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Review
. 2016 Jul 23;388(10042):412-436.
doi: 10.1016/S0140-6736(16)00684-X. Epub 2016 Jun 17.

Global health burden and needs of transgender populations: a review

Sari L Reisner  1 , Tonia Poteat  2 , JoAnne Keatley  3 , Mauro Cabral  4 , Tampose Mothopeng  5 , Emilia Dunham  6 , Claire E Holland  7 , Ryan Max  7 , Stefan D Baral  7
Affiliations
Review

Global health burden and needs of transgender populations: a review

Sari L Reisner et al. Lancet. .

Abstract

Transgender people are a diverse population affected by a range of negative health indicators across high-income, middle-income, and low-income settings. Studies consistently document a high prevalence of adverse health outcomes in this population, including HIV and other sexually transmitted infections, mental health distress, and substance use and abuse. However, many other health areas remain understudied, population-based representative samples and longitudinal studies are few, and routine surveillance efforts for transgender population health are scarce. The absence of survey items with which to identify transgender respondents in general surveys often restricts the availability of data with which to estimate the magnitude of health inequities and characterise the population-level health of transgender people globally. Despite the limitations, there are sufficient data highlighting the unique biological, behavioural, social, and structural contextual factors surrounding health risks and resiliencies for transgender people. To mitigate these risks and foster resilience, a comprehensive approach is needed that includes gender affirmation as a public health framework, improved health systems and access to health care informed by high quality data, and effective partnerships with local transgender communities to ensure responsiveness of and cultural specificity in programming. Consideration of transgender health underscores the need to explicitly consider sex and gender pathways in epidemiological research and public health surveillance more broadly.

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Figures

Figure I.
Figure I.
Sexual and Reproductive Health Outcomes in Transgender Health Research (n=219 Data Points).+ +Author Note: Studies that reported HIV and STI data were coded in the “HIV” category. “STI-related” indicates studies reporting only on STIs.
Figure II.
Figure II.
Violence/Victimization in Transgender Health Research (n=105 Data Points).
Figure 1.
Figure 1.
Map of the Distribution of Studies in Transgender Health (n=116).
Figure 2.
Figure 2.
Number of Studies Containing Transgender Health and Disease Burden Per Year (n=116).
Figure 3.
Figure 3.
Distribution of Studies By Assigned Sex at Birth in Transgender Health Research (n=116 studies)
Figure 4.
Figure 4.
Distribution of Data Points Grouped Into Six Health-Related Outcome Categories in Global Transgender Health Research (n=981).
See this image and copyright information in PMC

References

    1. IOM (Institute of Medicine). The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington, DC: The National Academies Press; 2011. - PubMed
    1. Liao L-M, Simmonds M. A values-driven and evidence-based health care psychology for Diverse Sex Development. Psychology & Sexuality. 2014;5(1):83–101.
    1. Council of Europe: Commissioner for Human Rights. Human Rights and Intersex People. Strasbourg: 2015.
    1. European Union Agency for Fundamental Rights (FRA). The fundamental rights situation of intersex people 2015.
    1. Swiss National Advisory Commission on Biomedical Ethics. On the management of differences of sex development: Ethical issues relating to “intersexuality”. Bern: 2012.

Publication types

MeSH terms