Factors Associated with Gender-Affirming Surgery and Age of Hormone Therapy Initiation Among Transgender Adults.
Factors Associated with Gender-Affirming Surgery and Age of Hormone Therapy Initiation Among Transgender Adults.
复制标题
DOI：
10.1089/trgh.2017.0028
复制
发表时间：
2017
影响因子：
2
通讯作者：
Keuroghlian AS
中科院分区：
文献类型：
--
作者：
Beckwith N;Reisner SL;Zaslow S;Mayer KH;Keuroghlian AS
目的：性别确认手术和激素治疗是缓解性别焦虑症的医学必要疗法；然而，在变性成年人中，关于手术使用和激素治疗开始年龄的研究和临床文献中存在着显著的差距。方法：我们对2010年7月1日至2015年6月30日(含)在马萨诸塞州波士顿一家城市社区卫生中心就诊的201名年龄在18岁至之间的变性人的电子健康记录数据进行了回顾。在我们的分析中，50%的人是跨性男性(TM)，50%的跨性女性，24%的人报告了性别酷儿/非二元性别认同。回归模型适用于评估性别确认手术和激素治疗开始年龄的人口统计学、性别认同相关、性史和心理健康相关因素。结果：总体而言，95%的患者由他们的初级保健提供者开出激素处方，开始男性化或女性化激素处方的平均年龄为31.8岁(SD=11.1)。开始开激素处方的年龄较小与TM、学生、异性恋/异性恋者、有随意性伴侣、既往无酒精使用障碍有关。约三分之一(32%)有明确的性别确认手术病史。与手术几率增加相关的因素包括年龄较大、收入水平较高、不认为自己是双性恋、以及没有目前的心理治疗师。结论：这项研究扩大了我们对寻求初级保健的变性人成年人中性别肯定治疗的患病率和相关因素的理解。这些发现可以为未来的干预措施提供参考，以扩大对变性人患者的临床护理。
Purpose: Gender-affirming surgeries and hormone therapy are medically necessary treatments to alleviate gender dysphoria; however, significant gaps exist in the research and clinical literature on surgery utilization and age of hormone therapy initiation among transgender adults. Methods: We conducted a retrospective review of electronic health record data from a random sample of 201 transgender patients of ages 18–64 years who presented for primary care between July 1, 2010 and June 30, 2015 (inclusive) at an urban community health center in Boston, MA. Fifty percent in our analyses were trans masculine (TM), 50% trans feminine, and 24% reported a genderqueer/nonbinary gender identity. Regression models were fit to assess demographic, gender identity-related, sexual history, and mental health correlates of gender-affirming surgery and of age of hormone therapy initiation. Results: Overall, 95% of patients were prescribed hormones by their primary care provider, and the mean age of initiation of masculinizing or feminizing hormone prescriptions was 31.8 years (SD=11.1). Younger age of initiation of hormone prescriptions was associated with being TM, being a student, identifying as straight/heterosexual, having casual sexual partners, and not having past alcohol use disorder. Approximately one-third (32%) had a documented history of gender-affirming surgery. Factors associated with increased odds of surgery were older age, higher income levels, not identifying as bisexual, and not having a current psychotherapist. Conclusion: This study extends our understanding of prevalence and factors associated with gender-affirming treatments among transgender adults seeking primary care. Findings can inform future interventions to expand delivery of clinical care for transgender patients.