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Transgender veterans as healthy as cisgender veterans, study finds

The study found demographic and economic differences between the two populations. Trans veterans experienced higher rates of poverty and less education and were less likely to be married or partnered compared to cisgender veterans.

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The mental and physical health of transgender veterans is similar to cisgender veterans. The only difference was trans veterans had higher odds of having at least one disability, such as a debility in vision, cognition, mobility, self-care or independent living.

The study, Transgender and Cisgender US Veterans Have Few Health Differences, was published in Health Affairs and co-authored by Janelle Downing, an assistant professor at the University of South Carolina, Kerith J. Conron, Blachford-Cooper distinguished scholar and research director at the Williams Institute at UCLA School of Law, Jody L. Herman, scholar of public policy at the Williams Institute, and John R. Blosnich, research health scientist for the VA Pittsburgh Healthcare System.

The study found demographic and economic differences between the two populations. Trans veterans experienced higher rates of poverty and less education and were less likely to be married or partnered compared to cisgender veterans.

In addition to veterans, researchers examined the health and well-being of trans and cisgender civilians and found transgender civilians were less likely to have health insurance and be employed. They had greater likelihood of not receiving primary care in the past year, delaying care because of cost and having multiple chronic conditions and depression compared to cisgender civilians.

“Disparities in education and poverty have been found to increase the risk of poor health,” said lead author Janelle Downing. “Those may be contributing to the poor health outcomes we observed in transgender civilians, but it was not true for trans veterans. It is possible that the veterans represent a particularly resilient subset of trans people.”

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The study analyzed responses from 517,539 people living in 31 American states and Guam, who participated in the 2014-2016 Behavioral Risk Factor Surveillance System, a nationally representative survey by the Centers for Disease Control and Prevention that collects state-level data on health, risk factors and sociodemographic characteristics of adults in the US.

According to the study, there are an estimated 163,000 transgender veterans in the US. Researchers found that overall, trans people (10.4%) served at similar rates compared to cisgender people (10.1%). However, trans people assigned male at birth were less likely to be veterans and those assigned female at birth were nearly five times more likely to be veterans compared to cisgender people.

But while – in March 2018 – the US Department of Defense issued a memorandum that states an intent to ban trans people with gender dysphoria from joining the military, the study found “no evidence to support the (Donald Trump) administration’s intent to ban trans people from serving in the military,” said study author Jody L. Herman. “On the contrary, the positive and long-term health outcomes of transgender veterans illustrate how well the existing criteria work to determine who is fit for military service.”

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Health & Wellness

Female to male trans adolescents report highest rate of attempted suicide at 50.8%

A study found that almost 14% of adolescents reported a previous suicide attempt, with disparities by gender identity in suicide attempts. Female to male adolescents reported the highest rate of attempted suicide (50.8%), followed by adolescents who identified as not exclusively male or female (41.8%).

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 Nearly 14% of adolescents reported a previous suicide attempt, with female to male adolescents reporting the highest rate of attempted suicide at 50.8%.

This is according to “Transgender Adolescent Suicide Behavior“, a study done by Russell B. Toomey, Amy K. Syvertsen and Maura Shramko, and released in Pediatrics. The study eyed to examine prevalence rates of suicide behavior across six gender identity groups: female; male; transgender, male to female; transgender, female to male; transgender, not exclusively male or female; and questioning. A secondary objective was to examine variability in the associations between key sociodemographic characteristics and suicide behavior across gender identity groups.

Data from the “Profiles of Student Life: Attitudes and Behaviors” survey (N = 120 617 adolescents; ages 11–19 years) were used to achieve the study objectives. Data were collected over a 36-month period: June 2012 to May 2015. A dichotomized self-reported lifetime suicide attempts (never versus ever) measure was used. Prevalence statistics were compared across gender identity groups, as were the associations between sociodemographic characteristics (i.e. age, parents’ highest level of education, urbanicity, sexual orientation, and race and/or ethnicity) and suicide behavior.

The study found that almost 14% of adolescents reported a previous suicide attempt, with disparities by gender identity in suicide attempts. Female to male adolescents reported the highest rate of attempted suicide (50.8%), followed by adolescents who identified as not exclusively male or female (41.8%), male to female adolescents (29.9%), questioning adolescents (27.9%), female adolescents (17.6%), and male adolescents (9.8%).

READ:  Discrimination in focus

Identifying as non-heterosexual exacerbated the risk for all adolescents except for those who did not exclusively identify as male or female (i.e. non-binary). For transgender adolescents, no other sociodemographic characteristic was associated with suicide attempts.

According to the researchers, “Suicide prevention efforts can be enhanced by attending to variability within transgender populations, particularly the heightened risk for female to male and non-binary transgender adolescents.”

