Halley P. Crissman

Transgender Demographics: A Household Probability Sample of US Adults, 2014

OBJECTIVES To estimate the proportion of US adults who identify as transgender and to compare the demographics of the transgender and nontransgender populations. METHODS We conducted a secondary analysis of data from states and territories in the 2014 Behavioral Risk Factor Surveillance System that asked about transgender status. The proportion of adults identified as transgender was calculated from affirmative and negative responses (n = 151 456). We analyzed data with a design-adjusted χ2 test. We also explored differences between male-to-female and nontransgender females and female-to-male and nontransgender males. RESULTS Transgender individuals made up 0.53% (95% confidence interval = 0.46, 0.61) of the population and were more likely to be non-White (40.0% vs 27.3%) and below the poverty line (26.0% vs 15.5%); as likely to be married (50.5% vs 47.7%), living in a rural area (28.7% vs 22.6%), and employed (54.3% vs 57.7%); and less likely to attend college (35.6% vs 56.6%) compared with nontransgender individuals. CONCLUSIONS Our findings suggest that the transgender population is a racially diverse population present across US communities. Inequalities in the education and socioeconomic status have negative implications for the health of the transgender population.

Interpersonal Relationships and Social Support in Transitioning Narratives of Black Transgender Women in Detroit

Information about the health and well-being of transgender communities is sparse, and even less is known about ethnic minority transgender communities. The little research that exists suggests that transgender women suffer high rates of HIV seropositivity, poor mental health outcomes, and body-modification-related health problems, challenges that are intensified among some ethnic minority communities (Garofalo, Deleon, Osmer, Doll, & Harper, 2006; Golub, Walker, Longmire-Avital, Bimbi, & Parsons, 2010; Nemoto, Bodeker, & Iwamoto, 2011). Even so, transgender communities are tremendously resilient in the face of transphobia and great structural disadvantage (Bith-Melander et al., 2010; Fish, 2012). Social support has been shown to play a key role in overcoming adversities associated with marginalized identities, including racial and sexual minority statuses in the United States (Brown, 2008; Graham, 2012). Yet there is a dearth of information regarding psychosocial determinants of health, such as the role of social networks in the gender transition process and the well-being of transgender communities—including ethnic minority transgender communities. The role of social networks in influencing health outcomes may be particularly important among individuals of multiple marginalized identities, such as Black transgender women, whereby support derived from networks may mitigate the negative effects of transphobia and racial discrimination (Nemoto et al., 2011). Given the role of social resources in determining health outcomes, considering gender transition experiences and identity development in the context of social networks is likely a meaningful approach to understanding vulnerabilities and

Intention to deliver in a healthcare facility and healthcare facility-based delivery rates among women in Akwatia, Ghana

This article discusses a study that investigated the beliefs delivery intentions and subsequent delivery locations among women receiving prenatal care in the Eastern Region of Ghana where the reported rate of deliveries in healthcare facilties with skilled birth attendance (SBA) is 59%. Copyright

U.S. Women's Intended Sources for Reproductive Health Care.

INTRODUCTION The current sociopolitical climate and context of the Affordable Care Act have led some to question the future role of family planning clinics in reproductive health care. We explored where women plan to get their future contraception, pelvic exam/pap smears, and sexually transmitted infection testing, with a focus on the role of family planning clinics. METHODS Data were drawn from a study of United States adults conducted in January 2013 from a national online panel. We focused on English-literate women aged 18-45 years who answered items on intended sources of care (private office/health maintenance organization [HMO], family planning clinic, other, would not get care) for reproductive health services. We used Rao-Scott F tests to compare intended sources across sociodemographic groups, and logistic regression to model odds of intending to use family planning clinics. Probability weights were used to adjust for the complex sampling design. RESULTS The response rate was 61% (n = 2,182). Of the 723 respondents who met the inclusion criteria, approximately half intended to use private offices/HMOs. Among some subgroups, including less educated (less than high school), lower annual incomes (<

Opportunities for Obstetrician-Gynecologists in Transition-Related Care of Transgender Individuals [1M]

25,000) and uninsured women, the proportion intending to use family planning clinics was higher than the proportion intending to use private office/HMO in unadjusted analyses. Across all service types, unmarried and uninsured status were associated with intention to use family planning clinics in multivariable models. CONCLUSIONS While many women intend to use private offices/HMOs for their reproductive health care, family planning clinics continue to play an important role, particularly for socially disadvantaged women.

Children with disorders of sex development: A qualitative study of early parental experience

INTRODUCTION: Transgender individuals face barriers to transition-related healthcare. ACOG has called for obstetrician-gynecologists to assist in the care of transgender individuals. However, little is known about the unmet need for transition-related care which could be provided by obstetrician-gynecologists, particularly outside of major metropolitan areas. METHODS: Individuals in the University of Michigan Comprehensive Gender Services Program database were invited via mailed letters to complete an IRB-exempt voluntary, anonymous online survey about transgender health. Responses were collected from April to September 2015. Data were analyzed using descriptive statistics in STATA. RESULTS: There were 67 respondents, with a mean age of 38 (range 19–88 years). The majority of respondents were Caucasian (91%), had at least some college education (85%), and had health insurance (92%). Respondents were 61% (n=41) natal males and 39% (n=26) natal females. Most (81%) had used gender-confirming hormones; 24% had used hormones without a prescription. The majority (92%) of those who had not used hormones planned future use. Among natal females, 23% had undergone hysterectomies and 19% oophorectomies. The majority of natal females who had not had these surgeries desired to have them in the future (hysterectomy: 80%, oophorectomy: 67%). Vaginectomy was less common (4%), but was desired by 20% of natal females. CONCLUSION: Reliance on non-prescribed hormones, and unmet medication and surgical needs are high, even among a highly educated and insured cohort of transgender individuals. Obstetrician-gynecologists are uniquely positioned to provide transition-related care, particularly surgical interventions for female-to-male individuals, and basic hormonal management.