Toward an improved screening protocol: developing and testing an organ inventory for strengthening clinical care and research

项目总结 该项目旨在开发和测试一种新的衡量标准--基于证据的器官库存--以改进 对变性人和非二元性别(少数性别)的性别认同的现有衡量 人口在癌症研究和护理中的作用。性别少数群体在获得医疗保健方面面临着许多障碍，而且 特别是癌症护理，这在很大程度上是由于目前筛查方案的性别性质。 流行病学数据强调了对可改变的癌症风险因素的不成比例的暴露和不成比例的 少数性别人群中的癌症负担。然而，性别少数群体也不太可能获得适当的 癌症筛查。这种不和谐的部分原因是，目前使用的性别认同衡量标准失败了 研究和临床护理，为癌症筛查、护理和研究提供必要的信息 性别少数，他们中的许多人的器官可能与他们的性别认同不一致。这个项目 建议实施一项混合方法研究，旨在开发一种新的措施来改善数据 质量，加强对推荐的针对性别少数群体的癌症筛查方案的遵守，并减少 参与者负担。该项目的具体目标包括(1)发展一个循证器官。 英语和西班牙语的清单，这是世界上性别少数群体使用的两种最常见的语言 美国，通过收集少数性别和顺性别参与者的定性研究获得信息 通过重点小组讨论；和(2)评价性别之间器官清单的可接受性 少数群体，以及对清单中报告的现有器官之间的不协调程度的估计 性别认同和出生时分配的性别，通过在线定量调查。世界专业人士 变性人健康协会呼吁建立这样的器官清单，这一措施将要求每个人 个人从不分性别或性别的列表中指明他们拥有的器官。这项研究将 解决目前衡量性别认同方面的重要方法差距，并使我们能够改进 以更高的准确性、敏感度和相关性进行癌症护理和研究的资格筛查 比以前可能的人口范围更广、更多样化。对于性别少数群体，这项研究可以 通过更具包容性、更少负担、更准确的措施，转化为增加研究参与度 数据，并最终降低与癌症相关的发病率、死亡率，以及由于早期风险而产生的医疗成本 侦测。此外，器官清单可能适用于所有性别的人；以及未来的研究 可以探索翻译成其他语言和在#年实施器官清单的最佳做法 为所有人提供临床入院表格、筛查清单、研究资格评估等。

PROJECT SUMMARY This project aims to develop and test a novel measure – an evidence-based organ inventory – to improve upon existing measurement of gender identity among transgender and gender nonbinary (gender minority) populations in cancer research and care. Gender minorities face numerous barriers to healthcare access, and specifically to cancer care, in large part due to the gendered nature of current screening protocols. Epidemiological data highlight disproportionate exposure to modifiable cancer risk factors and disproportionate cancer burden among gender minorities. However, gender minorities are also less likely to receive appropriate cancer screening. This discord is, in part, due to the failure of current measures of gender identity used in research and clinical care to provide the requisite information for cancer screening, care, and research for gender minorities, many of whom may have organs that are inconsistent with their gender identity. This project proposes to implement a mixed methods study aimed at developing a novel measure that will improve data quality, strengthen adherence to recommended cancer screening protocols for gender minorities, and reduce participant burden. The specific aims of this project include the (1) development of an evidence-based organ inventory in English and Spanish, the two most common languages spoken among gender minorities in the United States, informed by qualitative research with both gender minority and cisgender participants collected via focus group discussions; and (2) evaluation of the acceptability of the organ inventory among gender minorities, and estimation of the discordance between organs present as reported in the inventory versus gender identity and sex assigned at birth, via an online, quantitative survey. The World Professional Association for Transgender Health has called for such an organ inventory, a measure that would ask each person to indicate the organs that they have from a list that is not gender- or sex-specific. This study will address important methodological gaps in current measurement of gender identity and enable us to improve eligibility screening for cancer care and research with greater accuracy, sensitivity, and relevance, across a broader and more diverse population than previously possible. For gender minorities, this research could translate to increased research participation via more inclusive, less burdensome measures, more accurate data, and ultimately, reduced cancer-related morbidity, mortality, and healthcare costs due to earlier risk detection. Further, the organ inventory could be generalizable for people of all genders; and future research could explore translation into other languages and best practices for implementing the organ inventory in clinical intake forms, screening checklists, research eligibility assessment, and more, for all people.