Thesis (M.A.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at firstname.lastname@example.org. Thank you. / BACKGROUND: Transgender women suffer a great deal of self-reported anxiety and concern about their facial appearance as they may readily be identified by observers as "trans" when they would prefer to be interpreted solely as women. Little is known about the psychological distress that transgender individuals experience in their decision to undergo major aesthetic plastic surgery as a result of their appearance concern. As such, it remains unknown whether transgender individuals experience improved appearance anxiety and a greater quality of life following facial feminization surgery. AIMS: The objective of this study is to determine, using the Derriford Appearance Scale 24, whether any improvement can be seen among transgender patients in their level of appearance anxiety following facial feminization surgery. We also aim to look at whether additional improvements can be seen in the quality of life of transgender patients. METHODS: A prospective study was conducted on patients undergoing facial feminization surgery. The outcome measure used was the Derriford Appearance Scale 24. The Derriford Appearance Scale 24 was given to transgender patients to fill out at the end of their pre-operative visit before their schedule facial feminization surgery. The scale was then also administered three weeks following surgery and three months following surgery, via the Internet. RESULTS: Twenty-four patients were enrolled. Of these, fourteen patients completed at least one of the surveys, post-operatively; twelve patients completed all three surveys. Of those patients who completed at least two out of the three surveys, scores revealed that 85% of transgender patients displayed higher levels of psychological distress when completing the first survey, preoperatively, than in subsequent post-operative surveys. CONCLUSIONS: Transgender individuals enrolled in the study showed decreased levels of distress both three weeks after surgery and three months after surgery. These results were promising in displaying amelioration of appearance anxiety following facial feminization surgery. Though results show increased quality of life, the degree of impact that gender confirming facial features may have on quality of life for transgender patients has yet to be assessed.
Cameron, Larry Jack
01 January 2017
In the United States, homelessness is often connected to traumatic events such as domestic violence, job loss, or post incarceration experiences, frequently resulting in substance use disorders, medical issues, and related mental illnesses. Although researchers have considered how homelessness and social service interventions affect sexual and gender minority youth, they have not adequately studied the causes and effects of homelessness among transgender women. The purpose of this interpretive phenomenological study was to bridge this gap in knowledge by exploring the experiences of chronically homeless transgender women. The research question focused on the lived experiences of chronically homeless transgender women who try to obtain social services from outreach workers. A purposive sample of 8 chronically homeless transgender women from the southeastern United States completed individual face-to-face interviews. Using phenomenological strategies, the narratives were analyzed and interpreted into codes, categories, and themes. Four central themes were identified, including reasons for homelessness, the lived experience of chronic homelessness, experiences related to transgender identity, and involvement with social services. Participants faced barriers with social services agencies and outreach workers, including administrative demand for binary gender classification, blatant ignorance and discrimination, and a lack of trans-positive treatment facilities and shelters. The findings and recommendations from this study may advance positive social change by guiding the efforts of social service agencies and outreach workers to improve the quality of social services for transgender women.
Intimate Partner Violence Against Transgender Women: Prevalence and Correlates in Lima, Peru (2016–2018)Murphy, Ellen C., Segura, Eddy R., Lake, Jordan E., Huerta, Leyla, Perez-Brumer, Amaya G., Mayer, Kenneth H., Reisner, Sari L., Lama, Javier R., Clark, Jesse L. 01 June 2020 (has links)
Limited data exists on intimate partner violence (IPV) among transgender women (TW), though global trends suggest IPV is associated with HIV risk in this population. We describe the prevalence of verbal, physical, and/or sexual violence as well as participant- and partner-level correlates of IPV among TW in Lima, Peru. Among 389 respondents, 15.2% reported IPV with one or more of their last three sexual partners: 9.2% verbal, 8.2% physical, and 2.3% sexual violence. Physical and verbal violence were more common with stable partners (aPR 3.46, 95% CI 1.17–10.25, aPR 2.46, 95% CI 1.14–5.28, respectively). Physical violence was associated with condomless receptive anal intercourse (cRAI) (aPR 2.22, 95% CI 1.19–4.13) and partner alcohol use (aPR 4.38, 95% CI 1.56–12.33) while verbal violence correlated with participant inebriation (aPR 4.86, 95% CI 1.63–14.46). Our results link IPV with stable partnerships, alcohol use, and cRAI, suggesting TW in Peru may benefit from multidimensional IPV prevention strategies to foster supportive relationships and reduce HIV transmission. / amfAR, The Foundation for AIDS Research / Revisión por pares
