Transgender Groups Research Articles

Autistic traits in individuals self-defining as transgender or nonbinary

BackgroundAutism spectrum traits are increasingly being reported in individuals who identify as transgender, and the presence of such traits have implications for clinical support. To-date little is known about autism traits in individuals who identify as nonbinary. AimsTo empirically contribute to current research by examining autistic traits in a self-identifying transgender and nonbinary gender group. MethodOne hundred and seventy-seven participants responded to a survey consisting of the Autism Spectrum Quotient (AQ), the Empathy Quotient (EQ), the Systematising Quotient (SQ) and the Reading the Mind in the Eyes Task (RME). Comparisons were made between cisgender, transgender and nonbinary groups. ResultsIndividuals with autism spectrum disorder (ASD) or meeting the AQ cut-off score for ASD were over-represented in both the transgender and nonbinary groups. The key variables differentiating the transgender and nonbinary groups from the cisgender group were systematising and empathy. Levels of autistic traits and cases of ASD were higher in individuals assigned female at birth than those assigned male at birth. ConclusionsA proportion of individuals seeking help and advice about gender identity will also present autistic traits and in some cases undiagnosed autism. Lower levels of empathy, diminished theory of mind ability and literalness may impede the delivery of effective support. Clinicians treating transgender and nonbinary individuals, should also consider whether clients, especially those assigned female at birth, have an undiagnosed ASD.

Proposition 8 and Homophobic Bullying in California.

Bias-based bullying is associated with negative outcomes for youth, but its contextual predictors are largely unknown. Voter referenda that target lesbian, gay, bisexual, and transgender groups may be 1 contextual factor contributing to homophobic bullying. Data come from 14 consecutive waves (2001-2014) of cross-sectional surveys of students participating in the California Healthy Kids Survey (N = 4 977 557). Student responses were aggregated to the school level (n = 5121). Using a quasi-experimental design, we compared rates of homophobic bullying before and after Proposition 8, a voter referendum that restricted marriage to heterosexuals in November 2008. Interrupted time series analyses confirmed that the academic year 2008-2009, during which Proposition 8 was passed, served as a turning point in homophobic bullying. The rate of homophobic bullying increased (b linear = 1.15; P < .001) and accelerated (b quadratic = 0.08; P < .001) in the period before Proposition 8. After Proposition 8, homophobic bullying gradually decreased (b linear = -0.28; P < .05). Specificity analyses showed that these trends were not observed among students who reported that they were bullied because of their race and/or ethnicity, religion, or gender but not because of their sexual orientation. Furthermore, the presence of a protective factor specific to school contexts among lesbian, gay, bisexual, and transgender youth (gay-straight alliances) was associated with a smaller increase in homophobic bullying pre-Proposition 8. This research provides some of the first empirical evidence that public campaigns that promote stigma may confer risk for bias-based bullying among youth.

Gender congruence and body satisfaction in nonbinary transgender people: A case control study

Background: Binary transgender people access gender affirming medical interventions to alleviate gender incongruence and increase body satisfaction. Despite the increase in nonbinary transgender people, this population are less likely to access transgender health services compared to binary transgender people. No research has yet understood why by exploring levels of gender congruence and body satisfaction in nonbinary transgender people.Objective: The aim of this study was to compare levels of gender congruence and body satisfaction in nonbinary transgender people to controls [binary transgender people and cisgender (nontrans) people].Method: In total, 526 people from a community sample in the UK took part in the study (97 nonbinary, 91 binary, and 338 cisgender identifying people). Participants were asked to complete an online survey about gender congruence and body satisfaction.Results: There were differences in gender congruence and body satisfaction between nonbinary and binary transgender people. On sex-specific parts of the body (i.e., chest, genitalia, and secondary sex characteristics), nonbinary transgender people reported significantly higher levels of gender and body satisfaction compared to binary transgender people. However, there was no difference in congruence and satisfaction with social gender role between the two transgender groups (nonbinary and binary). Cisgender people reported significantly higher levels of gender congruence and body satisfaction compared to transgender people (nonbinary and binary).Conclusions: There are differences in gender congruence and body satisfaction between nonbinary and binary transgender people. Nonbinary individuals may be less likely to access transgender health services due to experiencing less gender incongruence and more body satisfaction compared to binary transgender people. Transgender health services need to be more inclusive of nonbinary transgender people and their support and treatment needs, which may differ from those who identify within the binary gender system.

