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1. Cross-sex Hormones and Acute Cardiovascular Events in Transgender Persons: A Cohort Study. (PubMed)

Cross-sex Hormones and Acute Cardiovascular Events in Transgender Persons: A Cohort Study. Venous thromboembolism (VTE), ischemic stroke, and myocardial infarction in transgender persons may be related to hormone use.To examine the incidence of these events in a cohort of transgender persons.Electronic medical record-based cohort study of transgender members of integrated health care systems who had an index date (first evidence of transgender status) from 2006 through 2014. Ten male and 10 (...) who initiated hormone therapy during follow-up. The evidence was insufficient to allow conclusions regarding risk among transmasculine participants.Inability to determine which transgender members received hormones elsewhere.The patterns of increases in VTE and ischemic stroke rates among transfeminine persons are not consistent with those observed in cisgender women. These results may indicate the need for long-term vigilance in identifying vascular side effects of cross-sex estrogen.Patient

2018 Annals of Internal Medicine

2. Effects of Gender-Affirming Hormones on Lipid, Metabolic, and Cardiac Surrogate Blood Markers in Transgender Persons. (PubMed)

Effects of Gender-Affirming Hormones on Lipid, Metabolic, and Cardiac Surrogate Blood Markers in Transgender Persons. Gender-affirming hormonal therapy consists of testosterone in transgender men and estrogens and antiandrogens in transgender women. Research has concluded that gender-affirming therapy generally leads to high satisfaction rates, increased quality of life, and higher psychological well-being. However, given the higher incidence of cardiometabolic morbidity and mortality (...) and/or mortality in transgender women (but not transgender men) mainly covered data on transgender women using the now obsolete ethinyl estradiol and, therefore, are no longer valid. Currently, most of the available literature on transgender people adhering to standard treatment regimens consists of retrospective cohort studies of insufficient follow-up duration. When assessing markers of cardiometabolic disease, the available literature is inconclusive, which may be ascribed to relatively short follow-up

2019 Clinical Chemistry

3. Dermatologic care for lesbian, gay, bisexual, and transgender persons: Terminology, demographics, health disparities, and approaches to care. (PubMed)

Dermatologic care for lesbian, gay, bisexual, and transgender persons: Terminology, demographics, health disparities, and approaches to care. More than 10 million lesbian, gay, bisexual, and transgender (LGBT) persons live in the United States. Improving their health is a public health priority. LGBT persons have specific health concerns and face health care disparities. Awareness of those issues and disparities can enable dermatologists to provide medically appropriate and culturally competent (...) care to LGBT patients. This review highlights terminology important in caring for LGBT persons, LGBT demographics in the United States, health care disparities faced by LGBT persons, and approaches to caring for LGBT patients.Copyright © 2018 American Academy of Dermatology, Inc. All rights reserved.

2019 Journal of American Academy of Dermatology

4. Dermatologic care for lesbian, gay, bisexual, and transgender persons: Epidemiology, screening, and disease prevention. (PubMed)

Dermatologic care for lesbian, gay, bisexual, and transgender persons: Epidemiology, screening, and disease prevention. Lesbian, gay, bisexual, and transgender (LGBT) persons face important health issues relevant to dermatologists. Men who have sex with men (MSM) are at higher risk of certain infectious diseases, including HIV, syphilis and other sexually transmitted diseases (STDs), methicillin-resistant Staphylococcus aureus infections, and invasive meningococcal disease, and might (...) be at higher risk of non-infectious conditions, including skin cancer. Recommendations for preventive health care, including screening for HIV and other STDs, sexual health-related vaccinations, and HIV pre-exposure prophylaxis, differ for MSM compared with non-MSM. Women who have sex with women experience disparities in STDs, including chlamydia and HPV. Transgender patients have unique, and often unmet, dermatologic needs during gender transition (also called gender affirmation), related to hormonal

2019 Journal of American Academy of Dermatology

5. The Louisiana Wellness Centers Program for HIV/STD Prevention Among Gay and Bisexual Men and Transgender Persons. (PubMed)

