Brennan, Ann Marie Walsh; Barnsteiner, Jane; Siantz, Mary Lou de Leon; Cotter, Valeri T; Everett, Janine
There has been limited identification of core lesbian, gay, bisexual, transgendered, or intersexed (LGBTI) experience concepts that should be included in the nursing curricula. This article addresses the gap in the literature. To move nursing toward the goals of health equity and cultural humility in practice, education, and research, nursing curricula must integrate core LGBTI concepts, experiences, and needs related to health and illness. This article reviews LGBTI health care literature to address the attitudes, knowledge, and skills needed to address curricular gaps and provide content suggestions for inclusion in nursing curricula. Also considered is the need to expand nursing students' definition of diversity before discussing the interplay between nurses' attitudes and culturally competent care provided to persons who are LGBTI. Knowledge needed includes a life span perspective that addresses developmental needs and their impact on health concerns throughout the life course; health promotion and disease prevention with an articulation of unique health issues for this population; mental health concerns; specific health needs of transgender and intersex individuals; barriers to health care; interventions and resources including Internet sites; and legal and policy issues. Particular assessment and communication skills for LGBTI patients are identified. Finally, there is a discussion of didactic, simulation, and clinical strategies for incorporating this content into nursing curricula at the undergraduate and graduate levels. Copyright © 2012 Elsevier Inc. All rights reserved.
... DEPARTMENT OF JUSTICE National Institute of Corrections Solicitation for a Cooperative Agreement--Lesbian, Gay, Bisexual, Transgender, and Intersex Guidance Project AGENCY: National Institute of... result in a policy guide for corrections practitioners charged with the care and custody of lesbian, gay...
Significant progress has been made in equal rights for lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) individuals, yet schools remain institutions where sexual and gender diversity are marginalized and/or silenced. Queer theory, a non-linear theory that disrupts dominant beliefs about gender and sexuality and what…
Full Text Available INTRODUCTION: A number of studies have identified that gay, lesbian, bisexual, transgender, and intersex (GLBTI people have poorer mental health than the general population. This article describes current mental health promotion and service provision for GLBTI people in New Zealand, and the views of stakeholders on current service delivery and concerns facing the sector. METHODS: An email survey of service providers gathered descriptive data about mental health promotion and services provided for GLBTI people. Data obtained from interviews with key informants and online submissions completed by GLBTI individuals were analysed thematically. FINDINGS: Five organisations provide clear, specific and utilised services and programmes to some or all of the GLBTI populations. Twelve GLBTI-focused mental health promotion resources are identified. The analysis of data from key informants and GLBTI respondents identified factors affecting mental health for these populations occurring at three levels-macro-social environment, social acceptance and connection, and services and support. CONCLUSION: While GLBTI individuals have the same basic mental health promotion and service provision needs as members of the general population, they have additional unique issues. To enhance the mental health of GLBTI New Zealanders, a number of actions are recommended, including building sector capacity, allocating sufficient funding, ensuring adequate research and information is available, and reducing stigma, enhancing young people's safety, and supporting practitioners through training and resources. An important role for government, alongside GLBTI input, for improving mental health is noted.
Berger, Israel; Mooney-Somers, Julie
Tobacco use among lesbian, gay, bisexual, and transgender (LGBT) people is double the general population. Limited evidence suggests high smoking rates among intersex people. Lesbian, gay, bisexual, transgender, and intersex (LGBTI) people are a priority population in Australian health policy, particularly mental health and aging. Despite associations between smoking and noncommunicable diseases relevant to aging and mental health, LGBTI-targeted smoking cessation interventions in Australia have been limited to people living with HIV. Applying existing interventions to marginalized populations without modification and evaluation may fail and exacerbate inequities. To assess outcomes and characterize the populations served, cultural modifications, and behavior change techniques (BCTs) of interventions to reduce LGBTI smoking. We searched MEDLINE, six additional databases, and contacted authors to retrieve published and unpublished program evaluations. We retrieved 19 studies (3663 participants). None used control groups. Overall quit rate was 61.0% at the end of interventions and stabilized at 38.6% at 3-6 months. All studies included gay men, 13 included lesbians, 13 "LGBT," 12 bisexual people, five transgender people, and none included intersex people. Transgender people comprised 3% of participants. Of programs open to women, 27.8% of participants were women. Cultural modifications were used by 17 (89.5%) studies, commonly meeting in LGBT spaces, discussing social justice, and discussing LGBT-specific triggers. Common BCTs included providing normative information, boosting motivation/self-efficacy, relapse prevention, social support, action planning, and discussing consequences. Quit rates were high; using control groups would improve evaluation. Existing programs may fail to reach groups other than gay men. This review examines the evidence for LGBTI-targeted smoking cessation interventions. Populations within LGBTI are not proportionally represented in smoking
Stotzer, Rebecca L; Ka‘opua, Lana Sue I; Diaz, Tressa P
This paper presents findings from a statewide needs assessment of lesbian, gay, bisexual, transgender, questioning, and intersex (LGBTQI) people in Hawai‘i that relate to health status and health-related risk factors such as having health insurance coverage, having a regular doctor, experiencing sexual orientation (SO) or gender identity/expression (GI/E) discrimination in health/mental health care settings, and delaying care due to concerns about SO and GIE discrimination in Hawai‘i, Honolul...
Full Text Available This article provides a theoretical contemplation on how reciprocation of an assimilationist, liberationist and/or transgressive approach by lesbian, gay, bisexual, transgender, intersex, queer and/or questioning (LGBTIQ+ individuals on university campuses may encourage transformation initiatives in South African universities. The author ascribe to the contributions of previous research studies on a social constructionist approach to resilience to debate how individuals potentially navigate the disparity between sexual structure and agency within their ideological and physical construction and enactment of their academic and student persona. A theoretical basis is provided for the influence of social resilience to emphasise the localised, intersectional and plural experiences of LGBTIQ+ individuals as opposed to a monolithic and universal ‘either/or’ account of their being solely docile victims or free agents in a heteronormative context.
Stotzer, Rebecca L; Ka'opua, Lana Sue I; Diaz, Tressa P
This paper presents findings from a statewide needs assessment of lesbian, gay, bisexual, transgender, questioning, and intersex (LGBTQI) people in Hawai'i that relate to health status and health-related risk factors such as having health insurance coverage, having a regular doctor, experiencing sexual orientation (SO) or gender identity/expression (GI/E) discrimination in health/mental health care settings, and delaying care due to concerns about SO and GIE discrimination in Hawai'i, Honolulu, Kaua'i, and Maui counties. Results suggest that LGBTQI people in these counties generally rated their self-assessed health as "very good" or "excellent," but had slightly higher rates of smoking and less health insurance coverage than the general population of Hawai'i. Many respondents reported challenges to their health, and negative experiences with healthcare. Unlike prior studies that have shown no difference or a rural disadvantage in care, compared to urban locations, Hawai'i's counties did not have a clear rural disadvantage. Honolulu and Kaua'i Counties demonstrated better health indicators and lower percentages of people who had delayed care due to gender identity concerns. Findings suggest that health/mental health care providers should address potential bias in the workplace to be able to provide more culturally competent practice to LGBTQI people in Hawai'i.
... Objectives » Lesbian, Gay, Bisexual, and Transgender Health Lesbian, Gay, Bisexual, and Transgender Health Overview (active tab) Objectives National Snapshots Lesbian, Gay, Bisexual, and Transgender Health View HP2020 Data for: ...
Security for women and the lesbian, gay, bisexual, transgender and intersex people in the conflict-affected regions in Colombia. Colombia is currently in the process of concluding peace negotiations with the guerrilla group Colombian Revolutionary Armed Forces (FARC). One of the principal expectations generated by the ...
... Division of Reproductive Health More CDC Sites Lesbian, Gay, Bisexual, and Transgender Persons and Tobacco Use Recommend ... and Influence Resources References People who are lesbian, gay, bisexual, or transgender (LGBT) include all races and ...
Krane, Vikki; Barak, Katie Sullivan
The purpose of this article is to help physical educators and coaches better understand the issues raised in recent news stories about transgender and intersex athletes and to encourage them to engage students and athletes in dialogues about these topics. In conversations with students, it is important for teachers and coaches to separate facts…
To discuss lesbian, gay, bisexual, and transgender (LGBT)-specific survivorship issues including: integrating sexual and gender minority identities with cancer survivor identities; coordinating medical care and disclosing identities to health care providers; dealing with late effects of treatment; and addressing LGBT family and relationship issues. Published articles, quotes from an online survey of 311 LGBT survivors. The transition from active cancer treatment to survivorship presents challenges, and LGBT cancer survivors may face additional challenges as they enter the survivorship phase. Oncology nurses can improve the quality of survivorship care delivered to LGBT survivors and their caregivers by addressing the disparities and gaps in health care. Copyright © 2017 Elsevier Inc. All rights reserved.
..., Gay, Bisexual, and Transgender Pride Month, 2012 By the President of the United States of America A... live and love as we see fit. The lesbian, gay, bisexual, and transgender (LGBT) community has written a... coverage to someone just because they are lesbian, gay, bisexual, or transgender. Because we understand...
Mulcahy, Molly; Dalton, Sarah; Kolbert, Jered; Crothers, Laura
The authors identified the process that 10 lesbian, gay, bisexual, and transgender (LGBT) high school students used to establish an informal adult-mentor relationship with a school personnel member. Five major themes emerged: (a) how LGBT students determined whether this person would be a safe mentor, (b) a listing of the important qualities of…
..., Gay, Bisexual, and Transgender Pride Month, 2013 By the President of the United States of America A... equality from founding promise into lasting reality. Lesbian, gay, bisexual, and transgender (LGBT... Constitution and the laws of the United States, do hereby proclaim June 2013 as Lesbian, Gay, Bisexual, and...
Skerrett, Delaney Michael; Kõlves, Kairi; De Leo, Diego
Sexual orientation is seldom recorded at death in Australia, and to date there have been no studies on the relationship between those that have died by suicide and sexuality or minority gender identity in Australia. The aim of the present study is to determine whether or not lesbian, gay, bisexual, transgender (LGBT), and intersex individuals who die by suicide constitute a unique subpopulation of those who die by suicide, when compared with non-lesbian, gay, bisexual, transgender, and intersex suicide deaths. The Queensland Suicide Register holds records of all suicides in Queensland since 1990. All cases from 2000 to 2009 (inclusive; a total of 5,966 cases) were checked for potential indicators of individuals' sexual orientation and gender identification. A total of 35 lesbian (n = 10), gay (n = 22), bisexual (n = 2), and transgender (n = 1) suicide cases were identified. Three comparison cases of non-LGBT suicides for each LGBT suicide were then located, matched by age and gender. Conditional logistic regression was used to calculate odds ratios with 95% confidence intervals. It was significantly more likely that depression was mentioned in the cases of LGBT suicides than in non-LGBT cases. While 12.4% of the comparison group had been diagnosed with psychotic disorders, there were no such diagnoses among LGBT individuals. LGBT individuals experienced relationship problems more often, with relationship conflict also being more frequent than in non-LGBT cases. Despite its limitations, this study - the first of its kind in Australia - seems to indicate that LGBT people would require targeted approaches in mental and general health services. © 2014 Wiley Publishing Asia Pty Ltd.
Erosheva, Elena A.; Kim, Hyun-Jun; Emlet, Charles; Fredriksen-Goldsen, Karen I.
Purpose This study examines global social networks—including friendship, support, and acquaintance networks—of lesbian, gay, bisexual, and transgender (LGBT) older adults. Design and Methods Utilizing data from a large community-based study, we employ multiple regression analyses to examine correlates of social network size and diversity. Results Controlling for background characteristics, network size was positively associated with being female, transgender identity, employment, higher income, having a partner or a child, identity disclosure to a neighbor, engagement in religious activities, and service use. Controlling in addition for network size, network diversity was positively associated with younger age, being female, transgender identity, identity disclosure to a friend, religious activity, and service use. Implications According to social capital theory, social networks provide a vehicle for social resources that can be beneficial for successful aging and well-being. This study is a first step at understanding the correlates of social network size and diversity among LGBT older adults. PMID:25882129
Erosheva, Elena A; Kim, Hyun-Jun; Emlet, Charles; Fredriksen-Goldsen, Karen I
This study examines global social networks-including friendship, support, and acquaintance networks-of lesbian, gay, bisexual, and transgender (LGBT) older adults. Utilizing data from a large community-based study, we employ multiple regression analyses to examine correlates of social network size and diversity. Controlling for background characteristics, network size was positively associated with being female, transgender identity, employment, higher income, having a partner or a child, identity disclosure to a neighbor, engagement in religious activities, and service use. Controlling in addition for network size, network diversity was positively associated with younger age, being female, transgender identity, identity disclosure to a friend, religious activity, and service use. According to social capital theory, social networks provide a vehicle for social resources that can be beneficial for successful aging and well-being. This study is a first step at understanding the correlates of social network size and diversity among LGBT older adults. © The Author(s) 2015.
Dank, Meredith; Lachman, Pamela; Zweig, Janine M; Yahner, Jennifer
Media attention and the literature on lesbian, gay, and bisexual youth overwhelmingly focus on violence involving hate crimes and bullying, while ignoring the fact that vulnerable youth also may be at increased risk of violence in their dating relationships. In this study, we examine physical, psychological, sexual, and cyber dating violence experiences among lesbian, gay, and bisexual youth--as compared to those of heterosexual youth, and we explore variations in the likelihood of help-seeking behavior and the presence of particular risk factors among both types of dating violence victims. A total of 5,647 youth (51 % female, 74 % White) from 10 schools participated in a cross-sectional anonymous survey, of which 3,745 reported currently being in a dating relationship or having been in one during the prior year. Results indicated that lesbian, gay, and bisexual youth are at higher risk for all types of dating violence victimization (and nearly all types of dating violence perpetration), compared to heterosexual youth. Further, when looking at gender identity, transgender and female youth are at highest risk of most types of victimization, and are the most likely perpetrators of all forms of dating violence but sexual coercion, which begs further exploration. The findings support the development of dating violence prevention programs that specifically target the needs and vulnerabilities of lesbian, gay, and bisexual youth, in addition to those of female and transgender youth.
..., Gay, Bisexual, And Transgender Pride Month, 2011 By the President of the United States of America A Proclamation The story of America's Lesbian, Gay, Bisexual, and Transgender (LGBT) community is the story of..., Don't Tell'' policy. With this repeal, gay and lesbian Americans will be able to serve openly in our...
..., Gay, Bisexual, and Transgender Pride Month, 2010 By the President of the United States of America A... equality on behalf of the lesbian, gay, bisexual, and transgender (LGBT) community. This month, as we.... That is why we must give committed gay couples the same rights and responsibilities afforded to any...
Full Text Available There is an increasing body of research on ageing and end-of-life care (EOLC of lesbian, gay, bisexual and transgender (LGBT older people in the UK, USA and Australia. In contrast, in South Africa, despite progressive legislation to protect LGBT rights, there has been minimal research in this area. This article reports on a critical review of literature on ageing of the LGBT community. Key themes identified include discrimination by health care workers and health risks for LGBT older people alongside the need for training of health professionals. The article concludes with consideration of the needs of LGBT persons in South Africa
Earnshaw, Valerie A; Bogart, Laura M; Poteat, V Paul; Reisner, Sari L; Schuster, Mark A
Bullying of lesbian, gay, bisexual, and transgender (LGBT) youth is prevalent in the United States, and represents LGBT stigma when tied to sexual orientation and/or gender identity or expression. LGBT youth commonly report verbal, relational, and physical bullying, and damage to property. Bullying undermines the well-being of LGBT youth, with implications for risky health behaviors, poor mental health, and poor physical health that may last into adulthood. Pediatricians can play a vital role in preventing and identifying bullying, providing counseling to youth and their parents, and advocating for programs and policies to address LGBT bullying. Copyright © 2016 Elsevier Inc. All rights reserved.
Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities; Board on the Health of Select Populations; Institute of Medicine
At a time when lesbian, gay, bisexual, and transgender individuals--often referred to under the umbrella acronym LGBT--are becoming more visible in society and more socially acknowledged, clinicians...
Russell, Stephen T.; Fish, Jessica N.
Today’s lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be at high risk for compromised mental health? We provide an overview of the contemporary context for LGBT youth, followed by a review of current science on LGBT youth mental health. Research in the past decade has identified risk and protective factors for mental health, which point to promising directions for prevention, intervention, and treatment. Legal and policy successes have set the stage for advances in programs and practices that may foster LGBT youth mental health. Implications for clinical care are discussed, and important areas for new research and practice are identified. PMID:26772206
Russell, Stephen T; Fish, Jessica N
Today's lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be at high risk for compromised mental health? We provide an overview of the contemporary context for LGBT youth, followed by a review of current science on LGBT youth mental health. Research in the past decade has identified risk and protective factors for mental health, which point to promising directions for prevention, intervention, and treatment. Legal and policy successes have set the stage for advances in programs and practices that may foster LGBT youth mental health. Implications for clinical care are discussed, and important areas for new research and practice are identified.
Saskia Keuzenkamp; Lisette Kuyper
Original title: Acceptatie van homoseksuelen, biseksuelen en transgenders in Nederland 2013 The Dutch government is committed to equal rights for and social acceptance of lesbian, gay, bisexual and transgender (LGBT) individuals, and also to securing their acceptance in Dutch society. Since
Rich, Ashleigh; Scott, Kai; Johnston, Caitlin; Blackwell, Everett; Lachowsky, Nathan; Cui, Zishan; Sereda, Paul; Moore, David; Hogg, Robert; Roth, Eric
Gay, bisexual, queer and other men who have sex with men are disproportionately affected by HIV in Canada. While up to 63% of transgender men identify as gay, bisexual or queer and report a variety of HIV sexual risk behaviours, transgender men are often overlooked within epidemiological HIV surveillance and research. While a growing body of research has begun to examine sexual risk for transgender gay, bisexual and queer men, most studies have been conducted in the USA. This study explored sexual HIV risk for this population in the Canadian context, specifically in British Columbia, in an environment of publically funded universal access to healthcare, including HIV testing and treatment. We conducted interviews with 11 gay, bisexual and queer transgender men. Participants' narratives suggest that HIV risk for these transgender men is shaped by a diversity of sexual behaviours, including inconsistent condom use, seeking partners online for greater safety and accessing HIV/STI testing and other healthcare services despite facing transition-related barriers. Public health prevention and health education must recognise the presence of transgender men and ensure health services and broader population health promotion meet the unique sexual health needs of this sub-population of gay, bisexual and queer men.
Horton, Paul; Rydstrøm, Helle; Tonini, Maria
Recent public debates about sexuality in India and Vietnam have brought the rights of lesbian, gay, bisexual and transgender people sharply into focus. Drawing on legal documents, secondary sources and ethnographic fieldwork conducted in the urban centres of Delhi and Hanoi, this article shows how the efforts of civil society organisations dedicated to the fight for lesbian, gay, bisexual and transgender rights have had different consequences in these two Asian contexts. The paper considers how these organisations navigated government regulations about their formation and activities, as well as the funding priorities of national and international agencies. The HIV epidemic has had devastating consequences for gay men and other men who have sex with men, and has been highly stigmatising. As a sad irony, the epidemic has provided at the same time a strategic entry point for organisations to struggle for lesbian, gay, bisexual and transgender recognition. This paper examines how the fight for lesbian, gay, bisexual and transgender recognition has been doubly framed through health-based and rights-based approaches and how the struggle for recognition has positioned lesbian, gay, bisexual and transgender people in India and Vietnam differently.
Fassinger, Ruth E; Shullman, Sandra L; Stevenson, Michael R
This article presents an affirmative paradigm for understanding the leadership of sexual minorities-that is, lesbian, gay, bisexual, and transgender (LGBT) people. Although research on LGBT issues in leadership to date is almost nonexistent, there are several bodies of literature that can contribute to an understanding of the unique leadership challenges faced by sexual minority people. These include the literatures on stigma and marginalization, leadership in particular status groups (e.g., college students, women), and LGBT vocational issues (especially workplace climate and identity disclosure). We propose a new, multidimensional model of LGBT leadership enactment that incorporates sexual orientation (particularly regarding identity disclosure), gender orientation (including leader gender), and the situation (conceptualized here as group composition); the model also is embedded in context, the most relevant factors that affect the enactment of leadership being stigma and marginalization. We explicate this model with findings and concepts from relevant literatures, and we conclude the article with recommendations for building a scholarly literature in LGBT leadership. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
... 3 The President 1 2010-01-01 2010-01-01 false Proclamation 8387 of June 1, 2009. Lesbian, Gay... Proclamation 8387 of June 1, 2009 Proc. 8387 Lesbian, Gay, Bisexual, and Transgender Pride Month, 2009By the... lesbian, gay, bisexual, and transgender (LGBT) community. Out of this resistance, the LGBT rights movement...
Fallin, Amanda; Goodin, Amie J.; King, Brian A.
Background Menthol can mask the harshness and taste of tobacco, making menthol cigarettes easier to use and increasing their appeal among vulnerable populations. The tobacco industry has targeted youth, women, and racial minorities with menthol cigarettes, and these groups smoke menthol cigarettes at higher rates. The tobacco industry has also targeted the lesbian, gay, bisexual, and transgender (LGBT) communities with tobacco product marketing. Purpose To assess current menthol cigarette smoking by sexual orientation among a nationally representative sample of U.S. adults. Methods Data were obtained from the 2009–2010 National Adult Tobacco Survey, a national landline and cellular telephone survey of non-institutionalized U.S. adults aged ≥18 years, to compare current menthol cigarette smoking between LGBT (n=2,431) and heterosexual/straight (n=110,841) adults. Data were analyzed during January–April 2014 using descriptive statistics and logistic regression adjusted for sex, age, race, and educational attainment. Results Among all current cigarette smokers, 29.6% reported usually smoking menthol cigarettes in the past 30 days. Menthol use was significantly higher among LGBT smokers, with 36.3% reporting that the cigarettes they usually smoked were menthol compared to 29.3% of heterosexual/straight smokers (p<0.05); this difference was particularly prominent among LGBT females (42.9%) compared to heterosexual/straight women (32.4%) (p<0.05). Following adjustment, LGBT smokers had greater odds of usually smoking menthol cigarettes than heterosexual/straight smokers (OR=1.31, 95% CI=1.09, 1.57). Conclusions These findings suggest that efforts to reduce menthol cigarette use may have the potential to reduce tobacco use and tobacco-related disease and death among LGBT adults. PMID:25245795
Existing research indicates the rate of smoking among lesbian, gay, bisexual, and transgender (LGBT) youths exceeds the general population's, possibly due to stress, habitual substance abuse, socializing in smoky venues, and tobacco marketing. The study's overall aim was to conduct qualitative research regarding tobacco use and avoidance by LGBT youths. This report focuses on identifying priority subpopulations and corresponding risk and resiliency factors. Purposive and maximum variation sampling were used to select 30 LGBT youths and 30 interactors for face-to-face interviews. Almost a third of participants said that all LGBT youths are at risk for smoking. Other respondents specified a range of high-risk groups, encompassing many subpopulations. Contributing factors for smoking included personal characteristics, interpersonal issues, environmental conditions, and structural issues. More than a third of young smokers were not acquainted with LGBT nonsmokers and could not imagine how they avoid using tobacco. Half of the interactors and four youths ascribed favorable qualities to nonsmokers--such as self-esteem, will power, and concern for personal health, appearance, and well-being. In conclusion, smoking is a pervasive problem among LGBT youths. The findings corroborate prior explanations and implicate new ones. Some risks (e.g., limited opportunities to socialize with LGBT peers outside of smoking venues, the desire to appear more masculine, and sexuality-related stress) and resiliency factors (e.g., positive sexual identity) are unique to LGBT populations, reinforcing the need for culturally specific approaches to prevention and cessation. Highlighting the positive attributes of nonsmokers and nonsmoking might prove useful in prevention campaigns.
... their lives. The Effects of Negative Attitudes on Gay, Bisexual, and Other Men Who Have Sex with Men Some people may have negative attitudes toward gay, bisexual, and other men who have sex with ...
Greytak, Emily A.; Kosciw, Joseph G.
This study examines how United States (US) teachers' experiences and beliefs may be predictive of their intervention in anti-lesbian, gay, bisexual, and transgender (LGBT) bullying and harassment using a US national sample of teachers (N?=?726) who completed an online survey. Results from regression analysis indicated that knowing LGBT people,…
Zubernis, Lynn; Snyder, Matthew
At some point every college freshman asks "Am I okay?" or "Am I normal?" Helping students answer this question is a familiar part of college counseling. However, this task becomes more complicated when students who are gay, lesbian, bisexual, transgender (GLBT), or questioning their sexuality seek counseling. The universal issues which all college…
Schwickrath, Heather M.
After an extensive literature review, results indicated research has been conducted examining the links between traditional bullying and suicide, lesbian, gay, bisexual, transgendered, and questioning (LGBTQ) identification and cyberbullying, as well as LGBTQ identification and suicide. However, it appears as though there is a dearth of studies…
Wolowic, Jennifer M; Heston, Laura V; Saewyc, Elizabeth M; Porta, Carolyn; Eisenberg, Marla E
While the pride rainbow has been part of political and social intervention for decades, few have researched how lesbian, gay, bisexual, transgender and queer young people perceive and use the symbol. How do lesbian, gay, bisexual, transgender and queer youth who experience greater feelings of isolation and discrimination than heterosexual youth recognise and deploy the symbol? As part of a larger study on supportive lesbian, gay, bisexual, transgender and queer youth environments, we conducted 66 go-along interviews with lesbian, gay, bisexual, transgender and queer youth people from Massachusetts, Minnesota and British Columbia. During interviews, young people identified visible symbols of support, including recognition and the use of the pride rainbow. A semiotic analysis reveals that young people use the rainbow to construct meanings related to affiliation and positive feelings about themselves, different communities and their futures. Constructed and shared meanings help make the symbol a useful tool for navigating social and physical surroundings. As part of this process, however, young people also recognize that there are limits to the symbolism; it is useful for navigation but its display does not always guarantee supportive places and people. Thus, the pride rainbow connotes safety and support, but using it as a tool for navigation is a learned activity that requires caution.
There is growing media interest in how lesbian, gay, bisexual or transgender (LGBT) Muslims negotiate their seemingly incompatible religious and sexual identities. Thus, there is a need to investigate how some LGBT Muslims utilise Islam as a resource for alternative pedagogical strategies to reconcile their personal beliefs and values. Their…
Liddle, Becky J.; Luzzo, Darrell Anthony; Hauenstein, Anita L.; Schuck, Kelly
Workplace climate refers to formal and informal organizational characteristics contributing to employee welfare. Workplace climates for lesbian, gay, bisexual, and transgendered (LGBT) employees range from actively supportive to openly hostile. An instrument measuring LGBT workplace climate will enable research on vocational adjustment of LGBT…
Horn, Stacey S.; Romeo, Katherine E.
Peer relationships are a vital part of adolescents' lives. For lesbian, gay, bisexual, and transgender (LGBT) youth, whether these relationships are supportive and positive, or filled with stigma, prejudice, and discrimination rests, to some degree, on their heterosexual peers' attitudes and beliefs about homosexuality. For while LGBT youth may…
Bidell, Markus P.
Lesbian, gay, bisexual, transgender, or questioning (LGBTQ) students often face considerable isolation, discrimination, and violence at school, which can exacerbate the acute psychosocial and academic problems they already encounter. The purpose of this article is to introduce gay-straight alliances (GSAs) as a social justice and advocacy approach…
Craig, Shelley L.; McInroy, Lauren; McCready, Lance T.; Alaggia, Ramona
Lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth have the potential for considerable resilience. Positive media representations may mediate negative experiences and foster self-esteem, yet the relationship between resilience and both traditional offline and new online media remains underaddressed for this population. This…
Heck, Nicholas C.; Flentje, Annesa; Cochran, Bryan N.
Lesbian, gay, bisexual, and transgender (LGBT) youth are at risk for engaging in negative health behaviors and for experiencing at-school victimization. Specific benefits of attending a high school with a gay-straight alliance (GSA), including lower levels of suicidality, have been published; however, it is unclear whether GSAs are related to…
Russell, Stephen T.; McGuire, Jenifer K.; Lee, Sun-A; Larriva, Jacqueline C.; Laub, Carolyn
A growing body of research indicates that lesbian, gay, bisexual, and transgender (LGBT) students are often unsafe at school. Little research has examined school safety for students with LGBT parents. We examined adolescents' perceptions of school safety for students with LGBT parents using data from a survey of 2,302 California sixth through…
Russell, Stephen T.; Ryan, Caitlin; Toomey, Russell B.; Diaz, Rafael M.; Sanchez, Jorge
Background: Adolescent school victimization due to lesbian, gay, bisexual, or transgender (LGBT) status is commonplace, and is associated with compromised health and adjustment. Few studies have examined the long-term implications of LGBT school victimization for young adult adjustment. We examine the association between reports of LGBT school…
Sowden, Beth; Fleming, Julia; Savage, Todd A.; Woitaszewski, Scott A.
Despite recent socially positive progression in the view and treatment of lesbian, gay, bisexual, and transgender (LGBT) individuals in the USA, the LGBT population continues to face complicated circumstances and significant hindrances in many societal institutions. One of the most challenging and complex arena is the educational system (Biegel…
Graybill, Emily C.; Varjas, Kris; Meyers, Joel; Watson, Laurel B.
Researchers suggest that supportive school personnel may decrease some of the challenges encountered by lesbian, gay, bisexual, and transgender (LGBT) youth in schools (Russell, Seif, & Truong, 2001); however, little is known about the approaches used by school-based advocates for LGBT youth. This exploratory study investigated the strategies used…
Bishop, Christa M.; Atlas, Jana G.
This study examined what elementary schools in New York State are doing to recognize lesbian, gay, bisexual, and transgender (LGBT) families in terms of curriculum, policies, and practices. In all, 116 school psychologists completed an online survey regarding their districts. Findings indicated that even though most school districts serve…
Diaz, Elizabeth M.; Kosciw, Joseph G.; Greytak, Emily A.
Lesbian, gay, bisexual, and transgender students often face challenges that prevent them from developing a sense of connectedness to school. Many LGBT youth attend schools that are unwelcoming or even overtly hostile. For any student, being victimized at school can negatively impact their sense of school connectedness. This article discusses the…
Munoz-Plaza, Corrine; Quinn, Sandra Crouse; Rounds, Kathleen A.
Lesbian, gay, bisexual and transgender youth (LGBT) continue to face extreme discrimination within the school environment. Existing literature suggests that LGBT youth are at high risk for a number of health problems, including suicide ideation and attempts, harassment, substance abuse, homelessness, and declining school performance. This…
Because of discrimination and secrecy, lesbian, gay, bisexual, and transgender (LGBT) people have poorer health outcomes, which include an increased risk for certain cancers and additional challenges in cancer treatment and survivorship. The oncology nurse also should be aware of issues of LGBT sexuality and the impact that oncology treatment may have on the LGBT patient's immediate and long-term sexual functioning.
Hoffman, Neal D; Freeman, Katherine; Swann, Stephanie
Lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth appear to be at higher risk for certain adverse health outcomes, and to have several personal, cultural and structural barriers to accessing healthcare. Little is known, however, about the experiences of LGBTQ youth with healthcare providers and healthcare services. Our goal was to recruit a sample of LGBTQ youth and to determine their preferences regarding healthcare providers, healthcare settings and the health issues that they consider important to discuss with a healthcare provider. We conducted a cross-sectional Internet-based survey. Respondents ages 13-21 years and living in the U.S. or Canada were asked to review three lists of items pertaining to qualities of healthcare providers, qualities of offices or health centers, and concerns or problems to discuss with a healthcare provider, and then to assign for each item a relative importance. Items in each of the three lists were then ranked, and differences among ranks were assessed. Inter-group differences by age, gender, and race/ethnicity were also assessed. 733 youth met eligibility criteria. Youth indicated as most important competence overall and specifically in issues unique to taking care of youth and LGBTQ persons, as well as being respected and treated by providers the same as other youth. Notably, youth ranked as least important the provider's gender and sexual orientation. Youth ranked accessibility issues higher than specific services provided. As health concerns to discuss with a provider, youth ranked preventive healthcare, nutrition, safe sex, and family as important as common morbidities. Youth placed as much importance on provider qualities and interpersonal skills as provider knowledge and experience, and placed little importance on a provider's gender and sexual orientation. Youth indicated the importance of providers addressing not only health risks, but also wellness and health promotion, and to do so within the context of
Johnson, Michael; Smyer, Tish; Yucha, Carolyn
The purpose of this study was to evaluate the methodological quality of quantitative lesbian, gay, bisexual, and transgender nursing research from 2000 to 2010. Using a key word search in Cumulative Index to Nursing and Allied Health Literature, 188 studies were identified and 40 met the criteria, which included descriptive, experimental, quasi-experimental, or observational (case control, cohort, and cross-sectional) design. The methodological quality of these studies was similar to that reported for medical and nursing educational research. The foci of these lesbian, gay, bisexual, and transgender studies were biased toward human immunodeficiency virus, acquired immunodeficiency syndrome, and sexually transmitted diseases, and 58.5% of the funded research was related to human immunodeficiency virus or acquired immunodeficiency syndrome. To provide evidence-based health care to these populations, an understanding of the current state of research is crucial.
