Table 1. Transgender and Other Gender Minority Population Health Research 2008–2014 by Region, Country, and then Author.
	Location	Sampling method	Sample	Assigned sex at birth	Sample size	Measure of prevalence/association	Significant associations	Health outcome measures
North America
Bauer, 20131	Ontario, Canada	Respondent-driven sampling	Trans gay, bisexual, and/or have sex with men	Female	173	Prevalence	None	Depressive symptoms
Moody, 20132	Canada	Internet-based	Transgender	Both	133	Beta	Perceived support from family, emotional stability, child-related concerns	Suicidal behavior
Alvarez-Wyssmann, 20133	Mexico City, Mexico	Chart review	HIV infected transgender men on HAART	Female	127	Prevalence	None	Diabetes
Reisner, 20144	Boston, USA	Chart review	Female to Male transgender with diagnosis of GID	Female	23	Prevalence	None	HIV seroprevalence, history of STIs, axis 1 diagnosis, axis 2 diagnosis, depression, anxiety, substance use disorder, PTSD, bipolar disorder, adjustment disorder, suicide attempt
Shipherd, 20125	Boston, USA	Trans conference-based	Male to Female transsexual and cross dresser veterans	Male	43	Prevalence	None	High cholesterol, blood pressure, vision problems, hearing problems, chronic pain, arthritis, digestive problems, cancer, lung problems, kidney problems, diabetes, depression, PTSD, anxiety, other mental health
Dowshen, 20116	Chicago, USA	Convenience sample	Young transgender women	Male	92	Prevalence	None	Drunk or buzzed in past 3 months
Garofalo, 20127	Chicago, USA	Active recruitment at local transgender gathering spots and passive recruitment through flyer distribution	Young transgender women	Male	51	Prevalence	None	HIV self-report, new STI diagnosis past 3 months
Fletcher, 20148	Los Angeles, USA	Venue-based recruitment	Community-based HIV prevention program attendees	Male	517	Prevalence	Marginally homeless, homeless	HIV self-report, cocaine use last 30 days, crack use last 30 days, methamphetamine use last 30 days, heroin use last 30 days, marijuana use last 30 days, hormone use last 30 days
Reback, 20149	Los Angeles, USA	Outreach based	Male to female transgender	Male	2136	Adjusted odds ratio; prevalence	African-American, Methamphetimine, Crack, Injection drug, sex work, unprotected anal sex with sex work partner	HIV self-report; alcohol past 30 days, marijuana past 30 days, cocaine past 30 days, crack past 30 days, injection drug/hormone
Simons, 201210	Los Angeles, USA	Clinic-based recruitment	Transgender adolescents	Both	28	Prevalence; pearson’s correlation coefficient	Less parental support	Significant depression; higher rates of depression
Simons, 201311	Los Angeles, USA	Clinic-based recruitment	Transgender youth	Both	66	Beta	Parental support	Depressive symptoms
Rohde Bowers, 201112	Los Angeles County, USA	Venue based	High risk HIV prevention program attendees	Male	1033 (320 transgender)	Prevalence	None	HIV self-report, alcohol (5 or more drinks), marijuana, methamphetamine, injected methamphetamine, cocaine, crack, ecstasy, GHB, amyl nitrate, heroin, injected heroin, hormones (non-prescribed), injected hormones
Benotsch, 201313	Mid-Atlantic, USA	Clinic-based recruitment	Transgender	Both	155	Prevalence	Individuals reporting non-medical use of prescription drugs	HIV-self report, BSI-depression, BSI-anxiety, BSI-somatic distress, BSI-Global Severity Index, alcohol use in past 3 months, cocaine use in past 3 months, methamphetamine use past 3 months, marijuana use past 3 months, poppers use past 3 months, ecstasy use past 3 months heroin use past 3 months, other recreational drug use past 3 months
McElory, 201214	Missouri, USA	Pride festivals recruitment	Sexual and gender minority individuals	NS	6537	Prevalence	None	Smoking
Irwin, 201415	Nebraska, USA	Community and internet-based	LGBT adults	Both	770 (92 transgender)	Adjusted odds ratio	Transgender	Suicidal ideation
Reisner, 201016	New England, USA	Venue-based	Transmen	Female	16	Prevalence	None	Herpes self-report, trichomonas self-report, bacterial vaginosis self-report, alcohol use during sex, marijuana use during sex, hallucinogen use during sex, ecstasy use during sex
Shipherd, 201117	New England, USA	Trans conference	Transgender	Male	97	Prevalence	None	Post-traumatic stress disorder, depressive symptoms
Hwahng, 201418	New York, USA	Organization based, venue referrals, and internet	HIV uninfected male to female transgender	Male	572	Prevalence	None	Major depression (early and late adolescence), suicidal ideation (early and late adolescence)
Koken, 200919	New York, USA	Peer outreach and snowball	Transwomen	Male	20	Prevalence	None	HIV self-report
Leinung, 201320	New York, USA	Clinic-based recruitment	Transsexual	Male	192	Prevalence	None	Drug and substance use, HIV
				Female	50	Prevalence	None	Drug and substance abuse
Nuttbrock, 200921	New York, USA	Organization based, venue referrals, internet advertisements	HIV uninfected male to female transgender	Male	571	Odds ratio	Commercial sex partners, androphilic, unemployment, sex identity disclosure, female attire in public, casual sex partners, substance use, psychoactive drug injection, Hispanic	HIV infected, syphilis, hepatitis B, hepatitis C
Nuttbrock, 201022	New York, USA	Organization based, venue referrals, internet advertisements	HIV uninfected male to female transgender	Male	571	Prevalence	None	Lifetime major depression, lifetime suicide plans, lifetime suicide attempt
Nuttbrock, 201323	New York, USA	Organization based, venue referrals, internet advertisements	HIV uninfected male to female transgender	Male	230	Adjusted odds ratio; odds ratio	Employment, sex work, transgender presentation, hormone therapy; psychological gender abuse, physical gender abuse	Major depression
Nuttbrock, 201324	New York, USA	Organization based, venue referrals, internet advertisements	HIV uninfected male to female transgender	Male	230	Prevalence; hazard ratio	Gender abuse, education, preoperative, non-white ethnicity, committed partners (unprotected) receptive anal intercourse, commercial partners (unprotected) receptive anal intercourse, depressive symptoms, legitimate income, hormone therapy, sexual reassignment surgery, younger age, sexually attracted to men only, casual partners (unprotected) receptive anal intercourse, CES-D score >=20	HIV seroprevalence, depression; incident HIV/STI, depressive symptoms
Nuttbrock, 201425	New York, USA	Organization based, venue referrals, internet advertisements	HIV uninfected male to female transgender	Male	230	Adjusted odds ratio	Income, sex work, transgender presentation, hormone therapy, gender abuse, depressive symptoms	Alcohol use, cannabis use, cocaine use, any substance use
Pathela, 201426	New York City, USA	HIV/STD surveillance registries	Transgender women living with HIV	Male	345	Incidence	Transgender, diagnosed with HIV at a younger age, living with HIV for less time	STD coinfection with HIV
Flentje, 201427	San Francisco, USA	Clinic based recruitment	Individuals entering substance abuse treatment	Male	13649 (146 transgender)	Prevalence; adjusted odds ratio	Transgender status	Methamphetamine; alcohol, cocaine, heroin, marijuana, other drug use,
				Female	13649 (53 transgender)	Prevalence	None	Alcohol, cocaine, heroin, methamphetamine, other drug use
Gamarel, 201428	San Francisco, USA	Purposive sampling in community spaces	Transgender females and their primary non transgender male partner	Male	382 (191 transwomen)	Adjusted odds ratio	Financial hardship, discrimination, relationship stigma	Depressive distress
Jefferson, 201329	San Francisco, USA	NS	Transwomen	Male	100	Adjusted odds ratio; odds ratio	Coping self-efficacy; transgender identity, racism, transphobia, high combined discrimination	Depression
Operario, 201130	San Francisco, USA	Venue-based	Transgender adults in relationship with non-trans men	Male	174	Prevalence	None	HIV self-report, STI diagnosis or symptoms past 12 months, any alcohol use past 3 months, any illicit drug use past 3 months, any injection drug use past 3 months, depression
Operario, 201431	San Francisco, USA	Purposive community sampling	Self-identifying transgender women	Male	191	Prevalence	None	Self-reported HIV, depressive symptoms, alcohol intoxication past 30 days, illicit drug use past 30 days
Rapues, 201332	San Francisco, USA	Respondent-driven sampling	Male to female transgender	Male	314	Prevalence (RDS weighted)	None	HIV seroprevalence, HIV self-report, hepatitis C
Reisner, 201433	San Francisco, USA	Purposive sampling in community spaces	Transgender females and their primary non transgender male partner	Male	382 (191 transwomen)	Prevalence; adjusted odds ratio	Age, financial hardship, discrimination	Depressive distress, HIV self-report; non-marijuana illicit drug use