Following the divine: an ethnographic study of structural violence among transgender jogappas in South India

Newly proposed legislation that aims to protect the well-being of transgender people in India offers hope of greater recognition of human rights and improved access to entitlements for these marginalised groups. However, social welfare and health institutions have a long way to go in translating proposed legislation into policies that can concretely address the social suffering of transgender people. Drawing on ethnographic field research in northern Karnataka among a highly understudied transgender group known as the jogappas, we describe the effects of overlapping forms of structural violence surrounding education, subsistence, family life and attempts to access social and health services. Findings reveal how social inequities are implicated in the emergence of transgender subjectivities along the road to becoming a jogappa. Our findings alert policy makers to the diverse needs of transgender people in India, which continually evolve while rooted in moral histories of religiosity.

Incidencia de la violencia física en la población LGBT en Ecuador

La violencia hacia algunos colectivos de género ha sido un fenómeno que en los últimos años se ha visibilizado en América Latina, no obstante, y a diferencia de los países desarrollados, la región no dispone de estudios sobre esta realidad e instrumentos para atenderla. En consecuencia, el objetivo del presente artículo es hallar los determinantes de la violencia física en Ecuador a través de una encuesta amplia de colectivos de lesbianas, gais, bisexuales y transexuales (LGBT). Los resultados muestran que un 50% de los encuestados han sido agredidos, siendo los transexuales con bajo nivel educativo los más afectados. Igualmente, el análisis cuantitativo encuentra diferencias entre regiones, etnias y grupo de referencia (homosexuales, bisexuales, transexuales, transgénero), sin embargo, también resalta los avances que ha hecho la sociedad ecuatoriana en este aspecto. Se concluye que las estrategias que sirvan para aumentar la inclusión de la población de todos los géneros dentro de las oportunidades que presente el Estado, contribuirán a la reducción de las tendencias violentas entre grupos.

Transgender women’s experiences and beliefs about hormone therapy through and beyond mid-age: An exploratory UK study

Background: Little is known about transgender women’s beliefs and experiences of hormone therapy (HT), as part of their transition process, and particularly as they grow older. Aims: This study aimed to investigate: (i) transgender women’s experiences and attitudes to HT, and (ii) expectations of what might occur and/or what occurred after they reached “menopausal age.” Methods: Participants were recruited through invitations to an online survey sent to 138 Lesbian, gay, bisexual, transgender plus (LGBT+) support groups across the UK. Sixty-seven transgender women consented and completed the questionnaire; responses were analyzed using a mixed-methods approach. The beliefs about medicines questionnaire (BMQ) was used to assess beliefs about HT, while an inductive thematic qualitative approach was used to explore participants’ personal expectations and experiences of HT and their views about the menopause. Results: Participants were aged on average 49 years ranging from 20 to 79 years old. Most (96%) were taking HT. BMQ scores revealed strong beliefs about the necessity of HT and some concerns. Positive views about HT were expressed, with themes including treatment importance, personal and mental health benefits, but concerns about long-term effects, side effects, and maintaining access to the treatment were also mentioned. Views about menopause included uncertainty and questioning of its relevance; some mentioned changes to HT dosage, but most expected to use HT indefinitely. Discussion: This study provides exploratory qualitative and quantitative information about transgender women’s views about HT and menopause. Practical implications include improving access to HT and provision of evidence-based information about long-term use.

