跨性别者的健康差异:在社区健康中心比较全队列研究和嵌套匹配对研究设计
Transgender Health Disparities: Comparing Full Cohort and Nested Matched-Pair Study Designs in a Community Health Center.
作者信息
Reisner Sari L, White Jaclyn M, Bradford Judith B, Mimiaga Matthew J
机构信息
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA ; The Fenway Institute at Fenway Health, Boston, MA, USA.
The Fenway Institute at Fenway Health, Boston, MA, USA.
出版信息
LGBT Health. 2014 Sep 1;1(3):177-184. doi: 10.1089/lgbt.2014.0009.
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 (<0.05); (3) transgender patients disproportionately reported social stressors (violence, discrimination, childhood abuse) relative to non-transgender patients (<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.
目的
美国的健康监测系统很少纳入识别跨性别受访者或监测这一服务不足且边缘化人群健康状况的措施。
方法
2001年至2002年期间,在马萨诸塞州的一家诊所对跨性别和非跨性别成年人进行了抽样。使用基于诊所的横断面样本(n = 2653),并通过跨性别身份对健康差异进行了形成性研究;以及一个嵌套匹配对子样本(n = 155)。
结果
两种设计得出的结果几乎相同:(1)跨性别和非跨性别患者的艾滋病毒、药物滥用和吸烟患病率没有显著差异;(2)与非跨性别患者相比,跨性别患者更有可能认可有过终身自杀未遂和自杀意念(<0.05);(3)与非跨性别患者相比,跨性别患者报告社会压力源(暴力、歧视、童年虐待)的比例过高(<0.05)。
结论
研究结果表明,嵌套设计可能为利用临床数据研究跨性别健康状况提供一种有效的方法,并强调在临床环境中常规收集性别身份信息的必要性。
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