Scheim Ayden I, Baker Kellan E, Restar Arjee J, Sell Randall L
Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA; email:
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Annu Rev Public Health. 2022 Apr 5;43:503-523. doi: 10.1146/annurev-publhealth-052620-100313. Epub 2021 Dec 9.
Transgender (trans) communities in the USA and globally have long organized for health and social equity but have only recently gained increased visibility within public health. In this review, we synthesize evidence demonstrating that trans adults in the USA are affected by disparities in physical and mental health and in access to health care, relative to cisgender (nontrans) persons. We draw on theory and data to situate these disparities in their social contexts, explicating the roles of gender affirmation, multilevel and intersectional stigmas, and public policies in reproducing or ameliorating trans health disparities. Until recently, trans health disparities were largely made invisible by exclusionary data collection practices. We highlight the importance of, and methodological considerations for, collecting inclusive sex and gender data. Moving forward, we recommend routine collection of gender identity data, an emphasis on intervention research to achieve trans health equity, public policy advocacy, and investment in supporting gender-diverse public health leadership.
美国以及全球的跨性别群体长期以来一直在为健康和社会公平而组织活动,但直到最近才在公共卫生领域获得了更高的关注度。在本综述中,我们综合了相关证据,表明相对于顺性别者,美国的跨性别成年人在身心健康以及获得医疗保健方面受到差异的影响。我们运用理论和数据将这些差异置于其社会背景中,阐述性别肯定、多层次和交叉污名以及公共政策在复制或改善跨性别健康差异方面所起的作用。直到最近,由于排他性的数据收集做法,跨性别健康差异在很大程度上不为人所见。我们强调收集包容性的性和性别数据的重要性以及方法上的考虑因素。展望未来,我们建议常规收集性别认同数据,强调开展干预研究以实现跨性别健康公平,进行公共政策倡导,并投资支持性别多元的公共卫生领导力。