scholarly journals BARRIERS TO TRANSGENDER HEALTH CARE IN PAKISTAN

2018 ◽  
Vol 16 (2) ◽  
pp. 33-34
Author(s):  
Munawar Hussain Soomro
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Federal Government ◽  
Binary Systems ◽  
Medical Training ◽  
Legal Protection ◽  
Mental Health Issue ◽  
Transgender People ◽  
Transgender Health ◽  
Transgender Persons

he term “transgender” refers to a spectrum of individuals who express gender in ways that deviate from the gender binary. It includes transsexuals, crossdressers and others.1,2 In Pakistan, the state of being a transgender presents a serious challenge to the traditionally established binary systems of nature/culture, man/woman, masculinity/ femininity and sex/gender. Even transgender community were given their identity as citizens of Pakistan in year 2009.3 Whereas the transgender persons suffer significant health disparities.4,5 Real or perceived stigma and discrimination within biomedicine and the health care provision in general may impact transgender people’s desire and ability to access appropriate care. The situation of the community is worse because they are left ignored and isolated without the survival facilities, education, employment opportunities, identity crisis or even the conformity from the dominant social class.3 National health services of Pakistan should include rigorous determination in the health care system to provide adequate care for transgender in the country. There is need to know the mechanism through the knowledge and biases of medical work force across the spectrum of medical training with regard to transgender health care. With these studies we can validate and propose potential solutions to address the identified gaps. Whereas the situation in other developing countries including those belonging to African and Asian regions is not good. In developed countries the situation is found to be much better. However, reported data shows that transgender people even in developed world face various kinds of discrimination especially in health care situations. The federal government of USA does not have laws specifically for protecting transgender people from discrimination in employment, housing, healthcare, and adoption. U.S. President Barack Obama had issued an executive order prohibiting discrimination against transgender people in employment by the federal government and its contractors. While in Pakistan there was no specific law for the transgender, however, a Senate committee had approved a bill in December 2017 for full legal protection to transgender people. It will provide a relief to transgender people for their health care and other facilities. Further, National Assembly of Pakistan approved the final Bill as Act called the Transgender Person (Protection of Rights) Act, 2018 on 18 May 2018.6 There is need to assess the perceptions and knowledge of the heath care provider workforce to provide medical care to transgender. Barriers may include fear of stigma associated with providing transgender medical care. Barriers may also include bias in the structure of clinics, forms, and electronic medical record systems in addition to gaps in knowledge and bias among support staff. Identification of solutions to the gaps is needed, which are not solely a lack of knowledge. The degree to which third party payer policy impedes access needs to be determined. Determination of change needed to overcome the financial barrier to care is also required. It is necessary to evaluate other barriers including societal stigma, mental health issue among patients, and socioeconomic issues. Finally evaluation of strategies to overcome these barriers is a must to address the matter.

scholarly journals Mental Health Care of Transsexual, Transgender and Gender Nonconforming People in Croatian Health System

2016 ◽  
Vol 9 (1) ◽  
pp. 26-26
Author(s):  
I. Zegura ◽  
◽  
G. Arbanas ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health System ◽  
Gender Transition ◽  
Transgender People ◽  
Transgender Health ◽  
Objective Health ◽  
Transgender Persons

Objective: Health and legal care of transgender people in Croatia is still at its beginnings. Further effort from the professional side is being engaged in order to establish complete health care of transgender people in Croatia. Design and Method: The aim was to examine if there are any differences in the levels of transgender persons quality of life, experienced violence and their present stage of gender transition and perceived level of social support and perceived quality of health care. Transgender clients who are in the process of gender transition within Croatian mental health system were asked to fill in the online questionnaire. Results: 80% of our transgender participants consider psychologists as the most competent and affirmative professionals concerning transgender health care. 15.6% say the same for psychiatrists and 4.4% consider endocrinologists as the most competent professionals to deal with transgender health issues. 28.8% of our participants are mostly or completely satisfied with mental health care, in contrast to only 6.6 % of those who are satisfied with medical health care. Conclusions: According to the facts that we have presented above, the agenda of health, mental health and legal care of transgender people in Croatia must be to build on permanent education, scientific work, ethical principles, standards of care and accessible health care. Minding the human rights of each patient, high quality of practice must be governed by the principles of competence in the work with transgender clients through affirmation of gender as personal construct of each client.

