Jaclyn White Hughto

Jaclyn White Hughto
Brown University · Department of Behavioral and Social Sciences; Department of Epidemiology

PhD, MPH

About

134
Publications
32,092
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
4,272
Citations
Introduction
Jaclyn M White Hughto is an Assistant Professor at the Brown School of Public Health. She is also an Adjunct Investigator at the Fenway Institute of Fenway Health. Her research examines the individual, interpersonal, and structural drivers of health inequities, with a focus on the impact of stigma on the health of sexual and gender minority populations, people who use drugs, and those living with HIV.
Additional affiliations
January 2018 - present
Brown University
Position
  • Investigator
August 2014 - present
The Fenway Institute
Position
  • Analyst
August 2014 - November 2017
Yale School of Public Health
Position
  • PhD Student
Education
August 2014 - December 2017
Yale University
Field of study
  • Epidemiology
August 2008 - May 2010
Emory University
Field of study
  • Public Health
August 2002 - May 2006
Boston University
Field of study
  • Psychology

Publications

Publications (134)
Article
Rationale: Correctional healthcare providers' limited cultural and clinical competence to care for transgender patients represents a barrier to care for incarcerated transgender individuals. Objective: The present study aimed to adapt, deliver, and evaluate a transgender cultural and clinical competence intervention for correctional healthcare prov...
Article
Full-text available
The Center for the AIDS Programme of Research in South Africa (CAPRISA) 004 and Pre-exposure Prophylaxis Initiative (iPrEx) studies demonstrated that topical or oral chemoprophylaxis could decrease HIV transmission. Yet to have an appreciable public health impact, physicians will need to be educated about these new HIV prevention modalities. Massac...
Article
Full-text available
Rationale Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. Objective This critical review aims to integrate the literature on stigma towards transgender people in the US. Results This review demonstrates that transgender stigma limits opportunities and access to resources...
Article
Full-text available
Purpose: To identify geographic and individual-level factors associated with healthcare access among transgender people in the United States. Methods: Multilevel analyses were conducted to investigate lifetime healthcare refusal using national data from 5831 U.S. transgender adults. Hierarchical generalized linear models examined associations be...
Article
Full-text available
Objectives: To review evidence from prospective cohort studies of the relationship between hormone therapy and changes in psychological functioning and quality of life in transgender individuals accessing hormone therapy over time. Data sources: MEDLINE, PsycINFO, and PubMed were searched for relevant studies from inception to November 2014. Ref...
Article
Full-text available
Gender-affirming hormones have been shown to improve psychological functioning and quality of life among transgender and nonbinary (trans) people, yet, scant research exists regarding whether and why individuals take more or less hormones than prescribed. Drawing on survey data from 379 trans people who were prescribed hormones, we utilized multiva...
Article
Full-text available
The sexual partnerships of transmasculine (TM) adults—those assigned female at birth who identify as transgender men or a masculine spectrum gender identity—and characteristics associated with STI/HIV risk behavior remains understudied. Participants in the current study were TM adults (n = 141) receiving care at a community health center in Boston,...
Article
Objectives. To compare survival by gender and race among transgender and cisgender people enrolled in private insurance in the United States between 2011 and 2019. Methods. We examined Optum’s Clinformatics Data Mart Database. We identified transgender enrollees using claims related to gender-affirming care. Our analytic sample included those we id...
Article
Full-text available
This case study provides a critical discourse analysis of 121 letters of complaint and self‐advocacy authored by Natasha Keating, a trans woman incarcerated in two Australian male correctional facilities from 2000 to 2007. During her incarceration, Natasha experienced victimization, misgendering, microaggression, and institutional discrimination. D...
Article
Trans women incarcerated throughout the world have been described as “vulnerable populations” due to significant victimization, mistreatment, lack of gender-affirming care, and human rights violations, which confers greater risk of trauma, self-harm, and suicide compared with the general incarcerated population. Most incarceration settings around t...
Article
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% rand...
