Medicaid prescription cap policies and acute care use and mortality among enrollees with opioid use disorder.

Background: Twelve state Medicaid programs limit the monthly number of covered prescriptions. Such cap policies may force enrollees to forego essential medications with important health consequences. We aimed to determine the impact of cap policies on acute care use and all-cause mortality among enrollees with opioid use disorder (OUD).

Cardiovascular Health at the Intersection of Race and Gender in Medicare Fee for Service.

Importance: Transgender and gender diverse (TGD) people have significantly higher rates of cardiovascular-related conditions than cisgender people, and Black and Hispanic people have higher rates of cardiovascular-related conditions than non-Hispanic White people. However, little is known about the prevalence of cardiovascular-related conditions among racial and ethnic subgroups of TGD people.

Objective: To compare the prevalence of cardiovascular-related conditions across racial and ethnic groups for TGD and cisgender people using quantitative intersectional methods.

Incident Atherosclerotic Cardiovascular Disease Among Veterans by Gender Identity: A Cohort Study.

Background: Transgender and gender diverse (trans) populations are at elevated risk for atherosclerotic cardiovascular disease (ASCVD).

Objective: Measure the association of gender identity and gender-affirming hormone therapy (GAHT) with ASCVD outcomes.

Design: Cohort study.

Association of state medicaid prescription cap policies with trajectories of buprenorphine use for opioid use disorder.

Background: Buprenorphine and other medications for opioid use disorder (OUD) can reduce opioid-related morbidity and mortality. It is unknown whether state Medicaid prescription cap policies that restrict the monthly number of covered prescription fills affect the duration of buprenorphine use.

Objective: To identify trajectories of buprenorphine use and determine the association of caps with trajectory group membership among individuals with OUD.

Characterizing disparities in the HIV care continuum among U.S. transgender and cisgender Medicare beneficiaries, 2008-2017.

Although HIV is more prevalent among transgender and gender-diverse individuals than cisgender people, a dearth of research has compared the HIV-related care engagement of these populations. Using 2008-2017 Medicare data, we identified TGD (trans feminine and non-binary [TFN], trans masculine and non-binary [TMN], unclassified gender) and cisgender (male, female) beneficiaries with HIV and explored within and between gender group differences in the predicted probability of engagement in the HIV Care Continuum. Transgender and gender-diverse individuals had a higher predicted probability of every HIV-related care outcome vs.

Chronic conditions among transgender Medicare beneficiaries: Variation by race, ethnicity, and Medicaid dual-enrollment.

Background: Transgender and gender diverse (TGD) adults experience disability at twice the rate of cisgender (non-TGD) adults in the US. TGD people of color and low-income TGD people experience intersecting discrimination that may compound chronic conditions and disability. To our knowledge, no research has focused on chronic conditions among TGD Medicare beneficiaries with disabilities.

An initial randomized controlled trial of a Combined Medication and Behavioral Activation Treatment (CoMBAT) for people with opioid use disorder.

Introduction: Opioid use disorder is a chronic, relapsing disease and a major source of morbidity and mortality in the U.S. Medications for opioid use disorder (MOUD) have been shown to reduce opioid use; however, MOUD maintenance is often suboptimal.

Exploring Perspectives on HIV Vulnerability Communication among Transgender and Gender Diverse Patients and Primary Care Providers.

Transgender and gender diverse (TGD) individuals represent a population with a heavy burden of HIV. Multi-level stigma encountered by TGD individuals can create significant barriers to discussing topics related to HIV prevention; however, research on communication between TGD patients and primary care providers (PCPs) about HIV vulnerability and prevention remains limited. This study used in-depth qualitative interviews with 25 TGD patients and 15 PCPs conducted in 2022 to explore perspectives on HIV vulnerability communication during primary care encounters.

Characterizing Disparities in the HIV Care Continuum among Transgender and Cisgender Medicare Beneficiaries.

Background: In the US, transgender and gender-diverse (TGD) individuals, particularly trans feminine individuals, experience a disproportionately high burden of HIV relative to their cisgender counterparts. While engagement in the HIV Care Continuum (e.g.

Understanding how primary care providers report discussing substance use with transgender and gender diverse patients.

