The Transgender Military Experience: Their Battle for Workplace Rights

Although there have been studies that focus on the experiences of the gay and lesbian population serving in the United States military, few have focused on the experience of active duty transgender service members. Transgender individuals transgress the binary conception of gender by deviating from societal gender norms associated with assigned sex at birth. The Department of Defense has set policies and standards that reflect a binary conception of gender, with a focus on conformity. We argue that able-bodied gender variant service personnel are just as capable of serving their country as anyone else. Because of the repercussions associated with active duty transgender military personnel, our sample is small and involves nine clandestine service members and two international service members who wanted to share their stories from a different perspective. Snowball sampling was aimed at finding current active duty and reserve transgender service members. Using a combination of telephone interviews and questionnaires, data were collected from active duty transgender service personnel throughout the United States and two from international militaries that allow transgender people to serve. Data collection focused on the overall experiences of the participants along with questions regarding workplace discrimination, suggestions for policy changes, and their views about the overturn of Don’t Ask, Don’t Tell. Our findings add to a growing source of information about the transgender military experience in the U.S. armed forces and the importance of overturning discriminatory workplace policies that negatively impact transgender service members

Characteristics of a cohort of high-risk men who have sex with men on pre-exposure prophylaxis reporting transgender sexual partners.

Transgender people continue to be at high-risk for HIV acquisition, but little is known about the characteristics of their sexual partners. To address this gap, we examined sociodemographic and sexual characteristics of cisgender men who have sex with men (MSM) on pre-exposure prophylaxis (PrEP) reporting transgender sexual partners.A cohort of 392 MSM in southern California in a randomized clinical trial for PrEP adherence were followed from 2013 to 2016. Multivariable generalized estimating equation and logistic models identified characteristics of MSM reporting transgender sexual partners and PrEP adherence.Only 14 (4%) MSM reported having transgender sexual partners. MSM were more likely to report transgender partners if they were African American, had incident chlamydia, reported injection drug-using sexual partners, or received items for sex. Most associations remained significant in the multivariable model: African American (adjusted odds ratio [AOR] 11.20, P = .01), incident chlamydia (AOR 3.71, P = .04), and receiving items for sex (AOR 5.29, P = .04). There were no significant differences in PrEP adherence between MSM reporting transgender partners and their counterpart.MSM who report transgender sexual partners share characteristics associated with individuals with high HIV prevalence. Identifying this group distinct from larger cohorts of MSM could offer new HIV prevention opportunities for this group of MSM and the transgender community

Transgender Healthcare Teaching in the Undergraduate Medical School Curriculum

With increasing recognition of the diverse and specific needs of transgender individuals in a health care setting, lack of knowledge, poor attitudes and prejudice towards transgender patients can result in this population being afraid to access medical care. Educating medical students early in their career in a sensitive and inclusive manner could help change these attitudes. It has been shown that medical undergraduates and post-graduates often feel unprepared or uncomfortable in caring for transgender patients due to lack of training and experience2-4. The aim of this study was to address this through introduction of basic transgender healthcare education into the University of Glasgow undergraduate medical curriculum, with the goal of implementing further interactive and fully inclusive teaching

HIV transmission networks among transgender women in Los Angeles County, CA, USA: a phylogenetic analysis of surveillance data.

BackgroundTransgender women are among the groups at highest risk for HIV infection, with a prevalence of 27·7% in the USA; and despite this known high risk, undiagnosed infection is common in this population. We set out to identify transgender women and their partners in a molecular transmission network to prioritise public health activities.MethodsSince 2006, HIV protease and reverse transcriptase gene (pol) sequences from drug resistance testing have been reported to the Los Angeles County Department of Public Health and linked to demographic data, gender, and HIV transmission risk factor data for each case in the enhanced HIV/AIDS Reporting System. We reconstructed a molecular transmission network by use of HIV-TRAnsmission Cluster Engine (with a pairwise genetic distance threshold of 0·015 substitutions per site) from the earliest pol sequences from 22 398 unique individuals, including 412 (2%) self-identified transgender women. We examined the possible predictors of clustering with multivariate logistic regression. We characterised the genetically linked partners of transgender women and calculated assortativity (the tendency for people to link to other people with the same attributes) for each transmission risk group.Findings8133 (36·3%) of 22 398 individuals clustered in the network across 1722 molecular transmission clusters. Transgender women who indicated a sexual risk factor clustered at the highest frequency in the network, with 147 (43%) of 345 being linked to at least one other person (adjusted odds ratio [aOR] 2·0, p=0·0002). Transgender women were assortative in the network (assortativity 0·06, p<0·001), indicating that they tended to link to other transgender women. Transgender women were more likely than expected to link to other transgender women (OR 4·65, p<0·001) and cisgender men who did not identify as men who have sex with men (MSM; OR 1·53, p<0·001). Transgender women were less likely than expected to link to MSM (OR 0·75, p<0·001), despite the high prevalence of HIV among MSM. Transgender women were distributed across 126 clusters, and cisgender individuals linked to one transgender woman were 9·2 times more likely to link to a second transgender woman than other individuals in the surveillance database. Reconstruction of the transmission network is limited by sample availability, but sequences were available for more than 40% of diagnoses.InterpretationClustering of transgender women and the observed tendency for linkage with cisgender men who did not identify as MSM, shows the potential to use molecular epidemiology both to identify clusters that are likely to include undiagnosed transgender women with HIV and to improve the targeting of public health prevention and treatment services to transgender women.FundingCalifornia HIV and AIDS Research Program and National Institutes of Health-National Institute of Allergy and Infectious Diseases