The Louisiana Wellness Centers Program for HIV/STD Prevention Among Gay and Bisexual Men and Transgender Persons. During the conduct of the described demonstration project (2012-2015), the Centers for Disease Control and Prevention funding standard for HIV testing was 1.0% newly diagnosed positivity in non-health care settings. For linkage to HIV medical care, the National HIV/AIDS Strategy goal was 85%, and the funding standard was 80% (the Centers for Disease Control and Prevention (...) and bisexual men and transgender persons.New HIV/STD diagnoses from testing, linkage to HIV care, and reengagement in HIV medical care.The percentage of persons who were newly diagnosed with HIV was 1.4% (44/3214). Of the newly diagnosed persons, 91% (40/44) were linked to HIV medical care. Of persons who were identified as out of care, 83% (5/6) were reengaged in HIV medical care. STD testing results showed that 9.0% (294/3251) of the syphilis tests were positive, and 8.3% (803/9719) of the chlamydia

2019 Journal of Public Health Management and Practice

6. Suicidal ideation and attempted suicide amongst Chinese transgender persons: National population study. (PubMed)

Suicidal ideation and attempted suicide amongst Chinese transgender persons: National population study. This study aims to understand suicidal ideation and suicide attempts among transgender individuals through an in-depth analysis of a nation-wide population general survey in China.Transgender Men (TM) and Women (TW) were investigated through a cross-sectional survey. A structured questionnaire was used to investigate participants' demographic information, perceived sexuality conflicts (...) , childhood adversity and mental health conditions. Logistic regression models were utilized to investigate risk factors associated with suicidal ideation and suicide attempts in these groups. We also conducted a quasi-meta-analysis in order to compare the prevalence of suicidal ideation and attempted suicide between general and transgender populations in China.A total of 1309 participants across 32 provinces and municipalities in China took part in this survey, out of 2060 valid questionnaires

2019 Journal of Affective Disorders

7. Transgender persons' HIV care (dis)engagement: a qualitative evidence synthesis protocol from an ecological systems theory perspective. (PubMed)

Transgender persons' HIV care (dis)engagement: a qualitative evidence synthesis protocol from an ecological systems theory perspective. There seems to be little information on interactional patterns of enabling and constraining factors contributing to HIV care engagement across systems and across time. Understanding these patterns from a (micro-meso-macro-exo) systems perspective can provide rich insights on relevant social networks affecting transgender populations. In this review, we (...) will synthesise the wealth of literature on transgender persons' engagement in the HIV care continuum.We will perform a networked systems approach to qualitative evidence synthesis of relevant qualitative research data generated from primary qualitative, mixed-method and evaluation studies exploring HIV care engagement among diverse transgender populations. Studies not using qualitative methods and studies not published in English will be excluded from this review. Empirical studies will be identified via

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2019 BMJ open

8. "I just want to be treated like a normal person": Oral health care experiences of transgender adolescents and young adults. (PubMed)

"I just want to be treated like a normal person": Oral health care experiences of transgender adolescents and young adults. Transgender and gender nonconforming (TGNC) people continue to experience health care disparities despite increasing visibility and acceptance. As far as is known, no information exists regarding their experiences with oral health care providers. In this study, the authors intended to understand how TGNC adolescents and young adults interface with their oral health care (...) providers.A total of 36 participants, including patients 14 through 24 years of age and their caregivers, were recruited from the Transgender Health Clinic at the Cincinnati Children's Hospital, Cincinnati, Ohio. Interviews were conducted using a semistructured interview guide. All interviews were transcribed verbatim, coded, and analyzed for major themes using grounded theory methodology.Overall, participants reported positive experiences with their oral health care providers. Those with negative

2019 Journal of the American Dental Association

9. Psychological Attempts to Change a Person's Gender Identity From Transgender to Cisgender: Estimated Prevalence Across US States, 2015. (PubMed)

Psychological Attempts to Change a Person's Gender Identity From Transgender to Cisgender: Estimated Prevalence Across US States, 2015. 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

2019 American Journal of Public Health

10. Practice Tools for Transgender Health Care

are (or identify as) non-binary as well as trans men and trans women. NON-BINARY Non-binary is an umbrella term for anyone who does not identify with static, binary gender identities. Includes persons who may identify as having an intermediary gender (e.g., genderqueer), as being multiple genders (e.g., bigender, polygender, etc.), as having a shifting gender (gender fluid), or as not having a gender altogether (agender). Transgender Health in Primary Care: Initial Assessment | April 2019 Practice Tool Page 7 (...) norms prescribed for people of a particular sex. GENDER DYSPHORIA The term refers to discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics). Transgender Health in Primary Care: Initial Assessment | April 2019 Practice Tool Page 8 of 14 Appendix B APPENDIX B INFORMATION SHEET: ADDITIONAL DETAILS TO CONSIDER IS IT REALLY GENDER DYSPHORIA? Rare

