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Lauckner C, Takenaka BP, Sesenu F, Brown JS, Kirklewski SJ, Nicholson E, Haney K, Adatorwovor R, Boyd DT, Fallin-Bennett K, Restar AJ, Kershaw T. Combined Motivational Interviewing and Ecological Momentary Intervention to Reduce Hazardous Alcohol Use Among Sexual Minority Cisgender Men and Transgender Individuals: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e55166. [PMID: 38578673 PMCID: PMC11031694 DOI: 10.2196/55166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Sexual minority cisgender men and transgender (SMMT) individuals, particularly emerging adults (aged 18-34 years), often report hazardous drinking. Given that alcohol use increases the likelihood of HIV risk behaviors, and HIV disproportionately affects SMMT individuals, there is a need to test interventions that reduce hazardous alcohol use and subsequent HIV risk behaviors among this population. Ecological momentary interventions (EMIs), which use mobile phones to deliver risk reduction messages based on current location and behaviors, can help to address triggers that lead to drinking in real time. OBJECTIVE This study will test an EMI that uses motivational interviewing (MI), smartphone surveys, mobile breathalyzers, and location tracking to provide real-time messaging that addresses triggers for drinking when SMMT individuals visit locations associated with hazardous alcohol use. In addition, the intervention will deliver harm reduction messaging if individuals report engaging in alcohol use. METHODS We will conduct a 3-arm randomized controlled trial (N=405 HIV-negative SMMT individuals; n=135, 33% per arm) comparing the following conditions: (1) Tracking and Reducing Alcohol Consumption (a smartphone-delivered 4-session MI intervention), (2) Tracking and Reducing Alcohol Consumption and Environmental Risk (an EMI combining MI with real-time messaging based on geographic locations that are triggers to drinking), and (3) a smartphone-based alcohol monitoring-only control group. Breathalyzer results and daily self-reports will be used to assess the primary and secondary outcomes of drinking days, drinks per drinking day, binge drinking episodes, and HIV risk behaviors. Additional assessments at baseline, 3 months, 6 months, and 9 months will evaluate exploratory long-term outcomes. RESULTS The study is part of a 5-year research project funded in August 2022 by the National Institute on Alcohol Abuse and Alcoholism. The first 1.5 years of the study will be dedicated to planning and development activities, including formative research, app design and testing, and message design and testing. The subsequent 3.5 years will see the study complete participant recruitment, data collection, analyses, report writing, and dissemination. We expect to complete all study data collection in or before January 2027. CONCLUSIONS This study will provide novel evidence about the relative efficacy of using a smartphone-delivered MI intervention and real-time messaging to address triggers for hazardous alcohol use and sexual risk behaviors. The EMI approach, which incorporates location-based preventive messaging and behavior surveys, may help to better understand the complexity of daily stressors among SMMT individuals and their impact on hazardous alcohol use and HIV risk behaviors. The tailoring of this intervention toward SMMT individuals helps to address their underrepresentation in existing alcohol use research and will be promising for informing where structural alcohol use prevention and treatment interventions are needed to support SMMT individuals. TRIAL REGISTRATION ClinicalTrials.gov NCT05576350; https://www.clinicaltrials.gov/study/NCT05576350. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/55166.