Article
Purpose: Transgender (TG) individuals are a historically understudied and underserved patient population. Although clinical guidelines for the care of TG patients exist, quality measures (QMs) specific to this population are lacking. The goal of this study was to obtain expert input on aspects of care for which quality measurement may be appropriat...
Article
Purpose: Prior algorithms enabled the identification and gender categorization of transgender people in insurance claims databases in which sex and gender are not simultaneously captured. However, these methods have been unable to categorize the gender of a large proportion of their samples. We improve upon these methods to identify the gender of a...
Article
Most incarceration settings around the world are governed by strong cisnormative policies, architectures, and social expectations that segregate according to a person's legal gender (i.e. male or female). This paper draws on the lived experiences of 24 formerly incarcerated trans women in Australia and the U.S. to elucidate the way in which the pri...
Article
Full-text available
When taken as prescribed, buprenorphine is effective in reducing opioid withdrawal, cravings, and use and preventing fatal overdose among people living with opioid use disorder (OUD). Despite the well-documented potential of buprenorphine provision to curb the opioid and overdose crises, this medication is severely underutilized in the treatment of...
Article
Background: Transgender and gender diverse (TGD) people are disproportionately incarcerated in the United States relative to the general population. A dearth of quantitative research has explored victimization as a risk factor for incarceration as well as the victimization experiences of formerly incarcerated TGD populations. Methods: In 2019, 574...
Article
Full-text available
Purpose: To facilitate identification of the impact of incarceration on the health of sexual and gender minority (SGM) populations, we sought to identify publicly accessible, representative health datasets that assessed SGM status and incarceration history from 2010 to 2020 and to examine SGM disparities in lifetime incarceration experiences. Metho...
Article
Study/research objective To develop and validate a brief intimate partner violence (IPV) scale that screens for controlling behaviors and psychological abuse tactics directed toward transgender individuals. Rationale Transgender individuals are at elevated risk of physical and sexual IPV compared to cisgender individuals. IPV often takes on unique...
Article
The burden of morbidity among privately insured transgender people is largely unknown. We identified transgender people enrolled in private insurance (using claims from 2001-19) and compared their rates of selected chronic conditions, using the Elixhauser Comorbidity Index, with claims for a matched cisgender cohort. We documented disparities betwe...
Article
Full-text available
Background People who experience non-fatal overdose (NFOD) are at high risk of subsequent overdose. With unprecedented increases in fentanyl in the US drug supply, many Massachusetts (MA) communities have seen a surge in opioid-related overdoses. The objective of this study was to determine factors associated with lifetime and past year NFOD in at-...
Article
Full-text available
Background: Fatal overdoses involving cocaine (powdered or crack) and fentanyl have increased nationally and in Massachusetts. It is unclear how overdose risk and preparedness to respond to an overdose differs by patterns of cocaine and opioid use. Methods: From 2017 to 2019, we conducted a nine-community mixed-methods study of Massachusetts resid...
Article
Full-text available
IntroductionRecent policies have restricted the rights of the US transgender people; there is a need to explore transgender people’s knowledge and attitudes regarding such policies and related mental health.Methods In 2019, 580 transgender adults living in the Northeastern US completed a survey assessing demographics, knowledge/attitudes toward tra...
Article
Background: Substantial research gaps exist regarding the relationship between transgender-related discrimination and substance use outcomes for transgender adults, with few studies accounting for other experiences of victimization. Methods: Transgender adults (N = 600) from Massachusetts and Rhode Island completed a survey online or in-person....
Article
Full-text available
Overdose deaths across the country have spiked since the onset of the COVID-19 pandemic. It is crucial now, more than ever, to address the continuing and worsening, complex and dynamic opioid and overdose epidemics. In 2018, The Center of Biomedical Research Excellence (COBRE) on Opioids and Overdose, based at Rhode Island Hospital, launched with t...