Self-Reported Gender Identity and Sexuality in an Online Sample of Cisgender, Transgender, and Gender-Diverse Individuals: An Exploratory Study

The relations between self-reported aspects of gender identity and sexuality were studied in an online sample of cisgender (n = 4,954), transgender (n = 406), and gender-diverse (n = 744) groups. Aspects of gender identity and sexual fantasies, attraction, behavior, and romantic relations were assessed using the Multi-gender Identity Questionnaire (Multi-GIQ) and a sexuality questionnaire. Results show a wide spectrum of gender experiences and sexual attractions within each group, an overlap among the groups, and very weak relations between atypical gender identity and atypical sexuality. At the group level, aspects of gender identity and sexuality were mainly predicted by gender and sex-gender configuration, with little contribution of sex assigned at birth. A principal component analysis (PCA) revealed that measures of gender identity and of sexuality were independent, the structure of sexuality was mostly related to gender, whereas the structure of gender identity was mostly related to sex-gender configuration. The results of both approaches suggest that measures of gender identity could roughly be divided into three classes: one including feeling as a man and feeling as a woman; a second including measures of nonbinary and “trans” feelings; and a third including feeling as a “real” woman and feeling as a “real” man. Our study adds to current scientific data that challenge dichotomous conventions within gender identity and sexuality research. Possible social and clinical implications are discussed.

Structural connections in the brain in relation to gender identity and sexual orientation

Both transgenderism and homosexuality are facets of human biology, believed to derive from different sexual differentiation of the brain. The two phenomena are, however, fundamentally unalike, despite an increased prevalence of homosexuality among transgender populations. Transgenderism is associated with strong feelings of incongruence between one's physical sex and experienced gender, not reported in homosexual persons. The present study searches to find neural correlates for the respective conditions, using fractional anisotropy (FA) as a measure of white matter connections that has consistently shown sex differences. We compared FA in 40 transgender men (female birth-assigned sex) and 27 transgender women (male birth-assigned sex), with both homosexual (29 male, 30 female) and heterosexual (40 male, 40 female) cisgender controls. Previously reported sex differences in FA were reproduced in cis-heterosexual groups, but were not found among the cis-homosexual groups. After controlling for sexual orientation, the transgender groups showed sex-typical FA-values. The only exception was the right inferior fronto-occipital tract, connecting parietal and frontal brain areas that mediate own body perception. Our findings suggest that the neuroanatomical signature of transgenderism is related to brain areas processing the perception of self and body ownership, whereas homosexuality seems to be associated with less cerebral sexual differentiation.

Gender incongruence and the brain – Behavioral and neural correlates of voice gender perception in transgender people

The phenomenon of gender incongruence is hypothesized to arise from a discrepant sexual development of the brain and the genitals, contingent on genetic and hormonal mechanisms. We aimed at visualizing transgender identity on a neurobiological level, assuming a higher functional similarity to individuals of the aspired rather than assigned sex. Implementing a gender perception paradigm featuring male and female voice stimuli, behavioral and functional imaging data of transmen were compared to men and women, and to transwomen, respectively. Men had decreased activation in response to voices of the other sex in regions across the frontoparietal and insular cortex, while the activation patterns of women and transmen were characterized by little or no differentiation between male and female voices. Further, transmen had a comparatively high discrimination performance for ambiguous male voices, possibly reflecting a high sensitivity for voices of the aspired sex. Comparing transmen and transwomen yielded only few differences in the processing of male compared to female voices. In the insula, we observed a pattern similar to that of men and women, the neural responses of the transgender group being in accordance with their gender identity rather than assigned sex. Notwithstanding the similarities found dependent on biological sex, the findings support the hypothesis of gender incongruence being a condition in which neural processing modes are partly incongruent with one's assigned sex.

