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This article is by a group of trans and nonbinary researchers and experts in the field of trans health who have conducted an analysis of trans health research needs. To highlight topics that need further research and to outline key considerations for those conducting research in our field. The first author conducted semi-structured interviews with all coauthors, and these were used to create a first draft of this manuscript. This draft was circulated to all authors, with edits made until consensus was reached among the authors. More comprehensive long-term research that centers trans people's experiences is needed on the risks and benefits of gender affirming hormones and surgeries. The trans health research field also needs to have a broader focus beyond medical transition or gender affirmation, including general health and routine healthcare; trans people's lives without, before, and after medical gender affirmation; and sexuality, fertility, and reproductive healthcare needs. More research is also needed on social determinants of health, including ways to make healthcare settings and other environments safer and more supportive; social and legal gender recognition; the needs of trans people who are most marginalized; and the ways in which healing happens within trans communities. The second part of this article highlights key considerations for researchers, the foremost being acknowledging trans community expertise and centering trans community members' input into research design and interpretation of findings, in advisory and/or researcher roles. Ethical considerations include maximizing benefits and minimizing harms (beneficence) and transparency and accountability to trans communities. Finally, we note the importance of conferences, grant funding, working with students, and multidisciplinary teams. This article outlines topics and issues needing further consideration to make the field of trans health research more responsive to the needs of trans people. This work is limited by our authorship group being mostly White, all being Anglophone, and residing in the Global North. [ABSTRACT FROM AUTHOR]

Objective: To examine the issues of primary care access and foregone health care among transgender adolescents and young adults.Methods: This cross-sectional analysis of data from the Canadian Trans Youth Health Survey was conducted online during 2013-2014. Participants included 923 youth aged 14-25 (323 adolescents aged 14-18 and 600 young adults aged 19-25). Main outcome measures were self-reported general and mental health status, comfort discussing transgender identity and health care needs with general practitioners, and types of and reasons for self-identified foregone health care.Results: Most youth reported poor/fair general and mental health status. Comfort with a family doctor was positively correlated with both general health (r(528) = 21, P < 0.001) and mental health (r(450) = 26, P < 0.001) status, as was having a doctor who was aware of one's transgender status. 47.2% (n = 219) of young adults reported foregoing needed health care. Among adolescents, levels of comfort with family doctor were negatively correlated with foregone mental health care in the previous 12 months (F3,166 = 3.829, P = 0.011), but not correlated with foregone physical health care (F3,165 = 0.506, P = 0.679). Reasons for missing needed care spanned the dimensions of health care access, ranging from cost barriers to previous negative experiences with health care providers, and concerns that a doctor would be uneducated about transgender people.Conclusion: General practitioners can play a key role in improving the health of transgender youth by demonstrating understanding of the health care needs of transgender youth and competence in gender-affirming care, and by ensuring that their practices are accessible to all transgender youth in need of care. [ABSTRACT FROM AUTHOR]