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Health & Wellness

Trans-inclusive policies on college campuses improve the well-being of trans students

New report provides recommendations to institutions of higher education regarding the creation of trans-inclusive communities.

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report by the Williams Institute at UCLA School of Law finds that transgender-inclusive policies and support systems on college campuses provide transgender students a greater sense of belonging and more positive perceptions of the campus environment.

The report reviews previous research on the experiences of transgender students and presents new findings from interviews, surveys and focus groups conducted with transgender students.

“The majority of transgender students arrive at college having endured harassment and bullying in secondary school, which research shows have a negative impact on their academic performance and mental health. This cycle may be compounded by further adverse treatment and institutional invisibility at college,” said author Abbie E. Goldberg, former visiting scholar at the Williams Institute at UCLA School of Law. “However, through relatively small changes, faculty and administrators can make a world of difference in the lives of transgender young adults.”

The current research focused on the institutional structures and interpersonal interactions at colleges and universities that either enforce biases or serve as sources of support for transgender students. The report concludes with ten recommendations to institutions of higher education on how to create more transgender-inclusive campus communities.

Key recommendations include:

  • Colleges and universities should explicitly include gender identity and expression in their nondiscrimination policies.
  • College curricula should address gender identity and specifically transgender identities and experiences.
  • Students should be provided with education/training to enhance their understanding and acceptance of gender diversity.
  • Faculty/staff should be exposed to mandatory training on gender identity issues.
  • Students should be able to list their preferred name on campus records and alternatives to male/female should be provided.
  • All university literature and publications should use gender-inclusive language.
  • Gender-inclusive or single-stall restrooms should be readily available on campus.
  • Universities should provide trans-inclusive/trans-accommodating housing options.
  • Counseling and health services staff should receive training on trans-inclusive and trans-affirming practices and health insurance coverage should be inclusive of trans students.
  • Trans-specific spaces and/or groups should be created with sufficient resources to support programming and events.
READ:  Religious faith linked to suicidal behavior in LGBQ adults, says study

“A growing body of research indicates that gender, including gender identity, expression and gender norms, plays a key role in academic, health and economic outcomes,” said Kerith J. Conron, the Blachford-Cooper Distinguished Scholar and Research Director at the Williams Institute. “Colleges should engage students and faculty in conversations about gender and examine policies, including those related to information systems, through a comprehensive gender lens. This would have the potential to improve campus safety and promote academic success for all students.”

READ THE REPORT HERE.

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Health & Wellness

Report identifies unique challenges for LGBT community facing Alzheimer’s and other dementias

Despite recent advances in LGBT rights, LGBT older people are often marginalized and face discrimination. They are twice as likely to age without a spouse or partner, twice as likely to live alone and three to four times less likely to have children.

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LGBT and Dementia – a new issues brief developed by the Alzheimer’s Association and SAGE – outlines the unique issues that arise when Alzheimer’s disease, sexual orientation, and gender identification and expression intersect, allowing advocates and care providers to better meet the needs of LGBT elders and their caregivers facing dementia.

“Living with Alzheimer’s or another dementia is not easy for anyone,” said Sam Fazio, Ph.D., director of quality care and psychosocial research, Alzheimer’s Association. “But LGBT individuals can often face additional challenges that need to be considered and addressed to ensure this population gets respectful and competent care.”

It is estimated that there are 2.7 million LGBT people over age 50 living in the US alone, and that number is increasing rapidly as baby boomers age and more people self-identify as LGBT. New research presented at the 2018 Alzheimer’s Association International Conference found that about one in 13 lesbian, gay or bisexual (LGB) seniors in the US are living with dementia. Dementia rates for the LGB population are 7.4 percent, compared to about 10 percent for the general population.

“While the LGBT community faces similar health concerns as the general public, LGBT people who receive a dementia diagnosis and LGBT caregivers face uniquely challenging circumstances,” said SAGE CEO Michael Adams. “This brief shines a light on these challenges, so we can begin taking steps to address them and improve the care and support LGBT people receive.”

Despite recent advances in LGBT rights, LGBT older people are often marginalized and face discrimination. They are twice as likely to age without a spouse or partner, twice as likely to live alone and three to four times less likely to have children – greatly limiting their opportunities for support. There’s also a lack of transparency as 40 percent of LGBT older people in their 60s and 70s say their healthcare providers don’t know their sexual orientation.

