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BMC Public Health Aug 2016Swedish research concerning the general health of trans people is scarce. Despite the diversity of the group, most Swedish research has focused on gender dysphoric...
BACKGROUND
Swedish research concerning the general health of trans people is scarce. Despite the diversity of the group, most Swedish research has focused on gender dysphoric people seeking medical help for their gender incongruence, or on outcomes after medical gender-confirming interventions. This paper examines self-rated health, self-reported disability and quality of life among a diverse group of trans people including trans feminine, trans masculine, and gender nonbinary people (identifying with a gender in between male of female, or identify with neither of these genders) as well as people self-identifying as transvestites.
METHODS
Participants were self-selected anonymously to a web-based survey conducted in 2014. Univariable and multivariable regression analyses were performed. Three backward selection regression models were conducted in order to identify significant variables for the outcomes self-rated health, self-reported disability and quality of life.
RESULTS
Study participants included 796 individuals, between 15 and 94 years of age who live in Sweden. Respondents represented a heterogeneous group with regards to trans experience, with the majority being gender nonbinary (44 %), followed by trans masculine (24 %), trans feminine (19 %) and transvestites (14 %). A fifth of the respondents reported poor self-rated health, 53 % reported a disability and 44 % reported quality of life scores below the median cut-off value of 6 (out of 10). Nonbinary gender identity (adjusted Odds Ratio (aOR) = 2.19; 95 % CI: 1.24, 3.84), negative health care experiences (aOR = 1.92; 95 % CI: 1.26, 2.91) and not accessing legal gender recognition (aOR = 3.06; 95 % CI: 1.64, 5.72) were significant predictors for self-rated health. Being gender nonbinary (aOR = 2.18; 95 % CI: 1.35, 3.54) and history of negative health care experiences (aOR = 2.33; 95 % CI: 1.54, 3.52) were, in addition, associated with self-reported disability. Lastly, not accessing legal gender recognition (aOR = 0.32; 95 % CI: 0.17, 0.61) and history of negative health care experiences (aOR = 0.56; 95 % CI: 0.36, 0.88) were associated with lower quality of life.
CONCLUSIONS
The results of this study demonstrate that the general health of trans respondents is related to vulnerabilities that are unique for trans people in addition to other well-known health determinants.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Disabled Persons; Female; Gender Identity; Health Status; Health Surveys; Humans; Internet; Male; Middle Aged; Odds Ratio; Quality of Life; Self Report; Sweden; Transgender Persons; Transsexualism; Transvestism; Young Adult
PubMed: 27576455
DOI: 10.1186/s12889-016-3560-5 -
Characteristics of hormone use by travestis and transgender women of the Brazilian Federal District.Revista Brasileira de Epidemiologia =... 2019Travestis and transgender women resort to the use of hormones for body modification. Due to restrictions in the access to health services, self-medication is frequent....
INTRODUCTION
Travestis and transgender women resort to the use of hormones for body modification. Due to restrictions in the access to health services, self-medication is frequent. The aim of this study was to describe the self-reported prevalence of hormones used by travestis and transgender women in the Federal District. Method: This is a cross-sectional study with Respondent Driven Sampling (RDS) and Knowledge, Attitudes and Practices questionnaire (KAP) along with travestis and transgender women over 18 years in the FD. Prevalence was calculated using the RDS-II estimator. Logistic models were used to investigate the associated factors. A total of 201 volunteers participated.
RESULTS
There was a young sample (median age of 24 years). The overall prevalence of continuous use of hormones was 64.5%. The most used formulation was the combination of estrogen and progesterone (86.2%) by injectable (75.1%) and oral (66%) administration. Most participants (84%) got the hormones without a prescription. Guidance on the use of these hormones came from their peers in 41% of the cases. We observed that the continuous use of hormones is associated with race, income and age, as well as the search for guidance of healthcare professionals, which is also associated with schooling.
DISCUSSION
The reality of the process of hormone use by these people in the quest for femininity is reflected in high rates of self-medication.
CONCLUSION
This study contributes to the visibility of the need to improve the access conditions of these people to health services.
Topics: Adolescent; Adult; Age Factors; Brazil; Cross-Sectional Studies; Female; Gender Identity; Hormones; Humans; Logistic Models; Male; Middle Aged; Risk Factors; Self Medication; Self Report; Socioeconomic Factors; Transgender Persons; Transvestism; Young Adult
PubMed: 31576980
DOI: 10.1590/1980-549720190004.supl.1 -
Cadernos de Saude Publica Mar 2019This article sought to estimate factors associated with the psychological well-being of transvestites and trans women. It is a cross-sectional study with 602...
