Transgender People: Epidemiology and treatment .

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Transgender Individuals: The study of disease transmission and treatment. Slide set created by JoAnne Keatley, MSW Exhibited by Danielle Castro, Group Preparation Authority. College of California, San Francisco Pacific Guides Instruction Preparing Center and Place for Helps Counteractive action Studies.
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Transgender People: Epidemiology and treatment Slide set created by JoAnne Keatley, MSW Presented by Danielle Castro, Community Mobilization Specialist University of California, San Francisco Pacific AIDS Education Training Center & Center for AIDS Prevention Studies

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A working meaning of Transgender: A man whose sex, sexual orientation character or sex expression varies from the one doled out to them during childbirth . "Trans" can be shorthand for transgender and transsexual and some of extra sexual orientation personalities.

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Regardless of financial status transgender individuals are the most medicinally underserved individuals in the United States. Lori Kohler, MD Family and Community Medicine UCSF

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what number trans individuals are there? Scope of current overall assessments: MTF 1 in 30,000 (.003%) 1 to 6 in 1,000 (.6%) 2 FTM 1 in 100,000 (.001%) 1 to 1 in 33,800 (.003%) 3 American Psychiatric Association, 1994 Winter, 2002 DeCuypere et al, 2007

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HIV Among Trans People No national appraisals Regional reviews have depended only on accommodation tests (i.e. members selected from social administration organizations, bars, and boulevards) Studies have concentrated on trans ladies; next to no data is accessible on trans men

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Data accumulation suggestions The Center of Excellence for Transgender Health ( ) makes the accompanying proposal for trans-comprehensive information gathering: What is your present sexual orientation personality? What was your doled out sex during childbirth?

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HIV Prevalence Among Trans People A current meta-investigation of 29 territorial reviews in the US 1 reasons that: Average commonness for trans ladies is 28% or 1 in 4 (when results are lab-affirmed) 12% or 1 in 8 (independent from anyone else report) African American transwomen have the most elevated predominance (56%) , contrasted with other racial/ethnic gatherings 2,3 Herbst et al, 2008 Clements, Marx, Guzman & Katz, 2001 Nemoto et al, 2004

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Predictors of HIV constructive status among transwomen : African-American race 1,2 Syphilis 1 Intravenous medication utilize 2 High number of sex accomplices (>200) 2 Less than secondary school instruction 2 History of sex work 3 History of rape 3 Unemployment 3 Elifson et al, 1993 Clements-Nolle et every one of the, 2001 Xavier et al, 2005

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Transgender ladies and HIV An investigation of four US urban communities found that transgender ladies living with HIV were less inclined to get profoundly dynamic antiretroviral treatment (HAART) than a non-transgender control bunch (59% versus 82%, p < .001). (Melendez et al, 2005)

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Hormone Therapy for Transgender People There are no noteworthy medication collaborations with medications used to treat HIV. Hormone treatment is not contraindicated in HIV malady at any stage. Ought not be viewed as "discretionary" and trans individuals ought to settle on possess treatment choices.

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Sex work/Survival sex (Sausa et. al, 2007, Kammerer et. al, 2001, Clements, 1999; Clements-Nolle et. al, 2001)

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Substance utilize (Nemoto et. al, 2004, Sausa et. al, 2007, Clements et. al, 1999; Clements-Nolle et. al, 2001)

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Incarceration issues Incarceration rates among trans ladies: 37 to 65% (Clements et. al, 2001; Nemoto et. al, 1999; Nemoto et. al, 1999; Risser et. al, 2001; Garofalo et. al, 2006).

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Transgender youth (Garofalo et. al, 2006; Sausa, 2003 & 2005; Lombardi et. al, 2001, Clements-Nolle, et. al, 2006, Sugano et. al, 2006)

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Transgender men and HIV Very few investigations of trans individuals have included transmen. Some transgender men participate in high-hazard sex, including having a high number of unknown accomplices and taking part in sex work with non-trans men. (Sevelius, under audit) Estimates of HIV commonness among transmen run from 1 - 3% ( Clements-Nolle et al, 2001; Sevelius, under survey; Xavier, 2005)

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Social support and emotional wellness (Clements-Nolle et. al, 2006; Garofalo et. al, 2006) In a San Francisco-based example, 55% of transgender men were discouraged, 32% announced having endeavored suicide in any event once. (Clements-Nolle et. al, 2001)

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Mental wellbeing In one investigation of 446 transmen, the individuals who had gotten hormone treatment announced higher personal satisfaction than the individuals who did not. (Newfield, Hart, Dibble, & Kohler, 2006) Hormone treatment alone can lighten despondency for some transgender individuals. (Bockting, Knudson, & Goldberg, 2006)

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Protective components Family acknowledgment Social bolster Self-regard Access to equipped human services Access to sex affirming hormone treatment and other sexual orientation related care Community association