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Affiliation(s)
- Carolyn Lauckner
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Bryce Puesta Takenaka
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Fidelis Sesenu
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Jaime S Brown
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Sally J Kirklewski
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Erin Nicholson
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Kimberly Haney
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Reuben Adatorwovor
- Department of Biostatistics, University of Kentucky, Lexington, KY, United States
| | - Donte T Boyd
- College of Social Work, The Ohio State University, Columbus, OH, United States
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, United States
| | - Keisa Fallin-Bennett
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY, United States
| | - Arjee Javellana Restar
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
- Department of Epidemiology, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
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Restar AJ, Layland EK, Davis B, Thompson H, Streed C. The Public Health Crisis State of Transgender Health Care and Policy. Am J Public Health 2024; 114:161-163. [PMID: 38335490 PMCID: PMC10862226 DOI: 10.2105/ajph.2023.307523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 02/12/2024]
Affiliation(s)
- Arjee Javellana Restar
- Arjee Javellana Restar is with the departments of Epidemiology and Health Systems and Population Health, School of Public Health, University of Washington, Seattle, as well as the Department of Social and Behavioral Sciences, Yale University, New Haven, CT. Eric K. Layland is with the Department of Human Development and Family Sciences, University of Delaware, Newark. Bee Davis is with the Digital Forensics, Brown University, Providence, RI. Hale Thompson is with Howard Brown Health, Chicago, IL. Carl Streed Jr is with the Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, and the GenderCare Center, Boston Medical Center, Boston, MA
| | - Eric K Layland
- Arjee Javellana Restar is with the departments of Epidemiology and Health Systems and Population Health, School of Public Health, University of Washington, Seattle, as well as the Department of Social and Behavioral Sciences, Yale University, New Haven, CT. Eric K. Layland is with the Department of Human Development and Family Sciences, University of Delaware, Newark. Bee Davis is with the Digital Forensics, Brown University, Providence, RI. Hale Thompson is with Howard Brown Health, Chicago, IL. Carl Streed Jr is with the Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, and the GenderCare Center, Boston Medical Center, Boston, MA
| | - Bee Davis
- Arjee Javellana Restar is with the departments of Epidemiology and Health Systems and Population Health, School of Public Health, University of Washington, Seattle, as well as the Department of Social and Behavioral Sciences, Yale University, New Haven, CT. Eric K. Layland is with the Department of Human Development and Family Sciences, University of Delaware, Newark. Bee Davis is with the Digital Forensics, Brown University, Providence, RI. Hale Thompson is with Howard Brown Health, Chicago, IL. Carl Streed Jr is with the Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, and the GenderCare Center, Boston Medical Center, Boston, MA
| | - Hale Thompson
- Arjee Javellana Restar is with the departments of Epidemiology and Health Systems and Population Health, School of Public Health, University of Washington, Seattle, as well as the Department of Social and Behavioral Sciences, Yale University, New Haven, CT. Eric K. Layland is with the Department of Human Development and Family Sciences, University of Delaware, Newark. Bee Davis is with the Digital Forensics, Brown University, Providence, RI. Hale Thompson is with Howard Brown Health, Chicago, IL. Carl Streed Jr is with the Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, and the GenderCare Center, Boston Medical Center, Boston, MA
| | - Carl Streed
- Arjee Javellana Restar is with the departments of Epidemiology and Health Systems and Population Health, School of Public Health, University of Washington, Seattle, as well as the Department of Social and Behavioral Sciences, Yale University, New Haven, CT. Eric K. Layland is with the Department of Human Development and Family Sciences, University of Delaware, Newark. Bee Davis is with the Digital Forensics, Brown University, Providence, RI. Hale Thompson is with Howard Brown Health, Chicago, IL. Carl Streed Jr is with the Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, and the GenderCare Center, Boston Medical Center, Boston, MA
