Looking at Population Health Beyond "Male" and "Female": Implications of Transgender Identity and Gender Nonconformity for Population Health
Looking at Population Health Beyond "Male" and "Female": Implications of Transgender Identity and Gender Nonconformity for Population Health
复制标题
DOI：
10.1007/s13524-018-0714-3
复制
发表时间：
2018-12-01
期刊：
影响因子：
3.5
通讯作者：
Lagos, Danya
中科院分区：
文献类型：
--
作者：
Lagos, Danya
超越男性或女性的二元衡量标准，可以揭示与性别认同而非生理性别相对应的健康不平等模式。本研究考察了美国人口中跨性别男性、跨性别女性、性别不符成年人以及顺性别（非跨性别）男性和女性在整体健康方面的差异。2014年至2016年期间来自美国32个州和地区的行为风险因素监测系统（BRFSS）数据产生了一个分析样本，其中确定了2229名跨性别和性别不符的成年人以及516753名顺性别成年人。以顺性别男性作为参照组，逻辑回归模型的估计结果显示，性别不符的受访者报告自评健康状况不佳的几率明显高于任何其他性别认同群体。在一些模型中，跨性别男性报告健康状况不佳的几率也较高，这与他们相对的社会经济劣势相符。我发现跨性别女性没有明显的健康劣势，而顺性别女性则存在持续的（尽管轻微的）劣势。在对人口统计学、社会经济和行为因素进行调整后，性别不符受访者报告健康状况不佳的预测概率仍然几乎是顺性别男性的两倍。他们与健康相关的持续劣势模式凸显了需要有关性别不符受访者的更高质量数据，这些数据应考虑出生时指定的性别。
Looking beyond binary measurements of male or female can illuminate health inequality patterns that correspond to gender identity rather than biological sex. This study examines disparities in overall health among transgender men, transgender women, gender-nonconforming adults, and cisgender (nontransgender) men and women in the U.S. population. Behavioral Risk Factor Surveillance System (BRFSS) data from 32 U.S. states and territories between 2014 and 2016 yield an analytic sample that identifies 2,229 transgender and gender-nonconforming adults and 516,753 cisgender adults. Estimates from logistic regression models, using cisgender men as a reference group, show that gender-nonconforming respondents have significantly higher odds of reporting poor self-rated health than any other gender identity group. Transgender men also display higher odds of reporting poor health in some models, corresponding to their relative socioeconomic disadvantage. I find no apparent health disadvantage among transgender women and a persistent, if slight, disadvantage among cisgender women. Gender-nonconforming respondents' predicted probabilities of reporting poor health remain nearly twice as high as those of cisgender men after adjustments for demographic, socioeconomic, and behavioral factors. Their persistent patterns of health-related disadvantage underscore the need for higher-quality data on gender-nonconforming respondents that account for sex assigned at birth.