scholarly journals Following Tanya’s Lead: The Mirage and Hope of Social Medicine Research

2021 ◽  
Vol 8 (1) ◽  
pp. 1-9
Author(s):  
Joshua Franklin
Keyword(s):  
Health Research ◽  
Transgender Women ◽  
Social Medicine ◽  
Collaborative Relationships ◽  
Transgender People ◽  
Medicine Research ◽  
National Hiv Behavioral Surveillance ◽  
Control And Prevention ◽  
Hiv Research ◽  
Research Initiatives

Entrenched structural inequalities raise challenging questions of how socially-oriented research initiatives are likely to improve health for marginalised people. The recent inclusion of transgender women in the National HIV Behavioral Surveillance (NHBS), an ongoing initiative funded by the Centers for Disease Control and Prevention (CDC) to study the HIV epidemic in the US, is designed to redress the exclusion of transgender people from past HIV research and to confront the disproportionate burden of HIV on transgender women through the production of specific knowledge about HIV risk factors in this population. The hope is that such research will ameliorate the burden of HIV among transgender women. Building on a decade-long ethnographic engagement with transgender activists and health practitioners, I delve into tensions between the health research that sustains this horizon of hope and what I call the ‘mirage’ of social medicine research. My interlocutors call out this mirage of scientific optimism in which ‘all the answers are already known’, suggesting that health research oriented towards social justice simply begets more research. Nonetheless, my interlocutors engaged with me, a physician-anthropologist trainee, in order to insist on the ethical necessity of including transgender people in health research even as they exposed the limits of such inclusion and, more broadly, the limits of medicine’s power to redress social injustice. We should follow their lead, embracing neither futility and hopelessness nor the mirage of medical salvation, in order to build collaborative relationships in the service of a more caring social medicine.

scholarly journals Monitoring Long-Term Cardiovascular Risk from Estrogen Use in Transgender Women - Evidence Update for Clinicians

2002 ◽  
Author(s):  
Keyword(s):  
Hormone Therapy ◽  
Female Gender ◽  
The United States ◽  
Transgender Women ◽  
Cardiovascular Risks ◽  
Psychological Benefits ◽  
Transgender People ◽  
New Information ◽  
Primary Care Clinicians

A PCORI-funded study provides new information for primary care clinicians about the need to monitor long-term cardiovascular risks in transgender women receiving hormone therapy. Approximately 1.4 million transgender people live in the United States. Many transgender women pursue medical transition with hormone therapy including estrogen to align their bodies with their female gender identity. Evidence suggests that medical transition confers significant psychological benefits including reduced depression, anxiety, and suicidality and improved quality of life. However, the risks of using estrogen, including cardiovascular risks, are not well understood. Recent evidence on these risks can help inform decisions and improve care for transgender women who are currently using or formerly used estrogen.

Visibly Unknown: Media Depiction of Murdered Transgender Women of Color

2019 ◽  
pp. 215336871988634 ◽  
Author(s):  
Frank Wood ◽  
April Carrillo ◽  
Elizabeth Monk-Turner
Keyword(s):  
Content Analysis ◽  
Women Of Color ◽  
Media Coverage ◽  
Significant Others ◽  
Transgender Women ◽  
Current Work ◽  
Transgender People ◽  
Media Depiction ◽  
Media Reports

Specific examples of transgender people misgendered and misidentified in media have been well-documented; however, little work explores how media depicts the murder of transgender people. The current work examines media coverage of the 23 transgender women of color murdered in 2016. Utilizing content analysis, we identified five themes including the brutality of these murders, the trivialization of the murders, misgendering the victims, the emotional toll on significant others, and resiliency among the transgender community. In general, media reports of deaths of transgender women of color in 2016 reveal the saliency of stigmatization. Did these lives matter?

scholarly journals Increasing Clinical, Community, and Patient-Centered Health Research for Preventing and Managing Multimorbidity

2013 ◽  
Vol 3 (2) ◽  
pp. 41-44 ◽  
Author(s):  
Jose M. Valderas
Keyword(s):  
Health Research ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Related Research ◽  
Department Of Health ◽  
Clinical Community ◽  
Usual Clinical Practice ◽  
Secondary Analyses ◽  
Research Initiatives

The report “Multiple Chronic Conditions: A Strategic Framework,” which was developed by the U.S. Department of Health & Human Services (HSS), has identified as one of the key goals for improving health and the provision of healthcare for people with multiple chronic conditions “to increase clinical, community and patient-centered research.” In their linked commentary of this special journal issue, Parekh and Goodman identify and consider the potential impact of a number of related research initiatives supported by the National Institutes of Health and the Agency for Health Research and Quality, particularly focusing on two very specific areas: behavioral medicine and secondary analyses of available datasets. In this paper, I comment on both documents and discuss the opportunities offered by the current approaches and highlight related research needs; in particular, the need for an improved and expanded conceptual model of healthcare for people with multimorbidity, and the need for further exploration of the use of multimorbidity-relevant outcomes as part of usual clinical practice.