Lim, Fidelindo A; Hsu, Richard
The aim of this study was to critically appraise and synthesize findings from studies on the attitudes of nursing students toward lesbian, gay, bisexual, and transgender (LGBT) persons. There is paucity of research to assess the attitudes of nursing students toward LGBT persons. An electronic search was conducted using PubMed, Medline, Web of Science, EbscoHost, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature using medical subject headings terminologies. Search terms used included gay, lesbian, transgender, bisexual, LGBT, nursing students, baccalaureate nursing, undergraduate nursing, homophobia, homosexuality, sexual minority, attitudes, discrimination, and prejudice. Less than 50 percent of the studies (5 out of 12) suggested positively leaning attitudes of nursing students toward LGBT persons; six studies reported negative attitudes, and one study reported neutral attitudes. There are some indications that student attitudes may be moving toward positively leaning. Studies published before 2000 reported a preponderance of negative attitudes.
Quinn, Gwendolyn P.; Sanchez, Julian A.; Sutton, Steven K.; Vadaparampil, Susan T.; Nguyen, Giang T.; Green, B. Lee; Kanetsky, Peter A.; Schabath, Matthew B.
This article provides an overview of the current literature on seven cancer sites that may disproportionately affect lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. For each cancer site we present and discuss the descriptive statistics, primary prevention, secondary prevention and preclinical disease, tertiary prevention and late stage disease, and clinical implications. Finally, an overview of psychosocial factors related to cancer survivorship is offered as well as strategies for improving access to care. PMID:26186412
This article discusses whether lesbian, gay, bisexual and transgender (LGBT) people are protected against discrimination and hate crime in Georgia. Georgia is dominated by deeply rooted traditions, history and religion which promote stigmatisation and enhance existing negative stereotypes of the LGBT community. This is aggravated by state practice and poor legislation which fail to ensure adequate protection of LGBT individuals against discrimination and hate crime. Even though homosexuality ...
van der Pijl, I.H.; Oude Breuil, B.C.M.; Swetzer, Lene; Drymioti, M.; Goderie, M.J.H.
Although the Netherlands is renowned for its forerunner position in lesbian, gay, bisexual, transgender/transsexual, and intersex (LGBTI) rights, this study urges one to question whether it can still live up to that image. Reports, news items, and signals from non-governmental organizations, such as
Alencar Albuquerque, Grayce; de Lima Garcia, Cintia; da Silva Quirino, Glauberto; Alves, Maria Juscinaide Henrique; Belém, Jameson Moreira; dos Santos Figueiredo, Francisco Winter; da Silva Paiva, Laércio; do Nascimento, Vânia Barbosa; da Silva Maciel, Érika; Valenti, Vitor Engrácia; de Abreu, Luiz Carlos; Adami, Fernando
The relationship between users and health services is considered essential to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and Transgender population suffer from prejudice and discrimination in access and use of these services. This study aimed to identify the difficulties associated with homosexuality in access and utilization of health services. A systematic review conducted using PubMed, Cochrane, SciELO, and LILACS, considering the period from 2004 to 2014. The studies were evaluated according to predefined inclusion and exclusion criterias. Were included manuscripts written in English or Portuguese, articles examining the Lesbian, Gay, Bisexual, and Transgender population's access to health services and original articles with full text available online. The electronic databases search resulted in 667 studies, of which 14 met all inclusion criteria. Quantitative articles were predominant, showing the country of United States of America to be the largest producer of research on the topic. The studies reveal that the homosexual population have difficulties of access to health services as a result of heteronormative attitudes imposed by health professionals. The discriminatory attendance implies in human rights violations in access to health services. The non-heterosexual orientation was a determinant factor in the difficulties of accessing health care. A lot must still be achieved to ensure access to health services for sexual minorities, through the adoption of holistic and welcoming attitudes. The results of this study highlight the need for larger discussions about the theme, through new research and debates, with the aim of enhancing professionals and services for the health care of Lesbian, Gay, Bisexual, and Transgender Persons.
Barrientos, Jaime; Silva, Jimena; Catalan, Susan; Gomez, Fabiola; Longueira, Jimena
This article describes the population participating in the LGBT Pride Parade in Santiago, Chile, from discrimination and victimization standpoints. The sample consisted of 488 subjects older than 18 years (M = 25.1), who were interviewed during the 2007 event. For this purpose, a questionnaire from the Latin American Centre of Sexuality and Human Rights (CLAM) was adapted and administered. Approximately 35% of respondents reported having experimented school, religious, or neighborhood discrimination. The more discriminated are transgender people. Approximately three fourths of respondents reported experiencing ridicule and almost 60% reported experiencing insults or threats. Transgender were significantly more likely than gay men, lesbians, and bisexuals to experience discrimination or victimization events. Finally, the parade acquired an important social and political character in the context of a clearly homophobic society.
Hancock, Adrienne; Haskin, Gregory
The cultures and service needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) minority groups are relevant to speech-language pathologists (SLPs). In particular, transgender individuals seeking communication services from SLPs in order to improve quality of life require culturally and clinically competent clinicians. Knowledge and attitudes regarding a population are foundational stages toward cultural competency (Turner, Wilson, & Shirah, 2006). The purpose of this research is to assess LGBTQ knowledge and attitudes among aspiring and practicing SLPs. An online survey was completed by 279 SLPs from 4 countries. Mean accuracy scores on LGBTQ culture questions were near 50%. Self-ratings indicated more comfort than knowledge, with generally positive feelings toward LGBTQ subgroups. Transgender communication is within SLPs' scope of practice, yet 47% indicated such services were not addressed in their master's curriculum, and 51% did not know how to describe transgender communication therapy. When respondents were asked to indicate priority of 10 LGBTQ topics for a continuing education seminar, communication masculinization/feminization best practice and case examples had the highest mean priority scores. There is a need to promote LGBTQ cultural competence within speech-language pathology. This study provides direction for improving LGBTQ cultural competence among SLPs.
Liddle, Becky J; Stowe, Angela M
SUMMARY Advantages of a lesbian/heterosexual team approach to education on lesbian, gay, bisexual and transgender issues are examined and a case study is analyzed. A lesbian guest lecturer provided a contact experience, personal anecdotes, passion, and expertise. Facilitation of later class discussion by the heterosexual instructor allowed for frank discussion among students, processing of presentation content, and modeling of gay-affirmative attitudes by the instructor and other students. Summaries of the guest lecture (fantasy exercise and informational lecture) and later discussion are provided. Student comments during discussion demonstrated evidence of deep challenge, attitude change, and heightened understanding.
McClain, Zachary; Peebles, Rebecka
Adolescence is a crucial period for emerging sexual orientation and gender identity and also body image disturbance and disordered eating. Body image distortion and disordered eating are important pediatric problems affecting individuals along the sexual orientation and gender identity spectrum. Lesbian, gay, bisexual, transgender (LGBT) youth are at risk for eating disorders and body dissatisfaction. Disordered eating in LGBT and gender variant youth may be associated with poorer quality of life and mental health outcomes. Pediatricians should know that these problems occur more frequently in LGBT youth. There is evidence that newer treatment paradigms involving family support are more effective than individual models of care. Copyright © 2016 Elsevier Inc. All rights reserved.
Haas, Ann P.; Eliason, Mickey; Mays, Vickie M.; Mathy, Robin M.; Cochran, Susan D.; D'Augelli, Anthony R.; Silverman, Morton M.; Fisher, Prudence W.; Hughes, Tonda; Rosario, Margaret; Russell, Stephen T.; Malley, Effie; Reed, Jerry; Litts, David A.; Haller, Ellen; Sell, Randall L.; Remafedi, Gary; Bradford, Judith; Beautrais, Annette L.; Brown, Gregory K.; Diamond, Gary M.; Friedman, Mark S.; Garofalo, Robert; Turner, Mason S.; Hollibaugh, Amber; Clayton, Paula J.
Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice. PMID:21213174
Higa, Darrel; Hoppe, Marilyn J.; Lindhorst, Taryn; Mincer, Shawn; Beadnell, Blair; Morrison, Diane M.; Wells, Elizabeth A.; Todd, Avry; Mountz, Sarah
Factors associated with the well-being of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth were qualitatively examined to better understand how these factors are experienced from the youths' perspectives. Largely recruited from LGBTQ youth groups, 68 youth participated in focus groups (n = 63) or individual interviews (n =…
Fisher, Emily S.; Komosa-Hawkins, Karen; Saldana, Enrique; Thomas, Genevieve M.; Hsiao, Cyndi; Rauld, Michelle; Miller, Dorian
Lesbian, gay, bisexual, transgendered, and questioning (LGBTQ) students are likely to be in every classroom in every secondary school in the United States; yet, their needs are often overlooked. LGBTQ students are at risk for developing academic, social, and emotional problems due to harassment and bullying experienced at school. Although schools…
Datti, Paul A.
Incorporating J. D. Krumboltz's (1979) social learning theory of career decision making, the author explores career development issues for gay, lesbian, bisexual, transgender, and questioning (GLBTQ) adolescents and young adults. Unique challenges for the GLBTQ population are discussed, specific recommendations for effective career counseling with…
Gay, Lesbian, and Straight Education Network, New York, NY.
This workbook provides an instrument to objectively analyze a school's current climate with regard to lesbian, gay, bisexual, and transgendered (LGBT) people and the steps needed to move that school toward a more inclusive environment. It provides a detailed assessment survey (to be completed by key school stakeholders), descriptive data, and…
Snow, Kevin C.
Lesbian, gay, bisexual, transgender, and questioning or queer (LGBTQ) students at evangelical Christian colleges are a population frequently overlooked in the literature on the spiritual lives of college students. The author used qualitative content analysis within a phenomenological tradition to examine blog posts by such students, who face…
The purpose of the report is to inform students, parents, school personnel, and officials of the legal issues related to harassment, bullying, and discrimination of lesbian, gay, bisexual, and transgender (LGBT) students. This report describes existing research on the current school climate for LGBT youth as well as the harmful effects of…
Treat, Alena R.; Whittenburg, Becky
This bibliography makes available to educators and others a comprehensive resource for information regarding gifted youth who are gay, lesbian, bisexual, transgender or questioning their sexual orientation and/or gender identity (G/GLBTQ). It includes articles, brochures, books, lesson plans, staff development, video media, and Web resources. As…
Smith, Nathan Grant
This study examined individual and institutional productivity in lesbian, gay, bisexual, and transgender (LGBT) scholarship published in counseling psychology--oriented journals for the years 1990 through 2008. Eight journals were included in the analyses. An author-weighted score was calculated for each scholar, using a formula developed by…
Kosciw, Joseph G.; Greytak, Emily A.; Bartkiewicz, Mark J.; Boesen, Madelyn J.; Palmer, Neal A.
In 1999, the Gay, Lesbian and Straight Education Network (GLSEN) identified the need for national data on the experiences of lesbian, gay, bisexual, and transgender (LGBT) students and launched the first National School Climate Survey (NSCS). At the time, the school experiences of LGBT youth were under-documented and nearly absent from national…
Bishop, Christa M.
This study examined what elementary schools in New York State are doing to recognize lesbian gay, bisexual, and transgender (LGBT) families in terms of curriculum, policies, and practices. One hundred and sixteen participants were recruited through the New York Association of School Psychologists email listserve and completed a brief online…
Grossman, Arnold H.; Haney, Adam P.; Edwards, Perry; Alessi, Edward J.; Ardon, Maya; Howell, Tamika Jarrett
This qualitative study used five focus groups of lesbian, gay, bisexual, and transgender (LGBT) youth attending public high schools to examine their experiences with school violence. Core themes focused on lack of community and empowerment leading to youth being without a sense of human agency in school. Negative attention themes were indicative…
Kosciw, Joseph G.; Greytak, Emily A.; Diaz, Elizabeth M.; Bartkiewicz, Mark J.
For 20 years, GLSEN (Gay, Lesbian and Straight Education Network) has worked to ensure safe schools for all students, regardless of sexual orientation, gender identity or gender expression. For 10 of those years, GLSEN has been documenting the school experiences of lesbian, gay, bisexual and transgender (LGBT) youth: the prevalence of anti-LGBT…
Ceres, Marc; Quinn, Gwendolyn P; Loscalzo, Matthew; Rice, David
To describe the current state of cancer screening and uptake for lesbian, gay, bisexual, and transgender (LGBT) persons and to propose cancer screening considerations for LGBT persons. Current and historic published literature on cancer screening and LGBT cancer screening; published national guidelines. Despite known cancer risks for members of the LGBT community, cancer screening rates are often low, and there are gaps in screening recommendations for LGBT persons. We propose evidence-based cancer screening considerations derived from the current literature and extant cancer screening recommendations. The oncology nurse plays a key role in supporting patient preventive care and screening uptake through assessment, counseling, education, advocacy, and intervention. As oncology nurses become expert in the culturally competent care of LGBT persons, they can contribute to the improvement of quality of care and overall well-being of this health care disparity population. Copyright © 2017 Elsevier Inc. All rights reserved.
Margolies, Liz; Brown, Carlton G
To review the current state of knowledge about cancer in lesbians, gay, bisexual, and transgender (LGBT) people by focusing on four major issues across the cancer continuum including: 1) lack of data collection on sexual orientation and gender identity; 2) need for a culturally competent workforce; 3) the need for a culturally competent health care system; and 4) creating LGBT tailored patient/client information and education. Published literature. Oncology nurses and health care providers can work to improve the care of LGBT patients with cancer by following suggestions in this article. Oncology nurses and other health care providers have many distinct occasions to improve overall cancer care for LGBT patients. Copyright © 2017 Elsevier Inc. All rights reserved.
Eckstrand, Kristen L; Lunn, Mitchell R; Yehia, Baligh R
Lesbian, gay, bisexual, and transgender (LGBT) populations face numerous barriers when accessing and receiving healthcare, which amplify specific LGBT health disparities. An effective strategic approach is necessary for academic health centers to meet the growing needs of LGBT populations. Although effective organizational change models have been proposed for other minority populations, the authors are not aware of any organizational change models that specifically promote LGBT inclusion and mitigate access barriers to reduce LGBT health disparities. With decades of combined experience, we identify elements and processes necessary to accelerate LGBT organizational change and reduce LGBT health disparities. This framework may assist health organizations in initiating and sustaining meaningful organizational change to improve the health and healthcare of the LGBT communities.
Cornelius, Judith B; Enweana, Ijeoma; Alston, Celeste Kaysha; Baldwin, Dee M
Nursing students require academic and clinical training in preparation for the increased demand for culturally competent care. One group that is in need of culturally knowledgeable health care providers is lesbian, gay, bisexual, and transgender (LGBT) individuals. The purpose of this study was to examine how LGBT health care content is integrated into North Carolina schools of nursing curricula and to examine the existence of specific LGBT policies. A survey was mailed to 70 deans and directors of RN programs in North Carolina. Over 90% of the schools indicated that LGBT health care issues were taught in the curricula. The majority of the content was taught as an "other" course (37%). More than two thirds of the schools devoted less than 5 hours teaching LGBT content. LGBT health care content is being taught, yet the presence of specific LGBT practice policies is basically nonexistent. [J Nurs Educ. 2017;56(4):223-226.]. Copyright 2017, SLACK Incorporated.
Nagata, Jason M
In this commentary, I reflect on challenges with conducting global health research internationally as a lesbian, gay, bisexual, and transgender (LGBT) person, grapple with decisions related to coming out in regions with anti-LGBT laws, and outline the risks and benefits of different advocacy options related to the promotion of LGBT health globally. Despite significant advances in LGBT rights in many countries, homosexuality remains illegal in many others. Using a critical medical anthropology framework, I argue that anti-LGBT laws constitute structural violence and have many detrimental consequences including discrimination and violence; poorer mental and physical health outcomes; and risky sexual behaviors. As a global health provider, there are many options for the promotion of LGBT health worldwide.
Wu, Harold Y; Yin, Ophelia; Monseur, Brent; Selter, Jessica; Collins, Lillian J; Lau, Brandyn D; Christianson, Mindy S
To assess geographical distribution and practice characteristics of fertility clinics inclusive of lesbian, gay, bisexual, and transgender (LGBT) patients. Cross-sectional analysis. Not applicable. None. None. Prevalence and geographical distribution of fertility clinic websites with LGBT-specific content, indicated by keywords and home page cues specific to the LGBT patient population. Assessment of relationship between LGBT-specific content and clinic characteristics, including U.S. region, clinic size, private versus academic setting, and state-mandated fertility insurance coverage. Of 379 websites analyzed, 201 (53%) contained LGBT content. Clinics with the highest proportion of LGBT website content were in the Northeast (59/82, 72%) and West (63/96, 66%), while the lowest proportion was in the Midwest (29/74, 39%) and South (50/127, 39%). Most frequently used terms included lesbian (72%), LGBT/LGBTQ (69%), and gay (68%), while less used terms included trans/transgender (32%) and bisexual (15%). Larger clinic size was associated with LGBT-specific website content (odds ratio, 4.42; 95% confidence interval, 2.07-9.67). Practice type and state-mandated fertility insurance coverage were not associated with a clinic website having LGBT content. Over half of Society for Assisted Reproductive Technology member fertility clinics included LGBT content on their websites, yet those in the Midwest and South were significantly less likely to do so. Predictive factors for having LGBT website content included location in northeastern and western regions and increasing clinic size. Further studies are needed to evaluate whether inclusion of LGBT content on clinic websites impacts use of reproductive services by the LGBT patient population. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Kitts, Robert Li
The objective of this article was to identify barriers to optimal care between physicians and LGBTQ (lesbian, gay, bisexual, transgender, and questioning) adolescents. To this end, 464 anonymous, self-administered surveys were distributed in 2003 to residents and attending physicians in pediatrics, internal medicine, obstetrics-gynecology, psychiatry, emergency medicine, and family practice at Upstate Medical University. The survey included questions pertaining to practice, knowledge, and attitude pertaining to lesbian, gay, transgender, or questioning (LGBTQ) adolescents. One hundred eight four surveys were returned. The majority of physicians would not regularly discuss sexual orientation, sexual attraction, or gender identity while taking a sexual history from a sexually active adolescent. As well, the majority of physicians would not ask patients about sexual orientation if an adolescent presented with depression, suicidal thoughts, or had attempted suicide. If an adolescent stated that he or she was not sexually active, 41% of physicians reported that they would not ask additional sexual health-related questions. Only 57% agreed to an association between being a LGBTQ adolescent and suicide. The majority of physicians did not believe that they had all the skills they needed to address issues of sexual orientation with adolescents, and that sexual orientation should be addressed more often with these patients and in the course of training. This study concludes that barriers in providing optimal care for LGBTQ adolescents can be found with regard to practice, knowledge, and attitude regardless of medical field and other demographics collected. Opportunities exist to enhance care for LGBTQ adolescents.
Bolderston, A.; Ralph, S.
Systematic discrimination against lesbian, gay, bisexual and transgender people (LGBT) persists across most contemporary societies and institutions such as health care despite increasing social tolerance and legislative progress. This article explores discrimination against LGBT people, and examines LGBT health and social issues. The implications this has for health care access and quality of care delivered by patient-facing health care professionals such as radiographers are explored. Finally, three categories of suggestions to improve the care of LGBT patients are suggested; changes to the physical environment, improvement in health forms and awareness training. Some of these suggestions can be taken up directly by radiographers, particular accessing training. Others (such as positive changes in the physical space) could be championed by department managers. There is a need to promote better culturally competent training for radiographers to be able to sensitively respond to their LGBT patients' specific health and social needs. - Highlights: • Lesbian, gay, bisexual and trans people can encounter health care discrimination. • Patient-facing professionals like radiographers routinely work with LGBT patients. • Positive changes can be made to improve patient care and access. • These include changes to the environment, health form improvement and training.
Goldbach, Jeremy T; Castro, Carl Andrew
Lesbian, gay, and bisexual service members can serve openly in the military with the repeal of the Don't Ask, Don't Tell policy. The fate of transgender service members remains uncertain as the policy preventing them from serving in the military remains under review. The health care needs of these populations remain for the most part unknown, with total acceptance and integration in the military yet to be achieved. In this paper, we review the literature on the health care needs of lesbian, gay, bisexual, and transgender (LGBT) service members, relying heavily on what is known about LGBT civilian and veteran populations. Significant research gaps about the health care needs of LGBT service members are identified, along with recommendations for closing those gaps. In addition, recommendations for improving LGBT acceptance and integration within the military are provided.
Green, Michael; Bobrowicz, Ania; Ang, Chee Siang
Computer-mediated communication has become a popular platform for identity construction and experimentation as well as social interaction for those who identify as lesbian, gay, bisexual or transgender (LGBT). The creation of user-generated videos has allowed content creators to share experiences on LGBT topics. With bullying becoming more common amongst LGBT youth, it is important to obtain a greater understanding of this phenomenon. In our study, we report on the analysis of 151 YouTube vid...
White, William; Brenman, Stephanie; Paradis, Elise; Goldsmith, Elizabeth S; Lunn, Mitchell R; Obedin-Maliver, Juno; Stewart, Leslie; Tran, Eric; Wells, Maggie; Chamberlain, Lisa J; Fetterman, David M; Garcia, Gabriel
Phenomenon: Lesbian, gay, bisexual, and transgender (LGBT) individuals face significant barriers in accessing appropriate and comprehensive medical care. Medical students' level of preparedness and comfort caring for LGBT patients is unknown. An online questionnaire (2009-2010) was distributed to students (n = 9,522) at 176 allopathic and osteopathic medical schools in Canada and the United States, followed by focus groups (2010) with students (n = 35) at five medical schools. The objective of this study was to characterize LGBT-related medical curricula, to determine medical students' assessments of their institutions' LGBT-related curricular content, and to evaluate their comfort and preparedness in caring for LGBT patients. Of 9,522 survey respondents, 4,262 from 170 schools were included in the final analysis. Most medical students (2,866/4,262; 67.3%) evaluated their LGBT-related curriculum as "fair" or worse. Students most often felt prepared addressing human immunodeficiency virus (HIV; 3,254/4,147; 78.5%) and non-HIV sexually transmitted infections (2,851/4,136; 68.9%). They felt least prepared discussing sex reassignment surgery (1,061/4,070; 26.1%) and gender transitioning (1,141/4,068; 28.0%). Medical education helped 62.6% (2,669/4,262) of students feel "more prepared" and 46.3% (1,972/4,262) of students feel "more comfortable" to care for LGBT patients. Four focus group sessions with 29 students were transcribed and analyzed. Qualitative analysis suggested students have significant concerns in addressing certain aspects of LGBT health, specifically with transgender patients. Insights: Medical students thought LGBT-specific curricula could be improved, consistent with the findings from a survey of deans of medical education. They felt comfortable, but not fully prepared, to care for LGBT patients. Increasing curricular coverage of LGBT-related topics is indicated with emphasis on exposing students to LGBT patients in clinical settings.
Mavhandu-Mudzusi, Azwihangwisi Helen; Sandy, Peter Thomas
This paper reports on the stigma and discrimination experienced by lesbian, gay, bisexual and transgender students at a rural university in South Africa. Twenty lesbian, gay, bisexual and transgender students recruited through snowball sampling participated in this study. Interpretative Phenomenological Analysis was used as a framework for data analysis. Findings indicate that religion-related stigma and discrimination are common at a rural-based university in South Africa. Lesbian, gay, bisexual and transgender students are typically ascribed a range of labels, including 'sinners', 'devils' and 'demon possessed'. They are also exposed to a number of discriminatory acts, such as the denial of financial and healthcare services and threats of and/or actual rape. Study participants reported attempts to convert lesbian, gay, bisexual and transgender students' sexual orientation which involved the use of intervention in the form of prayers. Derogatory labelling and associated discriminatory acts, for example the threat of rape, led many students to conceal their sexual identity, not attend specific classes, terminate their studies and even attempt suicide. Universities should develop policies to promote greater social inclusion and the acceptance of lesbian, gay, bisexual and transgender students. Policies should also specify the steps or approaches to be taken in addressing discriminatory practices.
Aguilar, Elizabeth; Fried, Jacquelyn
Although cultural competence education is being incorporated into most health care curricula, content addressing sexual minorities is lacking or, if present, inadequate. This void can result in compromised health care and can contribute to the social stigma surrounding the lesbian, gay, bisexual and transgender (LGBT) community. Increasing the knowledge and demystifying sexual minority issues can enhance the confidence and attitudes of health care workers when treating LGBT individuals. Suggestions for creating a more welcoming health care environment for LGBT individuals in different health care settings such as private clinics, public health settings and school based programs are offered. The purpose of this literature review was to systematically review available literature on health care providers' delivery of culturally competent care to the LGBT community. The investigators searched electronic databases that included Medline (Ovid), Eric and PubMed with consultation from information specialists at the Health Sciences and Human Services Library at the University of Maryland. The information was categorized into content areas. Discussion of the findings and future directions regarding health care delivery for the LGBT community are provided. Copyright © 2015 The American Dental Hygienists’ Association.
Lee, Joseph G L
Lesbian, gay, bisexual, and transgender (LGBT) people are more likely to use tobacco products than heterosexual people. This results in disproportionate death and disability for LGBT communities. Yet, addressing the tobacco epidemic is generally low on the agenda of LGBT community organizations, and LGBT individuals report lower levels of support for some evidence-based tobacco prevention and control policies than heterosexuals. Informed by agenda-setting theory, this study investigated coverage of the tobacco epidemic in LGBT news blogs. Sixteen blogs and 105 tobacco-related posts from 2003 to March 9, 2013, were identified, and a quantitative content analysis was conducted. Coverage of the tobacco epidemic was primarily concentrated in four blogs and focused on the epidemiology of the epidemic and on tobacco-related policies. Little coverage focused on the tobacco industry, addiction, or health effects. A substantial minority of coverage focused on socially conservative arguments comparing smoking to homosexuality as a lifestyle choice. Thirty-three organizations working on LGBT tobacco prevention and control were present in blog posts. LGBT news blogs have a potentially important and mostly untapped role in tobacco-related media advocacy. LGBT health advocates would do well to cultivate relationships with LGBT bloggers as well as include bloggers in dissemination and media strategy efforts.
Rostosky, Sharon S; Black, Whitney W; Riggle, Ellen D B; Rosenkrantz, Dani
Research on heterosexual allies has focused on heterosexual identity development models and pathways to ally activism. The positive aspects or positive experiences of identifying as an ally to lesbian, gay, bisexual, and transgender (LGBT) identified individuals and communities have received little attention. Using an online survey of participants recruited from LGBT ally related social media, we collected open-ended responses to a question about the positive aspects of self-identifying as a heterosexual ally. A final analytic sample of 292 self-identified male and female heterosexual adults (age 18-71, M = 33.47, SD = 13.32) provided responses that generated 8 themes. Positive aspects of being a heterosexual ally were: (a) increased knowledge and awareness, (b) upholding values of justice, (c) beneficial individual relationships, (d) community belonging, (e) educating others, (f) being a role model, (g) using social privilege, and (h) speaking out and taking a stand. The findings suggest that being a heterosexual ally is rewarding and may enhance individual well-being. These findings provide information that may contribute to effective ally development efforts. (c) 2015 APA, all rights reserved).
Fallin, Amanda; Neilands, Torsten B.; Jordan, Jeffrey W.
Introduction: Lesbian, gay, bisexual, and transgender (LGBT) individuals are more likely to smoke than the general population. This study evaluated a Social Branding intervention, CRUSH, which included an aspirational brand, social events, and targeted media to discourage smoking among LGBT young adults in Las Vegas, NV. Methods: Cross-sectional surveys (N = 2,395) were collected in Las Vegas LGBT bars at 2 time points 1 year apart. Multivariate logistic regressions examined associations between campaign exposure, message understanding, and current (past 30 days) smoking, controlling for demographics. Results: LGBT individuals were significantly more likely to report current (past 30 day) smoking than heterosexual/straight, gender-conforming participants. Overall, 53% of respondents reported exposure to CRUSH; of those exposed, 60% liked the campaign, 60.3% reported they would attend a CRUSH event on a night when they usually went somewhere else, and 86.3% correctly identified that the campaign was about “partying fresh and smokefree.” Current smoking was reported by 47% of respondents at Time 1 and 39.6% at Time 2. There were significant interactions between time and campaign exposure and campaign exposure and understanding the message. Among those who understood the CRUSH smokefree message, the highest level of campaign exposure was significantly associated with 37%–48% lower odds for current smoking. Conclusions: While longitudinal studies would better assess the impact of this intervention, CRUSH shows promise to reduce tobacco use among LGBT bar patrons. PMID:26180223
Gowen, L Kris; Winges-Yanez, Nichole
Sexuality education is perceived as one way to prevent unhealthy sexual behaviors. However, current sexuality education materials are not tailored to fit the needs of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth, and many have been critiqued for disenfranchising these populations. This study solicited the perspectives of LGBTQ youth on their experiences with school-based sexuality education in order to create a framework of LGBTQ-inclusive sexuality education. Five semistructured focus groups (N = 30 LGBTQ participants) were conducted to investigate the sexuality education experiences of LGBTQ youth and to solicit youth suggestions for improving the inclusiveness of sexuality education curricula. Results indicate that LGBTQ youth perceive current sexuality education as primarily "exclusive," although examples of "inclusive" sexuality education were provided. In addition, participants provided suggestions for creating a more inclusive experience, such as directly discussing LGBTQ issues, emphasizing sexually transmitted infection (STI) prevention over pregnancy prevention, and addressing healthy relationships. Educators and policymakers can use these ideas to help improve the quality of sexuality education-not only to make it more inclusive for LGBTQ youth but to make sexuality education more inclusive for all young people.
Very little is known about the experiences of lesbian, gay, bisexual, and transgender (LGBT) people in relation to mental health services. Therefore, the overall aim of the current research was to explore LGBT people\\'s experiences of mental health service provision in Ireland. The objectives were to identify barriers and opportunities, to highlight service gaps, and to identify good practice in addressing the mental health and well-being of LGBT people. A mixed methods research design using quantitative and qualitative approaches was deployed. A multipronged sampling strategy was used and 125 respondents responded to the questionnaire. A subset of phase 1 (n = 20) were interviewed in the qualitative phase. Quantitative data was analyzed using descriptive statistics. Qualitative data were analyzed thematically. The sample consisted of LGBT people (n = 125) over 18 years of age living in Ireland. Over three-quarters (77%) had received a psychiatric diagnosis. Findings include that whilst 63% of respondents were able to be \\'out\\' to practitioners, 64% felt that mental health professionals lacked knowledge about LGBT issues and 43% felt practitioners were unresponsive to their needs. Finally, respondent recommendations about how mental health services may be more responsive to LGBT people\\'s needs are presented.
Lee, Joseph G. L.; Matthews, Alicia K.; McCullen, Cramer A.; Melvin, Cathy L.
Context Lesbian, gay, bisexual, and transgender (LGBT) people are at increased risk for the adverse effects of tobacco use given their high prevalence of use, especially smoking. Evidence regarding cessation is limited. To determine if efficacious interventions are available and to aid the development of interventions, a systematic review was conducted of gray and peer-reviewed literature describing clinical, community, and policy interventions as well as knowledge, attitudes, and behaviors regarding tobacco use cessation among LGBT people. Evidence acquisition Eight databases for articles from 1987 to April 23, 2014 were searched. In February–November 2013, authors and researchers were contacted to identify gray literature. Evidence synthesis The search identified 57 records, of which 51 were relevant and 22 were from the gray literature; these were abstracted into evidence tables, and a narrative synthesis was conducted in October–May 2014. Group cessation curricula tailored for LGBT populations were found feasible to implement and show evidence of effectiveness. Community interventions have been implemented by and for LGBT communities; although these interventions showed feasibility, no rigorous outcome evaluations exist. Clinical interventions show little difference between LGBT and heterosexual people. Focus groups suggest that care is needed in selecting messaging used in media campaigns. Conclusions LGBT-serving organizations should implement existing evidence-based tobacco dependence treatment and clinical systems to support treatment of tobacco use. A clear commitment from government and funders is needed to investigate whether sexual orientation and gender identity moderate the impacts of policy interventions, media campaigns, and clinical interventions. PMID:25455123
Full Text Available This article explores the academic and social challenges experienced by students from the gay, lesbian, bisexual and transgender (glbt community on campus at a South African university. A qualitative study to investigate some of these academic and social challenges experienced by glbt students at a university campus was conducted. The population of the study was all students from glbt community on campus and a purposive sample of twelve (12 respondents was constituted and a semi-structured interview guide was designed and administered to all twelve (12 participants. Data were audio recorded and transcribed. Content analysis which is a method used to systematically analyse the meaning of communications was used to analyse data. Of central interest were the core themes that speakers referred to, the information or messages that they wanted to pass on to their audience. The findings suggest that glbt students grapple with issues such as labelling, sexual abuse, discrimination/marginalisation and unfairness in the allocation of resources such as accommodation. In response to these cancerous societal ills, the helping professions exhort practitioners to empower vulnerable populations, promote social justice, support client self-determination and keep abreast of current knowledge relevant to professional practice. This article concludes with a set of recommendations on some of the strategies to address the identified socio-academic challenges.