Article
See also Wesson et al., p. 446. I n the United States, transgender women who were assigned a male sex at birth and identify along the feminine gender spectrum experience extensive discrimination, violence, and other forms of stigma. 1 Transgender stigma operates at the structural (e.g., discriminatory laws and policies), inter-personal (e.g., enact...
Article
Background Limited research has explored risk factors for opioid pain medication misuse, concomitant substance misuse, and the unmet behavioral health treatment (BHTx) needs of transgender and gender diverse (TGD) adults. Methods In 2019, TGD adults (n = 562) in Massachusetts and Rhode Island were purposively recruited and completed a psychosocial...
Article
Full-text available
Background Valid and reliable quality measures can help catalyze improvements in health care. The care of transgender patients is ripe for quality measurement, as there is increasing awareness of the increasing prevalence of this population and the urgency of improving the health care they receive. While best practices may not exist for some aspect...
Article
Full-text available
Importance Substance use disorders are a major source of morbidity and mortality in the United States. National data comparing the prevalence of substance use disorder diagnoses (SUDDs) among transgender and cisgender individuals are lacking in the United States. Objectives To investigate the prevalence of SUDDs among transgender and cisgender adu...
Article
Full-text available
Purpose: The purpose of this study was to examine the extent to which transgender people have observed negative transgender-related messages in the media and the relationship between negative media message exposure and the mental health of transgender people. Methods: In 2019, 545 transgender adults completed an online survey assessing demographic...
Article
Background: Male sex workers (MSW) are disproportionately affected by HIV/AIDS, with an estimated HIV prevalence in the United States of 19.3%. Existing research suggests that MSW are also at risk of adverse psychosocial problems. Cross-sectional studies of MSW have suggested that co-occurring epidemics or a "syndemic" of psychosocial problems may...
Article
Historically, federal and state policies have narrowly defined treatment models that have resulted in limited access to and engagement in counseling for individuals receiving medications for opioid use disorder (MOUD; e.g., methadone and buprenorphine). In response to the coronavirus pandemic, outpatient MOUD treatment providers rapidly transitione...
Article
Full-text available
A dearth of research has explored concurrently the associations between multiple forms of gender affirmation (or transitioning) and the mental health of transgender adults. In 2015, 288 U.S. transgender adults completed a cross-sectional, online survey assessing demographics, gender affirmation experiences, and mental health. Adjusting for age and...
Article
Background: Large administrative databases often do not capture gender identity data, limiting researchers' ability to identify transgender people and complicating the study of this population. Objective: The objective of this study was to develop methods for identifying transgender people in a large, national dataset for insured adults. Resear...
Preprint
Full-text available
BACKGROUND Transgender and gender diverse (TGD) adults in the U.S. experience health disparities, especially in HIV infection. Medical gender affirmation such as hormone replacement therapy and gender-affirming surgeries is known to be medically necessary and to improve some health conditions. To our knowledge, however, no studies have assessed the...
Article
Background Transgender and gender diverse (TGD) adults in the United States experience health disparities, especially in HIV infection. Medical gender affirmation (eg, hormone therapy and gender-affirming surgeries) is known to be medically necessary and to improve some health conditions. To our knowledge, however, no studies have assessed the effe...
Article
Full-text available
There remains a limited understanding of current levels of transgender-related knowledge and acceptance among members of the general public. This study sought to develop and psychometrically evaluate a transgender knowledge, attitudes, and beliefs (T-KAB) scale in the general US population. We developed and evaluated the reliability and validity of...
Article
Full-text available
Background In recent years, Massachusetts (MA) and Rhode Island (RI) joined a growing list of states allowing residents to easily change the gender marker and name on government-identification (ID) documents. This was an important change for transgender and gender diverse (trans) residents, who face frequent mistreatment and thus for whom legal gen...
Article
The sexual partnerships of transmasculine adults-who were assigned female at birth and identify on the masculine gender continuum-remain understudied. This includes characteristics of transmasculine adults' sexual partnerships associated with engaging in HIV/sexually transmitted infection (STI) sexual risk behavior. This study examined individual-...
