Mackenzie C Gamble, Benjamin R Williams, James T McKenna, Ryan W Logan
SleepInvestigatoR: A flexible R function for analyzing scored sleep in rodents
bioRxiv : the preprint server for biology
genderaffirming hormone therapy gaht common medical intervention sought transgender gender diverse tgd individuals initiating gaht accordance clinical guideline recommendations ensures delivery highquality care however prior studies examined current gaht initiation compares recommended gaht initiation study assessed guideline concordance around feminizing masculinizing gaht initiation veterans health administration vha sample included 4676 veterans gender identity disorder diagnosis initiated feminizing n3547 masculinizing n1129 gaht 2007 2018 vha demographics health conditions veterans receiving feminizing masculinizing gaht assessed proportion guideline concordant veterans six vha guidelines feminizing masculinizing gaht initiation determined compared veterans receiving masculinizing gaht higher proportion veterans receiving feminizing gaht older 60 years 237 vs 63 white nonhispanic 835 vs 576 higher number comorbidities 7 140 vs 106 higher proportion veterans receiving masculinizing gaht black nonhispanic 215 vs 35 posttraumatic stress disorder 430 vs 339 positive military sexual trauma 335 vs168 pvalues0001 veterans receiving feminizing gaht among veterans started feminizing gaht estrogen 970 guideline concordant due documentation contraindication including venous thromboembolism breast cancer stroke myocardial infarction among veterans started spironolactone part feminizing gaht 981 guideline concordant documentation contraindication including hyperkalemia acute renal failure among veterans starting masculinizing gaht 901 guideline concordant due documentation contraindications breast prostate cancer hematocrit measured 918 veterans initiating masculinizing gaht 965 elevated hematocrit 50 prior starting masculinizing gaht among veterans initiating feminizing masculinizing gaht 912 documentation gender identity disorder diagnosis prior gaht initiation observed high concordance current gaht initiation practices vha guidelines particularly feminizing gaht findings suggest vha clinicians initiating feminizing gaht concordance clinical guidelines future work assess guideline concordance monitoring management gaht vha