Objectives: To explore how primary care providers report discussing substance use with transgender and gender diverse (TGD) adult patients within the context of discussing gender-affirming interventions.

Methods: Between March and April 2022, in-depth, semi-structured qualitative interviews were conducted with 15 primary care providers who care for TGD patients in the Northeastern US. Thematic analysis was used to analyze interview data and identify themes.

Adolescent Providers' Experiences of Harassment Related to Delivering Gender-Affirming Care.

Purpose: The politicization of adolescent gender-affirming care has occurred alongside targeted harassment (e.g., threats of violence, doxing, bomb threats) of adolescent gender-affirming care providers across the United States.

Hepatitis C Virus Testing and Care Cascade Among Transgender and Gender Diverse Individuals.

Introduction: Hepatitis C virus (HCV) prevalence among transgender and gender-diverse individuals ranges from 1.8% to 15.7% versus 1% in the general population.

US Black-White Differences in Mortality Risk Among Transgender and Cisgender People in Private Insurance, 2011-2019.

To compare survival by gender and race among transgender and cisgender people enrolled in private insurance in the United States between 2011 and 2019. We examined Optum's Clinformatics Data Mart Database. We identified transgender enrollees using claims related to gender-affirming care.

Differences in All-Cause Mortality Among Transgender and Non-Transgender People Enrolled in Private Insurance.

Few studies have analyzed mortality rates among transgender (trans) populations in the United States and compared them to the rates of non-trans populations. Using private insurance data from 2011 to 2019, we estimated age-specific all-cause mortality rates among a subset of trans people enrolled in private insurance and compared them to a 10% randomly selected non-trans cohort. Overall, we found that trans people were nearly twice as likely to die over the period as their non-trans counterparts.

Pediatric Provider Perspectives on Laws and Policies Impacting Sports Participation for Transgender Youth.

Since May 2021, numerous state legislatures in the United States have introduced bills to restrict the participation of transgender and gender diverse (trans) youth in gender-segregated sports in a manner consistent with their gender identity. The purpose of this study was to understand how medical providers of pediatric gender-affirming care for trans youth view these legislative efforts and how they believe these bills will affect their practice and patients. In March 2021, we recruited participants using listservs known to be frequented by providers of gender-affirming medical care to complete a survey about bills that restrict trans youths' participation in sex-segregated sports.

"These Laws Will Be Devastating": Provider Perspectives on Legislation Banning Gender-Affirming Care for Transgender Adolescents.

Purpose: The standards of care for transgender and gender diverse youth (TGDY) experiencing gender dysphoria are well-established and include gender-affirming medical interventions. As of July 2021, 22 states have introduced or passed legislation that bans the provision of gender-affirming medical care to anyone under the age of 18 even with parent or guardian consent. The purpose of this study is to understand what providers who deliver gender-affirming medical care to TGDY think about this legislation.

State-Level Policy Stigma and Non-Prescribed Hormones Use among Trans Populations in the United States: A Mediational Analysis of Insurance and Anticipated Stigma.

Background: Medical gender affirmation (i.e., hormone use) is one-way transgender (trans) people affirm their gender and has been associated with health benefits.

Weathering in Detroit: Place, Race, Ethnicity, and Poverty as Conceptually Fluctuating Social Constructs Shaping Variation in Allostatic Load.

Unlabelled: Policy Points Despite 30 years of attention to eliminating population health inequity, it remains entrenched, calling for new approaches. Targeted universalism, wellness-based local development, and Jedi Public Health approaches that are community informed, evidence based, and focused on improving everyday settings and diverse lived experiences are important policy directions. State and federal revenue transfers are necessary to mitigate the harms of austerity and assure greater equity in fiscal and population health in places like Detroit, Michigan.

Adapting Healthcare Quality Measures to Transgender Individuals.

The healthcare system's rapid shift toward value-based payment poses unique quality measurement challenges and new foci for researchers and policy makers. Quality measures that use sex-specific criteria may inappropriately include or exclude transgender individuals. More large-scale studies must be conducted to incorporate transgender individuals into measures that use sex-specific criteria, and "measure stewards" should consider the existing clinical guidelines and recommendations regarding transgender individuals when developing measures.