Later Life Care Planning and Concerns of Transgender Older Adults in Canada

2019 ◽  
Vol 89 (1) ◽  
pp. 39-56 ◽  
Author(s):  
Celeste Pang ◽  
Gloria Gutman ◽  
Brian de Vries
Keyword(s):  
Older Adults ◽  
Health Care ◽  
End Of Life Care ◽  
Health Care Services ◽  
Later Life ◽  
Care Planning ◽  
Life Care ◽  
Transgender People ◽  
Care Services ◽  
Transgender Persons

While the particular health-care concerns of transgender people have been documented and transgender aging is an emerging area of scholarship, little is known about planning for later and end-of-life care among transgender older adults. As part of a larger project, focus groups and interviews were conducted with 24 transgender older adults (average age 70 years) living in five cities in Canada exploring their concerns and explicit plans for later life care. Three primary themes emerged: (a) “dealing with the day-to-day” reflecting economic precarity and transitioning in later life, (b) fractures and support within family and community, and (c) “there’s a huge gap between principle and practice” reflecting mixed experiences and perceptions of health-care services. These themes suggest that effective promotion of care planning among older transgender persons requires an appreciation of the daily exigencies of their lives and the extent and nature of social support available to them.

scholarly journals Physician Assistants Employed by the Federal Government

2020 ◽  
Vol 185 (5-6) ◽  
pp. e649-e655 ◽  
Author(s):  
Noël E Smith ◽  
Andrzej Kozikowski ◽  
Roderick S Hooker
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Service ◽  
Federal Government ◽  
Public Health Service ◽  
Medical Training ◽  
Physician Assistants ◽  
National Commission ◽  
Federal Employment ◽  
The U.S

Abstract Objective Physician assistants (PAs) are health professionals who have received advance medical training and are licensed to diagnose illness, develop and manage treatment plans, prescribe medications, and serve as principal health care provider. Although the U.S. federal government is the largest single employer of PAs, at the same time little is known about them across the wide array of diverse settings and agencies. The objective of this project was to determine the census of PAs in federal employment, their location, and personal characteristics. This included approximating the number of uniformed PAs. Taking stock of a unique labor force sets the stage for more granular analyses of how and where PAs are utilized and are deployed. Methods No one central database identifies all federally employed PAs. To undertake this project, three sources were examined. Data were derived from the U.S. Office of Personnel Management and the National Commission on Certification of Physician Assistants. Uniformed PA numbers were the result of networking with senior chiefs in the military services and the U.S. Public Health Service. The data were collolated and summarized for comparison and discussion. Results As of 2018, approximately 5,200 PAs were dispersed in most branches and agencies of the government that provide health care services, including the Departments of Defense, Veterans Affairs, Health and Human Services, Justice, and Homeland Security. Federally employed PAs are civil servants or hold a commission in the uniformed services (ie, Army, Navy, Air Force, Coast Guard, and Public Health Service). Most PAs are in clinical roles, although a few hundred are in management positions. Approximately 81% of civilian PAs have had less than 15 years of federal employment. Conclusion The diverse utilization and deployment of PAs validate the importance of the role they serve as medical professionals in the federal government. From 2008 to 2019, PA employment in the federal government grew by approximately 50% supporting the forecast that substantial national PA growth is on track.

scholarly journals The current status of transgender health education in doctor of pharmacy curricula in North America

2017 ◽  
Vol 7 (4) ◽  
pp. 168-171 ◽  
Author(s):  
G. Lucy Wilkening
Keyword(s):  
Health Care ◽  
North America ◽  
Health Education ◽  
Health Care Disparities ◽  
Pharmacy Education ◽  
Current Status ◽  
Transgender Health ◽  
Mesh Terms ◽  
Transgender Persons ◽  
Doctor Of Pharmacy

Abstract Doctor of pharmacy programs across the country strive to prepare culturally competent pharmacy professionals who are trained to provide compassionate and evidence-based care to a variety of patients. Within the Accreditation Council for Pharmacy Education 2016 Standards and Key Elements for the Doctor of Pharmacy Degree, pharmacy schools are charged with the task of developing professionals who can identify and diminish health care disparities. Transgender persons represent one of the most underrepresented and underserved communities within the modern health care system, yet very little information is available for training future pharmacists to care for the transgender community. A literature search using the MeSH terms transgender persons or trans-sexualism and pharmacy education was conducted, and it revealed 1 article published by Parkhill and colleagues in the American Journal of Pharmacy Education. A Google® search of the phrase “transgender education in pharmacy school” was conducted and produced 1 additional published article as well as an online transgender education program launched in November 2016. The following commentary outlines the current literature and practices that involve integration of transgender health education into pharmacy schools in North America and a discussion on areas for future study.

scholarly journals Legal Protection of Patient Rights in Indonesia

2019 ◽  
Vol 3 (1) ◽  
pp. 75
Author(s):  
Istiana Heriani ◽  
Gunarto Gunarto ◽  
Anis Masdhurohatun
Keyword(s):  
Health Care ◽  
Health Services ◽  
Medical Care ◽  
Legal Protection ◽  
Secondary Data ◽  
Patient Rights ◽  
Normative Study ◽  
Factors Affecting ◽  
Patients Rights ◽  
Descriptive Qualitative

