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Journal of Sex & Marital Therapy 2023This systematic review aims to provide an up-to-date evaluation of the available literature on anodyspareunia and treatment interventions. It aims to identify research...
This systematic review aims to provide an up-to-date evaluation of the available literature on anodyspareunia and treatment interventions. It aims to identify research gaps and to evaluate treatment methods in psychosexual healthcare services. Electronic searches including PubMed, PsycINFO, Web of Science, and registered clinical trials yielded 8 studies. Research centered on men who have sex with men (MSM) and cisgender women with a 3:1 ratio. In terms of causes of anodyspareunia, correlates among both MSM and cisgender women included generalized anxiety, performance anxiety, compromised well-being, lack of stimulation, lack of lubrication, and lack of sexual arousal. While research has focused on anodyspareunia among cisgender gay men, limited research has targeted other genders or sexualities including heterosexual men and lesbian and bisexual women. No research was found on intersex, transgender, and gender nonconforming people. Similarly, there were no articles that discussed or evaluated treatment strategies. The findings of this review demonstrate the paucity of research on both the condition of anodyspareunia and its treatment across genders and sexually diverse groups. Both quantitative and qualitative research would not only develop our understanding of anodyspareunia but also contribute to public health through the development of suitable treatment interventions.
PubMed: 37089031
DOI: 10.1080/0092623X.2023.2196265 -
Trauma, Violence & Abuse Apr 2024Scientific interest in lesbian, gay, bisexual, transgender, queer and any other sexual orientation, gender identity and/or expression (LGBTQ+) bullying in educational... (Review)
Review
Scientific interest in lesbian, gay, bisexual, transgender, queer and any other sexual orientation, gender identity and/or expression (LGBTQ+) bullying in educational settings has grown exponentially in recent years. However, the varied ways of measuring its occurrence and associated factors have made it difficult to achieve a holistic understanding of this problem. Therefore, this systematic review aimed to provide an updated overview of individual and contextual factors related to LGBTQ+ bullying over the past two decades, based on the measurement approach to this phenomenon. Studies published from 2000 to 2020 were analyzed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses strategy. Inclusion and exclusion criteria were applied in a staggered process, and 111 articles met all the criteria. Studies focusing on LGBTQ+ bullying victimization or aggression were eligible for inclusion. Our analysis revealed LGBTQ+ bullying is usually examined by measures of general aggressions (47.8%) from the victims' perspective (87.3%). The best-represented factors across studies were individual characteristics (63.1%; = 70), especially participants' sexual orientation and gender identity and expression (68.5%). Boys/males, from a binary gender perspective, and sexual and gender minority youth in general, were more at risk of being targeted for LGBTQ+ bullying. Although contextual factors were far less well-represented, the results revealed that gay-straight alliances, anti-homophobia policies, and social support act as protective factors. This review highlights the need to analyze LGBTQ+ bullying considering the full spectrum of sexual and gender diversity, to examine in more detail its contextual risk/protective factors, and to design public policies and psychoeducational programs in order to address the low effectiveness of generic interventions. Implications for future research and practice are discussed.
Topics: Adolescent; Female; Humans; Male; Bisexuality; Bullying; Gender Identity; Sexual and Gender Minorities
PubMed: 37078578
DOI: 10.1177/15248380231165724 -
Revista de Saude Publica 2023To synthesize scientific evidence to characterize health care for transvestites and transsexuals in Brazil.
OBJECTIVE
To synthesize scientific evidence to characterize health care for transvestites and transsexuals in Brazil.
METHODS
This is a systematic review, conducted from July 2020 to January 2021 and updated in September 2021, whose protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) platform, under code CRD42020188719. The survey of evidence was carried out in four databases and eligible articles were evaluated for methodological quality, and those with a low risk of bias were included.
RESULTS
Fifteen articles were selected and the findings were grouped into six categories according to their thematic approaches: Possibilities to transform health care; Transvestiphobia and transphobia: violations inside and outside the Brazilian Unified Health System (SUS); Professional unpreparedness to care for transvestites and transsexuals; Search for health care alternatives; Right to health for transvestites and transsexuals: utopia or reality?; The Transsexualization Process: advances and challenges.
CONCLUSIONS
There is evidence that health care for transvestites and transsexuals in Brazil is still exclusive, fragmented, centered on specialized care and guided by curative actions, resembling the care models that preceded the SUS and which have been heavily criticized since the Brazilian Sanitary Reform.