This article sought to estimate factors associated with the psychological well-being of transvestites and trans women. It is a cross-sectional study with 602 transvestites and trans individuals in seven cities in the state of São Paulo, Brazil from 2014 to 2015. We carried out a sample selection through a consecutive approach and using the snowball technique. The dependent variable was psychological well-being (WHOQOL-BREF) and the independent variables were: sociodemographic characteristics, body modifications, health conditions, violence and incarceration. We used a multiple variance analysis to identify associated factors. Most were black or brown and were aged between 25 and 39 years, had up to complete secondary education, individual income of up to two times the minimum wage and worked, and 42.3% were sex workers. Around one-quarter had been incarcerated. Around one-quarter were in treatment for HIV. Mean psychological well-being score was 63.2 (95%CI: 61.8-64.6). In the multiple analysis, the factors associated with lower psychological well-being were: not having a fixed address, having lower educational levels, being dissatisfied with personal relationships, friend support or the gender-affirming procedures they had undergone and having suffered verbal or sexual violence. While worse living conditions and exposure to violence harm the psychological well-being of transvestites and trans women, the possibility of undergoing desired body transformations and having their social name respected interfere positively in their evaluations of their lives.
Topics: Acquired Immunodeficiency Syndrome; Adult; Brazil; Cross-Sectional Studies; Female; Homophobia; Humans; Male; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires; Transgender Persons; Transvestism
PubMed: 30916176
DOI: 10.1590/0102-311X00064618 -
Ciencia & Saude Coletiva Oct 2012In the aftermath of studies on masculinity, it is impossible to consider the production of gender identities without linking them to the relationship aspect. This change...
In the aftermath of studies on masculinity, it is impossible to consider the production of gender identities without linking them to the relationship aspect. This change was due to the incorporation of the relationship perspective in this field of study and criticism of the concept of gender founded upon an alleged concept of femininity and masculinity to create interpretations of the place of bodies in the gender order. The objectives of this paper are: 1) to show how a given concept of gender can render multiple expressions of gender visible, like the trans identities (transsexuals, transvestites, cross dressers, drag queens, drag kings, transgenders) or sublimate them and contribute to their pathologization. The second objective will be to present narratives of trans men and trans women, who will tell us about their sexual experiences. Psycho-physicians contend the non-existence of sexuality in their bodies as being one of the indicators to lead to a diagnosis of transsexualism. I will attempt to argue that the theoretical basis that supports the pathologization of trans identities and the assertion that trans people are asexual is based on a conception that links and renders gender identities conditional upon biological structures.
Topics: Female; Gender Identity; Humans; Male; Sexuality; Transsexualism; Transvestism
PubMed: 23099753
DOI: 10.1590/s1413-81232012001000015 -
Archives of Sexual Behavior Jul 2017The World Health Organization is currently developing the 11th revision of the International Classifications of Diseases and Related Health Problems (ICD-11), with...
The World Health Organization is currently developing the 11th revision of the International Classifications of Diseases and Related Health Problems (ICD-11), with approval of the ICD-11 by the World Health Assembly anticipated in 2018. The Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH) was created and charged with reviewing and making recommendations for categories related to sexuality that are contained in the chapter of Mental and Behavioural Disorders in ICD-10 (World Health Organization 1992a). Among these categories was the ICD-10 grouping F65, Disorders of sexual preference, which describes conditions now widely referred to as Paraphilic Disorders. This article reviews the evidence base, rationale, and recommendations for the proposed revisions in this area for ICD-11 and compares them with DSM-5. The WGSDSH recommended that the grouping, Disorders of sexual preference, be renamed to Paraphilic Disorders and be limited to disorders that involve sexual arousal patterns that focus on non-consenting others or are associated with substantial distress or direct risk of injury or death. Consistent with this framework, the WGSDSH also recommended that the ICD-10 categories of Fetishism, Fetishistic Transvestism, and Sadomasochism be removed from the classification and new categories of Coercive Sexual Sadism Disorder, Frotteuristic Disorder, Other Paraphilic Disorder Involving Non-Consenting Individuals, and Other Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals be added. The WGSDSH's proposals for Paraphilic Disorders in ICD-11 are based on the WHO's role as a global public health agency and the ICD's function as a public health reporting tool.