Background: Transgender (trans) youth who identify outside the gender binary are a growing subpopulation. In this article, we document differences in access to gender-affirming health care between binary and non-binary identified trans youth and explore ways of meeting the health needs of non-binary youth within primary care settings. Methods: The Canadian Trans Youth Health Survey is a national online survey of trans youth, 14-25 years, conducted in 2013-2014. Among the 839 participants who responded to gender identity items in the survey, 41% identified as non-binary. We compared demographic, health outcome, and health care access responses between non-binary and binary (trans girls/women and trans boys/men) youth. Results: Non-binary and binary youth were similar in most demographics, including age, geographic distribution, and ethnocultural backgrounds, however a larger proportion (82%) of non-binary youth were assigned female at birth. Older non-binary youth (aged 19-25) were significantly more likely to forego needed healthcare than older binary youth; no significant differences were found between younger (14-18) non-binary and binary youth in foregoing healthcare. Overall, non-binary youth (13%) were significantly less likely than binary youth (52%) to access hormone therapy, but they were more likely than binary youth to report experiencing barriers to accessing hormone therapy when needed. Conclusions: Non-binary trans youth in Canada report challenges in accessing needed gender-affirming healthcare. Primary care providers are well-situated to integrate a broad range of gender-affirming care services into practice in order to address the unique needs of non-binary youth. Future research is warranted to explore experiences of non-binary youth related to barriers to care and to explore how services can be designed and delivered to better meet the needs of non-binary youth seeking gender-affirming primary care. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose Research has documented high rates of disordered eating for lesbian, gay, and bisexual youth, but prevalence and patterns of disordered eating among transgender youth remain unexplored. This is despite unique challenges faced by this group, including gender-related body image and the use of hormones. We explore the relationship between disordered eating and risk and protective factors for transgender youth. Methods An online survey of 923 transgender youth (aged 14-25) across Canada was conducted, primarily using measures from existing youth health surveys. Analyses were stratified by gender identity and included logistic regressions with probability profiles to illustrate combinations of risk and protective factors for eating disordered behaviors. Results Enacted stigma (the higher rates of harassment and discrimination sexual minority youth experience) was linked to higher odds of reported past year binge eating and fasting or vomiting to lose weight, while protective factors, including family connectedness, school connectedness, caring friends, and social support, were linked to lower odds of past year disordered eating. Youth with the highest levels of enacted stigma and no protective factors had high probabilities of past year eating disordered behaviors. Discussion Our study found high prevalence of disorders. Risk for these behaviors was linked to stigma and violence exposure, but offset by social supports. Health professionals should assess transgender youth for disordered eating behaviors and supportive resources. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:515-522) [ABSTRACT FROM AUTHOR]

Recalled childhood gender role/identity is a construct that is related to sexual orientation, abuse, and psychological health. The purpose of this study was to assess the factorial validity of a short version of Zucker et al.'s (2006) "Recalled Childhood Gender Identity/Gender Role Questionnaire" using confirmatory factor analysis and to test the stability of the factor structure across groups (measurement invariance). Six items of the questionnaire were completed online by 1929 participants from a variety of gender identity and sexual orientation groups. Models of the six items loading onto one factor had poor fit for the data. Items were removed for having a large proportion of error variance. Among birth-assigned females, a five-item model had good fit for the data, but there was evidence for differences in scale's factor structure across gender identity, age, level of education, and country groups. Among birth-assigned males, the resulting four-item model did not account for all of the relationship between variables, and modeling for this resulted in a model that was almost saturated. This model also had evidence of measurement variance across gender identity and sexual orientation groups. The models had good reliability and factor score determinacy. These findings suggest that results of previous studies that have assessed recalled childhood gender role/identity may have been susceptible to construct bias due to measurement variance across these groups. Future studies should assess measurement invariance between groups they are comparing, and if it is not found the issue can be addressed by removing variant indicators and/or applying a partial invariance model. [ABSTRACT FROM AUTHOR]

We analyzed the case of the World Health Organization’s Commission on Social Determinants of Health, which did not address gender identity in their final report. We argue that gender identity is increasingly being recognized as an important social determinant of health (SDH) that results in health inequities. We identify right to health mechanisms, such as established human rights instruments,as suitable policy tools for addressing gender identity as an SDH to improve health equity. We urge the World Health Organization to add gender identity as an SDH in its conceptual framework for action on the SDHs and to develop and implement specific recommendations for addressing gender identity as an SDH. [ABSTRACT FROM AUTHOR]

