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International Journal of Environmental... Jul 2022Mothers', fathers', or guardians' support for disclosures of diverse gender identity has significant relationships with decreased suicidality for transgender children... (Review)
Review
Mothers', fathers', or guardians' support for disclosures of diverse gender identity has significant relationships with decreased suicidality for transgender children and adolescents. They play an essential role in facing transphobia, protecting trans children, and strengthening the expression of their identity. These guardians need structural, emotional, and informative support; they need to be prepared to recognize and manage of their own feelings, as well as deal with the challenges that come with new social contexts of transphobia in schools, health institutions, and other community spaces. This study aimed to analyze the scientific evidence on the dynamics of secondary social networks to support mothers, fathers, or guardians of transgender children and adolescents. This is a systematic review of qualitative studies, guided by PRISMA guidelines. Controlled and free vocabularies were used to survey the primary studies in the following databases: EMBASE; Scopus; MEDLINE; Cumulative Index to Nursing and Allied Health Literature (CINAHL); PsycInfo; Latin American and Caribbean Literature in Health Sciences (LILACS); and Web of Science. A total of 28 articles made up the final sample of this review. Secondary social networks were described as fragile, characterized by conflicting and broken ties with healthcare services and professionals, isolation and unpreparedness from schools, and emotional and informational support from peer groups and some qualified healthcare professionals. The literature shows the potential of the dynamics of secondary social support networks; however, it presented the unpreparedness of professionals and institutional policies for welcoming transgender children and adolescents and their families, with the peer group being the main emotional and informative support network.
Topics: Adolescent; Child; Fathers; Female; Gender Identity; Humans; Male; Mothers; Social Networking; Social Support; Transgender Persons
PubMed: 35886503
DOI: 10.3390/ijerph19148652 -
Health & Social Care in the Community May 2022This scoping review mapped out the relevant literature, identified gaps and made suggestions on the influence of cisgender on the health literacy (HL) of the elderly... (Review)
Review
This scoping review mapped out the relevant literature, identified gaps and made suggestions on the influence of cisgender on the health literacy (HL) of the elderly people. This scoping review was guided by the PRISMA-ScR checklist. The databases Wiley Online Library™ and Elsevier™ were searched for academic articles published in the English language between February 2011 and February 2021 that met a pre-set criteria of content. The process of selection of sources of evidence based on screening and eligibility of evidence reduced the initially identified 153 sources of evidence in the searched databases to 14 sources of evidence. The content of these 14 sources of evidence was mapped out on a charting table where data was summarised and synthesised individually and collectively by the authors. Repetitive and irrelevant data were deleted. Identified gaps include the lack of extensive exploration of male and female genders alone as a determinant of HL, how gender may be utilised to encourage elderly men and women to apply HL, how different sociocultural and sociodemographic backgrounds of elderly men and women would require separate academic research, the scarcity of social sciences based research and qualitative research methodologies on the subject as well as the use of mixed-methodologies and longitudinal studies. Future research directions were suggested and limitations of this scoping review are addressed in the discussion.
Topics: Aged; Female; Gender Identity; Health Literacy; Humans; Male; Mass Screening
PubMed: 34644428
DOI: 10.1111/hsc.13604 -
Medical Education Online Dec 2024People who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and other sexual/gender minorities (LGBTQ+) may experience discrimination when... (Review)
Review
INTRODUCTION
People who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and other sexual/gender minorities (LGBTQ+) may experience discrimination when seeking healthcare. Medical students should be trained in inclusive and affirming care for LGBTQ+ patients. This narrative literature review explores the landscape of interventions and evaluations related to LGBTQ+ health content taught in medical schools in the USA and suggests strategies for further curriculum development.
METHODS
PubMed, ERIC, and Education Research Complete databases were systematically searched for peer-reviewed articles on LGBTQ+ health in medical student education in the USA published between 1 January 2011-6 February 2023. Articles were screened for eligibility and data was abstracted from all eligible articles. Data abstraction included the type of intervention or evaluation, sample population and size, and key outcomes.