The Use of Small Area Estimates in Place-Based Health Research

2020 ◽  
Vol 110 (6) ◽  
pp. 829-832
Author(s):  
Amanda Y. Kong ◽  
Xingyou Zhang
Keyword(s):  
Health Research ◽  
Small Area ◽  
Small Samples ◽  
Robert Wood Johnson Foundation ◽  
Secondary Use ◽  
Modeling Techniques ◽  
Control And Prevention ◽  
Survey Estimates ◽  
The Impact ◽  
Area Health

Interest in the impact of the built environment on health behaviors, outcomes, and disparities is increasing, and the growing development of statistical modeling techniques has allowed researchers to better investigate these relationships. However, without enough data that are identifiable at smaller geographic levels (e.g., census tract), place-based health researchers are unable to reliably estimate the prevalence of a health outcome at these more granular and potentially more salient neighborhood levels. When reliable direct survey estimates cannot be produced because of small samples or a lack of samples, estimates based on small area estimation techniques are often used. As place-based health research and the production and secondary use of small area estimates increase, it is critical that researchers understand both the underlying methods used to create these estimates and their limitations. Without this foundation, researchers may fit inappropriate models, or interpret findings inaccurately. As a demonstrative example, we focus this discussion on the small area health indicator estimates recently produced through the 500 Cities Project by the Robert Wood Johnson Foundation, the Centers for Disease Control and Prevention (CDC), and the CDC Foundation.

scholarly journals Perceptions of Barriers to and Facilitators of Participation in Health Research Among Transgender People

2016 ◽  
Vol 1 (1) ◽  
pp. 187-196 ◽  
Author(s):  
Ashli A. Owen-Smith ◽  
Cory Woodyatt ◽  
R. Craig Sineath ◽  
Enid M. Hunkeler ◽  
La Tasha Barnwell ◽  
...  
Keyword(s):  
Health Research ◽  
Transgender People

scholarly journals Prevalence of HIV, syphilis, and assessment of the social and structural determinants of sexual risk behaviour and health service utilisation among MSM and TG in Terai highway districts of Nepal: Findings based on an Integrated Biological and Behavioural Surveillance survey using respondent driven sampling

2019 ◽  
Author(s):  
Margrethe Storm ◽  
Keshab Deuba ◽  
Jose Damas ◽  
Upendra Shrestha ◽  
Bir Rawal ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Risk ◽  
Care Service ◽  
Health Care Service ◽  
Risk Behaviour ◽  
Transgender Women ◽  
Sexual Risk Behaviour ◽  
Respondent Driven Sampling ◽  
Structural Determinants ◽  
Transgender People

Abstract Background: Men who have sex with men (MSM) and transgender people are disproportionately affected by HIV and sexually transmitted infections. MSM and transgender people in Nepal experience considerable discrimination and marginalisation, they are subject to abuse from legal authorities and suffer from mental health issues. This study aims to assess the prevalence of HIV and syphilis, and how individual and socio-structural factors influence sexual risk behaviour and health care service uptake, among MSM and transgender women in the Terai highway districts of Nepal. Methods: A cross-sectional survey was conducted in June 2016 in eight Terai highway districts of Nepal, recruiting 340 MSM and transgender women through respondent driven sampling. The primary outcome variables were HIV and syphilis prevalence. The secondary outcome variables were sexual risk behaviour and health care service uptake. Logistic regression models were used to assess the individual and socio-structural determinants of sexual risk behaviour and health care service uptake. Results: The prevalence of HIV among MSM was 5%, whereas it was 13% in transgender women. The prevalence of active syphilis was 4% in MSM and 11% among transgender women. Among transgender women, 76% were involved in sex work, and 51% had experienced discrimination in one or more settings. In multivariable analysis, having visited an outreach centre was positively associated with condom use in the last sexual encounter among both MSM (AOR: 5.37, 95% CI: 2.42 - 11.94, p<0.001) and transgender women (AOR: 2.37, 95% CI: 1.12 – 5.02, p=0.025). Moreover, transgender women who reported being open towards family about sexual identity/behaviour were 2.4 more likely to have visited an outreach centre (AOR: 2.40, 95% CI: 1.04 – 5.57, p=0.041). Conclusions: The high prevalence of HIV and syphilis, as well as indicators of marginalisation and discrimination among transgender women, highlights the increased burden transgender women in Nepal are facing and the need for tailored interventions. Moreover, since health care service uptake is an important factor in determining sexual risk behaviour among MSM and transgender women in Nepal, outreach services should be scaled up.

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