While the Edinburgh Handedness Inventory has been widely used, there have been few studies assessing its factorial validity. There is evidence that the original instructions and response options are difficult to understand. Using simplified instructions and response options, the Edinburgh Handedness Inventory was administered on a sample of 1514 participants using an online questionnaire. In accordance with previous research, a model of the 10-item inventory had poor fit for the data. This study also detected model misspecification in the previously-proposed 7-item modification. A 4-item Edinburgh Handedness Inventory – Short Form had good model fit with items modelled as both continuous and ordinal. Despite its brevity, it showed very good reliability, factor score determinacy, and correlation with scores on the 10-item inventory. By eliminating items that were modelled with considerable measurement error, the short form alleviates the concern of the 10-item inventory over-categorising mixed handers. Evidence was found for factorial invariance across level of education, age groups, and regions (USA and Australia/New Zealand). There generally appeared to be invariance across genders for the 4-item inventory. The proposed Edinburgh Handedness Inventory – Short Form measures a single handedness factor with an inventory that has brief and simple instructions and a small number of items. [ABSTRACT FROM AUTHOR]

Ray Blanchard presented a theory of male-to-female (MtF) transsexualism based on a typology, classifying MtF transsexuals as autogynephilic or homosexual. This theory has produced much debate, and many transsexuals have disagreed with it. In this research, comments about Blanchard's theory were collected through an anonymous questionnaire from a convenience sample of 170 mostly White/European Internet-using MtF transsexuals. Positive responses to the theory were given by 15.9% of participants, 31.9% gave neutral responses, and 52.2% gave negative responses. The most common theme of the responses was that the theory was too narrow and restrictive. Other common themes were that the theory was simply wrong, did not apply to the participant's experience, was not acceptable, was not important, only applied to cross-dressers, and suggested underlying motives of the researcher. Some participants reported that they had experienced autogynephilia, and some reported changes of their sexual orientation. Given the anonymity of the participants, transsexual participants were unlikely to consciously distort their responses. Although there were sampling limitations, this study lends insight into the proportion of MtF transsexuals who are supportive of/opposed to Blanchard's typology and the reasons why some are opposed to it. The findings are of interest as transsexuals' reactions to the theory can be and have been used to theorize about the nature of autogynephilia. [ABSTRACT FROM AUTHOR]

Abstract: This study examined biological and psychosocial variables that are relevant to the etiology of gender-variance. Data were collected over the internet from 2277 participants of either gender who identified as transsexual, other gender-variant, and not gender-variant. We found number of gender-variant relatives, handedness, emotional abuse, finger length ratios (2D:4D), and systematizing significantly predicted Adult Gender-Variance among participants of both genders. Adult Gender-Variance was also predicted by number of older brothers among birth-assigned males. No significant differences were found in extreme right-handedness or mental rotation. No significant interaction effects were found with sexual orientation. While these findings are generally consistent with past research, there were limitations of the internet-based methodology, including a non-representative sample. [Copyright &y& Elsevier]

Abstract: This article reviews research on biological and psychosocial factors relevant to the etiology of gender-variant identities. There is evidence for a genetic component of gender-variant identities through studies of twins and other within-family concordance and through studies of specific genes. Evidence that prenatal androgens play a role comes from studies that have examined finger length ratios (2D:4D), prevalence of polycystic ovary syndrome among female-to-male transsexuals, and individuals with intersex and related conditions who are more likely to have reassigned genders. There is also evidence that transsexuals have parts of their brain structure that is typical of the opposite birth-assigned gender. A greater likelihood of non-right-handedness suggests developmental instability may also contribute as a biological factor. There is a greater tendency for persons with gender-variant identities to report childhood abuse and a poor or absent relationship with parents. It is unclear if this is a cause or effect of a gender-variant identity. Parental encouragement of gender-variance is more common among individuals who later develop a gender-variant identity. We conclude that biological factors, especially prenatal androgen levels, play a role in the development of a gender-variant identity and it is likely that psychosocial variables play a role in interaction with these factors. [Copyright &y& Elsevier]