High-Risk, but Hidden: Binge Drinking among Men Who Have Sex with Men and Transgender Women in Lima, Peru, 2012-2014Passaro, R.C., Passaro, R. Colby, Segura, Eddy R., Lama, Javier R., Sanchez, Jorge, Lake, Jordan E., Shoptaw, Steven, Clark, Jesse L. 03 February 2020 (has links)
Background: Binge drinking (BD) is common in Peru, but may not be routinely detected by standard assessments of hazardous drinking. Objectives: We describe prevalence and risk behaviors of men who have sex with men (MSM) and transgender women (TW) in Peru who met criteria for BD as compared with those who met criteria for hazardous drinking. Methods: In a cross-sectional sample of MSM and TW from Lima (2012-2014), we calculated prevalence of BD (consuming ≥6 alcoholic drinks per occasion by AUDIT-3 criteria), conducted bivariate analyses of associations of BD with demographic and behavioral characteristics, and compared prevalence and behaviors of BD to those of hazardous drinkers (identified by AUDIT-10 criteria). Results: Of 1,520 MSM (n = 1,384) and TW (n = 137) with median age 27 years, 74.4% of MSM and 86.9% of TW met criteria for BD. Among MSM, BD was associated with a greater likelihood of using alcohol (41.6% vs. 13.8%; p <.01) or drugs (7.8% vs. 2.8%; p <.01) prior to a recent sexual contact. Among TW, BD was associated with greater frequency of alcohol use (44.9% vs. 11.1%; p <.01) or unprotected anal intercourse (58.8% vs. 33.3%; p =.04) during ≥1 of their three most recent sexual contacts. There was a higher prevalence of BD (75.5%) than hazardous drinking (53.2%) in our sample, with binge drinkers exhibiting similar sexual risk behaviors to hazardous drinkers. Conclusions: Binge drinking is common among MSM and TW in Lima, associated with risky sexual behavior, and may not be adequately captured by AUDIT-10 criteria. / Revisión por pares
Media Ethics and Violence Against the Transgender Community: An Exploration of Ethically Covering Homicides of Black Transgender WomenWood, Kayla M January 2019 (has links)
No description available.
Syphilis in the Americas: a protocol for a systematic review of syphilis prevalence and incidence in four high-risk groups, 1980–2016Kitayama, Ken, Segura, Eddy R., Lake, Jordan E., Perez-Brumer, Amaya G., Oldenburg, Catherine E., Myers, Bethany A., Pourjavaheri, Paria, Okorie, Chinomnso N., Cabello, Robinson L., Clark, Jesse L. 10 October 2017 (has links)
Background: Syphilis infection has recently resurfaced as a significant public health problem. Although there has been a tremendous amount of research on the epidemiology of syphilis, there has been limited work done to synthesize the extensive body of research and systematically estimate patterns of disease within high-risk groups in the Americas. The purpose of this systematic review and meta-analysis is to (1) summarize recent patterns of syphilis infection in North and South America among four high-risk groups (MSM, transgender women, sex workers, and incarcerated individuals) from 1980 to 2016, (2) identify and differentiate regional geographic epidemiologic characteristics, and (3) compare the epidemics of the economically developed countries of North America from the developing countries and public health systems of Latin America and the Caribbean. Methods/design: Primary studies reporting syphilis prevalence and/or incidence in at least one of the four high-risk groups will be identified from Medline/PubMed, Embase, Lilacs, SciELO, The Cochrane Library, Web of Science, Scopus, ProQuest, CINAHL, Clase, and Periódica, as well as "gray" literature sources (conference abstracts, country reports, etc.). Studies published from 1980 through 2016 will be included. Data will be extracted from studies meeting inclusion and exclusion criteria and a random effects meta-analysis of prevalence and incidence estimates will be conducted. Heterogeneity, risk of bias, and publication bias will be assessed. Pooled prevalence and incidence estimates will be calculated for comparisons based on geographic region, risk factors, and time period. Discussion: Our systematic review and meta-analysis aims to contribute to an improved understanding of global epidemiologic patterns of syphilis infection in most-at-risk populations. Through systematic classification of the existing literature, and comparison of disease patterns across regional, temporal and socio-behavioral differences, we hope to improve public health surveillance and improve efforts to control the spread of disease across the Americas. Systematic review registration: PROSPERO CRD42016047306.
