Transgender Health Disparities: Comparing Full Cohort and Nested Matched-Pair Study Designs in a Community Health Center
- PMID: 25379511
- PMCID: PMC4219512
- DOI: 10.1089/lgbt.2014.0009
Transgender Health Disparities: Comparing Full Cohort and Nested Matched-Pair Study Designs in a Community Health Center
Abstract
Purpose: U.S. health surveillance systems infrequently include measures to identify transgender respondents or monitor the health of this underserved and marginalized population.
Methods: From 2001-2002, transgender and non-transgender adults were sampled at a Massachusetts clinic. Health differences were formatively examined by transgender identity using a cross-sectional, clinic-based sample (n=2,653); and a nested matched-pair subsample (n=155).
Results: Both designs produced virtually identical findings: (1) the prevalence of HIV, substance abuse, and smoking did not differ significantly for transgender and non-transgender patients; (2) transgender patients were more likely to endorse a lifetime suicide attempt and ideation compared to non-transgender patients (p<0.05); (3) transgender patients disproportionately reported social stressors (violence, discrimination, childhood abuse) relative to non-transgender patients (p<0.05).
Conclusion: Findings suggest that a nested design may provide an effective methodology for using clinical data to study transgender health, and underscore the need for routine collection of gender identity in clinical settings.
Keywords: Health disparity; gender identity; methods; study design; transgender.
References
-
- Institute of Medicine (IOM) The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Institute of Medicine; Washington, DC: 2011. - PubMed
-
- Clements-Nolle K, Marx R, Katz M. Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. J Homosex. 2006;51(3):53–69. - PubMed
-
- Kenagy GP. Transgender health: Findings from two needs assessment studies in Philadelphia. Health Soc Work. 2005;30(1):19–26. - PubMed
-
- Hotton AL, Garofalo R, Kuhns LM, Johnson AK. Substance Use as a Mediator of the Relationship Between Life Stress and Sexual Risk Among Young Transgender Women. AIDS Educ Prev. 2013;25(1):62–71. - PubMed
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