Huebner, David M; Thoma, Brian C; Neilands, Torsten B
Lesbian, gay, bisexual, and transgender (LGBT) adolescents are at increased risk for substance use, relative to their heterosexual counterparts. Although previous research has demonstrated that experiences of anti-LGBT harassment, discrimination, and victimization may explain some of this disparity, little is known about the mechanisms whereby such mistreatment leads to substance abuse. This study aimed to examine whether mechanisms suggested by the Social Development Model might explain the links between school-based victimization and substance use in this population. Five hundred and four ethnically diverse LGBT adolescents ages 14-19 reported their experiences with school victimization, substance abuse, school bonding, and deviant peer group affiliation. Anti-LGBT victimization in school was associated with substance abuse, and although causality cannot be established, structural equation modeling confirmed that the data are consistent with a theoretical model in which this association was mediated by increased affiliation with deviant peers. Preventive interventions for LGBT adolescents must not only attempt to make schools safer for these youth, but also help keep them engaged in healthy peer groups when they are confronted with mistreatment in school.
Fredriksen-Goldsen, Karen I.; Simoni, Jane M.; Kim, Hyun-Jun; Lehavot, Keren; Walters, Karina L.; Yang, Joyce; Hoy-Ellis, Charles P.
National health initiatives emphasize the importance of eliminating health disparities among historically disadvantaged populations. Yet, few studies have examined the range of health outcomes among lesbian, gay, bisexual, and transgender (LGBT) people. To stimulate more inclusive research in the area, we present the Health Equity Promotion Model—a framework oriented toward LGBT people reaching their full mental and physical health potential that considers both positive and adverse health-related circumstances. The model highlights (a) heterogeneity and intersectionality within LGBT communities; (b) the influence of structural and environmental context; and (c) both health-promoting and adverse pathways that encompass behavioral, social, psychological, and biological processes. It also expands upon earlier conceptualizations of sexual minority health by integrating a life course development perspective within the health-promotion model. By explicating the important role of agency and resilience as well as the deleterious effect of social structures on health outcomes, it supports policy and social justice to advance health and well-being in these communities. Important directions for future research as well as implications for health-promotion interventions and policies are offered. PMID:25545433
Anderson, Joan I; Patterson, April N; Temple, Henry J; Inglehart, Marita Rohr
The objectives of the study reported in this article were to assess dental student leaders' perceptions of educational efforts concerning lesbian, gay, bisexual, and transgender (LGBT) topics and the cultural climate concerning LGBT issues in dental schools in the United States and Canada. In addition, the perceptions of student leaders who self-identified as belonging to the LGBT community and of students with a heterosexual orientation were compared. Data were collected from 113 dental student leaders from twenty-seven dental schools in the United States and three in Canada. Fifty student leaders were females, and sixty-two were males. Only 13.3 percent of the respondents agreed that their dental education prepared them well to treat patients from LGBT backgrounds. The more the student leaders believed that their university has an honest interest in diversity, the better they felt prepared by their dental school program to treat patients from LGBT backgrounds (r=.327; pschools' administrations create a positive environment for students with LGBT orientations, the more they agreed that persons can feel comfortable regardless of their sexual orientation (r=.585; pschool administrators play an important role in ensuring that future care providers are well prepared to treat patients from LGBT backgrounds and that staff, faculty, students, and patients from these backgrounds are not discriminated against.
Sequeira, Gina M; Chakraborti, Chayan; Panunti, Brandy A
The lesbian, gay, bisexual, and transgender (LGBT) community is a diverse, underserved, and often stigmatized group that faces many barriers to accessing quality healthcare. Not only are few practicing physicians knowledgeable about and sensitive to the needs of LGBT patients, but medical school curricula include limited LGBT-related content. Our goals were to use LGBT-related educational sessions to gauge undergraduate medical students' interest and their perceptions of relevance and to eventually incorporate this topic into the curriculum. We provided 4 educational sessions to preclinical medical students at the Tulane University School of Medicine: 3 optional, 1-hour didactic sessions and 1 standardized patient encounter. Following sessions 1-3, students completed electronic feedback forms; we then analyzed their responses thematically. THE THEMATIC ANALYSIS OF STUDENT RESPONSES IDENTIFIED KEY THEMES: a current lack of exposure to LGBT content, agreement that LGBT material is applicable to students' work as future physicians, and the relevance of including such information in the medical school curriculum. The study validated the underlying assumption that LGBT educational sessions are meaningful to and valued by medical students.
Eliason, Michele J; Dibble, Suzanne L; Robertson, Patricia A
Little is known about the experiences of lesbian, gay, bisexual, and transgender (LGBT) physicians in the workplace. There is little formal education in medical school about LGBT issues, and some heterosexual physicians have negative attitudes about caring for LGBT patients or working with LGBT coworkers, setting the stage for an exclusive and unwelcoming workplace. The current study used an online survey to assess a convenience sample of 427 LGBT physicians from a database of a national LGBT healthcare organization, as well as a snowball sample generated from the members of the database. Although rates of discriminatory behaviors had decreased since earlier reports, 10% reported that they were denied referrals from heterosexual colleagues, 15% had been harassed by a colleague, 22% had been socially ostracized, 65% had heard derogatory comments about LGBT individuals, 34% had witnessed discriminatory care of an LGBT patient, 36% had witnessed disrespect toward an LGBT patient's partner, and 27% had witnessed discriminatory treatment of an LGBT coworker. Few had received any formal education on LGBT issues in medical school or residency. It appears that medical schools and health care workplaces continue to ignore LGBT issues and operate in discriminatory fashion far too often.
Huebner, David M.; Thoma, Brian C.; Neilands, Torsten B.
Lesbian, gay, bisexual, and transgender (LGBT) adolescents are at increased risk for substance use, relative to their heterosexual counterparts. Although previous research has demonstrated that experiences of anti-LGBT harassment, discrimination, and victimization may explain some of this disparity, little is known about the mechanisms whereby such mistreatment leads to substance abuse. This study aimed to examine whether mechanisms suggested by the Social Development Model might explain the links between school-based victimization and substance use in this population. Five hundred and four ethnically diverse LGBT adolescents ages 14–19 reported their experiences with school victimization, substance abuse, school bonding, and deviant peer group affiliation. Anti-LGBT victimization in school was associated with substance abuse, and although causality cannot be established, structural equation modeling confirmed that the data are consistent with a theoretical model in which this association was mediated by increased affiliation with deviant peers. Preventive interventions for LGBT adolescents must not only attempt to make schools safer for these youth, but also help keep them engaged in healthy peer groups when they are confronted with mistreatment in school. PMID:25529390
Ash, Marcia; Mackereth, Catherine
Health needs assessment is a fundamental tool in public health practice. It entails the identification of needs from a range of perspectives, including epidemiological data, the views of local and professional people, and the comparative needs of the group under consideration. This paper describes the process undertaken with the lesbian, gay, bisexual and transgender (LGBT) population of an area in the north-east of England. The findings were used to inform and influence commissioners and service providers about services and interventions that will address these needs, and bring about better emotional and mental health and wellbeing as identified by LGBT people themselves. Research shows that there are great inequalities in the experience of these groups when compared with the heterosexual population. This was confirmed by the local LGBT communities. Consultation with the LGBT population showed that they experience ongoing stigma and discrimination, despite the greater apparent acceptance of diversity within the community. Recommendations were identified, which particularly focus on increasing the visibility of these groups, highlighting training issues and addressing generic or specialist services, in order to reduce discrimination.
Zelle, Andraya; Arms, Tamatha
The 1.5 million older adults who self-identify as lesbian, gay, bisexual, and transgender (LGBT) are expected to double in number by 2030. Research suggests that health disparities are closely linked with societal stigma, discrimination, and denial of civil and human rights. More LGBT older adults struggle with depression, substance abuse, social isolation, and acceptance compared to their heterosexual counterparts. Despite individual preferences, most health care providers recognize the right of any individual to have access to basic medical services. The U.S. Department of Health and Human Services requires that all hospitals receiving funds from Medicare and Medicaid respect visitation and medical decision-making rights to all individuals identifying as LGBT. The Joint Commission also requires a non-discrimination statement for accreditation. The current literature review examines LGBT health disparities and the consequential psychosocial impact on LGBT older adults as well as brings awareness to the needs of this underserved and underrepresented population. Copyright 2015, SLACK Incorporated.
Full Text Available Sally StevensSouthwest Institute for Research on Women (SIROW and Department of Gender and Women’s Studies (GWS, University of Arizona, Tucson, AZ, USAAbstract: Research on the incidence, etiology and substance abuse treatment needs of lesbian, bisexual and transgender (LBT women is limited. Most research indicates higher levels of alcohol and drug abuse among these populations compared to their heterosexual counterparts, with recent research indicating that substance abuse is a particular concern for transgender individuals and an increasing problem among younger LBT individuals. Risk factors and reasons for substance abuse among sexual minority women are similar to those of heterosexual women, yet are substantially complicated by issues of family rejection and lack of social support, stigma and minority stress, as well as abuse and harassment. Historically, substance abuse prevention, early intervention, and clinical treatment programs were designed to meet the needs of the sexual majority population with relatively few programs designed to incorporate the specific needs of sexual minorities. This article reviews findings from previous studies and utilizes new data collected from community-based and residential substance abuse treatment programs to (1 examine issues relevant to LBT women and substance use, and (2 make recommendations for tailoring substance abuse treatment programs to meet the needs of these populations.Keywords: lesbian, bisexual, transgender, substance abuse, family rejection, social support, stigma, minority stress, abuse, harassment
Klotzbaugh, Ralph; Glover, Eileen
To develop an understanding of lesbian-, gay-, bisexual-, transgender-specific mental health and substance abuse needs in rural populations and to improve data about sexual orientation and gender identity. Existing literature on mental health needs for lesbian, gay, bisexual and transgender populations has continued to reveal higher levels of need. Research has also demonstrated that few mental health providers have expertise or comfort in treating lesbian, gay, bisexual and transgender clients. Descriptive correlational study. A sample (n = 456) of patient records admitted to a rural lesbian, gay, bisexual and transgender inpatient psychiatric clinic over 12 months were examined using descriptive statistics. Patient zip code information was used to determine the levels of rurality. Chi-square analysis was used to determine relationships between sexual orientation, rural/urban distinctions and concomitant drug use. Unexpectedly, those who identified as heterosexual were significantly more likely to concomitantly abuse alcohol and heroin than those who identified as lesbian, gay, bisexual and transgender. Patients residing in small or isolated rural areas were more likely to abuse alcohol or synthetics than those residing in urban or micropolitan areas. Results of this study concerning substance abuse among lesbian, gay, bisexual and transgender individuals are not reflective of prior studies. LGBT patients did not demonstrate a higher proportion of substance abuse compared with those identifying as heterosexual. Increased substance abuse among those from rural isolated areas does support prior studies. The context of gathering demographic information on sexual orientation was thought by staff to increase the number of those identifying as heterosexual. Context in which sensitive questions are asked may affect the accuracy of demographic data. Lack of information regarding patients' sexual orientation or gender identity may impact perceived need for
Sell, Randall L; Dunn, Patricia M
Researchers and public health advocates have long recognized the importance of demographic characteristics such as sex, race, ethnicity, age, and socioeconomic status in their efforts to understand and control the use of tobacco among population groups. Targeting prevention and cessation efforts based upon such characteristics has consistently been demonstrated to be both efficient and effective. In recent years, attention has modestly turned to how two additional demographic variables, sexual orientation and gender identity, can add to our understanding of how to reduce tobacco use. Research of tobacco industry papers has clearly documented targeted media campaigns to encourage smoking among lesbians and gays in the marketplace. The tobacco industry has long understood the role that sexual orientation can play in the uptake of smoking and the targeted marketing of brands. Those concerned with tobacco use prevention and cessation research have consequently responded to address tobacco use by lesbians and gays, and bisexuals and transgender people as well, but even more can be done. This article reviews what is known about smoking in lesbian, gay, bisexual, and transgender populations and then reviews recommendations from four panels created to examine this topic. In conclusion, we recommend that sexual orientation and gender identity be considered for inclusion as variables in all major research and epidemiological studies of tobacco use. Just as such studies, without hesitation, measure sex, race, ethnicity, age, and socioeconomic status, they need to also include questions assessing sexual orientation and gender identity. Although these new variables need not be the primary focus of these studies, at a minimum, considering their use as controlling variables should be explored. Lesbian, gay, bisexual, and transgender people can benefit from being openly included in the work researchers conduct to inform the design of tobacco control programs and policies.
Strong, Kristy L; Folse, Victoria N
Lesbian, gay, bisexual, and transgender (LGBT) patients experience barriers to health care that include fear of discrimination, as well as insensitivity and lack of knowledge about LGBT-specific health needs among providers. This study examined the effectiveness of an educational intervention designed to improve knowledge and attitudes of baccalaureate nursing students regarding LGBT patient care. Education focused on key terminology, health disparities, medical needs of transgender patients, and culturally sensitive communication skills for competent LGBT patient care. Knowledge level and attitudes were evaluated before and after the intervention using a survey based on a modified Attitudes Toward Lesbians and Gay Men Scale and two assessment tools developed for this study. A statistically significant increase in positive attitudes and knowledge level was found immediately after the intervention. Findings from this study support the inclusion of education related to LGBT patient health care in undergraduate nursing curricula to promote cultural competence and sensitivity. Copyright 2015, SLACK Incorporated.
Ewton, Tiffany A; Lingas, Elena O
Lesbian, gay, bisexual, and transgender (LGBT) medical providers in the United States have historically faced discrimination from their peers. To assess current workplace culture and attitudes, and to evaluate awareness of workplace and professional policies regarding LGBT discrimination, we sent a cross-sectional survey to 163 PAs (Physician Assistants). Respondents had an overall positive attitude towards LGBT providers, yet the majority was not aware of relevant policy statements (>60%). A significant association existed between policy awareness and LGBT inclusivity (Pharassment (P=.017). Despite improved societal attitudes toward LGBT providers, non-discriminatory work environments for LGBT physician assistants may relate to greater awareness of specific workplace policy standards.
Sullivan, Kathleen M
The social environment impacts the ability of older adults to interact successfully with their community and age-in-place. This study asked, for the first time, residents of existing Lesbian, Gay, Bisexual, and Transgender (LGBT) senior living communities to explain why they chose to live in those communities and what, if any, benefit the community afforded them. Focus groups were conducted at 3 retirement communities. Analysis found common categories across focus groups that explain the phenomenon of LGBT senior housing. Acceptance is paramount for LGBT seniors and social networks expanded, contrary to socioemotional selectivity theory. Providers are encouraged to develop safe spaces for LGBT seniors.
Cloyes, Kristin G; Hull, William; Davis, Andra
To identify the unique needs of lesbian, gay, bisexual, and transgender (LGBT) cancer patients and caregivers, and review recommendations supporting more effective and inclusive palliative and end-of-life care. Published research and clinical guidelines. Transitions in care raise particular challenges for LGBT patients, including provider communication, perceptions of safety and acceptance, and assessing and respecting patients' definitions of family and spirituality. LGBT patients and their caregivers need competent nurses to support them, especially during transitions. Implementing LGBT-inclusive education, training, and practice will improve outcomes for LGBT cancer patients and their caregivers - and potentially all patients. Copyright © 2017 Elsevier Inc. All rights reserved.
Fallin, Amanda; Neilands, Torsten B; Jordan, Jeffrey W; Ling, Pamela M
Lesbian, gay, bisexual, and transgender (LGBT) individuals are more likely to smoke than the general population. This study evaluated a Social Branding intervention, CRUSH, which included an aspirational brand, social events, and targeted media to discourage smoking among LGBT young adults in Las Vegas, NV. Cross-sectional surveys (N = 2,395) were collected in Las Vegas LGBT bars at 2 time points 1 year apart. Multivariate logistic regressions examined associations between campaign exposure, message understanding, and current (past 30 days) smoking, controlling for demographics. LGBT individuals were significantly more likely to report current (past 30 day) smoking than heterosexual/straight, gender-conforming participants. Overall, 53% of respondents reported exposure to CRUSH; of those exposed, 60% liked the campaign, 60.3% reported they would attend a CRUSH event on a night when they usually went somewhere else, and 86.3% correctly identified that the campaign was about "partying fresh and smokefree." Current smoking was reported by 47% of respondents at Time 1 and 39.6% at Time 2. There were significant interactions between time and campaign exposure and campaign exposure and understanding the message. Among those who understood the CRUSH smokefree message, the highest level of campaign exposure was significantly associated with 37%-48% lower odds for current smoking. While longitudinal studies would better assess the impact of this intervention, CRUSH shows promise to reduce tobacco use among LGBT bar patrons. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: email@example.com.
Full Text Available This paper discusses the social networks that is done by Ardhanary Institute LBT Women (Lesbian, Bisexual, Transgender organization in Jakarta. With the thesis that the environment in Indonesia are not permissive and cons with the presence of LGBT / LBT this organization even dare to "coming out", if it is not supported by an enabling environment through social networks. This discussion describes the social networks that made this organization, from building social relationships between actors / individuals up with foreign institutions (international and domestic, as well as with the mass media.As the study of anthropology, then more emphasis on the social network that is descriptive, not at the level of analytics. Data collection technique was not through measurement but more in the process of intensive observations, in-depth interviews and participatory observation. Using an ethnographic feminist approach, where the relationships globally can only be understood in the " real materials interlocked closely in the everyday encounter", namely action and everyday practicewhich became the subject of ethnography research.Conclusions: 1. The social network that is done by Ardhanary Institute organization through a relationship between actors and LBT/LGBT organizations in these areas. Externally also through multiple agencies (domestic and foreign. The actor, who is in this organization as a motivator, facilitator, and inspirator as well as the implications effect "struggling" for the movement of other LBT organizations in Indonesia 2. This organization is actively building a broader network through cooperation with other women's organizations, crisis centers, health care providers, safe houses, legal aid organizations and the National Commission for Women. And build working relationships with law enforcement agencies in providing assistance to victims of LBT violence.
Lee, Joseph G L; Matthews, Alicia K; McCullen, Cramer A; Melvin, Cathy L
Lesbian, gay, bisexual, and transgender (LGBT) people are at increased risk for the adverse effects of tobacco use, given their high prevalence of use, especially smoking. Evidence regarding cessation is limited. To determine if efficacious interventions are available and to aid the development of interventions, a systematic review was conducted of grey and peer-reviewed literature describing clinical, community, and policy interventions, as well as knowledge, attitudes, and behaviors regarding tobacco use cessation among LGBT people. Eight databases for articles from 1987 to April 23, 2014, were searched. In February-November 2013, authors and researchers were contacted to identify grey literature. The search identified 57 records, of which 51 were included and 22 were from the grey literature; these were abstracted into evidence tables, and a narrative synthesis was conducted in October 2013-May 2014. Group cessation curricula tailored for LGBT populations were found feasible to implement and show evidence of effectiveness. Community interventions have been implemented by and for LGBT communities, although these interventions showed feasibility, no rigorous outcome evaluations exist. Clinical interventions show little difference between LGBT and heterosexual people. Focus groups suggest that care is needed in selecting the messaging used in media campaigns. LGBT-serving organizations should implement existing evidence-based tobacco-dependence treatment and clinical systems to support treatment of tobacco use. A clear commitment from government and funders is needed to investigate whether sexual orientation and gender identity moderate the impacts of policy interventions, media campaigns, and clinical interventions. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Shiu, Chengshi; Muraco, Anna; Fredriksen-Goldsen, Karen
Lesbian, gay, bisexual, and transgender (LGBT) older adult caregivers may encounter obstacles in obtaining health and aging services due to discrimination in service and legal systems. The caregiving relationships in LGBT communities also differ from the general population in that friends are providing a large portion of informal care. This article examines how the relational context of caregiving relates to caregiving demands and resources, which in turn, influence perceived stress and depressive symptomatology among older LGBT caregivers. Using data from the National Health, Aging, and Sexuality Study: Caring and Aging with Pride, this study examines 451 participants who are providing caregiving to partners and friends. Structural equation modeling was applied to estimate the associations among the caregiver-care recipient relationship and caregiving demands, resources, perceived stress, and depressive symptomatology. On average, as compared with those caring for partners, those who provided care to friends reported experiencing lower levels of caregiving demands and lower levels of social support. The lower caregiving demands correlated positively with both lower perceived stress and less severe depressive symptomatology; however, the lower levels of social support were related to higher perceived stress and higher depressive symptomatology. Caregiving provided by friends, which has long been under recognized, plays an important role in the LGBT community. Because lower levels of caregiving demands are offset by less social support, LGBT friend-caregivers experience similar levels of perceived stress and depressive symptomatology to those providing care to spouses and partners. Policy and service reforms are needed to better acknowledge the continuum of informal caregiving relationships.
Joseph G L Lee
Full Text Available Research on the health of lesbian, gay, bisexual, and transgender (LGBT populations can provide important information to address existing health inequalities. Finding existing research in LGBT health can prove challenging due to the plethora of terminology used. We sought to describe existing search strategies and to identify more comprehensive LGBT search terminology. We iteratively created a search string to identify systematic reviews and meta-analyses about LGBT health and implemented it in Embase, PubMed/MEDLINE, and PsycINFO databases on May 28-29, 2015. We hand-searched the journal LGBT Health. Inclusion criteria were: systematic reviews and meta-analyses that addressed LGBT health, used systematic searching, and used independent coders for inclusion. The published search terminology in each record and search strings provided by authors on request were cross-referenced with our original search to identify additional terminology. Our search process identified 19 systematic reviews meeting inclusion criteria. The number of search terms used to identify LGBT-related records ranged from 1 to 31. From the included studies, we identified 46 new search terms related to LGBT health. We removed five search terms as inappropriate and added five search terms used in the field. The resulting search string included 82 terms. There is room to improve the quality of searching and reporting in LGBT health systematic reviews. Future work should attempt to enhance the positive predictive value of LGBT health searches. Our findings can assist LGBT health reviewers in capturing the diversity of LGBT terminology when searching.
Graybill, Emily C; Proctor, Sherrie L
Many lesbian, gay, bisexual, and transgender (LGBT) youth experience harassment and discrimination in schools and these experiences lead to increased negative social-emotional outcomes. Youth who can identify at least one supportive adult at school report better outcomes than youth who cannot identify a safe adult. Yet, many educators report feeling uncomfortable or unprepared to support LGBT youth. One reason for educators' discomfort may be that content related to issues unique to LGBT youth is sometimes missing or covered minimally in university training programs. We hypothesized that LGBT content may be covered minimally in school support personnel journals, as well. This study analyzed eight school support personnel journals across the disciplines of school counseling, school nursing, school psychology, and school social work for LGBT content published between 2000 and 2014 to gain a better understanding of the visibility of LGBT issues in the research. Results suggested that there has been a lack of presence of LGBT issues in journals across disciplines. These results also suggest a need for an intentional focus on issues relevant to LGBT youth in school support personnel journals. Thus, the article concludes with an introduction to two articles in this special topic section, including Russell, Day, Ioverno, and Toomey's (in this issue) study on teacher perceptions of bullying in the context of enumerated school policies and other supportive sexual orientation and gender identity related practices and Poteat and Vecho's (in this issue) study on characteristics of bystanders in homophobic bullying situations. The broad goal of these three studies is to increase visibility of critical LGBT issues in school support personnel journals. Copyright © 2015 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
Kamen, Charles S; Smith-Stoner, Marilyn; Heckler, Charles E; Flannery, Marie; Margolies, Liz
To describe factors related to diagnosis, identity disclosure, and social support among lesbian, gay, bisexual, and transgender (LGBT) patients with cancer, and to explore associations between these factors and self-rated health. Cross-sectional self-report survey design using descriptive and exploratory multivariate statistical approaches. Online, Internet-based. 291 LGBT patients (89% Caucasian; 50% gay, 36% lesbian, 7% bisexual, 3% transgender) with mixed cancers. Participants completed a researcher-designed online survey assessing experiences of cancer diagnosis among LGBT patients at a single time point. Demographics, which provider(s) delivered the patients' cancer diagnoses, to whom patients had disclosed their LGBT identity, how they disclosed, who was on their social support team at the time of diagnosis, and current self-rated health. 79% of participants reported disclosing their identities to more than one cancer care provider. Participants most commonly introduced the topic of LGBT identity themselves, sometimes as a way to correct heterosexual assumptions (34%). Friends were the most common members of LGBT patients' support teams (79%). Four disclosure and support factors were consistently associated with better self-rated health. Disclosure of LGBT identity is a common experience in the context of cancer care, and disclosure and support factors are associated with better self-reported health among LGBT patients. Creating safe environments for LGBT patients to disclose could improve cancer care delivery to this underserved population. Nurses and other providers should acknowledge and include diverse support team members in LGBT patients' care.
On July 17-18, 2008, the National Education Association hosted the NEA National Summit on gay, lesbian, bisexual, and transgender (GLBT) Issues in Education in Chicago, Illinois. The purpose of the Summit was to gather leading researchers, scholars, and practitioners on GLBT issues in education to assess the status of GLBT students in the United…
This article is an analysis of picture books and chapter books involving lesbian, gay, bisexual, and/or transgender characters. Over 30 picture and chapter books were reviewed, each of which would be appropriate for use in elementary classrooms. For grades K-2, several picture books highlight different types of families, including families that…
McCormick, Adam; Schmidt, Kathryn; Clifton, Emily
Few studies have examined the effectiveness of gay-straight alliances (GSAs) on the social and academic experiences of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youths. The limited research on GSAs suggests that they are associated with positive youth development and increased safety; however, little qualitative information…
Ng, Cara Ky; Haines-Saah, Rebecca J; Knight, Rodney E; Shoveller, Jean A; Johnson, Joy L
In Canada, the issue of creating safe and inclusive school environments for lesbian, gay, bisexual, transgender, and queer students has been in the spotlight. Several researchers and advocates have pointed out the positive effects of lesbian, gay, bisexual, transgender, and queer-positive policy frameworks on the health and wellbeing of all young people. In this article, we take a critical approach to analyzing narrative findings from qualitative interviews conducted with youth in three communities in British Columbia, Canada: "the North," Vancouver, and Abbotsford. Using a Foucauldian Discourse Analytic Approach and Butler's concept of Citationality, our analysis suggested that although explicit homophobia was largely absent from youth discussions, young people discursively constructed lesbian, gay, bisexual, transgender, and queer identities and "communities" in ways that reified heteronormativity. Youth made references to sociopolitical discourses of libertarianism and liberalism and to homonormative stereotypes regarding gay masculinity. A few young people also alluded to egalitarian, queer-positive discourses, which appeared to interrogate structures of heteronormativity. Since studies suggest a connection between the existence of institutional supports for lesbian, gay, bisexual, transgender, and queer students in schools and their mental and physical wellbeing, we conclude by considering the limitations and possibilities of these sociopolitical discourses in the struggle for sexual and gender equity, and how they might help frame future health-related, anti-homophobia policy frameworks in educational settings.
Kosciw, Joseph G.; Greytak, Emily A.; Diaz, Elizabeth M.
This study examines how locational (region and locale), community-level (school district poverty and adult educational attainment), and school district-level (district size and ratios of students to key school personnel) variables are related to indicators of hostile school climate for lesbian, gay, bisexual, and transgender (LGBT) youth.…
Kosciw, Joseph G.; Diaz, Elizabeth M.
Current estimates indicate that there are more than 7 million lesbian, gay, bisexual and transgender (LGBT) parents with school-age children in the United States, yet little is known about the experiences of this growing number of LGBT-headed families in schools across the country. In order to fill this crucial gap in our knowledge of LGBT issues…
Gay, Lesbian and Straight Education Network (GLSEN), 2012
In 1999, the Gay, Lesbian and Straight Education Network (GLSEN) identified the need for national data on the experiences of lesbian, gay, bisexual, and transgender (LGBT) students and launched the first National School Climate Survey (NSCS). At the time, the school experiences of LGBT youth were under-documented and nearly absent from national…
Gay, Lesbian and Straight Education Network (GLSEN), 2010
For 20 years, GLSEN (Gay, Lesbian and Straight Education Network) has worked to ensure safe schools for all students, regardless of sexual orientation, gender identity or gender expression. For 10 of those years, GLSEN has been documenting the school experiences of lesbian, gay, bisexual and transgender (LGBT) youth: the prevalence of anti-LGBT…
Gay, Lesbian and Straight Education Network (GLSEN), 2009
In 2007, Gay, Lesbian and Straight Education Network (GLSEN) conducted the fifth National School Climate Survey (NSCS), a biennial survey of LGBT (lesbian, gay, bisexual and transgender) secondary school students. The NSCS examines the experiences of LGBT youth in U.S. middle and high schools, documenting bias and behaviors that make schools…
Lelutiu-Weinberger, Corina; Pachankis, John E.
Purpose: Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills.
Pedro, Kris Tunac De; Esqueda, Monica Christina
Military-connected youth often experience daily stressors that affect their academic success and social and emotional development. Stressors such as multiple deployments and frequent school transitions may weaken the social ties that military-connected youth have with school communities, placing them at risk of social alienation and victimization. Within this youth population, military-connected lesbian, gay, bisexual, and transgender (LGBT) youth may be especially at risk of school victimization. However, to the authors' knowledge, no empirical studies have been conducted on the school experiences of military-connected LGBT youth. Drawing from the California Healthy Kids Survey (CHKS; n = 634,978), this study explored school victimization and weapon carrying among military-connected LGBT youth and their peers. Multivariate logistic regression analyses revealed that military connection, LGB identity, and transgender identity were associated with an increased odds of nonphysical victimization, physical violence, and weapon carrying. Military transgender youth were at an increased risk of weapon carrying (adjusted odds ratio [AOR] = 1.63; 95% confidence interval [CI] = [1.23, 2.16]). Future research is needed to explore risk and protective factors influencing school victimization and weapon carrying among military-connected LGBT youth.
Obedin-Maliver, Juno; Goldsmith, Elizabeth S; Stewart, Leslie; White, William; Tran, Eric; Brenman, Stephanie; Wells, Maggie; Fetterman, David M; Garcia, Gabriel; Lunn, Mitchell R
Lesbian, gay, bisexual, and transgender (LGBT) individuals experience health and health care disparities and have specific health care needs. Medical education organizations have called for LGBT-sensitive training, but how and to what extent schools educate students to deliver comprehensive LGBT patient care is unknown. To characterize LGBT-related medical curricula and associated curricular development practices and to determine deans' assessments of their institutions' LGBT-related curricular content. Deans of medical education (or equivalent) at 176 allopathic or osteopathic medical schools in Canada and the United States were surveyed to complete a 13-question, Web-based questionnaire between May 2009 and March 2010. Reported hours of LGBT-related curricular content. Of 176 schools, 150 (85.2%) responded, and 132 (75.0%) fully completed the questionnaire. The median reported time dedicated to teaching LGBT-related content in the entire curriculum was 5 hours (interquartile range [IQR], 3-8 hours). Of the 132 respondents, 9 (6.8%; 95% CI, 2.5%-11.1%) reported 0 hours taught during preclinical years and 44 (33.3%; 95% CI, 25.3%-41.4%) reported 0 hours during clinical years. Median US allopathic clinical hours were significantly different from US osteopathic clinical hours (2 hours [IQR, 0-4 hours] vs 0 hours [IQR, 0-2 hours]; P = .008). Although 128 of the schools (97.0%; 95% CI, 94.0%-99.9%) taught students to ask patients if they "have sex with men, women, or both" when obtaining a sexual history, the reported teaching frequency of 16 LGBT-specific topic areas in the required curriculum was lower: at least 8 topics at 83 schools (62.9%; 95% CI, 54.6%-71.1%) and all topics at 11 schools (8.3%; 95% CI, 3.6%-13.0%). The institutions' LGBT content was rated as "fair" at 58 schools (43.9%; 95% CI, 35.5%-52.4%). Suggested successful strategies to increase content included curricular material focusing on LGBT-related health and health disparities at 77 schools (58
, and Transgender (LGBT) Pride Month Social Media Facebook Twitter Instagram 2015 Pride Month Poster transgender environment at the Defense Department over the past 20 years. Carter: Diversity, Inclusion Critical to Force of Future Embracing diversity and inclusion is critical to recruiting and retaining the
Full Text Available To date there has been minimal empirical inquiry on what may constitute inclusive learning environments for older (50+ years lesbian, gay, bisexual and transgendered (LGBT adults. This paper draws upon a recent life-histories study with older LGBT adults in Scotland to consider how such environments can be developed. To do so, intersectional analysis is applied to interrogate how participants' lived realities and sense of self are enabled and constrained by the interactions between their diverse ageing, LGBT and other identities in the particular contexts of later life, post work. The paper argues that by adopting this approach to intersectional analysis, critical educational gerontology (CEG is equipped to more effectively realise inclusive, meaningful and potentially empowering learning environments for older LGBT adults. These will be more attuned to their later life realities, enabling them to reflect on the changing significance of being LGBT as they age, while allowing potential for personal growth and renewed sense of self.