Topics: Fetishism, Psychiatric; Humans; International Classification of Diseases; Masochism; Paraphilic Disorders; Sexual Behavior; Sexuality; Transvestism
PubMed: 28210933
DOI: 10.1007/s10508-017-0944-2 -
Archives of Sexual Behavior Apr 2011In a series of important but now highly controversial articles, Blanchard examined associations of sexual orientation and transvestic fetishism among male-to-female...
In a series of important but now highly controversial articles, Blanchard examined associations of sexual orientation and transvestic fetishism among male-to-female (MTF) transgender persons in Toronto, Canada. Transvestic fetishism was rare among the homosexuals but prevalent among the non-homosexuals. Subtypes of non-homosexual MTFs (heterosexual, bisexual, and asexual) were consistently high with regard to transvestic fetishism. Non-linear associations of a continuous measurement of sexual attraction to women (gynephilia) and transvestic fetishism were interpreted in terms of an etiological hypothesis in which transvestic fetishism interferes with the early development of heterosexuality. Blanchard concluded that homosexual versus non-homosexual sexual orientation is a dominant and etiologically significant axis for evaluating and understanding this population. We further assessed these findings among 571 MTFs from the New York City metropolitan area. Using the Life Chart Interview, multiple measurements of transvestic fetishism were obtained and classified as lifetime, lifecourse persistent, adolescent limited, and adult onset. Large (but not deterministic) differences in lifetime, lifecourse persistent, and adolescent limited transvestic fetishism were found between the homosexuals and non-homosexuals. Contrary to Blanchard, differences in transvestic fetishism were observed across subtypes of the non-homosexuals, and linear (not curvilinear) associations were found along a continuous measurement of gynephilia and transvestic fetishism. Age and ethnicity, in addition to sexual orientation, were found to be statistically significant predictors of transvestic fetishism. The clinical, etiological, and sociopolitical implications of these findings are discussed.
Topics: Adult; Gender Identity; Heterosexuality; Homosexuality, Male; Humans; Interviews as Topic; Male; Middle Aged; Regression Analysis; Transsexualism; Transvestism
PubMed: 20039113
DOI: 10.1007/s10508-009-9579-2 -
BMJ (Clinical Research Ed.) Jul 2008To explore female and transvestite sex workers' perceptions of risk in the sex work environment in Serbia.
OBJECTIVE
To explore female and transvestite sex workers' perceptions of risk in the sex work environment in Serbia.
DESIGN
Qualitative interview study.
SETTING
Street based locations for sex work in Belgrade and Pancevo, Serbia.
PARTICIPANTS
31 female and transvestite sex workers.
RESULTS
Violence, including police violence, was reported as a primary concern in relation to risk. Violence was linked to unprotected sex and the reduced capacity for avoiding sexual risk. Participants reported that coerced sex was routinely provided to the police in exchange for freedom from detainment, arrest, or fine, and was enforced by the perceived threat of violence, sometimes realised. Accounts contained multiple instances of physical and sexual assault, presented as abuses of police authority, and described policing as a form of moral punishment. This was largely through non-physical means but was also enforced through physical violence, especially towards transvestite and Roma sex workers, whose experience of police violence was reported as relentless and brutal and connected with broader social forces of discrimination in this setting, especially towards Roma.
CONCLUSION
Preventing violence towards sex workers, which can link with vulnerability to sexually transmitted infections, is a priority in Serbia. This requires monitoring perpetrators of violence, providing legal support to sex workers, and creating safer environments for sex work.
Topics: Adolescent; Adult; Attitude to Health; Female; Humans; Male; Police; Qualitative Research; Risk Factors; Sex Work; Transvestism; Unsafe Sex; Violence; Yugoslavia
PubMed: 18667468
DOI: 10.1136/bmj.a811 -
International Journal of Infectious... Sep 2011Due to the scarce data on the prevalence of sexually transmitted infections (STIs) among male-to-female trans-sex workers (TSW) and male sex workers (MSW) in Argentina,...
First report on sexually transmitted infections among trans (male to female transvestites, transsexuals, or transgender) and male sex workers in Argentina: high HIV, HPV, HBV, and syphilis prevalence.
OBJECTIVES
Due to the scarce data on the prevalence of sexually transmitted infections (STIs) among male-to-female trans-sex workers (TSW) and male sex workers (MSW) in Argentina, the present study aimed to estimate the incidence of human immunodeficiency virus (HIV), and the prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum. Human papillomavirus (HPV) and Chlamydia trachomatis infections were tested among TSW.
