Thomas Siobhan D, King Robert, Murphy Mike, Dempsey Maria
School of Applied Psychology, University College Cork, Cork Enterprise Centre, North Mall, Cork, Ireland.
Dialogues Health. 2023 Nov 14;3:100159. doi: 10.1016/j.dialog.2023.100159. eCollection 2023 Dec.
Healthcare avoidance and delay (HAD) in the transgender population has been well documented, and research has explored a range of associated factors that help to identify those most at risk of HAD. This review addresses a gap in the research by synthesizing research exploring associations between HAD and demographic factors.
A systematic search of literature published at any time up to December 2021 was conducted, using five databases (EBSCO, EMBASE, PubMed, Scopus, and Web of Science) and manually searching reference lists of included studies. After exclusion of duplicates, 608 unique records were subjected to double screening. Papers reporting statistical analyses of HAD in association with any sociodemographic variables were included in this review. Papers consisted of nineteen cross-sectional studies. Narrative synthesis was used to address findings.
Nineteen studies met inclusion criteria, exploring HAD in association with a wide range of demographic factors, including sex and gender, social transition factors, age, race and ethnicity, socioeconomic factors, veteran status, education, sexuality, relationship status, citizenship, place of residence, and state demographics. Findings identified intra-community demographic risk factors, with consistent evidence for increased HAD among transmasculine, and younger, participants. Lower income and higher educational attainment were also associated with increased HAD, while remaining areas had weak or little evidence for association with HAD.
This review expands knowledge in this area by highlighting demographic factors associated with increased HAD in research literature, and exploring how these may be further investigated to address substantial gaps in the body of research.
跨性别群体中医疗保健回避与延误（HAD）现象已有充分记录，且研究已探讨了一系列相关因素，以帮助确定那些HAD风险最高的人群。本综述通过综合探索HAD与人口统计学因素之间关联的研究，填补了该研究领域的空白。
对截至2021年12月任何时间发表的文献进行系统检索，使用五个数据库（EBSCO、EMBASE、PubMed、Scopus和Web of Science），并手动检索纳入研究的参考文献列表。排除重复记录后，对608条独特记录进行了双重筛选。本综述纳入了报告HAD与任何社会人口统计学变量关联的统计分析的论文。论文包括19项横断面研究。采用叙述性综合分析来阐述研究结果。
19项研究符合纳入标准，探讨了HAD与广泛的人口统计学因素之间的关联，包括性别、社会转型因素、年龄、种族和民族、社会经济因素、退伍军人身份、教育程度、性取向、恋爱状况、公民身份、居住地点和州人口统计学特征。研究结果确定了群体内部的人口统计学风险因素，有一致证据表明，跨男性参与者和年轻参与者中HAD增加。低收入和高教育程度也与HAD增加有关，而其他领域与HAD关联的证据薄弱或几乎没有。
本综述通过强调研究文献中与HAD增加相关的人口统计学因素，并探讨如何进一步研究这些因素以填补研究主体中的重大空白，扩展了该领域的知识。
