortable with one’s gender identity, and feeling satisfied with one’s body and gender expression. Gender affirmation can reduce gender dysphoria and mitigate deleterious health effects of marginalization. We sought to create an instrument to measure psychological gender affirmation among transgender women. Following initial item development using qualitative interviews, we used self-administered survey data from two distinct samples (N1 = 278; N2 = 368) of transgender women living with HIV in the USA. We used data from Study 1 to perform exploratory factor analysis (EFA) and data from Study 2 to perform confirmatory factor analysis (CFA), yielding the five-item single-factor Psychological Gender Affirmation (PGA) scale with high reliability (α = 0.88). This scale is psychometrically sound as demonstrated by its convergent and discriminant validity via correlations with select measures and by its predictive validity through associations in hypothesized directions with measures of mental health and substance use. The PGA scale will aid research on psychological gender affirmation that can in turn inform interventions as well as gender-affirming clinical and social practices to promote the health and well-being of transgender and gender diverse people.

Transgender and Gender Diverse Community Connection, Help-Seeking, and Mental Health Among Black Transgender Women Who Have Survived Violence: A Mixed-Methods Analysis

2021 ◽  
pp. 107780122110138
Author(s):  
Athena D. F. Sherman ◽  
Sarah Allgood ◽  
Kamila A. Alexander ◽  
Meredith Klepper ◽  
Monique S. Balthazar ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Help Seeking ◽  
Longitudinal Research ◽  
Care Delivery ◽  
Poor Mental Health ◽  
Transgender Women ◽  
Gender Diverse ◽  
Diverse Community ◽  
And Gender

Black transgender women are disproportionately affected by violence and poor care-delivery, contributing to poor mental health. Little is known regarding the effect of transgender and gender diverse (TGD) community connection (TCC) on health. This analysis (a) explores relationships between TCC, polyvictimization, and mental health and (b) analyzes how TCC influenced help-seeking following violent experiences among Black transgender women. Mixed-methods data from 19 Black transgender women were analyzed using correlational and thematic content analyses. Findings suggest that TCC is associated with improved help-seeking and mental health among Black transgender women, highlighting a need for longitudinal research to identify approaches for leveraging TCC.

scholarly journals Pre-Exposure Prophylaxis (PrEP) for HIV Infection in Cisgender and Transgender Women in the U.S.: A Narrative Review of the Literature

2021 ◽  
Author(s):  
Aleta Baldwin ◽  
Brenda Light ◽  
Waridibo E. Allison
Keyword(s):  
Hiv Infection ◽  
Population Group ◽  
Transgender Women ◽  
Sex And Gender ◽  
Individual Level ◽  
Pubmed Database ◽  
Trans Women ◽  
And Gender ◽  
Exposure Prophylaxis ◽  
The U.S

AbstractUsing a socioecological approach, this review describes the peer-reviewed literature on oral pre-exposure prophylaxis (PrEP) among both cisgender (cis women) and transgender women (trans women) in the U.S. A search of the PubMed database and HIV-related conference abstracts generated over 2,200 articles and abstracts. Of these, 103 fulfilled review inclusion criteria. Most of the existing research presents findings on individual-level factors associated with PrEP use such as willingness and perceived barriers. There was far less investigation of factors related to PrEP at more distal ecological levels. Though trans women are at greater risk of HIV infection than cisgender women, less is known about this population group with respect to PrEP despite their inclusion in many major clinical trials. Further, the literature is characterized by a persistent conflation of sex and gender which makes it difficult to accurately assess the reviewed research on HIV prevention and PrEP apart from risk group. Informed by these findings, we highlight specific opportunities to improve access to PrEP and reduce socioecological barriers to PrEP care engagement for cisgender and transgender women.

“Bridging the Gap”: School Nurse Experiences Providing Care for Transgender and Gender Diverse Students and Their Parents/Guardians

2021 ◽  
pp. 105984052110254
Author(s):  
Tammy Neiman ◽  
Laurie Sieve ◽  
Louise Stenberg ◽  
Nicole Molesky ◽  
G. Nic Rider
Keyword(s):  
School Nurses ◽  
Parental Acceptance ◽  
Institutional Barriers ◽  
Gender Diverse ◽  
Semistructured Interviews ◽  
Gender Affirmation ◽  
And Gender ◽  
Set Up ◽  
Interpersonal Collaboration ◽  
And Training

School systems are often not set up to support transgender and gender diverse (TGD) students, which results in unsafe and unsupportive environments and other institutional barriers to helping TGD students thrive. An important factor to students' feeling safe and supported in schools may be their relationship with school nurses. The purpose of this study was to describe school nurses' experiences working with TGD students and their parents/guardians, their role in working with this community, and the challenges nurses face when trying to serve TGD students. Semistructured interviews were conducted with 23 school nurses across a Midwestern state. Thematic analysis was used to identify themes: gender-affirming education and interpersonal collaboration, bridging the gap between TGD youth and parents/guardians, gender-affirming care and confidentiality, and navigating parental acceptance and gender-affirmation. School nurses expressed a strong desire to support TGD students but lack the structure and training within schools.

