Meg Quint

All Publications

• Gender-Affirming Surgical History, Satisfaction, and Unmet Needs Among Transgender Adults. JAMA network open Pletta, D. R., Quint, M., Radix, A. E., Mayer, K. H., Potter, J., Coon, D., Keuroghlian, A. S., Hughto, J. M., Reisner, S. L. 2025; 8 (9): e2532494

  Abstract

  Importance: Gender-affirming surgery (GAS) is an effective treatment for gender dysphoria among transgender, nonbinary, and gender diverse (TGD) individuals. Research is needed to assess GAS history, factors associated with GAS satisfaction, desired yet unobtained GAS, and barriers and facilitators to GAS access for TGD individuals.Objective: To assess of the prevalence of GAS, surgical satisfaction, and encountered barriers among TGD adults and the factors associated with these outcomes.Design, Setting, and Participants: This cross-sectional study, conducted from October 2024 to June 2025, used baseline electronic survey data from TGD adult primary care patients enrolled in LEGACY, a longitudinal cohort study. Data were collected from February 2019 to March 2021.Exposures: Age, gender identity, race, Latine or Hispanic ethnicity, educational attainment, homelessness, income, health insurance, HIV status, gender marker change, gender-affirming hormone use, severe psychological distress, self-rated health, and participation during the COVID-19 pandemic.Main Outcomes and Measures: The main outcomes were receipt of GAS, high surgical satisfaction, and encountered barriers to GAS (eg, waiting lists, cost). Descriptive analyses and logistic regression models, stratified by gender identity, were used to examine the association between the exposures and these outcomes.Results: The study cohort of 2176 patients were a mean (SD) age of 30.3 (10.3) years; 1413 (64.9%) identified as transmasculine (TM), 763 (35.1%) as transfeminine (TF), and 672 (30.9%) as nonbinary. A total of 634 patients (29.1%) identified as a member of a racial minority group and 237 (10.9%) as Latine or Hispanic. Overall, 946 patients (43.5%) had received GAS, and 776 of these patients (82.0%) reported high satisfaction. The most desired surgeries were hysterectomy (868 of 1413 [61.4%]) for TM patients and facial feminization (516 of 763 [67.6%]) for TF patients. Most patients (2054 [94.4%]) encountered a barrier to GAS, with the most common being cost (1455 [66.9%]). In multivariable models, younger age (eg, 18-24 years vs ≥40 years) was associated with lower odds of GAS (TM patients: adjusted odds ratio [AOR], 0.19 [95% CI, 0.11-0.34]; TF patients: AOR, 0.22 [95% CI, 0.12-0.42]) and higher odds of encountering a barrier (TM patients: AOR, 3.16 [95% CI, 1.59-6.30]; TF patients: AOR, 9.39 [95% CI, 2.47-35.67]). Gender marker change (TM patients: AOR, 8.61 [95% CI, 6.19-11.98]; TF patients: AOR, 6.29 [95% CI, 4.01-9.87) and hormone use (TM patients: AOR, 4.71 [95% CI, 3.02-7.34]; TF patients: AOR, 7.69 [95% CI, 1.79-33.04]) were associated with greater odds of GAS; lack of insurance was associated with lower satisfaction (TM patients: AOR, 0.31 [95% CI, 0.13-0.76]; TF patients: AOR, 0.09 [95% CI, 0.02-0.49]).Conclusions and Relevance: In this cross-sectional study, TGD patients reported high GAS satisfaction but substantial unmet need and frequent barriers to care. Efforts appear to be needed to improve accessibility for TGD patients desiring GAS.

  View details for DOI 10.1001/jamanetworkopen.2025.32494

  View details for PubMedID 40965883

• Management of Complications Associated With Vulvovaginoplasty. Clinical obstetrics and gynecology Quint, M., Grimstad, F. 2025

  Abstract

  Over the past few decades, vulvovaginoplasty for transfeminine patients has rapidly advanced in both technique and access. However, a variety of barriers, including geographical access to surgeons, may make it difficult to access the original surgical team for evaluation and management of complications. Given this, local gynecologists and other health professionals may play a vital role in the evaluation and management of nonsurgical complications. Here, we review common complications and provide an overview of their related nonsurgical and surgical management for vulvovaginoplasty for transfeminine patients.

