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PloS One 2024Gender expression may be associated with exercise self-efficacy and outcome expectations for exercise in the general population. Exercising for challenge and enjoyment...
Gender expression may be associated with exercise self-efficacy and outcome expectations for exercise in the general population. Exercising for challenge and enjoyment are associated with the instrumental traits typically held by individuals with masculine gender expressions. Conversely, exercising for weight loss to receive validation from others are in line with the expressive traits most commonly held by individuals with feminine gender expressions. Moreover, possessing neither dominant nor expressive traits (undifferentiated gender expressions) have been linked to poorer psychological outcomes. Exercise is important after stroke, but gender differences in psychosocial factors for exercise in this population were unknown. The purpose of this study was to explore whether gender expression differences exist in exercise self-efficacy and outcome expectations for exercise post-stroke. Gender expression (masculine, feminine, androgynous, undifferentiated) was assessed using the Bem Sex-Role Inventory-12 (BSRI-12) in 67 individuals with stroke. Self-efficacy and outcomes expectations for exercise were assessed using the Self-Efficacy for Physical Activity Scale and Short Outcome Expectations for Exercise Scale, respectively. One-way analysis of covariance models were conducted, adjusting for biological sex, age, and time post-stroke. There were differences in exercise self-efficacy across the four gender expression groups (F(3,60) = 4.28, p<0.01), where individuals with masculine gender expressions had higher self-efficacy than those with undifferentiated gender expressions (adjusted mean: 3.56 [SE: 0.17] vs. 2.72 [SE:0.18], p<0.01). There were no differences in outcome expectations for exercise (F(3,57) = 1.08, p = 0.36) between gender expressions. In our pairwise comparisons, we found that individuals with masculine gender expressions had higher exercise self-efficacy than individuals possessing undifferentiated gender expressions. Strategies to enhance exercise self-efficacy after stroke are needed, particularly for individuals with undifferentiated gender expression. There were no associations between gender expression and outcome expectations for exercise after stroke. Clinicians may continue reinforcing the positive expectations towards exercise across all gender expressions.
Topics: Humans; Male; Female; Gender Identity; Self Efficacy; Motivation; Masculinity; Femininity; Exercise
PubMed: 38478486
DOI: 10.1371/journal.pone.0299288 -
Revista Brasileira de Enfermagem 2024to analyze continuing nursing education actions in the scientific literature in the face of homophobia. (Review)
Review
OBJECTIVES
to analyze continuing nursing education actions in the scientific literature in the face of homophobia.
METHODS
an integrative literature review with structured search in June 2022 in eight databases, using the descriptors Nursing Education, Homophobia, Sexual and Gender Minorities. Final sample consisted of six primary studies.
RESULTS
continuing nursing education actions are supported by strategies such as use of teaching materials, lectures, case studies and focus groups, addressing content such as gender identity issues and affective-sexual orientation, health disparities and their relationship with homophobia in healthcare settings.
FINAL CONSIDERATIONS
carried out in various healthcare settings, continuing education actions proved to be successful in raising nurses' awareness in facing homophobia in health services, however, their expansion is necessary to create health spaces that meet the specific needs of these people.
Topics: Female; Humans; Male; Education, Nursing, Continuing; Homophobia; Gender Identity; Databases, Factual; Focus Groups
PubMed: 38477814
DOI: 10.1590/0034-7167-2023-0094 -
PloS One 2024Adolescence is a sensitive developmental period for neural sex/gender differentiation. The present study used multiparametric mapping to better characterize adolescent...
