First Scientific Transgender Health Journal Coming Soon

Liam Davenport

August 04, 2015

A peer-reviewed, multidisciplinary journal focusing on scientific and clinical studies to advance understanding of the health issues faced by transgender people will be launched this fall.

Transgender Health , published by Mary Ann Liebert, Inc., will be an open access journal and will cover topics such as disparities in treatment and barriers to care, sexually transmitted infections and preventive measures, and best practices, protocols, and guidelines to ensure optimal care.

Robert Garofalo, MD, MPH, professor in pediatrics-adolescent medicine and preventive medicine, Northwestern University Feinberg School of Medicine, in Chicago, is the new journal's editor in chief.

"It's a real honor to have been selected to be the editor in chief of this journal in this moment in the history of the healthcare needs of transgender people," Dr Garofalo told Medscape Medical News.

"From my perspective, it's the right time for a journal of this nature to step forward and try to forge a position for itself in the academic literature," he added.

"There's a tremendous, for the lack of a better word, movement afoot to better understand the health needs and healthcare disparities that affect transgender people, and by and large, there's not a lot of avenues for specific academic publications for this particular population."

"So for the publishers to carve out a niche specific to transgender health makes a lot of sense at this point in history."

Filling an Unmet Need

Jordan Schilling, director of Open Access Publishing, Mary Ann Liebert, Inc, noted that recent publications by the National Institutes of Health, the Institute of Medicine, and the Foreign Affairs Council of the European Union have encouraged greater focus on lesbian, gay, bisexual, and transgender (LGBT) health equity.

"We envisioned a timely, international journal that would focus on publishing peer-reviewed articles dedicated to addressing the healthcare needs of transgender individuals throughout the lifespan and identifying gaps in knowledge, as well as priority areas where policy development and research are needed to achieve healthcare equity," Schilling told Medscape Medical News.

"We decided that Transgender Health should be open access so that everyone can freely read and disseminate the research.... We anticipate that Transgender Health will further the transgender healthcare movement and foster more research, as well as funding, on an international scale," he added.

Dr Garofalo noted that along with having a medical and clinical focus, the journal will emphasize surgical procedures and outcomes that are currently underrepresented in the literature.

"That could be anything from paradigms of care to specific healthcare outcomes of treatment protocols," he said, adding: "It could be case reports of specific treatment options that people have pursued, and it could hopefully include long-term outcome studies, which are almost entirely missing from the public literature outside of some small groups in Europe."

"For instance, in the United States, there have been very little, if not zero, outcome-driven data on long-term outcomes for many of the hormone protocols that exist for transgender people. So hopefully there'll be more and more of that going forward," he added.

Dr Garofalo noted that although standardized guidelines for transgender health have been produced by the Endocrine Society and the World Professional Association of Transgender Health Professionals, they "are constantly being revised, and I wouldn't exactly say, by and large, they are empirically driven, in the sense that there's not a lot of published literature to frame those guidelines, particularly cultures outside of a European context."

Transgender issues have been under the spotlight recently owing to public awareness of celebrities such as Laverne Cox and Caitlyn Jenner. Does Dr Garofalo welcome this focus on transgender issues?

He replied: "Well, I don't think there's been a tremendous amount of news coverage about health issues; I think there's been a tremendous amount of coverage of social and cultural issues."

"So I welcome a focus that now maybe turns some of the attention from social and cultural issues to more of some of the health issues that affect transgender people. I think, in general, it's hard to know whether, long-term, this is going to create the social change that I think this community needs," he added.

"What I really do think the transgender community needs is transformational change, and I think what we're experiencing now, it's a big blip in media attention...but I'm hopeful that those moments can steamroll or build into the transformational change that hopefully will shed light on the unique needs of this population."

Dr Garofalo concluded: "This has been a population that I have cared for throughout my career, initially through a very specific HIV lens, but more and more we see the healthcare needs of transgender people from a much broader, population-based lens."

Better Healthcare

Jack Drescher, MD, clinical professor of psychiatry and behavioral sciences, New York Medical College, in Valhalla, and an associate editor for LGBT Health , also published by Mary Ann Liebert, Inc, discussed the launch of the journal with Medscape Medical News.

Commenting on recent media coverage, he said that there is a "growing awareness of the phenomenon of the experience of being transgender that's sort of paralleling how gay people started coming out 30, 40 years ago."

Referring to the Oscar Wilde quote, "There is only one thing in life worse than being talked about, and that is not being talked about," he said: "When the conversation begins, you see all the kinds of resistance to conversation or all the prejudices that people have that usually are submerged or spoken privately and not in a public way."

"So it's inevitable that, once you start a conversation and say, 'Well, here I am' in public, people start talking in public about the critical things and the negative things they say in private, and that becomes part of the conversation too."

"There'll always be a backlash when the conversation starts, but ultimately...if you believe speech is good for people, then more speech is better than no speech," he added.

Dr Drescher hopes that the media coverage and the launch of journals such as Transgender Health can translate into improved healthcare for transgender people.

"One of the issues is that there's much more media coverage of transgender issues than there is coverage of transgender issues within the training of healthcare and mental healthcare professionals," he said.

"So it seems to me that a journal that would take up these issues specifically would provide a needed niche for people in this area to get to know each other and publish, because the odds of getting published or getting lost within larger journals makes it, I think, difficult," he added.


What is also needed, Dr Drescher emphasized, is more research in larger populations, driven by clinics specialized in treating transgender people. In 2011, the Institute of Medicine published a report outlining what is known and what needs to be researched in LGBT health.

"When you look at the transgender part, very little is known, so we can speak in broad specifics and generalities that more attention is needed. We need to know more, we need more prospective studies of what works and what doesn't work.... Those are the kinds of things that I assume the journal intends to present," Dr Drescher noted.

Finally, Dr Drescher is hopeful that the journal will help "increase the respectability" of the field of transgender health and reduce some of the stigma that surrounds it.

"What you often find is if you have a stigmatized patient population, the people who treat the stigmatized patient populations are often associated with them and are stigmatized," he said.

"So psychiatry, for example, is a stigmatized profession because the kinds of problems we treat in psychiatry are stigmatized by the general public; when people say psychiatrists are crazy, they mean we're crazy and the people we treat are crazy and it brushes off on us."

Noting that the publishers should be "congratulated," Dr Drescher concluded: "A formal journal by a respectable publisher only can destigmatize the phenomenon."


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