Article
Full-text available
An estimated 1.2 million people in the United States are living with HIV. Of those living with HIV, only 40% are engaged in HIV care, 37% are prescribed antiretroviral therapy (ART), and 30% are virally suppressed. Individual-, interpersonal-, and structural-level factors that represent barriers to engagement along the HIV care continuum are import...
Article
Rationale: A growing body of transgender (trans) health research has explored the relationship between stigma and health; yet, studies have conceptualized and operationalized anti-trans stigma in multiple ways. Objective: This scoping review aims to critically analyze quantitative measures of anti-trans stigma in the U.S. using a socioecological...
Article
Gay and bisexual men might face unique, status-based competitive pressures given that their social and sexual relationships often occur with other men, who are known to compete for social and sexual gain. In a multistage study, we delineated intraminority gay community stress theory-that status-focused elements of the gay community challenge the me...
Article
Full-text available
Background: In the U.S., transgender and gender diverse (TGD) populations face structural, interpersonal, and individual barriers to healthcare. Less is known, however, about the HIV prevention and treatment experiences of TGD youth in the U.S. The current study was developed to fill this research gap. Methods: This article describes the researc...
Article
Background: Transgender men (TM) have a male, masculine, or non-female gender identity, yet were assigned female sex at birth on the basis of their external genitalia. The majority of TM are at-risk of infection with one of several high-risk strains of the human papillomavirus (hr-HPV), acquired primarily through sexual contact, that cause 99.7% o...
Article
Full-text available
Background: In the U.S., non-binary refers to transgender people who have a gender identity not aligned with their assigned sex at birth, and who identify outside of the traditional male-female binary, such as genderqueer, genderfluid, or gender nonconforming. Few data are available to characterize the health of non-binary adults. Methods: The c...
Article
Full-text available
Transgender people incarcerated around the world remain a “vulnerable group,” and continue to experience signifi- cant mistreatment, human rights violations, and erasure of their gender identity, conferring greater risk of trauma, suicide, and self-harm than experienced by the general incarcerated population. As transgender rights and health schola...
Article
Full-text available
Objectives: This study aims to identify factors associated with the reproductive planning of trans-masculine adults. Study design: Between 2015 and 2016, providers enrolled 150 trans-masculine adults in a sexual health study assessing sociodemographics, social support, gender affirmation, sexual partnering, and reproductive history and planning....
Article
Full-text available
Across HIV prevention studies, as many as 25% of men who have sex with men (MSM) report meeting male partners at private sex events and attendance is associated with increased number of sexual partners, condomless anal sex (CAS), and HIV infection. Despite the need for effective HIV prevention interventions, no risk reduction interventions have bee...
Article
Men who have sex with men (MSM) continue to be the largest risk group for HIV infections in the U.S., where crystal methamphetamine abuse heightens risk for HIV infection through greater engagement in condomless anal sex (CAS). Existing treatments lack attention to replacement activities or the role of depressed mood. Behavioral activation (BA) is...
Article
Full-text available
Limited provider knowledge of transgender health contributes to stigmatizing interactions and access-to-care challenges for incarcerated transgender people. Drawing on interviews with recently incarcerated transgender individuals and correctional staff, a transgender health care provider training was developed and piloted. Providers indicated the t...
Article
Intimate partner violence (IPV) takes on unique dimensions when directed against transgender individuals, with perpetrators leveraging transphobia to assert power and control. Standard IPV measurement tools do not assess this type of IPV. Four questions to assess transgender-related IPV (T-IPV) were developed: (a) being forced to conform to an unde...
Article
Background: Worldwide, young transgender women (YTW) contend with exceptionally high-risks for HIV infection. Cross-sectional studies have suggested that co-occurring epidemics or "syndemics" of psychosocial problems may accelerate HIV acquisition and transmission via elevated sexual risk behavior among transgender women. We aimed to examine how a...