RESULTS
One hundred thirty-four articles met inclusion criteria and were reviewed. This includes 6 (4.5%) that evaluate existing curriculum, 77 (57.5%) study the impact of curriculum components and interventions, 36 (26.9%) evaluate student knowledge and learning experiences, and 15 (11.2%) describe the development of broad learning objectives and curriculum. Eight studies identified student knowledge gaps related to gender identity and affirming care and these topics were covered in 34 curriculum interventions.
CONCLUSION
Medical student education is important to address health disparities faced by the LGBTQ+ community, and has been an increasingly studied topic in the USA. A variety of curriculum interventions at single institutions show promise in enhancing student knowledge and training in LGBTQ+ health. Despite this, multiple studies indicate that students report inadequate education on certain topics with limitations in their knowledge and preparedness to care for LGBTQ+ patients, particularly transgender and gender diverse patients. Additional integration of LGBTQ+ curriculum content in areas of perceived deficits could help better prepare future physicians to care for LGBTQ+ patients and populations.
Topics: Humans; Male; Female; United States; Students, Medical; Gender Identity; Sexual and Gender Minorities; Curriculum; Health Education
PubMed: 38359164
DOI: 10.1080/10872981.2024.2312716 -
International Journal of Environmental... Jun 2022Mothers, fathers, or guardians of children and adolescents who do not identify with the gender they were assigned at birth face barriers in their social network to... (Review)
Review
Mothers, fathers, or guardians of children and adolescents who do not identify with the gender they were assigned at birth face barriers in their social network to recognize their children's gender identity. This study aimed to analyze the scientific evidence on the dynamics of primary social networks to support mothers, fathers, or guardians of transgender children and adolescents. This is a systematic review of qualitative studies guided by the PRISMA guidelines. Controlled and free vocabulary were used to survey the studies in the EMBASE, Scopus, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Latin American and Caribbean Literature in Health Sciences (LILACS), and Web of Science databases. A total of 21 studies composed the final sample. Primary social networks were described as fragile and conflicting family/blood relationship ties with disapproval, isolation, rejection, a lack of understanding, and feelings of exclusion were expressed. Some have lost friends, reported tension in marriage and with relatives, and were commonly treated with hostility and harassment. Social transition does take place in the mutual context of struggle and resistance which demands a support network for parents or guardians.
Topics: Adolescent; Child; Fathers; Female; Gender Identity; Humans; Infant, Newborn; Male; Mothers; Social Networking; Transgender Persons
PubMed: 35805599
DOI: 10.3390/ijerph19137941 -
Archives of Sexual Behavior Oct 2023
Correction: Sexual and Dating Violence Prevention Programs for Male Youth: A Systematic Review of Program Characteristics, Intended Psychosexual Outcomes, and Effectiveness.
PubMed: 37488272
DOI: 10.1007/s10508-023-02664-w -
ANZ Journal of Surgery Mar 2022Gender dysphoria is defined as discomfort or distress that is caused by a discrepancy between a person's gender identity and that person's sex assigned at birth. The... (Review)
Review
BACKGROUND
Gender dysphoria is defined as discomfort or distress that is caused by a discrepancy between a person's gender identity and that person's sex assigned at birth. The main objective of this study was to review the application, efficacy and outcomes of a novel surgical technique, peritoneal pull-through technique vaginoplasty, in gender-affirming surgery. Specific outcome parameters include (1) healing time (2) depth of cavity achieved (3) alleviation of dysphoria (4) morbidity of the surgery.
METHODS
This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and PROSPERO registration obtained prior to commencement (PROSPERO CRD42020206736). A search was performed in OVID MEDLINE, EMBASE, Willey Online Library and PubMed. Specialty-related journals, grey literature and reference lists of relevant articles were manually searched.
RESULTS
From 476 potentially relevant articles, 12 articles were analysed. The publications were all level 4 or level 5 evidence. Healing times were poorly reported or often not mentioned. Eight authors reported neovagina cavity depth of at least 13 cm and good patient satisfaction. Alleviation of dysphoria was not discussed by any of the publications and only six reported complications. Average follow up reported ranged from 6 weeks to 14.8 months.
