Study of Transition, Outcomes, and Gender

{{Short description|Cohort study}}

{{cs1 config|name-list-style=vanc}}

{{Use dmy dates|date=February 2023}}

The Study of Transition, Outcomes, and Gender (STRONG) is a cohort study of health in transgender people before and during or after gender-affirming treatments such as gender-affirming hormone therapy and gender-affirming surgery.{{cite journal | vauthors = Quinn VP, Nash R, Hunkeler E, Contreras R, Cromwell L, Becerra-Culqui TA, Getahun D, Giammattei S, Lash TL, Millman A, Robinson B, Roblin D, Silverberg MJ, Slovis J, Tangpricha V, Tolsma D, Valentine C, Ward K, Winter S, Goodman M | title = Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people | journal = BMJ Open | volume = 7 | issue = 12 | pages = e018121 | date = December 2017 | pmid = 29284718 | pmc = 5770907 | doi = 10.1136/bmjopen-2017-018121 | url = }} It is being conducted at Kaiser Permanente sites in Northern California, Southern California, and Georgia and includes over 6,000 transgender people. The study was underway by 2015Quinn VP, Becerra TA, Gillespie T, Hunkeler E, Baird T, Baisch NM, Owen-Smith A, Roblin D, Stephenson R, Tangpricha V, Valentine C, Goodman M. Embedding Patients, Providers, and Community Stakeholders in Research to Improve Transgender Health. J Patient Cent Res Rev 2015;2:114–115. http://dx.doi.org/10.17294/2330-0698.1137 and the first paper for the study was published in 2017. The STRONG cohort represents the largest cohort of transgender people studied to date and the first such large-scale study conducted in the United States.

