No label defined (Q33547)
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No description defined
- Clinicians in the Veterans Health Administration initiate gender-affirming hormone therapy in concordance with clinical guideline recommendations.
| Language | Label | Description | Also known as |
|---|---|---|---|
| English | No label defined |
No description defined |
|
Statements
Gender-affirming hormone therapy (GAHT) is a common medical intervention sought by transgender and gender diverse (TGD) individuals. (English)
BACKGROUND (English)
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Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Initiating GAHT in accordance with clinical guideline recommendations ensures delivery of high-quality care. (English)
BACKGROUND (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
However, no prior studies have examined how current GAHT initiation compares to recommended GAHT initiation. (English)
BACKGROUND (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
This study assessed guideline concordance around feminizing and masculinizing GAHT initiation in the Veterans Health Administration (VHA). (English)
OBJECTIVE (English)
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Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
The sample included 4,676 veterans with a gender identity disorder diagnosis who initiated feminizing (<i>n</i>=3,547) and masculinizing (<i>n</i>=1,129) GAHT between 2007 and 2018 in VHA. (English)
METHODS (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Demographics and health conditions on veterans receiving feminizing and masculinizing GAHT were assessed. (English)
METHODS (English)
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Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Proportion of guideline concordant veterans on six VHA guidelines on feminizing and masculinizing GAHT initiation were determined. (English)
METHODS (English)
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Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Compared to veterans receiving masculinizing GAHT, a higher proportion of veterans receiving feminizing GAHT were older (≥60 years: 23.7% vs. 6.3%), White non-Hispanic (83.5% vs. 57.6%), and had a higher number of comorbidities (≥7: 14.0% vs. 10.6%). (English)
RESULTS (English)
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Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
A higher proportion of veterans receiving masculinizing GAHT were Black non-Hispanic (21.5% vs. 3.5%), had posttraumatic stress disorder (43.0% vs. 33.9%) and positive military sexual trauma (33.5% vs.16.8%; all p-values<0.001) than veterans receiving feminizing GAHT. (English)
RESULTS (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Among veterans who started feminizing GAHT with estrogen, 97.0% were guideline concordant due to no documentation of contraindication, including venous thromboembolism, breast cancer, stroke, or myocardial infarction. (English)
RESULTS (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Among veterans who started spironolactone as part of feminizing GAHT, 98.1% were guideline concordant as they had no documentation of contraindication, including hyperkalemia or acute renal failure. (English)
RESULTS (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Among veterans starting masculinizing GAHT, 90.1% were guideline concordant due to no documentation of contraindications, such as breast or prostate cancer. (English)
RESULTS (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Hematocrit had been measured in 91.8% of veterans before initiating masculinizing GAHT, with 96.5% not having an elevated hematocrit (>50%) prior to starting masculinizing GAHT. (English)
RESULTS (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Among veterans initiating feminizing and masculinizing GAHT, 91.2% had documentation of a gender identity disorder diagnosis prior to GAHT initiation. (English)
RESULTS (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
We observed high concordance between current GAHT initiation practices in VHA and guidelines, particularly for feminizing GAHT. (English)
CONCLUSION (English)
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Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Findings suggest that VHA clinicians are initiating feminizing GAHT in concordance with clinical guidelines. (English)
CONCLUSION (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Future work should assess guideline concordance on monitoring and management of GAHT in VHA. (English)
CONCLUSION (English)
no value
Copyright © 2024 Jasuja, Wolfe, Reisman, Vimalananda, Rao, Blosnich, Livingston and Shipherd. (English)
2024
Guneet K (English)
Jasuja (English)
GK
Joel I (English)
Reisman (English)
JI
Varsha G (English)
Vimalananda (English)
VG
Sowmya R (English)
Rao (English)
SR
John R (English)
Blosnich (English)
JR
Nicholas A (English)
Livingston (English)
NA
Jillian C (English)
Shipherd (English)
JC
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (English)