The goal of this exploratory study was to delineate health differences among transgender subpopulations (transgender women/TW, transgender men/TM, gender nonbinary/GNB adults). 2015 Behavioral Risk Factor Surveillance System data were analyzed to compare the health of three groups (TW:N = 369; TM:N = 239; GNB:N = 156). Logistic regression and adjusted odds ratios were used to determine whether health outcomes (fair/poor health, frequent physical and mental unhealthy days, chronic health conditions, and health problems/impairments) are related to group and its interaction with personal characteristics and socioeconomic position. Group was a significant predictor of fair/poor health and frequent mental unhealthy days, revealing significant health differences between the transgender groups. The odds of poor/fair health were approximately 2.5 times higher in TM and GNB adults relative to TW. The odds of frequent mental unhealthy days for TM were approximately 1.5-2 times greater than TW and GNB adults. Among those with health insurance, the odds of fair/poor health for GNB adults was more than 1.5-2 times higher that of TM and TW. Among those without health insurance, TM had over 7 times greater odds of fair/poor health than TW. This study underscores the importance of classifying and examining the health of the transgender population as unique subpopulations, as notable health differences were discovered. TM and GNB adults have significant health concerns, requiring the attention of clinical interventions aimed at promoting health and preventing illness.

Transgender, or trans, describes an incongruence between an individual's sex assigned at birth and their current gender identity, or their sense of being male, female, both, or neither. 1 Individuals with an alignment between their assigned sex and gender identity are considered cisgender. The transgender population represents a spectrum of gender identities and expressions. 2 Transgender women, or male-to-female (MTF) individuals, were assigned male at birth and currently identify as women or female; transgender men, or female-to-male (FTM) individuals, were assigned female at birth and now identify as men or male. 3 Some, but not all, transgender people desire gender-affirming medical interventions such as crosssex hormone therapies, gender-affirming surgeries, and other body modifications. 1 The number of adults who identify as transgender in the U.S. is approximately 1.4 million; 4 however, the absence of a consistent definition for the term transgender and the social stigma associated with transgender identities likely contribute to under-reporting. 5 The term transgender is part of the lesbian, gay, bisexual, transgender and queer (LGBTQ) acronym that represents both sexual orientation and gender identity groups. 1 Lesbian, gay, bisexual, and sometimes queer are used to express sexual orientation, which includes sexual and/or romantic attractions to people of different gender. 3 Transgender people have a range of sexual orientations, including but not limited to gay, bisexual, asexual, queer, and

Background Sexual and gender minority (SGM; i.e., non-heterosexual and transgender or gender-expansive, respectively) people experience physical health disparities attributed to greater exposure to minority stress (experiences of discrimination or victimization, anticipation of discrimination or victimization, concealment of SGM status, and internalization of stigma) and structural stigma. Purpose To examine which components of minority stress and structural stigma have the strongest relationships with physical health among SGM people. Methods Participants (5,299 SGM people, 1,902 gender minority individuals) were from The Population Research in Identity and Disparities for Equality (PRIDE) Study. Dominance analyses estimated effect sizes showing how important each component of minority stress and structural stigma was to physical health outcomes. Results Among cisgender sexual minority women, transmasculine individuals, American Indian or Alaskan Native SGM individuals, Asian SGM individuals, and White SGM individuals a safe current environment for SGM people had the strongest relationship with physical health. For gender-expansive individuals and Black, African American, or African SGM individuals, the safety of the environment for SGM people in which they were raised had the strongest relationship with physical health. Among transfeminine individuals, victimization experiences had the strongest relationship with physical health. Among Hispanic, Latino, or Spanish individuals, accepting current environments had the strongest relationship with physical health. Among cisgender sexual minority men prejudice/discrimination experiences had the strongest relationship with physical health. Conclusion Safe community environments had the strongest relationships with physical health among most groups of SGM people. Increasing safety and buffering the effects of unsafe communities are important for SGM health.

This article highlights key health issues, contemporary research topics, and opportunities for advancing aging research with sexual and gender minority (SGM) older adults, or individuals who identify as lesbian, gay, bisexual, transgender, queer or questioning, intersex, non-binary, or who exhibit attractions and behaviors that do not align with heterosexual or traditional gender norms. Using a life course perspective, we provide a sociohistorical context and highlight the social, psychological, and physical health, and healthcare experiences of SGM older adults in the U.S. Additionally, we present an overview of SGM aging research disseminated in the Journals of Gerontology: Series B over the past five years. After reviewing these topics, we discuss limitations and gaps in the current research and provide recommendations for future research with SGM aging populations.