The George Washington University, Washington, DC, USA.
University of Michigan School of Nursing, Michigan, USA.
J Interpers Violence. 2022 Jul;37(13-14):NP11720-NP11742. doi: 10.1177/0886260521997460. Epub 2021 Feb 25.
Transgender patients are at elevated risk of intimate partner violence (IPV), but national guidelines do not recommend routine screening for this population. This paper explores the feasibility and effectiveness of routine IPV screening of transgender patients in a primary care setting by describing an existing screening program and identifying factors associated with referral and engagement in IPV-related care for transgender patients. An IPV "referral cascade" was created for 1,947 transgender primary care patients at an urban community health center who were screened for IPV between January 1, 2014 to May 31, 2016: (a) Of those screening positive, how many were referred? (b) Of those referred, how many engaged in IPV-specific care within 3 months? Logistic regression identified demographic correlates of referral and engagement. Of the 1,947 transgender patients screened for IPV, 227 screened positive. 110/227 (48.5%) were referred to either internal or external IPV-related services. Of those referred to on-site services, 65/103 (63.1%) had an IPV-related appointment within 3 months of a positive screen. IPV referral was associated with being assigned male at birth (AMAB) versus assigned female at birth (AFAB) (AOR = 2.69, 95% CI 1.52, 4.75) and with nonbinary, rather than binary, gender identity (AOR = 2.07, 95%CI 1.09, 3.73). Engagement in IPV-related services was not associated with any measured demographic characteristics. Similar to published rates for cisgender women, half of transgender patients with positive IPV screens received referrals and two-thirds of those referred engaged in IPV-specific care. These findings support routine IPV screening and referral for transgender patients in primary care settings. Provider training should focus on how to ensure referrals are made for all transgender patients who screen positive for IPV, regardless of gender identity, to ensure the benefits of screening accrue equally for all patients.
跨性别患者的亲密伴侣暴力（IPV）风险较高，但国家指南不建议对该人群进行常规筛查。本文通过描述一个现有的筛查项目，以及确定与跨性别患者的 IPV 相关护理的转诊和参与相关的因素，探讨了在初级保健环境中对跨性别患者进行常规 IPV 筛查的可行性和有效性。在一个城市社区健康中心，对 1947 名接受 IPV 筛查的跨性别初级保健患者创建了一个 IPV“转诊级联”：（a）在筛查阳性的患者中，有多少人被转诊？（b）在转诊的患者中，有多少人在 3 个月内接受了特定于 IPV 的护理？Logistic 回归分析确定了转诊和参与的人口统计学相关性。在筛查 IPV 的 1947 名跨性别患者中，有 227 人筛查阳性。110/227（48.5%）被转介到内部或外部与 IPV 相关的服务。在转介到现场服务的患者中，有 65/103（63.1%）在阳性筛查后 3 个月内预约了与 IPV 相关的服务。与出生时被指定为女性（AFAB）相比，被指定为男性（AMAB）（AOR=2.69，95%CI 1.52，4.75）和非二元性别认同（AOR=2.07，95%CI 1.09，3.73）与 IPV 转诊相关。参与与 IPV 相关的服务与任何测量的人口统计学特征均无关。与 cisgender 女性的发表率相似，一半筛查阳性的跨性别患者收到了转诊，三分之二的转诊患者接受了特定于 IPV 的护理。这些发现支持在初级保健环境中对跨性别患者进行常规 IPV 筛查和转诊。提供者培训应侧重于如何确保为所有筛查阳性的跨性别患者转诊，无论其性别认同如何，以确保所有患者都平等地受益于筛查。