Zea, Maria Cecilia; Reisen, Carol A; Bianchi, Fernanda T; Gonzales, Felisa A; Betancourt, Fabián; Aguilar, Marcela; Poppen, Paul J
Colombia has endured six decades of civil unrest, population displacement and violence. We examined the relationships between contextual conditions, displacement and HIV among gay, bisexual and transgender individuals in Bogotá, Colombia. A total of 19 key informants provided information about internal displacement of sexual minorities. Life-history interviews were conducted with 42 participants aged 18 to 48 years and included questions about displacement experiences, sexual behaviour, life prior to displacement and participants' economic and social situation in Bogotá. The interplay of a variety of factors - including internal conflict and violence, homonegativity and 'social cleansing', gender and sexual identity and poverty - strongly shaped the varied experiences of displacement. Migration, sexual violence, exchange sex and low rates of HIV testing were risk factors that increased vulnerability for HIV in this displaced sample. Although displacement and HIV in Colombia are major problems, both are understudied.
Pomeranz, Jennifer L
Discrimination causes health inequities for stigmatized groups. Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals, in particular, are at significantly increased risk for disparate health outcomes when they reside in states that fail to extend equal protections to them or that actively deprive equal rights to them. Several states and the federal government have proposed or enacted laws that permit residents to discriminate against LGBTQ individuals. One such law, Arkansas's Intrastate Commerce Improvement Act of 2015, preempts or prohibits local governments from enacting civil rights protections for LGBTQ individuals that are also lacking at the state level. State laws such as Arkansas's undermine local control, damage the economy, and create injustices that harm LGBTQ people. I set forth 2 constitutional arguments to challenge such laws, and I provide information to help advocates support evidence-based policymaking and prevent the passage of similar laws in their states.
Ramirez-Valles, Jesus; Molina, Yamile; Dirkes, Jessica
Stigma negatively affects the health of people living with HIV/AIDS (PLWHA). Negative attitudes and discriminatory actions towards PLWHA are thought to be based, among other factors, on stigma towards sexual minorities and beliefs about personal responsibility. Yet, there is little evidence to support these linkages and explain how they take place, especially among Latinos. This study analyzes attitudes towards PLWHA among 643 Latino gay/bisexual men and transgender (GBT) people. It examines whether discriminatory actions are predicted by beliefs about personal responsibility and internalized homosexual stigma. Results indicate that Discriminatory Actions towards PLWHA is associated with HIV/AIDS Personal Responsibility Beliefs and Internalized Homosexual Stigma. Further, HIV/AIDS Personal Responsibility Beliefs partially mediates the relationship between Internalized Homosexual Stigma and Discriminatory Actions towards PLWHA. Latino GBT persons who have internalized negative views about homosexuality may project those onto PLWHA. They may think PLWHA are responsible for their serostatus and, hence, deserving of rejection. PMID:23631713
Keuroghlian, Alex S.; Shtasel, Derri; Bassuk, Ellen L.
A disproportionate number of lesbian, gay, bisexual and transgender (LGBT) youth experience homelessness each year in the United States. LGBT youth who are homeless have particularly high rates of mental health and substance use problems, suicidal acts, violent victimization, and a range of HIV risk behaviors. Given the intense needs of LGBT youth experiencing homelessness, it is imperative that we understand their unique experiences and develop responsive practices and policies. The range and severity of health risks vary across subgroups of all homeless LGBT youth, and since the population is nonhomogeneous their particular needs must be identified and addressed. Thus the purpose of this article is to review the causes of homelessness among LGBT youth, discuss the mental health and victimization risks faced by this population, address differences among homeless LGBT subgoups, and recommend effective interventions and best practices. We conclude by discussing promising future research and public policy directions. PMID:24826829
McClain, Zachary; Hawkins, Linda A; Yehia, Baligh R
Health outcomes are affected by patient, provider, and environmental factors. Previous studies have evaluated patient-level factors; few focusing on environment. Safe clinical spaces are important for lesbian, gay, bisexual, and transgender (LGBT) communities. This study evaluates current models of LGBT health care delivery, identifies strengths and weaknesses, and makes recommendations for LGBT spaces. Models are divided into LGBT-specific and LGBT-embedded care delivery. Advantages to both models exist, and they provide LGBT patients different options of healthcare. Yet certain commonalities must be met: a clean and confidential system. Once met, LGBT-competent environments and providers can advocate for appropriate care for LGBT communities, creating environments where they would want to seek care.
Ramirez-Valles, Jesus; Molina, Yamile; Dirkes, Jessica
Stigma negatively affects the health of people living with HIV/AIDS (PLWHA). Negative attitudes and discriminatory actions towards PLWHA are thought to be based, among other factors, on stigma towards sexual minorities and beliefs about personal responsibility. Yet, there is little evidence to support these linkages and explain how they take place, especially among Latinos. This study analyzes attitudes towards PLWHA among 643 Latino gay/bisexual men and transgender (GBT) people. It examines whether discriminatory actions are predicted by beliefs about personal responsibility and internalized homosexual stigma. Results indicate that Discriminatory Actions towards PLWHA is associated with HIV/AIDS Personal Responsibility Beliefs and Internalized Homosexual Stigma. Further, HIV/AIDS Personal Responsibility Beliefs partially mediates the relationship between Internalized Homosexual Stigma and Discriminatory Actions towards PLWHA. Latino GBT persons who have internalized negative views about homosexuality may project those onto PLWHA. They may think PLWHA are responsible for their serostatus and, hence, deserving of rejection.
H Logie, Carmen; Perez-Brumer, Amaya; Jenkinson, Jesse; Madau, Veli; Nhlengethwa, Winnie; Baral, Stefan
Swaziland has among the highest national adult HIV prevalence globally. There is limited knowledge of HIV vulnerabilities and prevention engagement among lesbian, gay, bisexual and transgender (LGBT) persons in the context of Swaziland's criminalization of consensual same-sex practices. This study explored social processes of marginalization to assess how they could potentiate HIV vulnerabilities and limit engagement in HIV prevention services. Additionally, we assessed positive change to better understand existing strategies employed by LGBT persons to challenge these HIV prevention barriers. Guided by community-based research methodology and conducted in Mbabane and Manzini, Swaziland, data were collected by LGBT peer-research assistants (PRA) in collaboration with an LGBT community organization in Manzini. Semi-structured interviews were conducted by trained PRAs and explored HIV prevention, including experiences of stigma and coping. Audio files were transcribed verbatim, translated to English, and analyzed using thematic techniques. Among participants (n = 51; mean age: 26.47, SD: 4.68), 40 self-identifed as gay or lesbian (78.4%), 11 bisexual (22.6%), and 12 (23.5%) identified as transgender. Findings highlighted three primary processes of marginalization and positive change in structural, community, and internal domains. First, structural marginalization, which included criminalization, healthcare discrimination, and a scarcity of LGBT tailored HIV prevention resources was challenged by grassroots networks created to access and share specific HIV resources with LGBT persons and the Ministry of Health. Second, community marginalization included stigma and multi-dimensional forms of violence, however, this was met with LGBT persons providing mutual peer support, including for accessing HIV testing services. Thirdly, internal marginalization comprised of self-stigma and associated sexual risk practices was contrasted with coping strategies focused on self
Coulter, Robert W S; Bersamin, Melina; Russell, Stephen T; Mair, Christina
We tested three competing models about whether gender- and sexuality-based harassment at school have nonindependent, additive, or interactive effects on adolescents' electronic cigarette use (i.e., vaping), cigarette smoking, alcohol use, and heavy episodic drinking (HED). We also tested whether harassment mediated substance use disparities between lesbian, gay, bisexual, transgender (LGBT) adolescents and their cisgender heterosexual peers. We analyzed cross-sectional data from the 2013-2014 California Healthy Kids Survey, including 316,766 students in grades 7, 9, and 11 from more than 1,500 middle and high schools. We used logistic regression models and interaction terms to estimate associations of past-year gender- and sexuality-based harassment at school on past-month substance use, and the Karlson-Holm-Breen method to test whether harassment mediated LGBT disparities in substance use. Vaping, smoking, drinking, HED, and gender- and sexuality-based harassment were higher for transgender adolescents than for cisgender males and females, and for adolescents who were lesbian, gay, or bisexual only versus heterosexual only. Gender- and sexuality-based harassments were independently associated with greater odds of using each substance in every grade. These two types of harassment had positive interactions with each other for vaping in grade 11, smoking in grade 11, and HED in grades 9 and 11. Gender- and sexuality-based harassment significantly mediated many of the LGBT disparities in substance use. Gender- and sexuality-based harassment at school independently or interactively produced LGBT disparities in substance use. Reducing these types of discrimination in schools will likely mitigate these disparities. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Kenst, Karey S.; Bowen, Deborah J.; Scout
Objectives. We examined the proportion of studies funded by the National Institutes of Health (NIH) that focused on lesbian, gay, bisexual, and transgender (LGBT) populations, along with investigated health topics. Methods. We used the NIH RePORTER system to search for LGBT-related terms in NIH-funded research from 1989 through 2011. We coded abstracts for LGBT inclusion, subpopulations studied, health foci, and whether studies involved interventions. Results. NIH funded 628 studies concerning LGBT health. Excluding projects about HIV/AIDS and other sexual health matters, only 0.1% (n = 113) of all NIH-funded studies concerned LGBT health. Among the LGBT-related projects, 86.1% studied sexual minority men, 13.5% studied sexual minority women, and 6.8% studied transgender populations. Overall, 79.1% of LGBT-related projects focused on HIV/AIDS and substantially fewer on illicit drug use (30.9%), mental health (23.2%), other sexual health matters (16.4%), and alcohol use (12.9%). Only 202 studies examined LGBT health–related interventions. Over time, the number of LGBT-related projects per year increased. Conclusions. The lack of NIH-funded research about LGBT health contributes to the perpetuation of health inequities. Here we recommend ways for NIH to stimulate LGBT-related research. PMID:24328665
Rhodes, Scott D; Alonzo, Jorge; Mann, Lilli; Downs, Mario; Simán, Florence M; Andrade, Mario; Martinez, Omar; Abraham, Claire; Villatoro, Guillermo R; Bachmann, Laura H
The burden of HIV is disproportionate for Guatemalan sexual minorities (e.g., gay and bisexual men, men who have sex with men [MSM], and transgender persons). Our bi-national partnership used authentic approaches to community-based participatory research (CBPR) to identify characteristics of potentially successful programs to prevent HIV and promote sexual health among Guatemalan sexual minorities. Our partnership conducted Spanish-language focus groups with 87 participants who self-identified as male (n=64) or transgender (n=23) and individual in-depth interviews with ten formal and informal gay community leaders. Using constant comparison, an approach to grounded theory, we identified 20 characteristics of potentially successful programs to reduce HIV risk, including providing guidance on accessing limited resources; offering supportive dialogue around issues of masculinity, socio-cultural expectations, love, and intimacy; using Mayan values and images; harnessing technology; increasing leadership and advocacy skills; and mobilizing social networks. More research is clearly needed, but participants reported needing and wanting programming and had innovative ideas to prevent HIV exposure and transmission.
Gurung, Sitaji; Ventuneac, Ana; Rendina, H Jonathon; Savarese, Elizabeth; Grov, Christian; Parsons, Jeffrey T
Despite the repeal of Don't Ask, Don't Tell, Don't Pursue (DADT) and the update to the Transgender Policy, there remain concerns about the persistence of military sexual trauma (MST) and sexual orientation discrimination against lesbian, gay, bisexual, and transgender (LGBT) service members. A sample of 253 participants (89 women, 164 men) completed an Internet-based survey that assessed the prevalence of sexual orientation discrimination (e.g., offensive speech, physical or discriminatory behaviors) and MST (e.g., sexual harassment and sexual assault). The survey was conducted between April 2012 and October 2013. Women and men reported similar levels of sexual orientation discrimination in the military. Participants reported experiencing more threats and intimation, vandalism, and physical assault outside of the military than inside the military ( p sexual harassment and sexual assault) in the military was high among both genders, women were more likely to report experiences of sexual harassment compared to men ( p sexual orientation discrimination among LGBT service members in the military and point to the need for strong accountability and oversight to protect sexual minority persons while they are serving their country.
Johnson, Michael J; Mueller, Martina; Eliason, Michele J; Stuart, Gail; Nemeth, Lynne S
The purposes of this study were to measure the prevalence of, and identify factors associated with, cervical cancer screening among a sample of lesbian, bisexual and queer women, and transgender men. Past research has found that lesbian, bisexual and queer women underuse cervical screening service. Because deficient screening remains the most significant risk factor for cervical cancer, it is essential to understand the differences between routine and nonroutine screeners. A convergent-parallel mixed methods design. A convenience sample of 21- to 65-year-old lesbian and bisexual women and transgender men were recruited in the USA from August-December 2014. Quantitative data were collected via a 48-item Internet questionnaire (N = 226), and qualitative data were collected through in-depth telephone interviews (N = 20) and open-ended questions on the Internet questionnaire. Seventy-three per cent of the sample was routine cervical screeners. The results showed that a constellation of factors influence the use of cervical cancer screening among lesbian, bisexual and queer women. Some of those factors overlap with the general female population, whereas others are specific to the lesbian, bisexual or queer identity. Routine screeners reported feeling more welcome in the health care setting, while nonroutine screeners reported more discrimination related to their sexual orientation and gender expression. Routine screeners were also more likely to 'out' to their provider. The quantitative and qualitative factors were also compared and contrasted. Many of the factors identified in this study to influence cervical cancer screening relate to the health care environment and to interactions between the patient and provider. Nurses should be involved with creating welcoming environments for lesbian, bisexual and queer women and their partners. Moreover, nurses play a large role in patient education and should promote self-care behaviours among lesbian women and transgender
Jered B. Kolbert
Full Text Available This study was designed to ascertain teachers’ perceptions of bullying of Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ youth. In a sample of 200 educators (61.0% female; 96.5% White from a county in southwestern Pennsylvania, there was a significant positive relationship between the teachers’ perceptions of the supportiveness of school staff towards students regardless of sexual orientation and those teachers’ reports of the frequency of bullying victimization experienced by LGBTQ students. Teachers’ perceptions of a higher level of staff and student support was associated with higher reported frequencies of students’ use of derogatory language about LGBTQ individuals and various types of bullying of LGBTQ students. Teachers with a lesbian, gay, or bisexual orientation were found to rate the school staff and students as significantly less supportive of students regardless of their sexual orientation, gender identity, or gender expression in comparison to heterosexual teachers. Finally, teachers who either were unaware of or believed that their school lacked an anti-bullying policy reported significantly higher rates of physical bullying victimization of LGBTQ students when compared to the rates observed by teachers who reported knowledge of their schools’ anti-bullying policies.
Kolbert, Jered B.; Crothers, Laura M.; Bundick, Matthew J.; Wells, Daniel S.; Buzgon, Julie; Berbary, Cassandra; Simpson, Jordan; Senko, Katherine
This study was designed to ascertain teachers’ perceptions of bullying of Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) youth. In a sample of 200 educators (61.0% female; 96.5% White) from a county in southwestern Pennsylvania, there was a significant positive relationship between the teachers’ perceptions of the supportiveness of school staff towards students regardless of sexual orientation and those teachers’ reports of the frequency of bullying victimization experienced by LGBTQ students. Teachers’ perceptions of a higher level of staff and student support was associated with higher reported frequencies of students’ use of derogatory language about LGBTQ individuals and various types of bullying of LGBTQ students. Teachers with a lesbian, gay, or bisexual orientation were found to rate the school staff and students as significantly less supportive of students regardless of their sexual orientation, gender identity, or gender expression in comparison to heterosexual teachers. Finally, teachers who either were unaware of or believed that their school lacked an anti-bullying policy reported significantly higher rates of physical bullying victimization of LGBTQ students when compared to the rates observed by teachers who reported knowledge of their schools’ anti-bullying policies. PMID:26030341
Kolbert, Jered B; Crothers, Laura M; Bundick, Matthew J; Wells, Daniel S; Buzgon, Julie; Berbary, Cassandra; Simpson, Jordan; Senko, Katherine
This study was designed to ascertain teachers' perceptions of bullying of Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) youth. In a sample of 200 educators (61.0% female; 96.5% White) from a county in southwestern Pennsylvania, there was a significant positive relationship between the teachers' perceptions of the supportiveness of school staff towards students regardless of sexual orientation and those teachers' reports of the frequency of bullying victimization experienced by LGBTQ students. Teachers' perceptions of a higher level of staff and student support was associated with higher reported frequencies of students' use of derogatory language about LGBTQ individuals and various types of bullying of LGBTQ students. Teachers with a lesbian, gay, or bisexual orientation were found to rate the school staff and students as significantly less supportive of students regardless of their sexual orientation, gender identity, or gender expression in comparison to heterosexual teachers. Finally, teachers who either were unaware of or believed that their school lacked an anti-bullying policy reported significantly higher rates of physical bullying victimization of LGBTQ students when compared to the rates observed by teachers who reported knowledge of their schools' anti-bullying policies.
Gillespie, Gordon Lee; Willis, Danny G; Amar, Angela F
Bullying has been long seen as a natural part of childhood and adolescence. However, a growing body of evidence suggests bullying and now cyberbullying may inflict harm or distress on targeted youth including physical, psychological, social, or educational harm. The purpose of this paper is to endorse the National Academies of Sciences, Engineering, and Medicine statement, summarize the report, and apply the recommendations to two focus areas: screening and lesbian, gay, bisexual, and transgender youth as they relate to bullying and cyberbullying. Screening for bullying against youth; lesbian, gay, bisexual, and transgender youth as a high-risk group for bullying victimization; and implications to address bullying against youth are exemplified. Nurses need to promote policies that foster inclusive, supportive, safe, and healthy schools and environments for youth. Copyright © 2018 Elsevier Inc. All rights reserved.
Patterson Thomas L; Shoveller Jean A; Wood Evan; Marshall Brandon DL; Montaner Julio SG; Kerr Thomas
Abstract Background Methamphetamine (MA) use continues to be a major public health concern in many urban settings. We sought to assess potential relationships between MA use and individual, social, and structural HIV vulnerabilities among sexual minority (lesbian, gay, bisexual or transgendered) drug users. Methods Beginning in 2005 and ending in 2008, 2109 drug users were enroled into one of three cohort studies in Vancouver, Canada. We analysed longitudinal data from all self-identified sex...
Logie, Carmen H; James, LLana; Tharao, Wangari; Loutfy, Mona R
Background: Lesbian, bisexual, queer and transgender (LBQT) women living with HIV have been described as invisible and understudied. Yet, social and structural contexts of violence and discrimination exacerbate the risk of HIV infection among LBQT women. The study objective was to explore challenges in daily life and experiences of accessing HIV services among HIV-positive LBQT women in Toronto, Canada. Methods: We used a community-based qualitative approach guided by an intersectional theore...
Full Text Available BACKGROUND: HIV prevalence among men who have sex with men (MSM and transgender (TG persons is high and increasing in Chiang Mai, northern Thailand. OBJECTIVES: To describe demographic, socioeconomic, sexual behavior and interest in future HIV prevention trials among gay and bisexual MSM and TG presenting for HIV testing (VCT and pre-screening for the iPrEx pre-exposure chemoprophylaxis trail. METHODS: In 2008-09, MSM/TG participants attending VCT were interviewed and tested for HIV and STI. Univariate and multivariate regression analyses were done to assess associations with HIV infection. RESULTS: A total of 551 MSM clients (56.1% gay, 25.4% TG, and 18.5% bisexual (BS were enrolled. The mean age was 23.9 years. HIV prevalence among MSM overall was 12.9% (71/551; 16.5% among gay men, 9.3% among TG, and 6.9% among BS. Consistent use of condom was low, 33.3% in insertive anal sex and 31.9% in receptive anal sex. Interest in participation was high, 86.3% for PrEP, 69.7% for HIV vaccine trials, but 29.9% for circumcision. HIV was independently associated with being gay identified, aOR 2.8, p = 0.037 and with being aged 25-29, aOR 2.7, p = 0.027. Among repeat testers, HIV incidence was 8.2/100 PY, 95% CI, 3.7/100PY to 18.3/100PY. CONCLUSION: HIV risks and rates varied by self-reported sexual orientation and gender identity. HIV was associated with sexual practices, age, and being gay-identified. These are populations are in need of novel prevention strategies and willing to participate in prevention research.
Birkett, Michelle; Newcomb, Michael E; Mustanski, Brian
The mental health and victimization of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth have garnered media attention with the "It Gets Better Project." Despite this popular interest, there is an absence of empirical evidence evaluating a possible developmental trajectory in LGBTQ distress and the factors that might influence distress over time. This study used an accelerated longitudinal design and multilevel modeling to examine a racially/ethnically diverse analytic sample of 231 LGBTQ adolescents aged 16-20 years at baseline, across six time points, and over 3.5 years. Results indicated that both psychological distress and victimization decreased across adolescence and into early adulthood. Furthermore, time-lagged analyses and mediation analyses suggested that distress was related to prior experiences of victimization, with greater victimization leading to greater distress. Support received from parents, peers, and significant others was negatively correlated with psychological distress in the cross-sectional model but did not reach significance in the time-lagged model. Analyses suggest that psychological distress might "get better" when adolescents encounter less victimization and adds to a growing literature indicating that early experiences of stress impact the mental health of LGBTQ youth. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Griebling, Tomas L
Sex and sexuality are core components of the human experience. Many older adults and people with terminal illness still consider sexuality important in their lives. The palliative care experiences of lesbian, gay, bisexual, and transgender (LGBT) persons are unique in a number of important ways with regard to sexuality and sexual expression. To date, there has been relatively limited scholarly research on sexual health needs of people in palliative care and near end of life, and an even greater paucity of data specifically about sexual minorities. Forms of sexual expression may change with advancing age and illness. Physical intimacy and emotional connection may take on greater roles compared with more traditional concepts of sexual activity. Several recent studies have examined sexual health in palliative care and a few have examined LGBT cohorts. Advances in public policy, including the recent US Supreme Court decision regarding marriage equality, have continued to shape the cultural landscape for LGBT people. This article reviews recent literature with considerations for future research. Sexuality and intimacy remain important for many people facing terminal illness. LGBT people face unique challenges with regard to sexuality during palliative care. Clinicians should work to avoid heteronormative stereotypes and focus on goals of care to enhance quality of life for all patients.
Jannat-Khah, Deanna P; Dill, LeConté J; Reynolds, Simone A; Joseph, Michael A
This study contributes to the emerging literature on lesbian, gay, bisexual, transgendered, and queer (LGBTQ) health disparities and tobacco use by examining the motivations for smoking among the New York City (NYC) LGBTQ population. We used grounded theory and blended methods from 3 grounded theorists-Strauss, Corbin, and Charmaz-for data collection, coding, and analysis. NYC has extensive legislation to prevent smoking; however, the current smoking prevalence of homosexuals is double that of heterosexuals. Study participants were leaders from 23 NYC LGBTQ organizations. Leaders were chosen to establish a relationship with community and to ensure cultural sensitivity. Eligibility criteria required holding a leadership position in an organization serving the NYC LGBTQ community. Interviews were transcribed verbatim and uploaded into Dedoose for analysis. An initial code list was developed from the interview guide. Key themes were identified as the themes with the most number of quotes. Three key themes emerged from our interviews: image, socializing, and stress. Smoking was reported to be a socialization aid and a maladaptive coping technique for stress arising from interactions of conflicting identities. Future smoking cessation interventions among the LGBTQ community should equip smokers with healthy coping mechanisms that address the stressors that arise from the intersections of smokers' many identities.
Schmitz, Rachel M; Tyler, Kimberly A
Familial responses to lesbian, gay, bisexual, transgender, and queer (LGBTQ) young people's identities range on a spectrum from rejection to acceptance and these reactions strongly impact family relationships and young adult well-being. Less is known, however, about how family members' reactions may differ based on young people's contexts of socioeconomic status. Through a qualitative, life course analysis of in-depth interview data from 46 LGBTQ college students and LGBTQ homeless young adults, our study highlights the diverse, contextual nuances of young people's "linked lives" within their families. We find that the context of socioeconomic status influenced how a young person managed family rejection. Conversely, processes of familial acceptance were also connected to life course transitions that worked in some cases to enhance LGBTQ young adults' family relationships. Finally, the intricacy of familial reactions to a young person's LGBTQ identity transcended socioeconomic contexts as many respondents shared similar experiences of rejection and acceptance. These findings have implications for understanding how young people manage family relationships across different contexts of socioeconomic status and how these experiences can shape their life course trajectories. Results from this study can inform LGBTQ youth service providers by tailoring intervention programs that account for contextual social diversity.
Burgess, Diana; Tran, Alisia; Lee, Richard; van Ryn, Michelle
Previous research has found that lesbian, gay, bisexual and transgender (LGBT) individuals are at risk for a variety of mental health disorders. We examined the extent to which a recent experience of a major discriminatory event may contribute to poor mental health among LGBT persons. Data were derived from a cross-sectional strata-cluster survey of adults in Hennepin County, Minnesota, who identified as LGBT (n=472) or heterosexual (n=7,412). Compared to heterosexuals, LGBT individuals had poorer mental health (higher levels of psychological distress, greater likelihood of having a diagnosis of depression or anxiety, greater perceived mental health needs, and greater use of mental health services), more substance use (higher levels of binge drinking, greater likelihood of being a smoker and greater number of cigarettes smoked per day), and were more likely to report unmet mental healthcare needs. LGBT individuals were also more likely to report having experienced a major incident of discrimination over the past year than heterosexual individuals. Although perceived discrimination was associated with almost all of the indicators of mental health and utilization of mental health care that we examined, adjusting for discrimination did not significantly reduce mental health disparities between heterosexual and LGBT persons. LGBT individuals experienced more major discrimination and reported worse mental health than heterosexuals, but discrimination did not account for this disparity. Future research should explore additional forms of discrimination and additional stressors associated with minority sexual orientation that may account for these disparities.
Jones, K Nicole; Brewster, Melanie E
In recent history, heterosexual allies have played an integral role in promoting change for lesbian, gay, bisexual, and transgender (LGBT) populations in the United States; however, questions have been raised as to what drives heterosexual allies to promote change via activism. To delineate factors important in engagement in activism, 207 self-identified heterosexual allies completed an online survey measuring components associated with LGBT activism using Bandura's (1986) model of triadic reciprocal determinism: personal factors (ally identity, social justice self-efficacy and outcome expectations, empathetic perspective taking, and gender) and environmental factors (social justice related supports and barriers, positive marginality, and education level) to predict behaviors (LGBT activism). A hierarchical multiple regression analysis revealed a model accounting for 62% of the variance in LGBT activism, with dimensions of ally identification, social justice self-efficacy, outcome expectations, and education level emerging as significant predictors of engagement in activism behaviors. Empathetic perspective taking and social justice related barriers predicted lack of engagement in LGBT activism, however. Supporting the notion that personal and environmental factors simultaneously impact engagement in LGBT activism. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Harper, Gary W; Schneider, Margaret
Lesbian, gay, bisexual, and transgendered (LGBT) people continue to experience various forms of oppression and discrimination in North America and throughout the world, despite the social, legal, and political advances that have been launched in an attempt to grant LGBT people basic human rights. Even though LGBT people and communities have been actively engaged in community organizing and social action efforts since the early twentieth century, research on LGBT issues has been, for the most part, conspicuously absent within the very field of psychology that is explicitly focused on community research and action--Community Psychology. The psychological and social impact of oppression, rejection, discrimination, harassment, and violence on LGBT people is reviewed, and recent advances in the areas of LGBT health, public policy, and research are detailed. Recent advances within the field of Community Psychology with regard to LGBT research and action are highlighted, and a call to action is offered to integrate the knowledge and skills within LGBT communities with Community Psychology's models of intervention, prevention, and social change in order to build better theory and intervention for LGBT people and communities.
Shields, Linda; Zappia, Tess; Blackwood, Diana; Watkins, Rochelle; Wardrop, Joan; Chapman, Rose
Few studies have examined the issues faced by lesbian, gay, bisexual, and transgender (LGBT)-parented families in relation to their access to and satisfaction with healthcare services for their children. It is thought that LGBT individuals have experienced negative interactions with the healthcare environment. To systematically review the literature investigating the experience of LGBT parents seeking health care for their children. A search of the following databases: Cochrane Library, CINAHL, Embase, Google Scholar, Medline, PsychInfo, Science Direct, Sociological Abstracts, Proquest, Scopus, and Web of Science was conducted. Using the PRISMA flow chart and processes of the United Kingdom Centre for Reviews and Dissemination, we selected and analysed relevant studies. Four studies that met the inclusion criteria were identified. Studies showed that while the experience of LGBT parents seeking health care was largely positive, strategies need to be implemented to improve the quality of healthcare services for LGBT families and ensure that their needs are met. Although many LGBT parents have positive experiences of health care, some still experience discrimination and prejudice. Specific educational interventions are needed to support LGBT parents seeking health care for their children. Further research is required to explore LGBT-parented families' experiences of healthcare services, and this should include children's experiences. © 2012 Sigma Theta Tau International.
Social Insertion of Transgender by Education: Transcidadania Project and Resolution No. 12/2015, of the National Council to Fight Against Discrimination and Promotion of Lesbian, Gay, Bisexual, Transvestites and Transgenders Rights
Leandro Reinaldo da Cunha
Full Text Available The transgender people's condition in actual society deserves a special attention because it is a social minority in situation of deep vulnerability. It is an attribution of the State to protect everyone, being inacceptable that, under a huge bias, segregate and marginalize those who should protect. Concerning the education aspect is important the adoption of directives that to ensure the transsexual full access to education, either through measures to prevent school evasion, as by the implantation of projects that allow his return to the student benches and a better qualification for the job. Measures such as resolution No. 12 of the National Council to Combat Discrimination and promotion of lesbian, gay, bisexual and transgender, an agency of the Department of Human Rights, and the Transcidadania project of the São Paulo City Hall has this purpose as this paper seeks to demonstrate. To reach this goal, will use in this paper the scientific-deductive method of bibliography.
Bennett, Elaine; Berry, Karen; Emeto, Theophilus I; Burmeister, Oliver K; Young, Jeanine; Shields, Linda
To examine the attitudes to and knowledge and beliefs about homosexuality of nurses and allied professionals in two early parenting services in Australia. Early parenting services employ nurses and allied professionals. Access and inclusion policies are important in community health and early childhood service settings. However, little is known about the perceptions of professionals who work within early parenting services in relation to lesbian, gay, bisexual and transgender families. This is the final in a series of studies and was undertaken in two early parenting services in two states in Australia using a cross-sectional design with quantitative and qualitative approaches. Validated questionnaires were completed by 51 nurses and allied professionals and tested with chi-squared test of independence (or Fisher's exact test), Mann-Whitney U-test, Kruskal-Wallis one-way analysis of variance or Spearman's rank correlation. Thematic analysis examined qualitative data collected in a box for free comments. Of the constructs measured by the questionnaires, no significant relationships were found in knowledge, attitude and gay affirmative practice scores by sociodemographic variables or professional group. However, attitude scores towards lesbians and gay men were significantly negatively affected by conservative political affiliation (p = 0·038), held religious beliefs (p = 0·011) and frequency of praying (p = 0·018). Six overall themes were found as follows: respect, parenting role, implications for the child, management, disclosure, resources and training. The study provided an in-depth analysis of the attitudes, knowledge and beliefs of professionals in two early parenting services, showing that work is needed to promote acceptance of diversity and the inclusion of lesbian, gay, bisexual and transgender families in planning, developing, evaluating and accessing early parenting services. Access and inclusion plans for lesbian, gay, bisexual and transgender
Banerjee, Smita C; Walters, Chasity B; Staley, Jessica M; Alexander, Koshy; Parker, Patricia A
Delivery of culturally competent care toward lesbian, gay, bisexual, and transgender (LGBT) patients depends on how health-care providers (HCPs) communicate with them; however, research about knowledge, attitude, and behavior of HCPs toward LGBT patients is scant. The objectives of our study were to describe oncology HCPs' knowledge and examine if beliefs about LGB and transgender patients mediate the effects of LGBT health-care knowledge on open communication behaviors with LGB and transgender patients, respectively. A total of 1253 HCPs (187 physicians, 153 advance practice professionals (APPs), 828 nurses, and 41 others) at a Comprehensive Cancer Center completed an online survey that included the following measures: LGBT health-care knowledge, beliefs, communication behaviors, willingness to treat LGBT patients, encouraging LGBT disclosure, and perceived importance of LGBT sensitivity training. Only 50 participants (5%) correctly answered all 7 knowledge items, and about half the respondents answered 3 (out of 7) items correctly. Favorable beliefs about LGBT health care mediated the effect of higher LGBT health-care knowledge on open communication behaviors with transgender patients, controlling for effects of type of profession, religious orientation, gender identity, sexual orientation, and having LGBT friends/family. The results of this study demonstrated an overall lack of medical knowledge and the need for more education about LGBT health care among oncology HCPs.
Hatzenbuehler, Mark L; Pachankis, John E
In this article, we review theory and evidence on stigma and minority stress as social/structural determinants of health among lesbian, gay, bisexual, and transgender (LGBT) youth. We discuss different forms of stigma at individual (eg, identity concealment), interpersonal (eg, victimization), and structural (eg, laws and social norms) levels, as well as the mechanisms linking stigma to adverse health outcomes among LGBT youth. Finally, we discuss clinical (eg, cognitive behavioral therapy) and public health (eg, antibullying policies) interventions that effectively target stigma-inducing mechanisms to improve the health of LGBT youth. Copyright © 2016 Elsevier Inc. All rights reserved.