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Restar AJ. Why confronting positionality matters to advancing trans research and discourse. Lancet Reg Health Am 2023; 24:100568. [PMID: 37575266 PMCID: PMC10416008 DOI: 10.1016/j.lana.2023.100568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/15/2023]
Affiliation(s)
- Arjee Javellana Restar
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
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Restar AJ. Gender-affirming care is preventative care. Lancet Reg Health Am 2023; 24:100544. [PMID: 37383047 PMCID: PMC10290445 DOI: 10.1016/j.lana.2023.100544] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Arjee Javellana Restar
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
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Restar AJ, Quilantang MI, Wickersham J, Adia A, Guigayoma J, Bermudez AN, Galárraga O, Flores DD, Cu‐Uvin S, Nazareno J, Operario D, Sison O. Predictors of PrEP awareness, PrEP discussion and interest in long-acting injectable PrEP among Filipina transfeminine adults. J Int AIDS Soc 2023; 26:e26080. [PMID: 37306123 PMCID: PMC10258862 DOI: 10.1002/jia2.26080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/08/2023] [Indexed: 06/13/2023] Open
Abstract
INTRODUCTION Transfeminine adults are impacted by the HIV epidemic in the Philippines, and newly approved modalities of pre-exposure prophylaxis (PrEP), including long-acting injectable (LAI-PrEP), could be beneficial for this group. To inform implementation, we analysed PrEP awareness, discussion and interest in taking LAI-PrEP among Filipina transfeminine adults. METHODS We utilized secondary data from the #ParaSaAtin survey that sampled Filipina transfeminine adults (n = 139) and conducted a series of multivariable logistic regressions with lasso selection to explore factors independently associated with PrEP outcomes, including awareness, discussion with trans friends and interest in LAI-PrEP. RESULTS Overall, 53% of Filipina transfeminine respondents were aware of PrEP, 39% had discussed PrEP with their trans friends and 73% were interested in LAI-PrEP. PrEP awareness was associated with being non-Catholic (p = 0.017), having previously been HIV tested (p = 0.023), discussing HIV services with a provider (p<0.001) and having high HIV knowledge (p = 0.021). Discussing PrEP with friends was associated with older age (p = 0.040), having experienced healthcare discrimination due to transgender identity (p = 0.044), having HIV tested (p = 0.001) and having discussed HIV services with a provider (p < 0.001). Very interested in LAI-PrEP was associated with living in Central Visayas (p = 0.045), having discussed HIV services with a provider (p = 0.001) and having discussed HIV services with a sexual partner (p = 0.008). CONCLUSIONS Implementing LAI-PrEP in the Philippines requires addressing systemic improvements across personal, interpersonal, social and structural levels in healthcare access, including efforts to create healthcare settings and environments with providers who are trained and competent in transgender health and can address the social and structural drivers of trans health inequities, including HIV and barriers to LAI-PrEP.
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Affiliation(s)
- Arjee Javellana Restar
- Department of EpidemiologyUniversity of Washington School of Public HealthSeattleWashingtonUSA
- Department of Behavioral and Social Sciences, Research Education Institute for Diverse Scholars (REIDS)Yale University School of Public HealthNew HavenConnecticutUSA
- Philippines Health Initiative for Research, Service & Training (PHIRST)Brown University School of Public HealthProvidenceRhode IslandUSA
| | - Ma Irene Quilantang
- Philippines Health Initiative for Research, Service & Training (PHIRST)Brown University School of Public HealthProvidenceRhode IslandUSA
- Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceRhode IslandUSA
- Department of Behavioral SciencesUniversity of Philippines‐ManilaManilaPhilippines
| | - Jeffrey Wickersham
- Department of Behavioral and Social Sciences, Research Education Institute for Diverse Scholars (REIDS)Yale University School of Public HealthNew HavenConnecticutUSA
- Department of Internal MedicineYale University School of MedicineNew HavenConnecticutUSA
| | - Alex Adia
- Philippines Health Initiative for Research, Service & Training (PHIRST)Brown University School of Public HealthProvidenceRhode IslandUSA
- Division of Health Policy and ManagementUniversity of California – Berkeley School of Public HealthBerkeleyCaliforniaUSA
| | - John Guigayoma
- Philippines Health Initiative for Research, Service & Training (PHIRST)Brown University School of Public HealthProvidenceRhode IslandUSA
- Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceRhode IslandUSA
