Transgender Research Articles

Patient-reported outcomes in genital gender-affirming surgery.

We reviewed the latest articles in patient-reported outcomes as it relates to genital gender-affirming surgery (GGAS) and provide a narrative summary of each article. The current landscape of patient-reported outcomes measures (PROMs) within GGAS largely consists of various ad hoc questionnaires. Within the last two years, one new PROM, validated within the transgender and gender-diverse (TGD) community, have been described. Patient-reported outcomes measures seek to elucidate the questions and answers of particular interest to patients and stakeholders of a particular population. To date, within GGAS, surgeon-reported outcomes and nonvalidated patient-reported outcomes comprise the bulk of the literature on the subject. However, there is growing interest in PROMs developed with TGD collaboration within all phases of the research process. Three new PROMs designed with and for the TGD community, are described which provides hope for continued progression of the field toward patient-centered and patient-collaborative research.

The development of legal rights for intersex persons: Part II: Advancement.

Having addressed the nature and complexity of intersexuality including commonalities with and differences from the transgender condition, we now address major legal challenges to the bisexual status quo through the legal advancement of rights for intersexual persons. Identified here are four domains in which the rights of intersex individuals are being advanced through litigation and legislation: (a) Sex assignment at birth and in early childhood, including the individual's right to consent and self-determination and to be spared from surgery that is not needed for medical reasons; (b) the right to change one's legal sex on legal documents such as birth certificates and passports, (c) the right of intersex persons to marry, and (d) the right not to be discriminated against. Within this legal framework, we identify commonalities with and differences from the struggle for rights within the transgender community.

Water, sanitation, and hygiene among transgender population living in urban informal settlements: a qualitative study in Odisha, India

Background Access to safe drinking water, sanitation, and hygiene (WASH) is recognized as a fundamental human right. However, transgender people residing in low-resource settings such as urban slums encounter unique challenges in accessing WASH facilities. Aims To explore the WASH-related issues and health outcomes associated with these challenges among transgender people living in urban informal settlements in India. Materials and Methods A qualitative phenomenological approach was employed, involving in-depth interviews with 24 transgender people residing in urban informal slums in Odisha, India. The interviews were digitally recorded, transcribed, translated and analyzed using the thematic analysis methods. Results The findings reveal that transgender people faced significant challenges in accessing adequate sanitation facilities. Many of them used inadequate toilet facilities due to sex segregation, which exposed them to harassment and discrimination. Moreover, transgender people who engaged in sex work faced heightened risks of infections due to risky sexual practices driven by economic necessity and the need for gender validation. Despite these obstacles, transgender people have mobilized nonprofit organizations to address these issues comprehensively, prioritizing health and overall well-being. Conclusion The study underscores the critical need for improving sanitation infrastructure, regular maintenance, and comprehensive hygiene education tailored to the specific needs of transgender people. Efforts should prioritize enhancing sanitation facilities and promoting hygiene practices to mitigate health risks effectively. Additionally, awareness and education programs focusing on various aspects of hygiene, including hand hygiene, oral hygiene, and peri-anal hygiene, are essential to promote better health outcomes within the transgender community.

Addressing Environmental and Social Challenges: A Mixed-Method Study on the Education and Inclusion of Eunuchs in South Punjab, Pakistan

This study seeks to identify the environmental issues that impede learning opportunities for the transgender community in South Punjab, Pakistan, which exacerbate their lack of access to education. Despite the growing legal acceptance of transgender individuals, several pressing social issues persist, including widespread environmental problems such as water pollution and deforestation. This study utilized a mixed-methods methodology that included both quantitative and qualitative data. According to the survey, nearly all transgender individuals (96%) lacked social protection and a stable income source, and 92% believed that environmental education could have a positive impact on their lives. Individuals with lower educational backgrounds participated in inclusive policies, yet their equality remained restricted. These findings suggest that targeted initiatives addressing environmental concerns and social integration via education are required. Suggestions include promoting collaboration with non-governmental organizations, peer-led education initiatives, government-led projects, and economic empowerment to improve marginalized communities.