  View details for DOI 10.1097/GRF.0000000000000958

  View details for PubMedID 40689480

• Factors contributing to long term Medicaid sustainment among burn patients enrolled via California's Hospital Presumptive Eligibility program. Journal of burn care & research : official publication of the American Burn Association Quint, M., Arnow, K., Reid, L., Gibson, A., Hendricks, W., Romanowski, K., Sheckter, C., Knowlton, L. M. 2025

  Abstract

  BACKGROUND: Hospital Presumptive Eligibility (HPE) provides uninsured patients temporary Medicaid coverage at the time of hospitalization and offers a pathway to securing long term Medicaid coverage in California. This is of particular importance for burn survivors who have ongoing healthcare needs and may experience financial hardship due to acute and long-term recovery service utilization.METHODS: Using Medicaid claims eligibility data, the California Department of Health Care Services Management Information Systems and the Decisions Support System records, patients ages 18-64 with a primary diagnosis of burn were identified. Descriptive characteristics and Pearson's chi2 tests were used to evaluate bivariate relationships between those who sustained Medicaid after 6months and those who did not. Multivariate logistic regression was used to determine association of various factors with Medicaid sustainment.RESULTS: Of 1382 included patients, 73% sustained Medicaid 6months after HPE enrollment. There were significant differences in Medicaid sustainment between race/ethnicity groups, primary language, total burn surface area (TBSA), length of inpatient stay, and need for mechanical ventilation (p=.008) indicating intensive care unit (ICU) admission. For those who were discharged, multivariate analyses show Spanish speakers and those who did not disclose their language vs. English speakers (p=.020 and p<.001 respectively), those who did not disclose race/ethnicity vs. white (p=.017), those with <10% TBSA vs 20+% TBSA (p<.001), and those who were discharged home vs. those discharged to services (p=.047) were less likely to sustain Medicare. Similar results were observed for all inpatients, except those without concurrent trauma (p=.042) were also less likely to sustain Medicaid.CONCLUSIONS: HPE enrollment at the time of burn injury hospitalization provides a viable path for patients to obtain long term Medicaid insurance, but additional support pathways must be identified to support Medicaid sustainment for those who are not English speakers and those who are less likely to require long term follow up care (i.e., those with lower TBSA and those who are discharged home).

  View details for DOI 10.1093/jbcr/iraf105

  View details for PubMedID 40474549

• The AFFIRM Framework for gender-affirming care: qualitative findings from the Transgender and Gender Diverse Health Equity Study. BMC public health Quint, M., Bailar, S., Miranda, A., Bhasin, S., O'Brien-Coon, D., Reisner, S. L. 2025; 25 (1): 491

