Decrements in health-related quality of life associated with gender nonconformity among US adolescents and young adults
Decrements in health-related quality of life associated with gender nonconformity among US adolescents and young adults
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DOI：
10.1007/s11136-017-1545-1
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发表时间：
2017-08-01
影响因子：
3.5
通讯作者：
Austin, S. Bryn
中科院分区：
文献类型：
--
作者：
Gordon, Allegra R.;Krieger, Nancy;Austin, S. Bryn
性别不一致，即超越传统的“男性”与“女性”特征，往往受到污名化。污名化和歧视是社会压力因素，会增加对身心健康产生不利后果的风险，并可能导致卫生不平等。然而，很少有人知道这些社会压力和健康相关的生活质量（HRQOL）之间的关系。本文旨在研究美国青少年和年轻人队列中感知性别不一致与HRQOL之间的关联。（18-31岁）在美国成长的今天研究（93%为白色，88%为中高收入），我们估计了性别不一致性的风险比（RR（三个等级：高度性别一致、中度一致和性别一致）和使用EuroQol问卷（EQ-5D-5L）的HRQOL。模型根据人口统计学特征进行了调整，包括性取向认同。（95%置信区间）：1.76（1.16，2.68）]，日常活动[2.29（1.67，3.13）]，疼痛或不适[1.59，（1.38，1.83）]，焦虑或抑郁[1.72（1.39，2.13）]，调整性取向和人口统计学特征后。观察到性别不一致性导致健康效用下降：与性别高度一致的人相比，中等性别一致性的平均健康效用较低[beta（SE）：-0.011（.002）]，最性别一致性的平均健康效用最低[-0.034（.005）]。未来的研究，包括在更多样化的人群中，应衡量与性别有关的骚扰，歧视和暴力受害对健康和HRQOL的影响。
Gender nonconformity, that is, transgressing conventionally "masculine" vs. "feminine" characteristics, is often stigmatized. Stigmatization and discrimination are social stressors that raise risk of adverse mental and physical health outcomes and may drive health inequities. However, little is known about the relationship between such social stressors and health-related quality of life (HRQOL). This paper aimed to examine associations between perceived gender nonconformity and HRQOL in a cohort of U.S. adolescents and young adults.Using data from 8408 participants (18-31 years) in the U.S. Growing Up Today Study (93% white, 88% middle-to-high income), we estimated risk ratios (RRs) for the association of gender nonconformity (three levels: highly gender conforming, moderately conforming, and gender nonconforming) and HRQOL using the EuroQol questionnaire (EQ-5D-5L). Models were adjusted for demographic characteristics, including sexual orientation identity.Gender nonconformity was independently associated with increased risk of having problems with mobility [RR (95% confidence interval): 1.76 (1.16, 2.68)], usual activities [2.29 (1.67, 3.13)], pain or discomfort [1.59, (1.38, 1.83)], and anxiety or depression [1.72 (1.39, 2.13)], after adjusting for sexual orientation and demographic characteristics. Decrements in health utility by gender nonconformity were observed: compared to persons who were highly gender conforming, mean health utility was lower for the moderately gender conforming [beta (SE): -0.011 (.002)] and lowest for the most gender nonconforming [-0.034 (.005)].In our study, HRQOL exhibited inequities by gender nonconformity. Future studies, including in more diverse populations, should measure the effect of gender-related harassment, discrimination, and violence victimization on health and HRQOL.