Cisgender Research Articles

The Politics of Menstruation

Menstrual blood is still regarded as embarrassing and taboo in many places all over the world. This article focuses on the study of the Red Tent as an example of feminist-spiritual menstrual activism established in 2007 in the US because it represents an important form of breaking the menstrual taboo. Although contemporary spiritualities present themselves as nonhierarchical and gender equal, spirituality and well-being in the women's circles is predominantly practiced by cisgender, heterosexual, and white middle-class women, excluding lesbian, gay, bisexual, transgender, queer/questioning, and others (LGBTQ+). Constructs around the sacredness of female experiences (menstruation, menopause) are problematic for transgender women who do not share these experiences, and a lack of diversity may perpetuate systematic inequities and discrimination. This article discusses whether the Red Tent in Slovenia is open to include transgender and nonbinary people. By creating alternative domains of representation in which nonnormative bodies can exist, we disrupt the sex/gender system and dismantle normative femininity and masculinity. The article argues that in this way the Red Tent has the potential to subvert the dominant ideology of gender binary construction by providing alternative models for the embodiment of gender to challenge traditional conservative gender essentialisms in society. The methodology employed consists of ethnographic fieldwork, which was performed in the Red Tent gatherings and semistructured in-depth interviews with participants who host or participate in them. Because a part of the scope of the research “lives” in the cyber world, the ethnographic research methodology was integrated with the phenomena and data obtained from the internet in the form of netnography.

Bystanders to Sexual Violence: Findings From a National Sample of Sexual and Gender Diverse Adolescents.

Mobilizing bystanders to prevent sexual violence is an increasingly popular prevention strategy. While research has identified characteristics related to opportunity and actions around helping, a more nuanced understanding of how helping behavior and its modifiable levers may differ for youth of various genders is needed. The current study examined bystander-helping behaviors in sexual violence situations in a national, social media-recruited sample of adolescents 14 to 16 years of age. Measures of opportunity and self-reported actions were included in an online survey along with items assessing attitudes related to violence and helping. Given that prevention programs may work differently for cisgender, transgender, and nonbinary young people, between-group differences in amount of opportunity and helping behaviors were examined. Further, we examined correlates of opportunities to help as well as helping behaviors within each group. Overall, few attitude and personal experience characteristics consistently predicted opportunities and behaviors across groups. Group differences that emerged, such as the association between attitudes supportive of rape and lower helping for cisgender but not trans or nonbinary youth, support attending to these group differences in both basic and intervention research to inform tailoring of prevention programs.

Body Self-Esteem and Sexual Satisfaction in Chilean Adults: Implications for Comprehensive Sexual Education

Sex education is a complex and often controversial issue, and in Chile, this is no exception. The country's progress towards a curriculum that extends beyond public health-related sex topics has experienced ups and downs, resulting in the current lack of a comprehensive program. Comprehensive sexual education (CSE) programs typically include topics known to have a positive effect on individuals' overall sexual health, such as body self-esteem. The effectiveness of these programs can be measured through individuals' sexual satisfaction. Given the limited national evidence on this subject, the objective of this study was to analyze the relationship between body self-esteem and sexual satisfaction in Chilean adults, considering various socio-demographic variables. The sample consisted of 203 cisgender individuals who completed body self-esteem and sexual satisfaction scales. The results indicated a positive relationship between body self-esteem and sexual satisfaction. Using multiple regression, it was found that body self-esteem explained 17% of sexual satisfaction variability. These findings underscore the importance of sex education and its impact on individuals' sexual well-being.

Rethinking Transit Safety: Understanding and Addressing Gender-Based Harassment and Enhancing Safety on San Francisco’s Muni Transit System

The goal of this research is to support prioritizing safety on the Muni system from a gender equity lens. This work is specifically aimed to inform the Safety Equity Initiative of the San Francisco Municipal Transportation Agency (SFMTA). Using a mixed-method approach, we surveyed Muni transit riders ( n = 1,613) to explore their travel behaviors, experiences with gender-based harassment, and perceptions of safety while riding Muni. We find that the pervasiveness of gender-based harassment on the Muni public transit system is significant, with 67% of our sample reporting that they have experienced harassment in the last six months. Perceptions of safety are also quite low, with 68% always or often feeling safe while riding Muni during the daytime and only 32% feeling safe at nighttime. We found that certain populations are disproportionately victimized while riding transit with statistically significant differences across both perception of safety and experiences of harassment between women versus men, gender minorities versus cis gender people, transit dependent riders versus those who have access to a private vehicle, and white versus non-white riders. Based on these findings we provide transformative recommendations to address the high rates of harassment among certain groups of Muni riders. The recommendations are organized into three categories: service changes, infrastructure improvements, and campaigns and advocacy. This work adds to the existing knowledge about gender-based harassment in the transit environment while also specifically informing the Safety Equity Initiative of the SFMTA.

"It shouldn't be just hush-hush": A qualitative community-based study of menstrual health communication among women in Philadelphia.

Although menstruation is a natural biological process, many people feel embarrassed of their menses and struggle to discuss it. To mitigate menstrual communication stigma, it is necessary to first elucidate communication experiences and perceptions. Thus, we qualitatively explore menstrual communication among cisgender women who menstruate and their family, friends, healthcare providers, and community. In partnership with No More Secrets (NMS), a Philadelphia menstrual health non-profit, we conducted a community-based participatory research (CBPR) project in Fall 2020. Cisgender, menstruating individuals ages 18-45 recruited from NMS' catchment in Philadelphia participated in semi-structured interviews about their menstrual experiences and communication (N = 20). A deductive, theory-driven approached based on the social-ecological model was used to analyze the data. Varying emotional responses arose across social-ecological levels: communication was awkward and simplistic with family; positive and supportive with friends and community members; and uncomfortable and frustrating with healthcare providers. Participants echoed the importance of menstrual communication as a means of sharing information, feeling less alone, and decreasing menstrual stigma. Findings can inform future CBPR workshops that address stigma in familial, healthcare, and community-based discussions to improve menstrual health and experiences for cisgender girls and women, transgender men, and gender non-binary individuals who menstruate.

Internalized Oppression: Exploring the Nuanced Experiences of Gender and Sexuality in Historically Black Colleges and Universities

In the American South at the turn of the twentieth century, quality education was scarce and legislative laws were put in place to ensure that African American individuals remained far away from Predominantly White Institutions (PWIs). As a result, Historically Black Colleges and Universities (HBCUs) became a catalyst for change in this “separate but equal” society. This article will explore the significance of HBCUs in elevating Black Americans throughout the twentieth century, while also assessing the conservative nature of the institutions and their inflexibility towards the various nuances of African American communities. While it is not particular to HBCUs, a tolerance of toxic masculinity and severe conservatism has resulted in starkly different Black experiences for cis-gendered heterosexual men, in contrast to cisgendered women and other members of the 2SLGBTQI+ community. By investigating various experiences within HBCUs, this article will explain the unifying and uplifting benefits for Black individuals in these institutions, as well as its many divisive components. My research will strive to analyze and properly convey the various nuanced experiences throughout HBCUs and assess the variety of factors that have led to these underrepresented interactions. This article will provide an understanding of how HBCUs have and continue to reflect American society but also demonstrate their role in various Black communities and their representation of non-dominant Black groups from the late nineteenth century to the present.