  Abstract

  BACKGROUND: Transgender, nonbinary, and gender diverse (TGD) people experience stigma in healthcare settings impacting healthcare utilization, including avoidance of care due to anticipated discrimination. Gender-affirming care refers to care for medical gender affirmation, such as gender-affirming hormones and surgery, as well as general care that affirms and respects TGD patients. This study sought to explore the experiences of TGD adults to inform gender-affirming care delivery and develop an actionable framework for practice.METHODS: Between May-October 2021, one-time individual in-depth interviews were conducted with 27 TGD adults receiving any healthcare in the greater Boston Massachusetts area to gather data about gender-affirming care. Interviews were semi-structured, explored prior and current experiences in healthcare and ideal gender-affirming care models, and conducted virtually via a secure Zoom platform. Analyses were conducted using immersion crystallization and reflexive thematic analysis; interview transcripts were double coded by two coders.RESULTS: Participants had a mean age of 28.5, ranging 18-45years, and were: 7 transgender men, 6 transgender women, 8 nonbinary, 3 genderqueer, 1 agender, and 2 gender not specified. Themes about gender-affirming care coalesced into the acronym AFFIRM: (1) Affirms in individual interactions: Participants called for affirmation of TGD identity, lived expertise, and competent TGD providers and staff. (2) Flexible and accessible: Participants expressed the need for gender-affirming care to be available beyond urban population-specific clinics, in a timely fashion without long wait lists, and in a community-centered manner such as offering non-traditional times and settings. (3) Fights systemic oppression: Participants emphasized the need for providers and health systems to eliminate gatekeeping practices for gender-affirming care and create care models that resist intersecting oppressive systems such as racism and cisgenderism. (4) Interacts with community: Patients desired intentional interaction with TGD community to holistically address health and unmet gender affirmation needs. (5) Retains patients in care: Patients shared the need to collaboratively identify and problem-solve obstacles to gender-affirming care with providers and healthcare systems to optimize TGD-specific retention strategies. (6) Multidisciplinary: Patients called for interdisciplinary teams with co-located services such as primary care and mental healthcare with letter-writing for surgical care, and incorporation of peer navigators to meet the broader social, health, and well-being needs of TGD people.CONCLUSIONS: Findings from this study and the AFFIRM Framework which emerged from TGD patient narratives can be applied to improve current care and set benchmarks for high-quality gender-affirming care delivery and practice.

  View details for DOI 10.1186/s12889-024-21261-7

  View details for PubMedID 39915834

• Injectable Estradiol Use in Transgender and Gender-Diverse Individuals in the U.S.: A Multicenter Retrospective Study. The Journal of clinical endocrinology and metabolism Misakian, A. L., Kelley, C. E., Sullivan, E. A., Chang, J. J., Singh, G., Kokosa, S., Avila, J., Cooper, H., Liang, J. W., Botzheim, B., Quint, M., Jeevananthan, A., Chi, E., Harmer, M., Hiatt, L., Kowalewski, M., Steinberg, B., Tausinga, T., Tanner, H., Ho, T. F., Mark, B., Zenger, B., Hu, S., Gebregzabheir, A., Penny, J. M., Loeb, D. F., Strickland, T., Iwamoto, S. J., Rothman, M. S., Hamnvik, O. R., Ariel, D. 2025

  Abstract

  Guidelines for use of injectable estradiol esters (valerate [EV] and cypionate [EC]) among transgender and gender diverse (TGD) individuals designated male at birth vary considerably, with many providers noting supraphysiologic serum estradiol concentrations based on current dosing recommendations.1. Determine dose of injectable estradiol (subcutaneous [SC] and intramuscular [IM]) needed to reach guideline-recommended estradiol concentrations for TGD adults using EC/EV. 2. Describe relationship between estradiol concentration relative to timing/dose of last estradiol injection and other covariates. 3. Determine dosing differences between IM/SC EV/EC.Cross-sectional retrospective study across six United States medical centers including TGD adults on same-dose injectable estradiol for >75 days, with confirmed timing of estradiol concentration relative to last injection, from 1/1/2019---12/31/2023. Descriptive statistics were used to describe patient characteristics and weighted linear mixed models to evaluate relationship between various covariates and estradiol concentration.Data from 562 patients were included. Among those injecting every seven days who reached the guideline-recommended estradiol concentration (n=131, 27.5%), the median estradiol dose was 4.0 mg (interquartile range 3.0---5.0 mg). Among all patients, the majority reached supraphysiologic estradiol concentrations (>200 pg/mL [>734 pmol/L]) while dose and timing in the injection cycle were significant covariates for the estradiol concentration. There were no significant dosing differences between IM/SC EV/EC.Injectable estradiol esters effectively reach guideline-recommended estradiol concentrations but at lower doses than previously recommended. Estradiol concentrations are best interpreted relative to timing of last injection. Route of administration and type of ester do not significantly impact estradiol concentrations.