READ:  Discrimination in focus

The brief identifies seven areas which can create unique or additional challenges for LGBT individuals living with dementia and their caregivers. They include:

  • Stigma
  • Social isolation
  • Poverty
  • Health disparities
  • Sexuality and sexual expression
  • Barriers to utilizing existing services
  • Living with HIV/AIDS

According to the brief, LGBT individuals may not reach out for services and support because they fear poor treatment due to their LGBT identity, because they fear the stigma of being diagnosed with dementia, or both. Several studies document that LGBT elders access essential services, including visiting nurses, food stamps, senior centers, and meal plans, much less frequently than the general aging population.

The Institute of Medicine identified the following pressing health issues for LGBT people: lower rates of accessing care (up to 30 percent); increased rates of depression; higher rates of obesity in the lesbian population; higher rates of alcohol and tobacco use; higher risk factors of cardiovascular disease for lesbians; and higher incidents of HIV/AIDS for gay and bisexual men. Risk factors for heart disease — including diabetes, tobacco use, high blood pressure and high cholesterol — are also risk factors for Alzheimer’s and stroke-related dementia.

Among the recommendations for organizations and service providers, the Alzheimer’s Association and SAGE suggest:

  • Expand your definition of family.
  • Educate yourself and your staff on LGBT cultural competency.
  • Find or create support groups specifically for LGBT people.
  • Partner with local LGBT community groups and political organizations.
  • Help LGBT people and their families with legal and financial planning.
READ:  Thomson Reuters earns perfect score on HRC's 2015 Corporate Equality Index

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Health & Wellness

6 Ways you’re wrecking your mental health

In recent years, the stigma surrounding mental health has started to lift, allowing us to finally have open conversations about our well-being. However mentally healthy you may be or think you are, it’s crucial that you do what you can to take care of yourself.

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Like physical health, we all have a state of mental health, with some people being deemed relatively healthy and others requiring professional help. In recent years, the stigma surrounding mental health has started to lift, allowing us to finally have open conversations about our well-being. However mentally healthy you may be or think you are, it’s crucial that you do what you can to take care of yourself.

Keeping that in mind, here are six mental health mistakes to avoid.

1. Lack Of Physical Activity

Everyone knows that exercise helps us to stay physically fit, but what many people don’t realize is that it can prevent stress and anxiety too. In fact, experts believe that a simple thirty-minute walk can have an effect, with more physical activities having a bigger and better outcome. Because of this, it’s vital that you make time to exercise for at least thirty minutes every single day.

2. Not Getting Enough Sleep

While it’s important to stay active, this doesn’t mean sacrificing sleep in the process. When you have a rough nights sleep, it can leave you feeling cranky, emotional, and stressed, and this will start to cause damage unless you get into a proper routine and stick to seven or eight hours a night. To help you ensure this, you should keep your room dark and cool, with no electronics.

While you should certainly distance yourself from people that make you feel bad, you shouldn’t isolate yourself from everyone you know.
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3. Associating With Negative People

Regardless of the state of your mental health, associating with people that make you feel bad about yourself will always cause some damage. If the person making you feel this way is a family member or spouse, then you should consider family counseling and couples therapy retreats to deal with your issues. For those that aren’t family, you may want to distance yourself.

4. Isolating Yourself From Friends

While you should certainly distance yourself from people that make you feel bad, you shouldn’t isolate yourself from everyone you know. Even introverted people need social interaction now and then, or you’ll start to feel lonely, depressed, and may even develop social anxiety. If you start to spend lots of time alone, arrange to meet up with friends after work or give your mom a call.

5. Refusing To Get Help

No matter what people tell you, there’s nothing wrong with asking for help when you need it. In fact, that’s the very best thing you can do. With that in mind, it’s crucial that you speak to a doctor, counsellor, or therapist when you start to notice problems with your mental health. They’ll be able to offer advice on ways to boost your mental health, including possible treatment options.

6. Self-Medicating With Substances

Drinking, smoking, and taking drugs may offer a temporary release from your mental health issues, but they are far from a cure. In fact, all they’re ever going to do is make your problems worse, while adding an addiction to the mix. Instead of trying to handle things yourself, speak to a professional for support and advice on proper treatment methods.

Mental health is not something that should be taken lightly, so avoid making the mistakes listed above.

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Health & Wellness

LGBQ adolescents at substantially greater risk for substance use, according to study

Almost 72% of LGBQ teens had tried alcohol in their lifetimes, as had 63% of heterosexual youth. With cigarettes, 47% of LGBQ youth said they had smoked at least once, as did 31% of heterosexual teens.

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Lesbian, gay, bisexual or questioning teens are at least twice as likely than their heterosexual peers to use illegal drugs like cocaine, ecstasy, heroin and methamphetamines. This is according to a US study, “Substance Use Among Lesbian, Gay, Bisexual, and Questioning Adolescents in the United States, 2015” by Theodore L. Caputi, Laramie R. Smith, Steffanie A. Strathdee and John W. Ayers; and published in the American Journal of Public Health (AJPH) this August.

