An Intersectional Approach to Gender Affirmation in Sex and Gender Reporting among Racial/Ethnically Diverse Trans Populations

项目摘要 正在进行的研究，以改善跨性别参与者的性和性别评估仍然是一个关键 要务为了确保对跨性别健康的研究是有效的，有影响力的，有效的，有意义的， 确认对性别和性特征的衡量至关重要。目前的建议强调， 使用两步方法，要求个人在出生时指定的性别和当前的性别认同。 然而，已经测试过的两步方法仍然很难适应两性人的经历， 非二元性别身份的经验。此外，可选择的两步法，三步法， 所有适用的方法，以及开放式反应方法都被提出作为替代方案，在最近的 年因此，当务之急是有效地改进目前的两步法， 相对于其他建议方法的比较测试。此外，性别化的经验是背景的，文化的， 目前使用的许多两步法没有捕捉到时间和其他形式的性别多样性。 定制我们的方法，以提高对不符合标准的跨性别和性别多样性个体的有效性。 因此，在美国，规范的、二元的性别经验是必不可少的。最后，虽然问题 测量有效性是这项工作的关键，也很重要的是要考虑的方式， 性别多样的个人经历的行为报告性别和性别的调查问题本身，并在 特别是，性和/或性别的措施可能被认为是污名化或肯定的方式， 由跨性别和性别多样的受访者。与歧视和受害有关的压力源， SGM状态与健康差异密切相关，而多层次的肯定经验则与健康差异密切相关。 在个人和群体层面促进跨性别健康。因此，我们必须考虑到， 加强这些结构的规范概念化的性和性别措施， 潜在的作为微侵略少数压力源，并有助于对跨性别者的健康产生负面影响 和其他性别多样的受访者。该项目是对现有混合方法研究的补充， 通过社区改善对性、性取向和性别认同的衡量， 参与的方法，解决了目前文献中关于两步的有效性和 性和性别的替代措施，并提出了一个新的调查路线，中心的重要性， 研究中的反肯定。此外，借鉴交叉性的理论和方法， 该项目将促进了解如何最好地衡量和应对跨性别者的健康不平等 和其他不同性别的有色人种社区。通过定性和定量测试，我们将更好地 在更多样化的人群中验证现有的性和性别指标，并开发新的调查路线 这可以用来加强跨性别健康研究的发展。

PROJECT SUMMARY Ongoing research to improve assessment of sex and gender among transgender participants remains a key priority. In order to ensure research on transgender health is effective, impactful, and valid, meaningful and affirming measurement of gender and sex characteristics is essential. Current recommendations emphasize use of a two-step method which asks for individuals' sex assigned at birth and current gender identity. However, two-step methods which have been tested remain poorly attuned to intersex experiences and experiences of non-binary gender identity. In addition, alternative two-step methods, three-step methods, choose-all-that-apply methods, and open-response methods have all been proposed as alternatives in recent years. As a result, it is imperative that current two-step methods are effectively refined and receive appropriate comparative testing relative to other proposed methods. Moreover, gendered experience is contextual; cultural, temporal, and other forms of gender diversity are not captured by many two-step methods currently in use. Tailoring our methods to improve validity for transgender and gender-diverse individuals who do not fit the normative, binary experience of gender in the United States is therefore essential. Finally, while questions of measure validity are critical to this work, it is also important to consider the ways in which transgender and gender diverse individuals experience the act of reporting sex and gender on survey questions itself, and in particular, the ways in which measures of sex and/or gender may be experienced as stigmatizing or affirming by transgender and gender diverse respondents. Stressors related to discrimination and victimization tied to SGM status are strongly associated with health disparities, whereas multilevel experiences of affirmation are known to promote transgender health on the individual and population levels. Therefore, we must consider that measures of sex and gender which reinforce normative conceptualizations of these constructs have the potential to act as microaggressive minority stressors, and to contribute negatively to the health of transgender and other gender diverse respondents. This project, a supplement to an existing, mixed-methods study aimed at improving measurement of sex, sexual orientation, and gender identity (SSOGI) through community- engaged methodologies, addresses both the current gaps in the literature regarding the validity of two-step and alternative measures of sex and gender, and advances a new line of inquiry which centers the importance of trans affirmation in research. In addition, drawing on the theory and methodology of intersectionality, this project will advance understanding of how best to measure and respond to health inequities for transgender and other gender diverse communities of color. Through qualitative and quantitative testing, we will better validate existing measures of sex and gender in more diverse populations, and develop new lines of inquiry which can be used to strengthen transgender health research moving forward.