  View details for DOI 10.1210/clinem/dgaf015

  View details for PubMedID 39797602

• Barriers experienced by and educational needs of clinicians who provide care for transgender, nonbinary, and gender-diverse young adults in the Mid-Atlantic and Southern United States PLOS ONE Kremen, J., Quint, M., Tham, R., Kane, K., Boskey, E. R., Morrow, C., Reisner, S. L., Xu, R. 2025; 20 (6): e0326420

  Abstract

  The purpose of this study is to identify and explore the educational needs of and broader barriers experienced by clinicians who provide care to transgender, nonbinary, and gender diverse (TGD) young adults (aged 18-24), with a focus on unique healthcare needs and challenges.Between April 2022 - July 2022, we conducted qualitative interviews with 13 clinicians (n = 9 medical and n = 4 mental health) about perceived needs and barriers relating to the care of TGD young adults. Clinicians were recruited throughout the Southeastern and Mid-Atlantic United States and were a mix of general practitioners and specialists. Using a hybrid deductive and inductive thematic analysis approach, the interview transcripts were analyzed and key themes identified.Thematic analyses of these interviews identified three main themes: the need for knowledgeable clinicians, the need and desire for reliable training resources and mentorship, and concerns surrounding the impact of the sociopolitical environment. Many participants noted a lack of access to local educational opportunities and mentorship but expressed willingness to seek these out if centralized resources, such as national platforms or accessible training modules, were available.This study identifies both gaps in clinician education and broader barriers - such as local politics and access to mentorship - that hinder the ability to provide effective care to TGD young adults. These findings will help to inform the development of clinician education and support programs.

  View details for DOI 10.1371/journal.pone.0326420

  View details for Web of Science ID 001513830700023

  View details for PubMedID 40549722

  View details for PubMedCentralID PMC12184940

• A Content and Readability Analysis of Genitourinary and Sexual Health-Related Patient-Reported Outcome Measures in Gender-Affirming Care. Urology Hu, S., Quint, M., Boysen, W. R., Coon, D., Odeluga, N., Dy, G. W., Pusic, A. L., Kaur, M. N. 2024

  Abstract

  To the evaluate the readability and comprehensiveness of genitourinary and sexual health-related patient-reported outcomes (PROMs) used in gender-affirming care.Common PROMs that measure genitourinary and sexual health-related outcomes in gender-affirming care literature were identified from six recent systematic reviews. Readability analysis was completed at the level of individual items and full scale using established readability assessment tool, including Flesch Kincaid Grade Level (FKGL), Gunning Fog Score (GF), Coleman Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG) Index. The concepts measured by the PROMs were evaluated for comprehensiveness.25 PROMs were included, of which 12 assessed genitourinary outcomes and 13 assessed sexual health outcomes. A total of seven genitourinary domains and eight sexual health domains were identified during concept mapping. Readability analysis showed a median PROM grade level of 9.0 and 9.5 in genitourinary and sexual PROMs, respectively. The Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction v2.0 had the lowest median reading grade level of 5.7, and the Female Sexual Function Index has the highest median reading grade level of 13.9. No single PROM was found to be comprehensive. Multiple PROMs contained double-barreled items or used outdated terminology.Most PROMs used in the genital gender-affirming literature failed to meet the readability recommendations for patient-facing material and were culturally unfit for use in transgender and gender-diverse individuals. None of the PROMs were found to be comprehensive for evaluating outcomes of gender-affirming care. Validated gender-affirming care-specific PROMs that are comprehensible, comprehensive, and relevant are urgently needed.

  View details for DOI 10.1016/j.urology.2024.06.044

  View details for PubMedID 38936626

• "We Followed their Lead": Exploring Relational Change and Support among Caregivers of Transgender and Gender Diverse Youth. SSM. Qualitative research in health Tarantino, M. R., Tham, R. L., Quint, M. R., Kremen, J., Kane, K., Rangel-Gomez, M., Boskey, E., Xu, R., Reisner, S. L. 2024; 5