Topics: Humans; Brazil; Delivery of Health Care; Transsexualism; Transvestism
PubMed: 37075402
DOI: 10.11606/s1518-8787.2023057004693 -
Acta Paediatrica (Oslo, Norway : 1992) Nov 2023The aim of this systematic review was to assess the effects on psychosocial and mental health, cognition, body composition, and metabolic markers of hormone treatment in... (Review)
Review
AIM
The aim of this systematic review was to assess the effects on psychosocial and mental health, cognition, body composition, and metabolic markers of hormone treatment in children with gender dysphoria.
METHODS
Systematic review essentially follows PRISMA. We searched PubMed, EMBASE and thirteen other databases until 9 November 2021 for English-language studies of hormone therapy in children with gender dysphoria. Of 9934 potential studies identified with abstracts reviewed, 195 were assessed in full text, and 24 were relevant.
RESULTS
In 21 studies, adolescents were given gonadotropin-releasing hormone analogues (GnRHa) treatment. In three studies, cross-sex hormone treatment (CSHT) was given without previous GnRHa treatment. No randomised controlled trials were identified. The few longitudinal observational studies were hampered by small numbers and high attrition rates. Hence, the long-term effects of hormone therapy on psychosocial health could not be evaluated. Concerning bone health, GnRHa treatment delays bone maturation and bone mineral density gain, which, however, was found to partially recover during CSHT when studied at age 22 years.
CONCLUSION
Evidence to assess the effects of hormone treatment on the above fields in children with gender dysphoria is insufficient. To improve future research, we present the GENDHOR checklist, a checklist for studies in gender dysphoria.
Topics: Adolescent; Humans; Child; Young Adult; Adult; Gender Dysphoria; Gonadotropin-Releasing Hormone; Gender Identity; Longitudinal Studies; Bone Density
PubMed: 37069492
DOI: 10.1111/apa.16791 -
Psycho-oncology Jun 2023Cisheteronormativity refers to the relationship of heterosexual and cisgender privilege stemming from patriarchy. Although studies have shown that cisheteronormativity... (Review)
Review
OBJECTIVE
Cisheteronormativity refers to the relationship of heterosexual and cisgender privilege stemming from patriarchy. Although studies have shown that cisheteronormativity can impact health outcomes for lesbian, gay, bisexual, transgender, queer and other sexual, gender diverse, and gender nonconforming (LGBTQ+) people, the specific impact on cancer care has not been described. We synthesized the qualitative evidence on how cisheteronormativity impacts the psychosocial experience of LGBTQ+ people with cancer.
METHODS
We conducted a historic search in the CINAHL, LGBT+ Health, PsycInfo, and PubMed databases. Qualitative studies that described the psychosocial experience of LGBTQ+ people with cancer were included. After appraising the quality of the publications, 11 articles were included. Then, we conducted inductive nominal coding, taxonomic analysis, and thematic synthesis.
RESULTS
Two main themes emerged, (1) Cisheteronormativity as a social determinant of health, and (2) Cancer, sexual orientation, and gender: Associations and introjections. The themes comprise four categories and 13 subcategories that describe the impact of cisheteronormativity on the cancer experience of LGBTQ+ people.
CONCLUSION
Cisheteronormativity within the healthcare system impacts the psychosocial experience of LGBTQ+ people with cancer. Understanding how these gender biases, norms, and social expectations impact the cancer experience is necessary to transform social norms and promote health equity.
Topics: Humans; Male; Female; Health Promotion; Sexual Behavior; Sexual and Gender Minorities; Gender Identity; Neoplasms; Transgender Persons
PubMed: 37025048
DOI: 10.1002/pon.6133 -
JAMA Network Open Apr 2023Gender-affirming care is a key clinical area that can benefit from implementation of patient-reported outcome measures (PROMs). Identifying barriers to and enablers of...
IMPORTANCE
Gender-affirming care is a key clinical area that can benefit from implementation of patient-reported outcome measures (PROMs). Identifying barriers to and enablers of PROM implementation is needed to develop an evidence-based implementation strategy.
OBJECTIVE
To identify (1) PROMs previously implemented for gender-affirming care and constructs measured, (2) how patients completed PROMs and how results were reported and used, and (3) barriers to and enablers of PROM implementation.