Objective: Most previous studies of the prevalence of transsexualism have used data from individuals seeking sex reassignment surgery. New Zealand is unique in that transsexual people can apply to have an 'X' for the sex on their passport if they have a name on their birth certificate that is congruent with the sex opposite to their birth assigned sex, and provide a statutory declaration stating they have lived as a member of that sex. Method: From information provided by the New Zealand Passports Office, it was ascertained that the prevalence of transsexualism among New Zealand passport holders was at least 1:6364. Results: The prevalence of male-to-female transsexualism was estimated at 1:3639, and the corresponding figure for female-to-male transsexualism was 1:22 714. Conclusions: These estimates were higher than most previous estimates of transsexualism prevalence. There was also a larger than expected ratio of male-to-female transsexual people to female-to-male transsexual people (6:1), which could in part be due to female-to-male transsexual people being relatively overrepresented among those transsexual people for whom we did not have data on the direction of sex change, or this may be indicative of the demography of transsexualism in Australasia. [ABSTRACT FROM AUTHOR]

In this article, the author focuses on the working of the periodical "International Journal of Transgenderism" for transgender representation in academic publishing. It mentions the working of an professional organization WPATH for transgender people. It also mentions that the periodical works for transgender people in the academic and health professional.

The article discusses the special issue of the "International Journal of Transgenderism" that will focus on the experiences of transgender youth relevant to health, well-being and school achievement and experiences. Topics covered include call for submission of papers that promote the practice of intellectual humility in public course and recommended topics including sociological barriers that affect the understanding of variations in gender identity and protective factors for gender minority.

A response by Jaime F. Veale, David E. Clarke, and Terri C. Lomax about their article on transsexual groups are autogynephilic and nonautogynephelic, published online in November 7, 2008 issue is presented.

Transgender persons can face a number of barriers in accessing primary and specialist care that is equitable, inclusive and appropriate for their needs. In this Viewpoint, commissioned to recognize Pride, five researchers with expertise across different disciplines, including nephrology, endocrinology, public health, psychology and sociology, provide their perspectives on key considerations that are required to achieve optimal primary and nephrology care for transgender individuals, including barriers to care and how these might be overcome to ensure that the provision of care is inclusive and safe. [ABSTRACT FROM AUTHOR]

Background: Little is known about experiences and barriers for trans and non‐binary (TGNB) people eligible for cervical screening in Aotearoa New Zealand. Aims: To identify uptake, barriers and reasons for delaying cervical cancer screening among TGNB people in Aotearoa. Materials and Methods: The 2018 Counting Ourselves data on TGNB people assigned female at birth aged 20–69 years who had ever had sex, were analysed to report on experiences of those who were eligible for cervical screening (n = 318). Participants answered questions about whether they had taken part in cervical screening and reasons behind any delays in receiving the test. Results: Trans men were more likely than non‐binary participants to report that they did not require cervical screening or were unsure if they needed it. For those who had delayed cervical screening, 30% did so due to feeling worried about how they would be treated as a trans or non‐binary person and 35% due to another reason. Other reasons for delay related to general and gender‐related discomfort, previous traumatic experiences, anxiety or fear of the test and pain. Material barriers to access included cost and lack of information. Conclusions: The current cervical screening program in Aotearoa does not consider the needs of TGNB people, leading to delayed and reduced uptake of cervical screening. Health providers require education on the reasons TGNB people delay or avoid cervical screening in order to provide appropriate information and affirmative healthcare environments. The human papillomavirus self‐swab may address some of the existing barriers. [ABSTRACT FROM AUTHOR]

Project K is a positive youth development programme targeting 13-15 year old students with low self-efficacy. It involves three components: wilderness adventure, community challenge and individual mentoring. This longitudinal study aimed to investigate changes in self-efficacy, resilience, connectedness and wellbeing in students participating in Project K. Eighty students (59% male) were recruited from five secondary schools across the North Island of New Zealand for a quasi-experimental study. Participants displaying delinquent behaviour, self-harm, suicidal ideation, or an eating disorder were excluded. Over 14 months, six waves of measurement were completed by Project K participants (n = 49), while four waves of measurement were completed by a control group (n = 31). Analyses using multilevel models showed that completion of Project K had substantial positive effects on selfefficacy, resilience, and wellbeing, although the effect on connectedness was not significant. We conclude that Project K appears to be an effective positive youth development programme for adolescents with low self-efficacy. [ABSTRACT FROM AUTHOR]