  Abstract

  Transgender and gender diverse youth and young adults (TGDY) experience higher mental health morbidity, including self-harm, suicide ideation, and suicide attempts, as compared to cisgender peers. Support from family members is associated with improved mental health outcomes for TGDY. However, little is known about the process that caregivers who consider themselves supportive undergo and how caregiver-youth relationships evolve through a TGDY's gender journey. Through a reflexive thematic analysis of 14 interviews conducted with caregivers of TGDY from April-July 2022, we sought to understand how caregivers who considered themselves supportive of TGDY navigated shifting relationships with themselves, their children, and their communities. Applying theories of Ambiguous Loss and Thriving Through Relationships, findings coalesced around several themes including reflecting on change, re-negotiating interpersonal relationships, and educating through relationships. The gender journeys of TGDY required caregivers to navigate relationships with self (feeling loss and wrestling with worry for their child), negotiate relationships with others (disclosing to extended family and social networks), and educate themselves and others through relationships (connecting through personal narratives from other families, parents supporting parents, learning to advocate for their child). The process of caregivers learning to support their children was facilitated through profound intrapersonal and interpersonal reflection, connection, and community. Understanding this process is important to inform educational interventions and programs that help caregivers learn to support and advocate effectively for TGDY.

  View details for DOI 10.1016/j.ssmqr.2024.100429

  View details for PubMedID 38778873

• TRANSforming Gender Identity Data Collection and Representation for Gender Diverse Youth. Pediatrics Quint, M., Reece-Nguyen, T. L. 2024

  View details for DOI 10.1542/peds.2024-065932

  View details for PubMedID 38752290

• WE FOLLOWED THEIR LEAD": EXPLORING RELATIONAL CHANGE AND SUPPORT AMONG CAREGIVERS OF TRANSGENDER AND GENDER DIVERSE YOUTH Tarantino, M. R., Quint, M., Tham, R. L., Kremen, J., Kane, K., Rangel-Gomez, M., Xu, R., Reisner, S. L. ELSEVIER SCIENCE INC. 2024: S89-S90

  View details for Web of Science ID 001301045100168

• Exploring gender euphoria in a sample of transgender and gender diverse patients at two U.S. urban community health centers. Psychiatry research Reisner, S. L., Pletta, D. R., Harris, A., Campbell, J., Asquith, A., Pardee, D. J., Deutsch, M. B., Aguayo-Romero, R., Quint, M., Keuroghlian, A. S., Radix, A. 2023; 329: 115541

  Abstract

  Transgender and gender diverse (TGD) people are affected by mental health inequities. Gender euphoria-positive emotions or joy in gender-may be associated with positive mental health. Between February 2019-July 2021, we surveyed 2,165 adult TGD patients (median age=28 years; 29.2% people of color; 29.6% nonbinary; 81.0% taking hormones) evaluating gender euphoria and mental health. Overall, 35.0% self-reported gender euphoria, 50.9% gender dysphoria, 23.5% alcohol misuse, and 44.5% resilience. Gender euphoria differed by race, gender, insurance, and hormone use, and was associated with reduced gender dysphoria (adjusted Odds Ratio[aOR]=0.58; 95% confidence interval [95%CI]=0.47-0.72) and alcohol misuse (aOR=0.75; 95%CI=0.60-0.95), and increased resilience (aOR=1.31; 95%CI=1.07-1.61). The construct of gender euphoria may be a promising mental health target.

  View details for DOI 10.1016/j.psychres.2023.115541

  View details for PubMedID 37857133

• A qualitative exploration of how to support PrEP adherence among young men who have sex with men AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV Psaros, C., Hill-Rorie, J., Quint, M., Horvitz, C., Dormitzer, J., Biello, K. B., Krakower, D. S., Safren, S. A., Mimiaga, M. J., Sullivan, P., Hightow-Weidman, L. B., Mayer, K. H. 2023: 1-12