This study examines the legal protection of patient rights in health services in Indonesia. The aims of the study are to find out how the legal protection of patients as consumers in receiving health services and what factors affecting the legal protection of patients’ rights in receiving health services. The method employed in this study is a normative study by analysing data obtained from library. The data gathered are in form of secondary data. All the data collected are analysed descriptive qualitative. The problem raised herein is Law Number 44/2009 Concerning the Hospital is not fully well implemented. The results showed that there were many factors influent the effectiveness of Law Number 44/2009 above. The conclusion drawn up that the malpractice in terms of providing medical care may cause disharmony between physicians and patients; the facilities and infrastructures in the health care provided for in the hospital do not support the patients’ rights to obtain health care. Any responsibility borne to the hospital may only in the case of the patients suffered from the malpractice. Should this happen the patients can submit any formal complain to the Court

Transgenderzorg als zorgpraktijk - De werking van cultuur, geld en instituties in een genderidentiteitskliniek in de Verenigde Staten

2014 ◽  
Vol 17 (1) ◽  
pp. 47-64
Author(s):  
Marieke van Eijk
Keyword(s):  
United States ◽  
Health Care ◽  
Gender Identity ◽  
Well Being ◽  
The United States ◽  
Transgender People ◽  
Transgender Health ◽  
Practice Culture ◽  
Verenigde Staten ◽  
Health And Well Being

Transgender health care as a care practice. Culture, money, and institutions at work in a gender identity clinic in the United States While often approached as a field structured by stringent socio-medical ideas about gender and sex, transgender health care is, in addition, like any other medical field, also shaped by local ideologies of health and well-being, health insurance regulations, and institutional administrative processes. Drawing upon ethnographic fieldwork conducted in a gender identity clinic in the Midwestern United States, I offer a tripartite approach to understanding the interactions among culture, money, and institutions for the constitution of transgender health care. This tripartite model shows the dilemmas clinicians and transgender people are confronted with when providing help in or seeking access to an ideologically fragile field of medicine, in which the various parties involved raise questions of what constitutes transgenderism, who should cover the costs of care, and how to use mandatory diagnostic criteria. This article demonstrates that transgender care is as much about health and care, as it is about gender and sex.

scholarly journals O112: Health care provision for transgender people in developing countries: the experience of the first transgender health clinic in Mexico

2015 ◽  
Vol 18 (3 (Suppl 2)) ◽  
Author(s):  
Esmeralda Román ◽  
Hamid Vega-Ramirez ◽  
Jeremy Cruz ◽  
Jesús Casillas-Rodríguez ◽  
Andrea González-Rodríguez ◽  
...  
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Health Clinic ◽  
Health Care Provision ◽  
Care Provision ◽  
Transgender People ◽  
Transgender Health

scholarly journals The Role of the Endocrinologist in the Gender Adequacy Process and the Barriers for Adequate Transgender Health Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A796-A796
Author(s):  
Alexandra Saliba
Keyword(s):  
Health Care ◽  
Professional Training ◽  
Federal District ◽  
Specific Knowledge ◽  
Transgender People ◽  
Transgender Health ◽  
Wide Range ◽  
The Subject

Abstract The transgender universe comprises a wide range of individuals who do not identify with the gender role related to their birth sex, presenting distinct gender identities that transcend the binary concept of female and male. The follow-up of this population requires specific knowledge and training for its demands and peculiarities. Hormone therapy is a key point in the process of gender adequacy, and despite the increase in demand for specialized health services, there are still many barriers to full and free of prejudice health care. This is a descriptive and exploratory study about the characteristics of the professional training of the doctors involved in transgender health care, in particular the endocrinologist, and to enable an overview of the doctor-patient relationship and medical follow-up in the context of transsexuality in the Federal District. For this purpose, questionnaires were used for physicians: endocrinologists, family and community physicians, urologists, and psychiatrists; and transgender people residents of the Federal District. This study shows that most of the professionals involved in the process of gender adequacy, in particular the endocrinologist, do not present confidence or knowledge to accomplish it, and prejudice is still presented in a striking way in health care. In Federal District, services are not adequately structured for the care of this population, both from the perspective of doctors and transgender people. Moreover, in this sample, it was observed that the higher degree of specific knowledge in the subject increases the sensation of confidence of the professional to treat transgender people but does not correlate with the prejudice.

scholarly journals Improving Residents’ Competency in Caring for Transgender Individuals Through Development of a Curriculum