Santos, 201434	San Francisco, USA	Respondent-driven sampling	Transfemale	Male	314	Adjusted odds ratio; prevalence	Any methamphetamine	HIV seroprevalence; crack cocaine, powdered cocaine, club drugs, downers, painkiller, hallucinogens, heroin, marijuana, alcohol, binge drinking, any substance
Sevelius, 200935	San Francisco, USA	Clinic and location based	Transgender	Male	153	Prevalence	None	HIV self-report, injecting drug use past year, alcohol use (five or more drinks per day) stimulant use
Wilson, 201436	San Francisco, USA	Respondent-driven sampling	Transgender women	Male	235	Prevalence	None	HIV seroprevalence, injection drug use
Wilson, 201437	San Francisco, USA	Respondent-driven sampling	Transgender women	Male	233	Prevalence	None	HIV seroprevalence, injected drugs
Nemoto, 201438	San Francisco and Oakland, USA	Purposive community sampling	Transgender women with a history of sex work	Male	573	Prevalence	Race	Depressive symptoms, self-reported HIV, STI history in past 12 months
Brennan, 201239	Chicago and Los Angeles, USA	Clinic-based, venue-based, and peer outreach and referral	Young transgender women	Male	151	Prevalence; point biserial correlations; adjusted odds ratio	Intimate partner violence, unprotected anal intercourse, polysubstance use; 3 or 4 syndemic index factors (low self-esteem, polysubstance use, victimization, and intimate partner violence) vs 0	Polysubstance use; HIV self-report
Bradford, 201340	Virginia, USA	Internet and peer referral	Transgender	Both	350	Prevalence	None	HIV seroprevalence
Blosnich, 201341	USA	Clinic-based recruitment	Veterans Health Association users with diagnosis of GID	NS	1326 in 2009 1162 in 2010 1326 in 2011	Period prevalence	None	Suicide-related event
Bockting, 201342	USA	Internet-based	Transgender adults	Both	1093	Adjusted odds ratio	Transwomen compared to transmen, age, education, enacted stigma, felt stigma, peer support, family support, identity pride	Depression, anxiety, somatization, Global Severity Index
Budge, 201343	USA	Internet-based	Transgender adults	Male	226	Beta	Transition status, social support	Depression, anxiety
				Female	125	Beta	Transition status, social support	Depression, anxiety
Effrig, 201144	USA	College campus survey	College students	NS	21686 (86 transgender or “other” gender	Prevalence	None	Attempted suicide, suicidal ideation
Feldman, 201445	USA	Internet based	Transgender	Both	1229	Prevalence	None	HIV self-report
Fredriksen-Goldsen, 201446	USA	Community-agency based	LGBT adults 50 and older	NS	2201 (174 transgender)	Prevalence	None	Disability, Obesity
Horvath, 201447	USA	Internet based	Rural and urban transgender	Male	692	Prevalence	None	HIV self-report, regular heavy alcohol use, binge alcohol use, marijuana use, non-marijuana drug use
				Female	523	Prevalence	None	HIV self-report, regular heavy alcohol use, binge alcohol use, marijuana use, non-marijuana drug use
Hotton, 201348	USA	NS	Young transgender women	Male	116	Prevalence; odds ratio	Life stress	Substance use in past 3 months, alcohol use in the past 3 months
House, 201149	USA	Internet-based	LGBT adults	Both	1126 (164 transgender)	Adjusted odds ratio	Transgender compared with male	Non-suicidal self-harm, attempted suicide
Mustanski, 201350	USA	Venue-based	LGBT youth	Both	237 (21 transgender)	Prevalence	None	Lifetime suicidal attempt
Peitzmeier, 201451	USA	Clinic-based	Clinic patients receiving Pap tests	Female	3858 (233 transgender)	Prevalence	None	HIV seroprevalence
Rath, 201352	USA	Probabilty-based	Young adults	NS	4159 (12 transgender)	Prevalence	None	Major depressive disorder, current alcohol use, cigarette use
Reisner, 201353	USA	Brief intercept	Transmasculine	Female	73	Prevalence	All health outcomes compared to depression only	Lifetime clinical depression, alcohol abuse, current or former smoking, asthma, obese; avoided/delayed health care, younger age, queer or non-binary sexual orientation
Reisner, 201454	USA	Convenience sample	Transfeminine gender identity	Male	3878	Prevalence; risk ratio	Jail/prison time, mistreated/victimized in jail/prison, denied healthcare in jail/prison	HIV self-report, daily cigarette smoker, substance use to cope, suicide attempt
Reisner55	USA	Clinic-based	Participants from the Community Health Center Core Data Project	Both	2653 (31 transgender)	Prevalence	Transgender	Suicidal ideation, attempted suicide ever, substance abuse history, smoking, HIV self-report
Sánchez, 200956	USA	Transgender event	Male to female transsexuals	Male	53	Beta	Transgender-related fears	Psychological distress
Sevelius, 200957	USA	Snowball sampling, listservs, web sites	Trans MSM	Female	45	Prevalence	None	HIV self-report, STI diagnosis ever, HPV, gonorrhea, chlamydia, herpes, trichomoniasis, bacterial vaginosis, hepatitis C, pelvic inflammatory disease, pubic lice
South and Central America
Toibaro, 200958	Buenos Aires, Argentina	Clinic-based recruitment	Patients at a clinic	Both	4118 (105 transgender)	Prevalence	None	HIV seroprevalence, syphilis, drug use, alcohol use
Carobene, 201459	Argentina	Not specified	Trans sex workers	NS	273	Prevalence	None	HIV seroprevalence, HBV seroprevlance, HCV seroprevalence
Socias, 201460	Argentina	Snowball sampling and quota sampling	Transgender	Male	452	Prevalence	None	HIV self-report
Rocha, 201361	Brazil	Transvestite clinic case records	Transvestites	NS	59	Prevalence	None	Alcohol use, drug use
Johnston, 201362	Dominican Republic	Respondent-driven sampling	Gay, transsexuals, and MSM	Male	1388 (83 transsexuals)	Adjusted odds ratio	Transsexual compared to MSM	HIV seroprevalence
Aguayo, 201363	Paraguay	NS	Transwomen	Male	311	Prevalence	None	HIV, syphilis
Lipsitz, 201364	Lima, Peru	Clinic-based recruitment	Men and transwomen	Male	2717 (332 transwomen)	Prevalence	None	HIV seroprevalence
Verre, 201465	Peru	Peer outreach and snowball	MSM and transgender women	Male	5148 (714 transgender)	Prevalence	None	HIV seroprevalence, syphilis seroprevalence
Europe
Wierckx, 201366	Ghent, Belgium	Clinic-based recruitment	Transgender persons diagnosed with GID and on cross-sex hormone therapy	Male	214	Cases/1000 persons	Transwomen compared to age matched women	Myocardial infarction, transient ischemic health attack, type 2 diabetes,
				Female	138	Cases/1000 persons	Transmen compared to age matched men	Type 2 diabetes, cancer
Auer, 201367	Munich, Germany	Clinic based recruitment	Transsexuals with a diagnosis of GID, not in hormone therapy or undergone reassignment surgery	Female	131	Prevalence	None	Pubertal and menstrual irregularities, premature or delayed menarche, oligomenorrhea, polymenorrhea, amenorrhea, adrenal hyperplasia, polycystic ovary syndrome, hypogonadism, anorexia nervosa
				Male	192	Prevalence	None	Pubertal irregularities, delayed oigarche, cryptorchidism, no pubertal voice change
Judge, 201468	Dublin, Ireland	Clinic-based recruitment	Patients with suspected or confirmed GID	Male	159	Prevalence	None	Hypertension, dyslipidemia, diabetes, depression, schizophrenia, bipolar affective disorder, self-harm/ suicide attempt, asthma, Asperger’s
				Female	59	Prevalence	None	Hypertension, dyslipidemia, diabetes, depression, schizophrenia, bipolar affective disorder, self-harm/ suicide attempt, asthma, Asperger’s
Manieri, 201469	Torino, Italy	Clinic-based recruitment	Transgender subjects undergoing hormone therapy	Male	56	Prevalence	None	Obesity, hypercholesterolemia, hypertriglyceridemia, diabetes, metabolic syndrome, HIV seroprevalence,
				Female	27	Prevalence	None	Obesity, metabolic syndrome
Imbimbo, 200970	Italy	Clinic-based recruitment	Male to female transsexuals who have undergone sexual reassignment surgery	Male	139	Prevalence	None	Contemplated suicide, attempted suicide
Asscheman, 200971	Amsterdam, Netherlands	Clinic based recruitment	Transsexuals on cross-sex hormones	Male	966	Adjusted Hazard Ratio; Standardized Mortality Ratio	Male to Female transsexual compared to the age and sex adjusted general population	Cardiovascular mortality; All-cause mortality, mortality from malignant neoplasm, AIDS, external causes, illicit drug use, suicide
				Female	365	Standardized Mortality Ratio	Female to male transsexual compared to the age and sex adjusted general population	Mortality from external causes, illicit drug use
de Vries, 201072	Amsterdam, Netherlands	Clinic-based recruitment	Children and adolescents referred to Gender Identity Clinic	Both	205	Incidence	None	Autism spectrum disorder
de Vries, 201173	Amsterdam, Netherlands	Clinic-based recruitment	Adults and adolescents with a diagnosis of GID	Male Female	207 adults, 43 adolescents	Prevalence	None	Depression, schizophrenia, hysteria, hypochondria, paranoia, psychopathic deviate, hypomania, other mental health outcomes
					86 adults, 40 adolescents	Prevalence	None	Depression, schizophrenia, hysteria, hypochondria, paranoia, psychopathic deviate, hypomania, other mental health outcomes