| | - Amiel Nazer Bermudez
- Philippines Health Initiative for Research, Service & Training (PHIRST)Brown University School of Public HealthProvidenceRhode IslandUSA
- Department of EpidemiologyBrown University School of Public HealthProvidenceRhode IslandUSA
- Department of Epidemiology and BiostatisticsUniversity of Philippines‐ManilaManilaPhilippines
| | - Omar Galárraga
- Department of Health Services, Policy, and PracticeBrown University School of Public HealthProvidenceRhode IslandUSA
| | - Dalmacio Dennis Flores
- Department of Behavioral and Social Sciences, Research Education Institute for Diverse Scholars (REIDS)Yale University School of Public HealthNew HavenConnecticutUSA
- Department of Family and Community HealthUniversity of Pennsylvania School of NursingPhiladelphiaPennsylvaniaUSA
| | - Susan Cu‐Uvin
- Philippines Health Initiative for Research, Service & Training (PHIRST)Brown University School of Public HealthProvidenceRhode IslandUSA
- Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceRhode IslandUSA
| | - Jennifer Nazareno
- Philippines Health Initiative for Research, Service & Training (PHIRST)Brown University School of Public HealthProvidenceRhode IslandUSA
- Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceRhode IslandUSA
| | - Don Operario
- Philippines Health Initiative for Research, Service & Training (PHIRST)Brown University School of Public HealthProvidenceRhode IslandUSA
- Department of Behavioral, Social, and Health Education SciencesEmory University Rollins School of Public HealthAtlantaGeorgiaUSA
| | - Olivia Sison
- Philippines Health Initiative for Research, Service & Training (PHIRST)Brown University School of Public HealthProvidenceRhode IslandUSA
- Department of EpidemiologyBrown University School of Public HealthProvidenceRhode IslandUSA
- Institute of Clinical Epidemiology, National Institutes of HealthUniversity of Philippines‐ManilaManilaPhilippines
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Restar AJ, Garrison-Desany HM, Adamson T, Childress C, Millett G, Jarrett BA, Howell S, Glick JL, Beckham SW, Baral S. HIV treatment engagement in the context of COVID-19: an observational global sample of transgender and nonbinary people living with HIV. BMC Public Health 2021; 21:901. [PMID: 33980193 PMCID: PMC8114659 DOI: 10.1186/s12889-021-10977-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/29/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND HIV services, like many medical services, have been disrupted by the COVID-19 pandemic. However, there are limited data on the impacts of the COVID-19 pandemic on HIV treatment engagement outcomes among transgender (trans) and nonbinary people. This study addresses a pressing knowledge gap and is important in its global scope, its use of technology for recruitment, and focus on transgender people living with HIV. The objective of this study is to examine correlates of HIV infection and HIV treatment engagement outcomes (i.e., currently on ART, having an HIV provider, having access to HIV treatment without burden, and remote refills) since the COVID-19 pandemic began. METHODS We utilized observational data from the Global COVID-19 Disparities Survey 2020, an online study that globally sampled trans and nonbinary people (n = 902) between April and August 2020. We conducted a series of multivariable logistic regressions with lasso selection to explore correlates of HIV treatment engagement outcomes in the context of COVID-19. RESULTS Of the 120 (13.3%) trans and nonbinary people living with HIV in this survey, the majority (85.8%) were currently on HIV treatment. A smaller proportion (69.2%) reported having access to an HIV provider since COVID-19 control measures were implemented. Less than half reported being able to access treatment without burdens related to COVID-19 (48.3%) and having the ability to remotely refill HIV prescription (44.2%). After adjusting for gender in the multivariable models, younger age and anticipated job loss were significantly associated with not having access to HIV treatment without burden. Outcomes also significantly varied by geographic region, with respondents reporting less access to an HIV provider in nearly every region outside of South-East Asia. CONCLUSION Our results suggest that currently taking ART, having access to an HIV provider, and being able to access HIV treatment without burden and remotely refill HIV medication are suboptimal among trans and nonbinary people living with HIV across the world. Strengthening support for HIV programs that are well-connected to trans and nonbinary communities, increasing remote access to HIV providers and prescription refills, and providing socioeconomic support could significantly improve HIV engagement in trans and nonbinary communities.