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A799-A799
Author(s):  
Michele Gortakowski ◽  
Chelsea Gordner
Keyword(s):  
Health Care ◽  
Medical School ◽  
Medical Training ◽  
Panel Discussion ◽  
Role Playing ◽  
Baseline Survey ◽  
Free Text ◽  
Formal Curriculum ◽  
Residency Programs ◽  
Transgender Health

Abstract Objectives: Several recent publications have described the lack of education in transgender health care among providers across all levels of medical training. Here we describe a QI project that developed and implemented a transgender health care curriculum for the University of Massachusetts Medical School-Baystate Medical Center (UMass-Baystate) pediatric and combined internal medicine-pediatrics residency programs. Methods: We designed a curriculum for the UMass-Baystate pediatric (9 residents/yr) and med-peds (8 residents/yr) residency programs. The curriculum included grand rounds presentations on transgender health care, didactic sessions integrated into the residents’ protected educational time throughout the academic year, and a panel discussion with non-binary and transgender individuals from the community. The didactic sessions included a mixture of lectures, role- playing, and case-based discussion. The curriculum development was guided by a curriculum design specialist and adapted each year based on feedback. Residents’ self- reported comfort and competency level were assessed through a survey at baseline and at the end of each year. Results: Ninety-eight percent (42/43) completed the baseline survey. Forty percent (17/42) had received no formal training in medical school, and 21% (9/42) had never taken care of a transgender patient. At baseline, 62% felt a little less comfortable and 50% felt somewhat competent, 2.4% very competent caring for transgender individuals compared to cisgender individuals. After three years, 25% felt a little less comfortable and 44% felt somewhat competent, 19% felt very competent caring for transgender individuals compared ot cisgender individuals. The community panel was very well received. Free text comments regarding the curriculum included “very helpful,” “loved the panel,” “clinically relevant.” Conclusions: This QI initiative served as the groundwork for the development of a formal curriculum to enhance medical education among residents in caring for transgender individuals. After three years, residents felt more comfortable and competent in caring for transgender individuals as compared to the baseline survey. We will continue to adapt the curriculum as it continues. The curriculum has expanded to include the pediatric nurses and the UMass medical students.

scholarly journals How the COVID-19 pandemic affects transgender health care in upper-middle-income and high-income countries – A worldwide, cross-sectional survey

2020 ◽  
Author(s):  
Andreas Koehler ◽  
Joz Motmans ◽  
Leo Mulió Alvarez ◽  
David Azul ◽  
Karen Badalyan ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
Low Income ◽  
Social Group ◽  
High Income ◽  
Transgender People ◽  
Middle Income ◽  
Transgender Health ◽  
The Impact

AbstractBackgroundSince the beginning of the COVID-19 pandemic, access to medical care was restricted for nearly all non-acute medical conditions. Due to their status as a vulnerable social group and the inherent need for transition-related treatments (e.g., hormone treatment), transgender people are assumed to be affected particularly severely by the restrictions caused by the COVID-19 pandemic. This study aims to assess the impact of the COVID-19 pandemic on the health and health care of transgender people.Methods and findingsAs an ad hoc collaboration between researchers, clinicians, and 23 community organizations, we developed a web-based survey. The survey was translated into 26 languages, and participants were recruited via various social media and LGBTIQ-community sources. Recruitment started in May 2020. We assessed demographical data, physical and mental health problems (e.g., chronic physical conditions), risk factors (e.g., smoking), COVID-19 data (symptoms, contact history, knowledge and concerns about COVID-19), and the influence of the COVID-19 pandemic on access to transgender health care and health-related supplies. To identify factors associated with the experience of restrictions to transgender health care, we conducted multivariate logistic regression analysis.5267 transgender people from 63 higher-middle income and high-income countries participated in the study. Over 50% of the participants had risk factors for a severe course of a COVID-19 infection and were at a high risk of avoiding testing or treatment of a COVID-19 infection due to the fear of mistreatment or discrimination. Access to transgender health care services was restricted due to the COVID-19 pandemic for 50% of the participants. Male sex assigned at birth and a lower monthly income were significant predictors for the experience of restrictions to health care. 35.0% of the participants reported at least one mental health conditions. Every third participant had suicidal thoughts, and 3.2% have attempted suicide since the beginning of the COVID-19 pandemic. A limitation of the study is that we did not analyze data from low-income countries and access to the internet was necessary to participate.ConclusionsTransgender people are assumed to suffer under the severity of the pandemic even more than the general population due to the intersections between their status as a vulnerable social group, their high amount of medical risk factors, and their need for ongoing medical treatment. The COVID-19 pandemic can potentiate these vulnerabilities, add new challenges for transgender individuals, and, therefore, can lead to devastating consequences, like severe physical or mental health issues, self-harming behaviour, and suicidality.

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