This ought not to come as a surprise, with earlier researches suggesting that various stressors related to being closeted or coming out, and being rejected by family or friends could contribute to an increased risk of substance use among sexual minority teens.

For this study, the researchers looked at data from 14,703 high school students who were surveyed about their lifetime and prior-month use of 15 different substances, including illegal drugs, as well as tobacco, alcohol and prescription drugs that weren’t given to them by a physician.

Sadly, LGBQ teens were 12% more likely than other teens to report any substance use in their lifetimes and 27% more likely to report substance use in the previous month.

Other findings included:

  • LGBQ youth were more than three times more likely to try heroin or methamphetamines at least once, and more than twice as likely to try ecstasy or cocaine.
  • The vast majority of teens didn’t use illegal drugs, regardless of sexual orientation.
    For example, “only” 6.6% of LBGQ teens had used heroin in their lifetimes, compared with 1.3% of heterosexual youth. Also, 8.6% of LGBQ adolescents had used methamphetamines compared with 2.1% of other teens.
  • Marijuana was more commonly used at some point by half of LGBQ youth and almost 38% of other teens.
  • Teen drinking and smoking were more common. Almost 72% of LGBQ teens had tried alcohol in their lifetimes, as had 63% of heterosexual youth. With cigarettes, 47% of LGBQ youth said they had smoked at least once, as did 31% of heterosexual teens.
READ:  LGBT community among the hardest hit by smoking

Interviewed by Reuters Health, one of the study’s authors, John Ayers, was quoted as saying that stressors faced by LGBQ teens, such as stigma and isolation, “may make drugs foolishly appear attractive as a coping mechanism.”

Ayers quipped that “even experimentation with these harder drugs can derail a teen’s future.”

It is worth noting that the study wasn’t a controlled experiment designed to prove whether or sexual orientation might directly influence substance use or impact how much teens smoked, drank or did drugs.

All the same, the researchers of this study stressed that “policymakers should invest in prevention and early intervention resources to address substance use risks among LGBQ adolescents.”

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Health & Wellness

Gender-affirming hormone therapy impacts results of lab tests for trans patients

The fact that many medical protocols do not account for sex/gender incongruence is a significant barrier for transgender individuals seeking healthcare.

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Gender-affirming hormone therapy markedly impacts the results of common laboratory tests for transgender patients. This is according to a study that underscores the need for transgender-specific reference intervals to ensure this underserved population receives accurate diagnoses and effective treatments.

The fact that many medical protocols do not account for sex/gender incongruence is a significant barrier for transgender individuals seeking healthcare. In particular, for the nearly 50% of transgender individuals on hormone therapy, the medical field has yet to define reference intervals, which are the ranges of test result values observed in a healthy population that are used to determine whether individual lab results are normal or concerning.

Without tailored reference intervals, test results for transgender patients on hormone therapy could indicate an underlying condition but go unrecognized if they are considered normal for cisgender individuals (those whose gender matches their assigned-at-birth sex). Conversely, if lab results for transgender patients fall outside of cisgender reference intervals, they could trigger unnecessary follow-up work even if the results are actually normal.

To help build the case for developing transgender reference intervals, a research team led by Jeff SoRelle, MD, of University of Texas Southwestern Medical Center in Dallas, investigated whether transgender patients on hormone therapy exhibit altered results for laboratory tests ordered during yearly check-ups. The study authors recorded lab values for a complete blood count, comprehensive metabolic panel, and lipid tests in 264 healthy transgender patients undergoing hormone therapy in transgender clinics from 2007 to 2017. Of these patients, 133 were taking estradiol to transition from male to female, and 89 were taking testosterone to transition from female to male. The scientists also gathered lab results for 149 transgender patients not undergoing hormone therapy to serve as a point of comparison.

READ:  Discrimination in focus

From this, the researchers determined that both transgender women and men taking hormones displayed altered values for measures of red blood cell, kidney, and liver health. Transgender women taking hormones also had altered sodium, calcium, total protein, glucose, and platelet levels, while transgender men taking hormones displayed altered lipid values. Interpretation of these altered test results in the context of cisgender reference intervals could have serious consequences, from preventing diagnosis of anemia or kidney disease to affecting assessment of cardiovascular disease risk.

“Transgender patients will need their own reference ranges for several important parameters such as hemoglobin and creatinine,” said SoRelle. “It will also be important to determine whether proteins from cardiac muscle or the prostate, such as troponins or prostate specific antigen, are altered, too, which could affect diagnosis of heart attacks and prostate cancer.”

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