CONCLUSION
The application of peritoneal pull-through vaginoplasty in gender-affirming surgery is promising and novel. However, there is a paucity of data. Further research and longer-term data are required to assess the efficacy and safety of this technique. Patients seeking this surgery overseas should be informed of the potential difficulties they may face.
Topics: Female; Gender Identity; Gynecologic Surgical Procedures; Humans; Infant, Newborn; Male; Patient Satisfaction; Peritoneum; Sex Reassignment Surgery; Vagina
PubMed: 34427039
DOI: 10.1111/ans.17147 -
International Immunopharmacology Jul 2021This systematic review, with meta-analysis and meta-regression aims to evaluate the effect of colchicine administration on mortality in patients with coronavirus disease... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This systematic review, with meta-analysis and meta-regression aims to evaluate the effect of colchicine administration on mortality in patients with coronavirus disease 2019 (COVID-19) and factors affecting the association.
METHODS
A systematic literature search using the PubMed, Scopus, and Embase databases were performed from inception of databases up until 3 March 2021. We included studies that fulfill all of the following criteria: 1) observational studies or randomized controlled trials (RCTs) that report COVID-19 patients, 2) reporting colchicine use, and 3) mortality within 30 days. There was no restriction on the age, inpatients or outpatients setting, and severity of diseases. The intervention was colchicine administration during treatment for COVID-19. The control was receiving placebo or standard of care. The outcome was mortality and the pooled effect estimate was reported as odds ratio (OR). Random-effects restricted maximum likelihood meta-regression was performed to evaluate factors affecting the pooled effect estimate.
RESULTS
Eight studies comprising of 5530 patients were included in this systematic review and meta-analysis. There were three RCTs and five observational studies. Pooled analysis showed that colchicine was associated with lower mortality in patients with COVID-19 (OR 0.47 [0.31, 0.72], p = 0.001; I: 30.9, p = 0.181). Meta-regression analysis showed that the association between colchicine and mortality was reduced by increasing age (OR 0.92 [0.85, 1.00], p = 0.05), but not gender (reference: male, p = 0.999), diabetes (p = 0.376), hypertension (p = 0.133), and CAD (p = 0.354).
CONCLUSION
This meta-analysis indicates that colchicine may reduce mortality in patients with COVID-19. Meta-regression analysis showed that the benefit was reduced as age increases.
PROSPERO
CRD42021240609.
Topics: Age Factors; Colchicine; Diabetes Complications; Diabetes Mellitus; Female; Gender Identity; Humans; Hypertension; Male; Mortality; Odds Ratio; Regression Analysis; SARS-CoV-2; COVID-19 Drug Treatment
PubMed: 34162130
DOI: 10.1016/j.intimp.2021.107723 -
International Journal of Infectious... Feb 2013To describe syphilis prevalence in men who have sex with men (MSM), the transgender population, and sex workers and their clients, identifying critical geographical... (Review)
Review
OBJECTIVE
To describe syphilis prevalence in men who have sex with men (MSM), the transgender population, and sex workers and their clients, identifying critical geographical areas, trends, and data gaps in Latin America and the Caribbean.
METHODS
A systematic review of syphilis prevalence was conducted by searching PubMed, LILACS, EMBASE, conference records, and other sources (2000-2010).
RESULTS
Forty-eight articles were included in the review, from which 84 data points were identified relating to MSM and female sex workers and only 10 relating to the transgender population, male sex workers, and clients of sex workers. Most studies were from Latin America (83%), with fewer from the Caribbean (17%). Critical 'hotspot' cities were Sao Paulo, Buenos Aires, Guatemala, Puerto Barrios, San José, San Pedro, Managua, San Salvador, and Acajutla, with high syphilis prevalence in more than one study population. Gaps in the availability of information on syphilis prevalence were identified for Ecuador, Uruguay, and Bolivia, and most countries in the Caribbean. Chronological trends showed that syphilis infection is well-established among the study populations.
CONCLUSIONS
Consistently high levels of syphilis among the investigated populations throughout the study period show that there is a need to improve monitoring, surveillance, and evaluation of sexually transmitted infection control interventions among these populations. Improved reporting and standardization of syphilis testing is recommended, as well as a heightened focus on more effective syphilis control strategies.
