Publications

Juno Obedin-Maliver
Juno Obedin-Maliver
Associate Professor of Obstetrics and Gynecology (Gynecology & Gynecologic Specialties/Generalist) and, by courtesy, of Epidemiology and Population Health

Publications

  • Understanding Differences in Types of Social Support and Their Effects on Mental Health Over Time for Trans and Nonbinary Adults PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY Tebbe, E., Lisha, N. E., Neilands, T. B., Lubensky, M. E., Dastur, Z., Lunn, M. R., Obedin-Maliver, J., Flentje, A. 2025

    View details for DOI 10.1037/sgd0000789

    View details for Web of Science ID 001386419000001

  • Trauma Symptoms, Minority Stress, and Substance Use: Implications for Trauma Treatment in Sexual and Gender Minority Communities Psychology of Sexual Orientation and Gender Diversity Flentje, A., Ceja, A., Dilley, J. W., Lisha, N. E., Cloitre, M., Artime, T. M., Shumway, M., Einhorn, L., Edward, D., Ong, L., Lubensky, M. E., Neilands, T. B., Obedin-Maliver, J., Lunn, M. R. 2025

    View details for DOI 10.1037/sgd0000783

  • Healthcare provider communication and current contraceptive use among transgender men and gender-diverse people: results from an online, cross-sectional survey in the United States. Contraception Berry, J., Obedin-Maliver, J., Ragosta, S., Hastings, J., Lunn, M. R., Flentje, A., Capriotti, M. R., Dastur, Z., Lubensky, M. E., Inman, E. M., Moseson, H. 2024: 110784

    Abstract

    To explore whether discussing contraceptive use with a healthcare provider is associated with current contraceptive use among transgender men and gender-diverse (TMGD) individuals.In 2019, we conducted a cross-sectional survey among transgender men and gender-diverse adults in the United States who were assigned female or intersex at birth. We measured whether respondents had ever discussed contraception with a healthcare provider as well as current use of contraception, reasons for use, and barriers to use. We described frequencies and ranges for key variables and implemented a series of nested logistic regression models to evaluate the association between ever having spoken to a provider about contraception and current use of contraception for any reason, overall and by method type.Among 1,694 respondents, about half (48%) were currently using a method of contraception for any reason, most commonly barrier methods (17%) and long-acting-reversible-contraception (LARC) (17%). Compared to those who never had a conversation about contraception with a provider, respondents who spoke with a provider were more likely to be currently using contraception - particularly among those who self-initiated the conversation (aOR: 3.8, 95% CI: 2.5-5.6). Having discussed contraception with a healthcare provider was most strongly associated with current LARC use.Having had a conversation with a provider about contraception use was positively associated with current contraception use among a large, national sample of transgender men and gender-diverse people. Facilitating patient participation in contraception counseling for transgender and gender-diverse patients should be emphasized in provider training.Given formidable barriers to healthcare faced by TMGD people, training providers on how to initiate affirming and relevant conversations with TMGD patients about contraceptive needs and preferences is essential, as are efforts to educate and empower TMGD individuals to advocate for the information they need in these interactions.

    View details for DOI 10.1016/j.contraception.2024.110784

    View details for PubMedID 39701207

  • Acceptability of an organ inventory for cancer screening across gender identity and intersex status. Journal of the National Cancer Institute Moseson, H., Ragosta, S., Gómez, A. M., Corman, J., Zussman, J., Lesser-Lee, B., Reese, S., Carter-Bolick, I. R., Obedin-Maliver, J. 2024

    Abstract

    To evaluate the acceptability and performance of an organ inventory as an alternative to asking about gender and/or sex assigned at birth in cancer screening.We fielded an online, self-administered survey to a convenience sample of English- or Spanish-speaking transgender and gender-diverse (TGD), intersex, and cisgender people (>/=15 years) in the US. The survey contained an organ inventory developed with community input and questions regarding acceptability. The primary outcome was organ inventory acceptability by the four-item Acceptability of Intervention Measure (AIM). Additional outcomes included inter-method screening agreement between the organ inventory, gender, and sex assigned at birth.In 2022, 333 eligible individuals completed the survey; 44.4% cisgender, 34.2% TGD, and 14.1% intersex. Overall, participants rated the organ inventory as acceptable (median AIM score = 18/20, IQR: 16-20). Most (73%) found it easy to understand, and comfortable to complete (65%). Cancer screening eligibility varied based on the method used; relying solely on gender or sex data would have missed some eligible participants that the organ inventory identified.Using an organ inventory as an alternative to gender or sex-based screening questions was acceptable, and has implications for addressing cancer screening disparities.

