Causes of Death of Transgender and Gender Diverse Veterans.
Causes of Death of Transgender and Gender Diverse Veterans.
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跨性别者和性别多样化退伍军人的死亡原因。
DOI：
10.1016/j.amepre.2023.11.014
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发表时间：
2024
影响因子：
5.5
通讯作者：
Blosnich,JohnR
中科院分区：
文献类型：
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作者：
Henderson,EmmettR;Boyer,TaylorL;Wolfe,HillL;Blosnich,JohnR
由于耻辱和边缘化，跨性别和性别多样化（TGD）退伍军人面临许多挑战，这对他们的健康和福祉产生了重大影响。然而，在美国，TGD退伍军人群体的死因特异性死亡率数据不足。本研究的目的是描述在接受退伍军人健康管理局护理的TGD退伍军人样本中的主要死亡原因。方法利用1999年10月1日至2019年12月31日退伍军人健康管理局电子健康档案数据与国家死亡索引中的死亡证明记录进行二次数据分析。利用国家死亡指数数据中的记录轴代码，总结了25种最常见的潜在死亡原因和所有死亡原因。结果1415名TGD退伍军人死亡。从死亡证明上的任何提及来看，使用精神活性物质导致的精神和行为障碍（17.2%）、传导障碍和心律失常（15.3%）、慢性阻塞性肺病（15.1%）、糖尿病（13.9%）和慢性缺血性心脏病（13.3%）是前五大死亡原因。三种不同的自杀方式分别出现在退伍军人死亡原因的第7位（火器）、第17位（自毒）和第24位（上吊）。结论有针对性的预防措施或干预措施，减少死亡原因的频率和严重程度，特别是精神和行为健康障碍和代谢障碍，可以预防TGD成人的过早死亡。
IntroductionTransgender and gender diverse (TGD) veterans face numerous challenges due to stigma and marginalization, which have a significant impact on their health and well-being. However, there is insufficient data on cause-specific mortality in TGD veteran populations in the U.S. The purpose of this study was to describe the leading causes of death in a sample of TGD veterans who received care from the Veterans Health Administration.MethodsA secondary data analysis was conducted using Veterans Health Administration electronic health record data matched with death certificate records from the National Death Index from October 1, 1999 to December 31, 2019. Using record axis codes from National Death Index data, the 25 most frequent underlying and all causes of death were summarized.ResultsDeaths occurred in 1,415 TGD veterans. Ranking by any mention on the death certificate, mental and behavioral disorders due to psychoactive substance use (17.2%), conduction disorders and cardiac dysrhythmias (15.3%), chronic obstructive pulmonary disease (15.1%), diabetes mellitus (13.9%), and chronic ischemic heart disease (13.3%) were the top five causes of death. Three distinct methods of suicide appeared as the 7th (firearms), 17th (self-poisoning), and 24th (hanging) underlying causes of death for TGD veterans.ConclusionsTargeted prevention efforts or interventions to reduce the frequency and severity of causes of death, particularly mental and behavioral health disorders and metabolic disorders, could prevent premature mortality among TGD adults.