Almeida, 201474	Lisbon, Portugal	Clinic-based recruitment	Sex workers	NS	151 (20 transgender)	Prevalence	None	HIV seroprevalence
Guzman-Parra, 201475	Malaga, Spain	Clinic-based	Transsexuals	NS	379	Prevalence	None	Lifetime only cannabis use, lifetime only cocaine use, current cannabis use
Hill, 201176	London, UK	Clinic-based recruitment	Transgender sex workers	Both	24	Prevalence	None	HIV seroprevalence, syphilis, genital herpes, chlamydia-negative urethritis or proctitis, gonorrhea, chlamydia, hepatitis B, any STI
Pasterski, 201477	London, UK	Clinic-based recruitment	Adults with gender dysphoria or GID	Both	91	Prevalence	None	Autism spectrum disorder
Davey, 201478	England	Clinic-based recruitment	Individuals diagnosed with gender dysphoria and age and gender-matched controls	Both	206 (103 transgender)	PWI mean score; SCL-90-R mean score; SF-36 v.2 mean score	Gender dysphoric	PWI total score; global severity index, somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoneuroticism; mental health component summary, social functioning, role limitations due to emotional problems, mental health
Claes, 201479	United Kingdom	Clinic-based recruitment	Transsexuals	Male	103	Prevalence	None	Non-suicidal self-injury
				Female	52	Prevalence	None	Non-suicidal self-injury
Turner, 201480	United Kingdom	Clinic-based recruitment	Persons who sell sex	Male	96 (13 transgender)	Prevalence	None	Chlamydia, gonorrhea, genital warts
Heylens, 201481	Netherlands, Belgium, Germany Norway	Clinic-based recruitment	Adults seeking gender reassignment surgery	Both	298	Prevalence	None	One or more Axis 1 personality disorders, one or more Axis 2 personality disorders, affective disorders, anxiety disorders, substance-related disorders, eating disorders, psychotic disorders
Central and South Asia
Kalra, 201382	Mumbai, India	Clinic-based recruitment	Hijra (individuals who do not conform to the conventional notions of male or female gender)	Male	50 (49 male, 1 female)	Prevalence	None	Depressive disorder, dysthymic disorder, alcohol abuse or dependence
Arora, 201383	New Delhi, India	NS	MSM and transgender women	Male	65 (24 transgender)	Prevalence	None	Anal dysplasia
Ramakrishnan, 201284	Tamil Nadu, India	Probability-based	Transgender	Both	807	Prevalence	None	HIV seroprevalenece, lifetime syphilis
Brahmam, 200885	India	Probability-based	MSM and Hijra	Male	4600 (575 Hijra)	Prevalence	None	HIV seroprevalence, syphilis seroprevalence, HSV-2 seroprevalence
Aghabikloo, 201286	Tehran, Iran	Clinic-based recruitment	Transsexuals with GID seeking sexual reassignment surgery	Female	25	Prevalence	None	Mood disorders, anxiety disorders, suicide attempts, substance-related disorder
				Male	44	Prevalence	None	Mood disorders, anxiety disorders, suicide attempts, substance-related disorder
Ahmadzad-Asl, 201387	Tehran, Iran	Chart review	Transsexuals with a diagnosis of GID	Male	138	Prevalence	None	General medical condition co-morbidity; current smoker, psychiatric co-morbidity
				Female	143	Prevalence	None	General medical condition co-morbidity; current smoker, psychiatric co-morbidity
Javaheri, 201088	Tehran, Iran	Clinic-based recruitment	Transsexuals	Both	40	Prevalence	None	Thought of committing suicide, suicide attempt
Bhatta, 201489	Nepal	Snowball/cha in referral and venue-based	Male to female transgender persons	Male	232	Prevalence	None	Alcohol in last 6 months, smoking in last 6 months
Rehan, 201190	Karachi and Lahore, Pakistan	Random sample of gurus	Hijras	Male	400	Prevalence	None	Extra-inguinal lymphadenopathy, urethral discharge, anal discharge, anal warts, anal tears, genital ulcers
Emmanuel, 201391	Pakistan	Peer referral	Key populations	Male	16642 (3714 Hijra sex workers)	Prevalence	None	HIV seroprevalence, injected drugs in the past 6 months
South East Asia
Chemnasiri, 201092	Bangkok, Chaing Mai, Phuket, Thailand	Venue-day-time	MSM and transgender women	Male	827 (241 transgender)	Prevalence	None	HIV seroprevalence, history of STIs, used alcohol ever, used drugs ever
Gooren, 201593	Thailand	Snowball sampling	Kathoeys (transgender women)	Male	60	Prevalence	None	Unprescribed hormone use
			Toms (transgender men)	Female	60	Prevalence; t-test	Using cross-sex hormones	Unprescribed hormone use; bodily harm, mental health
Yadegarfard, 201394	Thailand	Organization-based recruitment	Transgender	Male	190	MANOVA	Age, education, >10 sexual partners	PANSI-positive (Positive and Negative Suicide Ideation Inventory), PANSI-negative, depression, loneliness, HIV self-report
Lai, 201095	Taiwan	Recruitment letter sent	First year college students	Male	2585 (49 gender dysphoric)	Odds ratio	Gender dysphoria compared to non-gender dysphoric	Generalized anxiety disorder, panic disorder, hypochondriasis, major depressive disorder, body dysmorphic disorder, schizoid personality, suicidal ideation, anxiety disorder, depressive disorder, other mental health disorders
				Female	2615 (176 gender dysphoric)	Odds ratio	Gender dysphoria compared to non-gender dysphoric	Generalized anxiety disorder, hypochondriasis, major depressive disorder, body dysmorphic disorder, schizoid personality, suicidal ideation, anxiety disorder, depressive disorder, other mental health disorders
Oceania
Kelly, 201496	Brisbane, Australia	Venue-based	LGBT youth	NS	161 (24 transgender)	Prevalence	None	Alcohol, tobacco, any illicit drug use, poly-drug use, cannabis, stimulants, inhalants, prescription, medications, LSD, opiates, steroids
Pell, 201197	Sydney, Australia	Clinic-based recruitment	Transgender	Male	141	Prevalence	None	Mental health diagnosis, HIV, past or present intravenous drug use
				Female	17	Prevalence	None	Mental health diagnosis, past or present intravenous drug use
Boza, 201498	Australia	Internet-based	Transgender identity	Both	243	Prevalence	None	Depressive symptoms, suicide attempt
Clark, 201499	New Zealand	Randomly selected high school recruitment	Students	NS	8166 (96 transgender)	Adjusted odds ratio	Transgender compared with non-transgender	Significant depressive symptoms, self-harmed in last 12 months, attempted suicide
Pitts, 2009100	Australia and New Zealand	Internet based	Trans people	Both	253	Number and types of discrimination	Chi square; prevalence	Depression; thoughts of suicide or hurting self in past 2 weeks, thoughts of feeling down, depressed or hopeless, major depressive episode
Multi-country
Becerra-Fernandez, 2014101	Not specified-abstract	Not specified-abstract	Female to Male transsexuals prior to cross-sex hormone therapy	Female	77	Prevalence	None	Obesity, polycystic ovary syndrome, metabolic syndrome, hyperandrogenism
Reisner, 2014102	Latin America/Caribbean, Portugal, Spain	Internet based	MSM	Male	35483 (158 MtF transgender)	Prevalence	None	Suicide attempt ever, depressive distress past week, HIV self-report, any STI past 12 months, syphilis, gonorrhea, chlamydia, HPV, genital herpes
				Female	35483 (32 FtM transgender)	Prevalence	None	Suicide attempt ever, depressive distress past week, HIV self-report, any STI past 12 months, gonorrhea, HPV, genital herpes
Buchbinder, 2014103	Brazil, Ecuador, Peru, South Africa	NS	MSM and transgender women	Male	2499 (162 transgender women)	Prevalence, incidence	None	HIV seroprevalence
Meier, 2013104	19 countries	Internet-based	Female to male transgender	Female	503	Contrast estimate	Attracted to both men and women	Anxiety
Table 2. Transgender and Other Gender Minority Population Health Research on Stigma, Discrimination, Violence/ Victimization, and Sex Work Among 2008–2014 by Region, Country, and then Author.
	Location	Sampling method	Sample	Assigned sex at birth	Sample size	Measure of prevalence/association	Significant associations	Health outcome measures
North America
Bauer, 2014105	Ontario, Canada	Respondent-driven sampling	Trans emergency department patients	Male	195	RDS-weighted prevalence	None	Ever avoided emergency department because trans, negative emergency department experience, refused or ended care, hurtful or insulting language, refused to discuss trans concerns, told not really trans, discouraged from exploring gender, provider does not know enough to provide care, belittled or ridiculed, thought gender marker on ID was a mistake, refused to examine parts of body
				Female	214	RDS-weighted prevalence	None	Ever avoided emergency department because trans, negative emergency department experience, refused or ended care, hurtful or insulting language, refused to discuss trans concerns, told not really trans, discouraged from exploring gender, provider does not know enough to provide care, belittled or ridiculed, thought gender marker on ID was a mistake, refused to examine parts of body
McGuire, 2010106	California, USA	Gay Straight Alliance organization-based recruitment	LGBT and allies students	NS	2260 (68 transgender)	T-test	Transgender compared to non-transgender	Feeling unsafe at school