STRONG has published papers assessing transgender population size and demographics,{{cite journal | vauthors = Zhang Q, Rechler W, Bradlyn A, Flanders WD, Getahun D, Lash TL, McCracken C, Nash R, Panagiotakopoulos L, Roblin D, Sandberg DE, Silverberg MJ, Tangpricha V, Vupputuri S, Goodman M | title = Changes in Size and Demographic Composition of Transgender and Gender Non-Binary Population Receiving Care at Integrated Health Systems | journal = Endocr Pract | volume = 27 | issue = 5 | pages = 390–395 | date = May 2021 | pmid = 33678315 | doi = 10.1016/j.eprac.2020.11.016 | s2cid = 232140899 | url = }} agreement between electronic medical records and self-reported gender identity,{{cite journal | vauthors = Gerth J, Becerra-Culqui T, Bradlyn A, Getahun D, Hunkeler EM, Lash TL, Millman A, Nash R, Quinn VP, Robinson B, Roblin D, Silverberg MJ, Tangpricha V, Vupputuri S, Goodman M | title = Agreement between medical records and self-reports: Implications for transgender health research | journal = Rev Endocr Metab Disord | volume = 19 | issue = 3 | pages = 263–269 | date = September 2018 | pmid = 30219985 | pmc = 6438197 | doi = 10.1007/s11154-018-9461-4 | url = }} gender dysphoria and mental health,{{cite journal | vauthors = Owen-Smith AA, Gerth J, Sineath RC, Barzilay J, Becerra-Culqui TA, Getahun D, Giammattei S, Hunkeler E, Lash TL, Millman A, Nash R, Quinn VP, Robinson B, Roblin D, Sanchez T, Silverberg MJ, Tangpricha V, Valentine C, Winter S, Woodyatt C, Song Y, Goodman M | title = Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction, and Mental Health in a Cohort of Transgender Individuals | journal = J Sex Med | volume = 15 | issue = 4 | pages = 591–600 | date = April 2018 | pmid = 29463478 | pmc = 5882508 | doi = 10.1016/j.jsxm.2018.01.017 | url = }}{{cite journal | vauthors = Becerra-Culqui TA, Liu Y, Nash R, Cromwell L, Flanders WD, Getahun D, Giammattei SV, Hunkeler EM, Lash TL, Millman A, Quinn VP, Robinson B, Roblin D, Sandberg DE, Silverberg MJ, Tangpricha V, Goodman M | title = Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers | journal = Pediatrics | volume = 141 | issue = 5 | pages = | date = May 2018 | pmid = 29661941 | pmc = 5914494 | doi = 10.1542/peds.2017-3845 | url = }} suicidality,{{cite journal | vauthors = Mak J, Shires DA, Zhang Q, Prieto LR, Ahmedani BK, Kattari L, Becerra-Culqui TA, Bradlyn A, Flanders WD, Getahun D, Giammattei SV, Hunkeler EM, Lash TL, Nash R, Quinn VP, Robinson B, Roblin D, Silverberg MJ, Slovis J, Tangpricha V, Vupputuri S, Goodman M | title = Suicide Attempts Among a Cohort of Transgender and Gender Diverse People | journal = Am J Prev Med | volume = 59 | issue = 4 | pages = 570–577 | date = October 2020 | pmid = 32798005 | pmc = 7508867 | doi = 10.1016/j.amepre.2020.03.026 | url = }} "passing" and mental health,{{cite journal | vauthors = To M, Zhang Q, Bradlyn A, Getahun D, Giammattei S, Nash R, Owen-Smith AA, Roblin D, Silverberg MJ, Tangpricha V, Vupputuri S, Goodman M | title = Visual Conformity With Affirmed Gender or "Passing": Its Distribution and Association With Depression and Anxiety in a Cohort of Transgender People | journal = J Sex Med | volume = 17 | issue = 10 | pages = 2084–2092 | date = October 2020 | pmid = 32807706 | pmc = 7529975 | doi = 10.1016/j.jsxm.2020.07.019 | url = }} progression of gender dysphoria in transgender youth,{{cite journal | vauthors = Wagner S, Panagiotakopoulos L, Nash R, Bradlyn A, Getahun D, Lash TL, Roblin D, Silverberg MJ, Tangpricha V, Vupputuri S, Goodman M | title = Progression of Gender Dysphoria in Children and Adolescents: A Longitudinal Study | journal = Pediatrics | volume = 148 | issue = 1 | pages = | date = July 2021 | pmid = 34099504 | pmc = 8276590 | doi = 10.1542/peds.2020-027722 | url = }} hematological parameters,{{cite journal | vauthors = Antun A, Zhang Q, Bhasin S, Bradlyn A, Flanders WD, Getahun D, Lash TL, Nash R, Roblin D, Silverberg MJ, Tangpricha V, Vupputuri S, Goodman M | title = Longitudinal Changes in Hematologic Parameters Among Transgender People Receiving Hormone Therapy | journal = J