Globally, transgender people have been described as a highly marginalised population due to cisgenderism that delegitimises their gender identities and expressions. Despite robust evidence from many countries noting the association of discrimination and stigma for being transgender with heightened mental health risks, qualitative research that examines the nuances of mental health indicators using health equity frameworks has been scant both in Aotearoa/New Zealand and overseas. Using an inductive thematic approach, this paper analysed 222 open-text responses in the mental health section of the 2018 Counting Ourselves: Aotearoa New Zealand, Trans and Non-binary Health Survey. Our findings showed four overarching themes: gender-affirming healthcare, mental healthcare services and accessibility, gender minority stress, and self-affirmation and social support. Participants' narratives described pervasive gender minority stress experiences in gender-affirming and mental healthcare services, including unmet healthcare needs, lack of competency in healthcare delivery, and pathologisation of their genders. In social settings, our participants commonly reported discrimination and violence, although they also reported that self-affirmation strategies and social support offset the impacts of gender minority stress on their mental health. The current findings indicate the importance of exploring mental health outcomes for transgender people in relation to cisgenderism and resultant gender minority stress. [ABSTRACT FROM AUTHOR]

Introduction: Internationally, trans women are disproportionately impacted by HIV, encounter specific barriers navigating safer sex and face inequities accessing HIV prevention, including pre‐exposure prophylaxis (PrEP). Aotearoa/New Zealand (hereafter Aotearoa) was one of the first countries internationally to publicly fund PrEP in 2018, including for trans people. However, few data exist on PrEP awareness or sexual negotiation among trans populations to guide implementation. We present the first Aotearoa data on trans people's ability to negotiate barrier protection and awareness of PrEP efficacy and availability. Methods: We used data from a large, diverse community‐based nationwide survey of trans (including non‐binary) people in Aotearoa: Counting Ourselves (N = 1178) conducted from 21 June to 30 September 2018. Generalized regression analyses were carried out among participants who have had sex (n = 704; Mage = 32.5) to identify associations between demographic factors (age, gender and sexual attraction, ethnicity, income, education qualification and current sex work involvement) and the Trans‐Specific Barrier Negotiation Self‐Efficacy (T‐Barrier) Scale and PrEP awareness. Results: The mean value of a 40‐point T‐Barrier Scale was 33.45 (SD: 6.89), suggesting a relatively high perceived ability among our participants to negotiate protective barrier usages in different situations. Asian participants scored 3.46 points lower compared to Pākehā (White) participants, and trans women attracted to men (cisgender and/or trans men) scored 2.40 points higher than trans women not attracted to men. Three‐fifths (59.7%) were aware that PrEP reduced HIV risks and did not prevent sexually transmitted infections (STI) transmission, and only two‐fifths (40.2%) knew PrEP was publicly funded for trans people. In multivariate models, we found participants who were older, trans women or those with lower education qualifications were less likely to have increased levels of PrEP awareness. Conclusions: Participants attracted to men have a higher potential need for PrEP and were more likely to report PrEP awareness and that they could negotiate protective barrier usage. However, trans women and those with lower educational qualifications reported lower levels of PrEP awareness. More trans‐competent sexual health education, drawing on the newly released PrEP guidelines, is needed to promote the benefits of PrEP in the Aotearoa HIV epidemic context, particularly for trans women. [ABSTRACT FROM AUTHOR]