Harawa, 2010107	Los Angeles, USA	Random sample from prison census	MSM and male to female transgender inmates	Male	101 (19 transgender)	Prevalence	None	Receiving money, protection, food, or other goods in exchange for sex
Rohde Bowers, 201112	Los Angeles County, USA	Venue based	High risk HIV prevention program attendees	Male	1033 (320 transgender)	Prevalence	None	Exchange sex
Hwahng, 201418	New York, USA	Organization based, venue referrals, and internet	HIV uninfected male to female transgender	Male	572	Prevalence	None	Verbal gender abuse early adolescence, physical gender abuse early adolescence, verbal or physical gender abuse early adolescence, verbal gender abuse late adolescence, physical gender abuse late adolescence, verbal or physical gender abuse late adolescence
Nuttbrock, 201022	New York, USA	Organization based, venue referrals, internet advertisements	HIV uninfected male to female transgender	Male	571	Prevalence	None	Lifetime gender-related psychological abuse, lifetime gender-related physical abuse
Nuttbrock, 201323	New York, USA	Organization based, venue referrals, internet advertisements	HIV uninfected male to female transgender	Male	230	Adjusted odds ratio	Employment, sex work, transgender presentation, hormone therapy	Psychological gender abuse, physical gender abuse
Nuttbrock, 201324	New York, USA	Organization based, venue referrals, internet advertisements	HIV uninfected male to female transgender	Male	230	Prevalence	None	Psychological or physical gender abuse, psychological and physical gender abuse
Reisner, 201016	New England, USA	Venue-based	Transmen	Female	16	Prevalence	None	Sex work ever, internalized homophobia
Rapues, 201332	San Francisco, USA	Respondent-driven sampling	Male to female transgender	Male	314	Prevalence (RDS weighted)	None	Commercial sex work
Sevelius, 200935	San Francisco, USA	Clinic and location based	Transgender	Male	153	Prevalence	None	Sex work
Wilson, 201437	San Francisco, USA	Respondent-driven sampling	Transgender women	Male	233	Prevalence	None	Engagement in sex work
Nemoto, 201438	San Francisco and Oakland, USA	Purposive community sampling	Transgender women with a history of sex work	Male	573	Prevalence	Race	Sex work in past 6 months
Brennan, 201239	Chicago and Los Angeles, USA	Clinic-based, venue-based, and peer outreach and referral	Young transgender women	Male	151	Prevalence; point biserial correlations; beta	Intimate partner violence, unprotected anal intercourse, polysubstance use; syndemic index (low self-esteem, polysubstance use, victimization, intimate partner violence)	Victimization, intimate partner violence; history of sex work
Bradford, 201340	Virginia, USA	Internet and peer referral	Transgender	Both	350	Prevalence; Adjusted odds ratio	Suburban vs urban setting, FTM spectrum, racial/ethnic minority, education, low-income, living full time, age at transawareness, hormones, hormone therapy needed but not obtained past 3 months, counseling or psychotherapy needed but not obtained past 3 months, forced or unwanted sex, physically attacked, tobacco problem ever, drinking problem, family not supportive, being connected to the transgender community, hostility or insensitivity in school	Health care discrimination, employment discrimination; discrimination
Benotsch, 201313	Mid-Atlantic, USA	Clinic-based recruitment	Transgender	Both	155	Prevalence	Individuals reporting non-medical use of prescription drugs	Discrimination-gender identity
Bockting, 201342	USA	Internet -based	Transgender adults	Both	1093	Prevalence, beta	Non-white race/ethnicity, income, investment in passing, outness, age, transgender women compared to transgender men	Enacted stigma, felt stigma
Cruz, 2014108	USA	Internet based	Transgender participants from the National Discrimination Survey	Both	4049	Prevalence; odds ratio	Trans discrimination or both discrimination and affordability; male vs other identity, female vs male identity, female vs other identity, somewhat genderqueer identity, hormones, top surgery, bottom surgery main place seeking care,, no health insurance, income	Postponement of curative care due to discrimination
Dank, 2014109	USA	School-based recruitment	Students	NS	5647 (18 transgender)	Prevalence	Transgender status	Physical dating violence, psychological dating abuse, cyber dating abuse, sexual coercion
House, 201149	USA	Internet-based	LGBT adults	Both	1126 (164 transgender)	Prevalence	None	Interpersonal trauma, experiences of discrimination
Kosciw, 2009110	USA	Internet-based	Secondary school students	NS	5420 (245 transgender)	Beta	Transgender identity compared to male identity	Victimization related to sexual orientation, victimization related to gender expression
Mitchell, 2014111	USA	Internet based	13–18 year olds completing the Teen Health and Technology survey	Both	5498 (189 transgender, 209 gender nonconforming or other gender)	Prevalence; adjusted conditional odds	Transgender vs cisgender male, gender nonconforming or other gender vs cisgender male	Sexual harassment (any mode, in-person, online, by text message, by phone call, some other way), made obscene or sexual comments, asked for sexual information, asked to do something sexual, touched grabbed or pinched, showed/sent obscene or sexual messages, intentionally brushed up against, spread sexual rumors, blocked/cornered; non-distressing sexual harassment; distressing sexual harassment
Reisner, 201353	USA	Brief intercept	Transmasculine	Female	73	Prevalence	None	Perceived discrimination by health care provider
Reisner, 201454	USA	Convenience sample	Transfeminine gender identity	Male	3878	Prevalence; risk ratio	Jail/prison time, mistreated/victimized in jail/prison, denied healthcare in jail/prison	Denied healthcare in jail, mistreated victimized in jail/prison; sex work, any physical assault, any sexual assault
Reisner, 201455	USA	Clinic-based	Participants from the Community Health Center Core Data Project	Both	2653 (31 transgender)	Prevalence	Transgender	Childhood abuse, experienced intimate partner violence, any victimization as adult, verbally attacked, physically attacked, sexually harmed, any discrimination, employment discrimination, healthcare discrimination
Ybarra, 2014112	USA	Targeted online recruitment	LGBT youth	Both	5542 (442 transgender)	Prevalence	None	Online peer victimization: bullying, in person peer victimization: bullying, online peer victimization: sexual harassment, in person peer victimization: harassment
South and Central America
Marin, 2013113	Argentina	Sexual Workers Union registration	Female sex workers and transvestites	NS	950 (110 transgender)	Prevalence	None	Discrimination in health care
Socias, 201460	Argentina	Snowball sampling and quota sampling	Transgender	Male	452	Prevalence; chi square; adjusted odds ratio	Any internalized stigma, history of sex work, experienced police violence, ever arrested, perceived discrimination by healthcare workers, perceived discrimination by patients, current residency in Buenos Aires; extended health insurance	Sex work, healthcare avoidance because of transgender identity
Delgado, 2014114	Chile	Snowball	Gay men and transgender women	Male	437 (121 transgender)	Prevalence	None	Not being hired or being fired, being denied access or permanence in a public place, poorly-assisted by public officials, not accepted or excluded from school, not accepted or excluded from a group of friends, molested or harassed by neighbors, not accepted or excluded from a social group, not accepted or excluded from family, not accepted or excluded from a religious environment, verbal or physical mistreatment or being denied help by the police
Miller, 2011115	Guatemala city, Guatemala	Respondent-driven sampling	MSM and transgender women	Male	505 (99 transgender)	Prevalence	None	Transactional sex
Europe
Prunas, 2014116	Milan, Italy	Census	Transgender victims of transphobic murder	Male	20	Prevalence	None	Sex work, primary indicator of LGBT hate crime, secondary indicator of LGBT hate crime
Central and South Asia
Brahmam, 200885	India	Probability-based	MSM and Hijra	Male	4600 (575 Hija)	Prevalence	None	Selling sex
Javaheri, 201088	Tehran, Iran	Clinic-based recruitment	Transsexuals	Both	40	Prevalence	None	Being discriminated against for being transsexual
Oceania
Pell, 201197	Sydney, Australia	Clinic-based recruitment	Transgender	Male	141	Prevalence	None	Past or present sex work
Multi-country
Reisner, 2014102	Latin America/Caribbean, Portugal, Spain	Internet based	MSM	Male	35483 (158 MtF transgender)	Prevalence	None	Transactional sex past 12 months, childhood gender-related harassment, adulthood gender-related harassment
				Female	35483 (32 FtM transgender)	Prevalence	None	Transactional sex past 12 months, childhood gender-related harassment, adulthood gender-related harassment

GID=Gender identity disorder; NS=not specified; MSM=men who have sex with men.

^1.Bauer GRR, Nik; Bradley Kaitlin; Scheim Ayden I. Sexual Health of Trans Men Who Are Gay, Bisexual, or Who Have Sex with Men: Results from Ontario, Canada. International Journal of Transgenderism 2013;14(2):66–74.

^2.Moody CS, N. G. Suicide protective factors among trans adults. Archives of sexual behavior 2013;42(5):739–52.

^3.Alvarez-Wyssmann VC-Z, M.; Casillas J.; Rodriguez- Nolasco E.; Nino-Vargas R.; Escobedo T.; Rodriguez A.; Magis-Rodriguez C. Diabetes prevalence and factors associated among patients at an outpatient HIV clinic in Mexico City. Journal of the International AIDS Society 2013;16:14.

^4.Reisner SLW, Jaclyn M.; Mayer Kenneth H.; Mimiaga Matthew J. Sexual risk behaviors and psychosocial health concerns of female-to-male transgender men screening for STDs at an urban community health center. AIDS Care 2014;26(7):857–64.

^5.Shipherd JCM, Lauren; Shira Maguen; Green Kelly E. Male-to-Female Transgender Veterans and VA Health Care Utilization. International Journal of Sexual Health 2012;24(1):78–87.

^6.Dowshen NF, Christine M.; Johnson Amy K.; Kuhns Lisa M.; David Rubin; Robert Garofalo. Religiosity As a Protective Factor Against HIV Risk Among Young Transgender Women. Journal of Adolescent Health 2011;48(4):410–14.

^7.Garofalo RJ, A. K.; Kuhns L. M.; Cotten C.; Joseph H.; Margolis A. Life Skills: Evaluation of a Theory-Driven Behavioral HIV Prevention Intervention for Young Transgender Women. Journal of Urban Health 2012;89(3):419–31.

^8.Fletcher JBK, Kimberly A.; Reback Cathy J. Housing status and hiv risk behaviors among transgender women in los angeles. Archives of Sexual Behavior 2014.

^9.Reback CF, Jesse. HIV Prevalence, Substance Use, and Sexual Risk Behaviors Among Transgender Women Recruited Through Outreach. AIDS & Behavior 2014;18(7):1359–67.

^10.Simons LO, Johanna; Belzer Marvin; Clark Leslie; Schrager Sheree. 29. The Relationship Between Parental Support and Depression and Suicidality in Transgender Adolescents. Journal of Adolescent Health 2012;50(2):S29–S29.

^11.Simons LS, Sheree M.; Clark Leslie F.; Belzer Marvin; Olson Johanna. Parental Support and Mental Health Among Transgender Adolescents. Journal of Adolescent Health 2013;53(6):791–93.

^12.Rohde Bowers JB, C. M.; Fletcher J.; Reback C. J. Differences in substance use and sexual partnering between men who have sex with men, men who have sex with men and women and transgender women. Culture, Health & Sexuality 2011;13(6):629–42.

^13.Benotsch EGZ, Rick; Laurie Cathers; Shawn McNulty; Juan Pierce; Ted Heck; Perrin Paul B.; Daniel Snipes. Non-medical use of prescription drugs, polysubstance use, and mental health in transgender adults. Drug & Alcohol Dependence 2013;132(1–2):391–94.

^14.McElroy JE, K.; Ge B. Out, proud and healthy project: Characterizing smoking behaviors and beliefs for 6,537 sexual and gender minority individuals. Epidemiology 2012;23(5):S656.

^15.Irwin JAC, J. D.; Fisher C. M.; Marasco V. M. Correlates of Suicide Ideation Among LGBT Nebraskans. Journal of Homosexuality 2014;61(8):1172–91.

^16.Reisner SLP, B.; Mimiaga M. J. A Mixed Methods Study of the Sexual Health Needs of New England Transmen Who Have Sex with Nontransgender Men. AIDS Patient Care & STDs 2010;24(8):501–13.

^17.Shipherd JCM, Shira; Skidmore W. Christopher; Abramovitz Sarah M. Potentially traumatic events in a transgender sample: Frequency and associated symptoms. Traumatology 2011;17(2):56–67.

^18.Hwahng SJN, Larry. Adolescent gender-related abuse, androphilia, and HIV risk among transfeminine people of color in New York City. Journal of homosexuality 2014;61(5):691–713.