A unique pseudo-eligibility analysis of longitudinal laboratory performance data from a transgender female competitive cyclist

Abstract Background and Aims The Union Cycliste Internationale has deemed transgender female athlete’s ineligible for the female category due to concerns about performance advantages. We conducted a follow-up analysis on laboratory-based performance indicators of sports performance using data from a longitudinally assessed transgender woman athlete undergoing gender-affirming hormone therapy (GAHT). Methods We evaluated laboratory performance indicators in transgender and cisgender women athletes using dual-energy X-ray absorptiometry scanning, handgrip strength measurement, jump testing, and cardiopulmonary exercise. Additionally, we assessed a transgender sub-elite cyclist before and after undergoing GAHT. Results After one year of GAHT, the transgender athlete showed declines in handgrip strength (7–13 %), countermovement jump (23–29 %), and V̇O2max (15–30 %). After 3 months, several performance indicators (absolute handgrip, peak power, relative peak power, average power, relative average power, V̇O2max and relative V̇O2max) were above the mean of cisgender female athletes, while others (Relative handgrip, countermovement jump and relative countermovement jump) were below. Similar trends were observed at 6 months and 1 year. Summary This hypothetical analysis, although with limited evidence, suggests the transgender athlete could compete equitably in elite cycling events within the female category after one year of GAHT. Adjustments based on competition data would ensure fairness. Further analysis after an additional 12 months is recommended to assess the impact of 2 years of GAHT. An outright ineligibility for the female category for transgender women athletes would hinder a true assessment of performance fairness.

LGBTQI Sexual Well-Being and Embodiment After Cancer: A Mixed-Methods Study

ABSTRACT This study examined lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) cancer patients’ sexual well-being post-cancer, and the associations between sexual well-being and social support, physical concerns, distress, quality of life (QOL), and coping. We used a mixed-methods approach, including 430 surveys and 103 interviews, representing a range of tumor types, sexual and gender identities, age groups, and intersex status. The findings indicated that LGBTQI people with cancer experience declines in sexual well-being following cancer, which are associated with reduced QOL, greater physical concerns, and lower social support. The perceived helpfulness of coping mechanisms was associated with greater sexual well-being across genders, with cisgender men reporting the sharpest declines in sexual well-being and highest use of coping mechanisms. Across all groups, searching for information online was the most frequently used coping mechanism, with support groups and counseling the most under-utilized. Qualitative findings facilitated interpretation of these results, providing examples of ways in which cancer impacted sexual well-being and how physical changes influence sexual embodiment or desire to engage in sex. Concerns about reduced sexual desire and activity, associated with changes to breasts, vulva, vagina, penis, erectile dysfunction, incontinence, scarring, and stoma, reflect previous findings in the non-LGBTQI cancer population. Unique to this population are the impact of physical changes on LGBTQI embodiment, including disruption to sexual and gender identities, and feelings of disconnection from queer communities. Addressing LGBTQI sexual well-being within oncology healthcare is a matter of sexual and reproductive justice, for a population whose needs are often overlooked within cancer care.

A qualitative investigation of nicotine and tobacco use in young pregnant and birthing sexual minority people.

Sexual minority youth, especially those who identify as bisexual, have higher rates of nicotine and tobacco use and are more likely to become pregnant at a younger age than heterosexual youth. The goal of this study was to investigate the nicotine and tobacco experiences and motivations of sexual minority people before and during pregnancy. Pregnant and birthing individuals ages 16-24 who identified as a sexual minority in an online survey were recruited for semi-structured video interviews about nicotine and tobacco use. Thirteen participants described nicotine and tobacco initiation, current or recent use, and cessation efforts. Using thematic analysis, the research team coded de-identified interview transcripts and identified themes related to their nicotine and tobacco use. Participants were cisgender women (average age = 19.6). Most identified as bisexual (86%) in addition to Black (36%) or Biracial (36%). Four themes about nicotine and tobacco use were identified from participant interviews. Participants' reasons for nicotine and tobacco initiation were social, yet reasons for more regular use were stress related. Participants' use of cigarettes was triggered by their cannabis use, and several substituted cannabis for cigarettes during cessation attempts. Participants identified pregnancy as a strong motivator to quit smoking, and attempted cessation without clinical assistance. Young sexual minority people's greater risk of initiation and dependence on nicotine and tobacco products prior to conception may be related to social needs, stress, and use of cannabis. Current approaches and materials on smoking cessation are not being utilized by this population. This is the first qualitative study of nicotine and tobacco use among young pregnant sexual minority people, primarily bisexual-identified, who are underrepresented in prenatal tobacco research. By telling their own stories, sexual minority participants with lived experience of nicotine and tobacco use described the evolution of their motivations to use these products over time, cannabis use as a precipitant, the importance of pregnancy for smoking cessation, and perceptions about effective and ineffective factors in cessation efforts. The results of this study provide key information for prevention efforts to reduce tobacco-related health disparities for sexual minority people.