Health of Transgender Adults in the U.S., 2014–2016

Transgender people experience significant interpersonal and structural discrimination and stigma. However, little is known about the health of transgender people, and even less about the health of specific groups-including male-to-female, female-to-male, and gender-nonconforming transgender populations-despite the variation in social and biological characteristics across groups. Data are from the 2014-2016 Behavioral Risk Factor Surveillance System, analyzed in 2017. The study population included 2,221 transgender and 523,080 cisgender respondents from 31 states and one territory. The authors estimated the prevalence and adjusted odds of chronic health conditions, health-related quality of life, disabilities, health behaviors, and health utilization among three transgender groups, when compared separately with cisgender males and cisgender females. An estimated 0.24% (95% CI=0.21, 0.27) identified as male-to-female; 0.14% (95% CI=0.12, 0.17) identified as female-to-male; and 0.10% (95% CI=0.08, 0.12) identified as gender-nonconforming. All transgender groups experience worse mental health and disabilities; few differences in healthcare access and utilization were observed. Gender-nonconforming people had higher odds of multiple chronic conditions, poor quality of life, and disabilities than both cisgender males and females. Female-to-male people had a higher odds of no exercise and cardiovascular disease compared with cisgender females. Given the high burden of disabilities; poor mental health; and multiple chronic conditions among transgender (particularly gender-nonconforming) populations, supportive services and care coordination may be consequential levers for improving transgender health.

516 Mental health status of treatment seeking young transgender people: a comparative study between young transgender people and the general population

To assess the mental health status of young people (<25 years) attending a national transgender health service in the United Kingdom during a 3 years period and to compare the findings to a matched population control group. Every young person who was offered an assessment at a national transgender health service in the UK was invited to participate in the study. Measurements of depression and anxiety (Hospital Anxiety and Depression Scale-HADS) were collected and compared to a cisgender (non-trans) population matched by age and sex assigned at birth. The cisgender population was recruited as part of a different project (n=1200). For the matched control comparison 300 people in each group (cisgender and transgender) were selected. A total of 1095 people were invited for assessment during the study period, of which 565 (51.6%) were younger than 25 years. There were slightly more assigned females at birth (51.9%) than assigned males at birth (48.1%), and 14.7% did not identified as binary transgender. More than half of the people (54.6%) suffered from a possible anxiety disorder and 47.3% a possible depressive disorder. When compared with the cisgender population, the transgender group presented with statistically significant more anxiety and depressive symptoms than the cisgender group (p<.05). Predictors of psychopathology were found to be having a transphobia experience(β = .18, p < .001), low self-esteem (β = -.29, p < .001), and presenting with interpersonal problems) (β = .48, p < .001). Psychopathology did not differ across gender groups in the transgender population. Those presenting with having started cross-sex hormones before assessment (via other professionals or the Internet) did present with less depressive and anxiety symptoms.

Trans women are real women: a critical realist intersectional response to Pilgrim

ABSTRACTIn this paper, I explain why I disagree with David Pilgrim’s claim that critical realists should deny any ‘natal male’ claim to womanhood. Specifically, Pilgrim and I have different definitions of the transitive and intransitive dimensions of reality. In my version – which I believe is in the spirit of the Bhaskarian version – the transitive dimension embraces everything that is currently being affected by human praxis. This allows for an intersectional view of gender in which it is perfectly possible for the same human, in different contexts, to be an ontological woman (e.g. for the purposes of their everyday life), an ontological trans woman (for the purposes of a transgender support group); and an ontological person with a prostate gland, some might say a man (e.g. for the purposes of a medical examination). In the same way, it is perfectly possible for a room to contain 17 people for the purposes of setting out tea cups, but 18 people for the purposes of providing lecture hand-outs. For the purposes of everyday life, and even, I argue, for the fight against sexism, trans women have the same claim to being women as cis women.

Alternative kinship structures, resilience and social support among immigrant trans Latinas in the USA

Latinas comprise the largest racial/ethnic group of trans women (male-to-female transgender people) in New York City, where HIV seroprevalence among trans Latinas has been found to be as high as 49%. Despite this population’s high risk of HIV, little is known about resilience among trans Latinas that may provide protective health factors. Six focus groups and one in-depth interview were conducted with 34 low-income trans/gender-variant people of colour who attended transgender support groups at harm reduction programmes in New York City. This paper reports on data from 13 participants who identified as immigrant trans Latinas. Focus groups were coded and analysed using thematic qualitative methods. The majority of immigrants were undocumented but reported having robust social support. Unique characteristics of immigrant trans Latinas included alternative kinship structures and sources of income. Social creativity was used to develop achievable ways in which to improve their health outcomes. Resilience was evident in informal kinship dynamics, formal support groups, gender-transition, educational access and skills training and substance use reduction. Individual-level resilience increased as a result of strong community-level resilience.