  Abstract

  New HIV infections disproportionately affect young men who have sex with men (YMSM). PrEP is effective in preventing HIV acquisition; however, adherence is critical and is often suboptimal among YMSM. Interventions addressing the unique PrEP adherence challenges faced by YMSM are needed. We conducted qualitative interviews with 20 HIV-negative, YMSM (ages 15-24) with a PrEP indication and 11 healthcare professionals to inform adaption of a PrEP adherence intervention (Life-Steps for PrEP) for YMSM. We explored environmental, healthcare, and individual factors influencing uptake, adherence, attitudes, and perspectives (including desired modifications) on the Life-Steps intervention. Interviews were analyzed using content analysis. Of YMSM study participants (mean age 21.6) 55% were White, 15% Hispanic, and 5% Black. Most YMSM were PrEP-experienced (70%). Healthcare professionals (6 prescribers, 1 nurse, 2 health educators, 2 other/unspecified) averaged 6.9 years of experience caring for YMSM. All described stigma as a barrier to PrEP; YMSM expressed concern around being perceived as "risky" and concern about inadvertent PrEP disclosure if family/friends found their medication, or if parental insurance was used. Difficulty with planning for potential adherence challenges were identified by both groups. YMSM highlighted benefits of a nurse-led intervention (i.e., adding "legitimacy"), but stressed need for nonjudgmental, "savvy" interventionists. YMSM expressed a desire for comprehensive YMSM-specific sexual health information. These findings informed modification and expansion of Life-Steps content. Results highlight key potential barriers, many of which center around privacy. Content that addresses PrEP stigma, disclosing PrEP use, navigating insurance, and planning ahead in a nonjudgmental environment by trusted providers emerged as important components of a YMSM-focused delivery of Life-Steps for PrEP.

  View details for DOI 10.1080/09540121.2023.2240070

  View details for Web of Science ID 001070203000001

  View details for PubMedID 37748111

• 'Wow, That's Me': Uneven Access To Gender-Affirming Care. Health affairs (Project Hope) Quint, M. 2023; 42 (9): 1304-1307

  Abstract

  A nonbinary/genderqueer person reflects on their experience pursuing a chest reduction as gender-affirming care.

  View details for DOI 10.1377/hlthaff.2023.00333

  View details for PubMedID 37669484

• Hepatitis C Virus Testing and Care Cascade Among Transgender and Gender Diverse Individuals AMERICAN JOURNAL OF PREVENTIVE MEDICINE Wolfe, H. L., Hughto, J. M. W., Quint, M., Hashemi, L., Hughes, L. D. 2023; 64 (5): 695-703

  Abstract

  Hepatitis C virus (HCV) prevalence among transgender and gender-diverse individuals ranges from 1.8% to 15.7% versus 1% in the general population. Previous HCV studies inclusive of transgender and gender-diverse individuals primarily rely on convenience-based sampling methods or are geographically restricted. The purpose of this study is to compare the prevalence of HCV diagnoses, testing, and care engagement between transgender and gender-diverse and cisgender individuals.Using Optum's de-identified Clinformatics® Data Mart Database, in 2022, the unadjusted prevalence of HCV testing among all adults and people who inject drugs from January 2001 to December 2019 was measured. Multivariable logistic regression was used to compare the adjusted odds of HCV diagnoses and care engagement by gender subgroup.The overall unadjusted frequency of HCV diagnoses among transgender and gender-diverse individuals was approximately 3 times that of cisgender individuals (1.06% vs 0.38%, p<0.001), including among people who inject drugs (6.36% vs 2.36%, p=0.007). Compared with cisgender women, transfeminine/nonbinary individuals had over 5 times the adjusted odds of a HCV diagnosis and approximately 3.5 times the odds of being tested for HCV. In addition, compared with cisgender women, transfeminine/nonbinary individuals had significantly increased odds of having a HCV‒related procedure (e.g., abdominal ultrasounds, liver biopsies, Fibroscans). Cisgender men had significantly increased odds of receiving HCV medication compared with cisgender women.Although testing was higher among transgender and gender-diverse individuals, the higher overall frequency of HCV diagnoses among transgender and gender-diverse than among cisgender individuals signals persistent health disparities. Interventions are warranted to prevent HCV and increase ongoing testing and treatment uptake among transgender and gender-diverse populations.

