Landon D. Hughes, Wesley M. King, Kristi E. Gamarel, and Arline T. Geronimus are with the School of Public Health, University of Michigan, Ann Arbor, and the Institute for Social Research, University of Michigan. Orestis A. Panagiotou and Jaclyn M. W. Hughto are with the School of Public Health, Brown University, Providence, RI.
Am J Public Health. 2022 Oct;112(10):1507-1514. doi: 10.2105/AJPH.2022.306963. Epub 2022 Aug 18.
To compare survival by gender and race among transgender and cisgender people enrolled in private insurance in the United States between 2011 and 2019. We examined Optum's Clinformatics Data Mart Database. We identified transgender enrollees using claims related to gender-affirming care. Our analytic sample included those we identified as transgender and a 10% random sample of cisgender enrollees. We limited our sample to those 18 years or older who were non-Hispanic Black or White. We identified 18 033 transgender and more than 4 million cisgender enrollees. We fit Kaplan-Meier survival curves and calculated standardized mortality ratios while adjusting for census region. Black transfeminine and nonbinary people assigned male sex at birth were 2.73 times more likely to die than other Black transgender people and 2.38 and 3.34 times more likely than Black cisgender men and women, respectively; similar results were found when White transfeminine and nonbinary people assigned male sex at birth were compared with White cisgender cohorts. Our findings highlight glaring inequities in mortality risks among Black transfeminine and nonbinary people assigned male sex at birth and underscore the need to monitor mortality risks in transgender populations and address the social conditions that increase these risks. (. 2022;112(10):1507-1514. https://doi.org/10.2105/AJPH.2022.306963).
比较 2011 年至 2019 年期间，美国私人保险中跨性别和 cisgender 人群的性别和种族生存率。我们检查了 Optum 的 Clinformatics Data Mart 数据库。我们使用与性别肯定护理相关的索赔来识别跨性别参保人。我们的分析样本包括我们确定为跨性别者和 10%的 cisgender 参保者的随机样本。我们将样本限制在 18 岁或以上的非西班牙裔黑人或白人。我们确定了 18033 名跨性别者和 400 多万名 cisgender 参保者。我们拟合了 Kaplan-Meier 生存曲线，并计算了标准化死亡率比值，同时调整了人口普查区域。黑人跨性别女性和非二元性别者出生时被指定为男性的人死亡的可能性比其他黑人跨性别者高 2.73 倍，比黑人 cisgender 男性和女性分别高 2.38 倍和 3.34 倍；当比较出生时被指定为男性的白人跨性别女性和非二元性别者与白人 cisgender 队列时，也发现了类似的结果。我们的研究结果突显了黑人跨性别女性和非二元性别者出生时被指定为男性的人在死亡率风险方面存在明显的不平等现象，并强调需要监测跨性别群体的死亡率风险，并解决增加这些风险的社会条件。（2022 年；112（10）：1507-1514. https://doi.org/10.2105/AJPH.2022.306963）。