Topics: Caribbean Region; Female; Health Knowledge, Attitudes, Practice; Homosexuality, Male; Humans; Latin America; Male; Prevalence; Risk Assessment; Sex Workers; Sexual Behavior; Sexually Transmitted Diseases; Syphilis; Transsexualism
PubMed: 23063547
DOI: 10.1016/j.ijid.2012.07.021 -
AIDS Patient Care and STDs Jun 2022HIV pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV; however, PrEP use among transgender individuals remains low. We conducted a systematic review...
HIV pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV; however, PrEP use among transgender individuals remains low. We conducted a systematic review to identify barriers and facilitators to PrEP uptake, adherence, and persistence among transgender individuals in the United States. We conducted a literature search in PubMed and CINAHL databases in March 2021 and followed PRISMA guidelines. Studies were eligible if they were published in a peer-reviewed journal and reported interest, uptake, adherence, and/or persistence of PrEP use among transgender individuals. Articles that did not disaggregate results for transgender participants were excluded. Data from included articles were coded using content analysis and narratively synthesized using a framework matrix. We screened 254 unique articles published after US Food and Drug Administration approval of PrEP, and 33 articles were included in the review. Five themes were identified in the literature, including (1) PrEP concentrations were lower among individuals taking feminizing hormones, but the difference did not appear clinically significant; (2) concerns regarding interactions between gender-affirming hormone therapy and PrEP remain a large barrier; (3) PrEP initiation may facilitate increased self-advocacy and self-acceptance; (4) lack of trust in medical institutions impacts PrEP uptake; and (5) social networks have a significant influence on PrEP knowledge, interest, and adherence. Additional research is needed involving transgender men and nonbinary persons, and efforts to improve PrEP persistence among the transgender community are needed. Training health care providers to provide inclusive and affirming care is perhaps one of the strongest areas for intervention to increase PrEP uptake and persistence.
Topics: Anti-HIV Agents; HIV Infections; Homosexuality, Male; Humans; Male; Pre-Exposure Prophylaxis; Transgender Persons; Transsexualism; United States
PubMed: 35687813
DOI: 10.1089/apc.2021.0236 -
Drug and Alcohol Dependence Jun 2021Substance use-related stigma is a significant barrier to care among persons who use drugs (PWUD). Less is known regarding how intersectional identities, like gender,... (Review)
Review
BACKGROUND
Substance use-related stigma is a significant barrier to care among persons who use drugs (PWUD). Less is known regarding how intersectional identities, like gender, shape experiences of substance use-related stigma. We sought to answer the following question: Do men or women PWUD experience more drug use stigma?
METHODS
Data were drawn from a systematic review of the global, peer-reviewed scientific literature on substance use-related stigma conducted through 2017 and guided by the Stigma and Substance Use Process Model and PRISMA guidelines. Articles were included in the present analysis if they either qualitatively illustrated themes related to the gendered nature of drug use-related stigma, or quantitatively tested the moderating effect of gender on drug use-related stigma.
RESULTS
Of the 75 studies included, 40 (53 %) were quantitative and 35 (47 %) were qualitative. Of the quantitative articles, 22 (55 %) found no association between gender and drug use-related stigma, 4 (10 %) identified women who use drugs (WWUD) were more stigmatized, and 2 (5 %) determined men who use drugs (MWUD) were more stigmatized. In contrast, nearly all (34; 97 %) of the qualitative articles demonstrated WWUD experienced greater levels of drug use-related stigma.
CONCLUSION
The quantitative literature is equivocal regarding the influence of gender on drug use-related stigma, but the qualitative literature more clearly demonstrates WWUD experience greater levels of stigma. The use of validated drug use-related stigma measures and the tailoring of stigma scales to WWUD are needed to understand the role of stigma in heightening the disproportionate harms experienced by WWUD.
Topics: Female; Gender Identity; Humans; Male; Pharmaceutical Preparations; Social Stigma; Substance-Related Disorders
PubMed: 33901753
DOI: 10.1016/j.drugalcdep.2021.108706