Substance and Non-Prescribed Hormone Use Among Transmen

项目总结/摘要 这项拟议中的研究将调查物质使用的轨迹，处方激素的使用 (PHU)，非处方激素使用（NPHU）和心理健康， transwomen（男性对女性的跨性别者）和transmen（女性对男性的跨性别者 （a）在出生时指定的性别以外确定自己性别的人。许多跨性别者试图 调整他们的外表，以配合他们的内部性别认同，通过采取交叉， 性激素和外科手术世界专业护理标准 跨性别健康协会建议开始使用跨性别激素， 手术治疗那些谁是从出生时分配的性别过渡到性别 在心理健康专业人员的全面咨询后，他们认同。期间 过渡，许多transwomen/men面临着一些困难，由于transphobia，暴露于 性暴力和身体暴力以及基于性别的歧视。激素治疗和外科手术 干预措施帮助变性妇女/男子增进健康和福祉， 安全为代价的在变性妇女/男子中，药物使用和NPHU的流行率很高， 报道使用NPH的跨性别女性比使用NPH的跨性别女性报告了更多的物质使用 只有处方激素（PH）。NPH使用者也表现出更高的抑郁症患病率， 自杀念头，跨性别恐惧症，以及较低的自尊水平。据报道， NPHU是麻烦的，因为NPHU与不适当的剂量和缺乏 医疗监测会增加健康风险。很少有研究调查了 药物使用和PHU/NPHU与变性妇女/男子的心理社会因素有关。 本研究的具体目的是：（1）纵向描述和了解 跨性别女性的物质使用轨迹、PHU/NPHU和心理健康 以及与背景变量相关的transmen（例如，性别认同和过渡， 性取向和性伙伴关系的流动性）; 2）探索和确定心理社会 因素并检查心理社会因素的中介作用（例如，变性恐惧症 尊重，对性别转变的满意度，社会支持和跨社区身份） 健康结果（例如，物质使用、PHU/NPHU和心理健康）; 3） 在物质使用轨迹、PHU/NPHU方面比较变性女性和变性男性， 与心理社会因素和背景变量有关的心理结果; 4） 通过演讲和出版物传播研究结果，并为未来的健康 对被研究忽视的变性妇女/男子的促进干预研究 问题研究为了达到特定的目标，我们将采用混合方法：首先进行 对跨性别者/男性进行定性访谈，然后对跨性别者进行纵向研究 （n=120）和transmen（n=120）在旧金山弗朗西斯科湾地区招募。

Project Summary/Abstract The proposed study will investigate the trajectories of substance use, prescribed hormone use (PHU), non-prescribed hormone use (NPHU), and psychological well-being among transwomen (male-to-female transgender persons) and transmen (female-to-male transgender persons) who identify their gender other than that assigned at birth. Many trans people seek to align their physical appearance to match their internal gender identity through taking cross- gender hormones and surgical procedures. The Standard of Care, World Professional Association for Transgender Health recommends the initiation of cross-gender hormone and surgical treatments to those who are transitioning from a gender assigned at birth to a gender they identify with after comprehensive counseling by mental health professionals. During the transition, many transwomen/men face a number of difficulties due to transphobia, exposure to sexual and physical violence, and gender-based discrimination. Hormone therapy and surgical interventions help transwomen/men to increase health and well-being and assist them to attain safety. A high prevalence of substance use and NPHU among transwomen/men has been reported. Transwomen who used NPHs reported more substance use than those who used only prescribed hormones (PHs). NPH users also showed higher prevalence of depression, suicidal thoughts, and transphobia, and lower levels of self-esteem. The reported widespread NPHU is troublesome because NPHU is associated with improper dosage and a lack of medical monitoring that elevates health risks. Few studies have investigated the trajectories of substance use and PHU/NPHU in relation to psychosocial factors among transwomen/men. The Specific Aims of the Study are: 1) To longitudinally describe and understand the trajectories of substance use, PHU/NPHU, and psychological well-being among transwomen and transmen in relation to background variables (e.g., gender identity and transition and fluidity of sexual orientation and sexual partnership); 2) To explore and determine psychosocial factors and examine the mediating effects of psychosocial factors (e.g., transphobia, self- esteem, satisfaction with gender transition, social support, and trans community identity) on health outcomes (e.g., substance use, PHU/NPHU, and psychological well-being); 3) To compare transwomen and transmen in term of trajectories of substance use, PHU/NPHU, and psychological outcomes in relation to psychosocial factors and background variables; 4) To disseminate study findings through presentations and publications and prepare a future health promotion intervention study for transwomen/men who have been neglected by research studies. In order to attain the specific aims, we will utilize mixed methods; first conducting qualitative interviews with transwomen/men, and then a longitudinal study with transwomen (n=120) and transmen (n=120) recruited in the San Francisco Bay area.