HIV-Related Healthcare Needs and Access Barriers for Brazilian Transgender and Gender Diverse People

There is an increasing demand for trans and gender diverse (TGD) health services worldwide. Given the unique and diverse healthcare needs of the TGD community, best practice TGD health services should be community-led. We aimed to understand the healthcare needs of a broad group of TGD Australians, how health professionals could better support TGD people, and gain an understanding of TGD-related research priorities. An anonymous online survey received 928 eligible responses from TGD Australian adults. This paper focuses on three questions out of that survey that allowed for free-text responses. The data were qualitatively coded, and overarching themes were identified for each question. Better training for healthcare professionals and more accessible transgender healthcare were the most commonly reported healthcare needs of participants. Findings highlight a pressing need for better training for healthcare professionals in transgender healthcare. In order to meet the demand for TGD health services, more gender services are needed, and in time, mainstreaming health services in primary care will likely improve accessibility. Evaluation of training strategies and further research into optimal models of TGD care are needed; however, until further data is available, views of the TGD community should guide research priorities and the TGD health service delivery.

Download Full-text

ACCESS, BARRIERS, AND REGRET SURROUNDING FERTILITY PRESERVATION AMONG TRANSGENDER AND GENDER DIVERSE INDIVIDUALS

Fertility and Sterility ◽

10.1016/j.fertnstert.2020.02.058 ◽

2020 ◽

Vol 113 (4) ◽

pp. e26-e27

Author(s):

Nina Vyas ◽

Christopher Douglas ◽

Chris Mann CSW ◽

Amy K. Weimer ◽

Molly M. Quinn

Keyword(s):

Fertility Preservation ◽

Access Barriers ◽

Gender Diverse ◽

And Gender

Download Full-text

Access, barriers, and decisional regret in pursuit of fertility preservation among transgender and gender-diverse individuals

Fertility and Sterility ◽

10.1016/j.fertnstert.2020.09.007 ◽

2020 ◽

Author(s):

Nina Vyas ◽

Christopher R. Douglas ◽

Christopher Mann ◽

Amy K. Weimer ◽

Molly M. Quinn

Keyword(s):

Fertility Preservation ◽

Access Barriers ◽

Gender Diverse ◽

And Gender ◽

Decisional Regret

Download Full-text

An undergraduate medical curriculum framework for providing care to transgender and gender diverse patients: A modified Delphi study

Perspectives on Medical Education ◽

10.1007/s40037-021-00692-7 ◽

2021 ◽

Author(s):

Rachel H. Ellaway ◽

Nicole L. Thompson ◽

Claire Temple-Oberle ◽

Danièle Pacaud ◽

Helena Frecker ◽

...

Keyword(s):

Medical Students ◽

Delphi Study ◽

Medical Curriculum ◽

Healthcare Services ◽

Community Members ◽

Modified Delphi ◽

Healthcare Needs ◽

Gender Diverse ◽

Curriculum Framework ◽

And Gender

Abstract Introduction The lack of attention to transgender and gender diverse (TGD) people in undergraduate medical education (UME) is a point of concern, particularly among medical students. A project was undertaken to develop a UME curriculum framework for teaching the healthcare needs of TGD people. Methods Using a modified Delphi methodology, four rounds of surveys were presented to an expert stakeholder group that included content experts, generalist physicians, UME teaching faculty, and medical students. Questions covered what content should be taught, who should teach the content, and how much time should be dedicated for this teaching. Once the Delphi process was complete, feedback on the provisional framework was sought from members of the TGD community to ensure it represented their needs and perspectives. Results 71 panel members and 56 community members participated in the study. Core values included the scope of the framework, and topics such as inclusivity, and safety in practice and in teaching. The framework included terminology, epidemiology, medical and surgical treatment, mental health, sexual and reproductive health, and routine primary care. There was also guidance on who should teach, time to be allocated, and the learning environment. Discussion There is a clear need to train tomorrow’s doctors to provide competent and respectful healthcare services to and for TGD patients. Although local factors will likely shape the way in which this framework will be implemented in different contexts, this paper outlines a core UME-level curriculum framework for Canada and, potentially, for use in other parts of the world.

Download Full-text

Trans and gender diverse people’s experiences of healthcare access in Australia: A qualitative study in people with complex needs

PLoS ONE ◽

10.1371/journal.pone.0245889 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245889

Author(s):

Bridget Gabrielle Haire ◽

Eloise Brook ◽

Rohanna Stoddart ◽

Paul Simpson

Keyword(s):