Transgender Healthcare: A Historical Narrative of Gender-Affirming Plastic Surgery.

This historical narrative presents a comprehensive historical journey delving into the diverse facets of gender identity and expression across ancient cultures. It explores these civilizations' perspectives on gender diversity, highlighting instances that challenged conventional gender norms. Transitioning to the modern era, the narrative examines the dynamic landscape of LGBTQ+ and trans movements, spotlighting influential figures whose advocacy has significantly influenced societal perceptions and advanced the rights of gender diverse individuals. Their contributions continue to shape contemporary affirming care practices. Exploring the emergence of gender-affirming surgery, the narrative highlights pioneering surgeons and original techniques employed in these transformative procedures. It shows the courage and innovation of early surgeons who laid the groundwork for contemporary practices. At the core of this historical narrative lies the pivotal role of plastic surgeons in gender-affirming care. It emphasizes the significance of a collaborative multidisciplinary approach among medical professionals to ensure comprehensive and patient-centered care for transgender individuals seeking affirming interventions. However, intertwined with this narrative are legislative barriers that have hindered progress in gender-affirming care. The narrative navigates these obstacles, highlighting their complexities and emphasizing the urgent need for sustained medical advocacy and legislative reforms to foster an inclusive healthcare landscape. Ultimately, this narrative stands as a testament to the ongoing struggle and resilience within the realm of gender-affirming care, shedding light on its profound impact on individuals' lives, emphasizing the ongoing need for compassionate, comprehensive, and inclusive healthcare practices.

Genetic Analyses on Transgender Individuals: Impact on Physician Attitudes and Surgical Decision-Making.

Genetic studies on the transgender and gender diverse (TGD) community have started to appear in the literature. However, there are limited studies on how genetic data will impact attitudes and perspectives toward TGD individuals. In this study, we investigated the impact of genetic alterations on physicians' attitudes toward TGD individuals and on physicians' decisions concerning gender confirmation surgery (GCS). In this context, we intended to highlight a number of strategies to reduce the inequalities that the TGD community is exposed to in accessing health-care services. An online survey including the Turkish version of the Attitudes Toward Transgendered Individuals Scale (ATTIS) was completed by 224 physicians from relevant specialties. Scheffé and least significant difference (LSD) post hoc analysis methods were used to determine physicians' perspectives on whether genetic findings would cause TGD individuals to feel validated/invalidated. Multivariate multinomial logistic regression analysis was employed to assess their responses concerning the decision to perform GCS when genetic alterations had been identified. More than half of the physicians expressed the view that genetic analyses for TGD individuals would confer benefits (67.1%). Those who thought that the presence of gender-diversity-related genetic alterations would have a "positive impact" on their GCS-related decision to operate were found to have less positive attitudes toward TGD individuals (Bonferroni corrected p < 0.001). Multivariate multinomial logistic regression analysis revealed that age, presenting the odds ratio as the strongest factor, distinguished the "no impact" group from the reference "positive impact" group, particularly among those aged ≤ 35 years (3.299, 95% CI: 1.355-8.033; p = 0.009). Although genetic analysis of TGD individuals is predicted to have a positive effect on physicians' attitudes toward them and on the GCS decision-making process, it should be emphasized that the benefits for TGD individuals must outweigh the potential harm. The results showed that physicians need "early and continuing education" to develop a comprehensive perspective on gender identity. The most appropriate approach for genetic testing would be to include the TGD community in decision-making processes and to develop guidelines for the interpretation of genetic data.

