ArticleTransgender health2026
Validation of the "Gender Affirmation in Healthcare Settings" Scale Among Transgender Women Living with HIV in India: Findings from Exploratory and Confirmatory Factor Analyses.
Article in Transgender health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Gender affirmation (GA) has been associated with improved healthcare engagement and health outcomes. Given the lack of a valid tool to measure GA in healthcare settings (GAHS) among transgender women living with HIV (TWLH) in India, we tested the validity and reliability of a 4-item GAHS scale. Methods: We used baseline, 3-month, and 6-month data from a longitudinal observational cohort study among 140 TWLH. We conducted exploratory factor analysis (EFA) using baseline data to determine the underlying factor structure measuring GA, and confirmatory factor analysis (CFA) using 3-month data. We assessed group ('transgender woman' vs indigenous transfeminine identities) and longitudinal measurement invariance across three time points. Convergent validity was assessed by correlating GA scores with medical GA and social factors, discriminant validity by their correlation with baseline HIV-related stigma, and predictive validity by their correlation with mental health and antiretroviral treatment (ART) outcomes. Results: EFA indicated a single-factor structure. CFA confirmed a 4-item single-factor model with good fit (χ Conclusion: The GAHS scale demonstrated strong psychometric properties, exhibiting good validity and reliability, making it suitable for screening or monitoring GA in healthcare settings and for research purposes. Future studies should evaluate this scale among diverse populations of transgender people.
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