These are the results to the study my colleagues and I conducted last year for the Williams Institute as part of their Gender Identity in U.S. Surveillance (GenIUSS) Project. A PDF copy is available.
Health research examining the disparities faced by gender minorities (transgender, transsexual, and other gender nonconforming individuals) has reached a stage where population based studies are needed in order to expand upon what smaller, community based studies have identified within the population. One of the issues hindering the inclusion of measures needed to identify gender minority populations is the lack of measures that can effectively identify gender minority populations but can be understood by gender majority populations and provide data usable by researchers. This study examined measures that can identify gender identity/gender transition and gender expression by conducting cognitive interviews with 50 people (25 gender minority, 25 gender majority). The interviews asked people to read and answer the questions; afterwards they were interviewed about why they answered the way they did. The gender identity/gender transition question was found to be understood by all participants and only requires small changes to improve its usage. The researchers found gender minority and majority participants to have problems answering the gender expression questions. The results show that the gender expression measures may not be effective when used in a population based study. Researchers conclude that the gender identity/gender transition questions would be effective in quantitative studies and be useful in identifying health disparities among gender minority populations.
Examination of Gender Identity and Expression Measures within a Mid – West Sample: Report to the Williams Institute
Prevalence of Gender Identity Disorder and Suicide Risk Among Transgender Veterans Utilizing Veterans Health Administration Care
The paper is very unique in that the authors are utilizing a database that allowed them to examine trans people along side a cis sample within the Veterans Health Administration database They identified their trans sample based on those who were given CD-9 diagnosis codes for Gender Identity Disorder (GID) from 2000-2011 (They did not utilize self-identification for their study). They identified 3177 unique trans people within the time period (the vast majority were military personnel and not dependents). They report two interesting findings.
The first was the increase in the prevalence of people being given GID diagnoses from 13/100,000 in 2002 to 23/100,000 in 2011. There measure of prevalence was much higher than estimates made for general populations. The implication being either that military populations have a greater percentage of trans people then general populations (i.e. Flight into hypermasculinity). They do not identify the difference between those assigned male and those assigned female, but identify that 95% of the VHA data were assigned male. This is one issue I have with this study. Another possibility is that general population estimates under represent trans populations. This may be true as the number of people given a GID diagnosis have been increasing overtime within the VHA dataset.
The second part of the study was to examine rates of suicide related measures among this population. They found their sample to have a very high rate of suicide related events, much higher than rates found within general populations (of cis people). They can’t say if rates are different from non-veteran trans people.
While the study is not perfect it is an important step in the study of the health issues of trans populations. We need to include population based studies of trans people along with community based convenience samples. This is the reason why measures are needed to effectively identify trans samples within larger populations, so that studies like this one can be done. There are those who would question this considering the small number of trans people found within general populations studies, and the percentage of trans people within the VA study itself represented .02%% of the total VA data-set. However, its important because while trans people represent a small population, they are likely to experience higher levels of social and health disparities that require some sort of intervention.
That makes two NIH grants submitted this summer.
R21 The impact of discrimination and social support upon the health of transgender men and women.
R13 Current Issues in Lesbian, Gay, Bisexual, and Transgender (LGBT) Health Research. My colleagues and I are hoping to do a LGBT health conference just prior to the Gay Games being held in Cleveland next year. Both events would work wonderfully together.
I should hear about both early in 2014.