Endocr Soc | volume = 4 | issue = 11 | pages = bvaa119 | date = November 2020 | pmid = 33834151 | pmc = 8011434 | doi = 10.1210/jendso/bvaa119 | url = | doi-access = free }} liver parameters,{{cite journal | vauthors = Hashemi L, Zhang Q, Getahun D, Jasuja GK, McCracken C, Pisegna J, Roblin D, Silverberg MJ, Tangpricha V, Vupputuri S, Goodman M | title = Longitudinal Changes in Liver Enzyme Levels Among Transgender People Receiving Gender Affirming Hormone Therapy | journal = J Sex Med | volume = 18 | issue = 9 | pages = 1662–1675 | date = September 2021 | pmid = 34366264 | pmc = 8444147 | doi = 10.1016/j.jsxm.2021.06.011 | url = }} acne risk,{{cite journal | vauthors = Yeung H, Ragmanauskaite L, Zhang Q, Kim J, Tangpricha V, Getahun D, Silverberg MJ, Goodman M | title = Prevalence of moderate to severe acne in transgender adults: A cross-sectional survey | journal = J Am Acad Dermatol | volume = 83 | issue = 5 | pages = 1450–1452 | date = November 2020 | pmid = 32109538 | pmc = 7483412 | doi = 10.1016/j.jaad.2020.02.053 | url = }}{{cite journal | vauthors = Braun H, Zhang Q, Getahun D, Silverberg MJ, Tangpricha V, Goodman M, Yeung H | title = Moderate-to-Severe Acne and Mental Health Symptoms in Transmasculine Persons Who Have Received Testosterone | journal = JAMA Dermatol | volume = 157 | issue = 3 | pages = 344–346 | date = March 2021 | pmid = 33471032 | pmc = 7970332 | doi = 10.1001/jamadermatol.2020.5353 | url = }} psoriasis risk,{{cite journal | last1 = Braun | first1 = Hayley | last2 = Thompson | first2 = Elaine C. | last3 = Zhang | first3 = Qi | last4 = Tangpricha | first4 = Vin | last5 = Goodman | first5 = Michael | last6 = Yeung | first6 = Howa | title = Prevalence of Psoriasis and Perceived Association with Hormone Therapy in Transgender Adults | journal = Transgender Health | date = 28 March 2022 | volume = 8 | issue = 4 | pages = 396–399 | issn = 2688-4887 | eissn = 2380-193X | doi = 10.1089/trgh.2021.0104 | pmid = 37525834| pmc = 10387154 | s2cid = 247823888 | url = }} cardiovascular health,{{cite journal | vauthors = Getahun D, Nash R, Flanders WD, Baird TC, Becerra-Culqui TA, Cromwell L, Hunkeler E, Lash TL, Millman A, Quinn VP, Robinson B, Roblin D, Silverberg MJ, Safer J, Slovis J, Tangpricha V, Goodman M | title = Cross-sex Hormones and Acute Cardiovascular Events in Transgender Persons: A Cohort Study | journal = Ann Intern Med | volume = 169 | issue = 4 | pages = 205–213 | date = August 2018 | pmid = 29987313 | pmc = 6636681 | doi = 10.7326/M17-2785 | url = }}{{cite journal | vauthors = Goodman M, Getahun D, Silverberg MJ, Safer J, Tangpricha V | title = Cross-Sex Hormones and Acute Cardiovascular Events in Transgender Persons | journal = Ann Intern Med | volume = 170 | issue = 2 | pages = 143 | date = January 2019 | pmid = 30641565 | doi = 10.7326/L18-0564 | s2cid = 58004787 | url = }} diabetes risk,{{cite journal | vauthors = Islam N, Nash R, Zhang Q, Panagiotakopoulos L, Daley T, Bhasin S, Getahun D, Sonya Haw J, McCracken C, Silverberg MJ, Tangpricha V, Vupputuri S, Goodman M | title = Is There a Link Between Hormone Use and Diabetes Incidence in Transgender People? Data From the STRONG Cohort | journal = J Clin Endocrinol Metab | volume = 107 | issue = 4 | pages = e1549–e1557 | date = March 2022 | pmid = 34850912 | doi = 10.1210/clinem/dgab832 | pmc = 8947226 | url = }}{{cite journal | vauthors = Tangpricha V | title = Gender-affirming Hormone Therapy and Risk of Diabetes in Transgender Persons | journal = J Clin Endocrinol Metab | volume = 107 | issue = 6 | pages = e2632–e2633 | date = May 2022 | pmid = 35106582 | pmc = 9113784 | doi = 10.1210/clinem/dgac060 | url = }} and cancer risk.{{cite journal | vauthors = Silverberg MJ, Nash R, Becerra-Culqui TA, Cromwell L, Getahun D, Hunkeler E, Lash TL, Millman A, Quinn VP, Robinson B, Roblin D, Slovis J, Tangpricha V, Goodman M | title = Cohort study of cancer risk among insured transgender people | journal = Ann Epidemiol | volume = 27 | issue = 8 | pages = 499–501 | date = August 2017 | pmid = 28780974 | doi = 10.1016/j.annepidem.2017.07.007 | url = }}