Molina, Y.; Ramirez-Valles, J.
Despite the increased interest in HIV/AIDS stigma and its negative effects on the health and social support of people living with HIV/AIDS (PLWHA), little attention has been given to its assessment among Latino gay/bisexual men and transgender women (GBT) living with HIV/AIDS. The purpose of this paper is twofold: to develop a multidimensional assessment of HIV/AIDS stigma for Latino GBT living with HIV/AIDS, and to test whether such stigma is related to self-esteem, safe sex self-efficacy, s...
This autobiographical essay of a Chinese transgender who has grown up in a special social background involves the Chinese family, religion, and some social background to demonstrate the current situation of lesbian, gay, bisexual, and transgender groups, especially the condition of female-to-male transgender.
Driskell, Jeff; Bradford, Judith
While we know that minority status differentiates the experience of aging, little research has been done to examine the ways in which patterns of successful aging may differ in diverse subgroups of older adults. In this exploratory study, we investigated and described experiences of successful aging in a sample of lesbian, gay, bisexual and transgender (LGBT) older adults. Directed by a community-based participatory research process, we conducted semi-structured in-depth interviews with 22 LGBT adults, age 60 and older. We took an inductive, grounded theory approach to analyze the taped and transcribed interviews. We coded respondent experiences in four domains: physical health, mental health, emotional state and social engagement. Four gradations of successful aging emerged. Very few in our sample met the bar for “traditional success” characterized by the absence of problems in all four domains of health. Most of the sample was coping to a degree with problems and were categorized in one of two gradations on a continuum of successful aging: “surviving and thriving” and “working at it.” A small number was “ailing”: not coping well with problems. Some of the experiences that respondents described were related to LGBT status; others were related to more general processes of aging. The research suggests that a successful aging framework that is modified to include coping can better describe the experiences of LGBT older adults. The modified conceptual model outlined here may be useful in future research on this population, as well as more broadly for diverse populations of adults, and may be adapted for use in practice to assess and improve health and well-being. PMID:23273552
People who identity as lesbian, gay, bisexual and transgender (LGBT) have specific health needs. Sexual orientation and gender identity are social determinants of health, as homophobia and heteronormativity persist as prejudices in society. LGBT patients often experience discrimination and prejudice in health care settings. While recent South African policies recognise the need for providing LGBT specific health care, no curricula for teaching about LGBT health related issues exist in South African health sciences faculties. This study aimed to determine the extent to which LGBT health related content is taught in the University of Cape Town's medical curriculum. A curriculum mapping exercise was conducted through an online survey of all academic staff at the UCT health sciences faculty, determining LGBT health related content, pedagogical methodology and assessment. 127 academics, across 31 divisions and research units in the Faculty of Health Sciences, responded to the survey, of which 93 completed the questionnaire. Ten taught some content related to LGBT health in the MBChB curriculum. No LGBT health related content was taught in the allied health sciences curricula. The MBChB curriculum provided no opportunity for students to challenge their own attitudes towards LGBT patients, and key LGBT health topics such as safer sex, mental health, substance abuse and adolescent health were not addressed. At present, UCTs health sciences curricula do not adequately address LGBT specific health issues. Where LGBT health related content is taught in the MBChB curriculum, it is largely discretionary, unsystematic and not incorporated into the overarching structure. Coordinated initiatives to integrate LGBT health related content into all health sciences curricula should be supported, and follow an approach that challenges students to develop professional attitudes and behaviour concerning care for patients from LGBT backgrounds, as well as providing them with specific LGBT
Many lesbian, gay, bisexual, and transgender (LGBT) university faculty worry about the effects of self-disclosure in their professional lives. One concern is that self-disclosure as LGBT could result in negative evaluations of one's teaching by students due to student bias against LGBT people. In order to investigate this concern, this study…
Perspective on Out & Equal Workplace Advocates Building Bridges Model: A Retrospect of the Past, Present, and Future of Training Impacting Lesbian, Gay, Bisexual, and Transgender Employees in the Workplace
Baillie, Pat; Gedro, Julie
As early as 1983, a group of lesbian, gay, bisexual, and transgenders (LGBTs) in the San Francisco Bay Area met with the United Way to discuss the needs of the community in the workplace. In 1986, the United Way authorized a board-level task force on LGBT issues, which looked at health and human care concerns. In 1990, Building Bridges was formed…
Sexual orientation and gender identity are social determinants of health for people identifying as lesbian, gay, bisexual and transgender (LGBT), and health disparities among sexual and gender minority populations are increasingly well understood. Although the South African constitution guarantees sexual and gender minority people the right to non-discrimination and the right to access to healthcare, homo- and transphobia in society abound. Little is known about LGBT people's healthcare experiences in South Africa, but anecdotal evidence suggests significant barriers to accessing care. Using the framework of the UN International Covenant on Economic, Social and Cultural Rights General Comment 14, this study analyses the experiences of LGBT health service users using South African public sector healthcare, including access to HIV counselling, testing and treatment. A qualitative study comprised of 16 semi-structured interviews and two focus group discussions with LGBT health service users, and 14 individual interviews with representatives of LGBT organisations. Data were thematically analysed within the framework of the UN International Covenant on Economic, Social and Cultural Rights General Comment 14, focusing on availability, accessibility, acceptability and quality of care. All interviewees reported experiences of discrimination by healthcare providers based on their sexual orientation and/or gender identity. Participants recounted violations of all four elements of the UN General Comment 14: 1) Availability: Lack of public health facilities and services, both for general and LGBT-specific concerns; 2) Accessibility: Healthcare providers' refusal to provide care to LGBT patients; 3) Acceptability: Articulation of moral judgment and disapproval of LGBT patients' identity, and forced subjection of patients to religious practices; 4) Quality: Lack of knowledge about LGBT identities and health needs, leading to poor-quality care. Participants had delayed or
Smith, Elizabeth A; Thomson, Katherine; Offen, Naphtali; Malone, Ruth E
In the public health literature, it is generally assumed that the perception of "targeting" as positive or negative by the targeted audience depends on the product or message being promoted. Smoking prevalence rates are high among lesbian, gay, bisexual, and transgender (LGBT) individuals, but little is known about how they perceive tobacco industry targeting. We conducted focus groups with LGBT individuals in 4 US cities to explore their perceptions. Our findings indicated that focus group participants often responded positively to tobacco company targeting. Targeting connoted community visibility, legitimacy, and economic viability. Participants did not view tobacco as a gay health issue. Targeting is a key aspect of corporate-community interaction. A better understanding of targeting may aid public health efforts to counter corporate disease promotion.
Fredriksen-Goldsen, Karen I.; Jen, Sarah; Bryan, Amanda E. B.; Goldsen, Jayn
Cognitive impairment, Alzheimer’s disease, and other dementias are important health concerns for older adults. As a marginalized and growing segment of the older adult population, lesbian, gay, bisexual, and transgender (LGBT) older adults face distinct risk factors related to cognitive impairment and dementias, including social isolation, discrimination, barriers to health care access, limited availability of and support for caregivers, and higher rates of certain chronic illnesses. We examine cognitive impairment and dementias among LGBT older adults, describe their unique risk factors, and outline key competencies for health care and human service providers to ensure culturally relevant care for LGBT older adults experiencing cognitive impairment, Alzheimer’s disease, or other dementias, as well as their caregivers, families, and communities. Implications include developing an awareness of the context of LGBT older adults’ lives and relationships, the importance of early detection and support, and the development of policies and practices that promote community-level advocacy and education. PMID:27729400
Keuroghlian, Alex S; Ard, Kevin L; Makadon, Harvey J
Lesbian, gay, bisexual and transgender (LGBT) people face pervasive health disparities and barriers to high-quality care. Adequate LGBT sexual health education for emerging health professionals is currently lacking. Clinical training programs and healthcare organisations are well poised to start addressing these disparities and affirming LGBT patients through curricula designed to cultivate core competencies in LBGT health as well as health care environments that welcome, include and protect LGBT patients, students and staff. Health education programs can emphasise mastery of basic LGBT concepts and terminology, as well as openness towards and acceptance of LGBT people. Core concepts, language and positive attitudes can be instilled alongside clinical skill in delivering inclusive sexual health care, through novel educational strategies and paradigms for clinical implementation. Caring for the health needs of LGBT patients also involves the creation of health care settings that affirm LGBT communities in a manner that is responsive to culturally specific needs, sensitivities and challenges that vary across the globe.
Fredriksen-Goldsen, Karen I; Jen, Sarah; Bryan, Amanda E B; Goldsen, Jayn
Cognitive impairment, Alzheimer's disease, and other dementias are important health concerns for older adults. As a marginalized and growing segment of the older adult population, lesbian, gay, bisexual, and transgender (LGBT) older adults face distinct risk factors related to cognitive impairment and dementias, including social isolation, discrimination, barriers to health care access, limited availability of and support for caregivers, and higher rates of certain chronic illnesses. We examine cognitive impairment and dementias among LGBT older adults, describe their unique risk factors, and outline key competencies for health care and human service providers to ensure culturally relevant care for LGBT older adults experiencing cognitive impairment, Alzheimer's disease, or other dementias, as well as their caregivers, families, and communities. Implications include developing an awareness of the context of LGBT older adults' lives and relationships, the importance of early detection and support, and the development of policies and practices that promote community-level advocacy and education.
Logie, Carmen H; James, LLana; Tharao, Wangari; Loutfy, Mona R
Background Lesbian, bisexual, queer and transgender (LBQT) women living with HIV have been described as invisible and understudied. Yet, social and structural contexts of violence and discrimination exacerbate the risk of HIV infection among LBQT women. The study objective was to explore challenges in daily life and experiences of accessing HIV services among HIV-positive LBQT women in Toronto, Canada. Methods We used a community-based qualitative approach guided by an intersectional theoretical framework. We conducted two focus groups; one focus group was conducted with HIV-positive lesbian, bisexual and queer women (n=7) and the second with HIV-positive transgender women (n=16). Participants were recruited using purposive sampling. Focus groups were digitally recorded and transcribed verbatim. Thematic analysis was used for analyzing data to enhance understanding of factors that influence the wellbeing of HIV-positive LBQT women. Results Participant narratives revealed a trajectory of marginalization. Structural factors such as social exclusion and violence elevated the risk for HIV infection; this risk was exacerbated by inadequate HIV prevention information. Participants described multiple barriers to HIV care and support, including pervasive HIV-related stigma, heteronormative assumptions in HIV-positive women's services and discriminatory and incompetent treatment by health professionals. Underrepresentation of LBQT women in HIV research further contributed to marginalization and exclusion. Participants expressed a willingness to participate in HIV research that would be translated into action. Conclusions Structural factors elevate HIV risk among LBQT women, limit access to HIV prevention and present barriers to HIV care and support. This study's conceptualization of a trajectory of marginalization enriches the discussion of structural factors implicated in the wellbeing of LBQT women and highlights the necessity of addressing LBQT women's needs in HIV
Logie, Carmen H; James, Llana; Tharao, Wangari; Loutfy, Mona R
Lesbian, bisexual, queer and transgender (LBQT) women living with HIV have been described as invisible and understudied. Yet, social and structural contexts of violence and discrimination exacerbate the risk of HIV infection among LBQT women. The study objective was to explore challenges in daily life and experiences of accessing HIV services among HIV-positive LBQT women in Toronto, Canada. We used a community-based qualitative approach guided by an intersectional theoretical framework. We conducted two focus groups; one focus group was conducted with HIV-positive lesbian, bisexual and queer women (n = 7) and the second with HIV-positive transgender women (n = 16). Participants were recruited using purposive sampling. Focus groups were digitally recorded and transcribed verbatim. Thematic analysis was used for analyzing data to enhance understanding of factors that influence the wellbeing of HIV-positive LBQT women. Participant narratives revealed a trajectory of marginalization. Structural factors such as social exclusion and violence elevated the risk for HIV infection; this risk was exacerbated by inadequate HIV prevention information. Participants described multiple barriers to HIV care and support, including pervasive HIV-related stigma, heteronormative assumptions in HIV-positive women's services and discriminatory and incompetent treatment by health professionals. Underrepresentation of LBQT women in HIV research further contributed to marginalization and exclusion. Participants expressed a willingness to participate in HIV research that would be translated into action. Structural factors elevate HIV risk among LBQT women, limit access to HIV prevention and present barriers to HIV care and support. This study's conceptualization of a trajectory of marginalization enriches the discussion of structural factors implicated in the wellbeing of LBQT women and highlights the necessity of addressing LBQT women's needs in HIV prevention, care and research
Kirk, James; Belovics, Robert
Because transgender individuals experience widespread employment discrimination, counselors need to understand and be able to work with members of the gay, lesbian, bisexual, and transgender communities. The aim of this article is to help counselors become more transgender literate by (a) defining gender dysphoric disorder and related terms; (b)…
Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study
Nama, Nassr; MacPherson, Paul; Sampson, Margaret; McMillan, Hugh J.
ABSTRACT Background: Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. Objective: The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. Design: Medical students ...
Watson, Lori Anne
Schools contribute heavily to the feelings of isolation and stigmatization that many gay, lesbian, and bisexual youth experience. Research demonstrates that the climate of US middle and high schools are generally unsupportive and unsafe for many of these youth who are often susceptible to harassment, discrimination, and other negative events,…
Logie, Carmen H; Lys, Candice
Youth in Canada's Northwest Territories (NWT) experience sexual and mental health disparities. Higher rates of sexual and mental health concerns among lesbian, gay, bisexual, transgender and queer (LGBTQ) youth in comparison with heterosexual and cisgender peers have been associated with stigma and discrimination. Although LGBTQ youth in the NWT are situated at the nexus of Northern and LGBTQ health disparities, there is little known about their health, well-being and experiences of stigma. This short communication discusses the process of developing a LGBTQ youth community-based research programme in the NWT. We developed an interdisciplinary research team of LGBTQ and allied young adults, including indigenous and non-indigenous researchers, community organisers and service providers in the NWT. We conducted meetings in Yellowknife with LGBTQ youth (n=12) and key stakeholders (n=15), including faculty, students, community groups and health and social service providers. Both meetings included LGBTQ and allied participants who were LGBTQ, indigenous, youth and persons at the intersection of these identities. LGBTQ youth participants discussed community norms that devalued same sex identities and stigma surrounding LGBTQ-specific services and agencies. Stigma among LGBT youth was exacerbated for youth in secondary schools, gender non-conforming and transgender youth and young gay men. In the stakeholder meeting, service providers discussed the importance of integrating LGBTQ issues in youth programmes, and LGBTQ community groups expressed the need for flexibility in service delivery to LGBTQ youth. Stakeholders identified the need to better understand the needs of indigenous LGBTQ youth in the NWT. Community-based LGBTQ groups, researchers and health and social service providers are interested in addressing LGBTQ youth issues in the NWT. The emergence of LGBTQ community building, support groups and activism in Northern Canada suggests that this is an opportune time
Carmen H. Logie
Full Text Available Background: Youth in Canada's Northwest Territories (NWT experience sexual and mental health disparities. Higher rates of sexual and mental health concerns among lesbian, gay, bisexual, transgender and queer (LGBTQ youth in comparison with heterosexual and cisgender peers have been associated with stigma and discrimination. Although LGBTQ youth in the NWT are situated at the nexus of Northern and LGBTQ health disparities, there is little known about their health, well-being and experiences of stigma. This short communication discusses the process of developing a LGBTQ youth community-based research programme in the NWT. Methods: We developed an interdisciplinary research team of LGBTQ and allied young adults, including indigenous and non-indigenous researchers, community organisers and service providers in the NWT. We conducted meetings in Yellowknife with LGBTQ youth (n=12 and key stakeholders (n=15, including faculty, students, community groups and health and social service providers. Both meetings included LGBTQ and allied participants who were LGBTQ, indigenous, youth and persons at the intersection of these identities. Results: LGBTQ youth participants discussed community norms that devalued same sex identities and stigma surrounding LGBTQ-specific services and agencies. Stigma among LGBT youth was exacerbated for youth in secondary schools, gender non-conforming and transgender youth and young gay men. In the stakeholder meeting, service providers discussed the importance of integrating LGBTQ issues in youth programmes, and LGBTQ community groups expressed the need for flexibility in service delivery to LGBTQ youth. Stakeholders identified the need to better understand the needs of indigenous LGBTQ youth in the NWT. Conclusions: Community-based LGBTQ groups, researchers and health and social service providers are interested in addressing LGBTQ youth issues in the NWT. The emergence of LGBTQ community building, support groups and activism
Wingo, Erin; Ingraham, Natalie; Roberts, Sarah C M
Little research documents the self-identified reproductive health priorities and health care experiences of lesbian, gay, bisexual, transgender, queer (LGBTQ)-identified individuals who may be in need of services. We conducted in-depth interviews with a diverse sample of 39 female-assigned-at-birth individuals (ages 18-44) who also identified as lesbian, bisexual, queer, and/or genderqueer, or transmasculine. Interviews were primarily conducted in person in the Bay Area of California, and Baltimore, Maryland, with 11 conducted remotely with participants in other U.S. We asked participants about their current reproductive health care needs, topics they felt researchers should pursue, and past reproductive health care experiences. Data were analyzed using a framework method, incorporating deductive and inductive thematic analysis techniques. Reproductive health care needs among participants varied widely and included treatment of polycystic ovary syndrome and irregular menses, gender-affirming hysterectomies, and fertility assistance. Many faced challenges getting their needs met. Themes related to these challenges cross-cutting across identity groups included primary focus on fertility, provider lack of LGBTQ health competency relevant to reproductive health priorities and treatment, and discriminatory comments and treatment. Across themes and identity groups, participants highlighted that sexual activity and reproduction were central topics in reproductive health care settings. These topics facilitated identity disclosures to providers, but also enhanced vulnerability to discrimination. Reproductive health priorities of LGBTQ individuals include needs similar to cisgender and heterosexual groups (e.g., abortion, contraception, PCOS) as well as unique needs (e.g., gender affirming hysterectomies, inclusive safer sex guidance) and challenges in pursuing care. Future reproductive health research should pursue health care concerns prioritized by LGBTQ populations
Bidell, Markus P
These three studies provide initial evidence for the development, factor structure, reliability, and validity of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS), a new interdisciplinary LGBT clinical self-assessment for health and mental health providers. Research participants were voluntarily recruited in the United States and United Kingdom and included trainees, clinicians, and educators from applied psychology, counseling, psychotherapy, and primary care medicine. Study 1 (N = 602) used exploratory and confirmatory factor analytic techniques, revealing an 18-item three-factor structure (Clinical Preparedness, Attitudinal Awareness, and Basic Knowledge). Study 2 established internal consistency for the overall LGBT-DOCSS (α = .86) and for each of the three subscales (Clinical Preparedness = .88, Attitudinal Awareness = .80, and Basic Knowledge = .83) and 2-week test-retest reliability (.87). In study 3 (N = 564), participant criteria (sexual orientation and education level) and four established scales that measured LGBT prejudice, assessment skills, and social desirability were used to support initial content and discriminant validity. Psychometric properties, limitations, and recommendations are discussed.
Shrader, Angela; Casero, Kellie; Casper, Bethany; Kelley, Mary; Lewis, Laura; Calohan, Jess
Lesbian, gay, bisexual, and transgender (LGBT) individuals serving within the U.S. military and their beneficiaries have unique health care requirements. Department of Defense Directive 1304.26 "Don't Ask, Don't Tell" created a barrier for service members to speak candidly with their health care providers, which left specific health care needs unaddressed. There are no standardized cultural education programs to assist Military Health System (MHS) health care providers in delivering care to LGBT patients and their beneficiaries. The purpose of this project was to develop, implement, and evaluate the effectiveness of an LGBT educational program for health care providers within the MHS to increase cultural awareness in caring for this special population. This multisite educational program was conducted at Travis Air Force Base and Joint Base Lewis-McChord from November 15, 2014, to January 30, 2015. A 15-question multiple-choice questionnaire was developed based on the education program and was administered before and after the education program. A total of 51 individuals completed the program. Overall posttest scores improved compared to pretest scores. This program was designed to begin the process of educating health care providers about the unique health care issues of military LGBT Service Members and their beneficiaries. This program was the first to address the disparities in LGBT health care needs within the Department of Defense. It also provided a platform for facilitating open communication among providers regarding LGBT population health needs in the military.
Bidell, Markus P; Stepleman, Lara M
There are exigent reasons to foster lesbian, gay, bisexual, and transgender (LGBT) competence, training, and ethical care for health professionals within an interdisciplinary paradigm. LGBT individuals experience serious health and psychosocial disparities; moreover, these inequalities can be amplified when other aspects of diversity such as race, ethnicity, age, gender, religion, disability, and socioeconomic status intersect with sexual orientation and gender identity (Institute of Medicine [IOM], 2011). While the origins of LGBT health and psychosocial disparities are manifold, deficiencies in professional training, ethical care, and clinical competence are underlying contributors (IOM, 2011). In addition, LGBT clinical competency advancements are often siloed within the various health care disciplines-thus advances by one group of health professionals often have limited impact for those practicing in different health and human service fields. This special issue explores LGBT clinical competence, professional training, and ethical care within an interdisciplinary context and, to our knowledge, represents the first attempt to address LGBT clinical competence from a multidisciplinary health care perspective.
Hatzenbuehler, Mark L.
Objectives. We examined whether past-year suicidality among sexual-minority adolescents was more common in neighborhoods with a higher prevalence of hate crimes targeting lesbian, gay, bisexual, and transgender (LGBT) individuals. Methods. Participants’ data came from a racially/ethnically diverse population-based sample of 9th- through 12th-grade public school students in Boston, Massachusetts (n = 1292). Of these, 108 (8.36%) reported a minority sexual orientation. We obtained data on LGBT hate crimes involving assaults or assaults with battery between 2005 and 2008 from the Boston Police Department and linked the data to the adolescent’s residential address. Results. Sexual-minority youths residing in neighborhoods with higher rates of LGBT assault hate crimes were significantly more likely to report suicidal ideation (P = .013) and suicide attempts (P = .006), than were those residing in neighborhoods with lower LGBT assault hate crime rates. We observed no relationships between overall neighborhood-level violent and property crimes and suicidality among sexual-minority adolescents (P > .05), providing evidence for specificity of the results to LGBT assault hate crimes. Conclusions. Neighborhood context (i.e., LGBT hate crimes) may contribute to sexual-orientation disparities in adolescent suicidality, highlighting potential targets for community-level suicide-prevention programs. PMID:24328619
Lelutiu-Weinberger, Corina; Pachankis, John E
Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills. We conducted a 2-day training for MHPs in Bucharest. Fifty-four attended and 33 provided training evaluation data at baseline and follow-up. The majority of trainees were female (90%) and heterosexual (73%) with a mean age of 36.4 (SD = 7.7). From baseline to follow-up, trainees demonstrated a significant increase in perceived LGBT-relevant clinical skills (P LGBT-affirmative practice attitudes (P LGBT individuals (P LGBT individuals were low at both baseline and follow-up. The majority of trainees reported being highly interested in the training (84%), which they reported had prepared them to interact with and care for LGBT individuals (74%). This pilot training appeared to be effective in increasing perceived LGBT competence among participating MHPs. This type of training model needs to be tested further in a randomized controlled trial with longer follow-up periods to assess intervention durability and implementation of clinical skills. Future trainings can be incorporated into existing curricula. National accreditation bodies might consider encouraging such training as part of standard educational requirements.
Adolescent health care providers frequently care for patients who identify as lesbian, gay, bisexual, or transgendered (LGBT), or who may be struggling with or questioning their sexual orientation or gender identity. Whereas these youth have the same health concerns as their non-LGBT peers, LGBT teens may face additional challenges because of the complexity of the coming-out process, as well as societal discrimination and bias against sexual and gender minorities. The Society for Adolescent Health and Medicine encourages adolescent providers and researchers to incorporate the impact of these developmental processes (and understand the impacts of concurrent potential discrimination) when caring for LGBT adolescents. The Society for Adolescent Health and Medicine also encourages providers to help positively influence policy related to LGBT adolescents in schools, the foster care system, and the juvenile justice system, and within the family structure. Consistent with other medical organizations, the Society for Adolescent Health and Medicine rejects the mistaken notion that LGBT orientations are mental disorders, and opposes the use of any type of reparative therapy for LGBT adolescents. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Choi, E P H; Wong, J Y H; Fong, D Y T
The use of social networking applications (apps) on smartphones has the potential to impact sexual health and behaviour. This was the first systematic review to critically appraise and summarize the existing literature on the use of social networking apps on smartphones and their associated sexual health and sexual behaviour effects in lesbian, gay, bisexual and transgender populations. A systematic search was conducted in five databases (CINAHL Plus, PsycINFO, PubMed, SCOPUS and Sociological Abstracts), using controlled terms and keywords. Thirteen articles from 11 studies were included in this review. Studied outcomes included rates of unprotected sexual intercourse, the number of sexual partners, drug/alcohol use prior to/during sexual intercourse, sexually transmitted infections (STIs) testing and the prevalence of STIs. Among app users, the prevalence of unprotected sex ranged from 17.0% to 66.7%. The mean number of sexual partners ranged from 1.4 to 2.9 (last 1-month period), and from 46.2 to 79.6 (lifetime). Two studies found that the prevalence of HIV infection was 1.9% and 11.4%, respectively. The self-reported prevalence of prior diagnosis of STIs other than HIV ranged from 9.1% to 51.0%. It should be noted that the heterogeneity of the study design and outcome measures across different studies hindered the comparison of findings across different studies. Furthermore, the findings in some studies are not reliable due to methodological problems. Our results highlight the need for more research with rigorous methodology to understand the negative impacts of using these apps on sexual health and sexual behaviour. For future studies, the operational definition of outcomes, including social networking app use and unprotected anal intercourse (UAI), should be clearly outlined. The use of validated tools to measure sexual behaviour and biological measures of HIV and other STDs is preferable so that outcomes can be standardized to facilitate comparisons between
Zhang, S X; Shoptaw, S; Reback, C J; Yadav, K; Nyamathi, A M
A randomized controlled study was conducted with 422 homeless, stimulant-using gay/bisexual (G/B) men and 29 transgender women (n = 451) to assess two community-based interventions to reduce substance abuse and improve health: (a) a nurse case-managed program combined with contingency management (NCM + CM) versus (b) standard education plus contingency management (SE + CM). Hypotheses tested included: a) completion of hepatitis A/B vaccination series; b) reduction in stimulant use; and c) reduction in number of sexual partners. A deconstructive cost analysis approach was utilized to capture direct costs associated with the delivery of both interventions. Based on an analysis of activity logs and staff interviews, specific activities and the time required to complete each were analyzed as follows: a) NCM + CM only; b) SE + CM only; c) time to administer/record vaccines; and d) time to receive and record CM visits. Cost comparison of the interventions included only staffing costs and direct cash expenditures. The study outcomes showed significant over time reductions in all measures of drug use and multiple sex partners, compared to baseline, although no significant between-group differences were detected. Cost analysis favored the simpler SE + CM intervention over the more labor-intensive NCM + CM approach. Because of the high levels of staffing required for the NCM relative to SE, costs associated with it were significantly higher. Findings suggest that while both intervention strategies were equally effective in achieving desired health outcomes, the brief SE + CM appeared less expensive to deliver. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Mullens, Amy B; Fischer, Jane; Stewart, Mary; Kenny, Kathryn; Garvey, Shane; Debattista, Joseph
Lesbian, gay, bisexual, and transgender (LGBT) populations are more likely to misuse alcohol and other drugs (AOD), compared to the general population. However, LGBT engagement with AOD treatment is often precluded by insensitivity and misunderstanding of LGBT issues. These treatment barriers may be a consequence of either worker attitudes, organizational factors or a combination of both. Few studies have compared service context as an impediment to AOD treatment. This pilot study sought to examine and compare staff attitudes, knowledge and awareness of LGBT issues in two state-wide AOD services within Australia. One organization was a government service, whilst the other was faith based. A cross-sectional study of a convenience sample (N = 130) of workers employed in a state-wide government AOD service (n = 65), and a state-wide non-government service (n = 65) was conducted. Participants self-completed a questionnaire comprising tools previously used to assess staff attitudes, knowledge and awareness of LGBT issues. Few significant differences in attitudes and awareness of LGBT issues between government and non-government respondents were found. Nearly all respondents were supportive of LGBT persons irrespective of organizational context, with a small number of negative views. Although most respondents demonstrated awareness of organizational policies and practices relating to LGBT clients, many were "unsure" or "neutral" of what these might be. It is confirming that the majority of staff report supportive attitudes towards LGBT clients. Findings suggest that organizations need to continue to take leadership to strengthen organizational training and capacity to deliver LGBT friendly AOD treatment practices.
Logie, Carmen H; Dias, Lisa V; Jenkinson, Jesse; Newman, Peter A; MacKenzie, Rachel K; Mothopeng, Tampose; Madau, Veli; Ranotsi, Amelia; Nhlengethwa, Winnie; Baral, Stefan D
Stigma and discrimination affecting lesbian, gay, bisexual, and transgender (LGBT) people compromise health and human rights and exacerbate the HIV epidemic. Scant research has explored effective LGBT stigma reduction strategies in low- and middle-income countries. We developed and pilot-tested a participatory theatre intervention (PTI) to reduce LGBT stigma in Swaziland and Lesotho, countries with the world's highest HIV prevalence. We collected preliminary data from in-depth interviews with LGBT people in Lesotho and Swaziland to enhance understanding of LGBT stigma. Local LGBT and theatre groups worked with these data to create a 2-hour PTI composed of three skits on LGBT stigma in health care, family, and community settings in Swaziland (Manzini) and Lesotho (Maseru, Mapoteng). Participants ( n = 106; nursing students, health care providers, educators, community members) completed 12 focus groups following the PTI. We conducted thematic analysis to understand reactions to the PTI. Focus groups revealed the PTI increased understanding of LGBT persons and issues, increased empathy, and fostered self-reflection of personal biases. Increased understanding included enhanced awareness of the negative impacts of LGBT stigma, and of LGBT people's lived experiences and issues. Participants discussed changes in attitude and perspective through self-reflection and learning. The format of the theatre performance was described as conducive to learning and preferred over more conventional educational methods. Findings indicate changed attitudes and awareness toward LGBT persons and issues following a PTI in Swaziland and Lesotho. Stigma reduction interventions may help mitigate barriers to HIV prevention, treatment, and care in these settings with a high burden of HIV.
Krakower, Douglas S; Ware, Norma C; Maloney, Kevin M; Wilson, Ira B; Wong, John B; Mayer, Kenneth H
The Centers for Disease Control and Prevention estimates that one in four sexually active men who have sex with men (MSM) could decrease their HIV risk by using HIV pre-exposure prophylaxis (PrEP). Because many MSM access healthcare from primary care providers (PCPs), these clinicians could play an important role in providing access to PrEP. Semistructured qualitative interviews were conducted with 31 PCPs in Boston, MA, to explore how they approach decisions about prescribing PrEP to MSM and their experiences with PrEP provision. Purposive sampling included 12 PCPs from an urban community health center specializing in the care of lesbian, gay, bisexual, and transgender persons ("LGBT specialists") and 19 PCPs from a general academic medical center ("generalists"). Analyses utilized an inductive approach to identify emergent themes. Both groups of PCPs approached prescribing decisions about PrEP as a process of informed decision-making with patients. Providers would defer to patients' preferences if they were unsure about the appropriateness of PrEP. LGBT specialists and generalists were at vastly different stages of adopting PrEP into practice. For LGBT specialists, PrEP was a disruptive innovation that rapidly became normative in practice. Generalists had limited experience with PrEP; however, they desired succinct decision-support tools to help them achieve proficiency, because they considered preventive medicine to be central to their professional role. As generalists vastly outnumber LGBT specialists in the United States, interventions to support PrEP provision by generalists could accelerate the scale-up of PrEP for MSM nationally, which could in turn decrease HIV incidence for this priority population.
