Sociodemographic and Clinical Characteristics of Transgender Adults in Australia

Cheung, Ada S; Ooi, Olivia; Leemaqz, Shalem; Cundill, Pauline; Silberstein, Nicholas; Thrower, Emily; Locke, Peter; Grossmann, Mathis; Zajac, Jeffrey D

doi:10.1089/trgh.2018.0019

Cited by 78 publications

(61 citation statements)

References 60 publications

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“…With increasing visibility of trans and gender diverse (TGD) people and increasing demand for TGD health services worldwide [1,2], attempts are being made to design appropriate health services. Correspondingly, there has been an exponential rise in the number of research studies published in TGD health [3].…”

Section: Introductionmentioning

confidence: 99%

Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

Zwickl

Wong

Bretherton

et al. 2019

IJERPH

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There is an increasing demand for trans and gender diverse (TGD) health services worldwide. Given the unique and diverse healthcare needs of the TGD community, best practice TGD health services should be community-led. We aimed to understand the healthcare needs of a broad group of TGD Australians, how health professionals could better support TGD people, and gain an understanding of TGD-related research priorities. An anonymous online survey received 928 eligible responses from TGD Australian adults. This paper focuses on three questions out of that survey that allowed for free-text responses. The data were qualitatively coded, and overarching themes were identified for each question. Better training for healthcare professionals and more accessible transgender healthcare were the most commonly reported healthcare needs of participants. Findings highlight a pressing need for better training for healthcare professionals in transgender healthcare. In order to meet the demand for TGD health services, more gender services are needed, and in time, mainstreaming health services in primary care will likely improve accessibility. Evaluation of training strategies and further research into optimal models of TGD care are needed; however, until further data is available, views of the TGD community should guide research priorities and the TGD health service delivery.

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Section: Introductionmentioning

confidence: 99%

Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

Zwickl

Wong

Bretherton

et al. 2019

IJERPH

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“…The goal is to alleviate gender dysphoria, the distress many TGD individuals experience when their gender identity is markedly and persistently incongruent from their birth‐assigned sex . An estimated 0.6%‐1.2% of the population identifies as TGD, and there is increasing demand for trans and gender diverse health care in Australia …”

Section: Introductionmentioning

confidence: 99%

“…Between 56% and 75% of transgender individuals have clinically diagnosed depression, and 48% have attempted suicide, rates far higher than the general population . Timely access to hormone therapies is associated with better psychological functioning and less anxiety, depression and gender dysphoria .…”

Section: Introductionmentioning

confidence: 99%

“…2 An estimated 0.6%-1.2% of the population identifies as TGD, [3][4][5] and there is increasing demand for trans and gender diverse health care in Australia. 6,7 Between 56% and 75% of transgender individuals have clinically diagnosed depression, and 48% have attempted suicide, rates far higher than the general population. [7][8][9][10] Timely access to hormone therapies is associated with better psychological functioning and less anxiety, depression and gender dysphoria.…”

Section: Introductionmentioning

confidence: 99%

“…6,7 Between 56% and 75% of transgender individuals have clinically diagnosed depression, and 48% have attempted suicide, rates far higher than the general population. [7][8][9][10] Timely access to hormone therapies is associated with better psychological functioning and less anxiety, depression and gender dysphoria. [11][12][13] Typically, feminization is achieved with oestradiol as well as suppression of endogenous sex hormones with gonadotropin-releasing hormone analogues or antiandrogen agents.…”

Section: Introductionmentioning

confidence: 99%

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Australian endocrinologists need more training in transgender health: A national survey