Travestis e mulheres trans vivendo com HIV/Aids: estudo transversal mensurando adesão à TARV e qualidade de vida em um centro de referência em HIV/Aids da cidade de São Paulo, Brasil / Adherence to antiretroviral treatment and quality of life in the population of transgender women living with HIV / AIDS: a cross-sectional study in the city of São Paulo, BrazilThiago Emerson Sabino 23 August 2018 (has links)
Estimativas mundiais apontam que 19% das travestis e mulheres trans estão vivendo com HIV/Aids; no Brasil, a prevalência está acima de 30%. Essas taxas são crescentes e expressam a falta de atenção à saúde desta população. Raros estudos abordam a adesão dessa população aos antirretrovirais, com resultados preocupantes demonstrando falhas na adesão; além disso, escassos trabalhos científicos descrevem a qualidade de vida de travestis e mulheres trans vivendo com HIV/Aids. Este estudo teve por objetivos: (i) descrever a adesão à terapia antirretroviral de travestis e mulheres trans vivendo com HIV/Aids; (ii) identificar fatores associados com a adesão à terapia antirretroviral; (iii) mensurar a qualidade de vida entre travestis e mulheres trans vivendo com HIV/Aids; (iv) identificar fatores associados à qualidade de vida; e (v) explorar a associação entre qualidade de vida e adesão à terapia. A ferramenta para estimar a adesão foi o autorrelato desenvolvido pelo grupo Terry Beirn Community Programs for Clinical Reserch on Aids, além do parâmetro clínico carga viral. Para avaliação da qualidade de vida o questionário utilizado foi o Patient Report Outcomes Quality of Life - HIV (PROQOL-HIV). Este estudo foi aprovado pelo comitê de ética e pesquisa da Faculdade de Medicina da Universidade de São Paulo - FMUSP e pelo comitê de ética e pesquisa do Centro de Referência e Treinamento CRT Santa Cruz, além de estar em consonância com as diretrizes da resolução nº 510 de 2016 pelo Conselho Nacional em Saúde. Os dados foram analisados no programa STATA 15.1, sendo aplicados teste qui-quadrado, teste da soma dos postos de Wilcoxon, cálculo da correlação não paramétrica de Spearman e modelo de regressão logística multivariada. Cento e seis travestis e mulheres trans vivendo com HIV/Aids foram incluídas nesse estudo, das quais 90% declararam adesão ao tratamento; idade mais avançada foi identificada como fator associado a melhor adesão. O escore de qualidade de vida esteve entre boa a excelente em cinco dos 8 domínios do PROQOL-HIV; e menor escolaridade, depressão e uso de drogas ilícitas foram fatores associados com pior escore de qualidade de vida. Não observamos correlação estatisticamente significante entre qualidade de vida e adesão. Nosso estudo sugere que os resultados obtidos possam estar relacionados ao modelo de atendimento adotado no centro recrutador. Estudos multicêntricos, com maior número de participantes e que considere unidades de atendimento localizadas em regiões remotas e menos favorecidas são necessários para expressar a real situação da adesão aos antirretrovirais e qualidade de vida de travestis e mulheres trans. / Worldwide estimates indicate that 19% of transgender women are living with HIV / AIDS; in Brazil, the prevalence is above 30%. The increase of the numbers express the lack of health care for this population. Rare previous studies address transgender women adherence to antiretroviral, with poor results and worrying results; In addition, rare scientific studies describe the quality of life in this population. This study focused on evaluating adherence to antiretroviral therapy, identified predictors for adherence, assessed quality of life, identified predictors for quality of life and explored the association between adherence and quality of life in a population of transgender women living with HIV/AIDS. We interviewed 106 transgender women treated at the outpatient clinic of the HIV / AIDS referral center in São Paulo about their adherence to antiretroviral, using a self-reported tool developed by Terry Beirn\'s group Community Programs for Clinical Research on AIDS and about quality of life using Patient Report Outcomes Quality of Life - HIV (PROQOL-HIV) questionnaire. We also used viral suppression as an indicator of adherence. Prior to the study, ethical clearance was obtained from a Health Research Ethics Committee and informed consent obtained from the study participants. Results formed part of adherence assessment. Data was analyzed using STATA 15.1, with x-square, Wilcoxon test, Spearman test and logistical regression analysis was performed. The sample declared 90% adherence to treatment in self-report, was created a new variable to measure adherence considering viral suppression and self-report, the results decrease to 78% of participants adherent; statistical analyses showed that younger transgender women have more chances to report low adherence. Most participants reported well to excellent quality of life, and lower schooling, depression, and illicit drug use were predictors for a worse quality of life score. We did not observe a statistically significant correlation between quality of life and adherence. Our study suggests good results from the service model adopted at the recruiting center. Multicentric studies with a larger number of participants and considering service units located in remote and less favored regions are necessary to express the real situation of adherence to antiretroviral and quality of life of transgender women.