^19.Koken JAB, D. S.; Parsons J. T. Experiences of Familial Acceptance-Rejection Among Transwomen of Color. Journal of Family Psychology 2009;23(6):853–60.

^20.Leinung MCU, M. F.; Patel N.; Sood S. C. Endocrine treatment of transsexual persons: extensive personal experience. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2013;19(4):644–50.

^21.Nuttbrock LH, S.; Bockting W.; Rosenblum A.; Mason M.; MacRi M.; Becker J. Lifetime risk factors for HIV/sexually transmitted infections among male-to-female transgender persons. Journal of Acquired Immune Deficiency Syndromes 2009;52(3):417–21.

^22.Nuttbrock LH, S.; Bockting W.; Rosenblum A.; Mason M.; Macri M.; Becker J. Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. Journal of sex research 2010;47(1):12–23.

^23.Nuttbrock L, Bockting W, Rosenblum A, et al. Gender Abuse and Major Depression Among Transgender Women: A Prospective Study of Vulnerability and Resilience. American journal of public health 2013(0):e1–e8.

^24.Nuttbrock LB, Walter; Rosenblum Andrew; Hwahng Sel; Mason Mona; Macri Monica; Becker Jeffrey. Gender Abuse, Depressive Symptoms, and HIV and Other Sexually Transmitted Infections Among Male-to-Female Transgender Persons: A Three-Year Prospective Study. American Journal of Public Health 2013;103(2):300–07.

^25.Nuttbrock L, Bockting W, Rosenblum A, et al. Gender Abuse, Depressive Symptoms, and Substance Use Among Transgender Women: A 3-Year Prospective Study. American journal of public health 2014;104(11):2199–206.

^26.Pathela PB, S.; Shepard C.; Schillinger J. Incidence of sexually transmitted diseases among transgender persons with HIV, New York City, 2000–2010. Sexually Transmitted Diseases 2014;41:S118.

^27.Flentje AH, Nicholas C.; Sorensen James L. Characteristics of transgender individuals entering substance abuse treatment. Addictive Behaviors 2014;39(5):969–75.

^28.Gamarel KER, Sari L.; Laurenceau Jean-Philippe; Nemoto Tooru; Don Operario. Gender minority stress, mental health, and relationship quality: A dyadic investigation of transgender women and their cisgender male partners. Journal of Family Psychology 2014;28(4):437–47.

^29.Jefferson KN, Torsten B.; Jae Sevelius. Transgender women of color: discrimination and depression symptoms. Ethnicity & Inequalities in Health & Social Care 2013;6(4):121–36.

^30.Operario DN, Tooru; Iwamoto Mariko; Toni Moore. Unprotected Sexual Behavior and HIV Risk in the Context of Primary Partnerships for Transgender Women. AIDS & Behavior 2011;15(3):674–82.

^31.Operario DY, M. F.; Reisner S. L.; Iwamoto M.; Nemoto T. Stigma and the syndemic of HIV-related health risk behaviors in a diverse sample of transgender women. Journal of Community Psychology 2014;42(5):544–57.

^32.Rapues JW, Erin C.; Packer Tracey; Colfax Grant N.; Raymond Fisher. Correlates of HIV Infection Among Transfemales, San Francisco, 2010: Results From a Respondent-Driven Sampling Study. American Journal of Public Health 2013;103(8):1485–92.

^33.Reisner SLG, Kristi E.; Nemoto Tooru; Don Operario. Dyadic effects of gender minority stressors in substance use behaviors among transgender women and their non-transgender male partners. Psychology of Sexual Orientation and Gender Diversity 2014;1(1):63–71.

^34.Santos G-MR, Jenna; Wilson Erin C.; Macias Oscar; Packer Tracey; Colfax Grant; Henry Fisher Raymond. Alcohol and substance use among transgender women in San Francisco: Prevalence and association with human immunodeficiency virus infection. Drug & Alcohol Review 2014;33(3):287–95.

^35.Sevelius JMR, O. G.; Hart S. L.; Schwarcz S. Informing interventions: the importance of contextual factors in the prediction of sexual risk behaviors among transgender women. AIDS Education & Prevention 2009;21(2):113–27.

^36.Wilson ECS, Glen-Milo; Raymond H. Fisher. Sexual mixing and the risk environment of sexually active transgender women: data from a respondent-driven sampling study of HIV risk among transwomen in San Francisco, 2010. BMC Infectious Diseases 2014;14:430–30.

^37.Wilson ER, J.; Jin H.; Raymond H. F. The use and correlates of illicit silicone or “fillers” in a population-based sample of transwomen, San Francisco, 2013. Journal of Sexual Medicine 2014;11(7):1717–24.

^38.Nemoto TB, Birte; Iwamoto Mariko; Sakata Maria. Practices of receptive and insertive anal sex among transgender women in relation to partner types, sociocultural factors, and background variables. AIDS Care 2014;26(4):434–40.

^39.Brennan JK, Lisa M.; Johnson Amv K.; Belzer Marvin; Wilson Erin C.; Garofalo Robert. Syndemic Theory and HIV-Related Risk Among Young Transgender Women: The Role of Multiple, Co-Occurring Health Problems and Social Marginalization. American Journal of Public Health 2012;102(9):1751–57.

^40.Bradford JR, Sari L.; Honnold Julie A.; Jessica Xavier. Experiences of Transgender-Related Discrimination and Implications for Health: Results From the Virginia Transgender Health Initiative Study. American Journal of Public Health 2013;103(10):1820–29.

^41.Blosnich JRB, George R.; Shipherd Jillian C.; Kauth Michael; Piegari Rebecca I.; Bossarte Robert M. Prevalence of Gender Identity Disorder and Suicide Risk Among Transgender Veterans Utilizing Veterans Health Administration Care. American Journal of Public Health 2013;103(10):e27–32.

^42.Bockting WOM, M. H.; Swinburne Romine R. E.; Hamilton A.; Coleman E. Stigma, mental health, and resilience in an online sample of the US transgender population. American journal of public health 2013;103(5):943–51.

^43.Budge SLA, Jill L.; Howard Kimberly A. S. Anxiety and depression in transgender individuals: The roles of transition status, loss, social support, and coping. Journal of Consulting and Clinical Psychology 2013;81(3):545–57.

^44.Effrig JCB, Kathleen J.; Locke Benjamin D. Examining victimization and psychological distress in transgender college students. Journal of College Counseling 2011;14(2):143–57.

^45.Feldman JR, R. S.; Bockting W. O. HIV Risk Behaviors in the U.S. Transgender Population: Prevalence and Predictors in a Large Internet Sample. Journal of homosexuality 2014;61(11):1558–88.

^46.Fredriksen-Goldsen KIC-D, Loree; Kim Hyun-Jun; Erosheva Elena A.; Emlet Charles A.; Hoy-Ellis Charles P.; Goldsen Jayn; Muraco Anna. Physical and Mental Health of Transgender Older Adults: An At-Risk and Underserved Population. Gerontologist 2014;54(3):488–500.

^47.Horvath KJI, A.; Swinburne-Romine R.; Bockting W. A comparison of mental health, substance use, and sexual risk behaviors between rural and non-rural transgender persons. Journal of homosexuality 2014;61(8):1117–30.

^48.Hotton ALG, Robert; Kuhns Lisa M.; Johnson Amy K. Substance Use as a Mediator of the Relationship Between Life Stress and Sexual Risk Among Young Transgender Women. AIDS Education & Prevention 2013;25(1):62–71.

^49.House ASVH, Elizabeth; Coppeans Christopher; Stepleman Lara M. Interpersonal trauma and discriminatory events as predictors of suicidal and nonsuicidal self-injury in gay, lesbian, bisexual, and transgender persons. Traumatology 2011;17(2):75–85.

^50.Mustanski BL, R. T. A longitudinal study of predictors of suicide attempts among lesbian, gay, bisexual, and transgender youth. Archives of sexual behavior 2013;42(3):437–48.

