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PloS One 2024Transgender and gender diverse (trans) health research has grown rapidly, highlighting the need to characterize the scientific evidence base. We conducted a systematic...
BACKGROUND AND OBJECTIVES
Transgender and gender diverse (trans) health research has grown rapidly, highlighting the need to characterize the scientific evidence base. We conducted a systematic review of peer-reviewed research on disease burden and correlates in trans adolescents and adults over a 20-month period to identify knowledge gaps and assess methodological characteristics including measurement of gender identity, community engagement, and study quality.
DATA SOURCES, ELIGIBILITY CRITERIA, AND SYNTHESIS METHODS
We searched seven databases using terms related to (a) transgender populations and (b) health or disease. Eligible studies were in English, French, or Spanish and reported original quantitative data on mental health or substance use conditions, infectious diseases, or non-communicable conditions in at least 25 trans individuals aged 15+. Quality assessment was performed in duplicate on a 10% sample of articles and findings were summarized using narrative synthesis.
RESULTS
The 328 included studies were conducted in 45 countries, with most from North America (54%) and limited research from South Asia (3%), Sub-Saharan Africa (3%), and the Middle East and North Africa (2%). Most studies used cross-sectional designs (73%) and convenience sampling (65%). Only 30% of studies reported any form of community engagement. Mental health and substance use disorders were the most studied area (77% of studies) and non-communicable conditions the least (16%). Available data indicated that trans populations experience high disease burden with considerable heterogeneity within and across settings. Of 39 articles assessed for quality, 80% were rated as fair, 18% as poor, and 3% as good quality.
CONCLUSIONS AND IMPLICATIONS
Geographic, gender-specific, and topical gaps remain in trans health, but we found more research from African countries, with transmasculine people, and on non-communicable conditions than previous syntheses. Areas for growth in trans health research include community engagement, non-binary health, chronic and age-related conditions, and health determinants.
REGISTRATION
PROSPERO CRD42021234043.
Topics: Adult; Adolescent; Humans; Male; Female; Transgender Persons; Cross-Sectional Studies; Gender Identity; Health Status; Cost of Illness; Africa South of the Sahara
PubMed: 38466747
DOI: 10.1371/journal.pone.0299373 -
Journal of Homosexuality Sep 2023Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at a higher risk of mental illness when compared to their heterosexual and cisgender counterparts....
Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at a higher risk of mental illness when compared to their heterosexual and cisgender counterparts. Most research emanates from Western countries, with a paucity of studies in the Arab world. We systematically reviewed studies assessing the mental health of LGBTQ individuals who live in the Arab world or are of Arab descent. Of 261 articles, seven were eligible for analysis. Depression was the most common psychiatric disorder. Suicidal ideations and attempts were frequent in trans women. Post-traumatic stress disorder was also common, with the majority of precipitating traumatic events being related to sexual orientation and/or gender identity. Societal and familial stressors in the Arab culture are major contributors to the increased vulnerability of the LGBTQ community to mental health challenges. Further research is of utmost need while taking into consideration the Arab socio-cultural context.
Topics: Humans; Female; Male; Sexual and Gender Minorities; Mental Health; Gender Identity; Arabs; Sexual Behavior; Transgender Persons
PubMed: 35499284
DOI: 10.1080/00918369.2022.2060624 -
Journal of Nursing Scholarship : An... Jan 2024Gender diverse older adults often endure health disparities, encounter discrimination in healthcare settings, and experience lack of access to healthcare. However,...
INTRODUCTION
Gender diverse older adults often endure health disparities, encounter discrimination in healthcare settings, and experience lack of access to healthcare. However, members of this population also have assets that help to mitigate these healthcare challenges. A systematic integrative review was performed to synthesize recent studies of the healthcare needs and assets of gender diverse older adults living in the United States.
METHODS
A search of PubMed, CINAHL, Web of Science, PsycINFO, and Google Scholar was conducted. Findings from selected studies were organized by theme and subtheme.
RESULTS
Thirty-five articles met inclusion criteria. Seven themes were identified: (1) Inclusivity and acceptance, (2) Antidiscrimination protections, (3) Community, (4) Care of mind, body, and spirit, (5) End of life preparations, (6) Financial security, and (7) Intersectionality. These themes were further divided into 20 healthcare needs and 9 healthcare assets.
CONCLUSION
The findings call for increased training for healthcare providers to provide safe, gender-inclusive care environments; policy to combat discrimination across all healthcare settings; supportive community resources and healthcare advocacy; empowerment of gender diverse older adults through acknowledgment of their healthcare assets; and more research to discern the role of intersectionality in the applicability of the identified themes to gender diverse older adults of various sociodemographic backgrounds.