EVIDENCE REVIEW
In this systematic review, PubMed, Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science were searched from inception to October 25, 2021, and updated on December 16, 2022. Gray literature was searched through gray literature database, online search engine, and targeted website searching. Inclusion criteria were (1) original articles of (2) a formally developed PROM or ad hoc instrument administered for gender-affirming care to (3) patients accessing gender-affirming care. The Critical Appraisal Skills Programme tool was used to evaluate quality of included studies. This review was registered on PROSPERO (CRD42021233080).
FINDINGS
In total, 286 studies were included, representing 85 395 transgender and nonbinary patients from more than 30 countries. A total of 205 different PROMs were used in gender-affirming care. No studies described using an implementation science theory, model, or framework to support PROM deployment. Key barriers to PROM implementation included issues with evidence strength and quality of the PROM, engaging participants, and PROM complexity. Key enablers of PROM implementation included using PROMs validated for gender-affirming care, implementing PROMs able to be deployed online or in person, implementing PROMs that are shorter and reduce patient burden, engaging key stakeholders and participants as part of developing an implementation plan, and organizational climate.
CONCLUSIONS AND RELEVANCE
In this systematic review of barriers to and enablers of PROM implementation in gender-affirming care, PROM implementation was inconsistent and did not follow evidence-based approaches in implementation science. There was also a lack of patient input in creating implementation strategies, suggesting a need for patient-centered approaches to PROM implementation. Frameworks created from these results can be used to develop evidence-based PROM implementation initiatives for gender-affirming care and have potential generalizability for other clinical areas interested in implementing PROMs.
Topics: Humans; Patient Reported Outcome Measures; Transgender Persons; Transsexualism; Quality of Life
PubMed: 37010869
DOI: 10.1001/jamanetworkopen.2023.6425 -
American Journal of Transplantation :... Jun 2023Sexual orientation and gender identity (SOGI)-diverse populations experience discrimination in organ and tissue donation and transplantation (OTDT) systems globally. We... (Review)
Review
Sexual orientation and gender identity (SOGI)-diverse populations experience discrimination in organ and tissue donation and transplantation (OTDT) systems globally. We assembled a multidisciplinary group of clinical experts as well as SOGI-diverse patient and public partners and conducted a scoping review including citations on the experiences of SOGI-diverse persons in OTDT systems globally to identify and explore the inequities that exist with regards to living and deceased OTDT. Using scoping review methods, we conducted a systematic literature search of relevant electronic databases from 1970 to 2021 including a grey literature search. We identified and screened 2402 references and included 87 unique publications. Two researchers independently coded data in included publications in duplicate. We conducted a best-fit framework synthesis paired with an inductive thematic analysis to identify synthesized benefits, harms, inequities, justification of inequities, recommendations to mitigate inequities, laws and regulations, as well as knowledge and implementation gaps regarding SOGI-diverse identities in OTDT systems. We identified numerous harms and inequities for SOGI-diverse populations in OTDT systems. There were no published benefits of SOGI-diverse identities in OTDT systems. We summarized recommendations for the promotion of equity for SOGI-diverse populations and identified gaps that can serve as targets for action moving forward.
Topics: Female; Humans; Male; Gender Identity; Sexual Behavior
PubMed: 36997028
DOI: 10.1016/j.ajt.2023.03.016 -
Psychiatry Research May 2023Transidentity and autism frequently co-occur. Previous reviews have focused mainly on frequencies. Here, we conducted a systematic review to condense all the studies and... (Review)
Review
Transidentity and autism frequently co-occur. Previous reviews have focused mainly on frequencies. Here, we conducted a systematic review to condense all the studies and themes on this co-occurrence and to offer a global view. We followed the PRISMA method and selected 77 articles (including 59 clinical studies) in April 2022. We found 5 main themes (sex ratio, theories, sexual orientation, clinical and social consequences, and care implications) in addition to frequencies. Many theories have been proposed to explain the co-occurrence. One posits that social difficulties related to autism would lead to less identification with gender norms and less pressure to conform to these norms, allowing for greater gender diversity in people with autism. Given their difficulties with social interactions and communication, the announcement of one's transidentity to one's social group is often discredited, increasing the risk of suffering and delayed care. Many reports reaffirm the importance of providing specialised care for transgender people with autism. Autism is not a contraindication for gender-affirming treatment. However, some cognitive specificities can affect the planning of care, and transgender people with autism are at high risk of discrimination and harassment. We conclude that there is a need to raise awareness about gender and autism.