Influence of Listener Characteristics on Perceptions of Sex and Gender

2017 ◽  
Vol 36 (5) ◽  
pp. 599-610 ◽  
Author(s):  
Adrienne B. Hancock ◽  
Sara F. Pool
Keyword(s):  
Sexual Orientation ◽  
Speech Perception ◽  
Transgender Women ◽  
Sex And Gender ◽  
Significant Evidence ◽  
Speech Treatment ◽  
And Gender ◽  
Gender Display

Inclusion of sex-atypical voices in speech perception protocols can reveal variations in listener perception and is particularly applicable in developing guidelines for transgender speech treatment. Ninety-three listeners, divided into four groups based on sex and sexual orientation, provided auditory-perceptual measures of sex and gender display for 21 cisgender men, 21 cisgender women, and 22 transgender women. There was no significant evidence that those listener characteristics were influential, except transgender women were perceived as significantly more feminine by nonstraight compared with straight listeners.

scholarly journals Applying concurrent multidisciplinary care to gender affirmation in transgender women: A case series

2020 ◽  
Vol 8 (11) ◽  
pp. 2135-2137
Author(s):  
Adam Lloyd ◽  
Sara Brenner ◽  
Lydia A. Fein ◽  
David Rosow
Keyword(s):  
Case Series ◽  
Multidisciplinary Care ◽  
Transgender Women ◽  
Gender Affirmation

Sublingual Estradiol Is Associated with Higher Estrone Concentrations than Transdermal or Injectable Preparations in Transgender Women and Gender Nonbinary Adults

LGBT Health ◽  
2021 ◽  
Author(s):  
Lauren R. Cirrincione ◽  
Gabrielle Winston McPherson ◽  
Jessica Rongitsch ◽  
Katerina Sadilkova ◽  
Julia C. Drees ◽  
...  
Keyword(s):  
Transgender Women ◽  
Women And Gender ◽  
And Gender

An adolescent requesting to pause puberty

2021 ◽  
pp. 203-212
Author(s):  
Cordelia Y. Ross ◽  
Alex S. Keuroghlian
Keyword(s):  
Gender Identity ◽  
Hormone Therapy ◽  
Gender Dysphoria ◽  
Social Stigma ◽  
Developmental History ◽  
Psychiatric Assessment ◽  
Gender Expression ◽  
Gender Affirmation ◽  
History Of ◽  
And Gender

Gender dysphoria occurs when a patient has distress associated with incongruence between a person’s experienced gender and the gender traditionally associated with their sex assigned at birth. This must occur for at least six months. The psychiatric assessment of a patient with gender dysphoria should include exploration of the child’s developmental history of gender-expansive identification and expression; sources of distress relating to familial, community, and social stigma; and ways to help families adopt an accepting and nurturing response. Gender affirmation can include psychological, social, legal, and biological interventions. The goal of psychotherapy is to help a person explore, discover, and affirm their gender identity. Social affirmation may include changing names, pronouns, and gender expression. Legal gender affirmation may take place through a name or gender marker change on official documents. Biological affirmation may include pubertal suppression for younger adolescents, gender-affirming hormone therapy, and/or gender-affirming surgery.

scholarly journals Venous Thrombotic Risk in Transgender Women Undergoing Estrogen Therapy: A Systematic Review and Metaanalysis

2019 ◽  
Vol 65 (1) ◽  
pp. 57-66 ◽  
Author(s):  
Jenna Khan ◽  
Robert L Schmidt ◽  
Matthew J Spittal ◽  
Zil Goldstein ◽  
Kristi J Smock ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Psychological Health ◽  
Estrogen Therapy ◽  
Incidence Rates ◽  
Transgender Women ◽  
High Quality Research ◽  
Thrombotic Risk ◽  
Clinically Significant ◽  
And Gender ◽  
Ottawa Scale

Abstract BACKGROUND Transgender women are female individuals who were recorded men at birth based on natal sex. Supporting a person's gender identity improves their psychological health, and gender-affirming hormones reduce gender dysphoria and benefit mental health. For transgender women, estrogen administration has clinically significant benefits. Previous reviews have reported conflicting literature on the thrombotic risk of estrogen therapy in transgender women and have highlighted the need for more high-quality research. CONTENT To help address the gap in understanding thrombotic risk in transgender women receiving estrogen therapy, we performed a systematic literature review and metaanalysis. Two evaluators independently assessed quality using the Ottawa Scale for Cohort Studies. The Poisson normal model was used to estimate the study-specific incidence rates and the pooled incidence rate. Heterogeneity was measured using Higgins I2 statistic. The overall estimate of the incidence rate was 2.3 per 1000 person-years (95% CI, 0.8–6.9). The heterogeneity was significant (I2 = 74%; P = 0.0039). SUMMARY Our study estimated the incidence rate of venous thromboembolism in transgender women prescribed estrogen to be 2.3 per 1000 person-years, but because of heterogeneity this estimate cannot be reliably applied to transgender women as a group. There are insufficient data in the literature to partition by subgroup for subgroup prohibiting the analysis to control for tobacco use, age, and obesity, which is a major limitation. Additional studies of current estrogen formulations, modes of administration, and combination therapies, as well as studies in the aging transgender population, are needed to confirm thrombotic risk and clarify optimal therapy regimens.

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