Publications by authors named "Ash B Alpert"

Transgender people's access to gender-affirming hormone therapy (GAHT) is under attack in the United States. In 2024, we interviewed US providers about how they prescribe GAHT. In accordance with informed consent models, providers reported that they reviewed patients' medical history, social supports, and comorbidities; prescribed GAHT formulations that aligned with patients' goals; monitored health regularly; and maintained open communication with patients.

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Background: The prevalence of cigarette smoking among transgender women in Argentina is 42%, more than double the rate compared to cisgender women.

Objectives: To understand biopsychosocial factors influencing cigarette smoking among transgender and gender-diverse (TGD) individuals living in Argentina.

Methods: Between December 2023 and January 2024, 19 qualitative semi-structured interviews were conducted face-to-face with TGD individuals.

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Gender-inclusive and gender-specific approaches are critically needed in cancer control continuum services to recognize and meet the needs of transgender and nonbinary (trans) populations. Current research, programs, and policies largely cater to cisgender populations and subscribe to a binary, gendered cisnormative ideology, both within health care systems and insurance policies, leaving trans people's cancer prevention and treatment needs neglected. Such disparities can be attributed to the significant gap in funding and research to address trans cancer prevention and treatment.

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Importance: Medicare covers gender-affirming surgical procedures on a case-by-case basis. The proportion of Medicare beneficiaries who receive gender-affirming surgical procedures is unknown.

Objective: To examine the frequency and trends of gender-affirming surgical procedures for Medicare beneficiaries.

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Objectives: We used community-based mixed methods to test whether transgender and gender diverse (TGD) people preferred gender identity questions developed by community members over current questions in use and generate hypotheses about data collection preferences.

Methods: We interviewed twenty TGD adults in English and Spanish, asking them to rate and discuss their responses to questions. We analyzed quantitative data with descriptive statistics and qualitative data with template analysis, then integrated them.

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Data on the health of transgender and gender diverse (TGD) people are scarce. Researchers are increasingly turning to insurance claims data to investigate disease burden among TGD people. Since claims do not include gender self-identification or modality (i.

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Background: Sexual and gender minority (SGM) people experience cancer disparities compared to heterosexual and cisgender (non-SGM) people and likely have barriers to cancer clinical trial enrollment. Data are sparse, however, regarding cancer clinical trial enrollment for SGM versus non-SGM people.

Methods: Using data from the 2020 Behavioral Risk Factor Surveillance Survey (BRFSS), we applied a logistic regression to assess associations between SGM status and clinical trial enrollment for 346 SGM and 9441 non-SGM people diagnosed with cancer.

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Purpose: Investigating transgender people's experiences sharing health information in clinical encounters may yield insights for family medicine clinicians.

Methods: This was a qualitative study using a community-based participatory research approach and interpretive description methodology. Seven qualitative focus groups were conducted with 30 transgender adults living in North America.

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A cancer diagnosis thrusts patients and caregivers into a foreign world of health care with systems, protocols, and norms that can leave little room for individual needs and circumstances. Quality and efficacious oncology care requires clinicians to partner with patients and caregivers to understand and incorporate their needs, values, and priorities into information sharing, decision making, and care provision. This partnership is necessary for effective patient- and family-centered care and access to individualized and equitable information, treatment, and research participation.

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Article Synopsis
  • NCCN aims to enhance equitable cancer care by promoting inclusion and representation of diverse populations in both professional and patient-facing materials.
  • Recent updates to the NCCN Clinical Practice Guidelines and the NCCN Guidelines for Patients focus on using inclusive, respectful language and diverse imagery to better support all patients with cancer.
  • NCCN is dedicated to continually improving its publications to ensure they are trustworthy, promote justice, and provide high-quality cancer care for everyone.
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Background: Transgender people experience extreme rates of violence and the electronic medical record (EMR) remains a mostly untapped resource to study the medical sequelae of such experiences.

Objectives: To develop and test a method for identifying experiences of violence using EMR data.

Research Design: Cross-sectional study utilizing EMR data.

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Background: Multiple national organizations recommend that cancer care providers and oncology practices be responsive to the needs of sexual and gender minority (SGM) patients. Oncology practices have attempted to incorporate this recommendation through SGM-focused cultural humility training interventions. It is unclear how best to adapt and implement such training across practices.

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Sexual and gender minority (SGM) people, including agender, asexual, bisexual, gay, gender diverse, genderqueer, genderfluid, intersex, lesbian, nonbinary, pansexual, queer, and transgender people, comprise approximately 10% or more of the U.S. population.

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Background: The 21st Century Cures Act and the OpenNotes movement have brought patients immediate access to their electronic health records (EHRs). The experiences of marginalized people, including transgender people, accessing and reviewing their EHRs could inform documentation guidelines to improve patient-clinician rapport and reduce harm.

Objective: To investigate the experiences of transgender people reviewing EHRs.

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Extranodal marginal zone lymphoma (EMZL) is a heterogeneous non-Hodgkin lymphoma. No consensus exists regarding the standard-of-care in patients with advanced-stage disease. Current recommendations are largely adapted from follicular lymphoma, for which bendamustine with rituximab (BR) is an established approach.

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Objective: To describe the experience of a Latino transgender man during his attempt to quit smoking using a text messaging intervention.

Methods: A Latino transgender man enrolled in a smoking cessation randomized controlled trial for Latino smokers. The participant was randomized to Decídetexto, a smoking cessation mobile intervention.

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Article Synopsis
  • Cancer research focusing on sexual and gender minority (SGM) populations is expanding, with a systematic review examining patient-reported health outcomes after cancer treatment among these groups.
  • The review analyzed 64 studies, mostly quantitative, finding significant differences in coping and resilience among sexual minority men and women, while experiences of transgender and intersex individuals were largely underrepresented.
  • Key findings highlight the importance of considering sexual orientation and gender identity in cancer care, emphasizing the need for clinicians to recognize the unique health outcomes and challenges faced by SGM cancer survivors.
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Objectives: Understanding barriers to care for transgender people with cancer is necessary to increase oncologic care access. Little has been published regarding the experiences of transgender people with cancer. We sought to explore these experiences, assess barriers to oncologic care, and elucidate potential solutions.

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Purpose: Cancer prevalence and outcomes data, necessary to understand disparities in transgender populations, are significantly hampered because gender identity data are not routinely collected. A database of clinical data on people with cancer, CancerLinQ, is operated by the ASCO and collected from practices across the United States and multiple electronic health records.

Methods: To attempt to identify transgender people with cancer within CancerLinQ, we used three criteria: (1) International Classification of Diseases 9/10 diagnosis (Dx) code suggestive of transgender identity; (2) male gender and Dx of cervical, endometrial, ovarian, fallopian tube, or other related cancer; and (3) female gender and Dx of prostate, testicular, penile, or other related cancer.

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