Lett Elle, Everhart Avery
Center for Applied Transgender Studies, Chicago, IL; Center for Health Equity Advancement, University of Pennsylvania, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Center for Applied Transgender Studies, Chicago, IL; Dornsife Spatial Sciences Institute, University of Southern California, Los Angeles, CA.
Ann Epidemiol. 2022 Jan;65:65-71. doi: 10.1016/j.annepidem.2021.10.009. Epub 2021 Oct 28.
Transgender identities and health are highly politicized in the United States leading to restrictions on relevant data collection in national health surveillance systems. This has serious implications on transgender population health research; an urgent area of study given the systemic discrimination faced by transgender individuals and the resultant social and health inequities. In this precarious political climate, obtaining high-quality data for research is challenging and in recent years, two data sources have formed the foundation of transgender health research in the United States, namely the 2015 United States Transgender Study and the Behavioral Risk Factor Surveillance System after the launch of the optional Sexual Orientation and Gender Identity Module in 2014. While useful, there are serious challenges to using these data to study transgender health, specifically related to survey weighting methodologies, ascertainment of gender identity, and study design. In this article, we detail these challenges and discuss the strengths and weaknesses of various methodological approaches that have been implemented as well as clarify several common errors that exist in the literature. We feel that this contribution is necessary to provide accurate interpretation of the evidence that currently informs policy and priority setting for transgender population health and will provide vital insights for future studies with these now ubiquitous sources of data in the field.
在美国，跨性别身份与健康问题高度政治化，导致国家卫生监测系统中相关数据收集受到限制。这对跨性别群体健康研究产生了严重影响；鉴于跨性别者面临的系统性歧视以及由此产生的社会和健康不平等，这是一个亟待研究的领域。在这种不稳定的政治环境下，获取高质量的研究数据具有挑战性，近年来，有两个数据源构成了美国跨性别健康研究的基础，即2015年的美国跨性别研究以及2014年推出可选的性取向和性别认同模块后的行为风险因素监测系统。虽然这些数据很有用，但利用它们来研究跨性别健康存在严重挑战，特别是在调查加权方法、性别认同的确定以及研究设计方面。在本文中，我们详细阐述了这些挑战，讨论了已实施的各种方法的优缺点，并澄清了文献中存在的几个常见错误。我们认为，这一贡献对于准确解读目前为跨性别群体健康政策和优先事项设定提供依据的证据是必要的，并且将为今后使用该领域这些现已普遍存在的数据源进行的研究提供重要见解。
