{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:50:37Z","timestamp":1780534237919,"version":"3.54.1"},"reference-count":66,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T00:00:00Z","timestamp":1538352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["LGBT Health"],"published-print":{"date-parts":[[2018,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Transgender individuals smoke tobacco at disproportionately higher rates than the general U.S. population, and concurrent use of gender-affirming hormones (estrogen or testosterone) and tobacco confers greater cardiovascular (CV) risk. This study examines the relationship between tobacco use and legal document gender-marker change, and medical\/surgical interventions for gender transition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Data came from an Internet-based survey of U.S. trans-feminine (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009631) and trans-masculine (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009473) individuals. We used multivariable logistic regression to investigate the relationship between past 3-month tobacco use and legal document gender-marker change, hormone use, and gender-affirming surgery controlling for demographic covariates and enacted and felt stigma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Compared to trans-feminine participants, trans-masculine individuals reported significantly higher rates of lifetime (74.4% vs. 63.5%) and past 3-month tobacco use (47.8% vs. 36.1%), and began smoking at an earlier age (14.5 vs. 15.5 years). Trans-feminine smokers reported significantly more frequent and heavier use. Adjusting for demographic covariates and enacted and felt stigma, legal document gender-marker change was associated with lower tobacco-use odds among trans-feminine individuals, whereas gender-affirming surgery predicted lower smoking odds among trans-masculine individuals. There were no significant differences in tobacco use by hormone use status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this study, trans-masculine individuals were more likely to smoke and trans-feminine individuals reported heavier use. It is concerning that individuals receiving hormones did not report lower smoking rates, given the elevated CV risk of this combination. This is a missed opportunity to intervene on a major public health issue and highlights the need for smoking cessation interventions in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lgbt.2018.0103","type":"journal-article","created":{"date-parts":[[2018,10,18]],"date-time":"2018-10-18T10:34:26Z","timestamp":1539858866000},"page":"401-411","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":53,"title":["The Relationship Between Tobacco Use and Legal Document Gender-Marker Change, Hormone Use, and Gender-Affirming Surgery in a United States Sample of Trans-Feminine and Trans-Masculine Individuals: Implications for Cardiovascular Health"],"prefix":"10.1177","volume":"5","author":[{"given":"Jeremy D.","family":"Kidd","sequence":"first","affiliation":[{"name":"Columbia University College of Physicians and Surgeons"},{"name":"New York State Psychiatric Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis","family":"Dolezal","sequence":"additional","affiliation":[{"name":"New York State Psychiatric Institute"},{"name":"Columbia University College of Physicians and Surgeons"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter O.","family":"Bockting","sequence":"additional","affiliation":[{"name":"New York State Psychiatric Institute"},{"name":"Columbia University College of Physicians and Surgeons"},{"name":"Columbia University School of Nursing"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,10,15]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6544a2"},{"key":"e_1_3_4_3_2","unstructured":"Institute of Medicine (US) Committee on Lesbian Gay Bisexual and Transgender Health Issues and Research Gaps and Opportunities: The Health of Lesbian Gay Bisexual and Transgender People: Building a Foundation for Better Understanding. 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