Heck, Nicholas C; Livingston, Nicholas A; Flentje, Annesa; Oost, Kathryn; Stewart, Brandon T; Cochran, Bryan N
Previous research suggests that lesbian, gay, bisexual, and transgender (LGBT) youth are at elevated risk for using illicit drugs and misusing prescription drugs relative to heterosexual youth. Previous research also indicates that LGBT youth who attend high schools with a gay-straight alliance (GSA) report having fewer alcohol problems and lower levels of cigarette smoking. The present study investigates whether the absence of a GSA is associated with risk for illicit drug use and prescription drug misuse in a sample of 475 LGBT high school students (M age=16.79) who completed an online survey. After controlling for demographic variables and risk factors associated with illicit drug use, the results of 12 logistic regression analyses revealed that LGBT youth attending a high school without a GSA evidenced increased risk for using cocaine (adjusted odds ratio [adjOR]=3.11; 95% confidence interval [95% CI]=1.23-7.86), hallucinogens (adjOR=2.59; 95% CI=1.18-5.70), and marijuana (adjOR=2.22; 95% CI=1.37-3.59) relative to peers attending a high school with a GSA. Youth without a GSA also evidenced increased risk for the misuse of ADHD medication (adjOR=2.00; 95% CI=1.02-3.92) and prescription pain medication (adjOR=2.00; 95% CI=1.10-3.65). These findings extend the research base related to GSAs and further demonstrate the importance of providing LGBT youth with opportunities for socialization and support within the school setting. Important limitations of the present study are reviewed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Wright, Leslie A; King, Diane K; Retrum, Jessica H; Helander, Kenneth; Wilkins, Shari; Boggs, Jennifer M; Portz, Jennifer Dickman; Nearing, Kathryn; Gozansky, Wendolyn S
Due to a history of oppression and lack of culturally competent services, lesbian, gay, bisexual and transgender (LGBT) seniors experience barriers to accessing social services. Tailoring an evidence-based ageing in place intervention to address the unique needs of LGBT seniors may decrease the isolation often faced by this population. To describe practices used in the formation of a community-based participatory research (CBPR), partnership involving social workers, health services providers, researchers and community members who engaged to establish a LGBT ageing in place model called Seniors Using Supports To Age In Neighborhoods (SUSTAIN). A case study approach was employed to describe the partnership development process by reflecting on past meeting minutes, progress reports and interviews with SUSTAIN's partners. Key partnering practices utilized by SUSTAIN included (i) development of a shared commitment and vision; (ii) identifying partners with intersecting spheres of influence in multiple communities of identity (ageing services, LGBT, health research); (iii) attending to power dynamics (e.g. equitable sharing of funds); and (iv) building community capacity through reciprocal learning. Although the partnership dissolved after 4 years, it served as a successful catalyst to establish community programming to support ageing in place for LGBT seniors. Multi-sector stakeholder involvement with capacity to connect communities and use frameworks that formalize equity was key to establishing a high-trust CBPR partnership. However, lack of focus on external forces impacting each partner (e.g. individual organizational strategic planning, community funding agency perspectives) ultimately led to dissolution of the SUSTAIN partnership even though implementation of community programming was realized. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Cicero, Ethan C.; Wesp, Linda M.
Throughout the United States, there has been a rise in public discourse about transgender people and transgender issues. Much of this attention stems from passed and proposed anti-LGBTQ (lesbian, gay, bisexual, transgender, queer or questioning) legislation, including "bathroom bills" that would require transgender people to use public…
Patterson Thomas L
Full Text Available Abstract Background Methamphetamine (MA use continues to be a major public health concern in many urban settings. We sought to assess potential relationships between MA use and individual, social, and structural HIV vulnerabilities among sexual minority (lesbian, gay, bisexual or transgendered drug users. Methods Beginning in 2005 and ending in 2008, 2109 drug users were enroled into one of three cohort studies in Vancouver, Canada. We analysed longitudinal data from all self-identified sexual minority participants (n = 248. Logistic regression using generalized estimating equations (GEE was used to examine the independent correlates of MA use over time. All analyses were stratified by biological sex at birth. Results At baseline, 104 (7.5% males and 144 (20.4% females reported sexual minority status, among whom 64 (62.1% and 58 (40.3% reported MA use in the past six months, respectively. Compared to heterosexual participants, sexual minority males (odds ratio [OR] = 3.74, p p = 0.003 were more likely to report recent MA use. In multivariate analysis, MA use among sexual minority males was associated with younger age (adjusted odds ratio [AOR] = 0.93 per year older, p = 0.011, Aboriginal ancestry (AOR = 2.59, p = 0.019, injection drug use (AOR = 3.98, p p = 0.008, unprotected intercourse (AOR = 1.62, p = 0.048, and increased depressive symptoms (AOR = 1.67, p = 0.044. Among females, MA use was associated with injection drug use (AOR = 2.49, p = 0.002, Downtown South residency (i.e., an area known for drug use (AOR = 1.60, p = 0.047, and unprotected intercourse with sex trade clients (AOR = 2.62, p = 0.027. Conclusions Methamphetamine use was more prevalent among sexual minority males and females and was associated with different sets of HIV risks and vulnerabilities. Our findings suggest that interventions addressing MA-related harms may need to be informed by more nuanced understandings of the intersection between drug use patterns, social and
Marshall, Brandon D L; Wood, Evan; Shoveller, Jean A; Patterson, Thomas L; Montaner, Julio S G; Kerr, Thomas
Methamphetamine (MA) use continues to be a major public health concern in many urban settings. We sought to assess potential relationships between MA use and individual, social, and structural HIV vulnerabilities among sexual minority (lesbian, gay, bisexual or transgendered) drug users. Beginning in 2005 and ending in 2008, 2109 drug users were enrolled into one of three cohort studies in Vancouver, Canada. We analysed longitudinal data from all self-identified sexual minority participants (n = 248). Logistic regression using generalized estimating equations (GEE) was used to examine the independent correlates of MA use over time. All analyses were stratified by biological sex at birth. At baseline, 104 (7.5%) males and 144 (20.4%) females reported sexual minority status, among whom 64 (62.1%) and 58 (40.3%) reported MA use in the past six months, respectively. Compared to heterosexual participants, sexual minority males (odds ratio [OR] = 3.74, p order or area restriction (i.e., "no-go zone") impact access to services or influence where drugs are used or purchased (AOR = 4.18, p = 0.008), unprotected intercourse (AOR = 1.62, p = 0.048), and increased depressive symptoms (AOR = 1.67, p = 0.044). Among females, MA use was associated with injection drug use (AOR = 2.49, p = 0.002), Downtown South residency (i.e., an area known for drug use) (AOR = 1.60, p = 0.047), and unprotected intercourse with sex trade clients (AOR = 2.62, p = 0.027). Methamphetamine use was more prevalent among sexual minority males and females and was associated with different sets of HIV risks and vulnerabilities. Our findings suggest that interventions addressing MA-related harms may need to be informed by more nuanced understandings of the intersection between drug use patterns, social and structural HIV vulnerabilities, and gender/sexual identities. In particular, MA-focused prevention and treatment programs tailored to disenfranchised male and female sexual minority youth are recommended.
Hopwood, Max; Lea, Toby; Aggleton, Peter
Hepatitis C virus (HCV) infection is increasingly reported among gay and bisexual men. However, little is known about the personal and social dimensions of HCV-related experience among these men in Australia. An online survey of 474 Australian gay and bisexual men was conducted from August to December 2013. A subsample of 48 HCV mono-infected and HIV/HCV co-infected men was analysed to explore HCV knowledge, sources of information, unmet information needs and use of HCV-related services. More than half of respondents in the subsample were unaware that HIV infection increases the risk of sexually acquired HCV and most wanted information about how to prevent the sexual transmission of HCV. A majority of respondents requested gay-specific HCV services, and approximately similar proportions of men indicated that they would like these services delivered by a hepatitis organization, a lesbian, gay, bisexual, transgender and intersex (LGBTI) organization and a HIV organization. Men in receipt of HIV antiretroviral treatments were most likely to request that gay-specific HCV information and support services be delivered by a LGBTI or HIV organization (OR = 8.63). These findings suggest that a variety of organizations are required to address the information and support needs of Australian gay and bisexual men with HCV. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: email@example.com.
Teachers who include intersex issues in their curricula can provide their intersex students with a sense of community. Intersex people, whether children, teenagers, or adults, often feel that they are going through their experiences absolutely alone. For them, realizing that there are others out there with similar experiences, facing similar…
Is the Lack of Specific Lesbian, Gay, Bisexual, Transgender and Queer/Questioning (LGBTQ) Health Care Education in Medical School a Cause for Concern? Evidence From a Survey of Knowledge and Practice Among UK Medical Students.
Parameshwaran, Vishnu; Cockbain, Beatrice C; Hillyard, Miriam; Price, Jonathan R
Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) people frequently report negative health care encounters. Medical professionals may inadequately manage LGBTQ persons' health if they have not received training in this area. An anonymous survey measuring efficacy in health situations among LGBTQ persons was answered by 166 medical students across all years of a UK university. Results show that 84.9% of participants reported a lack of LGBTQ health care education, with deficits in confidence clarifying unfamiliar sexual and gender terms, deciding the ward in which to nurse transgender patients, finding support resources, and discussing domestic abuse with LGBTQ patients. Most participants reported that they would not clarify gender pronouns or ask about gender or sexual identity in mental health or reproductive health settings. Participants reported infrequently observing doctors making similar inquiries. Participants held positive attitudes toward LGBTQ patients, with attitude scores positively correlating with LGBTQ terminology knowledge scores (r s = 0.5052, p LGBTQ patients.
Walters, Andrew S.; Rehma, Kae
Educators from a variety of disciplines include the concept of transgender and multiple gender identities in course curricula. The "T" (denoting the specific inclusion of transgender) in the popular acronym LGBT (lesbian, gay, bisexual, transgender) often is given less pedagogical attention than is sexual orientation, and the transgender…
For many years, educational practitioners have been implementing multicultural literature about African-American, Asian, and Latino families. Teachers have also presented literature about great leaders, such as Martin Luther King Jr. and Helen Keller. However, the same cannot be said about literature depicting lesbian, gay, bisexual, and…
Once described as hermaphrodites and later as intersex people, individuals born with intersex variations are routinely subject to so-called "normalizing" medical interventions, often in childhood. Opposition to such practices has been met by attempts to discredit critics and reasserted clinical authority over the bodies of women and men with "disorders of sex development." However, claims of clinical consensus have been selectively constructed and applied and lack evidence. Limited transparency and lack of access to justice have helped to perpetuate forced interventions. At the same time, associated with the diffusion of distinct concepts of sex and gender, intersex has been constructed as a third legal sex classification, accompanied by pious hopes and unwarranted expectations of consequences. The existence of intersex has also been instrumentalized for the benefit of other, intersecting, populations. The creation of gender categories associated with intersex bodies has created profound risks: a paradoxically narrowed and normative gender binary, maintenance of medical authority over the bodies of "disordered" females and males, and claims that transgressions of social roles ascribed to a third gender are deceptive. Claims that medicalization saves intersex people from "othering," or that legal othering saves intersex people from medicalization, are contradictory and empty rhetoric. In practice, intersex bodies remain "normalized" or eliminated by medicine, while society and the law "others" intersex identities. That is, medicine constructs intersex bodies as either female or male, while law and society construct intersex identities as neither female nor male. Australian attempts at reforms to recognize the rights of intersex people have either failed to adequately comprehend the population affected or lacked implementation. An emerging human rights consensus demands an end to social prejudice, stigma, and forced medical interventions, focusing on the right to
Greytak, Emily A.; Kosciw, Joseph G.; Boesen, Madelyn J.
This study examines the availability and effectiveness of lesbian, gay, bisexual, and transgender (LGBT)-related school resources for a national sample of transgender youth (N = 409), as compared to a national sample of LGB cisgender (non-transgender) youth (N = 6,444). All four examined resources--gay-straight alliances (GSAs), supportive…
Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study
Nama, Nassr; MacPherson, Paul; Sampson, Margaret; McMillan, Hugh J.
ABSTRACT Background: Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. Objective: The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. Design: Medical students at the University of Ottawa (N = 671) were contacted via email and invited to complete a confidential web-based survey. Results: Response rate was 15.4% (103/671). This included 66 cis-gender heterosexuals (64.1%) and 37 LGBT students (35.9%). Anti-LGBT discrimination had been witnessed by 14.6% and heterosexism by 31.1% of respondents. Anti-LGBT discrimination most often originated from fellow medical students. Respondents who self-identified as LGBT were more likely to have perceived heterosexism (favoring opposite-sex relationships) (OR = 8.2, p LGBT discrimination (OR = 6.6, p = 0.002). While half of LGBT students shared their status with all classmates (51.4%), they were more likely to conceal this from staff physicians (OR = 27.2, p = 0.002). Almost half of medical students (41.7%) reported anti-LGBT jokes, rumors, and/or bullying by fellow medical students and/or other members of the healthcare team. Still, most respondents indicated that they felt comfortable with and capable of providing medical care to LGBT patients (≥83.5%), and were interested in further education around LGBT health issues (84.5%). Conclusion: Anti-LGBT discrimination and heterosexism are noted by medical students, indicating a suboptimal learning environment for LGBT students. Nonetheless, students report a high level of comfort and confidence providing health care to LGBT patients. PMID:28853327
Medical students' perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study.
Nama, Nassr; MacPherson, Paul; Sampson, Margaret; McMillan, Hugh J
Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. Medical students at the University of Ottawa (N = 671) were contacted via email and invited to complete a confidential web-based survey. Response rate was 15.4% (103/671). This included 66 cis-gender heterosexuals (64.1%) and 37 LGBT students (35.9%). Anti-LGBT discrimination had been witnessed by 14.6% and heterosexism by 31.1% of respondents. Anti-LGBT discrimination most often originated from fellow medical students. Respondents who self-identified as LGBT were more likely to have perceived heterosexism (favoring opposite-sex relationships) (OR = 8.2, p LGBT discrimination (OR = 6.6, p = 0.002). While half of LGBT students shared their status with all classmates (51.4%), they were more likely to conceal this from staff physicians (OR = 27.2, p = 0.002). Almost half of medical students (41.7%) reported anti-LGBT jokes, rumors, and/or bullying by fellow medical students and/or other members of the healthcare team. Still, most respondents indicated that they felt comfortable with and capable of providing medical care to LGBT patients (≥83.5%), and were interested in further education around LGBT health issues (84.5%). Anti-LGBT discrimination and heterosexism are noted by medical students, indicating a suboptimal learning environment for LGBT students. Nonetheless, students report a high level of comfort and confidence providing health care to LGBT patients.
"It's for us -newcomers, LGBTQ persons, and HIV-positive persons. You feel free to be": a qualitative study exploring social support group participation among African and Caribbean lesbian, gay, bisexual and transgender newcomers and refugees in Toronto, Canada.
Logie, Carmen H; Lacombe-Duncan, Ashley; Lee-Foon, Nakia; Ryan, Shannon; Ramsay, Hope
Stigma and discrimination harm the wellbeing of lesbian, gay, bisexual and transgender (LGBT) people and contribute to migration from contexts of sexual persecution and criminalization. Yet LGBT newcomers and refugees often face marginalization and struggles meeting the social determinants of health (SDOH) following immigration to countries such as Canada. Social isolation is a key social determinant of health that may play a significant role in shaping health disparities among LGBT newcomers and refugees. Social support may moderate the effect of stressors on mental health, reduce social isolation, and build social networks. Scant research, however, has examined social support groups targeting LGBT newcomers and refugees. The purpose of this qualitative study was to explore experiences of social support group participation among LGBT African and Caribbean newcomers and refugees in an urban Canadian city. We conducted 3 focus groups with a venue-based sample of LGBT African and Caribbean newcomers and refugees (n = 29) who attended social support groups at an ethno-specific AIDS Service Organization. Focus groups followed a semi-structured interview guide and were analyzed using narrative thematic techniques. Participant narratives highlighted immigration stressors, social isolation, mental health issues, and challenges meeting the SDOH. Findings reveal multi-level benefits of social support group participation at intrapersonal (self-acceptance, improved mental health), interpersonal (reduced isolation, friendships), community (reciprocity, reduced stigma and discrimination), and structural (housing, employment, immigration, health care) levels. Findings suggest that social support groups tailored for LGBT African and Caribbean newcomers and refugees can address social isolation, community resilience, and enhance resource access. Health care providers can provide support groups, culturally and LGBT competent health services, and resource access to promote LGBT
Case, Kim A.; Stewart, Briana; Tittsworth, Josephine
Neumann (2005) called for an analysis of marginalization and inclusion of lesbian, gay, and bisexual students in psychology. As psychology instructors begin to infuse such content, the curriculum still overwhelmingly neglects the transgender community. This invisibility of transgender people within psychology courses allows for perpetuation of…
Stone, Amy L.
This paper is a content analysis of political flyers and messages developed by Religious Right campaigns between 1974 and 2013 to fight legislation supportive of lesbian, gay, bisexual, and transgender (LGBT) individuals. The analysis focuses on 16 campaigns in which Religious Right groups made claims about transgender adults and children. In…
The large number of Thai transgender women (Kathoey) in Thailand and their visible roles in society often lead casual visitors to believe that Thailand is open and accepting of LGBT (Lesbian, Gay, Bisexual, Transgender) culture. Hence, it is common to hear Thailand described as gender tolerant and
Scheim, Ayden I; Travers, Robb
Transgender men who have sex with men (trans MSM) may be at elevated risk for HIV and other sexually transmitted infections (STI), and therefore require access to HIV and STI testing services. However, trans people often face stigma, discrimination, and gaps in provider competence when attempting to access health care and may therefore postpone, avoid, or be refused care. In this context, quantitative data have indicated low access to, and uptake of, HIV testing among trans MSM. The present manuscript aimed to identify trans MSM's perspectives on barriers and facilitators to HIV and STI testing. As part of a community-based research project investigating HIV risk and resilience among trans MSM, 40 trans MSM aged 18 and above and living in Ontario, Canada participated in one-on-one qualitative interviews in 2013. Participants described a number of barriers to HIV and other STI testing. These included both trans-specific and general difficulties in accessing sexual health services, lack of trans health knowledge among testing providers, limited clinical capacity to meet STI testing needs, and a perceived gap between trans-inclusive policies and their implementation in practice. Two major facilitators were identified: access to trusted and flexible testing providers, and integration of testing with ongoing monitoring for hormone therapy. Based on these findings, we provide recommendations for enhancing access to HIV and STI testing for this key population.
Wentling, Tre; Windsor, Elroi; Schilt, Kristen; Lucal, Betsy
The recent visibility of transgender lives demonstrates the dawning of a new period in the potential to include transgender topics in sociology courses. The focus on transgender individuals, communities, and inclusive initiatives are gaining momentum on many public and private college and university campuses, awakening old and new curiosities,…
Walker, Charles A; Cohen, Harriet; Jenkins, David
Despite sensationalized media attention, transgender individuals are the most marginalized and misunderstood group in the lesbian, gay, bisexual, and transgender (LGBT) community. The current article presents a case study of one woman's quest for identity. Narrative inquiry was used to analyze data from interview transcripts and four themes emerged during analysis: (a) naming the ambiguity, (b) revealing-concealing the authentic self, (c) discovering the transgender community, and (d) embracing the "T" identity. Lifespan and empowerment theories were used to harvest meanings from these themes. Implications for nursing practice and research were examined based on study findings. Participatory action research offers an approach for future studies in which researchers advocate for transgender individuals and remove obstacles to their health care access. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 31-38.]. Copyright 2016, SLACK Incorporated.
... appropriate to your child’s age and level of maturity. Help your child come up with and practice ... likely than children of heterosexual parents to develop emotional or behavioral problems. If LGBT parents have questions ...
Full Text Available The transgender, gender-atypical or intersex protagonist challenges normative assumptions and expectations about gender, identity and sexuality. This article argues that contemporary transgender-themed young adult fiction and television uses the theme of creativity or the creative achievement script to override previously negative representations of adolescent transgender subjectivities. I consider three English-language novels and one television series for young adults and use script theory to analyse these four texts, each of which has an optimistic ending. The television series, Glee (2009- , is now in its sixth season and therefore has not yet formally concluded. This more recent selection of texts which date from 2011 validate young adult transgender experience and model diversity and acceptance. Cris Beam’s I Am J (2011 and Kirstin Cronn-Mills’ Beautiful Music for Ugly Children (2012, both originally published in the United States, depict female to male transitions. Alyssa Brugman’s Alex as Well (2013, originally published in Australia, foregrounds the experience of an intersex teenager, Alex, raised as a boy, but who, at the age of fourteen, decides she is female. Glee introduced the transgender character Unique in 2012, and she continues to be a central member of the New Directions choir. The Swedish graphic novel, Elias Ericson’s Åror (2013, includes two transgender characters who enact the creative achievement script and fall in love with each other. In other words, Ericson’s graphic novel goes further than the English-language texts to date. Collectively, these transgender, gender-atypical or intersex protagonists and central characters assert their individual agency and creative sense of self. The transgender character’s particular creativity ultimately secures a positive sense of self.
Roe, Stuart L.
School social workers can serve as valuable supporters of lesbian, gay, bisexual, and transgender (LGBT) youths in the public school system by providing services aimed to improve school climates for all students. This article describes a qualitative study that examined gay and bisexual adolescent experiences with peer support using a…
Tebbe, Esther N.; Moradi, Bonnie
This study aimed to identify theoretically relevant key correlates of anti-transgender prejudice. Specifically, structural equation modeling was used to test the unique relations of anti-lesbian, gay, and bisexual (LGB) prejudice; traditional gender role attitudes; need for closure; and social dominance orientation with anti-transgender prejudice.…
Cicero, Ethan C; Wesp, Linda M
Throughout the United States, there has been a rise in public discourse about transgender people and transgender issues. Much of this attention stems from passed and proposed anti-LGBTQ (lesbian, gay, bisexual, transgender, queer or questioning) legislation, including "bathroom bills" that would require transgender people to use public facilities corresponding with the sex designated on their birth certificates. With the recent discussion and legislation impacting school-aged children and adolescents, what does this mean for school nurses and how can they care and advocate for their transgender students? In this article, we aim to empower school nurses to join the discussion, advocate for inclusive and equitable school policies, and deliver gender-affirming care to transgender students. We will explain transgender identities; transgender-related stigma, prejudice, discrimination, and health concerns; gender-affirming approaches in caring for transgender youth; and implications for school nurses. School nurses play a key role in creating a space that is welcoming and affirming where transgender students can thrive.
Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare.
Park, Jason A; Safer, Joshua D
Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. Methods: At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. Results: After completing the elective, students who reported "high" comfort increased from 45% (9/20) to 80% (16/20) ( p =0.04), and students who reported "high" knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) ( p <0.001 ) . Conclusion: Although integrating evidence-based, transgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals.
Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare
Park, Jason A.; Safer, Joshua D.
Abstract Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. Methods: At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. Results: After completing the elective, students who reported “high” comfort increased from 45% (9/20) to 80% (16/20) (p=0.04), and students who reported “high” knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) (ptransgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals. PMID:29344576
Carmel, Tamar C; Erickson-Schroth, Laura
Although research into the physical and mental health disparities faced by transgender and gender nonconforming (TGNC) populations is becoming more popular, historically it has been limited. It is now recognized that TGNC people experience disproportionate rates of negative mental health outcomes relative to both their gender-normative, heterosexual peers, as well as their gender-normative lesbian, gay, and bisexual (LGB) peers. The theoretical basis of current transgender mental health research is rooted in the Minority Stress Model, which postulates that we live in a hetero-centric, gender-normative society that stigmatizes and discriminates against lesbian, gay, bisexual, and transgender (LGBT) people, subjecting them to chronic stress (Hendricks & Testa, 2012; Meyer, 1995). This chronic, potentially compounding stress, is responsible for the increased risk of negative mental health outcomes in LGBT populations. TGNC people, in particular, may experience more adverse outcomes than their LGB peers due to rejection and discrimination within society at large as well as within the LGB community. [Journal of Psychosocial Nursing and Mental Health Services, 54(12), 44-48.]. Copyright 2016, SLACK Incorporated.
Grieshaber, Casey A; Penland, Tiffany N; Kwak, Thomas J; Cope, W Gregory; Heise, Ryan J; Law, J Mac; Shea, Damian; Aday, D Derek; Rice, James A; Kullman, Seth W
Endocrine active compounds (EACs) are pollutants that have been recognized as an emerging and widespread threat to aquatic ecosystems globally. Intersex, the presence of female germ cells within a predominantly male gonad, is considered a biomarker of endocrine disruption caused by EACs. We measured a suite of EACs and assessed their associated impacts on fish intersex occurrence and severity in a large, regulated river system in North Carolina and South Carolina, USA. Our specific objective was to determine the relationship of contaminants in water, sediment, and fish tissue with the occurrence and severity of the intersex condition in wild, adult black bass (Micropterus), sunfish (Lepomis), and catfish (Ictaluridae) species at 11 sites located on the Yadkin-Pee Dee River. Polycyclic aromatic hydrocarbons (PAHs), ethinylestradiol (EE2), and heavy metals were the most prevalent contaminants that exceeded effect levels for the protection of aquatic organisms. Fish intersex condition was most frequently observed and most severe in black basses and was less frequently detected and less severe in sunfishes and catfishes. The occurrence of the intersex condition in fish showed site-related effects, rather than increasing longitudinal trends from upstream to downstream. Mean black bass and catfish tissue contaminant concentrations were higher than that of sunfish, likely because of the latter's lower trophic position in the food web. Principal component analysis identified waterborne PAHs as the most correlated environmental contaminant with intersex occurrence and severity in black bass and sunfish. As indicated by the intersex condition, EACs have adverse but often variable effects on the health of wild sport fishes in this river, likely due to fluctuations in EAC inputs and the dynamic nature of the riverine system. These findings enhance the understanding of the relationship between contaminants and fish health and provide information to guide ecologically
Barrington, Clare; Wejnert, Cyprian; Guardado, Maria Elena; Nieto, Ana Isabel; Bailey, Gabriela Paz
The purpose of this study is to improve understanding of HIV vulnerability and opportunities for HIV prevention within the social networks of male-to-female transgender persons in San Salvador, El Salvador. We compare HIV prevalence and behavioral data from a sample of gay-identified men who have sex with men (MSM) (n = 279), heterosexual or bisexual identified MSM (n = 229) and transgender persons (n = 67) recruited using Respondent Driven Sampling. Transgender persons consistently reported higher rates of HIV risk behavior than the rest of the study population and were significantly more likely to be involved in sex work. While transgender persons reported the highest rates of exposure to HIV educational activities they had the lowest levels of HIV-related knowledge. Transgender respondents' social networks were homophilous and efficient at recruiting other transgender persons. Findings suggest that transgender social networks could provide an effective and culturally relevant opportunity for HIV prevention efforts in this vulnerable population.
Jaffer, Mohamed; Ayad, John; Tungol, Jose Gabriel; MacDonald, Ross; Dickey, Nathaniel; Venters, Homer
Correctional settings create unique challenges for patients with special needs, including transgender patients, who have an increased rate of overall discrimination, sexual abuse, healthcare disparities, and improper housing. As part of our correctional health quality improvement process, we sought to review and evaluate the adequacy of care for transgender patients in the New York City jail system. Using correctional pharmacy records, transgender patients receiving hormonal treatment were identified. A brief in-person survey was conducted to evaluate their care in the community before incarceration, medical care in jail, and experience in the jail environment. Survey findings and analysis of transgender patient healthcare-related complaints revealed opportunities for improvements in the provision of care and staff understanding of this population. Utilizing these findings, we conducted lesbian, gay, bisexual, and transgender (LGBT) trainings in all 12 jail clinics for medical, nursing, and mental health staff. Three months after LGBT training, patient complaints dropped by over 50%. After the development and implementation of a newly revised transgender healthcare policy, complaints dropped to zero within 6 months. Our efforts to assess the quality of care provided to transgender patients revealed significant areas for improvement. Although we have made important gains in providing quality care through the implementation of policies and procedures rooted in community standards and the express wishes of our patients, we continue to engage this patient population to identify other issues that impact their health and well-being in the jail environment.
Experiences of lesbian, gay, bisexual, transgender and intersex students regarding sports participation in a South African rural based university · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. AH Mavhandu-Mudzusi, 710-720 ...
Results 351 - 360 of 8491 ... Technologies like the Internet and mobiles are disrupting many things, including ... Security for women and the lesbian, gay, bisexual, transgender and intersex people in the conflict-affected regions in Colombia.
Results 341 - 350 of 8491 ... Technologies like the Internet and mobiles are disrupting many things, including ... Security for women and the lesbian, gay, bisexual, transgender and intersex people in the conflict-affected regions in Colombia.
Su, Dejun; Irwin, Jay A.; Fisher, Christopher; Ramos, Athena; Kelley, Megan; Mendoza, Diana Ariss Rogel; Coleman, Jason D.
Abstract Purpose: This study assessed within a Midwestern LGBT population whether, and the extent to which, transgender identity was associated with elevated odds of reported discrimination, depression symptoms, and suicide attempts. Methods: Based on survey data collected online from respondents who self-identified as lesbian, gay, bisexual, and/or transgender persons over the age of 19 in Nebraska in 2010, this study performed bivariate t- or chi-square tests and multivariate logistic regre...
Danon, Limor Meoded; Krämer, Anike
Parents of intersex children are perceived in many studies as hopeless, highly dependent on the medical system, and as gate keepers of normative gendered bodies. In this article, we challenge these perceptions and argue that parents of intersex children are problematically positioned between their children's needs for care and well-being and the socialmedical forces that aim to "normalize" them. Their in-between position leads them to establish different parental strategies within and outside of traditional sex/gender norms. We focus on three intertwined parental strategy frameworks: bodily dialogue, sex/gender framing, and concealing/revealing practices, and describe how, in each of these strategic frameworks, the parents maneuver, act in accordance with or against, react to, and challenge the medical system, social interactions, and the sex/gender paradigm. This is a comparative study based on narrative interviews with 22 parents of intersex children in Germany and Israel.
Smith, Marie L; Telford, Elina; Tree, Jeremy J
Western cultures promote a thin and curvaceous ideal body size that most women find difficult to achieve by healthy measures, resulting in poor body image and increased risk for eating pathology. Research focusing on body image in lesbian and bisexual women has yielded inconsistent results. In total, 11 lesbian and bisexual women were interviewed regarding their experiences with body image. Interpretative phenomenological analysis revealed that these women experienced similar mainstream pressures to conform to a thin body ideal. Furthermore, participants perceived additional pressure to conform to heteronormative standards of beauty since the normalisation of homosexuality and the increase in Lesbian, Gay, Bisexual and Transgender representation in mainstream media.
Su, Dejun; Irwin, Jay A; Fisher, Christopher; Ramos, Athena; Kelley, Megan; Mendoza, Diana Ariss Rogel; Coleman, Jason D
Purpose: This study assessed within a Midwestern LGBT population whether, and the extent to which, transgender identity was associated with elevated odds of reported discrimination, depression symptoms, and suicide attempts. Methods: Based on survey data collected online from respondents who self-identified as lesbian, gay, bisexual, and/or transgender persons over the age of 19 in Nebraska in 2010, this study performed bivariate t - or chi-square tests and multivariate logistic regression analysis to examine differences in reported discrimination, depression symptoms, suicide attempts, and self-acceptance of LGBT identity between 91 transgender and 676 nontransgender respondents. Results: After controlling for the effects of selected confounders, transgender identity was associated with higher odds of reported discrimination (OR=2.63, p LGBT identity was associated with substantially lower odds of reporting depression symptoms (OR=0.46, p LGBT identity was associated with depression symptoms among transgender individuals.
Transfer of surgical competences in the treatment of intersex disorders in Togo. ... Background: To evaluate the impact of scientific seminar on the sexual ambiguity on patients and paediatric surgeons in French-speaking African countries. Materials and Methods: This was a report of the proceeding of a teaching seminar on ...
Iverson, Susan V.; Seher, Christin
Despite the proliferation of educational interventions and attitude change strategies, the prevalence of homophobia and widespread discrimination against lesbian, gay, bisexual, and transgender (LGBT) people on college campuses persists. This study investigates the impact of theatre on changes in college students' attitudes. Using a pre- and…
Brewster, Melanie E.; Velez, Brandon; DeBlaere, Cirleen; Moradi, Bonnie
The present study explored whether 3 existing measures of workplace constructs germane to the experiences of sexual minority people could be modified to improve their applicability with transgender individuals. To this end, the Workplace Heterosexist Experiences Questionnaire (WHEQ; C. R. Waldo, 1999); the Lesbian, Gay, Bisexual, and Transgendered…
Greytak, Emily A.; Kosciw, Joseph G.; Diaz, Elizabeth M.
Lesbian, gay, bisexual, and transgender (LGBT) youth may face particularly hostile school climates, as they often report experiencing harassment, discrimination, and other negative experiences in school. LGBT youth, regardless of their gender identity, often face victimization and stigmatization based on both sexual orientation and gender…
Poteat, V. Paul; Scheer, Jillian R.
Gay-Straight Alliances (GSAs) serve lesbian, gay, bisexual, transgender (LGBT) and heterosexual youth from diverse backgrounds. Although some attention has been given to youth members in general, little attention has been given to adult advisors. Among 47 GSA advisors from 33 high schools (39 cisgender female, 8 cisgender male), the authors…
Tornøe, Marie Schou; Lund, Simone Harlev; Ivanescu, Zlate; Gabriela, Roxana; Edske, Amalie Frejvald; Vigholt Olsen, Nina
This paper aims at investigating the way gender affects identity, with an emphasis on transgender individuals. It explores concepts of identity development and gender identity, uncovering the historical and transformative character of gender by looking into personal stories, statistics and laws in the transgender community. As transgender individuals do not adhere to the normative markers of intelligible reality, by not acting in accordance to the gender roles they were assigned, their very e...
Dunham, Yarrow; Olson, Kristina R.
