48th NAPCRG Annual Meeting

Submission Id: 2135

Title
Predictors of Age of Initiation of Gender Affirmation: Time Trends and Demographic Predictors
Submitted Category
Poster On Completed Research
Accepted Category
Poster On Completed Research
Presenters
rania elmais - CO AUTHOR
Christopher Morley, PhD, MA - SUBMITTER, LEAD PRESENTER
Rachel Hopkins - CO AUTHOR
Abstract
Context: Societal acceptance of transgender people in the United States has been historically limited as has
access to medically supervised hormone therapy and transition surgeries. In recent years there has been
increasing visibility and acceptance of transgender people in popular culture. Age of initiation may be a proxy
indicator for barriers to gender affirmation.​
Objective: To examine whether age at initiation of gender affirmation has shifted over time, as well as to
examine the effect of demographic covariates on age of initiation.​
Study Design: Retrospective Cohort study. Linear regression of year of initiation on age at initiation.​
Population Studied: All patients older than 18 who had initiated gender affirmation at any point in their lives,
who presented to an endocrine clinic from 20120-2019.​
Outcome Measures: Beta coefficients for year of initiation and for covariates.​
Results: Mean age over time appeared to trend unevenly upward, interrupted by a sharp upward spike in the
late 1990s and beginning of the new century, with gender affirmation to Trans-Female gradually trending
upward in age . In the final regression model, the year of initiation was not a significant predictor of age at
initiation, controlling for covariates. Trans-Females were over 6 years older than Trans-Males in the sample
(β=6.214, p<.001). White cases were nearly 4 years older (β=3.949, p=.013), and people who were employed
at first visit were over 6 years older than those who were unemployed (β=6.101, p<.001). On the other hand,
those with commercial insurance were over 5 years younger at initiation than those with non-commercial
insurance (β=-5.313, p<.001). ​
Conclusions: Gender affirmation to Trans-Female appears to begin later in life than for males, with significant
economic and social predictors at play. The decision to affirm as female appears to be trending upward over
time. Limitations include a single-clinic study, and retrospective convenience sample. Further study of barriers
to gender affirmation may be warranted.
First Objective: On completion of this session the participants should be able to...
On completion of this session the participants should be able to identify and describe the relationship between
demographic predictors of age of initiation of gender affirmation.
Second Objective: On completion of this session the participants should be able to...
On completion of this session the participants should be able to describe the relationship between year of
initiation and age at initiation of gender affirmation
Consider for Trainee Award?
No
Would you like this presentation to be considered for a NAPCRG Pearl award?
Yes
Priority 1
Social determinants and vulnerable populations
Priority 2
Diabetes and endocrine disease
Priority 3
Women’s health
Study Design 1
Observational study (cohort, case-control)
Study Design 2
Secondary data analysis