Article
Full-text available
The present study aims to develop the Physical Activity Tracking Preference Questionnaire (PATPQ), a measure of unit (distance, steps, calories, minutes) preference for tracking physical activity. The PATPQ was developed in two phases. During Phase One, the initial PATPQ was created (24 items), was assessed by an expert panel for face validity, and...
Article
Full-text available
Following publication of the original article [1], we have been notified of the below corrections.
Article
Full-text available
Background: Trans-masculine (TM) individuals, who are assigned female sex at birth and identify along the masculine gender spectrum, face mental health disparities relative to cisgender people. Limited research has sought to explore the multi-level risk and protective factors associated with mental health morbidity for TM populations. Methods: Betw...
Article
Full-text available
Purpose: This study examined whether older age moderates the association between gender-affirming medical treatment and quality of life (QOL) among transgender individuals. Methods: Transgender men and women from the National Transgender Discrimination Survey who had either recently or never undergone medical treatment were included (n = 2420)....
Article
Full-text available
Background In the United States, problematic stimulant use is a prevalent and difficult to treat problem among men who have sex with men (MSM), as well as a major driver of HIV transmission through the large number of sexual partners and concomitant condomless anal sex (CAS). Evidence-based behavioral studies that address problematic stimulant use...
Article
Full-text available
Background: HIV infection among youth in the United States is on the rise. A high level of antiretroviral therapy (ART) adherence is crucial to treatment success and can minimize the population burden of the disease. However, the overall rate of ART adherence among youth is generally suboptimal and no published efficacious interventions exist to a...
Article
Objectives: Given that prior mistreatment can lead to heightened vigilance to and perceptions of future rejection, the present study examined whether this heightened vigilance, known as rejection sensitivity, mediates the association between healthcare mistreatment and healthcare avoidance in trans masculine (TM) adults. Method: Between 2015 and...
Article
Full-text available
Purpose: Incarcerated transgender women often require healthcare to meet their physical-, mental-, and gender transition-related health needs; however, their healthcare experiences in prisons and jails and interactions with correctional healthcare providers are understudied. Design/methodology/approach: In 2015, 20 transgender women who had been i...
Article
Full-text available
Background: High-risk human papillomavirus (hrHPV) causes virtually all cervical cancers. Trans masculine (TM) people (those assigned female at birth who identify with a gender other than female) have low uptake of conventional cervical cancer screening. Self-collected hrHPV DNA testing has high levels of acceptability among cisgender (non-transge...
Article
Full-text available
Background: Transgender women are disproportionately incarcerated in the US relative to the general population. A dearth of research has explored the factors that predict incarceration among transgender women or the longitudinal impact of incarceration on the health of this population. Methods: Between 2012 and 2015, 221 transgender women ages 1...
Article
Purpose: To investigate whether the prevalence of eating disorders (EDs) differs across diverse gender identity groups in a transgender sample. Methods: Secondary analysis of data from Project VOICE, a cross-sectional study of stress and health among 452 transgender adults (ages 18–75 years) residing in Massachusetts. Age-adjusted logistic regressi...
Article
Purpose: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia....
Article
Full-text available
In the U.S., transgender and other gender minority (TG) youth are an at-risk group understudied in HIV prevention and treatment. This study sought to characterize the HIV prevention and care continua in a diverse sample of 181 sexually-active TG ages 16–24 years (mean age = 20.7 years; 76.8% trans feminine; 69.1% youth of color) recruited July–Dece...
Article
Full-text available
Globally, transgender women (TGW) experience multiple forms of victimization such as violence and discrimination that can place them at risk for poor sexual health. To date, research overlooks the heterogeneity in experiences of victimization among TGW. Furthermore, few studies have examined the association between victimization and sexual risk amo...
Conference Paper
Background: Transgender people experience limited access to culturally and clinically competent healthcare providers, posing a significant barrier to receiving care and serving as a likely driver of the healthcare disparities affecting transgender populations. Guided by the socio-ecological model, we examined a range of individual and institutional...