Adolescence is a sensitive developmental period for neural sex/gender differentiation. The present study used multiparametric mapping to better characterize adolescent white matter (WM) microstructure. WM microstructure was investigated using diffusion tensor indices (fractional anisotropy; mean, radial, and axial diffusivity [AD]) and quantitative T1 relaxometry (T1) in hormone therapy naïve adolescent cisgender girls, cisgender boys, and transgender boys (i.e., assigned female at birth and diagnosed with gender dysphoria). Diffusion indices were first analyzed for group differences using tract-based spatial statistics, which revealed a group difference in AD. Thus, two multiparametric and multivariate analyses assessed AD in conjunction with T1 relaxation time, and with respect to developmental proxy variables (i.e., age, serum estradiol, pubertal development, sexual attraction) thought to be relevant to adolescent brain development. The multivariate analyses showed a shared pattern between AD and T1 such that higher AD was associated with longer T1, and AD and T1 strongly related to all five developmental variables in cisgender boys (10 significant correlations, r range: 0.21-0.73). There were fewer significant correlations between the brain and developmental variables in cisgender girls (three correlations, r range: -0.54-0.54) and transgender boys (two correlations, r range: -0.59-0.77). Specifically, AD related to direction of sexual attraction (i.e., gynephilia, androphilia) in all groups, and T1 related to estradiol inversely in cisgender boys compared with transgender boys. These brain patterns may be indicative of less myelination and tissue density in cisgender boys, which corroborates other reports of protracted WM development in cisgender boys. Further, these findings highlight the importance of considering developmental trajectory when assessing the subtleties of neural structure associated with variations in sex, gender, and sexual attraction.
Topics: Male; Infant, Newborn; Humans; Female; Adolescent; White Matter; Brain; Gender Identity; Diffusion Magnetic Resonance Imaging; Estradiol
PubMed: 38470896
DOI: 10.1371/journal.pone.0300139 -
PloS One 2024Transgender and gender diverse (trans) health research has grown rapidly, highlighting the need to characterize the scientific evidence base. We conducted a systematic...
BACKGROUND AND OBJECTIVES
Transgender and gender diverse (trans) health research has grown rapidly, highlighting the need to characterize the scientific evidence base. We conducted a systematic review of peer-reviewed research on disease burden and correlates in trans adolescents and adults over a 20-month period to identify knowledge gaps and assess methodological characteristics including measurement of gender identity, community engagement, and study quality.
DATA SOURCES, ELIGIBILITY CRITERIA, AND SYNTHESIS METHODS
We searched seven databases using terms related to (a) transgender populations and (b) health or disease. Eligible studies were in English, French, or Spanish and reported original quantitative data on mental health or substance use conditions, infectious diseases, or non-communicable conditions in at least 25 trans individuals aged 15+. Quality assessment was performed in duplicate on a 10% sample of articles and findings were summarized using narrative synthesis.
RESULTS
The 328 included studies were conducted in 45 countries, with most from North America (54%) and limited research from South Asia (3%), Sub-Saharan Africa (3%), and the Middle East and North Africa (2%). Most studies used cross-sectional designs (73%) and convenience sampling (65%). Only 30% of studies reported any form of community engagement. Mental health and substance use disorders were the most studied area (77% of studies) and non-communicable conditions the least (16%). Available data indicated that trans populations experience high disease burden with considerable heterogeneity within and across settings. Of 39 articles assessed for quality, 80% were rated as fair, 18% as poor, and 3% as good quality.
CONCLUSIONS AND IMPLICATIONS
Geographic, gender-specific, and topical gaps remain in trans health, but we found more research from African countries, with transmasculine people, and on non-communicable conditions than previous syntheses. Areas for growth in trans health research include community engagement, non-binary health, chronic and age-related conditions, and health determinants.
REGISTRATION
PROSPERO CRD42021234043.
Topics: Adult; Adolescent; Humans; Male; Female; Transgender Persons; Cross-Sectional Studies; Gender Identity; Health Status; Cost of Illness; Africa South of the Sahara
PubMed: 38466747
DOI: 10.1371/journal.pone.0299373 -
The Lancet. Global Health May 2024
Topics: Humans; Gender Identity; Government Programs
PubMed: 38461835
DOI: 10.1016/S2214-109X(24)00120-7 -
Journal of Aging Studies Mar 2024Trans and non-binary older adults living with dementia experience forms of marginalization, pathologization, and discrimination embedded in epistemic violence that leads...
