"Counting" Transgender and Gender-Nonconforming Adults in Health Research: Recommendations from the Gender Identity in US Surveillance Group

Reisner, Sari L.; Conron, Kerith J.; Scout,; Baker, Kellan; Joseph, Herman; Lombardi, Emilia; Greytak, Emily A.; Gill, Alison; Matthews, Alicia K.

doi:10.1215/23289252-2848877

Cited by 88 publications

(61 citation statements)

References 65 publications

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“…Similarly, when gender identity was assessed, GMY were often either dropped from the analysis or combined with SMY. Studies that reported GMY-specific findings tended to use only self-reported gender identity rather than the recommended operational definition based on a combination of current gender identity and sex assigned at birth [101]. When possible, data from GMY should be examined separately from SMY to understand variations in risk and resilience in these groups.…”

Section: Discussionmentioning

confidence: 99%

Risk and Protective Factors for Substance Use Among Sexual and Gender Minority Youth: a Scoping Review

et al. 2018

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Purpose of Review: Alcohol and drug use are common among youth. Rates are especially high among sexual and gender minority youth (SGMY; lesbian, gay, bisexual, transgender). We conducted a scoping review of research on risk and protective factors for substance use among SGMY published between 2013–2017. Recent Findings: Ninety-seven studies met our inclusion criteria. Most focused on individual-level minority stress risk factors, particularly stigma. Fewer studies addressed protective factors such as social support or affirming policies, and few focused on gender minority youth (GMY). We identified important, yet understudied differences by race/ethnicity, sex assigned at birth, and sexual orientation. Summary: Findings highlight growing interest in this topic as well as methodological/topical gaps in the literature. Research is needed to examine SGMY substance use in nationally representative samples; expand information about GMY; investigate racial/ethnic and sex/gender differences; improve measurement; and increase translation of findings to support prevention and treatment interventions for this at-risk population.

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Section: Discussionmentioning

confidence: 99%

Risk and Protective Factors for Substance Use Among Sexual and Gender Minority Youth: a Scoping Review

et al. 2018

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“…The two-step method is recommended [15,49], including by the World Professional Association for Transgender Health (WPATH) [50]. The two-step method asks questions about current gender identity and assigned sex at birth (see Table 2) [50].…”

Section: Other Methodological Issues In Transgender Health Researchmentioning

confidence: 99%

“…An important methodological issue specific to transgender health research is identification, measurement, and operationalization of “transgender” [15]. Additional challenges facing transgender health research include heterogeneity of settings, limited numbers of trained physicians and researchers with a specific focus in transgender medicine, lack of uniform data collection, and potential problems of non-participation, retention, and drop-out.…”

Section: Introductionmentioning

confidence: 99%

Advancing methods for US transgender health research

Reisner

Deutsch

Bhasin

et al. 2016

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

151

136

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Purpose of Review To describe methodological challenges, gaps, and opportunities in U.S. transgender health research. Recent Findings Lack of large prospective observational studies and intervention trials, limited data on risks and benefits of gender affirmation (e.g., hormones and surgical interventions), and inconsistent use of definitions across studies hinder evidence-based care for transgender people. Systematic high-quality observational and intervention-testing studies may be carried out using several approaches, including general population-based, health systems-based, clinic-based, venue-based, and hybrid designs. Each of these approaches has its strength and limitations; however, harmonization of research efforts is needed. Ongoing development of evidence-based clinical recommendations will benefit from a series of observational and intervention studies aimed at identification, recruitment, and follow-up of transgender people of different ages, from different racial, ethnic, and socioeconomic backgrounds and with diverse gender identities. Summary Transgender health research faces challenges that include standardization of lexicon, agreed-upon population definitions, study design, sampling, measurement, outcome ascertainment, and sample size. Application of existing and new methods is needed to fill existing gaps, increase the scientific rigor and reach of transgender health research, and inform evidence-based prevention and care for this underserved population.

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“…The reported prevalence estimates are greatly affected by differences in methodology, and by variable definitions of transgender. 4–7 Several previous reviews have sought to synthesize the available information regarding the size and the demographic characteristics of transgender population; 8–10 however, these reviews did not systematically assess the impact of study methods on reported prevalence estimates. With these data gaps in mind, the main objectives of the present review were to evaluate the state-of the science on epidemiology of “transgender” and to examine how various definitions of transgender affected prevalence estimates.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Transgender Depends on the “Case” Definition: A Systematic Review

Collin

Reisner

Tangpricha

et al. 2016

The Journal of Sexual Medicine

247

145

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Background We conducted a systematic review and meta-analysis to evaluate how various definitions of “transgender” may affect prevalence estimates. Methods PubMed, Embase, and Medline were searched to identify studies reporting prevalence estimates of transgender in a population. All studies were grouped based on the case definition applied to the numerator. Summary estimates were derived using a random-effects model for total prevalence of transgender and for male-to-female (MTF) and female-to-male (FTM) subgroups. Overall and stratum-specific meta-prevalence estimates (mPs) and 95% confidence intervals (CIs) were accompanied by tests for heterogeneity, and meta-regressions to assess sources of heterogeneity. Results A total of 32 studies met the inclusion criteria for the systematic review. Of those, 27 studies provided necessary data for a meta-analysis. Overall mP (95% CI) per 100,000 population was 9.2 (4.9, 13.6) for surgical or hormonal gender affirmation therapy and 6.8 (4.6–9.1) for transgender-related diagnoses. Among studies assessing self-reported transgender identity, the mP was 871 (95% 519, 1224); however this result was influenced by a single outlier study. After removal of that study, the mP changed to 355 (95% CI 144, 566). Significant heterogeneity was observed in most analyses. Conclusions The empirical literature on the prevalence of transgender highlights the importance of adhering to specific case definitions because the results may range by orders of magnitude. Standardized and routine collection of transgender data is recommended.

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"Counting" Transgender and Gender-Nonconforming Adults in Health Research: Recommendations from the Gender Identity in US Surveillance Group

Cited by 88 publications

References 65 publications

Risk and Protective Factors for Substance Use Among Sexual and Gender Minority Youth: a Scoping Review

Risk and Protective Factors for Substance Use Among Sexual and Gender Minority Youth: a Scoping Review

Advancing methods for US transgender health research

Prevalence of Transgender Depends on the “Case” Definition: A Systematic Review

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