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Module 10 Clinical Issues with Transgender Individuals A Provider\'s Introduction to Substance Abuse for Lesbian, Gay, Bisexual, and Transgender Individuals First Edition

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Issues about appearance, "passing" and self-perception History of stowing away or stifling sex personality Lack of family and social bolster Isolation and absence of association with constructive, proactive transgender group assets Hormone treatment and utilize or infusion history Stigma and segregation Employment issues Relationship/kid care issues Clinical Issues and Implications for Treatment Power Point Slide # 10-7, n42 A Provider\'s Introduction to Substance Abuse for LGBT Individuals Module 5 - 12 Clinician\'s Guide

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TREATMENT DO\'S AND DON\'TS DO\'S Use the best possible pronouns in view of customer\'s self-character when conversing with/about transgender people. Get clinical supervision on the off chance that they have issues or emotions about working with transgender people. Permit transgender customers to proceed with the utilization of hormones when they are endorsed. Advocate that the transgender customer utilizing "road" hormones get prompt restorative care and lawfully recommended hormones. Take required preparing on transgender issues. Control Point Slide # 10-8, n43 A Provider\'s Introduction to Substance Abuse for LGBT Individuals Module 5 - 12 Clinician\'s Guide

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TREATMENT DO\'S AND DON\'TS DO\'S Find out the sexual introduction of all customers. Permit transgender customers to utilize washrooms and showers in light of their sex self-characters and sexual orientation parts. Require all customers and staff individuals to make and keep up a protected situation for every single transgender customer. Post a nondiscrimination approach in the holding up room that expressly incorporates sexual introduction and sex personality . Control Point Slide # 10-9, n44 A Provider\'s Introduction to Substance Abuse for LGBT Individuals Module 5 - 12 Clinician\'s Guide

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TREATMENT DO\'S AND DON\'TS Don\'t call somebody who recognizes as a female "he or him" or call somebody who distinguishes as male "she or her". Try not to extend transphobia onto the transgender customer or impart transphobic remarks to other staff individuals or customers. Never make the transgender customer pick amongst hormones and treatment and recuperation. Try not to make the transgender customer teach the staff. Try not to expect transgender ladies or men are gay. Try not to make transgender people living as females utilize male offices or transgender people living as guys utilize female offices. Never permit staff individuals or customers to make transphobic remarks or put transgender customers at hazard for physical or sexual mishandle or badgering. Control Point Slide # 10-10, n45 Prairelands ATTC Toolbox Training Module 5 – 12 Clinician\'s Overview

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Copyright 2009. Focus of Excellence for Transgender HIV Prevention. All Rights Reserved.

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Contact Information Danielle Castro Center of Excellence for Transgender Health University of California San Francisco 415-597-8094

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References American Psychiatric Association (1994). Analytic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV). American Psychiatric Association, Washington, DC. Bockting, W., Knudson, G., & Goldberg, J. (2006). Directing and Mental Health Care of Transgender Adults and Loved Ones . Vancouver, BC: Transgender Health Program. Places for Disease Control and Prevention (2006). HIV/AIDS Surveillance Report, 2005. Vol. 17. Atlanta: US Department of Health and Human Services, CDC; 2006:1–46. Clements-Nolle, K., Wilkinson, W., Kitano, K., Marx, R. HIV anticipation and wellbeing administration requirements for the transgender group in San Francisco. Worldwide Journal of Transgenderism 1999; 3(1+2) Clements-Nolle, K., Marx, R., Guzman, R., Katz, M. HIV commonness, hazard practices, social insurance utilize, and psychological wellness status of transgender people: Implications for general wellbeing intercession. American Journal of Public Health, 2001. 91: p. 915-921. Clements-Nolle, K., Marx, R., & Katz, M. (2006). Endeavored suicide among transgender people: The impact of sexual orientation based separation and exploitation. Diary of Homosexuality, 51, 53-69. Conway, L. (2002) How Frequently Does Transsexualism Occur?

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References Devor, H. (2002). Who are "we"? Where sexual introduction meets sex character. Diary of Gay and Lesbian Psychotherapy, 6 (2), 5-21. Garafalo, R., Deleon, J., Osmer, E., Doll, M., Harper, G. Neglected, misconstrued, and at-hazard: Exploring the lives and HIV danger of ethnic minority male-to-female transgender youth. Diary of Adolescent Health 2006;38:230-236. Glynn, M. & Rhodes, P. (2005). Evaluated HIV commonness in the United States toward the finish of 2003. National HIV Prevention Conference ; June 2005; Atlanta. Conceptual 595. Herbst, J., Jacobs, E., Finlayson, T., McKleroy, V., Neumann, M.S., Crepaz, N. Evaluating HIV pervasiveness and hazard practices of transgender people in the United States: A precise audit. Helps and Behavior, 2007. Kammerer, N., Mason, T., Connors, M., Durkee, R. Trans

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