Transgenders In India: A Study Of Educational Status And Legal Rights In Educational Institutes

Abstract In the present paper Transgenders in India: A study of Educational Status and Legal Rights in Educational Institutes done. In the study we selected 20 Educational institutes, 60 teachers and 17 trangenders. for data collecttion we use Questionnaire for the status of transgender Education in Educational Institute (QSTEEI) through Google Form. our OBJECTIVES is I. To study the educational accessibility of transgender in Educational Institutes. II. To analyze the legal safeguards and its implementation in educational institutes for the transgenders. III. To find out the problems faced by transgender to fulfil their educational aspirations. And HYPOTHESIS H 1. There is significant difference in accessibility of education between transgender and dominant genders. H 2. There is significant difference existence and implementation of legal rights for transgender community in improvising the educational accessibility in India. H 3. There is significant difference in the fulfillment of educational aspirations of transgender students. our conclusion of The studies revealed that the transgender community has a low educational level, transgender people felt excluded from the curriculum, and faces barriers to education. Major findings of the study showed that transgender students experienced discrimination, intolerance, and physical and mental harassment in school due to their sexual orientation and gender identity. Transgender and gender diverse students avoided their school because they can’t conform to the gender stereotypes dominant within the school. There is a lack of proper learning environment within school boundaries for the education of transgender children, because of their sexual orientation and gender identity, and face stigma. It is recognised that there is a need for reform in the educational system including that in the curriculum, for better representation of the Transgender community. However, only education can empower the community from within to make each one of them self-sufficient and confident. key word : Transgenders, Educational Status, Legal Rights, Educational Institutes

Knowledge profile about HIV/AIDS and clinical features of oral mucosal lesion in Persatuan Waria Kota Surabaya (PERWAKOS) community: a qualitative study

Introduction: Transgender is a term used for individuals who have different gender identities at birth with current gender identities. Members of the male-to-female transgender community in Indonesia often refer to themselves as "waria", which stands for wanita (women) and pria (men). Transvestites are 18 times more at risk of HIV infection than the general population. The high prevalence of HIV/AIDS and sexually transmitted infections in transvestites is in line with the lack of knowledge, lack of understanding of health services and poor support for transvestites with HIV. Material and Methods: This research is an observational descriptive study with cross-sectional design. The research subjects were all members of Persatuan Waria Kota Surabaya (PERWAKOS) in Wonokromo region, Surabaya. This research was attended by 20 respondents. Research subjects were taken blood samples for HIV and STI tests. A pre-test and post-test model is carried out to assess understanding knowledge about HIV/AIDS. The respondents were given a questionnaire containing questions about HIV/AIDS. Researchers provide brief education, information and pictorial leaflet media with counseling and discussion session. After pre-test and post-test, intra-oral examination of oral mucosal was carried out using a dental instrument. Results: The results of HIV and STI tests in 18 study subjects showed that 4 people (22.22%) had reactive results for HIV testing and none of the study subjects had an STI. Assessment of knowledge about HIV/AIDS showed that 12 people (60%) had the same score in the pre-test and post-test. Examination of oral mucosal lesions found that only 1 case required therapy (5%) of 20 respondents namely oral hairy leukoplakia (OHL). Conclusion: Preventing and controlling HIV infection in transvestites communities can be done by increasing knowledge about HIV/AIDS and routine checks through HIV testing and oral screening. This supports efforts to control HIV infection in the transvestite’s group who are considered to be at high risk.

Delivering an Inclusive Experience for Patients of All Genders in the Aesthetics Practice: A Roundtable Discussion

Abstract Background Transgender, nonbinary, and gender diverse individuals represent a growing proportion of patients desiring minimally invasive aesthetic treatments to enhance facial appearance. While awareness of the need for gender-affirming care is increasing and resources are available on approaches to injection in gender-diverse individuals, guidance on how to best provide this care is lacking. Objectives To share recommended practices for aesthetic clinicians who wish to treat transgender, nonbinary, and gender diverse individuals or wish to improve gender inclusivity within their aesthetic practices. Methods As part of a continuing medical education activity, the authors participated in a roundtable discussion on how individual practices can support inclusive care for transgender, nonbinary, and cisgender patients. Results A thorough understanding of vocabulary in support of gender diversity can help to improve clinician confidence and the patient experience. Consideration of clinic design, including the use of gender-neutral bathrooms and the display of gender diversity in advertisements or clinic artwork, can also support a gender-inclusive and welcoming environment. The use of correct pronouns and gender-neutral language by all clinic staff and clinicians as well as a thoughtful approach to language used on intake forms may also help to provide an inclusive and safe space for the transgender, nonbinary, and gender-diverse community. Conclusions Inclusive and gender-affirming healthcare improves the mental health and wellbeing of transgender, nonbinary, and gender-diverse populations. Individual aesthetic clinicians can improve inclusivity by considering their advertising, clinic design, intake forms as well as their consultation, treatment, and follow-up practices.

