Measuring Gender in the Healthy Oregon Project

项目总结 性和性别少数(SGM)群体(即LGBTQ+)在癌症中的比例极低 研究。因此，关于与癌症相关的健康结果和不平等的数据有限，而且缺乏 改善卫生公平的循证方法。重要的是，SGM这一总括术语包括 异质种群，但迄今为止的许多工作要么合并了亚群，要么未能解聚 变性人和性别多元化(TGD)个人。因此，更有必要包括TGD 在这项研究中纳入对性别认同的有意义和准确的评估。 NIH已经制定了改进临床研究的建议，以改善SGM的健康状况。这些 包括改进和扩大性别认同和性取向数据收集，注意 交叉性和社区参与，以确保文化能力/谦逊。建议数 行政补充项目遵循这些建议，让TGD参与者参与 创建性别衡量项目的过程，在大量现有队列中测试新的衡量标准，以及 进行描述性分析，为未来的研究提供信息。这个项目的主要目标是进行一项 混合方法研究，以指导关于用于评估健康人群性别的术语的决定 俄勒冈计划(HOP)。在改善和执行性别平等方面取得了很大进展 在衡量方面取得了很大进展，但长期存在的挑战依然存在。更具体地说，当前的建议是 所使用的语言/术语和答复选项可能不能充分和全面地反映性别或 性别认同的流动性。这类问题可能导致系统性的性别分类错误和答复率低 在研究中，以及在TGD个人中造成不适和被排斥的感觉。带着目标 关于改进的和包容性的性别衡量，我们建议通过 个人访谈、焦点小组、在大型社区队列中实施调查的迭代过程， 并就结果和建议与社区利益攸关方进行磋商。这项工作将增加 通过HOP收集的关于健康行为和癌症筛查的大量数据的新数据。在……里面 此外，拟议的补编将促进改善跨父母研究队列的数据收集 都是通过HOP招募的，并提供了一个宝贵的机会来解决未来关于以下方面的重要问题 TGD携带者在后续筛查和预防行为上的可能差异 HBOC或Lynch突变。更广泛地说，这些结果将有助于扩大有效性别的收集 身份数据，将特定于TGD的数据纳入研究，以及改进癌症结果评估 以及TGD社区的健康差距。

PROJECT SUMMARY The sexual and gender minority (SGM) community (i.e., LGBTQ+) is vastly underrepresented in cancer research. As such, there are limited data on cancer-related health outcomes and inequities, and a lack of evidence-based approaches to improve health equity. Importantly, the SGM umbrella term encompasses a heterogenous population, but much work to date has either combined subgroups or failed to disaggregate transgender and gender diverse (TGD) individuals. As such, there is an even greater need to include TGD individuals in research, and to include meaningful and accurate assessment of gender identity in that research. The NIH has developed recommendations for improvements in clinical research to improve SGM health. These include improved and expanded collection of gender identity and sexual orientation data, attention to intersectionality, and community engagement to ensure cultural competence/humility. The proposed administrative supplement project follows these recommendations by engaging TGD participants in the process of creating gender measurement items, testing the new measures in a large existing cohort, and conducting descriptive analyses to inform future research. The primary aim of this project is to conduct a mixed-methods study to guide decisions about terminology used for assessing gender within the Healthy Oregon Project (HOP). Much progress has been made toward improvement in and implementation of gender measurement, but persistent challenges remain. More specifically, current recommendations for language/terminology and response options used may not adequately and inclusively capture gender or the fluidity of gender identity. Such issues can lead to systemic gender miscategorization and low response rates in research, as well as contribute to discomfort and feelings of exclusion among TGD individuals. With the goal of improved and inclusive gender measurement, we propose to identify and test assessment items through an iterative process of individual interviews, focus groups, survey implementation in a large community cohort, and consultation with community stakeholders regarding results and recommendations. This work will add novel data to the extensive data already collected through HOP on health behaviors and cancer screening. In addition, the proposed supplement will facilitate improved data collection across the parent study cohorts that are recruited through HOP and provide a valuable opportunity to address important future questions regarding possible differences in follow on screening and prevention behaviors among TGD individuals who carry an HBOC or Lynch mutation. More broadly, the results will contribute to the expanded collection of valid gender identity data, the inclusion of TGD-specific data in research, and the improved assessment of cancer outcomes and health disparities for TGD communities.