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Experiences of and barriers to transition-related healthcare among Korean transgender adults: focus on gender identity disorder diagnosis, hormone therapy, and sex reassignment surgery
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Hyemin Lee, Jooyoung Park, Bokyoung Choi, Horim Yi, Seung-Sup Kim
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Epidemiol Health. 2018;40:e2018005. Published online February 27, 2018
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DOI: https://doi.org/10.4178/epih.e2018005
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Abstract
OBJECTIVES
Transgender people may encounter barriers to transition-related healthcare services. This study aimed to investigate the experiences of transition-related healthcare and barriers to those procedures among transgender adults in Korea.
METHODS In 2017, we conducted a nationwide cross-sectional survey of 278 transgender adults, which named Rainbow Connection Project II, in Korea. We assessed the prevalence of transition-related healthcare, including gender identity disorder (GID) diagnosis, hormone therapy, and sex reassignment surgery. To understand the barriers to those procedures, we also asked participants for their reasons for not receiving each procedure. Further, this study examined their experiences of and the reasons for using non-prescribed hormone medications.
RESULTS Of transgender people participated in the survey, 91.0% (n=253/278) were diagnosed with GID, 88.0% (n=243/276) received hormone therapy, and 42.4% (n=115/271) have had any kind of sex reassignment surgery. Cost was the most common barrier to transition-related healthcare among Korean transgender adults. Other common barriers were identified as follows: negative experiences in healthcare settings, lack of specialized healthcare professionals and facilities, and social stigma against transgender people. Among those who had taken hormone medications, 25.1% (n=61/243) reported that they had ever purchased them without a prescription.
CONCLUSIONS Our findings suggest that barriers to transition-related healthcare exist in Korea and constrain transgender individuals’ safe access to the needed healthcare. Institutional interventions are strongly recommended to improve access to transition-related healthcare. These interventions include provision of programs to train Korean healthcare professionals and expansion of national health insurance to include these procedures.
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Summary
Korean summary
- 본 연구는 한국 성인 트랜스젠더의 정신과진단, 호르몬요법, 성전환수술의 경험과 그 과정에서 마주하는 장벽에 대해 파악하고자 했다. 전체 트랜스젠더 중 성주체성장애 진단을 받은 참여자는 91.0%(N=253/278), 호르몬요법을 현재 받고 있거나 과거에 받은 경험이 있는 참여자는 88.0%(N=243/276), 한 가지 종류 이상 성전환수술을 받은 참여자는 42.4%(N=115/271)였다. 트랜스젠더가 의료적 트랜지션 과정에서 경험하는 가장 큰 장벽으로는 의료적 조치에 소요되는 비용인 것으로 밝혀졌다.
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Health disparities between lesbian, gay, and bisexual adults and the general population in South Korea: Rainbow Connection Project I
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Horim Yi, Hyemin Lee, Jooyoung Park, Bokyoung Choi, Seung-Sup Kim
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Epidemiol Health. 2017;39:e2017046. Published online October 19, 2017
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DOI: https://doi.org/10.4178/epih.e2017046
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54,347
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373
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26
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24
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Abstract
Summary
PDFSupplementary Material
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Abstract
OBJECTIVES
This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in Korea, where there is low public acceptance of sexual minorities and a lack of research on the health of sexual minorities.
METHODS The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPRs) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPRs of the LGB adults and the general population which participated in three different nationally representative surveys in Korea. SPRs were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women).
RESULTS Korean LGB adults exhibited a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempts, and musculoskeletal pain than the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general women population, whereas gay and bisexual men showed no differences with the general men population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed in bisexual men.
CONCLUSIONS The findings suggest that LGB adults have poorer health conditions compared to the general population in Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.
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Summary
Korean summary
본 연구는 만 19세 이상의 한국 성인 동성애자와 양성애자를 대상으로 이들의 건강상태에 대한 설문조사를 시행하고, 수집한 자료를 분석하여 동성애자·양성애자의 건강불평등 실태를 파악하고자 하였다. 본 연구의 목적은 자가평가건강, 정신건강(우울, 자살생각 및 자살시도), 신체적 건강(근골격계 통증) 및 건강관련행동(흡연율, 위험음주율)을 포함하여 다양한 측면에서 한국 성인 동성애자·양성애자와 일반인구집단의 건강수준을 비교하는 것이다.
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