    View details for DOI 10.1093/jnci/djae336

    View details for PubMedID 39672797

  • Anti-industry beliefs and attitudes mediate the effect of culturally tailored anti-smoking messages on quit intentions among sexual minority women. Scientific reports Zulkiewicz, B. A., Chen, J. T., Hanby, E. P., Ramanadhan, S., Obedin-Maliver, J., Lunn, M. R., Scout, N. F., Gordon, B., Applegate, J., Machado, A., Viswanath, K., Potter, J., Liu, S., Tan, A. S. 2024; 14 (1): 28084

    Abstract

    We conducted a longitudinal randomized controlled experiment between September 2021 and May 2022 to evaluate whether anti-tobacco industry beliefs and attitudes mediate the effect of culturally tailored anti-smoking messages on quit intentions among US young adult sexual minority women (SMW) ages 18-30 who smoke. Participants were randomized to view up to a total of 20 tailored versus non-tailored messages over one month. Outcomes were assessed at baseline and one-month follow-up. We fit a structural equation model testing the effect of LGBTQ + community-tailored, anti-smoking messages on quit intentions and mediating roles of anti-industry attitudes and beliefs (n = 966). Anti-industry beliefs (indirect effect size = 0.024, 95% confidence interval [CI] = [0.040, 0.056]) and attitudes (indirect effect size = 0.034, 95% CI = [0.006, 0.077]) significantly mediated the effect of the tailored condition on quit intentions. These findings suggest that LGBTQ + -tailored cues in anti-smoking messaging may promote quit intentions indirectly through influencing young adult SMW's beliefs and attitudes about the tobacco industry. Future campaigns to promote quitting among young adult SMW who smoke should consider incorporating themes to change their beliefs and attitudes about the tobacco industry.Trial registration This study was registered in ClinicalTrials.gov (NCT04812795) on 24/03/2021.

    View details for DOI 10.1038/s41598-024-78207-7

    View details for PubMedID 39543185

    View details for PubMedCentralID 5802250

  • Research for all: building a diverse researcher community for the All of Us Research Program. Journal of the American Medical Informatics Association : JAMIA Baskir, R., Lee, M., McMaster, S. J., Lee, J., Blackburne-Proctor, F., Azuine, R., Mack, N., Schully, S. D., Mendoza, M., Sanchez, J., Crosby, Y., Zumba, E., Hahn, M., Aspaas, N., Elmi, A., Alerté, S., Stewart, E., Wilfong, D., Doherty, M., Farrell, M. M., Hébert, G. B., Hood, S., Thomas, C. M., Murray, D. D., Lee, B., Stark, L. A., Lewis, M. A., Uhrig, J. D., Bartlett, L. R., Rico, E. G., Falcón, A., Cohn, E., Lunn, M. R., Obedin-Maliver, J., Cottler, L., Eder, M., Randal, F. T., Karnes, J., Lemieux, K., Lemieux, N., Lemieux, N., Bradley, L., Tepp, R., Wilson, M., Rodriguez, M., Lunt, C., Watson, K. 2024

    Abstract

    The NIH All of Us Research Program (All of Us) is engaging a diverse community of more than 10 000 registered researchers using a robust engagement ecosystem model. We describe strategies used to build an ecosystem that attracts and supports a diverse and inclusive researcher community to use the All of Us dataset and provide metrics on All of Us researcher usage growth.Researcher audiences and diversity categories were defined to guide a strategy. A researcher engagement strategy was codeveloped with program partners to support a researcher engagement ecosystem. An adapted ecological model guided the ecosystem to address multiple levels of influence to support All of Us data use. Statistics from the All of Us Researcher Workbench demographic survey describe trends in researchers' and institutional use of the Workbench and publication numbers.From 2022 to 2024, some 13 partner organizations and their subawardees conducted outreach, built capacity, or supported researchers and institutions in using the data. Trends indicate that Workbench registrations and use have increased over time, including among researchers underrepresented in the biomedical workforce. Data Use and Registration Agreements from minority-serving institutions also increased.All of Us built a diverse, inclusive, and growing research community via intentional engagement with researchers and via partnerships to address systemic data access issues. Future programs will provide additional support to researchers and institutions to ameliorate All of Us data use challenges.The approach described helps address structural inequities in the biomedical research field to advance health equity.

    View details for DOI 10.1093/jamia/ocae270

    View details for PubMedID 39545358

  • Disentangling gender, sex, and biology: a mixed methods study of gender identity data collection tools. Patient education and counseling Alpert, A. B., Hernandez, T., Ruddick, R., Manzano, C., Adams, S., Rivers, L., Ramos-Pibernus, A., Sevelius, J., Poteat, T., Obedin-Maliver, J., Cicero, E. C., Radix, A., Lett, E., Operario, D., Chapman, B., Wittink, M., Cupertino, A., Murchison, G. R., Nunez-Smith, M., Cartujano-Barrera, F. 2024; 130: 108473

    Abstract

    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.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.More participants preferred gender identity questions that were currently in use. Themes: 1) TGD participants find questions about "gender" and related terminology unclear because of conflations of sex, gender, and other constructs. 2) TGD participants resist cisgenderism in questions about gender identity. 3) TGD people desire questions that allow for autonomy, privacy, and safety. 4) Contextual factors, particularly safety, influence whether and how TGD people answer questions about gender and sex.TGD people have varied concepts of sex and gender and preferences about data collection. Future research should investigate the impacts of disentangling gender, sex, and biological factors, which could decrease stigma for TGD people.Medical care that disentangles gender, sex, and biological factors could improve data collection effectiveness and the safety of TGD people.

