-
LGBT Health 2023Patient empowerment is becoming increasingly important as health care moves toward more collaborative models of care. The goal of this study was to evaluate and...
Patient empowerment is becoming increasingly important as health care moves toward more collaborative models of care. The goal of this study was to evaluate and characterize patient empowerment in a sample of transgender/gender-diverse/nonbinary (TGDNB) youth aged 14-24 who have had at least one conversation with a medical health care provider about gender-affirming care. We adapted a health care empowerment scale for use with TGDNB young people and collected patient empowerment and sociodemographic data among TGDNB youth in the United States over an 8-week period in the spring of 2022. Overall and domain-specific empowerment (including knowledge and understanding, control, identity, decision-making, and supporting others) were assessed on a four-point scale from a low of 1 to a high of 4. A total of 177 youth completed the survey. Mean age was 18.4 ± 3.0 years, the sample was 39.5% gender-diverse/nonbinary, 16.4% transfemme, 44.1% transmasc, and 81.9% White. Average empowerment was 0.22 points higher in youth with supportive caregivers than those without (99% confidence interval [CI] 0.05-0.38, < 0.001) and 0.20 points higher in youth who sought gender-affirming mental health support (99% CI 0.04-0.36, = 0.001). Caregiver support increased youths' sense of control over their health/health care (estimated increase 0.29, 99% CI 0.09-0.50, < 0.001), and mental health support increased youths' decision-making agency by 0.30 points (99% CI 0.06-0.53, = 0.001). This is the first study to assess patient empowerment in TGDNB youth. Several sociodemographic factors were significantly associated with overall and domain-level empowerment. Further work in this area, both longitudinal and in larger samples, is warranted.
Topics: Humans; Adolescent; United States; Young Adult; Adult; Transgender Persons; Patient Participation; Transsexualism; Gender Identity; Surveys and Questionnaires
PubMed: 37126404
DOI: 10.1089/lgbt.2022.0276 -
Trauma, Violence & Abuse Oct 2023Violence against LGBT community can manifest in different forms and exists in all spheres of society, including education. The main purpose of this article is to deepen... (Review)
Review
Violence against LGBT community can manifest in different forms and exists in all spheres of society, including education. The main purpose of this article is to deepen the understanding of the state of the art about violence grounded in sexual orientation or gender identity in higher education in order to identify gaps for further research. The topic of this state-of-the-art literature review is the presence and magnitude of these forms of violence in the Spanish higher education system. For this reason, the inclusion criteria were empirical studies about the prevalence of violence against LGBTIQ+ individuals in the Spanish educational system. After analyzing the 25 articles that met the inclusion criteria, the main findings point that despite the existence of numerous international studies of the presence of violence against LGBTIQ+ people at colleges, little is known about this reality in Spain. The Spanish university system continues to remain hermetic, and violence against LGBTIQ+ people is silenced and hidden. Practice, policy and research implications of the findings are discussed in this article, highlighting the need of further research in this field. In this context, the research project Uni4Freedom, addresses this social and educational problem to contribute to the creation of safer universities for the LGBTIQ+ community and people who support them.
Topics: Humans; Male; Female; Sexual and Gender Minorities; Universities; Gender Identity; Sexual Behavior; Violence
PubMed: 35762331
DOI: 10.1177/15248380221111471 -
Nutricion Hospitalaria Nov 2023Women deserve special attention due to the different requirements they have in comparison with men. In the same way, transgender women need individualized attention....
Women deserve special attention due to the different requirements they have in comparison with men. In the same way, transgender women need individualized attention. Transgender women are at greater risk of suffering heart attacks or ischemic accidents, among other diseases, and are also at greater risk of developing eating disorders, poorer weight control and poorer perception of their image. Hormone therapy for gender reaffirmation in trans women modifies their body composition, and may also increase the risk of suffering from some pathologies. The nutritional needs of cisgender women are different from those of men, and trans women also have special needs, which may depend on whether or not they follow hormone therapy. Dietary studies, although scarce, suggest that transgender women have poor dietary habits and lifestyle. It is necessary to deepen the study of the nutritional situation of the female group, considering its diversity, and to develop standards and references appropriate to each case that allow better attention to the needs of these groups.
