Cohort study of mortality and morbidity in transgender persons

跨性别者死亡率和发病率的队列研究

• 批准号: 8701325
• 负责人: Michael Goodman
• 金额: $ 18.92万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8701325
• 关键词: Address; Advocate; Affect; Age; Age-Years; Agreement; Birth; California; Cardiovascular Diseases; Caring; Case Study; Categories; Cessation of life; Chronic; Chronic Disease; Cohort Analysis; Cohort Studies; Communities; Community Healthcare; Comorbidity; Computerized Medical Record; Consultations; Cross-Sectional Studies; Current Procedural Terminology Codes; Data; Data Set; Data Sources; Diabetes Mellitus; Diagnosis; Disease; Enrollment; Epidemiology; Estrogens; European; Female; Focus Groups; Foundations; Future; Gender; Gender identity disorder; Genital system; Goals; Gonadal Steroid Hormones; HIV; HIV diagnosis; Health; Health Personnel; Health Planning; Health Status; Health system; Healthcare Systems; Hepatitis C; Hormonal; Hormones; Incidence; Individual; Institute of Medicine (U.S.); International Classification of Disease Codes; Intervention; Intervention Trial; Knowledge; Lesbian Gay Bisexual Transgender Intersex; Letters; Link; Longitudinal Studies; Malignant Neoplasms; Malignant neoplasm of prostate; Managed Care; Measures; Medical Records; Menopause; Mental Health; Mental disorders; Morbidity - disease rate; NIH Program Announcements; Observational Study; Operative Surgical Procedures; Osteoporosis; Outcome; Participant; Persons; Phase; Population; Population Study; Prevalence; Procedures; Prospective Studies; Psychotherapy; Qualitative Methods; Qualitative Research; Recommendation; Records; Reporting; Research; Research Infrastructure; Risk; Risk Behaviors; Sampling; Sexually Transmitted Diseases; Site; Source; Staging; Testosterone; Thoracic Surgical Procedures; United States; United States Department of Veterans Affairs; Universities; Veterans; Woman; age related; base; breast surgery; cancer risk; cohort; gender dysphoria; male; member; men; minority health; mortality; multidisciplinary; physical conditioning; public health relevance; reconstruction; sexual minority; transgender

DESCRIPTION (provided by applicant): The goal of this application is to develop a longitudinal cohort study of the short- and long-term health outcomes among individuals who underwent hormonal and/or surgical gender reassignment interventions. Members of the transgender community and health care providers caring for transgender individuals express concerns about mental and physical health problems in this population; however longitudinal studies of transgender populations in the US have not been conducted. This project includes two distinct phases. The first phase is an electronic medical record (EMR) based study evaluating a cohort of 5462 transgender individuals, whose care is covered by the Veterans Administration (nationally) or by Kaiser Permanente (in Georgia and in Northern California). We will compare incidence, prevalence and mortality estimates in the full cohort and in the female-to-male (FTM) and male-to-female (MTF) sub-cohorts to the corresponding measures in the age- and health plan-matched samples of male and female enrollees. We will also perform within-cohort analyses to compare health outcomes across categories of transgender participants (e.g., MTF versus FTM or treatment with hormones versus hormones + surgery). The second phase (Aim 3) of the proposed project will describe facilitators of and barriers to research enrollment, and identify points of influence that would aid recruitment of transgender individuals into future observational studies and intervention trials. This aim will be achieved through Focus Group Discussions (FGDs), and the resulting information will be analyzed using qualitative methods. FGDs will aim to evaluate three central issues: 1) barriers to enrollment in research, 2) facilitators of research participation, and 3) recommendations for recruitment into future studies. The proposed project will be carried out by a multidisciplinary team that includes experts in epidemiology of chronic and sexually transmitted diseases, mental disorders, and sexual minority health issues. All of the project activities will be implemented in consultation wih the study liaisons who will serve as advocates for the transgender community. The proposed study will likely be the largest cohort of transgender individuals available to date, and the first study of its kind conducted in the United States. Another distinguishing feature of this project is that it will lay foundation for future full-scale studies that will use nationwide data sources.