Almendariz, Sergio E
Her Name Was is an examination of the oppression of transgender people in a society that is built on the nominalization of cisgender people, those who gender matchers their sex assigned at birth, and how this oppression lends itself to violence. In the summer of 2015, the body of Shade Schuler, an African American transgender woman, was found in a field outside of Dallas, Texas. Ms. Shade is part of an alarming epidemic of escalating levels of targeted violence against the transgender community. This documentary pulls back the curtain as it captures the feelings and struggles of the transgender community as they attempt to navigate and survive in a cis dominating society.
Personalized Cognitive Counseling Reduces Drinking Expectancy Among Men Who Have Sex with Men and Transgender Women in Lima, Peru: A Pilot Randomized Controlled TrialPassaro, R. Colby, Chávez-Gomez, Susan, Castañeda-Huaripata, Angelica, Gonzales-Saavedra, Williams, Beymer, Matthew R., Segura, Eddy R., Nanclares, Francisco, Dilley, James, Cabello, Robinson, Clark, Jesse L. 01 November 2020 (has links)
Personalized cognitive counseling (PCC) is an evidence-based intervention designed to modify HIV-related risk behavior. We assessed the impact of PCC on sexual behavior, drinking expectancy, and incidence of sexually transmitted infections (STIs) in a 6-month randomized controlled trial among 153 HIV-uninfected men who have sex with men (MSM) and transgender women (TW) in Peru. Study retention was ≥ 90%, with three HIV infections (3 Control) and 19 cases of GC/CT (10 Control, 9 PCC) at 6 months. There was a decline in condomless receptive anal intercourse in the Control (0.74, 95% CI 0.60-0.91; p < 0.01) and PCC arms (0.72, 0.55-0.94; p = 0.02) at 6-month follow-up. There was a decrease in drinking expectancy at 6 months among participants endorsing alcohol use in the PCC arm (0.89, 0.83-0.96; p < 0.01), versus no change in the Control arm (0.98, 0.92-1.04; p = 0.54). PCC was efficacious in reducing drinking expectancy and HIV risk among MSM and TW in Peru. / National Institutes of Health / Revisión por pares
Hines, Dana Darnell
23 June 2015
Indiana University-Purdue University Indianapolis (IUPUI) / Transgender women have the highest HIV prevalence rates of all gender and sexual minorities, yet are less likely to enter and be retained in HIV care. As a result, they are at high risk for HIV-related morbidity and mortality. This study aimed to describe the illness career of transgender women living with HIV and to describe how interactions with health care providers and important others influenced their illness trajectory. The findings are a theoretical model that includes four stages: Having the world come crashing down, shutting out the world, living in a dark world, and reconstructing the world. Relationships within the social network (family, friends, and romantic partners) and the network of health care providers provided the context of the women's illness careers. Pivotal moments marked movement from one phase to the next. Having the World Crashing Down was the first stage that occurred when the participants were diagnosed with HIV. They felt that their lives as they knew them had been destroyed. They indicated that the "whole world just shattered" the moment they found out they had HIV. Shutting Out the World occurred next. During this stage, many participants experienced withdrawal, denial, social isolation and loneliness. As they struggled with their diagnosis, they often avoided HIV care and avoided contact with important others. During the third stage, Living in a Dark World, participants descended into a dark phase of self-destructive life and health-threatening behaviors following their diagnosis. During the fourth stage, Reconstructing the World, participants began to reestablish themselves in the world and found new ways to reengage with important others and resume meaningful life activities. Findings confirm that the illness careers of HIV-positive transgender women are influenced by the social context of the health care setting and interactions with health care providers and important others.
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