Gender-affirming hormone therapy for transgender and gender-diverse adults in Australia.

Gender-affirming hormone therapy (GAHT) is used by many transgender and gender-diverse adults to align physical characteristics with their gender identity, reduce gender incongruence and improve psychological functioning. This narrative review provides an overview of the initiation and monitoring of GAHT in an Australian context. Trans individuals treated with testosterone typically receive standard testosterone doses and formulations recommended for cisgender men, whereas those receiving estradiol GAHT are typically treated with estradiol in combination with an anti-androgen in those without orchidectomy. Proactive monitoring and mitigation of cardiovascular risk factors is pertinent in all transgender and gender-diverse adults and bone health is an important consideration in those using estradiol GAHT.

Psychometric Properties of the Bisexual Microaffirmation Scale: For Women in a Sample of Bisexual + Women and Nonbinary People of Color

Though the Bisexual Microaffirmation Scale: For Women (BMSFW) was originally created to help mental health clinicians and researchers understand bisexual women’s experiences of stigma and affirmation, the scale has so far only been used with predominantly White samples. The present study used a sample 209 majority bisexual cisgender women from marginalized racial-ethnic backgrounds to test the psychometric properties of the BMFSW. This study’s findings include the BMSFW’s convergent validity with previously developed bisexual and queer specific scales and discriminant validity with the Balanced Inventory of Desirable Responding Short Form Impression Management subscale (BIDR-IM). This study also suggests a different factor structure than the one initially proposed by the original authors. The present study provides insight to the still underexamined construct, microaffirmations, and also extends beyond previous research on bisexual + individuals by highlighting the importance and need for more research and scales that look at the intersection and experiences of bisexual + women and nonbinary people of color.

Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women.

There are gaps in uptake of, adherence to, and persistence in the use of preexposure prophylaxis for human immunodeficiency virus (HIV) prevention among cisgender women. We conducted a phase 3, double-blind, randomized, controlled trial involving adolescent girls and young women in South Africa and Uganda. Participants were assigned in a 2:2:1 ratio to receive subcutaneous lenacapavir every 26 weeks, daily oral emtricitabine-tenofovir alafenamide (F/TAF), or daily oral emtricitabine-tenofovir disoproxil fumarate (F/TDF; active control); all participants also received the alternate subcutaneous or oral placebo. We assessed the efficacy of lenacapavir and F/TAF by comparing the incidence of HIV infection with the estimated background incidence in the screened population and evaluated relative efficacy as compared with F/TDF. Among 5338 participants who were initially HIV-negative, 55 incident HIV infections were observed: 0 infections among 2134 participants in the lenacapavir group (0 per 100 person-years; 95% confidence interval [CI], 0.00 to 0.19), 39 infections among 2136 participants in the F/TAF group (2.02 per 100 person-years; 95% CI, 1.44 to 2.76), and 16 infections among 1068 participants in the F/TDF group (1.69 per 100 person-years; 95% CI, 0.96 to 2.74). Background HIV incidence in the screened population (8094 participants) was 2.41 per 100 person-years (95% CI, 1.82 to 3.19). HIV incidence with lenacapavir was significantly lower than background HIV incidence (incidence rate ratio, 0.00; 95% CI, 0.00 to 0.04; P<0.001) and than HIV incidence with F/TDF (incidence rate ratio, 0.00; 95% CI, 0.00 to 0.10; P<0.001). HIV incidence with F/TAF did not differ significantly from background HIV incidence (incidence rate ratio, 0.84; 95% CI, 0.55 to 1.28; P = 0.21), and no evidence of a meaningful difference in HIV incidence was observed between F/TAF and F/TDF (incidence rate ratio, 1.20; 95% CI, 0.67 to 2.14). Adherence to F/TAF and F/TDF was low. No safety concerns were found. Injection-site reactions were more common in the lenacapavir group (68.8%) than in the placebo injection group (F/TAF and F/TDF combined) (34.9%); 4 participants in the lenacapavir group (0.2%) discontinued the trial regimen owing to injection-site reactions. No participants receiving twice-yearly lenacapavir acquired HIV infection. HIV incidence with lenacapavir was significantly lower than background HIV incidence and HIV incidence with F/TDF. (Funded by Gilead Sciences; PURPOSE 1 ClinicalTrials.gov number, NCT04994509.).

