دورية أكاديمية
Variation in Time-to-Gender-Affirming Hormone Therapy in US Active Duty Service Members.
العنوان: | Variation in Time-to-Gender-Affirming Hormone Therapy in US Active Duty Service Members. |
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المؤلفون: | Klein DA; Department of Family Medicine, Uniformed Services University, Bethesda, MD.; Department of Pediatrics, Uniformed Services University, Bethesda, MD.; Department of Family Medicine, David Grant Medical Center, Travis Air Force Base, CA., Gonzalez XB; Department of Family Medicine, David Grant Medical Center, Travis Air Force Base, CA., Highland KB; Department of Anesthesiology, Uniformed Services University, Bethesda, MD., Thornton JA; Clinical Investigations, David Grant Medical Center, Travis Air Force Base, CA.; Ripple Effect, Rockville, MD., Sunderland KW; Clinical Investigations, David Grant Medical Center, Travis Air Force Base, CA.; Ripple Effect, Rockville, MD., Funk W; Kennell and Associates, Falls Church, VA., Pav V; Kennell and Associates, Falls Church, VA.; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD., Brydum R; Kennell and Associates, Falls Church, VA., Schvey NA; Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD., Roberts CM; Department of Pediatrics, Mount Sinai Hospital, New York, NY. |
المصدر: | Medical care [Med Care] 2024 Jul 01; Vol. 62 (7), pp. 481-488. Date of Electronic Publication: 2024 May 16. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0230027 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-1948 (Electronic) Linking ISSN: 00257079 NLM ISO Abbreviation: Med Care Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: Philadelphia, etc., Lippincott. |
مواضيع طبية MeSH: | Military Personnel*/statistics & numerical data , Transgender Persons*/statistics & numerical data , Gender Dysphoria*/drug therapy, Humans ; Female ; Male ; Retrospective Studies ; United States ; Adult ; Young Adult ; Time-to-Treatment/statistics & numerical data ; Sex Reassignment Procedures/statistics & numerical data |
مستخلص: | Background: Beginning in July 2016, transgender service members in the US military were allowed to receive gender-affirming medical care, if so desired. Objective: This study aimed to evaluate variation in time-to-hormone therapy initiation in active duty Service members after the receipt of a diagnosis indicative of gender dysphoria in the Military Health System. Research Design: This retrospective cohort study included data from those enrolled in TRICARE Prime between July 2016 and December 2021 and extracted from the Military Health System Data Repository. Participants: A population-based sample of US Service members who had an encounter with a relevant International Classification of Diseases 9/10 diagnosis code. Measures: Time-to-gender-affirming hormone initiation after diagnosis receipt. Results: A total of 2439 Service members were included (M age 24 y; 62% white, 16% Black; 12% Latine; 65% Junior Enlisted; 37% Army, 29% Navy, 25% Air Force, 7% Marine Corps; 46% first recorded administrative assigned gender marker female). Overall, 41% and 52% initiated gender-affirming hormone therapy within 1 and 3 years of diagnosis, respectively. In the generalized additive model, time-to-gender-affirming hormone initiation was longer for Service members with a first administrative assigned gender marker of male relative to female ( P <0.001), and Asian and Pacific Islander ( P =0.02) and Black ( P =0.047) relative to white Service members. In time-varying interactions, junior enlisted members had longer time-to-initiation, relative to senior enlisted members and junior officers, until about 2-years postinitial diagnosis. Conclusion: The significant variation and documented inequities indicate that institutional data-driven policy modifications are needed to ensure timely access for those desiring care. Competing Interests: C.R. has previously received funding from Organon for contraception research (Organon investigator initiated grant program). She is no longer funded by Organon. The other authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
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تواريخ الأحداث: | Date Created: 20240518 Date Completed: 20240607 Latest Revision: 20240607 |
رمز التحديث: | 20240607 |
DOI: | 10.1097/MLR.0000000000002011 |
PMID: | 38761163 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1537-1948 |
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DOI: | 10.1097/MLR.0000000000002011 |