Topics: Humans; Male; Female; Autism Spectrum Disorder; Gender Dysphoria; Gender Identity; Transgender Persons; Sexual Behavior
PubMed: 36996732
DOI: 10.1016/j.psychres.2023.115176 -
Nursing Outlook 2023In the US, sexual and gender minority (SGM) individuals continue to experience health inequities, and nursing curricula content and nursing faculty with SGM health...
A systematic review of U.S. nursing faculty's knowledge, awareness, inclusion, and perceived importance of sexual and gender minority-related content in nursing curricula.
BACKGROUND
In the US, sexual and gender minority (SGM) individuals continue to experience health inequities, and nursing curricula content and nursing faculty with SGM health expertise in the US remain limited. Addressing health disparities begins with the preparation of future nurses-US nursing faculty must be supported to meet these growing needs.
PURPOSE
To describe, appraise, and synthesize research from 2000-2020 on US nursing faculty knowledge, awareness, inclusion, and perceived importance of SGM health content.
METHODS
Following PRISMA 2020 guidelines, we registered a systematic review and appraisal protocol in PROSPERO, and then executed the protocol and synthesized the literature.
DISCUSSION
We found an empirical evidence base surrounding US nursing faculty and SGM health much more limited than expected. Only four cross-sectional, descriptive empirical articles fit the a priori inclusion criteria. The studies were of moderate quality at best and often relied on unvalidated or older measures. In general, the studies focused on examining characteristics of nursing programs, faculty comfort with content, faculty perceptions of content importance, and hours dedicated to content.
CONCLUSION
Since the close of the review, new commentaries and editorials expanding the call for change in the US were published-the time for commentary has passed. It remains unclear whether US nursing faculty are adequately prepared to educate future nurses about SGM health issues-and an unprepared healthcare workforce is yet another barrier to SGM health equity. The evidence base supporting US nursing faculty development desperately needs more studies using rigorous methodologies.
Topics: Humans; Faculty, Nursing; Cross-Sectional Studies; Gender Identity; Sexual and Gender Minorities; Curriculum
PubMed: 36924597
DOI: 10.1016/j.outlook.2023.101950 -
Frontiers in Public Health 2023The representativeness of participants is crucial to ensure external validity of clinical trials. We focused on the randomized clinical trials which assessed COVID-19...
OBJECTIVE
The representativeness of participants is crucial to ensure external validity of clinical trials. We focused on the randomized clinical trials which assessed COVID-19 vaccines to assess the reporting of age, sex, gender identity, race, ethnicity, obesity, sexual orientation, and socioeconomic status in the results (description of the participants' characteristics, loss of follow-up, stratification of efficacy and safety results).
METHODS
We searched the following databases for randomized clinical trials published before 1st February 2022: PubMed, Scopus, Web of Science, and Excerpta Medica. We included peer-reviewed articles written in English or Spanish. Four researchers used the Rayyan platform to filter citations, first reading the title and abstract, and then accessing the full text. Articles were excluded if both reviewers agreed, or if a third reviewer decided to discard them.
RESULTS
Sixty three articles were included, which assessed 20 different vaccines, mainly in phase 2 or 3. When describing the participants' characteristics, all the studies reported sex or gender, 73.0% race, ethnicity, 68.9% age groups, and 22.2% obesity. Only one article described the age of participants lost to follow-up. Efficacy results were stratified by age in 61.9%, sex or gender in 26.9%, race and/or, ethnicity in 9.5%, and obesity in 4.8% of the articles. Safety results were stratified by age in 41.0%, and by sex or gender in 7.9% of the analysis. Reporting of gender identity, sexual orientation or socioeconomic status of participants was rare. Parity was reached in 49.2% of the studies, and sex-specific outcomes were mentioned in 22.9% of the analysis, most of the latter were related to females' health.
CONCLUSIONS
Axes of social inequity other than age and sex were hardly reported in randomized clinical trials that assessed COVID-19 vaccines. This undermines their representativeness and external validity and sustains health inequities.
Topics: Female; Humans; Male; COVID-19; COVID-19 Vaccines; Ethnicity; Gender Identity; Clinical Trials as Topic; Diversity, Equity, Inclusion
PubMed: 36891333
DOI: 10.3389/fpubh.2023.1069357