A Comparison of Intimate Partner Violence Victimization and Perpetration, Adverse Childhood Experiences, and Mental Health Among Men in Same-Gender and Different-Gender Relationships

Intimate partner violence (IPV) is a serious social and public health problem in the United States. Adverse childhood experiences (ACEs) and poor mental health are associated with IPV. Sexual minority men (SMM) experience each of these disproportionately; however, limited studies have examined the interrelationships of these variables among SMM. Cross-sectional data from the first wave (September 1, 2020–April 25, 2021) of the National Couples’ Health and Time Study were used to assess the prevalence of physical, sexual, and psychological IPV victimization and perpetration and the association with ACEs and depression, anxiety, and stress among cisgender men in same-gender and different-gender relationships. Log-binomial regression was used to evaluate relationships, stratified by couples’ gender identity. In a sample of 1,681 men, including 689 sexual minority men, 40.6% reported IPV victimization and 33.1% reported IPV perpetration. Stratified by couples’ gender identity, victimization and perpetration were reported more frequently among men in different-gender relationships compared to men in same-gender relationships (40.7% vs. 33.9%; 33.2% vs. 30.2%). Psychological victimization and perpetration were the most commonly reported. Among men in same-gender relationships, depression symptoms had the highest association with IPV victimization (prevalence ratio [PR] = 2.14, 95% confidence interval [CI]: 1.56–2.95) and perpetration (PR = 1.72, 95% CI: 1.24–2.39). Research, clinical screenings, and other settings that focus on understanding and intervening on partner violence victimization and perpetration should intentionally consider the experiences of SMM in order to effectively promote healthy relationships and optimal mental health.

Prostate cancer in transgender women: A propensity score-matched analysis of disease severity and survival.

Despite the rise in gender-affirming care, our understanding of prostate cancer (PCa) in transgender women (TGW) remains in its infancy. Health disparities and lack of PCa awareness and screening are possible barriers to providing quality care for this population. In addition, the implication of hormonal manipulation for the aggressiveness of PCa in TGW is yet to be determined. Here, this study sought to compare oncological characteristics and survival outcomes between transgender and cisgender (CG) patients with PCa via two national data sets. The Veterans Affairs Informatics and Computing Infrastructure database (1999-2020) and the Surveillance, Epidemiology, and End Results-Medicare database (2010-2017) were reviewed. Demographic and clinical details were analyzed. Logistic regression analysis was performed on propensity score-matched groups to identify predictors of high-risk disease and metastasis in patients with PCa. Groups were matched 5:1 (CG:TGW) on the basis of age, race, year of diagnosis, and Charlson Comorbidity Index score. Primary outcomes included metastatic presentation, high-risk localized disease, overall survival (OS), and prostate cancer-specific mortality (PCSM). A total of 1194 patients were included (199 TGW; 995 CG). Associations between transgender identity and metastatic presentation (odds ratio [OR], 0.38; p=.2), high-risk localized disease (OR, 1.19; p=.50), or PCSM (hazard ratio [HR], 0.65; p=.3) were not detected. Transgender identity was associated with improved OS (HR,0.67; p=.014). PCa-specific outcomes seem comparable between TGW and CG men, although the study was underpowered to detect modest differences. Further investigation into the incidence and outcomes of PCa in TGW is warranted.