The interaction of adverse childhood experiences, sex, and transgender identity as risk factors for depression: disparities in transgender adults.

The intersectionality of sexism, transphobia, and adverse childhood experiences (ACE) on the mental health of transgender adults is poorly understood. We assessed whether the known association between ACE and depression was modified (or differed) by adult transgender identity and by assigned sex at birth, which we used as a proxy for adults' biological (e.g., hormonal changes) and social (e.g., sexism) experiences in childhood. Data from a representative sample of 519 transgender and 127,214 cisgender US adults was retrieved from the 2019 and 2020 Behavioral Risk Factor Surveillance System surveys. The sample was stratified by assigned sex at birth. Adjusted, sample-weighted Poisson regressions and relative excess risk due to interaction (RERI) were used to assess whether transgender identity modified the association between ACE and depression within strata of assigned sex at birth. We found 42.4% of transgender compared to 24.9% of cisgender adults experienced 3+ ACE. The association between ACE and depression was stronger for transgender compared to cisgender adults, regardless of assigned sex at birth. However, transgender adults assigned female at birth with 1-2 ACE had a combined risk of depression that was higher than would be expected from the sum of the two risks alone (RERI test of interaction for transgender with 1-2 ACE vs. cisgender with zero ACE: 1.91 [95% confidence interval 0.47-3.36]; p = 0.009). The tests of interaction were not statistically significant (p > 0.05) for those assigned male at birth. Transgender adults may benefit more from depression interventions informed by and addressing childhood trauma than their cisgender counterparts, particularly for transgender adults who were assigned female at birth. Our findings suggest a need for greater and improved data collection of gender, experiences associated with assigned sex at birth, and ACE as these relate to the transgender community. This will allow for a better understanding of the intersecting influences of sexism, transphobia, and ACE on adult depression and for identifying particularly vulnerable sub-populations in need of support.

How socioeconomic and structural barriers influence dental care among transgender people

AbstractBackgroundWhile recent US policies restrict access to healthcare and resulting health disparities among the transgender community, little is known about oral health access and utilization among this population. This study assessed self‐reported access to dental care among transgender adults living in the United States.MethodThe study sample included 1,284,526 observations representing a weighted population of 290,000,163 from Behavioral Risk Factor and Surveillance Survey (BRFSS) datasets. Transgender identity was dichotomized and tested for association with having a dental visit in the past year. Pearson chi‐square statistics were computed for associations and multivariate logistic regression assessed the odds of seeing a dentist in the last year.ResultsNearly all socioeconomic and healthcare access covariates were associated with transgender identity. A significantly smaller proportion of transgender respondents reported established employment graduating high school, income over $50,000, non‐Hispanic White racial and ethnic identities, and a past‐year medical checkup (all p &lt; 0.01). In all three models and across all analyses, transgender respondents had significantly lower odds of having seen a dentist in the past year, compared to cisgender people.ConclusionsTo date, no research, aside from the present study, has assessed connections between transgender identity and oral healthcare access. The results of this analysis are consistent with other healthcare disparities that transgender people experience in that a smaller proportion of transgender respondents saw a dentist in the last year compared to cisgender respondents. Implications for establishing a foundation in future research to explore oral health access, utilization, and policy recommendations are discussed.