Transgender Need Not Apply: A Report on Gender Identity Job Discrimination

Make the Road New York investigated possible employment discrimination against transgender job-seekers in Manhattan's retail sector using the research tool of matched pair testing. We sent out carefully matched pairs of job applicants, one transgender and one not, to apply for the same jobs. Each pair was equivalent in age and ethnicity and equipped with fictionalized resumes that were evenly matched. Both testing pairs underwent extensive training on how to adopt similar interview styles and how to document their job-seeking interactions objectively. Transgender testers were instructed to explicitly inform store managers and interviewers of their transgender status whenever feasible.Our research revealed an astonishingly high degree of employment discrimination against our transgender job applicants

A structural magnetic resonance imaging study in transgender persons on cross-sex hormone therapy

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; To date, research findings are inconsistent about whether the neuroanatomy in transgender persons resembles that of their natal sex or their gender identity. Moreover, few studies have examined the effects of long-term cross-sex hormonal treatment on neuroanatomy in this cohort. The purpose of the present study was to examine neuroanatomical differences in transgender persons after prolonged cross-sex hormone therapy. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Eighteen transgender men (female-to-male), 17 transgender women (male-to-female), 30 nontransgender men (natal men), and 27 nontransgender women (natal women) completed a high-resolution structural magnetic resonance imaging scan at 3 T. Eligibility criteria for transgender persons were gender-affirming surgery and at least 2 years of cross-sex hormone therapy. Exclusion criteria for nontransgender persons were presence of psychiatric or neurological disorders. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The mean neuroanatomical volume for the amygdala, putamen, and corpus callosum differed between transgender women and natal women but not between transgender women and natal men. Differences between transgender men and natal men were found in several brain structures, including the medial temporal lobe structures and cerebellum. Differences between transgender men and natal women were found in the medial temporal lobe, nucleus accumbens, and 3rd ventricle. Sexual dimorphism between nontransgender men and women included larger cerebellar volumes and a smaller anterior corpus callosum in natal men than in natal women. The results remained stable after correcting for additional factors including age, total intracranial volume, anxiety, and depressive symptoms. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; Neuroanatomical differences were region specific between transgender persons and their natal sex as well as their gender identity, raising the possibility of a localized influence of sex hormones on neuroanatomy.</jats:p

Characterizing Transgender Health Issues in Twitter

Although there are millions of transgender people in the world, a lack of information exists about their health issues. This issue has consequences for the medical field, which only has a nascent understanding of how to identify and meet this population's health-related needs. Social media sites like Twitter provide new opportunities for transgender people to overcome these barriers by sharing their personal health experiences. Our research employs a computational framework to collect tweets from self-identified transgender users, detect those that are health-related, and identify their information needs. This framework is significant because it provides a macro-scale perspective on an issue that lacks investigation at national or demographic levels. Our findings identified 54 distinct health-related topics that we grouped into 7 broader categories. Further, we found both linguistic and topical differences in the health-related information shared by transgender men (TM) as com-pared to transgender women (TW). These findings can help inform medical and policy-based strategies for health interventions within transgender communities. Also, our proposed approach can inform the development of computational strategies to identify the health-related information needs of other marginalized populations

Transgender Need Not Apply: A Report on Gender Identity Job Discrimination

[Excerpt] Make the Road New York investigated possible employment discrimination against transgender job-seekers in Manhattan’s retail sector using the research tool of matched pair testing. We sent out carefully matched pairs of job applicants, one transgender and one not, to apply for the same jobs. Each pair was equivalent in age and ethnicity and equipped with fictionalized resumes that were evenly matched. Both testing pairs underwent extensive training on how to adopt similar interview styles and how to document their job-seeking interactions objectively. Transgender testers were instructed to explicitly inform store managers and interviewers of their transgender status whenever feasible

Trans Women in Incarceration: Housing, Healthcare, and Humanity

This paper seeks to analyze the experience of male-to-female transgender inmates housed in men’s prisons and to propose housing and healthcare policies with humanity and safety for all in mind. To do this, the paper examines gender dysphoria and its treatments, transgender prisoners’ increased risk of victimization, current housing placement policies, and lastly, transgender prison healthcare practices. Ultimately, this paper proposes the use of fair and adequately trained panel-based placement teams, the provision of comprehensive mental and physical health care and the establishment of impartial grievance procedures