Advancing methods for US transgender health research

doi:10.1097/MED.0000000000000229

Review

. 2016 Apr;23(2):198-207.

doi: 10.1097/MED.0000000000000229.

Advancing methods for US transgender health research

Sari L Reisner¹, Madeline B Deutsch, Shalender Bhasin, Walter Bockting, George R Brown, Jamie Feldman, Rob Garofalo, Baudewijntje Kreukels, Asa Radix, Joshua D Safer, Vin Tangpricha, Guy TʼSjoen, Michael Goodman

Affiliations

Affiliation

¹ aThe Fenway Institute, Fenway Health bDepartment of Epidemiology, Harvard T.H. Chan School of Public Health cDivision of General Pediatrics, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts dDepartment of Family and Community Medicine, University of California, San Francisco, California eResearch Program in Men's Health: Aging and Metabolism Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts fLGBT Health Initiative, New York State Psychiatric Institute/Columbia Psychiatry and the Columbia University School of Nursing, New York City, New York gQuillen College of Medicine, East Tennessee State University, Johnson City, Tennessee hDepartment of Family Medicine and Community Health, University of Minnesota, School of Medicine, Minneapolis, Minnesota iDepartment of Pediatrics, Northwestern University/Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA jCenter of Expertise on Gender Dysphoria, Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands kCallen-Lorde Community Health Center, New York City, New York lSection of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University School of Medicine, Boston, Massachusetts mDivision of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta nThe Atlanta VA Medical Center, Decatur, Georgia, USA oDepartment of Endocrinology and Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium pDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.

PMID: 26845331
PMCID: PMC4916925
DOI: 10.1097/MED.0000000000000229

Free PMC article

Review

Advancing methods for US transgender health research

Sari L Reisner et al. Curr Opin Endocrinol Diabetes Obes. 2016 Apr.

Free PMC article

. 2016 Apr;23(2):198-207.

doi: 10.1097/MED.0000000000000229.

Authors

Affiliation

¹ aThe Fenway Institute, Fenway Health bDepartment of Epidemiology, Harvard T.H. Chan School of Public Health cDivision of General Pediatrics, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts dDepartment of Family and Community Medicine, University of California, San Francisco, California eResearch Program in Men's Health: Aging and Metabolism Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts fLGBT Health Initiative, New York State Psychiatric Institute/Columbia Psychiatry and the Columbia University School of Nursing, New York City, New York gQuillen College of Medicine, East Tennessee State University, Johnson City, Tennessee hDepartment of Family Medicine and Community Health, University of Minnesota, School of Medicine, Minneapolis, Minnesota iDepartment of Pediatrics, Northwestern University/Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA jCenter of Expertise on Gender Dysphoria, Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands kCallen-Lorde Community Health Center, New York City, New York lSection of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University School of Medicine, Boston, Massachusetts mDivision of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta nThe Atlanta VA Medical Center, Decatur, Georgia, USA oDepartment of Endocrinology and Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium pDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.

PMID: 26845331
PMCID: PMC4916925
DOI: 10.1097/MED.0000000000000229

Abstract

Purpose of review: This article describes methodological challenges, gaps, and opportunities in US transgender health research.

Recent findings: Lack of large prospective observational studies and intervention trials, limited data on risks and benefits of sex affirmation (e.g., hormones and surgical interventions), and inconsistent use of definitions across studies hinder evidence-based care for transgender people. Systematic high-quality observational and intervention-testing studies may be carried out using several approaches, including general population-based, health systems-based, clinic-based, venue-based, and hybrid designs. Each of these approaches has its strength and limitations; however, harmonization of research efforts is needed. Ongoing development of evidence-based clinical recommendations will benefit from a series of observational and intervention studies aimed at identification, recruitment, and follow-up of transgender people of different ages, from different racial, ethnic, and socioeconomic backgrounds and with diverse gender identities.

Summary: Transgender health research faces challenges that include standardization of lexicon, agreed upon population definitions, study design, sampling, measurement, outcome ascertainment, and sample size. Application of existing and new methods is needed to fill existing gaps, increase the scientific rigor and reach of transgender health research, and inform evidence-based prevention and care for this underserved population.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None.

Figures

**Figure 1**
Distribution of health outcomes in U.S. Transgender Research, 2008–2014.

**Figure 2**
A flow diagram depicting data collection and design of a mixed retrospective/prospective health systems-based study.