Embracing diversity and inclusivity in nursing: challenges and opportunities for transgender and intersex individuals in Pakistan

Variety is an integral aspect of our world, adding beauty and enabling us to appreciate the diverse qualities present in different aspects of life. Imagine a world without diversity, where we are left with only one type of fruit, flower, or colour. Such uniformity would render life bland and monotonous. Hence, the importance of diversity cannot be overstated, as it brings vibrancy and richness to our existence, making it essential for our well-being. God created diverse sexes, including female, male, intersex, and transgender individuals, each with roles to fulfil. However, intersex and transgender people often face barriers to healthcare access, professionals' unfamiliarity with relevant terminology, failure to respect patients' preferred pronouns, and treatment in non-inclusive environments [1]. Similarly, a 2024 study by Nation, Austin found that LGBT individuals often face fear, stigma, discrimination, homophobia, and even violence when seeking healthcare and mental health services [2]. Transgender individuals are underrepresented in nursing worldwide, including in Pakistan, due to fears of discrimination and social rejection, despite the profession's esteemed status. Pakistan is grappling with a severe shortage of nurses, as evidenced by the 2022-23 report from the Pakistan Nursing Council, which indicates a total enrolment of 103,821 registered nurses. In the Asian region, there has been a notable increase in the departure of nursing professionals as a result of stress, burnout, and disproportionate workloads both proceeding and during the COVID-19 pandemic [3]. To address the nursing shortage, the transgender and intersex community's potential should be recognized, given their physical and mental strength. Historically, they held roles like guards and chamberlains in the Middle East and China [4]. Transgender individuals, known for their compassion and empathy, are ideal for nursing roles. Integrating them helps address the nursing shortage, provides dignified opportunities, and reduces involvement in unethical activities like sex work and begging. Nurses should explore how to integrate transgender and intersex individuals into the profession with respect and dignity, considering eligibility, educational gaps, cultural objections, and workplace readiness. Rigorous research is needed to address these issues and ensure equal rights for all.

On Unstable Ground: Trans-Civic, Trans Gender Fluidity in Chester’s ‘Play of the Flood’

This article explores potential audience reception of the character Uxor in the Chester ‘Play of the Flood’ in relation to the notion of gendered place in medieval Chester. After discussing the implications for divergent readings of Uxor according to cis-centric understandings of place of performance, I interrogate the possibilities of trans places and people in medieval Chester in order to trouble the historically cis approach to Uxor’s performance and potential reception. Ultimately, I posit that Uxor inhabits a trans identity that in a necessarily contingent and temporary way allows trans-Uxor to secure spiritual, if not physical, salvation for those denied access to the ark.

Pronouns, Pin Badges and Pride: LGBTQ+ Student Experiences of Inclusion and Belonging in a UK University

This article provides findings from a small-scale project undertaken to understand the student experience of the lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) student community in a large post-92 university in England. Focus groups were conducted with students that explored areas of student life, including support, the campus environment, and belonging. A social constructivist theoretical perspective underpins the article. Students develop common knowledge via social processes that are powerfully influenced by cultural factors that are constantly in a state of flux. The article also rejects essentialist delineations of LGBTQ+ gender and sexuality and subscribes instead to a Butlerian framework of identity where behaviours associated with gender and sexuality are instruments of regulatory regimes. Even within a university culture that is inclusive and welcoming, opportunities were not always provided for LGBTQ+ students to speak about their personal lives and identities authentically, and university classrooms did not always feel like safe places for students. Whilst staff were generally helpful and supportive to their LGBTQ+ students, many lacked the knowledge and skills to confidently meet the needs of these students, particularly those identifying as trans and non-binary. The recommendations include calls for universities to commit to high-quality mandatory training for staff so that trans and non-binary students in particular are supported by staff appropriately equipped to support their needs.

Exploring the utilization of targeted intervention services by transgender individuals in Uttarakhand, India: a qualitative study.

Transgender (TG) women face violence, discrimination, and stigma, which affect their mental health and hinder their access to targeted intervention (TI) services. This lack of access may increase the risk of human immunodeficiency virus/sexually transmitted infections (HIV/STIs). However, the utilization of TI services among transgender women in Uttarakhand, as well as across the country, remains understudied. The purpose of this study is to explore the utilization of TI services by the transgender community in Uttarakhand. This qualitative study focused on non-government organizations (NGOs) that implement TI projects in Haridwar and Roorkee, Uttarakhand, India. From September 2023 to January 2024, 5 focus group discussions (FGDs) involving 24 transgender women and 9 in-depth interviews (IDIs) involving NGO staff were conducted. Thematic analysis, guided by the Anderson and Newman healthcare utilization model, was employed. Several barriers to service utilization were identified, including ritual beliefs, low health literacy, stigma, social isolation, financial insecurity, privacy concerns, and inefficient service delivery. Challenges in the implementation of the STI program and neglect of transgender women in health facilities were also reported. However, enabling factors such as trusted providers, supportive laws, and initiatives by NGOs and government agencies were recognized. Nonetheless, there remains a significant need for information on gender-affirming services and addressing other prevalent health issues within the transgender female community. The study underscores the interplay of individual, social, and service-related factors affecting healthcare access among transgender women. Inclusive and high-quality healthcare services are necessary to address the complex sociocultural aspects influencing transgender women's healthcare access and utilization.

Identity or Solidarity? Trans Affective Publics and Identity Frames of Violence

ABSTRACT Transgender Day of Remembrance is a key political day of action for the trans movement, both in the USA where it was invented, and elsewhere. I attend to the frames used about violence circulating in—and intensifying—what I call trans affective publics at and around Transgender Day of Remembrance by people and organizations in a “glocal” manner. I address both looser and stable frames of violence around Transgender Day of Remembrance, the most important of which are what I call identity frames of violence. I argue that these identity frames attach transness with vulnerability to violence in a global and unifying way, bypassing intersectional reasons behind the violence, and that frames of violence solidify through circulation. I address the adaptation of these frames in Europe and Finland, as well as alternative rhetoric about the violence, which shakes these solidified frames. I propose that this alternative framing appeals to a reflective form of solidarity, inviting coalition politics between trans and sex workers movements as well as (other) feminists and a re-thinking of both the causes of violence and the “we” to which one is invited to feel responsibility to act in solidarity, in opposing exclusions and oppression.

'Taking it one day at a time' and 'Reaching back out to help someone': How transgender women living with HIV and community stakeholders navigate violence, oppression, and health through coping and advocacy.

Transgender women living with HIV face intersectional oppression resulting in consequences for their mental and physical health. Interventions are needed that center the voices of transgender women living with HIV (TWLWH) and community stakeholders engrossed in work on behalf of the transgender community through advocacy and/or work roles. Through a partnership with a trans led and focused program of a community-based health organization and an academic partner, from October 2020 through October 2021, TWLWH and community stakeholders participated in qualitative interviews on trauma, violence, mental health struggles, HIV stigma, gender discrimination, health behaviors (e.g., medication adherence), and their thoughts and recommendations for a proposed intervention. Using a virtual platform (i.e., Zoom or phone) TWLWH and stakeholders were administered a demographics survey via Research Electronic Data Capture (REDCap) and completed individual interviews that were audio recorded. These interviews were analyzed using thematic content analysis. All TWLWH and 50% of stakeholders were Black. Qualitative findings highlighted the magnitude of violence, stigma, and discrimination faced by TWLWH and the mental, physical, and economic consequences. Also highlighted were the adaptive strategies TWLWH are utilizing to cope, ways in which invested stakeholders (many of lived expertise) are showing up for women, and acceptability and valuable insights for a proposed intervention. TWLWH are navigating a hostile society and multilevel interventions (at the structural, community, interpersonal, and individual levels) centering their voices and those invested in advocating for the community are needed to address the sequelae of oppression they face.

Exploring the Incidence of Testicular Neoplasms in the Transgender Population: A Case Series.

The use of hormonal therapy and gender-affirming surgery in the transgender community has been rising during the last several years. Although it is generally safe, hormonal therapy's link to testicular cancer remains uncertain. To review the incidence of testicular cancer in specimens from gender-affirming orchiectomies at our institution and evaluate the tumors for histologic and genetic alterations. Pathology reports for gender-affirming orchiectomies (January 1, 2018, to August 1, 2023) were reviewed for testicular neoplasms, with additional analysis for chromosome 12 abnormalities. Incidence and chromosome variations were compared with those in the general population. Among 458 cases during 5.5 years, 5 germ cell neoplasms in 4 patients emerged. Our institution's annual incidence rate (159 per 100 000) is 26.5 times higher than the National Cancer Institute's previous report (6.0 per 100 000). Although they were morphologically no different from germ cell neoplasms in the general population, fluorescence in situ hybridization tests showed no i(12p) in 4 of 5 neoplasms (80%) in our cohort. The cause behind this rise in incidence remains uncertain but may be due to long term pretreatment with hormones or blockers. The lower isochromosome 12p frequency suggests an alternative mechanism driving tumor development, which requires more detailed molecular studies.

Media Representation of Male Protagonists in Thai Boy Love Commercials: A Visual Discourse Analysis

The media portrayal of the lesbian, gay, bisexual, transgender and queer (LGBTQ) community may impact public understanding and attitudes towards this community, which has not been extensively studied. This article explores the media representation of gay men in commercials by presenting a visual discourse analysis of three Thai Boy Love commercials. Combining the visual representation framework of social actors and genre and functionality analysis, it examines (a) how the male protagonists are visually represented in relation to the audience from three symbolic dimensions and (b) how the salient patterns of presenting boy love commercials are integrated with the story’s narrative stages and genre functions. The findings suggest that the boys are primarily portrayed positively as inclusive, close, agentive and ordinary social members who feature soft masculinity. Nevertheless, such a generic and idealised representation romanticises gay relationships, diminishes the individuality of gay people and obscures the diversity within the gay community. The portrayal also prioritises the female gaze to cater to the core audience of heterosexual young women consumers. This article provides insights into the reciprocal relationship between public receptivity towards the LGBTQ community and their favourable visual representations in commercials.

Prevalence of Cardiac Arrhythmias in Transgender and Nonbinary Adult Community Health Center Patients.

Purpose: Sex differences in cardiac arrhythmias are well established. This study aimed to explore the prevalence of arrhythmias in transgender and nonbinary (TGNB) adults. Methods: This cross-sectional study utilized electronic medical records from a center specializing in TGNB care. Adults aged ≥18 years with ≥2 medical visits between January 1, 2010, and December 31, 2021, were categorized into self-reported gender groups: TGNB (transgender men, transgender women, nonbinary [NB]-assigned male at birth, NB-assigned female at birth), cisgender men, and cisgender women. The primary outcome was any arrhythmia using age- and race-adjusted regression models comparing transgender patients with cisgender men and cisgender women. Prevalence of arrhythmias was explored in transgender people with a gender-affirming hormone therapy (GAHT) prescription. Results: The sample included 49,862 adults, with 7121 (14%) TGNB persons. Median age was 28 years. Prevalence of arrhythmias was low (0.7-1.4% NB persons, 1.4-1.5% transgender persons). After adjustment, transgender women and transgender men had similar odds of any arrhythmia compared with cisgender men (transgender women: adjusted odds ratio [aOR] 0.89, 95% confidence interval [CI] 0.63-1.24, p = 0.52; transgender men: aOR 1.17, 95% CI 0.82-1.62, p = 0.37), but higher odds of any arrhythmia compared with cisgender women (transgender women: aOR 1.65, 95% CI 1.13-2.34, p = 0.01; transgender men: aOR 2.15, 95% CI 1.48-3.04, p < 0.001). Prevalence of arrhythmias appeared similar among transgender adults regardless of GAHT use (transgender men: 1.5% vs 1.9%, transgender women: 1.2% vs 2.1%). Conclusion: Further research examining arrhythmias in TGNB patients and across gender minority subgroups is warranted, including longitudinal studies evaluating the potential impact of GAHT.