Entre negociação e conflito: uma análise da 5a Conferência de Políticas para as Mulheres de São Paulo

As conferências de políticas públicas para as mulheres são importantes instâncias de participação social, em que atrizes sociais agem e interagem a fim de influenciar o desenvolvimento de políticas na área. Neste artigo, buscamos compreender os repertórios e estratégias de ação mobilizados na 5a Conferência Municipal de Políticas Públicas para as Mulheres de São Paulo. Com base no estudo de Alvarez e colaboradoras (2003), identificamos três repertórios predominantes: dupla militância, autonomista e institucional. Observamos, ainda, a formação de uma coalizão detentora de poder, constituída pelo governo municipal e pelas organizações próximas a ele, a qual foi desafiada principalmente por mulheres transexuais e travestis, que buscavam maior representatividade na arena. Concluímos este estudo problematizando possíveis implicações para a dinâmica participativa das conferências.

Abstract P305: Psychosocial Stressors and Tobacco Use: Views of the Transgender Community in a 2016 Focus Groups Study

Background: Studies have found that cigarette smoking is higher among lesbian, gay, bisexual, transgender and queer (LGBTQ) groups compared to heterosexual individuals. However, limited research is available about factors related to tobacco initiation or continuation among transgender adults. Methods: During summer 2016, the AHA-Tobacco Regulatory and Addiction Center (A-TRAC) conducted 27 focus groups and 196 surveys among smokers and non-smokers (ages 18-64) who self-identified as lesbian, gay, bisexual, transgender, or queer (LGBTQ). Study participants were of diverse racial and ethnic backgrounds and were recruited in Chicago, New York City and San Diego. Using qualitative data analyses, we analyzed a subsample of the LGBTQ data to examine the views and experiences of transgender individuals and identified themes related to psychosocial stressors linked to tobacco use. Atlas ti.v 7.5 qualitative software was used for analysis. Results: A total of 26 participants were identified as transgender, representing 13.9% of the total LGBTQ sample. Psychosocial stressors that were often mentioned by study participants and were associated with initial and continuing tobacco use included: childhood and adulthood trauma due to family, peer and community rejection and/or exposure to partner and/or community violence; surgery and the side effects of medication; use of hormones and/or other experiences related to the process of transitioning. Structural discrimination associated with low income, housing, and employment was also mentioned. These psychosocial stressors were also associated with depression and the use of intoxicating substances (i.e., alcohol and drugs). Tobacco use was felt to provide relief from these stressors. Conclusion: Transgender individuals perceived tobacco use as a relief from everyday chronic psychosocial stressors and appears to be associated with tobacco initiation and continued use. Health communication messages stressing healthy lifestyle practices and encouraging drawing on professional and informal support systems may prevent tobacco use.

An assessment of quality of life of transgender adults in an urban area of Burdwan district, West Bengal

Background: Transgender people are stigmatised in our society and are being discriminated in every aspect of life. Many of them experience abuses in various forms since childhood. Accordingly these might have adverse consequences on their life and modify their quality of life (QOL). This aspect needs to be explored. In this context the present study was conducted to assess the QOL among adult transgender people and to find its association with their socio-demographic characteristics in Burdwan municipal area of Burdwan district.Methods: A cross-sectional study was conducted during July-December 2016 among 79 adult transgender people residing in the study area. Sample size was based on 50% having satisfactory QOL with 95% CI, 10% relative error, and 10% non-response rate with finite population correction (total target reference population 96). Subjects were selected by simple random sampling and recruited for interview by time space sampling. Socio-demographic characteristics were assessed by a predesigned schedule and QOL was assessed by using a validated Bengali version of WHO-QOL BREF questionnaires.Results: 56.9% people were found to be have good QOL score as a whole. Maximum and minimum percentages of good QOL score was found in environmental domain (84.7%) and social relationship domain (45.8%). A significant positive correlation was found between education and monthly income with QOL score while negative correlation between age and QOL score. Marital status, current living status and occupation were found to have a statistically significant association with QOL score.Conclusions: The study measured QOL as well as identified some important socio-demographic variables which affected QOL among transgender people. These findings can help the government to plan conceptually to improve QOL in this special transgender group of population by some legislation, social awareness and facilities dedicated towards them.