Trans and non-binary older adults living with dementia experience forms of marginalization, pathologization, and discrimination embedded in epistemic violence that leads them to be mistreated and dismissed as knowledgeable subjects. Based on empirical findings from a Canadian study examining the experiences of trans and non-binary people living with dementia and their carers, we combat this epistemic violence by focusing on the first-hand narratives of this population and their carers. Narrative interviews were conducted with six participants (N = 6): four carers of trans and non-binary adults living with dementia and two trans (binary) people living with dementia. Through a thematic analysis, we examine the unique aspects of living with dementia as a trans or non-binary person. First, the findings show how cogniticism impacts the experience of gender identity and cisgenderism, for example through blocked surgeries, excessive gatekeeping, and not being taken seriously by practitioners. Second, the findings discuss how dementia impacts gender identity and cisgenderism, for example, by increasing the need for formal care that can in turn increase vulnerability to structural violence. Third, the findings illustrate how cisgenderism and gender identity impact the experience of dementia and cogniticism, for example by limiting care options and the ability to advocate for oneself. Fourth, the findings highlight the silo mentality among practitioners, since most of them do not work with an intersectional lens. The article concludes by offering recommendations.
Topics: Humans; Male; Female; Aged; Gender Identity; Canada; Caregivers; Narration; Dementia
PubMed: 38458727
DOI: 10.1016/j.jaging.2024.101208 -
Hawai'i Journal of Health & Social... Mar 2024The purpose of this study was to assess the reproductive health experiences of transgender and gender diverse people in Hawai'i, identify reproductive health needs that...
The purpose of this study was to assess the reproductive health experiences of transgender and gender diverse people in Hawai'i, identify reproductive health needs that were unmet, and explore opportunities for addressing those needs. This was a qualitative, semi-structured individual interview study. Adults who identified as transgender or gender diverse were interviewed about their experiences accessing reproductive health services, their needs, and their ideas about clinical settings in which to receive reproductive health care services. Interviews were conducted until thematic saturation was reached. Six trans men, 6 trans women, and 4 people who identified as non-binary or genderqueer were interviewed. Negative experiences in health care settings, particularly when seeking reproductive health care services, were common. Participants often had multiple providers and gender-affirming care was often accessed separately from other health care services. Desires for fertility and pregnancy varied widely between participants but were often not addressed at the initiation of gender-affirming care. Finding trans-friendly providers was notably difficult and participants often relied on friends and other members of the transgender community for guidance. Obstetrics and gynecology clinics present a potential opportunity for access to reproductive health services although their gendered environment was concerning for some participants. Transgender and gender diverse people in Hawai'i have access to some reproductive health services but experience stigma in certain settings. There is a need for ongoing improvement in reproductive health care services in Hawai'i to improve access for transgender and gender nonconforming people in Hawai'i.
Topics: Male; Adult; Pregnancy; Humans; Female; Transgender Persons; Reproductive Health; Hawaii; Needs Assessment; Gender Identity
PubMed: 38456161
DOI: No ID Found -
F1000Research 2023Conversion therapy practices (CTPs) are discredited efforts that target lesbian, gay, bisexual, trans, queer, Two-Spirit, or other (LGBTQ2S+) people and seek to change,...
BACKGROUND
Conversion therapy practices (CTPs) are discredited efforts that target lesbian, gay, bisexual, trans, queer, Two-Spirit, or other (LGBTQ2S+) people and seek to change, deny, or discourage their sexual orientation, gender identity, and/or gender expression. This study aims to investigate the prevalence of CTPs across Canadian provinces and territories and identify whether CTP bans reduce the prevalence of CTPs.
METHODS
We collected 119 CTPs from 31 adults (18+) in Canada who have direct experience with CTPs, know people who have gone to CTPs, or know of conversion therapy practitioners using a 2020 anonymous online survey. Mapping analysis was conducted using ArcGIS Online. CTP prevalence was compared between provinces/territories with and without bans using chi-square tests.
RESULTS
Three provinces and eleven municipalities had CTP bans. The prevalence of CTPs in provinces/territories with bans was 2.34 per 1,000,000 population (95% CI 1.65, 3.31). The prevalence of CTPs in provinces/territories without bans was 4.13 per 1,000,000 population (95% CI 3.32, 5.14). Accounting for the underlying population, provinces/territories with the highest prevalence of CTPs per 1,000,000 population were New Brunswick (6.69), Nova Scotia (6.50), and Saskatchewan (6.37).
