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Palamenghi A, Franceschetti L, Tambuzzi S, D'Apuzzo A, Mazzarelli D, Cattaneo C. Transcending time: the forensic anthropological case study of three unidentified transgender women in Italy in the early 1990s. Int J Legal Med 2024; 138:1079-1084. [PMID: 37966516 PMCID: PMC11003900 DOI: 10.1007/s00414-023-03122-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/05/2023] [Indexed: 11/16/2023]
Abstract
In forensic anthropology, the estimation of skeletal sex results in a dichotomous outcome: male or female. This poses challenges when dealing with transgender individuals. Italy has the highest rate per capita of transgender murders, making their identification a compelling issue. This study presents three cases of unidentified skeletal remains of transgender women (MtF) that underwent autopsies in the 1990s at the Institute of Legal Medicine of Milan. The transgender status of the individuals was determined from the autopsy records which indicated the co-existence of breast implants and male genitalia. The biological profile was created by estimating sex, age, ancestry, and stature, and the bones were investigated looking for evidence of Facial Feminization Surgery (FFS). Anthropological estimations revealed that the skeletons belong to male, adults, European individuals, between 164 and 184 cm. Fragmented gelatinous masses were found in association with two skeletons, which were interpreted as remnants of breast implants. In two cases, signs of remodeling of the cortical surface were observed on the zygomatic bones, although the bone marks observed here were not specific enough to link them to FFS. Despite some limitations, this study highlights the need for greater awareness among practitioners about this limitedly addressed issue, advocating for a more inclusive forensic anthropology that strives to improve methods and interpretation of evidence for the identification of transgender individuals.
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Affiliation(s)
- Andrea Palamenghi
- LABANOF, Laboratorio Di Antropologia E Odontologia ForenseSezione Di Medicina Legale, Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Via Luigi Mangiagalli 37, 20133, Milan, Italy
| | - Lorenzo Franceschetti
- LABANOF, Laboratorio Di Antropologia E Odontologia ForenseSezione Di Medicina Legale, Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Via Luigi Mangiagalli 37, 20133, Milan, Italy.
| | - Stefano Tambuzzi
- LABANOF, Laboratorio Di Antropologia E Odontologia ForenseSezione Di Medicina Legale, Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Via Luigi Mangiagalli 37, 20133, Milan, Italy
| | - Annalisa D'Apuzzo
- LABANOF, Laboratorio Di Antropologia E Odontologia ForenseSezione Di Medicina Legale, Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Via Luigi Mangiagalli 37, 20133, Milan, Italy
| | - Debora Mazzarelli
- LABANOF, Laboratorio Di Antropologia E Odontologia ForenseSezione Di Medicina Legale, Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Via Luigi Mangiagalli 37, 20133, Milan, Italy
| | - Cristina Cattaneo
- LABANOF, Laboratorio Di Antropologia E Odontologia ForenseSezione Di Medicina Legale, Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Via Luigi Mangiagalli 37, 20133, Milan, Italy
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Alessi EJ, Cheung S, Kahn S, Yu M. A Scoping Review of the Experiences of Violence and Abuse Among Sexual and Gender Minority Migrants Across the Migration Trajectory. TRAUMA, VIOLENCE & ABUSE 2021; 22:1339-1355. [PMID: 34812109 DOI: 10.1177/15248380211043892] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Violence against sexual and gender minority (SGM) individuals has continued to proliferate globally. Yet, less is known about victimization among subgroups of SGM individuals, especially SGM immigrants, refugees, and asylum seekers. There has been a steady increase in this vulnerable group of migrants over the years, and emerging evidence has pointed to their heightened risk of victimization. We conducted a scoping review of the peer-reviewed literature that examined violence, abuse, and mental health among SGM individuals who migrate internationally. One hundred ninety-nine articles were identified by searching five scholarly databases and hand searching. Twenty-six articles met inclusion criteria. We first used the migration framework, which outlines the distinct phases of the migration trajectory (predeparture, travel, interception, destination, and return), to categorize findings and then identified four overarching themes to capture SGM migrants' experiences at each phase: severe and prolonged violence and abuse related to sexual orientation or gender identity (predeparture); continued victimization and high-risk for sexual violence (travel); detainment- and deportation-related violence and abuse (interception and return); and new manifestations of violence and abuse while living with past trauma (destination). Violence and abuse began in childhood and continued in the host country, where they faced discrimination while managing posttraumatic stress disorder and depression. Findings indicate that SGM migrants are extremely vulnerable to victimization. There is an immediate need for policies to protect SGM individuals worldwide and for affirmative, culturally informed practices to help SGM migrants manage trauma and the structural barriers impeding recovery.
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Affiliation(s)
| | | | | | - Melanie Yu
- Rutgers University, New Brunswick, NJ, USA
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Scandurra C, Carbone A, Baiocco R, Mezzalira S, Maldonato NM, Bochicchio V. Gender Identity Milestones, Minority Stress and Mental Health in Three Generational Cohorts of Italian Binary and Nonbinary Transgender People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9057. [PMID: 34501646 PMCID: PMC8430636 DOI: 10.3390/ijerph18179057] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/21/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022]
Abstract
Transgender and gender nonconforming (TGNC) people experience high rates of minority stress and associated risk for negative health outcomes. However, during the last years, significant positive socio-cultural changes have happened, and younger cohorts of TGNC individuals are having diverse experiences compared to older cohorts. By integrating the minority stress theory and the life course perspective, this cross-sectional, web-based study aimed to explore in 197 Italian TGNC people aged 18 to 54 years (M = 29.82, SD = 9.64) whether the average ages of gender identity milestones (i.e., first insights about being TGNC, self-labeling as a TGNC person, and coming out), minority stress, and mental health vary among three generational cohorts (i.e., Generation Z, Millennials, and Generation X). Compared with older cohorts, younger participants: (a) were more likely to be in the trans-masculine spectrum; (b) self-labeled as TGNC and came out earlier; (c) had more negative expectations and lower levels of disclosure; and (d) had higher levels of mental health problems. No generational differences related to first insights about being TGNC and distal minority stressors were found. Furthermore, compared with binary individuals, participants with a non-binary identity: (a) reported later ages for the gender identity milestones; (b) had higher negative expectations; and (c) had higher levels of mental health problems. Overall, our findings indicated that changes in the social environments have a limited impact on stigmatization processes and mental health of Italian TGNC people.
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Affiliation(s)
- Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy;
| | - Agostino Carbone
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (R.B.)
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (R.B.)
| | - Selene Mezzalira
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, 35139 Padova, Italy;
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy;
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, 87036 Cosenza, Italy;
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Mendes WG, Silva CMFPD. Homicide of Lesbians, Gays, Bisexuals, Travestis, Transexuals, and Transgender people (LGBT) in Brazil: a Spatial Analysis. CIENCIA & SAUDE COLETIVA 2020; 25:1709-1722. [PMID: 32402041 DOI: 10.1590/1413-81232020255.33672019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/07/2019] [Indexed: 11/22/2022] Open
Abstract
Violence against LGBT people has always been present in our society. Brazil is the country with the highest number of lethal crimes against LGBT people in the world. The aim of this study was to describe the characteristics of homicides of LGBT people in Brazil using spatial analysis. The LGBT homicide rate was used to facilitate the visualization of the geographical distribution of homicides. Public thoroughfares and the victim's home were the most common places of occurrence. The most commonly used methods for killing male homosexuals and transgender people were cold weapons and firearms, respectively; however, homicides frequently involved beatings, suffocation, and other cruelties. The large majority of victims were aged between 20 and 49 years and typically white or brown. The North, Northeast and Central-West regions, precisely the regions with the lowest HDI, presented LGBT homicide rates above the national rate. LGBT homicides are typically hate crimes and constitute a serious public health problem because they affect young people, particularly transgender people. This problem needs to be addressed by the government, starting with the criminalization of homophobia and the subsequent formulation of public policies to reduce hate crimes and promote respect for diversity.
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Affiliation(s)
- Wallace Góes Mendes
- Programa de Pós-Graduação em Epidemiologia em Saúde Pública, Escola Nacional de Saúde Pública Sérgio Arouca, Fiocruz, Rio de Janeiro, RJ, Brazil,
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Abstract
Bisexual people are a strongly stigmatized population experiencing health disparities caused by social stigmatization. The predominant framework helping to understand these health disparities and the impact of stigma on mental health of social groups belonging to a sexual minority identity constitutes the minority stress theory. In Italy, studies assessing this model in bisexual populations are very limited. Within this framework, the current study aimed at assessing in 381 Italian bisexual individuals (62 men and 319 women) the effects of anti-bisexual discrimination, proximal stressors (i.e., anticipated binegativity, internalized binegativity, and outness), and resilience on psychological distress. The results suggested that only anti-bisexual discrimination and internalized binegativity were positively associated with psychological distress, and that resilience was negatively associated with mental health issues. Furthermore, the results suggested that internalized binegativity mediated the relationship between anti-bisexual discrimination and mental health problems. No moderating effect of resilience was found. This is the first study to have thoroughly applied minority stress in Italian bisexual people, providing Italian clinicians and researchers with an outline of the associations between minority stress, stigma, resilience, and psychological distress within this population.
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Scandurra C, Dolce P, Vitelli R, Esposito G, Testa RJ, Balsam KF, Bochicchio V. Mentalizing stigma: Reflective functioning as a protective factor against depression and anxiety in transgender and gender-nonconforming people. J Clin Psychol 2020; 76:1613-1630. [PMID: 32222104 DOI: 10.1002/jclp.22951] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The current study examined the role of internalized transphobia (IT) as a mediator between gender-related rejection and mental health, and reflective functioning (or mentalization) as a resilience factor moderating the relationship between both rejection and IT with mental health. METHOD This online study included 203 Italian transgender and gender-nonconforming (TGNC) individuals ranged in age from 18 to 66 years old (M = 30.70; standard deviation = 10.79). Moderated-mediation analysis was performed using a structural equation modeling approach. RESULTS Both rejection and IT were positively associated with mental health, and IT mediated the relationship between rejection and mental health. Mentalization moderated the relationship between rejection and IT with mental health. The indirect effect of rejection on mental health through IT was moderated by mentalization. CONCLUSIONS Findings highlight psychological paths that may inform individual- and group-level mentalization-based interventions to reduce minority stress in TGNC individuals.
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Affiliation(s)
- Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
| | - Pasquale Dolce
- Department of Public Health, University of Naples Federico II, Napoli, Italy
| | - Roberto Vitelli
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
| | - Giovanna Esposito
- Department of Humanistic Studies, University of Naples Federico II, Napoli, Italy
| | - Rylan J Testa
- Center for LGBTQ Evidence-Based Applied Research (CLEAR), Palo Alto University, El Cerrito, California
| | - Kimberly F Balsam
- Department of Psychology, Center for LGBTQ Evidence-Based Applied Research (CLEAR), Palo Alto University, Palo Alto, California
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Anzani A, De Panfilis C, Scandurra C, Prunas A. Personality Disorders and Personality Profiles in a Sample of Transgender Individuals Requesting Gender-Affirming Treatments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1521. [PMID: 32120872 PMCID: PMC7084367 DOI: 10.3390/ijerph17051521] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 11/16/2022]
Abstract
The study aims to explore the personality patterns of a group of transgender individuals who accessed an Italian gender clinic to undergo gender affirming treatments, by evaluating both dimensional personality domains proposed by the Alternative Model of Personality Disorders and categorical DSM-IV personality disorder (PD) diagnoses. Eighty-seven participants (40 transgender women and 47 transgender men) completed the Personality Inventory for DSM-5 and the Structured Clinical Interview for DSM-IV Axis II personality disorders. Scores obtained were compared to those of the normative samples of cisgender women and men. Results indicated that transgender women scored lower than cisgender women on two main domains (Negative Affectivity and Psychoticism) and on seven facets. As for transgender men, lower scores than cisgender men were found on Antagonism and on five facets. Transgender men scored higher than cisgender men on Depressivity. Nearly 50% of participants showed at least one PD diagnosis, with no gender differences in prevalence. Borderline PD was the most frequent diagnosis in the overall sample. Self-report measures provide a less maladaptive profile of personality functioning than the clinician-based categorical assessment. Results are interpreted in the light of the Minority Stress Model and support the need for a multi-method assessment of personality in medicalized transgender people.
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Affiliation(s)
- Annalisa Anzani
- Department of Psychology, University of Milano–Bicocca, 20126 Milan, Italy;
- CREST, Centro per lo studio e la terapia dei disturbi di personalità, 20145 Milan, Italy
| | - Chiara De Panfilis
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy;
| | - Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy;
| | - Antonio Prunas
- Department of Psychology, University of Milano–Bicocca, 20126 Milan, Italy;
- CREST, Centro per lo studio e la terapia dei disturbi di personalità, 20145 Milan, Italy
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8
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Scandurra C, Vitelli R, Maldonato N, Valerio P, Bochicchio V. A qualitative study on minority stress subjectively experienced by transgender and gender nonconforming people in Italy. SEXOLOGIES 2019. [DOI: 10.1016/j.sexol.2019.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Worthen MGF, Tanzilli A, Caristo C, Lingiardi V. Social Contact, Social Distancing, and Attitudes Toward LGT Individuals: A Cross-Cultural Study of College Students in the United States, Italy, and Spain. JOURNAL OF HOMOSEXUALITY 2018; 66:1882-1908. [PMID: 30346910 DOI: 10.1080/00918369.2018.1519302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
More than any other time in modern history, today people are significantly more likely to know (or be) lesbian, gay, and transgender (LGT) people; however, prejudices directed toward these groups remain. In the current study, we explore how social contact and social distancing/desired social contact are related to LGT prejudices using Worthen's (2012) Attitudes Toward LGT People Scales and data from four heterosexual college student samples in Oklahoma, Texas, Italy, and Spain (N = 1,217). In doing so, we provide the first-ever study to explore Allport's (1954) contact hypothesis as it relates to transgender prejudices in Italy and Spain and the first study to examine desired social contact/social distancing and transgender prejudice in the U.S., Italy, and Spain. Our findings demonstrate that measures of desired social contact are strongly related to cross-cultural LGT attitudes, while simple measures of contact (i.e., knowing an LGT person) are significantly less robust.
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Affiliation(s)
| | - Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome , Rome , Italy
| | - Chiara Caristo
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome , Rome , Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome , Rome , Italy
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Prunas A, Bandini E, Fisher AD, Maggi M, Pace V, Quagliarella L, Todarello O, Bini M. Experiences of Discrimination, Harassment, and Violence in a Sample of Italian Transsexuals Who Have Undergone Sex-Reassignment Surgery. JOURNAL OF INTERPERSONAL VIOLENCE 2018; 33:2225-2240. [PMID: 26763285 DOI: 10.1177/0886260515624233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The present study aims to provide an overview of experiences of discrimination, harassment, and violence in a sample of Italian transsexuals who have undergone sex-reassignment surgery (SRS). Lack of support for gender transition from family members was also assessed, before and after SRS. Data were collected in the context of a multicentric study (Milan, Florence, and Bari) on SRS outcome. Patients who underwent SRS were contacted and asked to fill out a questionnaire concerning experiences of discrimination, harassment, violence, and crime they might have experienced in previous years. Seventy-two participants took part in the research: 46 were male-to-female (MtF; 64%) and 26 were female-to-male (FtM; 36%). Thirty-six percent of the total sample (with no differences between MtF and FtM) experienced at least one episode of harassment, violence, or discrimination. The workplace was reported to be the social area with the highest risk of discrimination and harassment (22% of participants). Reports of more than one incident of discrimination, harassment, and violence characterized the majority of participants in the MtF sample. Compared with previous studies carried out in other countries, a much larger proportion of participants could count on a supportive family environment before and after transition. Our results show that Italian society at large is prejudiced against transsexuals, but at a more "micro" level, having a trans person as a family member might result in a protective and tolerant attitude.