METHODS
Two hundred and seventy-three TSW and 114 MSW were recruited by nongovernmental organizations. HIV incidence was estimated by STARHS (serologic testing algorithm for recent HIV seroconversion). HPV and C. trachomatis infections were tested in anal cells from TSW.
RESULTS
TSW showed significantly higher prevalences of HIV (34.1 vs. 11.4%), HBV (40.2 vs. 22.0%), and T. pallidum (50.4 vs. 20.4%) than MSW. TSW tested positive for HPV in 111/114 cases and for C. trachomatis in 4/80 cases. Investigation of HBV, HCV, HIV, and T. pallidum co-infections showed that 72% of TSW and 39% of MSW had at least one STI. T. pallidum was the most frequent mono-infection. The estimated HIV incidence was 10.7 per 100 person-years (95% confidence interval (CI) 3.8-17.7) for TSW and 2.3 per 100 person-years (95% CI 0-6.7) for MSW.
CONCLUSIONS
The high prevalence of STIs and the high incidence of HIV demonstrate the great vulnerability of these high-risk populations and indicate the urgent need for preventive strategies on intervention and facilitation of access to healthcare programs.
Topics: Adult; Argentina; Coinfection; Female; HIV Infections; Hepatitis B; Hepatitis C; Humans; Incidence; Male; Papillomavirus Infections; Prevalence; Sex Workers; Sexual Behavior; Sexually Transmitted Diseases; Sexually Transmitted Diseases, Viral; Syphilis; Transsexualism; Transvestism; Young Adult
PubMed: 21742530
DOI: 10.1016/j.ijid.2011.05.007 -
Cadernos de Saude Publica Aug 2018This article aims to analyze how expressions of sexuality and gender emerge in the legal proceedings that determine the fate of individuals at the interface between...
This article aims to analyze how expressions of sexuality and gender emerge in the legal proceedings that determine the fate of individuals at the interface between crime and madness. The text explores the criminal proceedings against persons in mental distress that have committed crimes, or so-called "criminally insane" patients, and who are subject to security measures. Using genealogy as the methodological approach, the article analyzes the conditions underlying the source and emergence of the "abnormal", a figure produced and scrutinized by forensic medical discourse. Six court briefs were analyzed, focusing especially on the psychiatric reports pertaining to non-heterosexual and/or non-cisgender persons that were subjected to security measures. Analysis of the textual corpus indicates that the theoretical and conceptual basis for the assumptions in the security measures focuses on the forensic psychiatric report. The analysis of the forensic medical discourse points to a moral judgment of the expressions of sexuality and gender in the criminally insane patient, considered "deviant". Finally, the article signals alternatives for the production of new treatment modalities for the criminally insane patient, seeking to supplant the presumption of danger to society as a purportedly scientific concept, reviewing non-imputability as a legal device that violates the inalienable rights of individuals at the interface between crime and madness.
Topics: Commitment of Mentally Ill; Crime; Expert Testimony; Forensic Psychiatry; Gender Identity; Homosexuality; Human Rights; Humans; Mental Disorders; Sexuality; Social Adjustment; Transvestism
PubMed: 30133666
DOI: 10.1590/0102-311X00180317 -
Medical History Jan 2018This article examines the case files of patients diagnosed with Transvestitismus [transvestism] in the Psychiatric Clinic of the Helsinki University Central Hospital in...
This article examines the case files of patients diagnosed with Transvestitismus [transvestism] in the Psychiatric Clinic of the Helsinki University Central Hospital in the years 1954-68. These individuals did not only want to cross-dress, but also had a strong feeling of being of a different sex from their assigned one. The scientific concept of transsexuality had begun to take form, and this knowledge reached Finland in phases. The case files of the transvestism patients show that they were highly aware of their condition and were very capable of describing it, even if they had no medical name for it. Psychiatrists were willing to engage in dialogue with the patients, and did not treat them as passive objects of study. Although some patients felt that they had been helped, many left the institution as frustrated, angered or desperate as before. They had sought medical help in the hope of having their bodies altered to correspond to their identity, but the Clinic psychiatrists insisted on seeing the problem in psychiatric terms and did not recommend surgical or hormonal treatments in most cases. This attitude would gradually change over the course of the 1970s and 1980s.
Topics: Female; Finland; History, 20th Century; Hospitals, Psychiatric; Humans; Male; Transvestism
PubMed: 29199927
DOI: 10.1017/mdh.2017.73