Bretherton

Grossmann

Leemaqz

et al. 2020

Clinical Endocrinology

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Objective An increasing number of trans and gender diverse (TGD) individuals are seeking gender‐affirming hormone therapy for gender transition. Little is known about the levels of training, experience and confidence of endocrinologists in providing care and lack of training and experience is a potential barrier to individuals seeking appropriate and timely health care. We aimed to assess the level of training and confidence of Australian endocrinologists and trainees in the endocrine management of trans and gender diverse individuals in a representative sample. Design Endocrinologist and trainee members of the Endocrine Society of Australia were invited to participate in an anonymous 14‐item survey. Of the 545 members, 147 clinicians (95 adult endocrinologists, 2 paediatric endocrinologists and 50 endocrinology trainees) responded. Results When presented with a scenario regarding commencement of gender‐affirming hormone therapy, only 19% felt confident providing clinical care to TGD individuals. Compared to other areas of endocrinology, 75% felt less or not at all confident in commencing hormone therapy in a TGD patient. No training in transgender medicine during medical school or during their endocrinology training was reported by 96% and 60%, respectively. There were significantly higher levels of confidence in all aspects including performing a consultation in those who had previously seen a TGD patient. The desire for more training was high (91%). Conclusions These results highlight the shortfall in training in TGD health care amongst endocrinologists and show that prior clinical experience is associated with higher levels of confidence. Medical schools and endocrinology fellowship training programmes will need to adapt to meet the increasing demand for quality TGD health services.

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Early Access to Testosterone Therapy in Transgender and Gender-Diverse Adults Seeking Masculinization

Nolan,

Zwickl,

Locke

et al. 2023

JAMA Netw Open

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ImportanceTestosterone treatment is a necessary component of care for some transgender and gender-diverse individuals. Observational studies have reported associations between commencement of gender-affirming hormone therapy and improvements in gender dysphoria and depression, but there is a lack of data from randomized clinical trials.ObjectiveTo assess the effect of testosterone therapy compared with no treatment on gender dysphoria, depression, and suicidality in transgender and gender-diverse adults seeking masculinization.Design, Setting, and ParticipantsA 3-month open-label randomized clinical trial was conducted at endocrinology outpatient clinics and primary care clinics specializing in transgender and gender-diverse health in Melbourne, Australia, from November 1, 2021, to July 22, 2022. Participants included transgender and gender-diverse adults aged 18 to 70 years seeking initiation of testosterone therapy.InterventionsImmediate initiation of testosterone commencement (intervention group) or no treatment (standard care waiting list of 3 months before commencement). This design ensured no individuals would be waiting longer than the time to standard care.Main Outcomes and MeasuresThe primary outcome was gender dysphoria, as measured by the Gender Preoccupation and Stability Questionnaire. Secondary outcomes included the Patient Health Questionnaire-9 (PHQ-9) to assess depression and the Suicidal Ideation Attributes Scale (SIDAS) to assess suicidality. Questionnaires were undertaken at 0 and 3 months. The evaluable cohort was analyzed.ResultsSixty-four transgender and gender-diverse adults (median [IQR] age, 22.5 [20-27] years) were randomized. Compared with standard care, the intervention group had a decrease in gender dysphoria (mean difference, −7.2 points; 95% CI, −8.3 to −6.1 points; P &lt; .001), a clinically significant decrease in depression (ie, change in score of 5 points on PHQ-9; mean difference, −5.6 points; 95% CI, −6.8 to −4.4 points; P &lt; .001), and a significant decrease in suicidality (mean difference in SIDAS score, −6.5 points; 95% CI, −8.2 to −4.8 points; P &lt; .001). Resolution of suicidality assessed by PHQ-9 item 9 occurred in 11 individuals (52%) with immediate testosterone commencement compared with 1 (5%) receiving standard care (P = .002). Seven individuals reported injection site pain/discomfort and 1 individual reported a transient headache 24 hours following intramuscular administration of testosterone undecanoate. No individual developed polycythemia.Conclusions and RelevanceIn this open-label randomized clinical trial of testosterone therapy in transgender and gender-diverse adults, immediate testosterone compared with no treatment significantly reduced gender dysphoria, depression, and suicidality in transgender and gender-diverse individuals desiring testosterone therapy.Trial RegistrationANZCTR Identifier: ACTRN1262100016864

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Sociodemographic and Clinical Characteristics of Transgender Adults in Australia

Cited by 78 publications

References 60 publications

Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

Australian endocrinologists need more training in transgender health: A national survey

Early Access to Testosterone Therapy in Transgender and Gender-Diverse Adults Seeking Masculinization

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