**Figure 3**
A concept of a multisite U.S. national transgender cohort study.

See this image and copyright information in PMC

Cited by

Health status of transgender people globally: A systematic review of research on disease burden and correlates.
Scheim AI, Rich AJ, Zubizarreta D, Malik M, Baker KE, Restar AJ, van der Merwe LA, Wang J, Beebe B, Ridgeway K, Baral SD, Poteat T, Reisner SL. Scheim AI, et al. PLoS One. 2024 Mar 11;19(3):e0299373. doi: 10.1371/journal.pone.0299373. eCollection 2024. PLoS One. 2024. PMID: 38466747 Free PMC article.
Efficacy, safety, tolerability, and pharmacokinetics of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis in transgender women: a secondary analysis of the HPTN 083 trial.
Marzinke MA, Hanscom B, Wang Z, Safren SA, Psaros C, Donnell D, Richardson PA, Sullivan P, Eshleman SH, Jennings A, Feliciano KG, Jalil E, Coutinho C, Cardozo N, Maia B, Khan T, Singh Y, Middelkoop K, Franks J, Valencia J, Sanchez N, Lucas J, Rooney JF, Rinehart AR, Ford S, Adeyeye A, Cohen MS, McCauley M, Landovitz RJ, Grinsztejn B; HPTN 083 study group. Marzinke MA, et al. Lancet HIV. 2023 Nov;10(11):e703-e712. doi: 10.1016/S2352-3018(23)00200-X. Epub 2023 Sep 29. Lancet HIV. 2023. PMID: 37783219 Clinical Trial.
Associations between discrimination experiences and symptoms of depression and anxiety among transgender adults: a nationwide cohort study of 269 transgender adults in South Korea.
Choo S, Kim R, Lee H, Eom YJ, Yi H, Kim R, Kim SS. Choo S, et al. Soc Psychiatry Psychiatr Epidemiol. 2023 Aug 26. doi: 10.1007/s00127-023-02554-5. Online ahead of print. Soc Psychiatry Psychiatr Epidemiol. 2023. PMID: 37632566
A Call to Action for Improving LGBTQIA2S+ Inclusive Policies and Practices in Educating Science and Medical Professionals.
Filimonov AK, Gates AR, Allos AN, Billings HJ, Goldina A, Wisco JJ. Filimonov AK, et al. Med Sci Educ. 2023 May 27;33(3):767-772. doi: 10.1007/s40670-023-01797-w. eCollection 2023 Jun. Med Sci Educ. 2023. PMID: 37501802
A Scoping Review of Health Outcomes Among Transgender Migrants.
Castro VA, King WM, Augustaitis L, Saylor K, Gamarel KE. Castro VA, et al. Transgend Health. 2022 Oct 7;7(5):385-396. doi: 10.1089/trgh.2021.0011. eCollection 2022 Oct. Transgend Health. 2022. PMID: 36644484 Free PMC article. Review.

See all "Cited by" articles

References

1. Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. The National Academies Press; Washington, DC: 2011. - PubMed
1. Bockting WO, Miner MH, Swinburne Romine RE, Hamilton A, Coleman E. Stigma, mental health, and resilience in an online sample of the us transgender population. Am J Public Health. 2013;103(5):943–951. - PMC - PubMed
1. Budge SL, Adelson JL, Howard KA. Anxiety and depression in transgender individuals: The roles of transition status, loss, social support, and coping. J Consult Clin Psychol. 2013;81(3):545–557. - PubMed
1. Habarta N, Wang G, Mulatu MS, Larish N. Hiv testing by transgender status at centers for disease control and prevention-funded sites in the united states, puerto rico, and us virgin islands, 2009–2011. Am J Public Health. 2015;105(9):1917–1925. - PMC - PubMed
2. *Special interest: Article describing trends in HIV testing data from the Centers for Disease Control and Prevention by transgender status.
1. Coulter RW, Blosnich JR, Bukowski LA, Herrick AL, Siconolfi DE, Stall RD. Differences in alcohol use and alcohol-related problems between transgender- and nontransgender-identified young adults. Drug Alcohol Depend. 2015;33(3):287–295. - PMC - PubMed

Publication types

Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program

[1] Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. The National Academies Press; Washington, DC: 2011. - PubMed

[2] Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. The National Academies Press; Washington, DC: 2011. - PubMed

[3] Bockting WO, Miner MH, Swinburne Romine RE, Hamilton A, Coleman E. Stigma, mental health, and resilience in an online sample of the us transgender population. Am J Public Health. 2013;103(5):943–951. - PMC - PubMed

[4] Bockting WO, Miner MH, Swinburne Romine RE, Hamilton A, Coleman E. Stigma, mental health, and resilience in an online sample of the us transgender population. Am J Public Health. 2013;103(5):943–951. - PMC - PubMed

[5] Budge SL, Adelson JL, Howard KA. Anxiety and depression in transgender individuals: The roles of transition status, loss, social support, and coping. J Consult Clin Psychol. 2013;81(3):545–557. - PubMed

[6] Budge SL, Adelson JL, Howard KA. Anxiety and depression in transgender individuals: The roles of transition status, loss, social support, and coping. J Consult Clin Psychol. 2013;81(3):545–557. - PubMed

[7] Habarta N, Wang G, Mulatu MS, Larish N. Hiv testing by transgender status at centers for disease control and prevention-funded sites in the united states, puerto rico, and us virgin islands, 2009–2011. Am J Public Health. 2015;105(9):1917–1925. - PMC - PubMed

*Special interest: Article describing trends in HIV testing data from the Centers for Disease Control and Prevention by transgender status.

[8] Habarta N, Wang G, Mulatu MS, Larish N. Hiv testing by transgender status at centers for disease control and prevention-funded sites in the united states, puerto rico, and us virgin islands, 2009–2011. Am J Public Health. 2015;105(9):1917–1925. - PMC - PubMed

[9] *Special interest: Article describing trends in HIV testing data from the Centers for Disease Control and Prevention by transgender status.

[10] Coulter RW, Blosnich JR, Bukowski LA, Herrick AL, Siconolfi DE, Stall RD. Differences in alcohol use and alcohol-related problems between transgender- and nontransgender-identified young adults. Drug Alcohol Depend. 2015;33(3):287–295. - PMC - PubMed

[11] Coulter RW, Blosnich JR, Bukowski LA, Herrick AL, Siconolfi DE, Stall RD. Differences in alcohol use and alcohol-related problems between transgender- and nontransgender-identified young adults. Drug Alcohol Depend. 2015;33(3):287–295. - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Advancing methods for US transgender health research

Affiliation

Advancing methods for US transgender health research

Authors

Affiliation

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials