Evidence map›Paper›PMID 36867986›Full record

ArticlePublic health2023

Stressors in health care and their association to symptoms experienced by gender diverse people.

Kristen D Clark, Annesa Flentje, Jae M Sevelius, Carol Dawson-Rose, Sandra J Weiss

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.0field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. A Review of Patient Experiences and Provider Education to Improve Transgender Health Inequities in the USA.International journal of environmental research and public health · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Kristen D ClarkDepartment of Nursing, College of Health and Human Services, University of New Hampshire, Durham, NH, USA. Electronic address: Kristen.clark@unh.edu.
Annesa FlentjeDepartment of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA; Alliance Health Project, Department of Psychiatry, School of Medicine, University of California, San Francisco, USA.
Jae M SeveliusCenter for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA; Center of Excellence for Transgender Health, Department of Medicine, University of California, San Francisco, CA, USA.
Carol Dawson-RoseDepartment of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA.
Sandra J WeissDepartment of Community Health Systems, UCSF Depression Center, University of California, San Francisco, CA, USA.
University of California, San Francisco · USUniversity of New Hampshire · US

Funding

Mentoring clinical investigators in patient-oriented research on substance use and HIVK24DA051328 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SEVELIUS, JAE M. · 2020 to 2024
$771k
The Relationship of Stressors in Health Care to Emotional and Physical Symptoms Experienced by Marginalized PeopleF31NR019000 · NINR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CLARK, KRISTEN DREW · 2019 to 2021
$68k
NIDA NIH HHS K24 DA051328NINR NIH HHS F31 NR019000
6 · The paper itself

Abstract

objectivesMany individuals whose gender does not align with the sex they were assigned at birth (gender diverse [GD] people) report stressful health care encounters. We examined the relationship of these stressors to symptoms of emotional distress and impaired physical functioning among GD people. STUDY

designThis study was conducted using a cross-sectional design with data from the 2015 United States Transgender Survey.

methodsComposite metrics of health care stressors and physical impairments were developed, and the Kessler Psychological Distress Scale (K-6) provided a measure of emotional distress. Linear and logistic regression were used to analyze the aims.

resultsA total of 22,705 participants from diverse gender identity subgroups were included. Participants who experienced at least one stressor in health care during the past 12 months had more symptoms of emotional distress (β = 0.14, P < .001) and 85% greater odds of having a physical impairment (odds ratio = 1.85, P < .001). Transgender men exposed to stressors were more likely than transgender women to experience emotional distress and have a physical impairment, with other gender identity subgroups reporting less distress. Black participants exposed to stressful encounters reported more symptoms of emotional distress than White participants.

conclusionsThe results suggest that stressful encounters in health care are associated with symptoms of emotional distress and greater odds of physical impairment for GD people, with transgender men and Black individuals being at greatest risk of emotional distress. The findings indicate the need for assessment of factors that contribute to discriminatory or biased health care for GD people, education of health care workers, and support for GD people to reduce their risk of stressor-related symptoms.

Indexed as

Gender IdentityTransgender PersonsAdolescentAdultAgedCross-Sectional StudiesDelivery of Health CareFemaleHumansMaleMiddle AgedSurveys and QuestionnairesUnited StatesYoung AdultHealthcare systemMental healthPhysical healthSexual and gender minority

Identifiers

PMID36867986
PMCPMC10354568
OpenAlexW4322755945

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.