使用自我识别的性别身份数据在退伍军人卫生管理局的跨性别和性别多元退伍军人中推进健康平等
Guneet K Jasuja1,2,3, Mark S Zocchi1, Joel I Reisman1
1Center for Health Optimization and Implementation Research, VA Bedford Healthcare System, Bedford/Boston, MA.
Medical care
|September 26, 2025
概括
自认性别认同 (SIGI) 数据比单独的诊断更准确地识别了跨性别和性别多样性 (TGD) 的退伍军人. 虽然SIGI数据显示TGD退伍军人更健康,但诊断表明健康问题更高.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
背景情况:
- 传统的跨性别和性别多样性 (TGD) 个体的识别依赖于诊断和文本,而不是自我识别的性别认同 (SIGI).
- 退伍军人卫生管理局 (VHA) 在2017年实施了SIGI,用于精确识别TGD退伍军人,包括子组.
- 这使得人们能够超越有限的诊断代码来更细致地理解疾病.
研究的目的:
- 根据识别方法,比较TGD退伍军人的健康状况,健康的社会决定因素 (SDOH) 和医疗保健利用率.
- 使用SIGI数据分析TGD子组 (跨性别男性,跨性别女性,非二进制) 内的差异.
主要方法:
- 一项横截面研究分析了2019年至2023年期间20,079名TGD VHA患者的数据.
- 退伍军人被分为三个组:只有SIGI,SIGI和诊断/文本,以及诊断/文本 (没有SIGI).
- 关键措施包括健康状况,不良SDOH和医疗保健利用率.
主要成果:
- 与那些有诊断的退伍军人相比,SIGI确定的退伍军人只有较低的抑郁症,PTSD,住房不稳定,失业和心理健康访问率.
- 通过SIGI和诊断/文本识别的退伍军人和仅通过诊断/文本识别的退伍军人的健康状况更相似.
- 在拥有SIGI数据的退伍军人中,跨性别女性占49%,跨性别男性占38%,非二进制个人占14%.
- 与跨性别女性和男性相比,非二进制退伍军人有更高的酒精使用障碍,抑郁症,PTSD,心理健康访问和失业/财务问题记录率.
结论:
- SIGI数据可以识别TGD退伍军人,当仅考虑SIGI时,他们看起来更健康.
- 诊断的存在,无论SIGI如何,都与明显更高的健康问题相关.
- SIGI数据对于理解TGD退伍军人子组以及为VHA政策和实践提供信息至关重要.
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