Epidemiological considerations in transgender health: A systematic review with focus on higher quality data

Abstract

Background: High quality data pertaining to the size of the transgender and gender diverse (TGD) population are scant, however, several recently published studies may provide more reliable contemporary estimates.

Aims: To summarize the estimated number and proportion of TGD individuals overall and across age groups, based on most accurate data.

Methods: This systematic review focused on recent studies (published from 2009 through 2019) that utilized sound methodology in assessing the proportion of TGD people in the general population. Publications were included if they used clear definitions of TGD status, and calculated proportions based on a well-defined sampling frame. Nineteen eligible publications represented two broad categories of studies: those that used data from large health care systems; and those that identified TGD individuals from population surveys.

Results: Among health system-based studies, TGD persons were identified using relevant diagnostic codes or clinical notes. The proportions of individuals with a TGD-relevant diagnosis or other recorded evidence ranged between 17 and 33 per 100,000 enrollees. In population surveys TGD status was ascertained based on self-report with either narrow or broad definitions. The survey-based estimates were orders of magnitude higher and consistent across studies using similar definitions. When the surveys specifically inquired about ‘transgender’ identity, the estimates ranged from 0.3% to 0.5% among adults, and from 1.2% to 2.7% among children and adolescents. When the definition was expanded to include broader manifestations of ‘gender diversity’, the corresponding proportions increased to 0.5-4.5% among adults and 2.5-8.4% among children and adolescents. Upward temporal trends in the proportion of TGD people were consistently observed.

Conclusions: Current data indicate that people who self-identify as TGD represent a sizable and increasing proportion of the general population. This proportion may differ, depending on inclusion criteria, age, and geographic location, but well-conducted studies of similar type and design tend to produce comparable results.     

Social Networks and Forgiveness: The Role of Trust and Efficacy

We examine the link between social network size and forgiveness, as well as mediating effects of self-efficacy and trust. Data are from the Detroit Community Study, which include three racial/ethnic groups: African Americans, Arab Americans, and White Americans (N=907). Results indicated that larger network size is associated with more forgiveness, but is mediated by trust. Patterns varied within racial/ethnic group: among Arab Americans self-efficacy mediated the effect of network size on forgiveness; among African Americans there were no direct or mediating effects; among White Americans an indirect effect of trust on forgiveness was identified. Findings suggest complex associations with forgiveness.     

Keep calm and carry on: Maintaining self-control when intoxicated,upset, or depleted

This study tested within-person associations between intoxication, negative affect, and self-control demands and two forms of self-control failure, interpersonal conflict, and neglecting responsibilities. Effortful control was hypothesised to act as a buffer, reducing individual susceptibility to these within-person effects. In contrast, reactivity was hypothesised to potentiate the within-person associations. 274 young adults aged 18–27 (56% women, 93% white) completed experience sampling assessments for up to 49 days over the course of 1.3 years. Results indicated independent within-person effects of intoxication, negative affect, and self-control demands on the outcomes. Hypothesised moderating effects of reactivity were not supported. Effortful control did not moderate the effects of self-control demands as expected. However, effortful control exhibited a protective effect when individuals were intoxicated or upset to reduce the likelihood of maladaptive behavioural outcomes.     

Right-Wing Authoritarianism and Social Dominance Orientation Indirectly Predict Support for New York City’s Stop-&-Frisk Policy Through Prejudice

Until very recently, the New York City Police Department’s Stop, Question, and Frisk policy (i.e., Stop-&-Frisk) allowed NYPD officers to legally stop and detain New Yorkers under the suspicion that they may be involved in criminal activity. Previous research found that New Yorkers’ attitudes toward Stop-&-Frisk were generally mixed, and the current study tested whether authoritarianism, preferences for inequality, and prejudice predicted support for Stop-&-Frisk. One hundred forty-eight New York City college students reported their levels of right-wing authoritarianism (RWA), social dominance orientation (SDO), prejudice, and support for the NYPD’s Stop-&-Frisk policy. Both RWA and SDO had indirect effects through prejudice on support for Stop-&-Frisk. Limits and possible future developments of this research are discussed.     

Organic Unities

I defend the view that there are organic unities mainly by presenting examples of organic unities. I also defend the view against two objections. The first objection appeals to the notion of an evaluatively incomplete state of affairs. The second objection holds that the intrinsic value of a state of affairs can be different in different contexts. I argue that neither objection provides a compelling reason for rejecting these examples.     

What's Wrong With Methodism?

I distinguish between two theses, DPJ and DGP. DPJ asserts that one's justification for accepting particular epistemic propositions positively depends on one's being justified in believing general epistemic principles. DGP claims that one's justification in believing general epistemic propositions positively depends on one's being justified in believing particular epistemic propositions. I claim that methodism accepts DPJ and rejects DGP and particularism accepts DGP and rejects DPJ. I argue that we should reject DGP and methodism roughly because these views imply that many of us do not know epistemic propositions that we do know. This point is made by Roderick Chisholm in The Problem of the Criterion and challenged by Robert Amico. I consider Chisholm's arguments and Amico's objections. Finally, I argue that even if we reject DPJ and methodism, we need not embrace particularism, since we could reject both DPJ and DGP.     

Relative speed of processing determines color–word contingency learning

In three experiments, we tested a relative-speed-of-processing account of color–word contingency learning, a phenomenon in which color identification responses to high-contingency stimuli (words that appear most often in particular colors) are faster than those to low-contingency stimuli. Experiment 1 showed equally large contingency-learning effects whether responding was to the colors or to the words, likely due to slow responding to both dimensions because of the unfamiliar mapping required by the key press responses. For Experiment 2, participants switched to vocal responding, in which reading words is considerably faster than naming colors, and we obtained a contingency-learning effect only for color naming, the slower dimension. In Experiment 3, previewing the color information resulted in a reduced contingency-learning effect for color naming, but it enhanced the contingency-learning effect for word reading. These results are all consistent with contingency learning influencing performance only when the nominally irrelevant feature is faster to process than the relevant feature, and therefore are entirely in accord with a relative-speed-of-processing explanation.     

Are some negotiators better than others? Individual differences in bargaining outcomes

The authors address the long-standing mystery of stable individual differences in negotiation performance, on which intuition and conventional wisdom have clashed with inconsistent empirical findings. The present study used the Social Relations Model to examine individual differences directly via consistency in performance across multiple negotiations and to disentangle the roles of both parties within these inherently dyadic interactions. Individual differences explained a substantial 46% of objective performance and 19% of subjective performance in a mixed-motive bargaining exercise. Previous work may have understated the influence of individual differences because conventional research designs require specific traits to be identified and measured. Exploratory analyses of a battery of traits revealed few reliable associations with consistent individual differences in objective performance-except for positive beliefs about negotiation, positive affect, and concern for one's outcome, each of which predicted better performance. Findings suggest that the field has large untapped potential to explain substantial individual differences. Limitations, areas for future research, and practical implications are discussed.