Impact of Social Determinants of Health on Medical Conditions Among Transgender Veterans

Abstract

Social determinants are prevalent factors in transgender patients' lives, exhibiting strong associations with medical conditions. Documenting social determinants in electronic health records can help providers to identify and address these factors in treatment goals.

Community‐based screening of hepatitis C with a one‐step RNA detection algorithm from dried‐blood spots: Analysis of key populations in Barcelona, Spain

“…Despite the fact that the number of sex workers participating in the study was lower than MSM, the size of MSW and TWSW collectives in Barcelona is unknown, as these are hidden populations with a frequent geographical mobility. The scarce HCV data from Argentina and the US show that HCV seroprevalence among trans sex workers may be as high as 4.5% and 7.5%, respectively . Although further studies are needed in Spain, we currently recommend guiding HCV testing individually based on a comprehensive risk assessment, rather than universally screening MSW, TWSW and HIV‐negative MSM in the CBVCT setting.…”

Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies

“…Across papers, estimates of Alcohol Use Disorders Identification Test (AUDIT) scores indicative of hazardous drinking were fairly stable, at 47%-48% (Herrera et al, 2016; Kerr-Corrêa et al, 2017). Alcohol use disorder was rarely assessed; however, two studies found lifetime and past-year alcohol use disorder prevalence of 26% and 11%, respectively (Blosnich et al, 2017; Reisner et al, 2016). Noting that prevalence of current drinking outcomes varied widely, this may be evidence of high methodological variability across studies, which could impede the development of a coherent evidence base.…”

Transgender Health Care in the U.S. Military and Veterans Health Administration Facilities

“…Growing evidence supports the view that the chronic stress and stigma associated with minority identities and experiences (e.g., transgender and veteran)-also known as minority stress-contribute to poorer health compared with nontransgender people and non-veterans [13,14]. Indeed, in a study of VHA veterans in states where non-discrimination policies in employment included gender identity, transgender veterans living in states with these protections had fewer mental health diagnoses than transgender veterans living in states without protections [11]. Additionally, from VHA medical record data, individual-level indicators of social stresshomelessness, financial strain, and violence-were strongly associated with physical and mental health diagnoses among transgender veterans [11].…”

“…Indeed, in a study of VHA veterans in states where non-discrimination policies in employment included gender identity, transgender veterans living in states with these protections had fewer mental health diagnoses than transgender veterans living in states without protections [11]. Additionally, from VHA medical record data, individual-level indicators of social stresshomelessness, financial strain, and violence-were strongly associated with physical and mental health diagnoses among transgender veterans [11].…”

“…Using four ICD-9 diagnostic codes (gender identity disorder, gender identity disorder not otherwise specified, transsexualism, and transvestic fetishism), Brown and Jones identified 5135 unique transgender veterans in VHA between 1996 and 2013 [10••]. Using the same codes but different dates (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014), other investigators identified 6308 transgender veterans receiving care in VHA [11]. Diagnostically derived data likely underestimate the population of transgender veterans in VHA because some veterans may not identify themselves as transgender to their providers, including some who get their transition-related care outside of VHA.…”