Satisfaction with current hormone therapy and goals of additional gender-affirming care in transgender adults.
Satisfaction with current hormone therapy and goals of additional gender-affirming care in transgender adults.
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对跨性别成人当前激素治疗的满意度以及额外性别肯定护理的目标。
DOI：
10.1093/jsxmed/qdad011
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Yeung,Howa
中科院分区：
文献类型：
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作者：
Siira,Meron;Getahun,Darios;Silverberg,MichaelJ;Tangpricha,Vin;Goodman,Michael;Yeung,Howa
背景许多跨性别者寻求激素治疗以减少性别不安并提高生活质量，但对患者对当前性别肯定激素治疗的满意度知之甚少。目的是检查患者对当前性别肯定激素治疗的满意度以及患者额外激素治疗的目标。方法要求经过验证的多中心 STRONG 队列（过渡、结果和性别研究）中的跨性别成年人完成一项横断面调查，了解当前和计划的激素治疗以及他们经历或希望的效果来获得。报告对激素治疗总体满意度的受访者比例与 χ2 或 Fisher 精确检验进行比较。 Cochran-Mantel-Haenszel 分析用于比较感兴趣的协变量，同时控制调查完成时的年龄。结果对激素疗法的患者满意度（每种疗法均采用 5 分制进行测量）进行平均和二分法。结果在 2136 名符合条件的跨性别成人中，696 名 (33%) 完成了调查：350 名跨性别 (TF) 受访者和 346 名跨男性 (TM) 受访者。大多数参与者（80%）对他们目前的激素疗法感到满意或非常满意。 TF 参与者和老年参与者分别比 TM 参与者和年轻参与者更不可能对当前的激素治疗感到满意。然而，在控制调查完成时的年龄后，TM 和 TF 类别与患者满意度无关。更多 TF 人员计划接受额外治疗。 TF 人群额外激素治疗最常见的目标包括乳房增大、女性身体脂肪分布和面部特征软化；对于 TM 患者，目标包括减少烦躁不安、增加肌肉质量和男性化的身体脂肪分布。临床意义除了提供激素治疗外，多学科护理（例如手术、皮肤科、生殖健康、心理健康和/或性别表达护理的参与）可能对帮助实现未满足的性别肯定护理目标很重要。优点和局限性这项研究的反应率适中，并且仅包括有私人保险的受访者，限制了普遍性。结论了解患者满意度和目标护理将有助于在以患者为中心的性别肯定治疗中共同决策和咨询。
BackgroundMany transgender persons seek hormone therapy to reduce gender dysphoria and improve quality of life, but little is known about patient satisfaction with current gender-affirming hormone therapy.AimTo examine patient satisfaction with current gender-affirming hormone therapy and patients’ goals of additional hormone therapy.MethodsTransgender adults in the validated multicenter STRONG cohort (Study of Transition, Outcomes, and Gender) were asked to complete a cross-sectional survey about current and planned hormone therapy and the effects that they experienced or hoped to gain. The proportion of respondents reporting overall satisfaction with hormone therapy were compared with χ2or Fisher exact test. Cochran-Mantel-Haenszel analysis was used to compare the covariates of interest while controlling for age at the time of survey completion.OutcomesPatient satisfaction across hormone therapies, each measured with a 5-point scale, was averaged and dichotomized.ResultsOut of 2136 eligible transgender adults, 696 (33%) completed the survey: 350 transfeminine (TF) and 346 transmasculine (TM) respondents. Most participants (80%) were satisfied or very satisfied with their current hormone therapies. TF participants and older participants were less likely to report being satisfied with their current hormone therapies than TM participants and younger participants, respectively. However, TM and TF categories were not associated with patient satisfaction after controlling for age at the time of survey completion. More TF persons planned to take additional treatment. The most frequent goals for additional hormone therapy for TF persons included breast size growth, feminine body fat distribution, and facial feature softening; for TM persons, goals included diminishing dysphoria, greater muscle mass, and masculine body fat distribution.Clinical ImplicationsMultidisciplinary care beyond provision of hormone therapy—such as involvement of surgical, dermatologic, reproductive health, mental health, and/or gender expression care—may be important to help achieve unmet gender-affirming care goals.Strengths and LimitationsThis study had a modest response rate and included only respondents with private insurance, limiting generalizability.ConclusionUnderstanding patient satisfaction and goals of care will assist shared decision making and counseling in patient-centered gender-affirming therapy.