Biomedical issues in transgender health research (original) (raw)

Considerations for the Care of Transgender Individuals

Nursing Clinics of North America, 2019

The term transgender describes the experience of an individual whose gender identity does not match the sex they were assigned at birth. 1 Approximately 1 million individuals in the United States identify as transgender. 2 With this portion of the population identifying as transgender, it is important to contextualize and understand their experiences and health needs to ensure best patient outcomes. As transgender individuals are seen in all aspects of health care, it is critical that providers are prepared to care for this population. BACKGROUND/SIGNIFICANCE As a population, transgender individuals are at an increased risk of experiencing health disparities. For instance, transgender individuals have disproportionate rates of HIV compared with the cisgender population (cisgender describes the experience of one's gender identity matching the sex one was assigned at birth). 3 The increased incidence of HIV in transgender individuals is because of a multitude of factors, but likely is a combination of poor access to services, engaging in sex work, and Disclosure: There are no commercial or financial relationships to disclose.

Global health burden and needs of transgender populations: a review

The Lancet, 2016

Transgender people are a diverse population aff ected by a range of negative health indicators across high-income, middle-income, and low-income settings. Studies consistently document a high prevalence of adverse health outcomes in this population, including HIV and other sexually transmitted infections, mental health distress, and substance use and abuse. However, many other health areas remain understudied, population-based representative samples and longitudinal studies are few, and routine surveillance eff orts for transgender population health are scarce. The absence of survey items with which to identify transgender respondents in general surveys often restricts the availability of data with which to estimate the magnitude of health inequities and characterise the population-level health of transgender people globally. Despite the limitations, there are suffi cient data highlighting the unique biological, behavioural, social, and structural contextual factors surrounding health risks and resiliencies for transgender people. To mitigate these risks and foster resilience, a comprehensive approach is needed that includes gender affi rmation as a public health framework, improved health systems and access to health care informed by high quality data, and eff ective partnerships with local transgender communities to ensure responsiveness of and cultural specifi city in programming. Consideration of transgender health underscores the need to explicitly consider sex and gender pathways in epidemiological research and public health surveillance more broadly.

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

International Journal of Transgender Health, 2022

Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.

Current chalenges and future prospective of transgender health care

Research paper , 2023

Background: Transgender people are commonly known as ‘Hijra’ in India (Gurvinder Kalra,2012). Their existence was found in Indian mythology. Great epic ‘Mahabharata’ said about‘Shikhandi’ who was a Hijra and played a vital role in battle of Kurukshetra. Documentary proof revealed the existence of ‘Khojwa’ (Transgender) who played vital role to guard Mughal harem.They were part of different rituals of Indian customs. Since British invasion, they were treated brutally. So, modern health care system did not consider transgender people. Aim: The present study was aimed to find out current challenges and future prospective of transgender health care.Methodology: From the literature reviews (Google, Pubmed, Sciencedirect, Elsevier and Shodhganga) physiological and psychological health issues of Transgender were find out and current challenges and future prospective of transgender health care discussed here. Discussion: Critical analysis of literature revealed that transgender requires unique type of healthcare facilities. This review highlighted the transgender health care requirements, health issues of transgender, barriers to treat transgender, some remedial measures and future prospective Conclusion: There is an urgent need to evaluate and to find out solution to overcome barriers to treat transgender. (2) (PDF) CURRENT CHALLENGES AND FUTURE PROSPECTIVE OF TRANSGENDER HEALTH CARE. Available from: https://www.researchgate.net/publication/369594687\_CURRENT\_CHALLENGES\_AND\_FUTURE\_PROSPECTIVE\_OF\_TRANSGENDER\_HEALTH\_CARE#fullTextFileContent [accessed Apr 07 2023].

Gender identity and the management of the transgender patient: a guide for non-specialists

Journal of the Royal Society of Medicine, 2017

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 ...

Review on the Transgender Literature: Where Are We Now and a Step beyond the Current Practice?

Endocrines

The transgender concept is described as a clinically significant distress due to the incongruity between the experienced gender and assigned gender. A transgender person carries a gender identity that is different from their assigned sex at birth. Transgender people may be binary: male to female (transgender women) or female to male (transgender men) or genderqueer (non-binary, fluid or variable gender expression). The binary concept has been described in transgender population, where the term transwomen is used to describe people assigned male at birth (AMAB) who are recognized as females during gender transition; with the term transmen where they are assigned female at birth (AFAB) and are then recognized as males in gender transition. According to the DSM-5 classification, gender dysphoria is described when a transgender person develops clinically relevant bio-psychosocial suffering. Currently, the transgender population has gained massive public awareness through social media an...

Transgender Population: Health Promotion and Disease Prevention NUR 735 Demographics

University Alabama Huntsville Transgender Population: Health Promotion and Disease Prevention Federal health care agencies consider the health and welfare of transgender persons to be a health priority despite the lack of available science-based knowledge on this population (Institute of Medicine, 2011). This paper examines population health in the transgender population and discusses strategies related to health promotion and disease prevention. A list of terminology commonly mentioned in the field of transgender care is reviewed to facilitate understanding of this topic of interest. Thereafter this paper discusses demographic characteristics of transgender persons, health issues, health promotion practices and strategies, community resources, Healthy People 2020 goals, the impact of the Affordable Care Act on transgender persons and an applicable theoretical framework to plan changes for transgender persons at the community level. The Center of Excellence for Transgender Health (2013) describes the common terminology used in gender and sexual identity. Transgender is a term used to describe individuals who identify with the opposite sex or gender, and expresses, believes or has ideas that do not conform to their anatomically assigned birth gender. Gender Identity is the sense a person has of being either male or female. Gender dysphoria is defined as the distress or conflict caused by the discordance between anatomic gender and gender identity. Gender non-conformity means the degree to which a person gender identity or expression is different from the cultural norms expected for an individual of a particular sex. Male-to-Female (MTF) describes a person assigned male at birth but who identifies with the female gender. Female-to-Male (FTM) defines a person assigned female at birth but who identifies with the male gender. Gender expression is the expression of gender through clothing, behavior or preferences. Transition is the term used to define the period of time in which a person begins living as his or her desired gender. Transsexual describes those who seek hormonal treatment for transgenderism but may or may not choose surgical intervention to modify their bodies. Transvestitism describes persons who have an affinity to dress like the opposite sex but do not wish to change their biologic sex. Sexual orientation or sexual preference is the sex to which a person is attracted.

Transgender health 1 Transgender people: health at the margins of society

The Lancet, 2016

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 diffi culties accessing appropriate health care, whether specifi c 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 classifi cation 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.

Transgenders: The Neglected Group in Health Care

Journal of Complementary and Alternative Medical Research

Transgenders have always caught my attention. Be it at the signal where they are seen begging or in a moving bus where everyone shuns away from sitting near them. My initial fears about them turned to curiosity as to who they are. Are they normal? No one around me was able to give me any answer. I was apprehensive to talk to anyone too as I was always told they may harm me. But I made it a point to attend meetings that transgenders attended, squeezed myself into talking to them and getting acquainted with the group, and to my surprise I found out they were such a welcoming group. I gelled with them faster than I thought and today I am glad they are a part of my journey. As I explored their lives, the one thing I realized was that even healthcare members are not fully aware of transgenders, rather, they have too many misconceptions. And so, the need of the hour is that healthcare professionals should be trained on transgenders especially when statistics show that as per the 2011 cens...