Objectives. We examined the proportion of studies funded by the National Institutes of Health (NIH) that focused on lesbian, gay, bisexual, and transgender (LGBT) populations, along with investigated health topics. Methods. We used the NIH RePORTER system to search for LGBT-related terms in NIH-funded research from 1989 through 2011. We coded abstracts for LGBT inclusion, subpopulations studied, health foci, and whether studies involved interventions. Results. NIH funded 628 studies concerning LGBT health. Excluding projects about HIV/AIDS and other sexual health matters, only 0.1% (n = 113) of all NIH-funded studies concerned LGBT health. Among the LGBT-related projects, 86.1% studied sexual minority men, 13.5% studied sexual minority women, and 6.8% studied transgender populations. Overall, 79.1% of LGBT-related projects focused on HIV/AIDS and substantially fewer on illicit drug use (30.9%), mental health (23.2%), other sexual health matters (16.4%), and alcohol use (12.9%). Only 202 studies examined LGBT health–related interventions. Over time, the number of LGBT-related projects per year increased. Conclusions. The lack of NIH-funded research about LGBT health contributes to the perpetuation of health inequities. Here we recommend ways for NIH to stimulate LGBT-related research.

Introduction Tobacco use among transgender adults continues to be an area of research with few reported findings. The limited literature indicates higher cigarette use among transgender adults, compared with the general population. This national study is the first to report on cigarettes, cigars, and e-cigarettes by examining differences in transgender tobacco use independent of sexual orientation. Methods Data were collected in 2013 using a nationally cross-sectional online survey of U.S. adults (cisgender, n=17,164; transgender, n=168) and analyzed in 2015. Past 30–day tobacco use point estimates and adjusted logistic regression while controlling for false discovery rate were reported for transgender and cisgender respondents. Results Transgender adults reported higher past 30–day use of any cigarette/cigar/e-cigarette product (39.7% vs 25.1%) and current use of cigarettes (35.5% vs 20.7%), cigars (26.8% vs 9.3%), and e-cigarettes (21.3% vs 5.0%) compared with cisgender adults (all p-values ≤0.003). Transgender respondents had significantly higher odds of past 30–day tobacco product use for any cigarette/cigar/e-cigarette product (OR=1.97, 95% CI=1.25, 3.1), e-cigarettes (OR=5.15, 95% CI=3.36, 7.88), cigars (OR=3.56, 95% CI=2.27, 5.59), and cigarettes (OR=2.10, 95% CI=1.35, 3.28) versus cisgender respondents (all p-values ≤0.0035). Conclusions Transgender adults are at higher risk for tobacco use than cisgender adults and risk of specific product use varies by gender. This is the first U.S. national study to assess differences in use of various tobacco products using questions that specifically ask for gender identity separately from sexual orientation. This study provides data that can inform targeted interventions to promote transgender health.

No abstract

Efforts to monitor the health of transgender youth, a small but high-risk population, are hindered by a lack of knowledge about how to accurately measure gender identity. Adolescents (n = 30) participated in semistructured qualitative interviews after completing a close-ended transgender-inclusive measure of gender. Interviews explored item comprehension and respondent burden. Participants, who were diverse in age (range = 15-21), gender identity, sexual orientation, and race-ethnicity, were accurately classified as male, female, or transgender. All youth understood transgender as a difference between the physical body and a person's internal sense of self. Nontransgender youth frequently used an example (a woman in a man's body) in their explanations and were largely supportive of the transgender options. Most transgender youth found a response option that they felt was appropriate. Transgender response options were added to a gender measure without impacting the accuracy of nontransgender responses or burdening the nontransgender adolescents in our sample. A modified measure (Gender: male; female; transgender, male-to-female; transgender, female-to-male; transgender, do not identify as exclusively male or female) is recommended for testing in samples that vary by age, race-ethnicity, socioeconomic status, language, and geography. Additional suggestions for research in this area are provided.