跨性别成年人对当前激素治疗的满意度和对额外性别肯定护理的目标。
Satisfaction with current hormone therapy and goals of additional gender-affirming care in transgender adults.
机构信息
Department of Dermatology, School of Medicine, Emory University, Atlanta, GA 30322.
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, United States.
出版信息
J Sex Med. 2023 Mar 31;20(4):568-572. doi: 10.1093/jsxmed/qdad011.
BACKGROUND
Many transgender persons seek hormone therapy to reduce gender dysphoria and improve quality of life, but little is known about patient satisfaction with current gender-affirming hormone therapy.
AIM
To examine patient satisfaction with current gender-affirming hormone therapy and patients' goals of additional hormone therapy.
METHODS
Transgender adults in the validated multicenter STRONG cohort (Study of Transition, Outcomes, and Gender) were asked to complete a cross-sectional survey about current and planned hormone therapy and the effects that they experienced or hoped to gain. The proportion of respondents reporting overall satisfaction with hormone therapy were compared with χ2 or Fisher exact test. Cochran-Mantel-Haenszel analysis was used to compare the covariates of interest while controlling for age at the time of survey completion.
OUTCOMES
Patient satisfaction across hormone therapies, each measured with a 5-point scale, was averaged and dichotomized.
RESULTS
Out of 2136 eligible transgender adults, 696 (33%) completed the survey: 350 transfeminine (TF) and 346 transmasculine (TM) respondents. Most participants (80%) were satisfied or very satisfied with their current hormone therapies. TF participants and older participants were less likely to report being satisfied with their current hormone therapies than TM participants and younger participants, respectively. However, TM and TF categories were not associated with patient satisfaction after controlling for age at the time of survey completion. More TF persons planned to take additional treatment. The most frequent goals for additional hormone therapy for TF persons included breast size growth, feminine body fat distribution, and facial feature softening; for TM persons, goals included diminishing dysphoria, greater muscle mass, and masculine body fat distribution.
CLINICAL IMPLICATIONS
Multidisciplinary care beyond provision of hormone therapy-such as involvement of surgical, dermatologic, reproductive health, mental health, and/or gender expression care-may be important to help achieve unmet gender-affirming care goals.
STRENGTHS AND LIMITATIONS
This study had a modest response rate and included only respondents with private insurance, limiting generalizability.
CONCLUSION
Understanding patient satisfaction and goals of care will assist shared decision making and counseling in patient-centered gender-affirming therapy.
背景
许多跨性别者寻求激素治疗以减少性别焦虑并提高生活质量，但目前关于患者对性别肯定激素治疗的满意度知之甚少。
目的
研究患者对当前性别肯定激素治疗的满意度以及患者对额外激素治疗的目标。
方法
在经过验证的多中心 STRONG 队列（过渡、结果和性别研究）中，要求跨性别成年人完成一项关于当前和计划中的激素治疗以及他们所经历或希望获得的治疗效果的横断面调查。使用 χ2 或 Fisher 确切检验比较报告总体激素治疗满意度的受访者比例。在控制调查完成时的年龄这一协变量的同时，使用 Cochran-Mantel-Haenszel 分析比较感兴趣的协变量。
结果
通过 5 分制对激素治疗的满意度进行平均和二分法处理，以衡量患者的满意度。
结论
理解患者的满意度和治疗目标将有助于在以患者为中心的性别肯定治疗中进行共同决策和咨询。
局限性
本研究的响应率较低，且仅包括有私人保险的受访者，限制了其普遍性。
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