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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
Hyemin Lee, Jooyoung Park, Bokyoung Choi, Horim Yi, Seung-Sup Kim
Epidemiol Health. 2018;40:e2018005.   Published online February 27, 2018
DOI: https://doi.org/10.4178/epih.e2018005
  • 32,932 View
  • 457 Download
  • 36 Web of Science
  • 37 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
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.
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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Decomposing Gender Disparity in Total Physical Activity among Iranian Adults
Ebrahim Rahimi, Seyed Saeed Hashemi-Nazari, Koorosh Etemad, Hamid Soori
Epidemiol Health. 2017;39:e2017044.   Published online October 16, 2017
DOI: https://doi.org/10.4178/epih.e2017044
  • 14,270 View
  • 201 Download
  • 6 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
While gender differences in physical activity (PA) have been reported, their origin is not well understood. The present study aimed to identify factors contributing to this disparity.
METHODS
This was a population-based cross-sectional study based on the 2011 surveillance of risk factors of non-communicable diseases that was conducted among Iranian adults. Multi-staged sampling was performed to obtain the required study sample. The primary outcome was gender differences in the prevalence of sufficient physical activity (SPA). Total physical activity (TPA) was calculated as metabolic equivalents (MET) per minute during a typical week, as recommended by the World Health Organization. On this basis, achieving 600 MET-min/wk or more was defined as SPA. The nonlinear Blinder-Oaxaca decomposition technique was used to explain the disparity.
RESULTS
The predicted gap was 19.50%. About one-third of the gap was due to differences in the level of observable covariates. Among them, work status contributed the most (29.61%). A substantial portion of the gap remained unexplained by such differences, of which about 40.41% was related to unobservable variables. The differential effects of standard of living, ethnicity, and smoking status made the largest contribution, accounting for 37.36, 35.47, and 28.50%, respectively.
CONCLUSIONS
Interventions to reduce the gender gap in PA should focus on increasing TPA among housewives and women with chronic diseases, as well as those with a higher standard of living. In addition, it is essential to explore the impact of ethnicity and smoking status on women’s TPA in order to promote health.
Summary

Citations

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