2019 Toward Optimized Practice

11. Position statement on the hormonal management of adult transgender and gender diverse individuals

for the health of transsexual, transgender, and gender‐nonconforming people, version 7. Int J Transgenderism 2012; 13: 165–232. Hembree WC, Cohen‐Kettenis PT, Gooren L, et al. Endocrine treatment of gender‐dysphoric/gender‐incongruent persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2017; 102: 3869–3903. Bretherton I, Thrower E, Grossmann M, et al. Cross‐sex hormone therapy in Australia: the prescription patterns of clinicians experienced in adult transgender healthcare (...) therapy: results of a prospective multicenter study. J Clin Endocrinol Metab 2018; 103: 532–538. Bultynck C, Pas C, Defreyne J, et al. Self‐perception of voice in transgender persons during cross‐sex hormone therapy. Laryngoscope 2017; 127: 2796–2804. Gao Y, Maurer T, Mirmirani P. Understanding and addressing hair disorders in transgender individuals. Am J Clin Dermatol 2018; 19: 517–527. Ahmad S, Leinung M. The response of the menstrual cycle to initiation of hormonal therapy in transgender men

2019 MJA Clinical Guidelines

12. Neural correlates of ostracism in transgender persons living according to their gender identity: a potential risk marker for psychopathology? (PubMed)

Neural correlates of ostracism in transgender persons living according to their gender identity: a potential risk marker for psychopathology? Stigmatization in society carries a high risk for development of psychopathology. Transgender persons are at particularly high risk for such stigmatization and social rejection by others. However, the neural correlates of ostracism in this group have not been captured.Twenty transgender men (TM, female-to-male) and 19 transgender women (TW, male-to-female (...) . During re-inclusion, transgender persons showed greater ventral ACC activity relative to CW, possibly indicating persistent feelings of exclusion. Functional connectivity analyses supported these findings but showed a particularly altered functional connectivity between ACC and lateral prefrontal cortex in TM, which may suggest reduced emotional regulation to the ostracism experience in this group. Depressive symptoms or hormonal levels were not associated with these findings.The results bear

2018 Psychological Medicine

13. Biotechnologies that empower transgender persons to self-actualize as individuals, partners, spouses, and parents are defining new ways to conceive a child: psychological considerations and ethical issues (PubMed)

Biotechnologies that empower transgender persons to self-actualize as individuals, partners, spouses, and parents are defining new ways to conceive a child: psychological considerations and ethical issues Today, thanks to biomedical technologies advances, some persons with fertility issues can conceive. Transgender persons benefit also from these advances and can not only actualize their self-identified sexual identities but also experience parenthood. Based on clinical multidisciplinary (...) and the current ART options, we discuss how these new ways for persons to self-actualize and to experience parenthood can not only improve the condition of transgender persons (and the human condition as a whole through greater equity) but also introduce some elements of change in the habitual patterns of thinking especially in France. Finally, we discuss the ethical issues that accompany the arrival of these children and provide creative solutions to help society handle, accept, and support the advances made

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2018 Philosophy, ethics, and humanities in medicine : PEHM

14. Reduction in Gaps in High CD4 Count and Viral Suppression Between Transgender and Cisgender Persons Living With HIV in New York City, 2007-2016. (PubMed)

Reduction in Gaps in High CD4 Count and Viral Suppression Between Transgender and Cisgender Persons Living With HIV in New York City, 2007-2016. To compare trends in HIV outcomes for cisgender and transgender persons living with HIV (PLWH) in New York City.We used HIV surveillance data for the analysis. We based CD4 count on the last measurement in a calendar year and defined viral suppression as the last viral load being less than or equal to 200 copies per milliliter in the calendar year.The (...) estimated number of PLWH increased from 73 415 in 2007 to 83 299 in 2016, including 606 transgender persons (0.8%) in 2007 and 1054 transgender persons (1.3%) in 2016. The proportion with CD4 count of 500 cells per cubic millimeter or more increased from 38% in 2007 to 61% in 2016 among cisgender persons versus 32% to 60% among transgender persons. The proportion with a suppressed viral load increased from 52% in 2007 to 80% in 2016 among cisgender persons versus 42% to 73% among transgender

