Epidemiology, impact, and experience of acne in transgender persons

项目摘要/摘要 这项K23提案的总体目标是支持新的研究、培训和经验，对 候选人，医学博士，硕士，成为一名独立的，以患者为中心的研究性问题的调查员 以及在皮肤病方面的性别少数差异--例如变性人中的粉刺。严重粉刺 损害与健康相关的生活质量，并与抑郁、自卑和自杀念头有关。 关于内源性和外源性激素对痤疮发病率、严重程度、 影响、治疗和体验。我们先前的研究发现，荷尔蒙与粉刺患病率较高 并确定了变性人严重痤疮治疗的具体障碍。这项建议旨在 在变性人激素治疗的背景下检查痤疮的流行病学、影响和经验 人--在皮肤健康方面有显著知识差距的健康差距人群。流行性感冒的流行病学研究 痤疮将使用现有的大规模、经过验证的多中心过渡研究的数据进行检查， 结果和性别(强)。调节痤疮经历、治疗和治疗差异的因素 新的研究参与度将使用混合方法来吸引。开发和试点测试一种 招募方案和收集关于痤疮结果和心理健康共病的初步数据将 帮助启动一项关于接受激素治疗的变性人痤疮的前瞻性队列研究。要实现 这些目标，候选人将需要额外的培训，通过正规的教学相结合，实用 研究经验和专家的多学科指导。候选人将在性和性行为方面积累专业知识 性别少数民族健康和健康差异研究，以患者为导向的痤疮结果研究，混合- 方法研究技术，以及社区参与研究和患者招募的经验。 候选人的有指导的培训和研究计划将使他能够作为一名 独立的以患者为导向的调查者，解决皮肤病中的性和性别少数群体差异- 比如变性人身上的粉刺。关键结果将为新的痤疮和性别肯定激素提供信息 治疗范例以及未来干预措施的设计和实施，目的是减少已确定的 痤疮差异，优化痤疮临床结果，并改善以患者为中心的激素治疗 变性人。

PROJECT SUMMARY / ABSTRACT The overall objective of this K23 proposal is to support new research training and experience crucial for the candidate, Howa Yeung, MD MSc, to become an independent, patient-oriented investigator addressing sexual and gender minority disparities in skin diseases – such as acne in transgender persons. Acne significantly impairs health-related quality of life and is associated with depression, low self-esteem, and suicidal ideation. Little is known about the interplay of endogenous and exogenous hormones on acne incidence, severity, impact, treatment, and experience. Our prior studies noted higher acne prevalence associated with hormone therapy and identified specific barriers for severe acne treatment in transgender persons. This proposal aims to examine the epidemiology, impact, and experience of acne in the context of hormone therapy in transgender persons – a health disparity population with significant knowledge gaps in skin health. The epidemiology of acne will be examined using data from the existing large-scale, validated, multicenter Study of Transition, Outcomes and Gender (STRONG). Factors that mediate differences in acne experience, treatment, and research participation will be newly elicited using mixed methods. Development and pilot testing of a recruitment protocol and collection of preliminary data on acne outcomes and mental health comorbidity will help initiate a prospective cohort study of acne in transgender persons receiving hormone therapy. To achieve these aims, the candidate will require additional training through a combination of formal didactics, practical research experience, and expert multidisciplinary mentorship. The candidate will build expertise in sexual and gender minority health and health disparities research, patient-oriented outcomes research in acne, mixed- methods research techniques, as well as experience in community-engaged research and patient recruitment. The candidate’s mentored training and research plans will enable him to launch a successful career as an independent patient-oriented investigator addressing sexual and gender minority disparities in skin diseases – such as acne in transgender persons. Key results will inform new acne and gender-affirming hormone treatment paradigms and the design and implementation of future interventions, aimed to reduce the identified acne disparities, optimize acne clinical outcomes, and to improve patient-centeredness of hormone therapy in transgender persons.