Suicidal Ideation Disparities Among Transgender and Gender Diverse Compared to Cisgender Community Health Patients

Kirakosian, Norik; Stanton, Amelia M.; McKetchnie, Samantha M.; King, Dana; Dolotina, Brett; O’Cleirigh, Conall; Grasso, Chris; Potter, Jennifer; Mayer, Kenneth H.; Batchelder, Abigail

doi:10.1007/s11606-022-07996-2

Cited by 8 publications

(7 citation statements)

References 80 publications

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“…The present study findings support prior work among cisgender sexual minority participants [6][7][8][9][10][11][12][13][14][15] and research on mental health 18 and HIV diagnosis 19,52 among transgender people. However, there are limited data comparing the prevalence of cardiovascular disease, kidney disease, diabetes, and hypertension among transgender and gender diverse participants with cisgender populations.…”

Section: Discussionsupporting

confidence: 86%

“…Pain was scored from 0 to 10 but was rescored to a 5-point scale as recommended by Hays et al 44 (0 = 1; 1-3 = 2; 4-6 = 3; 7-9 = 4; 10 = 5, with higher values representing worse pain). Raw scores were calculated for each subscale (range, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] and standardized to T score values with a mean of 50 and standard deviation of 10. 45 PROMIS-PH scores less than 42 and PROMIS-MH scores less than 40 were used as established T score cutoffs for poor or fair health ratings.…”

Section: Patient-reported Outcome Measuresmentioning

confidence: 99%

“…Prior research has relied on small convenience samples, but studies have increasingly used populationbased surveys [6][7][8][9]11,13,16,17,21 and electronic health records (EHRs) to examine health disparities among SGM populations. 18,33,34 Although population-based surveys are often used to produce weighted estimates representative of a target population, 35,36 EHR data also have the potential to improve health care quality for SGM populations. Recent developments in methods to identify transgender people in claims data, in the absence of gender identity data, have provided promising results.…”

Section: Introductionmentioning

confidence: 99%

“…(Cisgender refers to individuals whose gender identity aligns with the gender commonly associated with the sex assigned to them at birth.) These health inequities include difficulties accessing equitable and culturally competent health care services, chronic health conditions, infectious diseases, mental health, and substance use . The National Institutes of Health has recognized SGM people as a “health disparity population for research.” However, resolving these inequities is hindered by data quality issues, such as inadequate sample sizes and limited social and biomedical data .…”

Section: Introductionmentioning

confidence: 99%

“…There are compelling needs for larger and more diverse SGM samples that integrate multiple data sources to identify health inequities and inform treatments and policies for intervention. Prior research has relied on small convenience samples, but studies have increasingly used population-based surveys and electronic health records (EHRs) to examine health disparities among SGM populations . Although population-based surveys are often used to produce weighted estimates representative of a target population, EHR data also have the potential to improve health care quality for SGM populations.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of 12 Common Health Conditions in Sexual and Gender Minority Participants in the All of Us Research Program

Tran,

Lunn,

Schulkey

et al. 2023

JAMA Netw Open

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ImportanceLimited data describe the health status of sexual or gender minority (SGM) people due to inaccurate and inconsistent ascertainment of gender identity, sex assigned at birth, and sexual orientation.ObjectiveTo evaluate whether the prevalence of 12 health conditions is higher among SGM adults in the All of Us Research Program data compared with cisgender heterosexual (non-SGM) people.Design, Setting, and ParticipantsThis cross-sectional study used data from a multidisciplinary research consortium, the All of Us Research Program, that links participant-reported survey information to electronic health records (EHR) and physical measurements. In total, 372 082 US adults recruited and enrolled at an All of Us health care provider organization or by directly visiting the enrollment website from May 31, 2017, to January 1, 2022, and were assessed for study eligibility.ExposuresSelf-identified gender identity and sexual orientation group.Main Outcomes and MeasuresTwelve health conditions were evaluated: 11 using EHR data and 1, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), using participants’ physical measurements. Logistic regression (adjusting for age, income, and employment, enrollment year, and US Census division) was used to obtain adjusted odds ratios (AORs) for the associations between each SGM group and health condition compared with a non-SGM reference group.ResultsThe analytic sample included 346 868 participants (median [IQR] age, 55 [39-68] years; 30 763 [8.9%] self-identified as SGM). Among participants with available BMI (80.2%) and EHR data (69.4%), SGM groups had higher odds of anxiety, depression, HIV diagnosis, and tobacco use disorder but lower odds of cardiovascular disease, kidney disease, diabetes, and hypertension. Estimated associations for asthma (AOR, 0.39 [95% CI, 0.24-0.63] for gender diverse people assigned male at birth; AOR, 0.51 [95% CI, 0.38-0.69] for transgender women), a BMI of 25 or higher (AOR, 1.65 [95% CI, 1.38-1.96] for transgender men), cancer (AOR, 1.15 [95% CI, 1.07-1.23] for cisgender sexual minority men; AOR, 0.88 [95% CI, 0.81-0.95] for cisgender sexual minority women), and substance use disorder (AOR, 0.35 [95% CI, 0.24-0.52] for gender diverse people assigned female at birth; AOR, 0.65 [95% CI, 0.49-0.87] for transgender men) varied substantially across SGM groups compared with non-SGM groups.Conclusions and RelevanceIn this cross-sectional analysis of data from the All of Us Research Program, SGM participants experienced health inequities that varied by group and condition. The All of Us Research Program can be a valuable resource for conducting health research focused on SGM people.

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