  View details for DOI 10.1016/j.amepre.2023.01.005

  View details for Web of Science ID 000985818500001

  View details for PubMedID 36759228

  View details for PubMedCentralID PMC10121731

• Digital-Assisted Self-interview of HIV or Sexually Transmitted Infection Risk Behaviors in Transmasculine Adults: Development and Field Testing of the Transmasculine Sexual Health Assessment JMIR PUBLIC HEALTH AND SURVEILLANCE Reisner, S. L., Pletta, D. R., Pardee, D. J., Deutsch, M. B., Peitzmeier, S. M., Hughto, J. M. W., Quint, M., Potter, J. 2023; 9: e40503

  Abstract

  The sexual health of transmasculine (TM) people-those who identify as male, men, or nonbinary and were assigned a female sex at birth-is understudied. One barrier to conducting HIV- and sexually transmitted infection (STI)-related research with this population is how to best capture sexual risk data in an acceptable, gender-affirming, and accurate manner.This study aimed to report on the community-based process of developing, piloting, and refining a digitally deployed measure to assess self-reported sexual behaviors associated with HIV and STI transmission for research with TM adults.A multicomponent process was used to develop a digital-assisted self-interview to assess HIV and STI risk in TM people: gathering input from a Community Task Force; working with an interdisciplinary team of content experts in transgender medicine, epidemiology, and infectious diseases; conducting web-based focus groups; and iteratively refining the measure. We field-tested the measure with 141 TM people in the greater Boston, Massachusetts area to assess HIV and STI risk. Descriptive statistics characterized the distribution of sexual behaviors and HIV and STI transmission risk by the gender identity of sexual partners.The Transmasculine Sexual Health Assessment (TM-SHA) measures the broad range of potential sexual behaviors TM people may engage in, including those which may confer risk for STIs and not just for HIV infection (ie, oral-genital contact); incorporates gender-affirming language (ie, genital or frontal vs vaginal); and asks sexual partnership characteristics (ie, partner gender). Among 141 individual participants (mean age 27, SD 5 years; range 21-29 years; n=21, 14.9% multiracial), 259 sexual partnerships and 15 sexual risk behaviors were reported. Participants engaged in a wide range of sexual behaviors, including fingering or fisting (receiving: n=170, 65.6%; performing: n=173, 66.8%), oral-genital sex (receiving: n=182, 70.3%; performing: n=216, 83.4%), anal-genital sex (receptive: n=31, 11.9%; insertive: n=9, 3.5%), frontal-genital sex (receptive: n=105, 40.5%; insertive: n=46, 17.8%), and sharing toys or prosthetics during insertive sex (n=62, 23.9%). Overall barrier use for each sexual behavior ranged from 10.9% (20/182) to 81% (25/31). Frontal receptive sex with genitals and no protective barrier was the highest (21/42, 50%) with cisgender male partners. In total, 14.9% (21/141) of participants reported a lifetime diagnosis of STI. The sexual history tool was highly acceptable to TM participants.The TM-SHA is one of the first digital sexual health risk measures developed specifically with and exclusively for TM people. TM-SHA successfully integrates gender-affirming language and branching logic to capture a wide array of sexual behaviors. The measure elicits sexual behavior information needed to assess HIV and STI transmission risk behaviors. A strength of the tool is that detailed partner-by-partner data can be used to model partnership-level characteristics, not just individual-level participant data, to inform HIV and STI interventions.