Topics: Male; Humans; Female; Transgender Persons; Transsexualism; Myocardial Infarction; Hormones
PubMed: 37929906
DOI: 10.20960/nh.04952 -
Therapeutische Umschau. Revue... Sep 2023Not all mothers and newborns have equal opportunities for a healthy motherhood and a healthy start. Differences exist in various diversity characteristics such as low...
Not all mothers and newborns have equal opportunities for a healthy motherhood and a healthy start. Differences exist in various diversity characteristics such as low socioeconomic status, migration background, sexual orientation, gender identity, and disability. In addition to a range of increased health risks for mothers and newborns, barriers in the care process, such as lack of awareness of the specific needs and interaction problems between clients and professionals, hinder the utilization of obstetric and maternity services. The elimination of access barriers and mechanisms of discrimination can be achieved through transcategorial competence. In the context of obstetrics and maternity care, transcategorial competence means, for example, the appropriate involvement of relatives in migrant women's care, recognition, and support of different family forms in LGBTI*Q people, and awareness of discriminatory behavior. Continuity in care provided by gynecologists and midwives facilitates healthcare provision and minimizes misunderstandings. The establishment of transcategorial competence requires institutional awareness of forms of discrimination and disadvantage. Interdisciplinary collaboration and diversity-sensitive education and training are crucial for reducing uncertainties and avoiding stereotyping.
Topics: Female; Pregnancy; Humans; Infant, Newborn; Male; Maternal Health Services; Gender Identity
PubMed: 37855562
DOI: No ID Found -
Facial Plastic Surgery Clinics of North... Aug 2023Injectable treatments are valuable tools to be considered in those seeking facial gender-affirming therapies. As stand-alone procedures, they are unlikely to meet... (Review)
Review
Injectable treatments are valuable tools to be considered in those seeking facial gender-affirming therapies. As stand-alone procedures, they are unlikely to meet expectations, particularly in those seeking facial feminization. However, injectables can be useful for those seeking to transition into another gender role, who are not ready for more permanent surgical treatment. They are also useful to help fine-tune features to one's satisfaction. Transgender people in the United States are more likely than the general population to be impoverished, and thus the cost of injectables may be a more salient concern.
Topics: Humans; United States; Gender Identity; Transgender Persons
PubMed: 37348983
DOI: 10.1016/j.fsc.2023.04.004 -
Urologie (Heidelberg, Germany) Nov 2023New research questions in the history of German sexology and sexual medicine include a new look at the Imperial and the Weimar Republic periods and Magnus Hirschfeld as... (Review)
Review
New research questions in the history of German sexology and sexual medicine include a new look at the Imperial and the Weimar Republic periods and Magnus Hirschfeld as a protagonist, as well as the contemporary history of the discipline in the Federal Republic with the two formative institutes in Frankfurt (Volkmar Sigusch) and Hamburg (Eberhard Schorsch). In the post-war period, the tendency to try to solve social problems through endocrinological and surgical approaches continued. This included the (voluntary) castration of sex offenders, which has been regulated by law in the West Germany since 1969. Questions of gender identity do not only arise in the context of gender reassignment surgery. They also have high social relevance and have become increasingly politicized in recent years. These questions are also persistently relevant for urology and clinical sexual medicine.
Topics: Humans; Male; Female; Gender Identity; Sexual Behavior; Sex Offenses; Urology; Sexology
PubMed: 37428184
DOI: 10.1007/s00120-023-02091-8 -
Acta Psychologica May 2024Traditional questionnaires do not capture the complexity of how people are viewed by others and grouped into categories on the basis of what is inferred (or not) about... (Review)
Review
Traditional questionnaires do not capture the complexity of how people are viewed by others and grouped into categories on the basis of what is inferred (or not) about them. This is critical in applying an intersectionality framework in research because people are negatively impacted because of "who they are" but also based on "how others see them." The purpose of this project was to develop and validate a questionnaire, grounded in intersectionality theory and a nuanced understanding of social position, that can be applied in large-scale, population-based surveys and studies. Drawing on 61 existing quantitative surveys collecting identity-based information and 197 qualitative studies on intersectionality describing the complex ways in which people's social positions are constructed and experienced, we created a draft questionnaire comprising five parts: 1) Sex and Gender, 2) Sexuality and Sexual Orientation, 3) Cultural Context, 4) Disability, Health, and Physical Characteristics, and 5) Socioeconomic Status. A draft of the questionnaire was then reviewed by experts via the Delphi process, which gauged the accessibility of the questionnaire (e.g., language used, length) and the relevance of its content using a 5-point scale and open-ended questions. These responses were ranked, analyzed, and synthesized to refine the questionnaire and, ultimately, to obtain ≥75 % consensus on each questionnaire item and response option. The SAFE questionnaire provides an opportunity to take a significant step forward in advancing our understanding of the complex, intersectional nature of social participation and marginalization.