Mental Health ◽

Health Care ◽

Healthcare Access ◽

Communication Styles ◽

Full Time ◽

Complex Needs ◽

Healthcare Needs ◽

Gender Diverse ◽

Trans People ◽

And Gender

Introduction This study aimed to explore the experiences of healthcare access in a diverse sample of trans and gender diverse individuals with complex needs using qualitative methods. We recruited 12 individuals using trans community-based networks facilitated by the Gender Centre. Each individual participated in an in-depth, semi structured interview conducted by a peer interviewer. Interviews were analysed thematically. Findings Participants had a range of complex health needs to manage, including ongoing access to gender-affirming hormones, mental health care and sexual health care. Some also had chronic diseases. Accordingly, scheduling appointments and affording the co-payments required were major preoccupations. Most participants were not in full time work, and economic hardship proved to be a major compounding factor in issues of healthcare access, impacting on the choice of clinician or practice. Other barriers to accessing health included issues within health services, such as disrespectful attitudes, misgendering, ‘deadnaming’ (calling the person by their previous name), displaying an excessive interest is aspects of the participants’ life that were irrelevant to the consultation, and displaying ignorance of trans services such that the participants felt an obligation to educate them. In addition, participants noted how stereotyped ideas of trans people could result in inaccurate assumptions about their healthcare needs. Positive attributes of services were identified as respectful communication styles, clean, welcoming spaces, and signs that indicated professionalism, care and openness, such as relevant information pamphlets and visibility of LGBTIQ service orientation. Participants valued peer-based advice very highly, and some would act on and trust medical advice from peers above advice from medical professionals. Conclusion These findings demonstrate a need for comprehensive wrap-around service provision for trans people with complex needs which includes a substantial peer-based component, and addresses physical and mental health and social services conveniently and affordably.

Download Full-text

Expanding the reach of Latinx psychology: Honoring the lived experiences of sexual and gender diverse Latinxs.

Journal of Latinx Psychology ◽

10.1037/lat0000144 ◽

2020 ◽

Vol 8 (1) ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Alison Cerezo

Keyword(s):

Lived Experiences ◽

Gender Diverse ◽

And Gender

Download Full-text

The Co-Occurrence of Autism and Gender Diversity

The Oxford Handbook of Autism and Co-Occurring Psychiatric Conditions ◽

10.1093/oxfordhb/9780190910761.013.11 ◽

2020 ◽

pp. 197-211

Author(s):

Jill C. Fodstad ◽

Rebecca Elias ◽

Shivali Sarawgi

Keyword(s):

Gender Dysphoria ◽

Gender Diversity ◽

Gender Nonconforming ◽

Medical Interventions ◽

Gender Diverse ◽

Nonbinary Gender ◽

Psychiatric Conditions ◽

The Common ◽

And Gender

Gender diversity refers to gender expressions and/or gender identity experiences that vary from the common experiences of gender. Gender-diverse people may be gender nonconforming, gender nonbinary, gender fluid, gender exploring, transgender, and so forth. Some gender-diverse individuals experience gender dysphoria and/or gender incongruence and may require gender-affirming supports, including gender-affirming medical interventions. The co-occurrence of autism and gender diversity has been highlighted in a series of studies internationally as well as through rich community expressions. Studies in gender-referred individuals reveal high rates of autism traits as well as high rates of existing autism diagnoses. Studies in autistic populations reveal greater gender diversity characteristics. The long-term course of gender diversity in autistic individuals is poorly understood. Clinical guidelines have been developed for adolescents with the co-occurrence, but much work remains: No gender-related measures have been developed and tested for use in neurodiverse populations, no programs exist to support gender-diverse neurodiverse adults, and little is known about co-occurring mental health profiles, risks, or protective factors for people with the co-occurrence. The inclusion of this chapter on co-occurring autism and gender diversity within a book on “co-occurring psychiatric conditions” is problematic, because gender diversity is not a “psychiatric condition,” but instead a form of human diversity. The diagnosis of Gender Dysphoria is useful only insomuch as it allows individuals to obtain necessary gender-related supports. The authors’ choice to include this chapter in this book reflects a compromise, motivated by the need for educating both autism and gender specialists in this common co-occurrence.

Download Full-text

Mapping of Household Surveys to Measure Barriers to Access to Maternal and Child Health Services in India

Journal of Health Management ◽

10.1177/0972063421995026 ◽

2021 ◽

Vol 23 (1) ◽

pp. 10-19

Author(s):

Shivam Gupta ◽

Priyanka Das ◽

Siddhartha Kumar ◽

Arindam Das ◽

P. R. Sodani

Keyword(s):

Child Health ◽

Health Services ◽

Health Survey ◽

Maternal And Child Health ◽

Household Surveys ◽

Access Barriers ◽

Health Service Provision ◽

Healthcare Needs ◽

Unmet Healthcare Needs ◽

And Child Health

Objective: To map the range of access barrier indicators for which data can be derived from the three most common health related household surveys in India. Methods: A mapping review study was conducted to identify access dimensions and indicators of access barriers for maternal and child health (MCH) services included in three household surveys in India: National Family Health Survey (NFHS), District Level Household and Facility Survey (DLHS) and Annual Health Survey (AHS). Results: The Tanahashi framework for effective coverage of health services was used in this study, and 12 types of access barriers were identified, from which 23 indicators could be generated. These indicators measure self-reported access barriers for unmet healthcare needs through delayed care, as well as forgone care, and unsatisfactory experiences during health service provision. Multiple barriers could be identified, although there was marked heterogeneity in variables included and how barriers were measured. Conclusions: This study identified tracer indicators that could be used in India to monitor the population that experiences healthcare needs but fails to seek and obtain appropriate healthcare, and determine what the main barriers are. The surveys identified are well validated and allow the disaggregation of these indicators by equity stratifiers. Given the variability of the frequency and methodologies used in these surveys, comparability could be limited.

Download Full-text