Priorities for transgender medical and healthcare research.
Priorities for transgender medical and healthcare research.
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DOI：
10.1097/med.0000000000000231
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发表时间：
2016-04
期刊：
影响因子：
--
通讯作者：
Safer JD
中科院分区：
文献类型：
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作者：
Feldman J;Brown GR;Deutsch MB;Hembree W;Meyer W;Meyer-Bahlburg HF;Tangpricha V;TʼSjoen G;Safer JD
跨性别者经历独特的健康差异，但很少有重点的健康研究。这份手稿回顾了当前关于跨性别医疗和心理健康结果的文献，并提出了解决知识差距的研究重点。已发表的跨性别卫生保健研究主要包括病例报告、回顾性和横断面研究，主要涉及欧洲环境。美国跨性别健康研究面临的挑战包括人口多样化，没有一个单一的中心有足够的患者基础进行统计严格的临床研究。治疗方案各不相同，需要研究最佳做法。目前的研究表明，未接受最佳护理的跨性别者的死亡率和抑郁症增加，并且可能与激素治疗相关的心血管风险适度增加。目前的证据不支持激素相关恶性肿瘤风险的担忧。跨性别医疗结果研究的优先事项应该是确定健康差异和共病的健康状况在整个生命周期，沿着心理健康，医疗和手术干预对发病率和死亡率的影响。基于文献中的频率、结局的潜在严重程度和以患者为中心的关注，关注的特定结局包括情感障碍、心血管疾病、恶性肿瘤、生育力和特定干预的时间-剂量相关反应。
Transgender individuals experience unique health disparities but are the subject of little focused health research. This manuscript reviews current literature on transgender medical and mental health outcomes and proposes research priorities to address knowledge gaps. Published research in transgender health care consists primarily of case reports, retrospective and cross-sectional studies, involving largely European settings. Challenges to US-based transgender health research include a diverse population where no single center has sufficient patient base to conduct clinical research with statistical rigor. Treatment regimens are heterogeneous and warrant study for best practices. Current research suggests increased mortality and depression in transgender individuals not receiving optimal care, and possibly a modest increase in cardiovascular risk related to hormone therapy. Current evidence does not support concerns for hormone related malignancy risk. The priorities for transgender medical outcomes research should be to determine health disparities and co-morbid health conditions over the life span, along with the effects of mental health, medical, and surgical interventions on morbidity and mortality. Specific outcomes of interest based on frequency in the literature, potential severity of outcome, and patient-centered interest, include affective disorders, cardiovascular disease, malignancies, fertility, and time-dose related responses of specific interventions.