Introduction: Internationally, trans women are disproportionately impacted by HIV, encounter specific barriers navigating safer sex and face inequities accessing HIV prevention, including pre‐exposure prophylaxis (PrEP). Aotearoa/New Zealand (hereafter Aotearoa) was one of the first countries internationally to publicly fund PrEP in 2018, including for trans people. However, few data exist on PrEP awareness or sexual negotiation among trans populations to guide implementation. We present the first Aotearoa data on trans people's ability to negotiate barrier protection and awareness of PrEP efficacy and availability. Methods: We used data from a large, diverse community‐based nationwide survey of trans (including non‐binary) people in Aotearoa: Counting Ourselves (N = 1178) conducted from 21 June to 30 September 2018. Generalized regression analyses were carried out among participants who have had sex (n = 704; Mage = 32.5) to identify associations between demographic factors (age, gender and sexual attraction, ethnicity, income, education qualification and current sex work involvement) and the Trans‐Specific Barrier Negotiation Self‐Efficacy (T‐Barrier) Scale and PrEP awareness. Results: The mean value of a 40‐point T‐Barrier Scale was 33.45 (SD: 6.89), suggesting a relatively high perceived ability among our participants to negotiate protective barrier usages in different situations. Asian participants scored 3.46 points lower compared to Pākehā (White) participants, and trans women attracted to men (cisgender and/or trans men) scored 2.40 points higher than trans women not attracted to men. Three‐fifths (59.7%) were aware that PrEP reduced HIV risks and did not prevent sexually transmitted infections (STI) transmission, and only two‐fifths (40.2%) knew PrEP was publicly funded for trans people. In multivariate models, we found participants who were older, trans women or those with lower education qualifications were less likely to have increased levels of PrEP awareness. Conclusions: Participants attracted to men have a higher potential need for PrEP and were more likely to report PrEP awareness and that they could negotiate protective barrier usage. However, trans women and those with lower educational qualifications reported lower levels of PrEP awareness. More trans‐competent sexual health education, drawing on the newly released PrEP guidelines, is needed to promote the benefits of PrEP in the Aotearoa HIV epidemic context, particularly for trans women. [ABSTRACT FROM AUTHOR]

Background: Past research has established that transgender people experience significant disparities in mental health outcomes and healthcare dissatisfaction compared with cisgender people, but more research is needed on how supportive healthcare interactions relate to the mental health of transgender people.Objectives: The 2 main aims of our analyses were: (i) to establish the most common negative experiences in healthcare and the most common supportive experiences specifically with primary care doctors for transgender people; and (ii) to examine the association of supportive experiences with mental health variables after controlling for demographic factors.Methods: Data from the 2018 Counting Ourselves nationwide survey of transgender people were analysed using regression modelling. The 948 participants with a primary care doctor or general practitioner were included in analyses. Participants were aged 14-83 years old (mean 30.20).Results: The most common supportive experiences involved primary care doctors treating transgender people equitably, with competence, and with respect. Participants with more negative healthcare experiences had higher psychological distress as well as higher likelihood of reporting nonsuicidal self-injury and suicidality. Conversely, participants with more experiences of supportive primary care doctors had lower psychological distress and were less likely to have attempted suicide in the past 12 months.Conclusion: When transgender people receive supportive care from their primary care providers they experience better mental health, despite ongoing negative healthcare experiences. Future research is needed to confirm ways of supporting positive trajectories of mental health for transgender people but these findings demonstrate the importance of positive aspects of care. [ABSTRACT FROM AUTHOR]

