美国跨性别健康研究的先进方法。
Advancing methods for US transgender health research.
作者信息
Reisner Sari L, Deutsch Madeline B, Bhasin Shalender, Bockting Walter, Brown George R, Feldman Jamie, Garofalo Rob, Kreukels Baudewijntje, Radix Asa, Safer Joshua D, Tangpricha Vin, TʼSjoen Guy, Goodman Michael
机构信息
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.
出版信息
Curr Opin Endocrinol Diabetes Obes. 2016 Apr;23(2):198-207. doi: 10.1097/MED.0000000000000229.
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.
综述目的
本文描述了美国跨性别者健康研究中的方法学挑战、差距和机遇。
最新发现
缺乏大型前瞻性观察性研究和干预试验，关于性别肯定（如激素和手术干预）的风险和益处的数据有限，以及各研究中定义使用不一致，这些都阻碍了为跨性别者提供循证护理。可以采用多种方法开展系统的高质量观察性和干预测试研究，包括基于一般人群、基于卫生系统、基于诊所、基于场所和混合设计。这些方法各有优缺点；然而，需要协调研究工作。正在制定的循证临床建议将受益于一系列观察性和干预性研究，这些研究旨在识别、招募和随访不同年龄、不同种族、族裔和社会经济背景以及具有不同性别认同的跨性别者。
总结
跨性别者健康研究面临诸多挑战，包括词汇标准化、商定的人群定义、研究设计、抽样、测量、结局确定和样本量等。需要应用现有和新的方法来填补现有差距，提高跨性别者健康研究的科学严谨性和覆盖面，并为这一服务不足人群的循证预防和护理提供依据。
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