Comparing In-Person and Online Survey Respondents in the U.S. National Transgender Discrimination Survey: Implications for Transgender Health Research

Reisner, Sari L.; Conron, Kerith J.; Scout, Nfn; Mimiaga, Matthew J.; Haneuse, Sebastien; Austin, S. Bryn

doi:10.1089/lgbt.2013.0018

Cited by 66 publications

(44 citation statements)

References 24 publications

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“…These findings can likely be attributed to differences in data collection and sampling methods. For example, research in the U.S. has shown demographic and health differences between online versus in-person participants, including within transgender communities, with self-reported HIV-infection being much lower among online compared to in-person participants (Reisner et al, 2014a). Thus, it is likely the HIV and past-year STI prevalence estimates were lower than would be obtained from other data collection and sampling methods, such as those in-person methods used in studies included in meta-analysis findings.…”

Section: Discussionmentioning

confidence: 99%

Using a Two-Step Method to Measure Transgender Identity in Latin America/the Caribbean, Portugal, and Spain

et al. 2014

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Few comparative data are available internationally to examine health differences by transgender identity. A barrier to monitoring the health and well-being of transgender people is the lack of inclusion of measures to assess natal sex/gender identity status in surveys. Data were from a cross-sectional anonymous online survey of members (n > 36,000) of a sexual networking website targeting men who have sex with men in Spanish- and Portuguese-speaking countries/ territories in Latin America/the Caribbean, Portugal, and Spain. Natal sex/gender identity status was assessed using a two-step method (Step 1: assigned birth sex, Step 2: current gender identity). Male-to-female (MTF) and female-to-male (FTM) participants were compared to non-transgender males in age-adjusted regression models on socioeconomic status (SES) (education, income, sex work), masculine gender conformity, psychological health and well-being (lifetime suicidality, past-week depressive distress, positive self-worth, general self-rated health, gender related stressors), and sexual health (HIV-infection, past-year STIs, past-3 month unprotected anal or vaginal sex). The two-step method identified 190 transgender participants (0.54%; 158 MTF, 32 FTM). Of the 12 health-related variables, six showed significant differences between the three groups: SES, masculine gender conformity, lifetime suicidality, depressive distress, positive self-worth, and past-year genital herpes. A two-step approach is recommended for health surveillance efforts to assess natal sex/gender identity status. Cognitive testing to formally validate assigned birth sex and current gender identity survey items in Spanish and Portuguese is encouraged.

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Section: Discussionmentioning

confidence: 99%

Using a Two-Step Method to Measure Transgender Identity in Latin America/the Caribbean, Portugal, and Spain

et al. 2014

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“…Using community-based participatory research principles (Leung, Yen, & Minkler, 2004), between March–July 2013 a team of community-based advocates, transgender leaders, researchers, and LGBT policy experts, working with gender minority people in the Commonwealth, together created the survey instrument and data collection plan. Whenever possible, validated questions or survey items adapted from prior transgender health research were utilized to ensure comparability of findings, including those from such sources as the U.S. National Transgender Discrimination Survey (Reisner, Conron, Scout, et al, 2014) and Behavioral Risk Factor Surveillance System (BRFSS) (CDC, 2012). The survey was designed for a 5 th grade reading level.…”

Section: Methodsmentioning

confidence: 99%

Discriminatory experiences associated with posttraumatic stress disorder symptoms among transgender adults.