Developmental research on social categorization has overwhelmingly focused on perceptions about and experiences of individuals who are clear or prototypical members of discrete and usually dichotomous social categories. For example, studies of social categorization, stereotyping, prejudice, and social identity have generally explored how children…
There is no clear-cut answer to the question of whether surgical genitoplasty affects gender identity in the intersex infant. The debate centres around which is more important for the development of gender identity: the biological sex of a child or the sex in which a child is reared. We believe that the surgical achievement of a phenotype concordant with the sex of rearing is a tremendous help to the parents of an intersex infant. We do not consider that the 'neutral' upbringing of a child with ambiguous genitalia is a feasible option, first because of the parents' distress which prevents them from raising their child normally and second because in most cultures around the world gender variants are not treated as equals. A neutral upbringing may induce psychosocial consequences that are more pernicious than carefully considered neonatal sex attribution and concordant surgical genitoplasty. (c) 2005 S. Karger AG, Basel.
Jones, Tiffany; Gray, Emily; Harris, Anne
Recognition of human rights on the basis of sexual orientation, gender identity and intersex status by the United Nations has led to the development of new policies concerning homophobia and transphobia in educational contexts. This paper examines new Australian education policies impacting gay, lesbian, bisexual, transgender, intersex and queer…
Full Text Available Although there have been studies that focus on the experiences of the gay and lesbian population serving in the United States military, few have focused on the experience of active duty transgender service members. Transgender individuals transgress the binary conception of gender by deviating from societal gender norms associated with assigned sex at birth. The Department of Defense has set policies and standards that reflect a binary conception of gender, with a focus on conformity. We argue that able-bodied gender variant service personnel are just as capable of serving their country as anyone else. Because of the repercussions associated with active duty transgender military personnel, our sample is small and involves nine clandestine service members and two international service members who wanted to share their stories from a different perspective. Snowball sampling was aimed at finding current active duty and reserve transgender service members. Using a combination of telephone interviews and questionnaires, data were collected from active duty transgender service personnel throughout the United States and two from international militaries that allow transgender people to serve. Data collection focused on the overall experiences of the participants along with questions regarding workplace discrimination, suggestions for policy changes, and their views about the overturn of Don’t Ask, Don’t Tell. Our findings add to a growing source of information about the transgender military experience in the U.S. armed forces and the importance of overturning discriminatory workplace policies that negatively impact transgender service members.
Full Text Available Police policy documents often articulate strategies and approaches that police organizations want to implement in their efforts to break down barriers with minority groups. However, most police policy documents are written for police audiences and not for members of the public. Police policy documents serve as a reflection of the aspirations of the agency and not necessarily the practice of the officers. Differential policing has been a salient experience for members of transgender communities because, as individuals who express gender in ways that deviate from the norm, they have experienced numerous documented cases of police mismanaged practice. In Australia, achieving police reform in the area of policing of diverse community groups has been difficult as new initiatives implemented to educate police officers about diverse groups such as transgender communities are scarce. My study sought to analyze a police policy document to assess how one police agency’s policy aspires to shape police contact/experiences with transgender people and how this document might shape intergroup identity differences between transgender people and the police. It is argued that the policy document will negatively affect police perceptions of transgender people and may enhance adverse perceptions of intergroup difference between police and transgender people. I also argue that using this document to achieve police reform in the area of policing of transgender people will be problematic as the policy document lacks substantial procedural guidelines regarding interaction with transgender people and may not favorably constrain discretionary police power.
Jasruddin, Jasruddin; Daud, Jasmin
Fenomena transgender dalam masyarakat mendapatkan berbagai macam reaksi. Kasus-kasus pun banyak bermunculan sehingga membutuhkan penanganan. Dalam penelitian ini memfokuskan pada persepsi masyarakat kota Makassar terhadap keberadaan transgender. Untuk menjawabnya peneliti menggunakan pendekatan secara agama dan sosiologi. Adapun jenis penelitian ini adalah kuantitatif deskriptif dengan menggunakan metode survey , yaitu dengan melakukan pendekatan langsung terhadap masyarakat kota Makassar se...
Samuels, Elizabeth A; Tape, Chantal; Garber, Naomi; Bowman, Sarah; Choo, Esther K
Transgender, gender-variant, and intersex (trans) people have decreased access to care and poorer health outcomes compared with the general population. Little has been studied and documented about such patients' emergency department (ED) experiences and barriers to care. Using survey and qualitative research methods, this study aims to identify specific areas for improvement and generate testable hypotheses about the barriers and challenges for trans individuals needing acute care. A survey and 4 focus groups were conducted with trans individuals older than 18 years who had been to an ED in the last 5 years. Participants were recruited by trans e-mail listservs; outreach to local trans organizations; and lesbian, gay, bisexual, and transgender periodical advertisements. The interview guide was reviewed by qualitative research and trans health content experts. Deidentified participant demographic information was collected with a standardized instrument. All discussions were captured on digital audio recorders and professionally transcribed. Interview coding and thematic analysis were conducted with a grounded theory approach. Among 32 participants, 71.9% were male identified and 78.1% were white. Nearly half (43.8%) reported avoiding the ED when they needed acute care. The factors that had the greatest influence on ED avoidance were fear of discrimination, length of wait, and negative previous experiences. There were 4 overarching discussion themes: system structure, care competency, discrimination and trauma, and avoidance of emergency care. Improvement recommendations focused on staff and provider training about gender and trans health, assurance of private gender identity disclosure, and accurate capture of sex, gender, and sexual orientation information in the electronic medical record. Efforts to improve trans ED experiences should focus on provider competency and communication training, electronic medical record modifications, and assurance of private means
Lee Pow, Crystal S. D.; Law, J. Mac; Kwak, Thomas J.; Cope, W. Gregory; Rice, James A.; Kullman, Seth W.; Aday, D. Derek
Male fish are susceptible to developing intersex, a condition characterized by the presence of testicular oocytes. In the present study, the relationship between intersex and exposure to estrogenic endocrine active contaminants (EACs) was assessed for 2 genera of sport fish, Micropterus and Lepomis, at 20 riverine sites. Seasonal trends and relationships between EACs and intersex (prevalence and severity) were examined at varying putative sources of EACs throughout North Carolina, identified as point sources, nonpoint sources, and reference sites. Intersex was identified in both genera, which was documented for the first time in wild-caught Lepomis. Intersex was more prevalent (59.8%) and more severe (1.6 mean rank) in Micropterus, which was highly correlation to EACs in sediment. In contrast, intersex was less common (9.9%) and less severe (0.2 mean rank) in Lepomis and was highly correlated to EACs in the water column. The authors found that concentrations of polycyclic aromatic hydrocarbons, polychlorinated biphenyls, industrial EACs, and estrogens were highest at point source sites; however, no source type variation was identified in the prevalence or severity of intersex, nor were there seasonal trends in intersex or EAC concentrations. The authors’ results associate genus-specific prevalence of intersex with specific EAC classes in common sport fishes having biological, ecological, and conservation implications.
Various studies have demonstrated that the presence of imposex, i.e. an imposition of a penis and/or a vas deferens in addition to the normal reproductive tracts in females of gonochoristics prosobranch gastropod species, is a common phenomenon in the marine environment today. However, also other....... This includes examples like transformation of the reproductive and genital tracts in gastropods and cephalopods, spermatogenesis in the female ovary and oocyte development in male testis (ovo-testis). ......Various studies have demonstrated that the presence of imposex, i.e. an imposition of a penis and/or a vas deferens in addition to the normal reproductive tracts in females of gonochoristics prosobranch gastropod species, is a common phenomenon in the marine environment today. However, also other...... signs of endocrine disruption causing sex reversal, characterized as intersex, have been reported for marine molluscs. Intersex can more generally be defined as disturbance of the phenotypic sex characters and different types of intersex have been recorded for both female and male molluscs...
Fisher, Celia B.; Macapagal, Kathryn; Mustanski, Brian
Abstract Purpose: The purpose of this study was to analyze bisexual female youth perspectives on their experiences accessing sexual health information and services provided by a doctor, nurse, or counselor. Specifically, we sought to: (1) understand how youth perceptions of providers' attitudes and behaviors affect their seeking and obtaining sexual health information and services; (2) examine how social stigmas within the family context might be associated with barriers to sexual health information and services; and (3) assess school-based sources of sexual health information. Method: We utilized a mixed-method study design. Data from bisexual female youth were collected through an online questionnaire and asynchronous online focus groups addressing lesbian, gay, bisexual, and transgender health and HIV prevention. Data were analyzed with descriptive statistics and thematic analysis. Results: Barriers to sexual healthcare included judgmental attitudes and assumptions of patient heterosexuality among healthcare providers, and missed opportunities for HIV and sexually transmitted infections (STI) testing. Bisexual stigma within families was associated with restricted youth openness with providers, suggesting fear of disclosure to parent or guardian. School-based sexual health education was limited by a restrictive focus on abstinence and condoms and the exclusion of STI risk information relevant to sex between women. Conclusion: We recommend that practitioners integrate nonjudgmental questions regarding bisexuality into standard contraceptive and sexual health practices involving female youth, including discussion of HIV and STI risk reduction methods. Further support for bisexual health among adolescent girls can come through addressing stigmas of female bisexuality, increasing sensitivity to privacy while engaging parents, and expanding the reach of school-based sexual health education. PMID:27604053
Hagen, Whitney B; Hoover, Stephanie M; Morrow, Susan L
Psychosocial benefits of activism include increased empowerment, social connectedness, and resilience. Yet sexual minority women (SMW) and transgender individuals with multiple oppressed statuses and identities are especially prone to oppression-based experiences, even within minority activist communities. This study sought to develop an empirical model to explain the diverse meanings of social justice activism situated in SMW and transgender individuals' social identities, values, and experiences of oppression and privilege. Using a grounded theory design, 20 SMW and transgender individuals participated in initial, follow-up, and feedback interviews. The most frequent demographic identities were queer or bisexual, White, middle-class women with advanced degrees. The results indicated that social justice activism was intensely relational, replete with multiple benefits, yet rife with experiences of oppression from within and outside of activist communities. The empirically derived model shows the complexity of SMW and transgender individuals' experiences, meanings, and benefits of social justice activism.
Bidell, Markus P.
Clinical training and counselor competency are essential for ethical practice when working with multiethnic, lesbian, gay, bisexual (LGB), and transgender clients. In this study, the author examined how multicultural courses related to students' (N = 286) LGB and multicultural competencies. Self-reported multicultural and LGB competencies…
Meyer, Elizabeth J.; Taylor, Catherine; Peter, Tracey
This paper presents findings from a national study on the beliefs and practices of K-12 educators regarding lesbian, gay, bisexual, transgender, and queer (LGBTQ) issues in schools. Over 3400 Canadian educators participated in the study, which took the form of a bilingual (English/French) online survey. Respondents answered questions about their…
Schools are quasi-public/private organisations and being a teacher involves negotiating personal and professional boundaries. These boundaries have posed particular challenges for lesbian, gay, bisexual, transgender and queer (LGBT-Q) teachers whose everyday lives are complicated by legislative, religious and cultural constraints, moral panics…
Muñoz-Laboy, Miguel; Severson, Nicolette; Levine, Ethan; Martínez, Omar
Latino men who have sex with transgender women make up an overlooked sector of the population that requires more attention than is currently given in sexuality and gender studies, particularly in regard to their non-commercial, long-term sexual and romantic relationships with transgender women. Sixty-one sexual histories were selected for this qualitative analysis from a larger study on Latino male bisexuality in the New York City metropolitan area. Findings suggest that participants' sexual and gender scripts with transgender women are strongly regulated by heteronormativity. Furthermore, homonegativity and transphobia often intersect in the lived experiences of men who have sex with transgender women, resulting in relationship conflicts over the control of transgender women's bodies, sexual behaviours and gender performance both in public and in private. Findings also suggest that low relationship conflict is more common among men who have sex with transgender women who exhibit diverse sexual roles (being both insertive and receptive during anal sex), or transgress heteronormative scripts through dialogue of desires and/or by embracing transgender women as human beings and not as hyperfeminised objects of desire. Stigma reduction and alternatives to heteronormative interventions are needed to improve relationship dynamics and potentially positively impact on the sexual health and overall wellbeing of Latino men who have sex with transgender women and their transgender partners.
Ciocan, Corina M.; Cubero-Leon, Elena; Langston, William J.; Pope, Nick; Cornelius, Keith; Hill, E.M.; Alvarez-Munoz, Diana; Indiveri, Paolo; Lerebours, Adelaide; Minier, Christophe; Rotchell, Jeanette M.
Highlights: • Expression of intersex-related genes was analysed in clam gonads sampled from the Channel. • Genes were differentially expressed at sites with varying levels of intersex and contaminants. • Correlations between gene expressions, key contaminants and sampling sites were identified. • No single gene expression studied correlated with intersex incidence. - Abstract: Intersex, the appearance of female characteristics in male gonads, has been identified in several aquatic species. It is a widespread phenomenon in populations of the bivalve, Scrobicularia plana, from the southwest coast of the U.K. Genes previously identified as differentially expressed (ferritin, testicular haploid expressed gene, THEG, proliferating cell nuclear antigen, PCNA; receptor activated protein kinase C, RACK; cytochrome B, CYB; and cytochrome c oxidase 1, COX1) in intersex clams relative to normal male clams, were selected for characterisation and an environmental survey of the Channel region. Transcripts were significantly differentially expressed at sites with varying intersex incidence and contaminant burdens. Significant correlations between specific gene expressions, key contaminants and sampling locations have been identified, though no single gene was associated with intersex incidence. The results highlight the difficulty in understanding the intersex phenomenon in molluscs where there is still a lack of knowledge on the control of normal reproduction
Examines the special needs fomented by sexual orientation when considering graduate education and access to the academic job market. Offers information on terms and definitions regarding sexual orientation, cultural influences, the relationship between one's personal and professional life, institutional policy, coming out, faculty-student…
Routh, Douglas; Abess, Gassan; Makin, David; Stohr, Mary K; Hemmens, Craig; Yoo, Jihye
Transgender inmates provide a conundrum for correctional staff, particularly when it comes to classification, victimization, and medical and health issues. Using LexisNexis and WestLaw and state Department of Corrections (DOC) information, we collected state statutes and DOC policies concerning transgender inmates. We utilized academic legal research with content analysis to determine whether a statute or policy addressed issues concerning classification procedures, access to counseling services, the initiation and continuation of hormone therapy, and sex reassignment surgery. We found that while more states are providing either statutory or policy guidelines for transgender inmates, a number of states are lagging behind and there is a shortage of guidance dealing with the medical issues related to being transgender.
Verschenen als elektronische publicatie (pdf); niet verkrijgbaar in gedrukte versie. De maatschappelijke en politieke aandacht voor transgender personen heeft de laatste jaren een hoge vlucht genomen. Wetenschappelijke kennis over hun leefsituatie in Nederland blijft hierbij achter. Het Sociaal en
In many countries throughout the world, increasing numbers of gender nonconforming/transgender youth are seeking medical services to enable the development of physical characteristics consistent with their experienced gender. Such medical services include use of agents to block endogenous puberty at Tanner stage II with subsequent use of cross-sex hormones, and are based on longitudinal studies demonstrating that those individuals who were first identified as gender dysphoric in early or middle childhood and continue to meet the mental health criteria for being transgender at early puberty are likely to be transgender as adults. This review addresses terms and definitions applicable to gender nonconforming youth, studies that shed light on the biologic determinants of gender identity, current clinical practice guidelines for transgender youth, challenges to optimal care, and priorities for research. PMID:28164070
... best support your child. For people who are transgender, the realization that they feel different from others also can be very difficult. They may face rejection, discrimination, and even anger from people who don't ...
Stephen M. Rosenthal
Full Text Available In many countries throughout the world, increasing numbers of gender nonconforming/transgender youth are seeking medical services to enable the development of physical characteristics consistent with their experienced gender. Such medical services include use of agents to block endogenous puberty at Tanner stage II with subsequent use of cross-sex hormones, and are based on longitudinal studies demonstrating that those individuals who were first identified as gender dysphoric in early or middle childhood and continue to meet the mental health criteria for being transgender at early puberty are likely to be transgender as adults. This review addresses terms and definitions applicable to gender nonconforming youth, studies that shed light on the biologic determinants of gender identity, current clinical practice guidelines for transgender youth, challenges to optimal care, and priorities for research.
Obedin-Maliver, Juno; Makadon, Harvey J
Transgender people have experienced significant advances in societal acceptance despite experiencing continued stigma and discrimination. While it can still be difficult to access quality health care, and there is a great deal to be done to create affirming health care organizations, there is growing interest around the United States in advancing transgender health. The focus of this commentary is to provide guidance to clinicians caring for transgender men or other gender nonconforming people who are contemplating, carrying, or have completed a pregnancy. Terms transgender and gender nonconforming specifically refer to those whose gender identity (e.g., being a man) differs from their female sex assigned at birth. Many, if not most transgender men retain their female reproductive organs and retain the capacity to have children. Review of their experience demonstrates the need for preconception counseling that includes discussion of stopping testosterone while trying to conceive and during pregnancy, and anticipating increasing experiences of gender dysphoria during and after pregnancy. The clinical aspects of delivery itself fall within the realm of routine obstetrical care, although further research is needed into how mode and environment of delivery may affect gender dysphoria. Postpartum considerations include discussion of options for chest (breast) feeding, and how and when to reinitiate testosterone. A positive perinatal experience begins from the moment transgender men first present for care and depends on comprehensive affirmation of gender diversity.
Bazzi, Angela Robertson; Whorms, Debra S; King, Dana S; Potter, Jennifer
We used retrospective (2012-2013) chart review to examine breast cancer screening among transgender persons and sexual minority women (n = 1263) attending an urban community health center in Massachusetts. Transgender were less likely than cisgender patients and bisexuals were less likely than heterosexuals and lesbians to adhere to mammography screening guidelines (respectively, adjusted odds ratios = 0.53 and 0.56; 95% confidence intervals = 0.31, 0.91 and 0.34, 0.92) after adjustment for sociodemographics. Enhanced cancer prevention outreach is needed among gender and sexual minorities.
An evaluation of social support to transgender people relating to gender identity, gender transition, discrimination and mental health, leading to consideration of the niche for transgender people in a bi-gendered society, and of the developing socialization of transgender which counter-balances the consequences of its initial medicalization.
Dickey, Lore M.; Loewy, Michael I.
Drawing on the existing literature, the authors' research and clinical experiences, and the first author's personal journey as a member and leader of the transgender community, this article offers a brief history of group work with transgender clients followed by suggestions for group work with transgender clients from a social justice…
Fossi Tankoua, O.; Amiard-Triquet, C.; Denis, F.; Minier, C.; Mouneyrac, C.; Berthet, B.
The bivalve Scrobicularia plana, an important species for the structure and functioning of estuarine and coastal mudflats, was studied in thirteen sites from NW France differing by their degree of contamination to document the presence of reproduction impairments (intersex, sex ratio, gonadosomatic indices) in relation to the condition revealed by using hepatosomatic and condition indices. In agreement with recent studies in other European estuaries, intersex was revealed in all the studied estuaries, including sites the chemical and ecological status of which is considered “good” according to the criteria of the European Water Framework Directive. The presence of endocrine disrupting chemicals (EDCs) could result in such disturbances. Our results re-inforce the concern linked to the subtle effects of EDCs, which are active at very low doses, often in the absence of any major sign of toxicity. However at this stage, no clear link may be established between intersex and population effects. - Highlights: ► Clams were collected from 13 estuaries differing by their degree of contamination. ► Gonadosomatic, hepatosomatic and condition indices were determined. ► Reproduction impairments (intersex, biased sex ratio, asynchronism) were shown. ► Intersex shown even at sites with good ecological status (Water Framework Directive). ► No clear links between intersex and populational effects. - Intersex in clams from estuaries, the chemical/ecological status of which was considered as good under the EC Water Framework Directive.
Nádia Perez Pino
Full Text Available A teoria queer emergiu como uma corrente teórica que colocou em xeque as formas correntes de compreensão das identidades sociais no mesmo período em que a problemática dos intersex se tornou socialmente visível. Apesar disso, a reflexão queer sobre os intersex é muito recente. Os intersex impõem reflexões sobre experiências invisíveis, paradoxos identitários e os limites do que compreendemos como humano. Neste artigo, exploro as diferentes definições sobre quem são os intersex, como a teoria queer lida com eles e, concluo com uma reflexão sobre a experiência corporal dos sujeitos marcados como intersex.Queer theory emerged as a theoretical orientation that challenged current forms of understanding social identities at the same moment when the question of the intersex became socially visible. In spite of this, queer reflection on the intersex is fairly recent. The intersex require reflection on invisible experiences, identity paradoxes and the limits of what we understand as human. In this article, I explore the different definitions of who are the intersex, how queer theory deals with them and I conclude with a reflection on the bodily experience of subjects marked as intersex.
This article discusses the ethics of the use of preimplantation genetic diagnosis (PGD) to prevent the birth of children with intersex conditions/disorders of sex development (DSDs), such as congenital adrenal hyperplasia (CAH) and androgen insensitivity syndrome (AIS). While pediatric surgeries performed on children with ambiguous genitalia have been the topic of intense bioethical controversy, there has been almost no discussion to date of the ethics of the use of PGD to reduce the prevalence of these conditions. I suggest that PGD for those conditions that involve serious medical risks for those born with them is morally permissible and that PGD for other "cosmetic" variations in sexual anatomy is more defensible than might first appear. However, importantly, the arguments that establish the latter claim have radical and disturbing implications for our attitude toward diversity more generally.
Zivony, Alon; Saguy, Tamar
Bisexuals are an invisible sexual minority. However, at the same time, bisexuals are stereotypically associated with confusion and promiscuity. Stereotype learning theories suggest that individuals who are unfamiliar with a social group are less likely to have stereotypical beliefs about its members. In contrast, it has been recently hypothesized that stereotypes about bisexuality are not necessarily learned but rather deduced based on common conceptualizations of sexuality. Because stereotypes are suppressed only if they are recognized as offensive, lack of knowledge regarding bisexual stereotypes should actually enhance their adoption. To assess the strength of the two competing accounts, we examined the relationship between explicit knowledge of bisexual stereotypes and stereotypical evaluation of bisexual individuals. Heterosexual participants (N = 261) read a description of two characters on a date and evaluated one of them. Bisexual women were evaluated as more confused and promiscuous relative to nonbisexual women. Moreover, the stereotypical evaluations of bisexual women were inversely related to knowledge about these stereotypes. The findings support the notion that bisexual stereotypes are not learned but rather deduced from shared assumptions about sexuality. Consequently, public invisibility not only exists alongside bisexual stereotypes but might also exacerbate their uninhibited adoption.
Greteman, Adam J.
In this article, the author seeks to assemble moments--scholarly, popular, and aesthetic--in order to explore the possibilities that emerge as moments collect in education's encounters with the needs, struggles, and possibilities of transgender lives and practices. Assembling moments, the author argues, illustrates the value of "moments"…
Besnier, N.; Whelehan, P.; Bolin, A.
Most societies of Polynesia include a small minority of nonnormatively gendered people. These are highly effeminate men and masculine women, whose gendering also implies an erotic attraction to persons of the same sex who are normatively gendered. The gender crossing that transgender Polynesians
Intersex people and bodies have been considered incapable of integration into society. Medical interventions on often healthy bodies remain the norm, addressing perceived familial and cultural demands, despite concerns about necessity, outcomes, conduct and consent. A global and decentralised intersex movement pursues simple core goals: the rights to bodily autonomy and self-determination, and an end to stigmatisation. The international human rights system is responding with an array of new policy statements from human rights institutions and a handful of national governments recognising the rights of intersex people. However, major challenges remain to implement those statements. Human rights violations of intersex individuals persist, deeply embedded in a deliberate history of silencing. Rhetoric of change to clinical practices remain unsubstantiated. Policy disjunctions arise in a framing of intersex issues as matters of sexual orientation and gender identity, rather than innate sex characteristics; this has led to a rhetoric of inclusion that is not matched by the reality. This paper provides an overview of harmful practices on intersex bodies, human rights developments, and rhetorics of change and inclusion. Copyright © 2016 Elsevier Inc. All rights reserved.
Ginsberg, Brian A; Calderon, Marcus; Seminara, Nicole M; Day, Doris
There are an estimated 700,000 or more transgender people in the United States, however their dermatologic needs are not fully established in the medical literature. Unique needs relate to hormone therapy, prior surgeries, and other aspects of physical transitioning. By examining attitudes and practices of transgender individuals, we aimed to identify areas for which dermatologists could contribute to their physical transformation. This cross-sectional study used an anonymous online survey, distributed via lesbian, gay, bisexual, and transgender organizations; social media; and at targeted locations and events. A total of 327 people completed the survey (63% men, 29% women, 9% other). Most transgender women indicated that their face was most imperative to have changed, whereas men noted their chest, in turn influencing procedures. Of women's facial procedures, hair removal predominated, followed by surgery then injectables, mostly performed by plastic surgeons. Hormone-induced facial effects varied, usually taking over 2 years for maximal effect. When choosing procedures, money was the major barrier and good aesthetic outcome the primary concern. Participants did not think that facial procedures necessitate the currently accepted prerequisites for chest and genital surgery. This study has limited size and convenience sampling. Dermatologists could contribute to the physical transformation of transgender patients through noninvasive procedures. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Stotzer, Rebecca L; Herman, Jody L; Hasenbush, Amira
The authors of this report reviewed 51 studies that analyze data about transgender parents. This report reviews the existing research on the prevalence and characteristics of transgender people who are parents, the quality of relationships between transgender parents and their children, outcomes for children with a transgender parent, and the reported needs of transgender parents. Overall, the authors found that substantial numbers of transgender people are parents, though at rates below the ...
Pitasi, Marc A; Oraka, Emeka; Clark, Hollie; Town, Machell; DiNenno, Elizabeth A
Transgender persons are at high risk for human immunodeficiency virus (HIV) infection; in a recent analysis of the results of over nine million CDC funded HIV tests, transgender women* had the highest percentage of confirmed positive results (2.7%) of any gender category (1). Transgender men, † particularly those who have sex with cisgender § men, are also at high risk for infection (2). HIV testing is critical for detecting and treating persons who are infected and delivering preventive services to those who are uninfected. CDC recommends that persons at high risk for HIV infection be screened for HIV at least annually, although transgender persons are not specified in the current recommendations. CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) to describe HIV testing among transgender women and men and two cisgender comparison groups in 27 states and Guam. After adjusting for demographic characteristics, transgender women and men had a lower prevalence of ever testing and past year testing for HIV (35.6% and 31.6% ever, and 10.0% and 10.2% past year, respectively) compared with cisgender gay and bisexual men (61.8% ever and 21.6% past year) and instead reported testing at levels comparable to cisgender heterosexual men and women (35.2% ever, and 8.6% past year). This finding suggests that transgender women and men might not be sufficiently reached by current HIV testing measures. Tailoring HIV testing activities to overcome the unique barriers faced by transgender women and men might increase rates of testing among these populations.
Blosnich, John R; Marsiglio, Mary C; Gao, Shasha; Gordon, Adam J; Shipherd, Jillian C; Kauth, Michael; Brown, George R; Fine, Michael J
To examine whether indicators of community- and state-level lesbian, gay, bisexual, and transgender equality are associated with transgender veterans' mental health. We extracted Veterans Administration data for patients who were diagnosed with gender identity disorder, had at least 1 visit in 2013, and lived in a zip code with a Municipality Equality Index score (n = 1640). We examined the associations of whether a state included transgender status in employment nondiscrimination laws and in hate crimes laws with mood disorders; alcohol, illicit drug, and tobacco use disorders; posttraumatic stress disorder; and suicidal ideation or attempt. Nearly half (47.3%) of the sample lived in states with employment discrimination protection, and 44.8% lived in states with hate crimes protection. Employment nondiscrimination protection was associated with 26% decreased odds of mood disorders (adjusted odds ratio [AOR] = 0.74; 95% confidence interval [CI] = 0.59, 0.93) and 43% decreased odds of self-directed violence (AOR = 0.57; 95% CI = 0.34, 0.95). Understanding lesbian, gay, bisexual, and transgender social stressors can inform treatment and care coordination for transgender populations.
Gaither, Thomas W; Awad, Mohannad A; Osterberg, E Charles; Romero, Angelita; Bowers, Marci L; Breyer, Benjamin N
We aim to describe the relationship between sexual orientation identity and medical morbidities in a large sample of male-to-female (MTF) transgender patients. We reviewed medical records of patients presenting for MTF sex reassignment surgery (SRS) by a single, high-volume surgeon from 2011 to 2015. Sexual attraction to men (heterosexual), women (lesbian), or both (bisexual) was asked of each patient. We examined 16 medical morbidities for this analysis. During the study period, 330 MTF transgender patients presented for SRS. The average age at the time of surgery was 38.9 (range 18-76). One hundred and one patients (32%) reported being heterosexual, 110 patients (34%) reported being lesbian, and 108 patients (34%) reported being bisexual. Lesbian patients presented for SRS at older ages (mean = 43 years old) compared with heterosexual patients (mean = 36 years old) and bisexual patients (mean = 37), P sexual orientation identity. Lesbian patients had greater odds of having a history of depression, age-adjusted odds ratio (aOR) = 2.36, 95% confidence interval (CI) 1.26-4.40, compared with heterosexual patients. Lesbian patients had higher odds of being married or partnered, aOR = 2.31, 95% CI (1.27-4.19), compared with heterosexual patients. Heterosexual patients had higher odds of having human immunodeficiency virus (HIV), aOR = 9.07, 95% CI (1.08-76.5) compared with lesbian patients. Sexual orientation identity in MTF transgender patients is variable. The majority of medical morbidities are not associated with sexual orientation identity. Although HIV and depression are common morbidities among MTF patients seeking SRS, the prevalence of these morbidities differs by sexual orientation identity, but these findings need replication. Counseling and future research initiatives in transgender care should incorporate sexual orientation identity and associated risk behavior.
As mainstream media focus more attention on transgender issues, and as anti-discrimination laws evolve, a shift is taking place on campuses. Many schools now include gender identity and expression in their inclusivity work and seek to establish policies and procedures to support transgender students and their families. It's not an easy task. In…
An emerging area of law is developing regarding sex/gender identity discrimination, also referred to as transgender discrimination, as distinguished from discrimination based on sexual orientation. A transgendered individual is defined as "a person who has a gender-identity disorder which is a persistent discomfort about one?s assigned sex or…
McGuire, Jenifer K; Anderson, Charles R; Toomey, Russell B; Russell, Stephen T
Transgender youth experience negative school environments and may not benefit directly from interventions defined to support Lesbian, Gay and Bisexual (LGB) youth. This study utilized a multi-method approach to consider the issues that transgender students encounter in school environments. Using data from two studies, survey data (total n = 2260, 68 transgender youth) from study 1 and focus groups (n = 35) from study 2, we examine transgender youth's experience of school harassment, school strategies implemented to reduce harassment, the protective role of supportive school personnel, and individual responses to harassment, including dropping out and changing schools. In both studies, we found that school harassment due to transgender identity was pervasive, and this harassment was negatively associated with feelings of safety. When schools took action to reduce harassment, students reported greater connections to school personnel. Those connections were associated with greater feelings of safety. The indirect effects of school strategies to reduce harassment on feelings of safety through connection to adults were also significant. Focus group data illuminate specific processes schools can engage in to benefit youth, and how the youth experience those interventions.
Dr.Sc. Jorida Xhafaj
Full Text Available identity is the way in which a person is self-identified with a gender category, as for example to be female or male, or in some cases intersex, which is none of the distinguishable biological sexes. In principal, intersex persons are part of the society with their rights and obligations, which are not the same with those of the other members of society, in special areas of life. This paper aims to treat the right of intersex persons to marriage and to establish a family. The paper begins with an overview of definition of intersex persons, their rights, and focuses primarily on the right to establish a family. The right for a family life has found protection in the Albanian national legislation. The Constitution of theRepublicofAlbaniaof 1998 in its Article 53 stipulates that "everyone has the right to marry and have a family" establishing the principle of equality before the law, closely linked to the principle of non-discrimination. The legal provisions set a controversial position on the right to get married and to establish family relationships of the intersex persons, which is based on different arguments. For the purposes of the research, we aim also to compare the national legislation with the European principles and practice of the European Court of Human Rights (hereinafter referred as ECHR. The paper also includes the opinions and recommendations of Albanian institutions, as well as those of foreign ones, mainly European, in the area of human rights protection, and especially regarding the rights of the intersex persons.
Boyce, Sabrina; Barrington, Clare; Bolaños, Herbert; Arandi, Cesar Galindo; Paz-Bailey, Gabriela
The purpose of this study was to identify barriers to accessing sexual health services among gay, bisexual and heterosexual-identifying men who have sex with men and male-to-female transgender persons in Guatemala City, to inform the development of high quality and population-friendly services. In-depth, semi-structured interviews were conducted with 29 purposively sampled individuals, including 8 transgender, 16 gay/bisexual and 5 heterosexual-identifying participants. Topical codes were applied to the data using software Atlas.ti™ to compare data between sub-groups. Analysis revealed that public clinics were most commonly used due to their lower cost and greater accessibility, but many participants experienced discrimination, violation of confidentiality and distrust of these services. Transgender and gay/bisexual-identifying participants preferred clinics where they felt a sense of belonging, while heterosexual-identifying participants preferred clinics unassociated with the men who have sex with men community. The most prominent barriers to sexual health services included fear of discrimination, fear of having HIV, cost and lack of social support. Findings highlight the need to strengthen existing public sexually transmitted infection clinics so that they address the multiple layers of stigma and discrimination that men who have sex with men and transgender persons experience.