CLINICAL RELEVANCE
This review benefits clinicians by suggesting practice changes to address healthcare needs of gender diverse older adults while describing healthcare assets of this population for integration into health promotion initiatives.
Topics: Humans; United States; Aged; Delivery of Health Care; Gender Identity; Sexual and Gender Minorities
PubMed: 36111650
DOI: 10.1111/jnu.12810 -
PloS One 2024Transgender individuals face stigma, discrimination, and other barriers impacting their ability to engage in physical activity (PA). We aim to review current literature...
Transgender individuals face stigma, discrimination, and other barriers impacting their ability to engage in physical activity (PA). We aim to review current literature on PA among transgender individuals. A systemic literature search of research studies from 2010-2023 was conducted. Studies must have reported a measure of PA and gender, be original research, and focus on transgender participants' PA. Rates of PA for transgender individuals were lower compared to cisgender or sexual minority individuals. Transgender women were less likely to engage in PA than other groups. Qualitative results suggest transgender oppression, stigma, discrimination, body image, unwelcoming environments (gyms, locker rooms, swimming pools), and the dichotomous structure of sport contribute to lower rates of PA among transgendered individuals. Disparities in PA for transgender individuals exist. Policy, environment, and system changes are needed to reduce transgender stigma in sport and PA settings. Current legislation is being developed and implemented in the United States regarding the place of transgender individuals in sport and PA. These results should inform public discourse on the topic.
Topics: Humans; Female; United States; Transgender Persons; Transsexualism; Gender Identity; Social Stigma; Exercise
PubMed: 38416705
DOI: 10.1371/journal.pone.0297571 -
Anaesthesia, Critical Care & Pain... Oct 2023Machine learning (ML) may improve clinical decision-making in critical care settings, but intrinsic biases in datasets can introduce bias into predictive models. This...
BACKGROUND
Machine learning (ML) may improve clinical decision-making in critical care settings, but intrinsic biases in datasets can introduce bias into predictive models. This study aims to determine if publicly available critical care datasets provide relevant information to identify historically marginalized populations.
METHOD
We conducted a review to identify the manuscripts that report the training/validation of ML algorithms using publicly accessible critical care electronic medical record (EMR) datasets. The datasets were reviewed to determine if the following 12 variables were available: age, sex, gender identity, race and/or ethnicity, self-identification as an indigenous person, payor, primary language, religion, place of residence, education, occupation, and income.
RESULTS
7 publicly available databases were identified. Medical Information Mart for Intensive Care (MIMIC) reports information on 7 of the 12 variables of interest, Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) on 7, COVID-19 Mexican Open Repository on 4, and eICU on 4. Other datasets report information on 2 or fewer variables. All 7 databases included information about sex and age. Four databases (57%) included information about whether a patient identified as native or indigenous. Only 3 (43%) included data about race and/or ethnicity. Two databases (29%) included information about residence, and one (14%) included information about payor, language, and religion. One database (14%) included information about education and patient occupation. No databases included information on gender identity and income.
CONCLUSION
This review demonstrates that critical care publicly available data used to train AI algorithms do not include enough information to properly look for intrinsic bias and fairness issues towards historically marginalized populations.
Topics: Humans; Male; Female; COVID-19; Gender Identity; Algorithms; Critical Care; Machine Learning
PubMed: 37211215
DOI: 10.1016/j.accpm.2023.101248 -
Journal of Homosexuality Mar 2024LGBTQ+ people tend to experience prejudice, stigma, and discrimination, which increases their risk of developing mental health difficulties. Support networks, including...
LGBTQ+ people tend to experience prejudice, stigma, and discrimination, which increases their risk of developing mental health difficulties. Support networks, including companion animals, can be used to cope with these challenges. We performed a systematic review of studies related to the effects of human-animal interactions on the LGBTQ+ population. The review included 18 empirical studies; the findings showed that participants tended to view companion animals as family members, as well as providers of love, acceptance, and social support. Thus, companion animals could alleviate stress and increase resilience. However, certain costs were also cited and, under some circumstances, poorer health was observed. The results are discussed considering three unique aspects of the "LGBTQ+ people-animal bond": (1) it promotes self-acceptance, (2) provides a sense of protection against sexuality-based stigma and social acts of aggression based on sex or gender, and (3) exposes animal guardians requesting animal care services to potential discrimination. By characterizing the LGBTQ+ people-animal bond, more effective responses to meet their needs and promote inclusion may be achieved.
Topics: Humans; Animals; Sexual and Gender Minorities; Pets; Sexual Behavior; Sexuality; Gender Identity
PubMed: 36625558
DOI: 10.1080/00918369.2022.2150920