DOI

https://doi.org/10.25772/5226-FD77

Defense Date

2023

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Jo Robins

Second Advisor

Ethan Coston

Third Advisor

Suzanne Ameringer

Fourth Advisor

RK Elswick

Fifth Advisor

Andrea Landis

Abstract

Atherosclerotic cardiovascular disease is the primary cause of myocardial infarction worldwide, resulting in more than one million deaths in the United States annually. Gender minority individuals (those who identify as a gender other than that assigned at birth) experience myocardial infarction at an odds ratio 1.7 times that of their cisgender peers, though the cause of this disparity is unknown. The purpose of this work was to explore the relationships between gender minority stress, gender affirming hormone therapy, and the risk for atherosclerotic cardiovascular disease in transgender individuals assigned female sex at birth who use testosterone therapy. An explanatory sequential mixed-method design was used for this pilot study of 15 transgender and 15 cisgender individuals enrolled from Central and Northern Virginia.

Mixed-methods studies leverage both quantitative and qualitative data to enrich findings. Cross-sectional descriptive statistics were used to characterize the sample along with Pearson’s correlation to identify relationships between gender minority stress and cardiovascular disease risk. An analysis of variance was used to determine the predictability of lifetime atherosclerotic cardiovascular risk by gender affirming therapy route. Finally, a qualitative focus group interview was conducted with a subset of transgender participants to explore quantitative findings and guide a future, larger study. The findings of the quantitative arm were aligned with previous research into the effects of gender affirming hormone therapy on atherosclerotic cardiovascular disease risk outcomes. Qualitative results indicated that gender minority stress is a strong contributor to health behaviors, and that discontinuation of gender affirming hormone therapy is not an acceptable option for risk mitigation. Qualitative results confirm that transgender individuals are excited to participate in research, and that cisnormativity is the root of various themes explained by participants. Continuing this work will allow researchers to develop population-specific lifestyle interventions, and hopefully improved lifetime cardiovascular outcomes for the transgender population.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

12-11-2023

Available for download on Saturday, December 09, 2028

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