Gendered Situated Vulnerabilities and Mental Health among Transgender Men in India

印度跨性别男性的性别处境脆弱性和心理健康

• 批准号: 10370311
• 负责人: Ayden I Scheim
• 金额: $ 18.72万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-15 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10370311
• 关键词: Address; Adult; Anxiety; Asia; Attention; Back; Birth; Caring; Cities; Communities; Country; Data; Development; Diagnosis; Discrimination; Evaluation; Face; Family; Female; Funding; Future; Gender; Gender Identity; Goals; Health; Health Policy; Health Surveys; Healthcare; Heterogeneity; Income; India; Institutes; Intervention; Interview; Legal; Masculine; Measures; Mental Depression; Mental Health; Mental disorders; Methodology; Methods; National Institute of Mental Health; Outcome; Participant; Persons; Policies; Population; Prevalence; Psychometrics; Publications; Qualitative Methods; Recommendation; Reporting; Research; Resources; Rights; Risk Factors; Self-Injurious Behavior; Social Policies; Suicide; Suicide attempt; Surveys; Time; United States; United States National Institutes of Health; Violence; Woman; base; cisgender; community based participatory research; compare effectiveness; court; design; ethnic diversity; experience; health data; health disparity; health disparity populations; hormone therapy; improved; innovation; low and middle-income countries; male health; men; mental development; minority stress; novel; peer; population survey; protective factors; racial and ethnic; recruit; resilience; same sex behavior; sex; social culture; social stigma; systematic review; transgender; transgender men; transgender women; transmasculine

Project Summary Transgender health research has historically focused on transgender women, yet where data are available, transgender men and transmasculine persons (TM) demonstrate similar or higher mental health burden. In low and middle-income countries, however, mental health among TM remains almost entirely unresearched. A 2019 systematic review revealed no scientific publications on TM mental health in India, a country that accounts for 15% of the global burden of mental disorders and where the transgender community is experiencing major socio-legal changes that may impact mental health. To fill this critical gap, a mixed- methods study of TM mental health is proposed, including the first quantitative survey of TM in South Asia. This study introduces a novel Transmasculine Gendered Situated Vulnerabilities framework which integrates gender-based analysis with a minority stress perspective to understand the mental health effects of vulnerabilities and resiliencies related to gender identity as well as assigned sex, situated within the Indian socio-cultural context. Applying a community-based participatory research approach and a sequential (QUAL  QUANT) mixed-methods design, 30 TM will be qualitatively interviewed (15 in Delhi and 15 in Mumbai, India's largest cities) and 300 TM (150 per city) will be recruited to a quantitative survey using online and in- person approaches. The specific aims are to: 1. Using qualitative methods, identify gendered situated vulnerabilities and resiliencies experienced by Indian TM and explore perceived mental health impacts and recommendations for interventions. 2. Develop, adapt, and psychometrically assess measures of vulnerabilities (e.g., family rejection and violence) and resiliencies (e.g., community connectedness, family acceptance), for Indian TM. 3. Quantify mental health challenges (depression, anxiety, self-injury, suicidality) among Indian TM and evaluate associations with gendered situated vulnerabilities and multi-level resiliencies. To inform future research and interventions with this population, survey data will also be used to compare the effectiveness of online versus in-person recruitment strategies. The significance of this timely study lies in the identification of multi-level factors associated with mental health among Indian TM, with the potential to impact rapidly evolving transgender health and social policies in India and beyond. The proposed research applies an innovative theoretical framework to “put the gender back into transgender health”. Expected outcomes include the development of new measures reflecting family experiences of TM, with applications for global and U.S. transgender health research. Study results will inform the development and evaluation of an intervention to promote mental health for TM in India (R34/R01).

项目摘要 跨性别健康研究历来侧重于跨性别妇女，但在数据可用的情况下， 跨性别男性和跨男性化者（TM）表现出类似或更高的心理健康负担。在低 然而，在中等收入国家，TM的心理健康仍然几乎完全没有研究。一 2019年的系统审查显示，印度没有关于TM心理健康的科学出版物， 占全球精神障碍负担的15%， 经历可能影响心理健康的重大社会法律变化。为了填补这一关键空白，混合- 方法提出了对TM心理健康的研究，包括首次在南亚进行的TM定量调查。 本研究介绍了一种新的基于性别的情境脆弱性框架， 基于性别的分析，从少数民族压力的角度来了解 与性别认同以及性别分配有关的脆弱性和不确定性，位于印度 社会文化背景。应用基于社区的参与性研究方法和顺序（QUAL） QUANT）混合方法设计，将对30名TM进行定性访谈（德里15名，孟买15名， 印度最大的城市）和300个TM（每个城市150个）将被招募到一个定量调查，使用在线和在线- 人接近。具体目标是： 1.使用定性方法，确定印度人所经历的性别脆弱性和暴力行为 TM和探索感知的心理健康影响和干预措施的建议。 2.制定、调整和心理评估脆弱性措施（例如，家庭排斥和暴力） 和不确定性（例如，社区连通性，家庭接受度），对于印度TM。 3.量化印度TM中的心理健康挑战（抑郁，焦虑，自伤，自杀）， 评估与基于性别的脆弱性和多层次的脆弱性之间的关联。 为了告知未来对这一人群的研究和干预措施，调查数据也将用于比较 在线招聘战略与面对面招聘战略的有效性。这一及时研究的意义在于， 确定与印度TM中心理健康相关的多层次因素，并有可能影响 在印度和其他地区迅速发展的跨性别健康和社会政策。该研究采用了一种 创新的理论框架，以“把性别回到变性人的健康”。预期成果包括 制定反映TM家庭经验的新措施，并应用于全球和美国。 变性人健康研究研究结果将为干预措施的制定和评估提供信息， 促进印度TM的心理健康（R34/R 01）。