描述（由申请人提供）：本申请的目标是在接受激素和/或手术性别重置干预的个体中开展一项短期和长期健康结局的纵向队列研究。跨性别社区成员和照顾跨性别者的医疗保健提供者对这一人群的心理和身体健康问题表示担忧;然而，美国尚未进行跨性别人群的纵向研究。该项目包括两个不同的阶段。第一阶段是一项基于电子病历（EMR）的研究，评估了5462名跨性别者的队列，他们的护理由退伍军人管理局（全国）或凯撒医疗机构（格鲁吉亚和北方加州）负责。我们将比较全队列、女性对男性（FTM）和男性对女性（MTF）子队列中的发病率、患病率和死亡率估计值与男性和女性入组者的年龄和健康计划匹配样本中的相应测量值。我们还将进行队列内分析，以比较跨性别参与者类别的健康结果（例如，MTF与FTM或激素治疗与激素+手术）。拟议项目的第二阶段（目标3）将描述研究招募的促进因素和障碍，并确定影响点，以帮助招募跨性别者进入未来的观察性研究和干预试验。这一目标将通过焦点小组讨论来实现，并将使用定性方法分析所得到的信息。FGD旨在评估三个核心问题：1）研究招募的障碍，2）研究参与的促进者，以及3）未来研究招募的建议。拟议的项目将由一个多学科小组执行，其中包括慢性病和性传播疾病流行病学、精神障碍和性少数健康问题方面的专家。所有项目活动都将在与研究联络员协商后实施，联络员将作为变性人社区的倡导者。这项拟议中的研究可能是迄今为止最大的跨性别人群，也是第一个 在美国进行的同类研究。这个项目的另一个特点是 它将为今后使用全国性数据来源的全面研究奠定基础。

项目成果

Progression of Gender Dysphoria in Children and Adolescents: A Longitudinal Study.

• DOI: 10.1542/peds.2020-027722
• 发表时间: 2021-07
• 期刊: Pediatrics
• 影响因子: 8
• 作者: Wagner S;Panagiotakopoulos L;Nash R;Bradlyn A;Getahun D;Lash TL;Roblin D;Silverberg MJ;Tangpricha V;Vupputuri S;Goodman M
• 通讯作者: Goodman M

Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people.

• DOI: 10.1136/bmjopen-2017-018121
• 发表时间: 2017-12-27
• 期刊: BMJ open
• 影响因子: 2.9
• 作者: Quinn VP;Nash R;Hunkeler E;Contreras R;Cromwell L;Becerra-Culqui TA;Getahun D;Giammattei S;Lash TL;Millman A;Robinson B;Roblin D;Silverberg MJ;Slovis J;Tangpricha V;Tolsma D;Valentine C;Ward K;Winter S;Goodman M
• 通讯作者: Goodman M

A novel method for estimating transgender status using electronic medical records.

• DOI: 10.1016/j.annepidem.2016.01.004
• 发表时间: 2016-03
• 期刊: Annals of epidemiology
• 影响因子: 5.6
• 作者: Roblin D;Barzilay J;Tolsma D;Robinson B;Schild L;Cromwell L;Braun H;Nash R;Gerth J;Hunkeler E;Quinn VP;Tangpricha V;Goodman M
• 通讯作者: Goodman M

Cross-sex Hormones and Acute Cardiovascular Events in Transgender Persons: A Cohort Study.

• DOI: 10.7326/m17-2785
• 发表时间: 2018-08-21
• 期刊: Annals of internal medicine
• 影响因子: 39.2
• 作者: Getahun D;Nash R;Flanders WD;Baird TC;Becerra-Culqui TA;Cromwell L;Hunkeler E;Lash TL;Millman A;Quinn VP;Robinson B;Roblin D;Silverberg MJ;Safer J;Slovis J;Tangpricha V;Goodman M
• 通讯作者: Goodman M

Frequency and distribution of primary site among gender minority cancer patients: An analysis of U.S. national surveillance data.

• DOI: 10.1016/j.canep.2018.02.008
• 发表时间: 2018-06
• 期刊: Cancer epidemiology
• 影响因子: 2.6
• 作者: Nash R;Ward KC;Jemal A;Sandberg DE;Tangpricha V;Goodman M
• 通讯作者: Goodman M