1 Department of Urology, San Francisco General Hospital, University of California San Francisco , San Francisco, California.
2 Department of Surgery, King Abdulaziz University , Rabigh, Saudi Arabia .
LGBT Health. 2017 Feb;4(1):11-16. doi: 10.1089/lgbt.2016.0097. Epub 2016 Dec 22.
We aim to describe the relationship between sexual orientation identity and medical morbidities in a large sample of male-to-female (MTF) transgender patients.
We reviewed medical records of patients presenting for MTF sex reassignment surgery (SRS) by a single, high-volume surgeon from 2011 to 2015. Sexual attraction to men (heterosexual), women (lesbian), or both (bisexual) was asked of each patient. We examined 16 medical morbidities for this analysis.
During the study period, 330 MTF transgender patients presented for SRS. The average age at the time of surgery was 38.9 (range 18-76). One hundred and one patients (32%) reported being heterosexual, 110 patients (34%) reported being lesbian, and 108 patients (34%) reported being bisexual. Lesbian patients presented for SRS at older ages (mean = 43 years old) compared with heterosexual patients (mean = 36 years old) and bisexual patients (mean = 37), P < 0.01. No differences were found in the majority of coexisting medical morbidities by sexual orientation identity. Lesbian patients had greater odds of having a history of depression, age-adjusted odds ratio (aOR) = 2.36, 95% confidence interval (CI) 1.26-4.40, compared with heterosexual patients. Lesbian patients had higher odds of being married or partnered, aOR = 2.31, 95% CI (1.27-4.19), compared with heterosexual patients. Heterosexual patients had higher odds of having human immunodeficiency virus (HIV), aOR = 9.07, 95% CI (1.08-76.5) compared with lesbian patients.
Sexual orientation identity in MTF transgender patients is variable. The majority of medical morbidities are not associated with sexual orientation identity. Although HIV and depression are common morbidities among MTF patients seeking SRS, the prevalence of these morbidities differs by sexual orientation identity, but these findings need replication. Counseling and future research initiatives in transgender care should incorporate sexual orientation identity and associated risk behavior.
我们旨在描述大量男性到女性（MTF）跨性别患者的性取向认同与医疗合并症之间的关系。
我们回顾了 2011 年至 2015 年间，由一位经验丰富的外科医生为 MTF 性别重置手术（SRS）就诊的患者的病历。每位患者均被问及对男性（异性恋）、女性（同性恋）或两者（双性恋）的性吸引。我们对这一分析共检查了 16 种医疗合并症。
在研究期间，330 名 MTF 跨性别患者接受了 SRS。手术时的平均年龄为 38.9 岁（范围 18-76 岁）。101 名患者（32%）报告为异性恋，110 名患者（34%）报告为同性恋，108 名患者（34%）报告为双性恋。与异性恋患者（平均年龄 36 岁）和双性恋患者（平均年龄 37 岁）相比，同性恋患者接受 SRS 的年龄更大（平均年龄 43 岁），P<0.01。性取向认同并没有在大多数共存的医疗合并症方面产生差异。与异性恋患者相比，有抑郁病史的同性恋患者的可能性更大，调整后的优势比（aOR）=2.36，95%置信区间（CI）1.26-4.40，同性恋患者的可能性更大。与异性恋患者相比，同性恋患者已婚或处于伴侣关系的可能性更高，调整后的优势比（aOR）=2.31，95%置信区间（CI）1.27-4.19。与同性恋患者相比，异性恋患者感染人类免疫缺陷病毒（HIV）的可能性更高，调整后的优势比（aOR）=9.07，95%置信区间（CI）1.08-76.5。
MTF 跨性别患者的性取向认同是多样化的。大多数医疗合并症与性取向认同无关。尽管 HIV 和抑郁是接受 SRS 的 MTF 患者的常见合并症，但这些合并症的患病率因性取向认同而异，但这些发现需要复制。在跨性别护理中，咨询和未来的研究计划应纳入性取向认同和相关的风险行为。