2018 American Journal of Public Health

15. Supporting sexuality and improving sexual function in transgender persons. (PubMed)

Supporting sexuality and improving sexual function in transgender persons. Sexuality is important for most cisgender as well as transgender persons and is an essential aspect of quality of life. For both the patient and their clinicians, managing gender dysphoria includes establishing a comfortable relationship with sexual health issues, which can evolve throughout the course of gender-affirming treatment. Gender-affirming endocrine treatment of transgender men and women has considerable (...) GAS can be present despite dissatisfaction with the surgery and vice versa. Factors involved in the integrated experience of gender-affirming treatment and the way in which sexuality is perceived are complex, and supporting sexuality and improving sexual function in transgender patients is, correspondingly, multifaceted. As the transgender patient moves through their life before, during, and after gender-affirming treatment, sexuality and sexual function should be considered and maximized at all

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2018 Nature reviews. Urology

16. Prospective Evaluation of Self-Reported Aggression in Transgender Persons. (PubMed)

Prospective Evaluation of Self-Reported Aggression in Transgender Persons. Although research on the relation between testosterone and aggression in humans is inconclusive, guidelines (including the World Professional Association for Transgender Health Standards of Care, edition 7) have warned for an increase in aggression in transgender men taking testosterone treatment.To investigate the association between levels of testosterone and aggression in treatment-seeking transgender people (...) and explore the role of mental health psychopathology (anxiety and depressive symptoms) and social support in aggression in this population.Every transgender person invited for assessment at a national transgender health clinic in the United Kingdom during a 3-year period (2012-2015) completed self-report measures for interpersonal problems, including levels of aggression (Inventory of Interpersonal Problems [IIP-32]), symptoms of anxiety and depression (Hospital Anxiety and Depression Scale [HADS

2018 Journal Of Sexual Medicine

17. Barriers to accessing health care among transgender individuals

, a male-to-female transgender person may outwardly present as a woman but retain the anatomy to require prostate examinations; a female-to-male transgender person may present as a man but retain the anatomy to require screening for breast, ovarian, cervical, or uterine cancers. Medical professionals, therefore, may be unaware that a transgender patient requires certain procedures. Even if they do, procedures that are ”mismatched” with recorded gender can greatly affect insurance coverage (13). A lack (...) Transgender Persons or Transsexualism) and (text terms [healthcare or health care or health service*] or MeSH term Delivery of Health Care). Reference lists of identified reviews were also searched. All searches were conducted on July 27, 2017 and results were limited to English articles published from 2007 to present in high-income countries. The search yielded 1,022 references from which 27 studies were included. Sample sizes of primary studies ranged from 6 to 408. Factors that may impact local

2018 Ontario HIV Treatment Network

18. PES Statement Promoting Safety of Transgender Youth

providers of transgender youth, we have seen the discrimination and safety concerns that this population faces, which may lead to mental illness and high risk of suicide. Transgender children and adolescents need a safe and supportive school environment in order to thrive like any other young person. Not allowing them to use the restroom that matches their gender identity is a violation of human rights and sends a message of intolerance that will promote further discrimination and segregation (...) PES Statement Promoting Safety of Transgender Youth March 2017 6728 Old McLean Village Drive • McLean • VA • 22101 • 703-556-9222 • www.pedsendo.org PES Statement Promoting Safety of Transgender Youth The Pediatric Endocrine Society (PES), the leading professional society for this specialty in the United States, strongly opposes the guidance issued on February 22, 2017, by the Departments of Justice and Education, which eliminates protection of the rights of transgender youth. As medical

2019 Pediatric Endocrine Society

19. “It’s for us –newcomers, LGBTQ persons, and HIV-positive persons. You feel free to be”: a qualitative study exploring social support group participation among African and Caribbean lesbian, gay, bisexual and transgender newcomers and refugees in T (PubMed)

“It’s for us –newcomers, LGBTQ persons, and HIV-positive persons. You feel free to be”: a qualitative study exploring social support group participation among African and Caribbean lesbian, gay, bisexual and transgender newcomers and refugees in T Stigma and discrimination harm the wellbeing of lesbian, gay, bisexual and transgender (LGBT) people and contribute to migration from contexts of sexual persecution and criminalization. Yet LGBT newcomers and refugees often face

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2016 BMC international health and human rights

20. Pre-exposure prophylaxis for MSM and transgender persons in early adopting countries. (PubMed)

Pre-exposure prophylaxis for MSM and transgender persons in early adopting countries. : Pre-exposure prophylaxis (PrEP) is a potent and underutilized HIV prevention tool. In this paper we review the state of knowledge regarding PrEP implementation for men who have sex with men and transgender persons in early adopting countries. We focus on implementation of PrEP in demonstration projects and clinical care, and describe the status of PrEP availability and uptake. We report on approaches

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2017 AIDS

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