Epidemiology, impact, and experience of acne in transgender persons

项目总结/摘要 K23提案的总体目标是支持新的研究培训和经验， 候选人，Howa Yeung，MD MSc，成为一名独立的，以患者为导向的研究者， 以及少数性别在皮肤病方面的差异-如变性人的痤疮。痤疮明显 损害与健康相关的生活质量，并与抑郁、低自尊和自杀意念有关。 关于内源性和外源性激素对痤疮发病率、严重程度 影响、治疗和经验。我们先前的研究指出，痤疮的发病率较高与激素有关 治疗，并确定了变性人严重痤疮治疗的具体障碍。这项建议旨在 检查流行病学，影响，和经验的痤疮在激素治疗的背景下，在变性人 人-在皮肤健康方面存在重大知识差距的健康差距人群。的流行病学 痤疮将使用现有的大规模，有效的，多中心的过渡研究的数据进行检查， 结果和性别（强）。因素介导的差异，痤疮的经验，治疗， 将使用混合方法重新吸引研究参与。开发和试点测试 招募方案和收集痤疮结果和精神健康并发症的初步数据将 帮助启动接受激素治疗的变性人痤疮的前瞻性队列研究。实现 这些目标，候选人将需要通过正式的教学法，实践， 研究经验和专家多学科指导。候选人将在性和 少数性别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，以及在社区参与的研究和病人招募的经验。 候选人的指导培训和研究计划将使他能够启动一个成功的职业生涯， 以患者为导向的独立调查员，解决皮肤病中的性和性别少数差异， 例如变性人的痤疮。关键结果将告知新的痤疮和性别肯定激素 治疗范例以及未来干预措施的设计和实施，旨在减少已确定的 痤疮的差异，优化痤疮的临床结果，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.