    View details for DOI 10.1016/j.pec.2024.108473

    View details for PubMedID 39471780

  • Factor structure and psychometric properties of the Muscle Dysmorphic Disorder Inventory (MDDI) among transgender women. Body image Nagata, J. M., Compte, E. J., McGuire, F. H., Lavender, J. M., Brown, T. A., Capriotti, M. R., Flentje, A., Lubensky, M. E., Obedin-Maliver, J., Lunn, M. R. 2024; 51: 101798

    Abstract

    Muscle dysmorphia (MD) is characterized by extreme preoccupation with insufficient muscularity that prompts pathological behaviors and distress/impairment. The Muscle Dysmorphic Disorder Inventory (MDDI) - a widely used measure of MD symptoms - has yet to be validated among transgender women, despite emerging evidence suggesting risk for muscularity-oriented concerns in this population. We examined the MDDI factor structure as well as the reliability and validity of its subscales in a sample of 181 transgender women ages 19-73 years who participated in a national longitudinal cohort study of U.S. sexual and gender minority adults. Confirmatory factor analysis was used to examine model fit for the original three-factor structure of the MDDI (drive for size, appearance intolerance, functional impairment). A re-specified three-factor model allowing covariance of residuals for two conceptually related items demonstrated good overall fit (χ2/df = 1.33, CFI =.94, TLI =.93, RMSEA =.06 [95 % CI =.01,.09], SRMR =.07). Moreover, results supported the internal consistency and convergent and discriminant validity of the MDDI subscales in transgender women. Findings inform the use of the MDDI among transgender women and provide a foundation to support future research on the MDDI and MD symptoms among gender minority populations.

    View details for DOI 10.1016/j.bodyim.2024.101798

    View details for PubMedID 39405723

  • Sexual Orientation-Related Disparities in Neonatal Outcomes. Obstetrics and gynecology Chakraborty, P., Reynolds, C. A., McKetta, S., Soled, K. R., Huang, A. K., Monseur, B., Corman, J. D., Obedin-Maliver, J., Eliassen, A. H., Chavarro, J. E., Austin, S. B., Everett, B., Haneuse, S., Charlton, B. M. 2024

    Abstract

    OBJECTIVE: To evaluate whether disparities exist in adverse neonatal outcomes among the offspring of lesbian, gay, bisexual, and other sexually minoritized (LGB+) birthing people.METHODS: We used longitudinal data from 1995 to 2017 from the Nurses' Health Study II, a cohort of nurses across the United States. We restricted analyses to those who reported live births (N=70,642) in the 2001 or 2009 lifetime pregnancy questionnaires. Participants were asked about sexual orientation identity (current and past) and same-sex attractions and partners. We examined preterm birth, low birth weight, and macrosomia among 1) completely heterosexual; 2) heterosexual with past same-sex attractions, partners, or identity; 3) mostly heterosexual; 4) bisexual; and 5) lesbian or gay participants. We used log-binomial models to estimate risk ratios for each outcome and weighted generalized estimating equations to account for multiple pregnancies per person over time and informative cluster sizes.RESULTS: Compared with completely heterosexual participants, offspring born to parents in all LGB+ groups combined (groups 2-5) had higher estimated risks of preterm birth (risk ratio 1.22, 95% CI, 1.15-1.30) and low birth weight (1.27, 95% CI, 1.15-1.40) but not macrosomia (0.98, 95% CI, 0.94-1.02). In the subgroup analysis, risk ratios were statistically significant for heterosexual participants with past same-sex attractions, partners, or identity (preterm birth 1.25, 95% CI, 1.13-1.37; low birth weight 1.32, 95% CI, 1.18-1.47). Risk ratios were elevated but not statistically significant for lesbian or gay participants (preterm birth 1.37, 95% CI, 0.98-1.93; low birth weight 1.46, 95% CI, 0.96-2.21) and bisexual participants (preterm birth 1.29, 95% CI, 0.85-1.93; low birth weight 1.24, 95% CI, 0.74-2.08).CONCLUSION: The offspring of LGB+ birthing people experience adverse neonatal outcomes, specifically preterm birth and low birth weight. These findings highlight the need to better understand health risks, social inequities, and health care experiences that drive these adverse outcomes.

    View details for DOI 10.1097/AOG.0000000000005747

    View details for PubMedID 39361956

  • GESTATIONAL CARRIER CYCLES AMONG MALE SAME-SEX COUPLES IN THE UNITED STATES, 20172020. Monseur, B., Shandley, L. M., Zhang, J., Leonard, S. A., Hipp, H. S., Obedin-Maliver, J., Alvero, R. J., Leondires, M. P. ELSEVIER SCIENCE INC. 2024: E290-E291

    View details for Web of Science ID 001342686801363