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Affiliation(s)
- Arjee Javellana Restar
- Department of Epidemiology, Johns Hopkins School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
| | - Henri M Garrison-Desany
- Department of Epidemiology, Johns Hopkins School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Tyler Adamson
- Department of Health, Policy, and Management, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Chase Childress
- School of Law and School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
| | | | - Brooke A Jarrett
- Department of Epidemiology, Johns Hopkins School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | | | - Jennifer L Glick
- Department of Health, Behavior, and Society, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - S Wilson Beckham
- Department of Health, Behavior, and Society, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
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Restar AJ, Jin H, Jarrett B, Adamson T, Baral SD, Howell S, Beckham SW. Characterising the impact of COVID-19 environment on mental health, gender affirming services and socioeconomic loss in a global sample of transgender and non-binary people: a structural equation modelling. BMJ Glob Health 2021; 6:e004424. [PMID: 33753401 PMCID: PMC7985976 DOI: 10.1136/bmjgh-2020-004424] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND We characterised the impact of COVID-19 on the socioeconomic conditions, access to gender affirmation services and mental health outcomes in a sample of global transgender (trans) and non-binary populations. METHODS Between 16 April 2020 and 3 August 2020, we conducted a cross-sectional survey with a global sample of trans and non-binary people (n=849) through an online social networking app. We conducted structural equational modelling procedures to determine direct, indirect and overall effects between poor mental health (ie, depression and anxiety) and latent variables across socioecological levels: social (ie, reduction in gender affirming services, socioeconomic loss impact) and environmental factors (ie, COVID-19 pandemic environment). RESULTS Anxiety (45.82%) and depression (50.88%) in this sample were prevalent and directly linked to COVID-19 pandemic environment. Adjusted for gender identity, age, migrant status, region, education and level of socioeconomic status, our final model showed significant positive associations between relationships of (1) COVID-19 pandemic environment and socioeconomic loss impact (β=0.62, p<0.001), (2) socioeconomic loss impact and reduction in gender affirming services (β=0.24, p<0.05) and (3) reduction in gender affirming services and poor mental health (β=0.19, p<0.05). Moreover, socioeconomic loss impact and reduction in gender affirming services were found to be partial mediators in this model. CONCLUSION The study results supported the importance of bolstering access to gender affirming services and strengthening socioeconomic opportunities and programmatic support to buffer the impact of COVID-19 pandemic environment on poor mental health among trans and non-binary communities globally.
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Affiliation(s)
- Arjee Javellana Restar
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Harry Jin
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Brooke Jarrett
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Tyler Adamson
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Stefan David Baral
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - S Wilson Beckham
- Department of Health Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Abstract
The gender-transformative approach to health promotion in the United States and globally has been central to defining gender as a determinant of health and advancing health programs, services, and policies that respond to gender-based inequities. However, current gender frameworks are built on historical perspectives that center cisgender people's experiences and reinforce the gender binary. This restricted focus does not respond to health inequities experienced by transgender people-to the detriment of health programs, services, and policies. As transgender people's health and rights continue to garner attention in movements across health services and policy spaces, it is crucial for frameworks to be expansively redefined to achieve truly transformative gender equality and equity for all gender identities and expressions.
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Affiliation(s)
- Arjee Javellana Restar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.,amfAR, The Foundation of AIDS Research, Washington, District of Columbia, USA
| | - Jennifer Sherwood
- amfAR, The Foundation of AIDS Research, Washington, District of Columbia, USA.,Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alberto Edeza
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Candice Collins
- amfAR, The Foundation of AIDS Research, Washington, District of Columbia, USA
| | - Don Operario
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
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Restar AJ. Methodological Critique of Littman's (2018) Parental-Respondents Accounts of "Rapid-Onset Gender Dysphoria". Arch Sex Behav 2020; 49:61-66. [PMID: 31011991 PMCID: PMC7012957 DOI: 10.1007/s10508-019-1453-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 04/05/2019] [Accepted: 04/05/2019] [Indexed: 05/23/2023]
Affiliation(s)
- Arjee Javellana Restar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S 121-2, Providence, RI, 02903, USA.
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