Allostatic Stress and Inflammatory Biomarkers in Transgender and Gender Expansive Youth: Protocol for a Pilot Cohort Study.
adolescence
allostatic load
biomarkers
gender
gender diverse
participatory
participatory action research
stress
stress biomarkers
transgender
Journal
JMIR research protocols
ISSN: 1929-0748
Titre abrégé: JMIR Res Protoc
Pays: Canada
ID NLM: 101599504
Informations de publication
Date de publication:
19 May 2021
19 May 2021
Historique:
received:
03
09
2020
accepted:
24
02
2021
revised:
01
02
2021
entrez:
19
5
2021
pubmed:
20
5
2021
medline:
20
5
2021
Statut:
epublish
Résumé
A growing number of adolescents are coming out as transgender and gender expansive (TGE). These teenagers have been shown to have significantly worse health outcomes than their cisgender peers. Hypotheses to explain this discrepancy are based on increased stress levels surrounding the societal acceptance of gender identity. In this context, elevated allostatic load (AL), which describes the wear and tear sustained by the body in response to repeated exposure to stress, has been associated with adverse long-term health outcomes. This protocol aims to measure AL among TGE adolescents compared with their cisgender peers and assess how AL varies depending on psychological stress and perceived societal acceptance. This is an observational proof-of-concept pilot study in which AL will be measured by assaying an array of inflammatory cytokines and cortisol in urine, saliva, and hair samples of TGE youth, and these parameters will be compared with those of age-matched control participants. A questionnaire will assess 4 aspects of psychosocial well-being: presence and management of depression and anxiety, gender identity support by family members, gender minority stress, and degree of perceived safety in the surrounding community. Samples and surveys will be collected at 3 visits (baseline, 6 months, and 12 months). This study will incorporate TGE coinvestigators to inform all aspects of design, data collection, and analysis and ensure that practices are carried out in a respectful and sensitive manner. As of May 2021, the start of data collection for this project has continued to be postponed as a result of the COVID-19 pandemic, which has both impacted the functioning of the clinic and funding requests. We hope to begin participant recruitment and interviews with coinvestigators soon. We hypothesize that AL will be primarily influenced by psychological well-being and perceived support and that it will be similar in TGE adolescents and in age-matched cisgender control participants when acceptance and perceived support are high. The results of this study have the potential to increase our understanding of the health challenges faced by TGE individuals during adolescence as well as to show that low levels of acceptance may have detrimental health outcomes secondary to elevated ALs; this may lead to the development of a biomarker profile to assess allostatic stress in TGE patients that can be used to guide management. PRR1-10.2196/24100.
Sections du résumé
BACKGROUND
BACKGROUND
A growing number of adolescents are coming out as transgender and gender expansive (TGE). These teenagers have been shown to have significantly worse health outcomes than their cisgender peers. Hypotheses to explain this discrepancy are based on increased stress levels surrounding the societal acceptance of gender identity. In this context, elevated allostatic load (AL), which describes the wear and tear sustained by the body in response to repeated exposure to stress, has been associated with adverse long-term health outcomes.
OBJECTIVE
OBJECTIVE
This protocol aims to measure AL among TGE adolescents compared with their cisgender peers and assess how AL varies depending on psychological stress and perceived societal acceptance.
METHODS
METHODS
This is an observational proof-of-concept pilot study in which AL will be measured by assaying an array of inflammatory cytokines and cortisol in urine, saliva, and hair samples of TGE youth, and these parameters will be compared with those of age-matched control participants. A questionnaire will assess 4 aspects of psychosocial well-being: presence and management of depression and anxiety, gender identity support by family members, gender minority stress, and degree of perceived safety in the surrounding community. Samples and surveys will be collected at 3 visits (baseline, 6 months, and 12 months). This study will incorporate TGE coinvestigators to inform all aspects of design, data collection, and analysis and ensure that practices are carried out in a respectful and sensitive manner.
RESULTS
RESULTS
As of May 2021, the start of data collection for this project has continued to be postponed as a result of the COVID-19 pandemic, which has both impacted the functioning of the clinic and funding requests. We hope to begin participant recruitment and interviews with coinvestigators soon.
CONCLUSIONS
CONCLUSIONS
We hypothesize that AL will be primarily influenced by psychological well-being and perceived support and that it will be similar in TGE adolescents and in age-matched cisgender control participants when acceptance and perceived support are high. The results of this study have the potential to increase our understanding of the health challenges faced by TGE individuals during adolescence as well as to show that low levels of acceptance may have detrimental health outcomes secondary to elevated ALs; this may lead to the development of a biomarker profile to assess allostatic stress in TGE patients that can be used to guide management.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
UNASSIGNED
PRR1-10.2196/24100.
Identifiants
pubmed: 34009131
pii: v10i5e24100
doi: 10.2196/24100
pmc: PMC8173394
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e24100Informations de copyright
©Mara Cohen, Baer Karrington, Howard Trachtman, Caroline Salas-Humara. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 19.05.2021.
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