Topics: Humans; Male; Female; Intersectional Framework; Gender Identity; Surveys and Questionnaires; Sexual Behavior
PubMed: 38531268
DOI: 10.1016/j.actpsy.2024.104235 -
International Journal of Environmental... Oct 2023Transgender individuals are an underserved, vulnerable population. They face many inequities including barriers in both accessing and receiving adequate healthcare.... (Review)
Review
Transgender individuals are an underserved, vulnerable population. They face many inequities including barriers in both accessing and receiving adequate healthcare. These inequities are proposed here to be rooted in a lack of education about transgender people and their experiences. We begin by exploring the existing transgender healthcare research carried out in the USA, examining client experiences, provider education and attitudes, and the barriers transgender people face to obtaining proper healthcare. Secondly, we look at the previous research on educational interventions implemented with medical students and practitioners in the USA to enhance knowledge about transgender people, and increase sensitivity and awareness, while also increasing the level of comfort in working with these clients. The limitations in these fields of study are discussed in order to understand how to better serve transgender clients in the USA. We will do this through a narrative review to determine evidence-based best practices for educational intervention, uncovering gaps in the literature and highlighting where to focus in future work for researchers and practitioners.
Topics: Humans; United States; Transgender Persons; Transsexualism; Delivery of Health Care; Health Inequities; Patient Outcome Assessment
PubMed: 37887687
DOI: 10.3390/ijerph20206949 -
Contemporary Clinical Trials Aug 2023The transgender and non-binary communities make up a significant, growing proportion of the population, but, to date, few clinical trials report including transgender...
Improving access for and experience of transgender and non-binary patients in clinical research: Insights from a transgender patient focus group and targeted literature reviews.
INTRODUCTION
The transgender and non-binary communities make up a significant, growing proportion of the population, but, to date, few clinical trials report including transgender and non-binary individuals.
METHODS
As part of a mixed-method approach, multiple literature searches for articles published from January 2018 to July 2022 and a Patient Advisory Council (a semi-structured patient focus group) meeting were conducted to identify challenges faced by the transgender and non-binary communities when accessing healthcare and participating in clinical research. A set of guidelines to promote inclusivity in clinical research was developed using these findings.
RESULTS
During this time period, only 107 (0.08%) of 141,661 published articles of clinical trials reported participation of transgender or non-binary patients. A targeted search identified only 48 articles reporting specific barriers to inclusion in clinical research, while an expanded search identified 290 articles reporting barriers to healthcare access for transgender and non-binary patients. Several key considerations to promote study inclusivity emerged from the literature searches and Patient Advisory Council: adjust clinical protocols, informed consent documents, and data collection forms to distinguish sex assigned at birth from gender identity; involve members of the transgender and non-binary communities in research whenever possible; provide communication training to personnel involved in clinical research; and maximize accessibility for potential participants.
CONCLUSION
Future research on investigational drug dosing and drug interactions in transgender and non-binary patients, along with regulatory guidance, are recommended to ensure clinical trials' processes, designs, systems, and technologies are transgender and non-binary patient-friendly, inclusive, and welcoming.
Topics: Infant, Newborn; Humans; Male; Female; Transgender Persons; Gender Identity; Focus Groups; Health Services Accessibility
PubMed: 37245727
DOI: 10.1016/j.cct.2023.107243 -
Lancet (London, England) Apr 2024
Topics: Humans; Neoplasms; Female; Male; Biomedical Research; Sex Factors; Gender Identity
PubMed: 38677852
DOI: 10.1016/S0140-6736(24)00593-2