Health Correlates of Criminal Justice Involvement in 4,793 Transgender Veterans
Health Correlates of Criminal Justice Involvement in 4,793 Transgender Veterans
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DOI：
10.1089/lgbt.2015.0052
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发表时间：
2015-12-01
期刊：
影响因子：
4.8
通讯作者：
Jones, Kenneth T.
中科院分区：
文献类型：
--
作者：
Brown, George R.;Jones, Kenneth T.
目的：变性人（TG）在监狱和美国退伍军人中的比例过高。健康差异的研究涉及大量的跨性别人群的刑事司法system.Methods：我们研究了一个大队列的TG退伍军人谁收到的照顾退伍军人健康管理局（VHA）设施在2007-2013年（n = 4,793）和3：1匹配的对照组的退伍军人没有已知的TG识别（n = 13,625）。三百二十六（n = 138 TG，188非TG）已收到VHA服务的方案，旨在解决司法参与（JI）退伍军人的需求。我们将三组患者与他们的医疗和行政数据联系起来。结果：TG退伍军人比对照组更有可能参与司法（2.88%对1.38%; P < .0001）。与非TG JI退伍军人相比，TG JI退伍军人更有可能有无家可归的历史（80%对67%; P < .05），并在军队服役期间报告性创伤（23%对12%; P < .01）。TG JI退伍军人抑郁症，高血压，肥胖症，创伤后应激障碍，严重的精神疾病，自杀意念/attempts.Conclusion：这些数据表明，TG退伍军人经历了一些健康风险相比，非TG退伍军人，包括司法参与的可能性增加。涉及刑事司法系统的TG退伍军人是一个特别脆弱的群体，旨在解决这一人群的医疗保健需求的服务，无论是在监禁期间还是在社区中，都应该考虑这些发现在制定健康筛查和治疗计划时。
Purpose: Transgender (TG) persons are overrepresented in prison settings and in the U.S. veteran population. Health disparities studies of large populations of transgender people involved with the criminal justice system have not been published to date.Methods: We studied a large cohort of TG veterans who received care in Veterans Health Administration (VHA) facilities during 2007-2013 (n = 4,793) and a 3: 1 matched control group of veterans without known TG identification (n = 13,625). Three hundred twenty six (n = 138 TG, 188 non-TG) had received VHA services in programs designed to address the needs of justice involved (JI) veterans. We linked patients in each of the three groups to their medical and administrative data.Results: TG veterans were more likely to be justice involved than controls (2.88% vs. 1.38%; P < .0001). Compared to non-TG JI veterans, TG JI veterans were more likely to have a history of homelessness (80% vs. 67%; P < .05) and to have reported sexual trauma while serving in the military (23% vs. 12%; P < .01). Significant health disparities were noted for TG JI veterans for depression, hypertension, obesity, posttraumatic stress disorder, serious mental illness, and suicidal ideation/attempts.Conclusion: These data suggest that TG veterans experience a number of health risks compared to non-TG veterans, including an increased likelihood of justice involvement. TG veterans involved with the criminal justice system are a particularly vulnerable group and services designed to address the health care needs of this population, both while incarcerated and when in the community, should take these findings into account in the development of health screenings and treatment plans.