Case-control study on challenges in loss of follow-up care and the limitations in the reach of HIV policies for women.

HIV has transitioned from a devastating 1980s epidemic to a manageable chronic condition with antiretroviral therapy. In Brazil, challenges persist, including high detection rates and loss of medical follow-up among people living with HIV/AIDS (PLHIV). Adherence, engagement, and avoiding loss to follow-up are critical for effective HIV/AIDS prevention and care. This case-control study within longitudinal research on PLHIV linkage and retention in Porto Alegre aims to analyze factors associated with treatment abandonment. The study, based on patients from the Therapeutic Care Service for HIV and AIDS at Sanatorio Partenon Hospital, involved 360 PLHIV in a retention and linkage outpatient clinic. Risk factors for loss to follow-up include cisgender women, diagnosis between 1991 and 2005, and non-adherence to antiretroviral treatment (ART). Conversely, cisgender men, diagnosis between 2015 and 2023, and good ART adherence were protective factors. Gender disparities and ART non-adherence pose significant challenges in comprehensive PLHIV care. Cisgender women diagnosed before 2005 face higher risk, while cisgender men diagnosed after 2015 with good ART adherence are more protected, influencing care and prevention strategies for PLHIV.

Relational gendered dimensions of emotions in heterosexual cisgender Men’s intimate partnerships

Illuminating relational gendered dimensions of emotions in heterosexual cisgender men’s intimate partnerships, this study addresses a significant knowledge gap in masculinities, emotionality and health work. Thematic analyses of individual photovoice interviews with 92 men from diverse locales and ethnocultural backgrounds revealed a trilogy of men’s practices regarding emotions. Emotional restraint was embodied by men withholding rather than freely expressing emotions, wherein participants justified diverse practices as the by-product of not understanding women partners’ emotionality and working to balance emotions in the relationship. In coached emotions men spoke about needing to unlearn suppressing their emotions while relying on women partners’ expertise for becoming more emotionally expressive and available. This included work around reading and accommodating their partner’s emotions. Emotionally orientated men positioned themselves as relationship ready, whereby they were equally or more emotional than their partners. This emotionality was claimed as an asset and strength integral to building contemporary intimate partner relationships. The findings highlight most men as operating across the three themes, revealing how wide-ranging socially constructed emotions are influenced by gender relations and a plurality of masculinities. Also afforded by these results are directions for working with heterosexual cisgender men to advance gender equity in heterosexual intimate partner relationships.

Differences in Self-Reported Stress Versus Hair and Nail Cortisol Among Adolescent and Young Adult Males.

Chronic stress causes harmful physiological responses that yield increased inflammation and subsequent health conditions. Stress is an important measure among minoritized populations who face social situations that predispose risk to developing mental health problems. Hair and fingernail cortisol have been studied as retrospective measures of chronic stress and to demonstrate biological response to social situations. The objective of this study was to compare the Perceived Stress Scale (PSS) with hair and nail cortisol concentrations and assess the risk factors associated with stress levels among heterosexual and sexual and gender-minoritized adolescent males. We recruited a cohort of adolescents who were assigned male sex at birth. Approximately half of our cohort consisted of sexual and gender-minoritized people, and half consisted of heterosexual cisgender males. Participants provided hair and nail samples and completed a survey that included demographic and hair hygiene questions and the PSS. Hair and nail samples were processed in a laboratory, and survey results were analyzed descriptively. Several samples were not provided or received, and some survey data were missing. Hair and nail cortisol values were significantly associated. There was no significant relationship between the PSS and hair and nail cortisol values. No significant differences were found between the heterosexual and sexual minoritized groups. Black participants reported lower perceived stress scores compared to White participants. Participants whose gender was nonbinary or genderqueer had higher hair cortisol values compared to those who identified as male. Older participants had higher hair cortisol values compared to younger participants. Previous researchers have similarly found no correlation between self-report stress scales and cortisol values, increased stress experience among nonbinary or genderqueer individuals compared to cisgender individuals, and a positive correlation between aging and stress. Yet, our finding that Black participants reported lower stress levels than White participants is unexpected. Our study demonstrates a high correlation between hair and nail cortisol values, suggesting the potential to substitute these markers as needed.

