Demographic and temporal trends in transgender identities and gender confirming surgery

Nolan, Ian T; Kuhner, Christopher; Dy, Geolani W.

doi:10.21037/tau.2019.04.09

Cited by 204 publications

(161 citation statements)

References 27 publications

(43 reference statements)

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“…Given rates of transsexualism nationwide ranging from 0.39-0.56%, discordance between reported sex and biologic sex is unlikely to impact our results. 32…”

mentioning

confidence: 99%

Outcome Disparities Among Men and Women With COVID-19: An Analysis of the New York City Population Cohort

Punjani

Ha²,

Caputo³

et al. 2020

JDD

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Background: Growing evidence suggests a possible sex disparity in COVID-19 disease related outcomes. Objective: To explore the sex disparity in COVID-19 cases and outcomes using New York City (NYC) population level data. Setting: NYC surveillance data from February 29 to June 12, 2020. Participants: Individuals tested for COVID-19 in metropolitan NYC. Outcome Measurements and Statistical Analysis: Outcomes of interest included rates of COVID-19 case positivity, hospitalization and death. Relative risks and case fatality rates were computed for all outcomes based on sex and were stratified by age groups. Results and Limitations: 911,310 individuals were included, of whom 434,273 (47.65%) were male and 477,037 (52.35%) were female. Men represented the majority of positive cases (n=106,275, 51.36%), a majority of hospitalizations (n=29,847, 56.44%), and a majority of deaths (n=13,054, 59.23%). Following population level adjustments for age and sex, testing rates of men and women were equivalent. The majority of positive cases and hospitalizations occurred in men for all age groups except age >75 years, and death was more likely in men of all age groups. Men were at a statistically significant greater relative risk of case positivity, hospitalization, and death across all age groups except those <18 years of age. The most significant difference for case positivity was observed in the 65-74 age group (RR 1.22, 95%CI 1.19-1.24), for hospitalization in the 45-65 age group (RR 1.85, 95% 1.80-1.90), and for death in the 18-44 age group (RR 3.30, 95% CI 2.82-3.87). Case fatality rates were greater for men in all age-matched comparisons to women. Limitations include the use of an evolving surveillance data set and absence of further demographic characteristics such as ethnographic data. Conclusion: Men have higher rates of COVID-19 positivity, hospitalization, and death despite greater testing of women; this trend remains after stratification by age.

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“…Given rates of transsexualism nationwide ranging from 0.39-0.56%, discordance between reported sex and biologic sex is unlikely to impact our results. 32…”

mentioning

confidence: 99%

Outcome Disparities Among Men and Women With COVID-19: An Analysis of the New York City Population Cohort

Punjani

Ha²,

Caputo³

et al. 2020

JDD

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“…1 It is estimated that 0.39%–2.7% of the US adult population is gender nonconforming and that this percentage is increasing. 2 As a result of increased insurance coverage and evolving social norms, the number of gender-affirming surgeries being performed in the United States is exponentially rising. 3…”

Section: Introductionmentioning

confidence: 99%

Crowdsourcing the Ideal Nipple-Areolar Complex Position for Chest Masculinization Surgery

Cohen

Maisner

Hazim

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Chest masculinization surgery is increasing in prevalence. However, the ideal location of the nipple-areolar complex (NAC) is unknown. Our purpose was to determine the most aesthetically favorable male NAC position for use in chest masculinization through crowdsourcing. Methods: Using Adobe Photoshop CC 2017, 8 locations for the NAC were created based on previous literature descriptions. Amazon Mechanical Turk was utilized as a crowdsourcing interface—respondents were asked to rank the top 3 most favorable and least favorable images. Analysis of variance with subsequent Tukey HSD was used for a statistical comparison of favorability scores for different NAC localizations. Values were considered significant with P < 0.05. Results: Eight hundred nineteen respondents participated in the survey. NAC positions of Images C (mean score = 1.9222) and A (mean score = 1.7365) received higher favorability scores than those of Images D, E, F, G, and H (all P < 0.05). There were no significant differences between Images C and A (C versus A: P = 0.6412). NAC localizations from Images G (mean score = −2.0353) and H (mean score = −1.6908) received lower favorability scores than Images A, B, C, D, E, and F (all P < 0.05). There were no significant differences between Images G and H (P = 0.2279). Conclusions: Most respondents preferred Images C and A, and few favored Images G and H, suggesting that lateral NAC placement is favored over more medial localizations. Additionally, both Images C and A utilize relatively inferior NAC placements. Therefore, we recommend a location inferior and lateral to the NAC. Ultimately, NAC localization during chest masculinization will be the result of shared decision-making between the patient and the surgeon to fulfill each patient’s aesthetic goals.

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“…The term transgender (trans) refers to individuals whose gender presentation differs from their sex assigned at birth. The term transgender includes diverse identities such as trans women, trans men, non-binary, gender queer, fa'afafine, brotherboy, sistergirl, two-spirited, gender fluid or gender-nonconforming [1,2]. Frameworks to understand transgender identity are often premised on antiquated theories based on gay and lesbian identity development [1].…”

Section: Introductionmentioning

confidence: 99%

“…Public clinics rarely offer specialist support to trans women for gender transitioning [19]. Due to perpetual discrimination and limited educational or employment opportunities, trans women are overrepresented in lower income brackets [2,20]. This presents a significant obstacle for trans women in accessing treatment at private healthcare facilities.…”

Section: Introductionmentioning

confidence: 99%

“…While some trans women found obtaining treatment and support relatively straightforward, others report receiving treatment that was invalidating of their gender identities, stigmatizing, or in some cases abusive. Financial concerns were often seen as a barrier to accessing medical support to transition [2,20]. While transitioning is sometimes positioned as a 'want', lack of support can result in heightened gender dysphoria, severe distress and potentially self-harm or risky coping strategies such as drug and alcohol use for some women [21].…”

Section: Introductionmentioning

confidence: 99%

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Embodying Transgender: An Analysis of Trans Women in Online Forums

Liamputtong

Noack-Lundberg

Dune

et al. 2020

IJERPH

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This paper discusses the way that trans women embody their transgender identity, focusing on identity questioning, gender dysphoria, clinical gatekeeping and medicalized narratives. Situated within the hermeneutics methodological approach, we adopted the unobtrusive research as our research method, where data was derived from online forums where trans women posted content about their perspectives and experiences of gender and gender transitioning. Thematic analysis method was used for data analysis. Our findings suggest that gender identity is embodied and socially negotiated. Many trans women were initially ambivalent about their transgender identity and some continued to question their desired identity throughout adulthood. When presenting to healthcare professionals many trans women reported being expected to adopt a ‘wrong body’ narrative in order to gain access to treatment and surgery for gender transitioning and affirmation. In doing so, trans women interact with significant others and health care providers, and face many challenges. These challenges must be understood so that trans women can perform self-determination practices as a way to achieve gender autonomy.

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Demographic and temporal trends in transgender identities and gender confirming surgery

Cited by 204 publications

References 27 publications

Outcome Disparities Among Men and Women With COVID-19: An Analysis of the New York City Population Cohort

Outcome Disparities Among Men and Women With COVID-19: An Analysis of the New York City Population Cohort

Crowdsourcing the Ideal Nipple-Areolar Complex Position for Chest Masculinization Surgery

Embodying Transgender: An Analysis of Trans Women in Online Forums

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