Understanding Perceived Access and Receipt of Gender-affirming Treatments Among Transgender Veterans
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 986
- 试验地点
- 1
- 主要终点
- Receipt of Gender Affirming Treatment
研究概览
简要总结
Transgender Veterans (trans Vets) frequently experience gender dysphoria or distress related to discord between their gender identity and birth sex. Gender-affirming treatments (GATs) are medically necessary treatments to reduce gender dysphoria. However, not much is known about the barriers and facilitators that influence GAT access and receipt in VA and VA Community Care (CC), among trans Vets who desire GATs. The goals of this mixed-methods study are to determine which GATs trans Vets receive and in which setting, identify barriers and facilitators associated with desired GAT receipt in VA and CC, examine association of GAT receipt, specifically mental healthcare and hormone therapy, with mental health and suicide risk and understand trans Vet experiences related to receipt and desire for mental healthcare and hormone therapy in VA and CC.
详细描述
Background: Transgender people experience discord between their gender identity and birth sex, defined as gender dysphoria. Gender-affirming treatments (GATs) are medically necessary treatments to reduce gender dysphoria. However, among transgender Veterans (trans Vets) who desire GATs, not much is known about barriers and facilitators to accessing and receiving GATs in VA and VA Community Care (CC). To ensure effective and equitable GAT access for trans Vets, it is critical to understand: [1] GATs trans Vets receive and where they receive them, [2] barriers, including social determinants of health (SDOH) barriers that are highly prevalent among trans Vets, and facilitators associated with desired GAT receipt in VA and CC, [3] association of GAT receipt, specifically mental healthcare and hormone therapy with mental health and suicide risk , and [4] experiences related to receipt of mental healthcare and hormone therapy in VA and CC .
Significance: This study addresses the 2022 HSR&D priority areas of Access to Care, Health Equity/SDOH, MISSION Act, and research gap of underserved LGBTQ+ Veterans. It is also a high priority for our operational partners in VA LGBTQ+ Health Program, Pharmacy Benefits Management, Office of Integrated Veteran Care, and Office of Mental Health and Suicide Prevention. Knowledge gained from this study will ensure that GAT delivery in the VA is patient-centered and is responsive to the lived realities and needs of trans Vets.
Innovation and Impact: This study will be the first to characterize the GATs received in VA and/or CC to understand how VA and CC are balanced in terms of delivering GATs. This study will also provide novel data on trans Vet experiences related to GAT access in CC and on services and resources used by trans Vets to address barriers that influence GAT access.
Specific Aims: We propose a sequential explanatory mixed method study whose aims are to:
Aim 1. Characterize the GATs received by trans Vets in VA and/or CC (VA/CC) Aim 2. Identify barriers and facilitators associated with desired GAT receipt in VA and CC Aim 3a: Explore association of mental healthcare and hormone with mental health and suicide risk.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •All veterans with documentation of gender identity disorder diagnoses
- •Self-reported gender identity as transgender and relevant transgender-related health factor
排除标准
- 未提供
研究组 & 干预措施
Transgender and Gender Diverse Veterans
Veterans with documentation of either a gender identity disorder diagnoses, self-identified gender identity as transgender and gender diverse or transgender-related health factor.
结局指标
主要结局
Receipt of Gender Affirming Treatment
时间窗: About 3.5 months
Through a national survey, the investigators will identify receipt of gender-affirming treatment in VA and VA Community Care among transgender and gender diverse Veterans.
次要结局
未报告次要终点