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Gordon, Allegra

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Gordon

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Allegra

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Gordon, Allegra
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    Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample
    (Mary Ann Liebert, Inc., 2018) Diemer, Elizabeth W.; White Hughto, Jaclyn M.; Gordon, Allegra; Guss, Carly; Austin, S. Bryn; Reisner, Sari L.
    Abstract Purpose: To investigate whether the prevalence of eating disorders (EDs) differs across diverse gender identity groups in a transgender sample. Methods: Secondary analysis of data from Project VOICE, a cross-sectional study of stress and health among 452 transgender adults (ages 18–75 years) residing in Massachusetts. Age-adjusted logistic regression models were fit to compare the prevalence of self-reported lifetime EDs in female-to-male (FTM), male-to-female (MTF), and gender-nonconforming participants assigned male at birth (MBGNC) to gender-nonconforming participants assigned female at birth (FBGNC; referent). Results: The age-adjusted odds of self-reported ED in MTF participants were 0.14 times the odds of self-reported ED in FBGNC participants (p=0.022). In FTM participants, the age-adjusted odds of self-reported ED were 0.46 times the odds of self-reported ED in FBGNC participants, a marginally significant finding (p=0.068). No statistically significant differences in ED prevalence were found for MBGNC individuals. Conclusions: Gender nonconforming individuals assigned a female sex at birth appear to have heightened lifetime risk of EDs relative to MTF participants. Further research into specific biologic and psychosocial ED risk factors and gender-responsive intervention strategies are urgently needed. Training clinical providers and ensuring competency of treatment services beyond the gender binary will be vital to addressing this disparity.
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    Spatial Distribution of Cosmetic-Procedure Businesses in Two U.S. Cities: A Pilot Mapping and Validation Study
    (MDPI, 2013) Austin, S. Bryn; Gordon, Allegra; Kennedy, Grace A.; Sonneville, Kendrin; Blossom, Jeffrey; Blood, Emily Alice
    Cosmetic procedures have proliferated rapidly over the past few decades, with over $11 billion spent on cosmetic surgeries and other minimally invasive procedures and another $2.9 billion spent on U.V. indoor tanning in 2012 in the United States alone. While research interest is increasing in tandem with the growth of the industry, methods have yet to be developed to identify and geographically locate the myriad types of businesses purveying cosmetic procedures. Geographic location of cosmetic-procedure businesses is a critical element in understanding the public health impact of this industry; however no studies we are aware of have developed valid and feasible methods for spatial analyses of these types of businesses. The aim of this pilot validation study was to establish the feasibility of identifying businesses offering surgical and minimally invasive cosmetic procedures and to characterize the spatial distribution of these businesses. We developed and tested three methods for creating a geocoded list of cosmetic-procedure businesses in Boston (MA) and Seattle (WA), USA, comparing each method on sensitivity and staff time required per confirmed cosmetic-procedure business. Methods varied substantially. Our findings represent an important step toward enabling rigorous health-linked spatial analyses of the health implications of this little-understood industry.
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    Monitoring the health of transgender and other gender minority populations: Validity of natal sex and gender identity survey items in a U.S. national cohort of young adults
    (BioMed Central, 2014) Reisner, Sari L; Conron, Kerith J; Tardiff, Laura Anatale; Jarvi, Stephanie; Gordon, Allegra; Austin, S Bryn
    Background: A barrier to monitoring the health of gender minority (transgender) populations is the lack of brief, validated tools with which to identify participants in surveillance systems. Methods: We used the Growing Up Today Study (GUTS), a prospective cohort study of U.S. young adults (mean age = 20.7 years in 2005), to assess the validity of self-report measures and implement a two-step method to measure gender minority status (step 1: assigned sex at birth, step 2: current gender identity). A mixed-methods study was conducted in 2013. Construct validity was evaluated in secondary data analysis of the 2010 wave (n = 7,831). Cognitive testing interviews of close-ended measures were conducted with a subsample of participants (n = 39). Results: Compared to cisgender (non-transgender) participants, transgender participants had higher levels of recalled childhood gender nonconformity age < 11 years and current socially assigned gender nonconformity and were more likely to have ever identified as not completely heterosexual (p < 0.001). No problems with item comprehension were found for cisgender or gender minority participants. Assigned sex at birth was interpreted as sex designated on a birth certificate; transgender was understood to be a difference between a person’s natal sex and gender identity. Participants were correctly classified as male, female, or transgender. Conclusions: The survey items performed well in this sample and are recommended for further evaluation in languages other than English and with diverse samples in terms of age, race/ethnicity, and socioeconomic status.
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    Gender Expression, Discrimination, and Health Among U.S. Adolescents and Young Adults: Quantitative and Qualitative Approaches
    (2015-04-27) Gordon, Allegra; Austin, Sydney B.; Krieger, Nancy; Okechukwu, Cassandra A.; Haneuse, Sebastien
    Young people who are perceived as transgressing societal gender norms—that is, who have a nonconforming gender expression—are at heightened risk of discrimination and violence victimization in the U.S., which can adversely impact health. However, gender expression has been under-examined in public health, a gap this dissertation sought to address. The first two studies draw on the Growing Up Today Study (GUTS), an ongoing cohort of the children of women in the Nurses’ Health Study II. The objective of the first study was to examine the relationship between gender nonconformity and health-related quality of life (HRQL), measured when participants were ages 18-31 years (n=8977). In multivariable regression models, higher levels of gender nonconformity were associated with higher risk of poor HRQL. Gender nonconforming young women had higher risk of functional limitations and pain relative to more conforming women, after adjusting for sexual orientation identity and potential confounders. Gender nonconformity was also associated with elevated risk of depression/anxiety among men and women. The second study extends this work by examining associations between gender nonconformity, reported gender expression-related discrimination, and depressive symptoms among GUTS sexual minority participants (e.g., lesbian, gay, bisexual, mostly heterosexual; n=1328). High levels of gender expression discrimination were reported by both sexual minority women and men, particularly among the most gender nonconforming. Among women, discrimination modestly attenuated the association between gender nonconformity and depressive symptoms. The third study is a qualitative study of disordered eating and weight and shape control behaviors among young transgender women (i.e., individuals who were assigned a male sex at birth and identify as women). Through in-depth interviews with 21 low-income, ethnically diverse transgender women, this study found that disordered weight and shape control behaviors occurred at the intersection of four key themes: (i) gender socialization processes and cultural femininity ideals, (ii) discrimination and unmet needs for gender affirmation, (iii) biological processes, and (iv) resilience processes. These three studies contribute to growing evidence that gender expression, in the context of societal intolerance for gender diversity and narrow cultural masculinity and femininity ideals, is an important dimension of gender and social determinant of health.