CONCLUSIONS
Findings suggest only 55% of Canadians were protected under CTP bans. The prevalence of CTPs in provinces/territories without bans was 1.76 times greater than provinces/territories with bans. CTPs are occurring in most provinces/territories, with higher prevalence in the west and the Atlantic. These findings and continued efforts to monitor CTP prevalence can help inform policymakers and legislators as society is increasingly acknowledging CTPs as a threat to the health and well-being of LGBTQ2S+ people.
Topics: Adult; Female; Humans; Male; Canada; Cross-Sectional Studies; Gender Identity; North American People; Prevalence
PubMed: 38434633
DOI: 10.12688/f1000research.134292.1 -
BMC Health Services Research Mar 2024Research evidence to inform primary care policy and practice is essential for building high-performing primary care systems. Nevertheless, research output relating to...
BACKGROUND
Research evidence to inform primary care policy and practice is essential for building high-performing primary care systems. Nevertheless, research output relating to primary care remains low worldwide. This study describes the factors associated with the research productivity of primary care researchers.
METHODS
A qualitative, descriptive key informant study approach was used to conduct semi-structured interviews with twenty-three primary care researchers across Canada. Qualitative data were analyzed using reflexive thematic analysis.
RESULTS
Twenty-three primary care researchers participated in the study. An interplay of personal (psychological characteristics, gender, race, parenthood, education, spousal occupation, and support), professional (mentorship before appointment, national collaborations, type of research, career length), institutional (leadership, culture, resources, protected time, mentorship, type), and system (funding, systematic bias, environment, international collaborations, research data infrastructure) factors were perceived to be associated with research productivity. Research institutes and mentors facilitated collaborations, and mentors and type of research enabled funding success. Jurisdictions with fewer primary care researchers had more national collaborations but fewer funding opportunities. The combination of institutional, professional, and system factors were barriers to the research productivity of female and/or racialized researchers.
CONCLUSIONS
This study illuminates the intersecting and multifaceted influences on the research productivity of primary care researchers. By exploring individual, professional, institutional, and systemic factors, we underscore the pivotal role of diverse elements in shaping RP. Understanding these intricate influencers is imperative for tailored, evidence-based interventions and policies at the level of academic institutions and funding agencies to optimize resources, promote fair evaluation metrics, and cultivate inclusive environments conducive to diverse research pursuits within the PC discipline in Canada.
Topics: Humans; Female; Canada; Gender Identity; Academic Medical Centers; Health Facilities; Primary Health Care
PubMed: 38429708
DOI: 10.1186/s12913-024-10644-6 -
BMJ Open Feb 2024To determine and identify distance patterns in the movements of medical students and junior doctors between their training locations.
OBJECTIVE
To determine and identify distance patterns in the movements of medical students and junior doctors between their training locations.
DESIGN
A retrospective cohort study of UK medical students from 2002 to 2015 (UKMED data).
SETTING
All UK medical schools, foundations and specialty training organisation.
PARTICIPANTS
All UK medical students from 2002 to 2015, for a total of 97 932 participants.
OUTCOME MEASURES
Individual movements and number of movements by county of students from family home to medical school training, from medical school to foundation training and from foundation to specialty training.
METHODS
Leslie matrix, principal components analysis, Gini coefficient, χ test, generalised linear models and variable selection methods were employed to explore the different facets of students' and junior doctors' movements from the family home to medical school and for the full pathway (from family home to specialty training).
RESULTS
The majority of the movements between the different stages of the full pathway were restricted to a distance of up to 50 km; although the proportion of movements changed from year-to-year, with longer movements during 2007-2008. At the individual level, ethnicity, socioeconomic class of the parent(s) and the deprivation score of the family home region were found to be the most important factors associated with the length of the movements from the family home to medical school. Similar results were found when movements were aggregated at the county level, with the addition of factors such as gender and qualification at entry (to medical school) being statistically associated with the number of new entrant students moving between counties.
CONCLUSION
Our findings show that while future doctors do not move far from their family home or training location, this pattern is not homogeneous over time. Distances are influenced by demographics, socioeconomic status and deprivation. These results may contribute in designing interventions aimed at solving the chronic problems of maldistribution and underdoctoring in the UK.
Topics: Humans; Retrospective Studies; Career Choice; Gender Identity; Social Class; Students, Medical; Schools, Medical; United Kingdom
PubMed: 38423780
DOI: 10.1136/bmjopen-2023-077635