^51.Peitzmeier SMR, Sari L.; Harigopal Padmini; Potter Jennifer. Female-to-Male Patients Have High Prevalence of Unsatisfactory Paps Compared to Non-Transgender Females: Implications for Cervical Cancer Screening. JGIM: Journal of General Internal Medicine 2014;29(5):778–84.

^52.Rath JMV, A. C.; Rubenstein R. A.; Vallone D. M. Tobacco use by sexual identity among young adults in the united states. Nicotine and Tobacco Research 2013;15(11):1822–31.

^53.Reisner SLG, Kristi E.; Dunham Emilia; Hopwood Ruben; Hwahng Sel. Female-to-Male Transmasculine Adult Health: A Mixed-Methods Community-Based Needs Assessment. Journal of the American Psychiatric Nurses Association 2013;19(5):293–303.

^54.Reisner SL, Bailey Z, Sevelius J. Racial/ethnic disparities in history of incarceration, experiences of victimization, and associated health indicators among transgender women in the US. Women & health 2014(just-accepted).

^55.Reisner SL, White JM, Bradford JB, et al. Transgender Health Disparities: Comparing Full Cohort and Nested Matched-Pair Study Designs in a Community Health Center. LGBT Health.

^56.Sanchez FJV, E. Collective Self-Esteem as a Coping Resource for Male-to-Female Transsexuals. J Couns Psychol 2009;56(1):202–09.

^57.Sevelius J. “There’s no pamphlet for the kind of sex I have”: HIV-related risk factors and protective behaviors among transgender men who have sex with nontransgender men. JANAC: Journal of the Association of Nurses in AIDS Care 2009;20(5):398–410.

^58.Toibaro JJE, J. F.; Parlante A.; Burgoa P.; Freyre A.; Romero M.; Losso M. H. Sexually transmitted infections among transgender individuals and other sexual identities. Medicina 2009;69(3):327–30.

^59.Carobene MB, F.; Farias M. S. D. R.; Quarleri J.; Avila M. M. HIV, HBV, and HCV molecular epidemiology among trans (transvestites, transsexuals, and transgender) sex workers in Argentina. Journal of Medical Virology 2014;86(1):64–70.

^60.Socías ME, Marshall BD, Arístegui I, et al. Factors associated with healthcare avoidance among transgender women in Argentina. International journal for equity in health 2014;13(1):81.

^61.Rocha RMGP, D. L.; Dias T. M. The context of drug use among transvestite sex workers. Saude Soc 2013;22(2):554–65.

^62.Johnston LGV, T. C.; Dolores Y.; Vales H. M. HIV, hepatitis B/C and syphilis prevalence and risk behaviors among gay, transsexuals and men who have sex with men, Dominican Republic. International Journal of STD & AIDS 2013;24(4):313–21.

^63.Aguayo NM, S. R.; Aguilar G. HIV and SYPHILIS prevalence and behaviour, practises and attitudes of the TRANS population in paraguay, 2011. Sexually Transmitted Infections 2013;89.

^64.Lipsitz MCS, E. R.; Anton C.; Castro J.; Clark J. L.; Lake J. E.; Cabello R. Bringing HIV testing to the people - Benefits of mobile unit testing in Lima, Peru, 2007–2009. Sexually Transmitted Infections 2013;89.

^65.Verre MCP, Jesus Segura, Eddy R.; Clark Jesse; Gonzales Pedro; Benites Carlos; Cabello Robinson; Sanchez Jorge; Lama Javier R. Socialization patterns and their associations with unprotected anal intercourse, hiv, and syphilis among high-risk men who have sex with men and transgender women in peru. AIDS and Behavior 2014.

^66.Wierckx KE, E.; Declercq E.; Heylens G.; De Cuypere G.; Taes Y.; Kaufman J. M.; T’Sjoen G. Prevalence of cardiovascular disease and cancer during cross-sex hormone therapy in a large cohort of trans persons: A case-control study. European Journal of Endocrinology 2013;169(4):471–78.

^67.Auer MKF, J.; Stalla G. K.; Athanasoulia A. P. Twenty years of endocrinologic treatment in transsexualism: Analyzing the role of chromosomal analysis and hormonal profiling in the diagnostic work-up. Fertility and Sterility 2013;100(4):1103–10.

^68.Judge COD, C.; Callaghan G.; Gaoatswe G.; O’Shea D. Gender dysphoria - prevalence and co-morbidities in an Irish adult population. Frontiers in Endocrinology 2014;5(June).

^69.Manieri CC, Elena; Crespi Chiara; Di Bisceglie Cataldo; Dell’Aquila Carlotta; Gualerzi Anna; Molo Mariateresa. Medical Treatment of Subjects with Gender Identity Disorder: The Experience in an Italian Public Health Center. International Journal of Transgenderism 2014;15(2):53–65.

^70.Imbimbo CV, P.; Palmieri A.; Longo N.; Fusco F.; Arcaniolo D.; Mirone V. A report from a single institute’s 14-year experience in treatment of male-to-female transsexuals. Journal of Sexual Medicine 2009;6(10):2736–45.

^71.Asscheman HG, L. Long term mortality in hormone-treated transsexuals. Journal of Sexual Medicine 2009;6:420.

^72.de Vries ALN, I. L.; Cohen-Kettenis P. T.; van Berckelaer-Onnes I. A.; Doreleijers T. A. Autism spectrum disorders in gender dysphoric children and adolescents. Journal of autism and developmental disorders 2010;40(8):930–6.

^73.de Vries ALCD, T. A. H.; Steensma T. D.; Cohen-Kettenis P. T. Psychiatric comorbidity in gender dysphoric adolescents. J Child Psychol Psychiatry 2011;52(11):1195–202.

^74.Almeida AB, A.; Costa J.; Eusebio M.; Fernandes R. Prevalence of and factors mediating HIV infection among sex workers in Lisbon, Portugal: the 5-year experience of a community organisation. Sexually Transmitted Infections 2014;90(6).

^75.Guzman-Parra JP-M, Pedro; de Diego-Otero Yolanda; Perez-Costillas Lucia; Villena-Jimena Amelia; Garcia-Encinas Maria A.; Bergero-Miguel Trinidad. Substance Use and Social Anxiety in Transsexual Individuals. Journal of Dual Diagnosis 2014;10(3):162–67.

^76.Hill SCD, J.; Benzie A.; Ayres J.; King G.; Smith A. Sexual health of transgender sex workers attending an inner-city genitourinary medicine clinic. International Journal of STD & AIDS 2011;22(11):686–87.

^77.Pasterski VG, Liam; Richard Curtis. Traits of autism spectrum disorders in adults with gender dysphoria. Archives of Sexual Behavior 2014;43(2):387–93.

^78.Davey AB, W. P.; Arcelus J.; Meyer C. Social Support and Psychological Well-Being in Gender Dysphoria: A Comparison of Patients With Matched Controls. Journal of Sexual Medicine 2014.

^79.Claes LB, W. P.; Witcomb G.; Thurston M.; Fernandez-Aranda F.; Arcelus J. Non-Suicidal Self-Injury in Trans People: Associations with Psychological Symptoms, Victimization, Interpersonal Functioning, and Perceived Social Support. The journal of sexual medicine 2014.

^80.Turner RH, M.; Campbell M.; Day S.; Sullivan A. High rates of STIs in SWISH clinic-a dedicated service for sex workers. HIV Medicine 2014;15:38.

^81.Heylens GE, E.; Kreukels B. P. C.; Paap M. C. S.; Cerwenka S.; Richter-Appelt H.; Cohen-Kettenis P. T.; Haraldsen I. R.; De Cuypere G. Psychiatric characteristics in transsexual individuals: Multicentre study in four European countries. British Journal of Psychiatry 2014;204(2):151–56.

^82.Kalra GS, Nilesh. The Cultural, Psychiatric, and Sexuality Aspects of Hijras in India. International Journal of Transgenderism 2013;14(4):171–81.

^83.Arora RP, D.; Mishra K.; Bhattacharya S. N.; Yhome V. A. Screening for anal dysplasia in HIV positive and HIV negative men who have sex with men using anal cytology and P16/Ink4 immunostaining; a crossectional study. Sexually Transmitted Infections 2013;89.