Are Gender Identities and Gender Ideologies Associated with the Variety and Type of Owned Sex Toys? Evidence from a Large Italian Sample of Cisgender Individuals.

Research on the use of sex toys has been primarily performed from a medical perspective, while there is still limited research from a psychosocial perspective. To bridge this gap, in this study we examined whether some psychosocial variables might be linked to sex toy ownership in a sample of 3960 Italian (cisgender men and women) sex toy buyers. More specifically, we investigated the association between gender identities and ideologies and the variety and types of sex toys owned. Based on the data, we detected two dimensions underlying the ownership of sex toys: (1) orientation to owning kinky sex toys and (2) orientation to owning clit-oriented sex toys. Results showed that benevolent sexism and gender system justification were negatively correlated with owning clit-oriented toys. Moreover, strongly gender-identified participants owned a small variety of different toys and preferred toys that were designed to stimulate the vagina or clitoris over less commonly-used toys. No significant correlation between feminist identification and sex toy type owned was found when gender identification was taken into account. These results suggest that the owning of sex toys might be associated with traditional gender ideology and the strength of gender identification.

Effect of testosterone formulations on hematocrit in transgender individuals: A systematic review.

Approximately, 11% of trans men experience erythrocytosis diagnosis due to testosterone administration during the first year of the gender-affirming hormone treatment (GAHT). To identify and compare the effect of different testosterone formulations on hematocrit (Hct) and diagnose erythrocytosis in trans men. This systematic review was based on PRISMA guidelines. We performed an electronic search of PubMed, Embase, and Web of Science in January 2024. The Newcastle-Ottawa scale was used to evaluate the quality of evidence in the observational studies. Of the 152 records retrieved, 18 met the eligibility criteria. Studies observed an increase of up to 5% in Hct in trans men using injectable testosterone undecanoate (TU), and up to 6.9% in trans men using intermediate injectable testosterone esters (TE). Trans men using TE experience a larger increase in serum Hct levels compared to those receiving TU. Erythrocytosis prevalence varies according to the cutoff used (50%, 52%, and 54%). Erythrocytosis was also associated with tobacco use, age at initiation of hormone therapy, body mass index (BMI), and pulmonary conditions. Studies that evaluated the effect of testosterone formulation on erythrocytosis diagnosis present conflicting result. Trans men have a hazard ratio of 7.4 (95% CI: 4.1, 13.4) of developing erythrocytosis compared to cisgender men, using a 52% hematocrit cutoff. All testosterone formulations result in an increase in Hct, irrespective of dose, formulation, and administration method. Smoking, higher age at initiation of the testosterone therapy, higher BMI, and a predisposing medical history are associated with this increase in Hct. The difference in effect of TE and TU on Hct is conflicting, although it is important to point out that these data come from observational studies, retrospective, and with a small-sample size.

The Relationship between Gender Identity and Gender Centrality among Transgender, Cisgender, Nonbinary, and Intersex Individuals

ABSTRACT This study highlights the relationship between gender identity and gender centrality, including self-reported measures of the centrality of masculinity and femininity in individuals’ interactional expression, physical expression, interests, and feeling masculine or feminine. This is a secondary data analysis of a larger study (The 2019 Pleasure Study). In this analysis, it was found that there is a notable relationship between gender identity and levels of gender centrality. Transgender men and transgender women reported higher levels of gender identity centrality (“How important is your gender identity to the way you think about yourself?”) than cisgender men and women. Nonbinary people and intersex individuals reported higher levels of gender identity centrality than cisgender men and cisgender women, but lower levels than transgender men and transgender women. In an average of centrality measures (“How important are how masculine/feminine your physical expression, interactional expression, feelings, and interests are?”), trans women had the highest average centrality scores while cis men had the lowest.