Issues addressed: To examine the mental health inequities, and social exclusion and isolation and protective factor differences between people of diverse genders and sexualities (lesbian/gay, bisexual, gender diverse and takatāpui) and cisgender and heterosexual people in Aotearoa/New Zealand. Methods: We employed data from the pooled probability sample of 2016 and 2018 New Zealand Mental Health Monitor. The sample comprised of 2938 people at least 15 years old, of which 93 had diverse gender and sexuality identities. Generalised linear models were used to test for differences in mental health (current and lifetime mental distress, depression, anxiety, self‐harm and suicide), social exclusion and isolation, and friend and family support for people of diverse genders and sexualities. We also conducted exploratory linear regression analyses to examine whether mental health difficulties were associated with social exclusion and isolation and friend/family support. Results: People of diverse genders and sexualities had high rates of mental health difficulties across all variables we examined. For example, people identifying as diverse genders and sexualities had three times the risk of considering self‐harm and suicide than their cisgender and heterosexual counterparts (22% vs 5%; RR = 3.12). People of diverse genders and sexualities also scored an average of 6.08 points higher on the 27‐point PHQ‐9 depression scale when they had experienced social isolation, and 4.01 points higher when they experienced social exclusion. Conclusion: Our results are consistent with current literature on the large mental health inequities faced by people of diverse genders and sexualities. So what?: Policy makers and health care providers in Aotearoa/New Zealand should consider the negative mental health consequences of social exclusion and isolation for people of diverse genders and sexualities. [ABSTRACT FROM AUTHOR]

Objective. Effectively addressing health disparities experienced by sexual minority populations requires high-quality official data on sexual orientation.We developed a conceptual framework of sexual orientation to improve the quality of sexual orientation data in New Zealand's Official Statistics System. Methods.We reviewed conceptual andmethodological literature, culminating in a draft framework. To improve the framework, we held focus groups and key-informant interviews with sexual minority stakeholders and producers and consumers of official statistics. An advisory board of experts provided additional guidance. Results. The framework proposes working definitions of the sexual orientation topic and measurement concepts, describes dimensions of the measurement concepts, discusses variables framing the measurement concepts, and outlines conceptual grey areas. Conclusion. The framework proposes standard definitions and concepts for the collection of official sexual orientation data in New Zealand. It presents a model for producers of official statistics in other countries, who wish to improve the quality of health data on their citizens. [ABSTRACT FROM AUTHOR]

Past studies that compare cisgender to transgender (or trans) and gender diverse people have found a higher prevalence of mental health problems among the latter groups. This article uses Testa's gender minority stress framework, which is an expansion of minority stress theory, to assess minority stressors that are specific to the experiences of trans and gender diverse people. The concept of cisnormativity, an ideology that positions cisgender identities as a norm, is used in relation to the gender minority stress framework to describe the marginalizing nature of social environments for trans and gender diverse people. This article provides a critical review that integrates and expands on past theoretical perspectives on gender minority stressors and protective factors. Specifically, this article demonstrates the relevance of cultural and ethnic backgrounds to complement the application of intersectionality in research on health disparities experienced by trans and gender diverse people. [ABSTRACT FROM AUTHOR]

The effects of health inequities on transgender (or trans) and gender diverse populations have been well documented internationally. Studies that compared the mental health of trans and gender diverse populations to cisgender populations found significant inequities for mental health problems. There has been very little research on this topic, however, from Aotearoa/New Zealand. We conducted database search in the PsycINFO, as well as manual searches for published grey literature in Aotearoa/New Zealand to identify theoretical and empirical literature on social determinants of health and related frameworks to explain the effects of social environments on health inequities experienced by trans and gender diverse people. We also complement international studies by considering Māori and Pacific trans and gender diverse identities and the ramifications of colonisation on the mental health and wellbeing of these populations. [ABSTRACT FROM AUTHOR]

The implementation of the New Zealand government's recently developed statistical standard for gender identity has led to, and will stimulate further, collection of gender identity data in administrative records, population surveys, and perhaps the census. This will provide important information about the demographics, health service use, and health outcomes of transgender populations to allow evidence-based policy development and service planning. However, the standard does not promote the two-question method, risking misclassification and undercounts; does promote the use of the ambiguous response category "gender diverse" in standard questions; and is not intersex inclusive. Nevertheless, the statistical standard provides a first model for other countries and international organizations, including United Nations agencies, interested in policy tools for improving transgender people's health. [ABSTRACT FROM AUTHOR]