  View details for DOI 10.2196/40503

  View details for Web of Science ID 000976765100033

  View details for PubMedID 36930204

  View details for PubMedCentralID PMC10131935

• Gender Affirmation-Related Information-Seeking Behaviors in a Diverse Sample of Transgender and Gender-Diverse Young Adults: Survey Study JMIR FORMATIVE RESEARCH Boskey, E. R., Quint, M., Xu, R., Kremen, J., Estrada, C., Tham, R., Kane, K., Reisner, S. L. 2023; 7: e45952

  Abstract

  Of the 1.6 million transgender and gender-diverse (TGD) people in the United States, approximately 700,000 are youth aged 13-24 years. Many factors make it difficult for TGD young people to identify resources for support and information related to gender identity and medical transition. These range from lack of knowledge to concerns about personal safety in the setting of increased antitransgender violence and legislative limitations on transgender rights. Web-based resources may be able to address some of the barriers to finding information and support, but youth may have difficulty finding relevant content or have concerns about the quality and content of information they find on the internet.We aim to understand ways TGD young adults look for web-based information about gender and health.In August 2022, 102 young adults completed a 1-time survey including closed- and open-ended responses. Individuals were recruited through the Prolific platform. Eligibility was restricted to people between the ages of 18-25 years who identified as transgender and were residents of the United States. The initial goal was to recruit 50 White individuals and 50 individuals who identified as Black, indigenous, or people of color. In total, 102 people were eventually enrolled.Young adults reported looking on the internet for information about a broad range of topics related to both medical- and social-gender affirmation. Most participants preferred to obtain information via personal stories. Participants expressed a strong preference for obtaining information from other trans people.There is a need for accessible, expert-informed information for TGD youth, particularly more information generated for the transgender community by members of the community.

  View details for DOI 10.2196/45952

  View details for Web of Science ID 001051210800001

  View details for PubMedID 37581925

  View details for PubMedCentralID PMC10466148

• Health and service utilization among a sample of gender-diverse youth of color: the TRUTH study BMC PUBLIC HEALTH Rusow, J. A., Hidalgo, M. A., Calvetti, S., Quint, M., Wu, S., Bray, B. C., Kipke, M. D. 2022; 22 (1): 2312

  Abstract

  While there is growing research considering the experiences of transgender youth whose identities align with the gender binary, especially among young trans women, there are significantly fewer studies that accurately capture data about nonbinary youth, and even fewer studies capturing the experiences of transgender and gender diverse (TGD) youth of color. The purpose of this research was to assess the prevalence of sexual health behaviors, mental health challenges, substance use, and healthcare utilization among Black/African American, Latinx, Asian/Pacific Islander, indigenous and multi-racial/ethnic TGD youth, who have been largely underrepresented in research.A total of 108 TGD youth ages 16-24 were recruited into the Trans Youth of Color Study (TRUTH). Each participant completed a 90-min survey administered by a research assistant with more sensitive information collected using ACASI. In addition to a completing a survey administered by research staff, participants also participated in specimen collection, which included urine sampling to assess recent substance use without a prescription, self-collected rectal/frontal and throat swabs to test for gonorrhea and chlamydia, and a blood draw to test for recent use of drugs, gonorrhea and chlamydia, and syphilis. The sample was recruited at public venues, community outreach and referral, through social media outreach, and via participant referral. Cross-sectional analyses were from a single study visit.Compared to rates among their cisgender peers, participants reported experiencing adverse social and structural determinants of health-e.g. food insecurity (61%), housing instability (30%), and limited access to healthcare (26% had no place to go for healthcare)-and elevated rates of illicit drug use (19-85%), mental health problems (e.g. 60% self-reported depression), and involvement in sexual risk-related behaviors (e.g. among those reporting penetrative sex 57-67% reported sex without a condom).This study adds descriptions of both mental and sexual health outcomes of a non-clinical sample of TGD youth to the literature, particularly among young transgender men and gender nonbinary youth, who have frequently been excluded from previous studies of sexual health. The findings document experiences and behaviors among TGD youth that contribute to mental and sexual health concerns, including rates of substance use, and healthcare utilization.

  View details for DOI 10.1186/s12889-022-14585-9

  View details for Web of Science ID 000897499200005

  View details for PubMedID 36496355

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• Lessons from Ciencia Viva: how teaching human genetics to XXIst century students must go beyond the classroom EUROPEAN JOURNAL OF HUMAN GENETICS Quint, M., Amaral, O. 2020; 28 (5): 533-534

  View details for DOI 10.1038/s41431-019-0541-z

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