Reisner¹,

Hughto²,

Gamarel³

et al. 2016

Journal of Counseling Psychology

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211

166

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Discrimination has been shown to disproportionately burden transgender people; however, there has been a lack of clinical attention to the mental health sequelae of discrimination, including posttraumatic stress disorder (PTSD) symptoms. Additionally, few studies contextualize discrimination alongside other traumatic stressors in predicting PTSD symptomatology. The current study sought to fill these gaps. A community-based sample of 412 transgender adults (mean age 33, SD=13; 63% female-to-male spectrum; 19% people of color; 88% sampled online) completed a cross-sectional self-report survey of everyday discrimination experiences and PTSD symptoms. Multivariable linear regression models examined the association between self-reported everyday discrimination experiences, number of attributed domains of discrimination, and PTSD symptoms, adjusting for prior trauma, sociodemographics, and psychosocial co-morbidity. The mean number of discrimination attributions endorsed was 4.8 (SD=2.4) and the five most frequently reported reasons for discrimination were: gender identity and/or expression (83%), masculine and feminine appearance (79%), sexual orientation (68%), sex (57%), and age (44%). Higher everyday discrimination scores (β=0.25; 95% CL=0.21–0.30) and greater number of attributed reasons for discrimination experiences (β=0.05; 95% CL=0.01–0.10) were independently associated with PTSD symptoms, even after adjusting for prior trauma experiences. Everyday discrimination experiences from multiple sources necessitate clinical consideration in treatment for PTSD symptoms in transgender people.

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“…Medical gender affirmation was assessed with the following item used in prior research with transgender adults (Reisner et al, 2014b). Specifically, medical gender transition was assessed by asking participants whether or not they had medically affirmed their gender via cross-sex hormones, surgery, or other medical interventions/technologies to change their bioanatomy (yes, no).…”

Section: Methodsmentioning

confidence: 99%

“…Because missingness was differential and violated the missing completely at random assumption required for valid statistical inferences using listwise deletion (Allison, 2001), data were multiply imputed. A fully conditional specification imputation method (Van Buuren, 2007; Van Buuren, Brand, Groothuis-Oudshoorn, & Rubin, 2006) was used as in previous transgender research (Reisner et al, 2014b). All subsequent statistical analyses were conducted in the imputed dataset.…”

Section: Methodsmentioning

confidence: 99%

Self-Reported Changes in Attractions and Social Determinants of Mental Health in Transgender Adults

et al. 2016

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This study examined associations between changes in self-reported attractions and mental health in a community-based sample of self-identified transgender adults. Participants were purposively recruited in 2013 using bimodal sampling methods and completed a one-time survey. Multivariable logistic regression models estimated Adjusted Risk Ratios (aRR) and 95% Confidence Intervals (95% CI) to examine associations between changes in attractions and mental health outcomes (lifetime self-harm, suicide attempts, depression diagnosis; past-week clinically significant depressive distress assessed via CES-D 10) among the entire sample (N = 452; 285 female-to-male spectrum, 167 male-to-female spectrum) and after gender transition among those who had socially transitioned (n = 205; 156 female-to-male spectrum, 49 male-to-female spectrum). Models were adjusted for known population social determinants (age, race/ethnicity, gender identity, socioeconomic status, sexual orientation identity), transgender-specific determinants (age of transgender realization, social transition, medical transition, visual gender nonconformity, non-binary gender identification), and survey mode (online vs. in-person sampling). Lifetime changes in attractions were significantly associated with increased probability of all mental health outcomes; individuals reporting any change in attractions were more likely than individuals not reporting changes to indicate lifetime self-harm, suicide attempts, depression diagnosis, and current depressive distress (all p’s < .05). Changes in attractions post-social transition were not significantly associated with mental health outcomes. Many, but not all, population and transgender-specific social determinants were significantly associated with mental health in the full sample and among those who had socially transitioned. Clinical implications of findings about changes in attractions and mental health are discussed for transgender individuals.

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Comparing In-Person and Online Survey Respondents in the U.S. National Transgender Discrimination Survey: Implications for Transgender Health Research

Abstract: Findings indicate that online and in-person data collection methods reach transgender respondents with vastly different health and life experiences. To achieve a more diverse sample of transgender adults, then, requires diverse recruitment settings and survey modalities.

Cited by 66 publications

References 24 publications

Using a Two-Step Method to Measure Transgender Identity in Latin America/the Caribbean, Portugal, and Spain

Using a Two-Step Method to Measure Transgender Identity in Latin America/the Caribbean, Portugal, and Spain

Discriminatory experiences associated with posttraumatic stress disorder symptoms among transgender adults.

Self-Reported Changes in Attractions and Social Determinants of Mental Health in Transgender Adults

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