^84.Ramakrishnan LG, P.; Subramaniam T.; Mathew S.; Ramanathan S.; George B.; Adhikary R.; Mainkar M. K.; Paranjape R. S. Transgender in Tamil Nadu are still highly vulnerable to HIV and STIs: Findings from bio-behavioral surveys. Journal of the International AIDS Society 2012;15:154–55.

^85.Brahmam GNK, V.; Rajkumar H.; Rachakulla H. K.; Kallam S.; Myakala S. P.; Paranjape R. S.; Gupte M. D.; Ramakrishnan L.; Kohli A.; Ramesh B. M. Sexual practices, HIV and sexually transmitted infections among self-identified men who have sex with men in four high HIV prevalence states of India. Aids 2008;22 Suppl 5:S45–57.

^86.Aghabikloo AB, M.; Saberi S. M.; Emamhadi M. A. Gender identity disorders in Iran; request for sex reassignment surgery. International Journal of Medical Toxicology and Forensic Medicine 2012;2(4):128–34.

^87.Ahmadzad-Asl MJ, A. H.; Alavi K.; Naserbakht M.; Taban M.; Mohseninia-Omrani K.; Eftekhar M. The epidemiology of transsexualism in Iran. European Psychiatry 2013;28.

^88.Javaheri F. A Study of Transsexuality in Iran. Iranian Studies 2010;43(3):365–77.

^89.Bhatta DN. HIV-related sexual risk behaviors among male-to-female transgender people in Nepal. International Journal of Infectious Diseases 2014;22:e11–e15.

^90.Rehan N. Genital examination of hijras. Journal of the Pakistan Medical Association 2011;61(7):695–96.

^91.Emmanuel FM, Salim; Naeem Akhtar; Salwa Arshad; Reza T. E. Second-generation surveillance for HIV/AIDS in Pakistan: results from the 4th round of Integrated Behavior and Biological Survey 2011–2012. (Special Issue: HIV/STI research in MENA.). Sexually Transmitted Infections 2013;89(Suppl. 3).

^92.Chemnasiri TN, T.; Visarutratana S.; Varangrat A.; Li A.; Phanuphak P.; Jommaroeng R.; Akarasewi P.; van Griensven F. Inconsistent condom use among young men who have sex with men, male sex workers, and transgenders in Thailand. AIDS Education & Prevention 2010;22(2):100–09.

^93.Gooren LJ, Sungkaew T, Giltay EJ, et al. Cross-sex hormone use, functional health and mental well-being among transgender men (Toms) and Transgender Women (Kathoeys) in Thailand. Culture, health & sexuality 2015;17(1):92–103.

^94.Yadegarfard MH, Robert; Bahramabadian Fatemeh. Influences on loneliness, depression, sexual-risk behaviour and suicidal ideation among Thai transgender youth. Culture, Health & Sexuality 2013;15(6):726–37.

^95.Lai MCC, Y. N.; Gadow K. D.; Gau S. S.; Hwu H. G. Correlates of gender dysphoria in taiwanese university students. Archives of Sexual Behavior 2010;39(6):1415–28.

^96.Kelly JD, Cassandra; Schlesinger Carla. Substance use by same sex attracted young people: Prevalence, perceptions and homophobia. Drug and Alcohol Review 2014.

^97.Pell CP, I.; Vlahakis E. Comparison of male to female (MTF) and female to male (FTM) transgender patients attending taylor square private clinic (TSPC) Sydney, Australia; clinical audit results. Journal of Sexual Medicine 2011;8:179.

^98.Boza CNP, Kathryn. Gender-Related Victimization, Perceived Social Support, and Predictors of Depression Among Transgender Australians. International Journal of Transgenderism 2014;15(1):35–52.

^99.Clark TCL, Mathijs F. G.; Bullen Pat; Denny Simon J.; Fleming Theresa M.; Robinson Elizabeth M.; Rossen Fiona V. The Health and Well-Being of Transgender High School Students: Results From the New Zealand Adolescent Health Survey (Youth’12). Journal of Adolescent Health 2014;55(1):93–99.

^100.Pitts MKC, M.; Mulcare H.; Crow S.; Mitchell A. Transgender people in Australia and New Zealand: health, well-being and access to health services. Feminism & Psychology 2009;19(4):475–95.

^101.Becerra-Fernandez AP-L, G.; Roman M. M.; Martin-Lazaro J. F.; Lucio Perez M. J.; Asenjo Araque N.; Rodriguez-Molina J. M.; Berrocal Sertucha M. C.; Aguilar Vilas M. V. Prevalence of hyperandrogenism and polycystic ovary syndrome in female to male transsexuals. Endocrinologia y Nutricion 2014;61(7):351–58.

^102.Reisner SLB, Katie; Rosenberger Joshua G.; Austin S. Bryn; Haneuse Sebastien; Perez-Brumer Amaya; Novak David S.; Mimiaga Matthew J. Using a two-step method to measure transgender identity in latin america/the caribbean, portugal, and spain. Archives of Sexual Behavior 2014.

^103.Buchbinder SPG, David V.; Liu Albert Y.; McMahan Vanessa; Guanira Juan V.; Mayer Kenneth H.; Goicochea Pedro; Grant Robert M. HIV pre-exposure prophylaxis in men who have sex with men and transgender women: a secondary analysis of a phase 3 randomised controlled efficacy trial. Lancet Infectious Diseases 2014;14(6):468–75.

^104.Meier SCP, S. T.; Labuski C.; Babcock J. Measures of clinical health among female-to-male transgender persons as a function of sexual orientation. Archives of sexual behavior 2013;42(3):463–74.

^105.Bauer GRS, Ayden I.; Deutsch Madeline B.; Massarella Carys. Reported emergency department avoidance, use, and experiences of transgender persons in ontario, Canada: results from a respondent-driven sampling survey. Annals of Emergency Medicine 2014;63(6):713–20.e1.

^106.McGuire JKA, C. R.; Toomey R. B.; Russell S. T. School climate for transgender youth: a mixed method investigation of student experiences and school responses. Journal of Youth & Adolescence 2010;39(10):1175–88.

^107.Harawa NTS, J.; George S.; Sylla M. Sex and condom use in a large jail unit for men who have sex with men (MSM) and male-to-female transgenders. Journal of Health Care for the Poor & Underserved 2010;21(3):1071–87.

^108.Cruz TM. Assessing access to care for transgender and gender nonconforming people: A consideration of diversity in combating discrimination. Social Science & Medicine 2014;110:65–73.

^109.Dank ML, Pamela; Zweig Janine M.; Yahner Jennifer. Dating violence experiences of lesbian, gay, bisexual, and transgender youth. Journal of Youth and Adolescence 2014;43(5):846–57.

^110.Kosciw JGG, E. A.; Diaz E. M. Who, what, where, when, and why: Demographic and ecological factors contributing to hostile school climate for lesbian, gay, bisexual, and transgender youth. Journal of Youth and Adolescence 2009;38(7):976–88.

^111.Mitchell KJY, M. L.; Korchmaros J. D. Sexual harassment among adolescents of different sexual orientations and gender identities. Child Abuse and Neglect 2014;38(2):280–95.

^112.Ybarra MLM, K. J.; Palmer N. A.; Reisner S. L. Online social support as a buffer against online and offline peer and sexual victimization among U.S. LGBT and non-LGBT youth. Child Abuse and Neglect 2014.

^113.Marin GS, M.; Martinez S.; Sanguinetti C. Healthcare program for sex workers: a public health priority. The International journal of health planning and management 2013.

^114.Delgado JBC, M. C. Construction and Validation of a Subjective Scale of Stigma and Discrimination (SISD) for the Gay Men and Transgender Women Population in Chile. Sex Res Soc Policy 2014;11(3):187–98.

^115.Miller WA, B.; Boyce S.; Alvarado A.; Barrington C.; Paz-Bailey G. Transgender persons in guatemala - Overexposed and under-protected - The findings of an RDS behavioural survey. Sexually Transmitted Infections 2011;87:A132.

^116.Prunas A, Clerici CA, Gentile G, et al. Transphobic Murders in Italy An Overview of Homicides in Milan (Italy) in the Past Two Decades (1993–2012). Journal of interpersonal violence 2014:0886260514554293.