Grey and white matter volumes either in treatment-na\xefve or hormone-treated transgender women: a voxel-based morphometry study

Many previous magnetic resonance imaging (MRI) studies have documented sex differences in brain morphology, but the patterns of sexual brain differences in transgender women – male sex assigned at birth – with a diagnosis of gender dysphoria (TW) have been rarely investigated to date. We acquired T1-weighted MRI data for the following four (n = 80) groups: treatment-naïve TW (TNTW), TW treated with cross-sex hormones for at least one year (TTW), cisgender men, and cisgender women (cisgender individuals as controls). Differences in whole-brain and regional white matter volume and grey matter volume (GMV) were assessed using voxel-based morphometry. We found lower global brain volumes and regional GMVs in a large portion of the posterior-superior frontal cortex in the cisgender women group than in the TTW and cisgender men groups. Additionally, both transgender groups exhibited lower bilateral insular GMVs than the cisgender women group. Our results highlight differences in the insula in both transgender groups; such differences may be characteristic of TW. Furthermore, these alterations in the insula could be related to the neural network of body perception and reflect the distress that accompanies gender dysphoria.

The possible role of the psychiatrist: The lesbian, gay, bisexual, and transgender population in India.

Sweeping social change is occurring in India with regard to the proposed transgender legislation and the enshrinement of associated rights. This progressive legislative change occurs as existing Indian law is profoundly reshaped by the judiciary with regard to other members of this sexually diverse group, the lesbian, gay, bisexual, and transgender (LGBT) group. Now as a group of immense interest within high-income countries, this article through Government, legal, and medical literature, explores the possible population of interest in India, relevant law and associated health disparities. The author considers the evidence of a mental health burden, among the estimated 45.4 million LGBT people in 2011. The complex contribution of psychiatrists is noted, and a prism for care delivery is suggested. The underlying goal of lower morbidity for the entire LGBT community is through enhanced care opportunities, understanding, and reduced societal discrimination.

Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people

PurposeThe Study of Transition, Outcomes and Gender (STRONG) was initiated to assess the health status of transgender people in general and following gender-affirming treatments at Kaiser Permanente health plans in...

Structural connections in the brain in relation to gender identity and sexual orientation

Both transgenderism and homosexuality are facets of human biology, believed to derive from different sexual differentiation of the brain. The two phenomena are, however, fundamentally unalike, despite an increased prevalence of homosexuality among transgender populations. Transgenderism is associated with strong feelings of incongruence between one’s physical sex and experienced gender, not reported in homosexual persons. The present study searches to find neural correlates for the respective conditions, using fractional anisotropy (FA) as a measure of white matter connections that has consistently shown sex differences. We compared FA in 40 transgender men (female birth-assigned sex) and 27 transgender women (male birth-assigned sex), with both homosexual (29 male, 30 female) and heterosexual (40 male, 40 female) cisgender controls. Previously reported sex differences in FA were reproduced in cis-heterosexual groups, but were not found among the cis-homosexual groups. After controlling for sexual orientation, the transgender groups showed sex-typical FA-values. The only exception was the right inferior fronto-occipital tract, connecting parietal and frontal brain areas that mediate own body perception. Our findings suggest that the neuroanatomical signature of transgenderism is related to brain areas processing the perception of self and body ownership, whereas homosexuality seems to be associated with less cerebral sexual differentiation.