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Affiliation(s)
- Antonio Prunas
- 1 University of Milano-Bicocca, Italy
- 2 Associazione Italiana Sessuologia e Psicologia Applicata, Milan, Italy
- 3 Ospedale Niguarda-Ca' Granda, Milano, Italy
| | | | | | - Mario Maggi
- 4 Careggi University Hospital, Florence, Italy
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Anzani A, Di Sarno M, Sacchi S, Prunas A. Maladaptive personality traits, defense mechanisms, and trans-negative attitudes. INT J TRANSGENDERISM 2018. [DOI: 10.1080/15532739.2018.1478759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Annalisa Anzani
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Marco Di Sarno
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Simona Sacchi
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Antonio Prunas
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
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12
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Vitelli R, Scandurra C, Pacifico R, Selvino M, Picariello S, Amodeo A, Valerio P, Giami A. Trans identities and medical practice in Italy: Self-positioning towards gender affirmation surgery. SEXOLOGIES 2017. [DOI: 10.1016/j.sexol.2017.08.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Vitelli R, Scandurra C, Pacifico R, Selvino M, Picariello S, Amodeo A, Valerio P, Giami A. Identifications de genre trans et pratiques médicales en Italie : positionnement personnel envers les formes de chirurgie de confirmation de genre. SEXOLOGIES 2017. [DOI: 10.1016/j.sexol.2017.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Amodeo AL, Picariello S, Valerio P, Scandurra C. Empowering transgender youths: Promoting resilience through a group training program. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2017. [DOI: 10.1080/19359705.2017.1361880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Anna Lisa Amodeo
- Department of Humanistic Studies, University of Naples Federico II, Napoli, Italy
| | | | - Paolo Valerio
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Napoli, Italy
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Dinno A. Homicide Rates of Transgender Individuals in the United States: 2010-2014. Am J Public Health 2017; 107:1441-1447. [PMID: 28727530 PMCID: PMC5551594 DOI: 10.2105/ajph.2017.303878] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To estimate homicide rates of transgender US residents and relative risks (RRs) of homicide with respect to cisgender comparators intersected with age, gender, and race/ethnicity. METHODS I estimated homicide rates for transgender residents and transfeminine, Black, Latin@, and young (aged 15-34 years) subpopulations during the period 2010 to 2014 using Transgender Day of Remembrance and National Coalition of Anti-Violence Programs transgender homicide data. I used estimated transgender prevalences to estimate RRs using cisgender comparators. I performed a sensitivity analysis to situate all results within assumptions about underreporting of transgender homicides and assumptions about the prevalence of transgender residents. RESULTS The overall homicide rate of transgender individuals was likely to be less than that of cisgender individuals, with 8 of 12 RR estimates below 1.0. However, the homicide rates of young transfeminine Black and Latina residents were almost certainly higher than were those of cisfeminine comparators, with all RR estimates above 1.0 for Blacks and all above 1.0 for Latinas. CONCLUSIONS Antiviolence public health programs should identify young and Black or Latina transfeminine women as an especially vulnerable population.
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Affiliation(s)
- Alexis Dinno
- At the time of the study, Alexis Dinno was with the Oregon Health and Science University-Portland State University School of Public Health, Portland, OR
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Reisner SL, Poteat T, Keatley J, Cabral M, Mothopeng T, Dunham E, Holland CE, Max R, Baral SD. Global health burden and needs of transgender populations: a review. Lancet 2016; 388:412-436. [PMID: 27323919 PMCID: PMC7035595 DOI: 10.1016/s0140-6736(16)00684-x] [Citation(s) in RCA: 758] [Impact Index Per Article: 94.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Transgender people are a diverse population affected by a range of negative health indicators across high-income, middle-income, and low-income settings. Studies consistently document a high prevalence of adverse health outcomes in this population, including HIV and other sexually transmitted infections, mental health distress, and substance use and abuse. However, many other health areas remain understudied, population-based representative samples and longitudinal studies are few, and routine surveillance efforts for transgender population health are scarce. The absence of survey items with which to identify transgender respondents in general surveys often restricts the availability of data with which to estimate the magnitude of health inequities and characterise the population-level health of transgender people globally. Despite the limitations, there are sufficient data highlighting the unique biological, behavioural, social, and structural contextual factors surrounding health risks and resiliencies for transgender people. To mitigate these risks and foster resilience, a comprehensive approach is needed that includes gender affirmation as a public health framework, improved health systems and access to health care informed by high quality data, and effective partnerships with local transgender communities to ensure responsiveness of and cultural specificity in programming. Consideration of transgender health underscores the need to explicitly consider sex and gender pathways in epidemiological research and public health surveillance more broadly.
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Affiliation(s)
- Sari L Reisner
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Fenway Institute, Fenway Health, Boston, MA, USA.
| | - Tonia Poteat
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - JoAnne Keatley
- Center of Excellence for Transgender Health, University of California San Francisco, San Francisco, CA, USA
| | - Mauro Cabral
- Global Action for Trans* Equality, Buenos Aires, Argentina and New York, NY, USA
| | | | - Emilia Dunham
- Fenway Institute, Fenway Health, Boston, MA, USA; Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Claire E Holland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ryan Max
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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