When a child is born with indeterminate genitalia (so-called intersex or disordered sex development), it becomes very difficult to balance the child's right to determine their own sexual future against the problems of living as a child with an indeterminate gender. Moreover, the initial assignment of gender may prove to be inappropriate and major psychological disturbances in the recipient can arise during adolescence and adult life. The problems of these children were explained to the Australian Senate Committee during its inquiry into intersex surgery in 2013. As a result, the Committee made a number of recommendations, including a proposal that all surgery be deferred until the child is able to consent to treatment. The author argues that the Committee's proposal to delay all modifications of indeterminate genitalia is impractical. The inclusion in the definition of intersex of common conditions (such as hypospadias in genetic male infants) means that necessary and uncontroversial surgery will be delayed until after puberty. This delay may be harmful and adverse to some children's best interests.
Olson, Kristina R; Key, Aidan C; Eaton, Nicholas R
A visible and growing cohort of transgender children in North America live according to their expressed gender rather than their natal sex, yet scientific research has largely ignored this population. In the current study, we adopted methodological advances from social-cognition research to investigate whether 5- to 12-year-old prepubescent transgender children (N = 32), who were presenting themselves according to their gender identity in everyday life, showed patterns of gender cognition more consistent with their expressed gender or their natal sex, or instead appeared to be confused about their gender identity. Using implicit and explicit measures, we found that transgender children showed a clear pattern: They viewed themselves in terms of their expressed gender and showed preferences for their expressed gender, with response patterns mirroring those of two cisgender (nontransgender) control groups. These results provide evidence that, early in development, transgender youth are statistically indistinguishable from cisgender children of the same gender identity. © The Author(s) 2015.
Chen, Diane; Simons, Lisa; Johnson, Emilie K; Lockart, Barbara A; Finlayson, Courtney
To describe fertility preservation (FP) utilization by transgender adolescents within a pediatric gender clinic between July 2013 and July 2016. A retrospective chart review was conducted to abstract demographic and clinical information among adolescents initiating gender-affirming hormones, including patient age at initial FP consultation, birth-assigned sex, race/ethnicity, and outcome of FP consultation. In our sample of 105 transgender adolescents, a total of 13 (seven transgender men and six transgender women) between the age of 14.2 and 20.6 years were seen in formal consultation for FP before initiating hormones. Of these adolescents, four completed sperm cryopreservation and one completed oocyte cryopreservation. Rates of FP utilization among transgender youth were low, which is consistent with a recently published report of FP utilization among transgender youth at another pediatric institution. Identified barriers to FP in our sample included cost, invasiveness of procedures, and desire not to delay medical transition. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Lee, Peter A; Money, John
The following is the actual transcript of an interview with a father whose child, who had a severe micropenis, was 3 weeks of age. The diagnosis had not yet been made, and a decision concerning sex of rearing had not yet been made. This text illustrates numerous important issues concerning communications with parents of infants with intersex.
Wölfer, Ralf; Hewstone, Miles
Two theories offer competing explanations of sex differences in aggressive behavior: sexual-selection theory and social-role theory. While each theory has specific strengths and limitations depending on the victim's sex, research hardly differentiates between intrasex and intersex aggression. In the present study, 11,307 students (mean age = 14.96 years; 50% girls, 50% boys) from 597 school classes provided social-network data (aggression and friendship networks) as well as physical (body mass index) and psychosocial (gender and masculinity norms) information. Aggression networks were used to disentangle intra- and intersex aggression, whereas their class-aggregated sex differences were analyzed using contextual predictors derived from sexual-selection and social-role theories. As expected, results revealed that sexual-selection theory predicted male-biased sex differences in intrasex aggression, whereas social-role theory predicted male-biased sex differences in intersex aggression. Findings suggest the value of explaining sex differences separately for intra- and intersex aggression with a dual-theory framework covering both evolutionary and normative components. © The Author(s) 2015.
of exposure to genotoxic chemicals, and the intersex index (ISI) observed in snails was an indicator of exposure to butyltin (BT) compounds. Biota and sediments were analysed for heavy metals (Cd, Cu, Pb and Zn), butyltin compounds (TBT, DBT and MBT), nine PCB congeners and 19 PAH compounds. The biological...
Valencia, Ainara; Rojo-Bartolomé, Iratxe; Bizarro, Cristina; Cancio, Ibon; Ortiz-Zarragoitia, Maren
Wastewater Treatment Plant (WWTP) discharges are an important source of endocrine disrupting chemicals (EDCs) into the aquatic environment. Fish populations inhabiting downstream of WWTP effluents show alterations in gonad and gamete development such as intersex condition, together with xenoestrogenic effects such as vitellogenin up-regulation. However, the molecular mechanisms participating in the development of intersex condition in fish are not elucidated. The aim of this study was to assess the impact of two WWTPs effluents (Gernika and Bilbao-Galindo situated in the South East Bay of Biscay) with different contaminant loads, in thicklip grey mullet (Chelon labrosus) populations inhabiting downstream, examining the presence and severity of intersex condition, during two seasons. Molecular markers of xenoestrogenicity and oocyte differentiation and development (vtgAa, cyp19a1a, cyp19a1b, cyp11b, foxl2, dmrt1 and gtf3a) were also studied. Intersex mullets were identified downstream of both WWTPs and vtgAa was upregulated in intersex and non intersex males. Sex dependent differential transcription levels of target genes were detected in mullets from Galindo. However, no such pattern was observed in mullets from Gernika, suggesting an attenuating effect over studied genes caused by a higher presence of EDCs in this site, as indicated by the elevated prevalence of intersex mullets in this population. In conclusion, no direct association between xenoestrogenic responses and intersex condition was established. Mullets from Gernika showed signs of severe EDC exposure compared to those from Galindo, as demonstrated by the higher prevalence of intersex males and the reduction in transcription profile differences between sexes of gametogenic gene markers. Copyright © 2016 Elsevier Inc. All rights reserved.
Barr, Sebastian M; Budge, Stephanie L; Adelson, Jill L
This study examined transgender community belongingness as a mediator between strength of transgender identity and well-being. A total of 571 transgender adults (n = 209 transgender women, n = 217 transgender men, and n = 145 nonbinary-identified individuals) completed an online survey assessing transgender community belongingness, strength of transgender identity (operationalized as the extent to which a person self-categorizes their identity as transgender and the extent to which they believe their gender transition to be important to their self-definition), and well-being (using measures of self-esteem, satisfaction with life, and psychological well-being). Structural equation modeling was used to analyze the data. When controlling for participants' income, age, and stage of gender transition, transgender community belongingness fully mediated the relationship between strength of transgender identity and well-being. Strength of transgender identity was indirectly and positively related to well-being through community belongingness, but was not directly related to well-being. Results suggest that transgender community belongingness is an important construct in the mental health of transgender people. The strength of a person's transgender identity also appears to be a significant construct in transgender people's well-being via its relationship with transgender community belongingness. Implications of the findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Kreukels, Baudewijntje P C; Köhler, Birgit; Nordenström, Anna; Roehle, Robert; Thyen, Ute; Bouvattier, Claire; de Vries, Annelou L C; Cohen-Kettenis, Peggy T
Information on the psychosexual outcome of individuals with disorders of sex development (DSDs) and intersex conditions is of great importance for sex assignment at birth of newborns with DSD. To assess gender change and gender dysphoria in a large sample of individuals with different DSDs. A cross-sectional study was conducted in 14 European centers with 1,040 participants (717 female-identifying and 311 male-identifying persons and 12 persons identifying with another gender) with different forms of DSD. The cohort (mean age = 32.36 years, SD = 13.57) was divided into 6 major subgroups: women with 45,X DSD and variants (Turner syndrome; n = 325), men with 47,XXY DSD and variants (Klinefelter syndrome; n = 219), women with XY DSD without androgen effects (n = 107) and with androgen effects (n = 63), men with XY DSD (n = 87), and women with 46,XX congenital adrenal hyperplasia (n = 221). Data on psychosexual outcome were gathered by medical interviews and questionnaires. Gender change and gender dysphoria. Although gender changes were reported by 5% of participants, only in 1% (3% if those with Klinefelter and Turner syndromes-conditions in which gender issues are not prominent-are excluded) did the gender change take place after puberty and was likely initiated by the patient. 39 participants (4%) reported gender variance: between male and female, a gender other than male or female, or gender queer, alternating gender roles, or a gender expression that differed from the reported gender. This group had lower self-esteem and more anxiety and depression than the other participants. Clinicians should be aware of and sensitive to the possibility that their patients with DSD not only might have transgender feelings and a desire to change gender, but also identify as different from male or female. The complexity of their feelings might require counseling for some patients. The study is unique in the large number of participants from many different clinics, with
Discussions on bisexual safe space(s) and online bisexual spaces are limited. This paper explores the potential of an online forum for bisexuals, their partners, and people who are interested in bisexuality to function as an online safe space. To understand whether the analysed forum is successful
Watson, Ryan J; Veale, Jaimie F; Saewyc, Elizabeth M
Research has documented high rates of disordered eating for lesbian, gay, and bisexual youth, but prevalence and patterns of disordered eating among transgender youth remain unexplored. This is despite unique challenges faced by this group, including gender-related body image and the use of hormones. We explore the relationship between disordered eating and risk and protective factors for transgender youth. An online survey of 923 transgender youth (aged 14-25) across Canada was conducted, primarily using measures from existing youth health surveys. Analyses were stratified by gender identity and included logistic regressions with probability profiles to illustrate combinations of risk and protective factors for eating disordered behaviors. Enacted stigma (the higher rates of harassment and discrimination sexual minority youth experience) was linked to higher odds of reported past year binge eating and fasting or vomiting to lose weight, while protective factors, including family connectedness, school connectedness, caring friends, and social support, were linked to lower odds of past year disordered eating. Youth with the highest levels of enacted stigma and no protective factors had high probabilities of past year eating disordered behaviors. Our study found high prevalence of disorders. Risk for these behaviors was linked to stigma and violence exposure, but offset by social supports. Health professionals should assess transgender youth for disordered eating behaviors and supportive resources. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:515-522). © 2016 Wiley Periodicals, Inc.
Austin, Ashley; Craig, Shelley L.; McInroy, Lauren B.
Social work has professional and academic standards consistent with transgender affirmative education and practice. Nevertheless, a growing body of research suggests that transgender issues are largely absent from social work education, resulting in practitioners who are uninformed or biased against transgender issues. The present study expands…
Wening Purbatin Palupi Soenjoto
Full Text Available Transgender phenomena in the community get a variety of reactions. Many cases have sprung up that need to be addressed. In this study focused on the opinions and forms of social action carried out by a student against transgender existence. To answer the researchers used the theory of social action, Max Weber. Snowball is a technique used to determine the informant with the help to the informant. This research was conducted by means of qualitative description and choose a location in the area of Jombang, East Java. Data collected by means of in-depth interviews were then analyzed inductively. Based on the results of the study, presented on the causes being a transgender. Researchers found a uniform answer as to the cause of both informants about being transgender subjectively. It can be seen that transgender is a person were has a biological disorder for example born with two genitals and some were caused by some external factors as the influence of the social environment. In addition there are internal factors that have an instinct that is different from the original gender.
Wernick, Laura J; Kulick, Alex; Inglehart, M H
Transgender young people are at increased risk for bullying, harassment, and negative mental health and academic outcomes compared to the general population as well as compared to other members of lesbian, gay, bisexual, transgender, queer, questioning, and similarly identified (LGBTQQ) communities. To inform interventions to support transgender students, the present study investigates students' willingness to intervene when witnessing anti-transgender harassment, using data collected from a participatory action research project investigating school climate. Multi-step linear regression was used to test the impacts of hearing transphobic language and witnessing teachers and others students intervene, while controlling for demographics and school. Hostile climate negatively predicted intervention intentions while witnessing peer intervention positively predicted likelihood to intervene. Witnessing teacher intervention did not significantly predict the outcome. These findings suggest that youth-led interventions in peer networks might be effective in diminishing transphobic bullying and supporting the healthy development of transgender young people. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Gender. Sexospécificités. Read more about South Asian Water (SAWA) Leadership Program on Climate Change. Language English. Read more about Security for women and the lesbian, gay, bisexual, transgender and intersex people in the conflict-affected regions in Colombia. Language English. Read more about ...
The issue of homosexuality attracts global debate, given that this constitutes risk factor for sexually transmitted diseases. An exploration of socio-cultural, religious and sexual activities of lesbian, gay, bisexual, transgender and intersex sector would inform future Human Immunodeficiency Virus programming.
Shannon, Barrie; Smith, Stephen J.
Sexuality education in Australian schools continues to struggle in its ability and willingness to address many of the broader social issues associated with sexuality, such as the needs of gay, lesbian, bisexual, transgendered, intersex and queer (GLBTIQ) students. Studies involving teachers have demonstrated that a reticence on their part to teach…
Harris, Anne; Farrington, David
Using collaborative performance ethnography in community- and school-based settings, sex education has the potential to challenge at-risk narratives for lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) youth. This paper problematises the youth-led drama project "Epic Queer" to test the "queer" potential of…
The "bullied" gay, lesbian, bisexual, transgender, intersex and otherwise Queer (GLBTIQ) student is a fairly recent figure in the sexuality education research literature. GLBTIQ students have previously been problematised by sex education research in a range of different ways and have been the subjects of varying methodological…
Goodrich, Kristopher M.; Luke, Melissa
The authors describe ethnographic research exploring the experiences of school stakeholders at a lesbian, gay, bisexual, transgender, queer, questioning, and intersex (LGBTQQI)-identified charter school. Participants evidenced use of an overt and covert narrative that appeared to reflect how they navigated the complexities at the…
Goodrich, Kristopher M.
This study surveyed a national sample of school counselors who were members of ASCA to understand what motivated their work, or not, with lesbian, gay, bisexual, transgender, queer, questioning, and intersex (LGBTQQI) students in school. The author implemented Q methodology to collect and analyze the data, and results provide scholars and…
The author examines the role U.S. lesbian- and gay-themed children's picture books play in the deployment of a homonormative subject, how that deployment occurs, and what the consequences are of such a deployment for children; lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) communities; and the larger society. The author, through…
Full Text Available ‘Homophobia’ is shorthand for stigmatising attitudes and practices towards people who demonstrate sexual diversity. In this article, we reflect on how African Christian faith may become redemptive rather than violent in the context of lesbian, gay, bisexual, transgender and intersex forms of sexuality.
Young, Abe Louise
In a school of 1,000 students, up to 100 will be gay, lesbian, or bisexual; 10 will be transgender; and one will be intersex (biologically neither male nor female). If their lives are average, 87 of them will be verbally harassed, 40 of them will be physically harassed, and 19 will be physically assaulted in the next year because of their sexual…
Lathrop, Breanna L; Cheney, Teresa B; Hayman, Annette B
The Making Ethical Decisions about Surgical Intervention (MEDSI) tool is designed to guide health care professionals, patients, and families faced with ethically charged decisions regarding surgical interventions for pediatric patients. MEDSI is built on the principles of beneficence, nonmaleficence, and patient autonomy and created to promote truth-telling, compassion, respect for patient cultural and religious preferences, and appropriate follow up in the clinical setting. Following an overview of the 8 steps that compose MEDSI, the tool is applied to the management of intersex infants. The birth of a child with a disorder of sexual development (DSD) and ambiguous genitalia presents an ethically challenging situation for the family and health care team. The use of the MEDSI model is demonstrated in a case study involving the decision of surgical intervention in the management of an intersex child.
Hoang, T.A.; Oosterhoff, P.
The laws in the Socialist Republic of Vietnam promote equality for all citizens and refer to ‘persons’ rather than ‘men’ or ‘women’. However, because of traditional gender norms, transgender people in Vietnam are facing severe stigma and discrimination in public, in schools, at home and in the
Full Text Available While a large body of research has established that there is substantial prejudice against atheists and nonreligious individuals, both in the US and in other countries where nonreligious people are minorities, to date very little research has looked beyond attitudes toward solitary identities (e.g., “atheists” vs. “gay atheists”. Given the growing recognition of the importance of intersectionality in understanding the experiences of minorities, in this article we examined attitudes toward intersected identities, combining five (nonreligious identities (i.e., Christian, Jewish, Muslim, atheist, and nonreligious with four sexual/gender identities (i.e., heterosexual, homosexual, bisexual, and transgender using a 100-point thermometer scale (N = 618. We found that sexual/gender identities were more influential in ordering the results than were religious identities, with heterosexual individuals being rated most positively, followed for the most part by: homosexual, bisexual, and then transgender individuals. However, within the sexual/gender identities, (nonreligion ordered the results; Christians and Jewish individuals rated most highly among heterosexuals while nonreligious and atheist individuals rated most highly among transgender individuals. We suggest these results indicate that people believe minority sexual/gender identities “taint” or “pollute” religious identities, unless those religious identities are already perceived as tainted, as is the case for atheists and the nonreligious.
In May 2016, the U.S. Department of Justice and the U.S. Department of Education issued guidance to schools intended to provide transgender students with safe and inclusive learning environments. On the heels of this guidance, Ellen Kahn, the Human Rights Campaign's director of Children, Youth, and Families Program, offers advice for educators…
Smith, Francis Duval
Transgender patients are individuals whose gender identity is not related to their biological sex. Assuming a new gender identity that does not conform to societal norms often results in discrimination and barriers to health care. The exact number of transgender patients is unknown; however, these patients are increasingly seen in health care. Transgender individuals may experience provider-generated discrimination in health care facilities, including refusal of service, disrespect, and abuse, which contribute to depression and low self-esteem. Transgender therapies include mental health counseling for depression and low self-esteem, hormone therapy, and sex reassignment surgery. Health care professionals require cultural competence, an understanding of the different forms of patient identification, and adaptive approaches to care for transgender patients. VA (Veterans Affairs) hospitals provide a model for the care for transgender patients and staff. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Pedro Paulo Sammarco Antunes
Full Text Available This study is aimed to understand transgender aging context in Brazil. Normal and abnormal were especially created by biological sciences. For being considered deviants, transgender people are not seen as human beings. They end up living in violent environments. Their life expectancy is low. Many of them do not believe to reach old age. They face a lot of prejudice and death threat. Those who get to what we call old age are considered survivals. This investigation was able to show satisfactorily their demands and needs. To be considered visible, they have to count on public policies to give them existence since their childhood. That way, we believe they will reach what we call old age with respect and dignity, already assured by the Universal Human Rights.
Patel, Viraj V; Masyukova, Mariya; Sutton, Desmond; Horvath, Keith J
Urban young men who have sex with men (YMSM) and transgender women continue to experience high rates of new HIV infections in the USA, yet most of this population is not reached by current prevention interventions. The rate of Internet and social media use among youth is high. However, continually updated understanding of the associations between social media access and use and HIV risk behaviors is needed to reach and tailor technology-delivered interventions for those most vulnerable to HIV-racially and ethnically diverse urban YMSM and transgender persons. Thus, we conducted an in-person, venue-based cross-sectional survey among young gay, bisexual, and transgender individuals at locations primarily visited by Black and Latino gay and bisexual and transgender individuals in New York City to understand social media use and how it may relate to HIV risk behaviors to inform social media-based interventions. Among 102 primarily Black and Latino gay and bisexual men (75.5 %) and transgender women (19.6 %), over 90 % were under 30 years of age, 18.6 % reported homelessness in the past 6 months, and 10.8 % reported having HIV. All participants used social media, most accessed these platforms most often via a mobile device (67.6 %) and most logged on multiple times per day (87.3 %). Participants used social media to seek sex partners (56.7 %), exchange sex for money or clothes (19.6 %), and exchange sex for drugs (9.8 %). These results confirm prior studies demonstrating the feasibility of using social media platforms to reach at-risk, urban youth. Of particular concern is the association between recent STI and exchanging sex for money/clothes and drugs. Interventions using social media for young, urban minority MSM and transgender populations should incorporate risk reduction modules addressing exchange partners and promote frequent and regular HIV/STI testing.
Pollock, Lealah; Silva-Santisteban, Alfonso; Sevelius, Jae; Salazar, Ximena
Transgender women in Lima, Peru have, until recently, been grouped together with gay and bisexual men in the category MSM, or men who have sex with men, with little consideration of their unique situation and needs. Transgender women, self-identified in Peru as travesti, are a socially vulnerable population with many unmet health needs, including an HIV prevalence of 30%. Understanding specific transgender identities and their contexts will contribute to the improvement and development of HIV prevention programs. Through qualitative open-ended interviews with trans-identified women in Lima, Peru, this study found that the non-normative travesti identity is constructed within a conservative homophobic and heteronormative social context. Participants strive towards appearances and relationships perceived as feminine, seeking out silicone injections and abusive men as social markers of this femininity. Sex work is the primary economic activity available and travestis are often alienated from their families and communities. Work is needed to increase self-esteem and decrease violence, stigma, and discrimination. There is a need for multilevel HIV prevention campaigns prioritising travesti in Lima, utilising a human rights framework.
Lennon-Dearing, Robin; Delavega, Elena
Across the United States there has been a spate of legislative bills and initiatives that blatantly stigmatize and discriminate against the lesbian, gay, bisexual, and transgender (LGBT) community. This study was a cross-sectional, exploratory survey designed to measure the attitudes, perceptions, and behaviors of Tennessee social workers and future social workers toward the LGBT population and toward proposed discriminatory legislation. A 3-way factorial ANOVA investigated the effects of political affiliation, religious affiliation, and social contact on the dependent measures. Significant main effects were found. Self-reported political affiliation was found to be the most important factor predicting LGBT acceptance and LGBT respect among this sample.
Bowring, Anna L; Pasomsouk, Nakhornphet; Hughes, Chad; van Gemert, Caroline; Higgs, Peter; Sychareun, Vanphanom; Hellard, Margaret; Power, Robert
People engaging in transactional sex are considered a key population for HIV prevention. Prior quantitative surveys demonstrated that behaviorally bisexual men in Vientiane, Laos commonly transact sex. In 2013, we conducted a qualitative study to explore behaviorally bisexual men's experience, motivations, and perceptions related to transactional sex in Vientiane. Behaviorally bisexual men were recruited from bars, nightclubs, and dormitories for five focus group discussions (FGDs) and 11 in-depth interviews (n = 31). Additionally, young women were recruited from a university, garment factory, and nightclub for four FGDs (n = 22). Transcripts were translated and thematically coded. Bisexual male participants most commonly described being paid for sex by male-to-female transgender people and buying sex from women. Both male and female participants reported that older, single women pay younger men for sex. Negotiation and direction of sexual transactions are influenced by age, attraction, and wealth. Common motivations for selling sex included the need for money to support family or fund school fees, material gain, or physical pleasure. Transactional sex was often opportunistic. Some behaviorally bisexual men reported selling sex in order to pay another more desirable sex partner or to buy gifts for their regular sex partner. Participants perceived high risk associated with intercourse with female sex workers but not with other transactional sex partners. Health interventions are needed to improve knowledge, risk perception, and health behaviors, but must recognize the diversity of transactional sex in Vientiane. Both physical and virtual settings may be appropriate for reaching behaviorally bisexual men and their partners.
Pedro Paulo Sammarco Antunes
Full Text Available This study is aimed to understand transgender aging context in Brazil. Normal and abnormal were especially created by biological sciences. For being considered deviants, transgender people are not seen as human beings. They end up living in violent environments. Their life expectancy is low. Many of them do not believe to reach old age. They face a lot of prejudice and death threat. Those who get to what we call old age are considered survivals. This investigation was able to show satisfactorily their demands and needs. To be considered visible, they have to count on public policies to give them existence since their childhood. That way, we believe they will reach what we call old age with respect and dignity, already assured by theUniversal Human Rights.
Auer, Matthias K; Fuss, Johannes; Höhne, Nina; Stalla, Günter K; Sievers, Caroline
Sexual orientation is usually considered to be determined in early life and stable in the course of adulthood. In contrast, some transgender individuals report a change in sexual orientation. A common reason for this phenomenon is not known. We included 115 transsexual persons (70 male-to-female "MtF" and 45 female-to-male "FtM") patients from our endocrine outpatient clinic, who completed a questionnaire, retrospectively evaluating the history of their gender transition phase. The questionnaire focused on sexual orientation and recalled time points of changes in sexual orientation in the context of transition. Participants were further asked to provide a personal concept for a potential change in sexual orientation. In total, 32.9% (n = 23) MtF reported a change in sexual orientation in contrast to 22.2% (n = 10) FtM transsexual persons (p = 0.132). Out of these patients, 39.1% (MtF) and 60% (FtM) reported a change in sexual orientation before having undergone any sex reassignment surgery. FtM that had initially been sexually oriented towards males ( = androphilic), were significantly more likely to report on a change in sexual orientation than gynephilic, analloerotic or bisexual FtM (p = 0.012). Similarly, gynephilic MtF reported a change in sexual orientation more frequently than androphilic, analloerotic or bisexual MtF transsexual persons (p =0.05). In line with earlier reports, we reveal that a change in self-reported sexual orientation is frequent and does not solely occur in the context of particular transition events. Transsexual persons that are attracted by individuals of the opposite biological sex are more likely to change sexual orientation. Qualitative reports suggest that the individual's biography, autogynephilic and autoandrophilic sexual arousal, confusion before and after transitioning, social and self-acceptance, as well as concept of sexual orientation itself may explain this phenomenon.
Full Text Available This study aimed to investigate the male-to-female morphological and physiological transdifferentiation process in rainbow trout (Oncorhynchus mykiss exposed to exogenous estrogens. The first objective was to elucidate whether trout develop intersex gonads under exposure to low levels of estrogen. To this end, the gonads of an all-male population of fry exposed chronically (from 60 to 136 days post fertilization--dpf to several doses (from environmentally relevant 0.01 µg/L to supra-environmental levels: 0.1, 1 and 10 µg/L of the potent synthetic estrogen ethynylestradiol (EE2 were examined histologically. The morphological evaluations were underpinned by the analysis of gonad steroid (testosterone, estradiol and 11-ketotestosterone levels and of brain and gonad gene expression, including estrogen-responsive genes and genes involved in sex differentiation in (gonads: cyp19a1a, ER isoforms, vtg, dmrt1, sox9a2; sdY; cyp11b; brain: cyp19a1b, ER isoforms. Intersex gonads were observed from the first concentration used (0.01 µg EE2/L and sexual inversion could be detected from 0.1 µg EE2/L. This was accompanied by a linear decrease in 11-KT levels, whereas no effect on E2 and T levels was observed. Q-PCR results from the gonads showed downregulation of testicular markers (dmrt1, sox9a2; sdY; cyp11b with increasing EE2 exposure concentrations, and upregulation of the female vtg gene. No evidence was found for a direct involvement of aromatase in the sex conversion process. The results from this study provide evidence that gonads of male trout respond to estrogen exposure by intersex formation and, with increasing concentration, by morphological and physiological conversion to phenotypic ovaries. However, supra-environmental estrogen concentrations are needed to induce these changes.
Depiereux, Sophie; Liagre, Mélanie; Danis, Lorraine; De Meulder, Bertrand; Depiereux, Eric; Segner, Helmut; Kestemont, Patrick
This study aimed to investigate the male-to-female morphological and physiological transdifferentiation process in rainbow trout (Oncorhynchus mykiss) exposed to exogenous estrogens. The first objective was to elucidate whether trout develop intersex gonads under exposure to low levels of estrogen. To this end, the gonads of an all-male population of fry exposed chronically (from 60 to 136 days post fertilization – dpf) to several doses (from environmentally relevant 0.01 µg/L to supra-environmental levels: 0.1, 1 and 10 µg/L) of the potent synthetic estrogen ethynylestradiol (EE2) were examined histologically. The morphological evaluations were underpinned by the analysis of gonad steroid (testosterone, estradiol and 11-ketotestosterone) levels and of brain and gonad gene expression, including estrogen-responsive genes and genes involved in sex differentiation in (gonads: cyp19a1a, ER isoforms, vtg, dmrt1, sox9a2; sdY; cyp11b; brain: cyp19a1b, ER isoforms). Intersex gonads were observed from the first concentration used (0.01 µg EE2/L) and sexual inversion could be detected from 0.1 µg EE2/L. This was accompanied by a linear decrease in 11-KT levels, whereas no effect on E2 and T levels was observed. Q-PCR results from the gonads showed downregulation of testicular markers (dmrt1, sox9a2; sdY; cyp11b) with increasing EE2 exposure concentrations, and upregulation of the female vtg gene. No evidence was found for a direct involvement of aromatase in the sex conversion process. The results from this study provide evidence that gonads of male trout respond to estrogen exposure by intersex formation and, with increasing concentration, by morphological and physiological conversion to phenotypic ovaries. However, supra-environmental estrogen concentrations are needed to induce these changes. PMID:25033040
Rajpert-De Meyts, Ewa; Jørgensen, N; Müller, Jørn
conditions which included 45,X/46,XY mosaicism; androgen insensitivity syndrome; and 46,XY/iso(p)Y mosaicism. Individuals with such disorders of sexual differentiation and Y-chromosome material carry a very high risk of developing testicular neoplasms. Fetal testicular germ cells of the intersex subjects...... expressed Kit at a later developmental age than controls, in which no Kit protein was detectable beyond the 15th week of gestation. This finding may indicate a disturbance of the chronology of germ cell development, or it may suggest a change of the regulation of c-kit expression in subjects with disorders...
Full Text Available What can the intersex body tell us? How does this issue get more complex if we think about its representation in the media, specially in cinema? In this article, starting from Lucia Puenzo's XXY, we pose these and other questions related to deviant bodies and desires. With a subversive and non-pathologizing discourse, XXY proposes a careful look at the subjectivities of these experiences. We argue that the film, in resonance with the queer studies, is alert to the politicization of the abject bodies.
Zivony, Alon; Lobel, Thalma
Bisexual men have little public visibility, yet previous reports indicate that heterosexuals have specific prejudicial attitudes towards them. This article reports on two studies that examined the stereotypical beliefs of heterosexual men and women regarding bisexual men. In Study 1 (n = 88), we examined awareness of social stereotypes (stereotype knowledge). Most of the participants were unable to describe the various stereotypes of bisexual men. Contrary to previous studies, low-prejudiced participants had more stereotype knowledge than high-prejudiced participants. In Study 2 (n = 232), we examined prejudice in a contextual evaluation task that required no stereotype knowledge. Participants evaluated a single target character on a first date: a bisexual man dating a heterosexual woman, a bisexual man dating a gay man, a heterosexual man dating a heterosexual woman, or a gay man dating a gay man. The findings indicated that participants implemented stereotypical beliefs in their evaluation of bisexual men: compared to heterosexual and gay men, bisexual men were evaluated as more confused, untrustworthy, open to new experiences, as well as less inclined towards monogamous relationships and not as able to maintain a long-term relationship. Overall, the two studies suggest that the stereotypical beliefs regarding bisexual men are prevalent, but often not acknowledged as stereotypes. In addition, the implementation of stereotypes in the evaluations was shown to be dependent on the potential romantic partner of the target. Possible theoretical explanations and implications are discussed.
McGuire, Jenifer K.; Conover-Williams, Meredith
This article explores the opportunity to create spaces within the family, school, and community that specifically promote the well-being of transgender adolescents and young adults. When social contexts are supportive, transgender youth report significantly less risk. Supportive home and school environments have been linked to better outcomes…
Selix, Nancy W; Rowniak, Stefan
Transgender individuals have unique health care needs and experience health disparities. There is an increased need for transgender health care services and primary care for this underserved population. However, provision of appropriate health care services for transgender persons requires cultural competency and skill on the part of the health care provider, and providers need specific skills to address the needs of this population. A review of the literature was performed by accessing CINAHL, PsycINFO, and PubMed databases. Pertinent research was extracted and reviewed for relevance. References in these publications were reviewed to identify additional publications that address primary prevention, secondary prevention, and tertiary care of transgender individuals. Articles that include prevention, screening, and treatment of health problems of transgender persons were identified. Research on the health needs of the transgender population is limited. Whenever available, research findings that address this unique population should be incorporated into clinical practice. When research evidence is not available to address the unique needs of transgender individuals, research and clinical care guidelines from the general population may be applied for health screening and maintenance. This article provides information about primary care services for transgender individuals and seeks to improve awareness of the health disparities this underserved population experiences. Simple solutions to modify clinical settings to enhance care are provided. © 2016 by the American College of Nurse-Midwives.
Beckwith, Noor; Reisner, Sari L.; Zaslow, Shayne; Mayer, Kenneth H.; Keuroghlian, Alex S.
Abstract Purpose: Gender-affirming surgeries and hormone therapy are medically necessary treatments to alleviate gender dysphoria; however, significant gaps exist in the research and clinical literature on surgery utilization and age of hormone therapy initiation among transgender adults. Methods: We conducted a retrospective review of electronic health record data from a random sample of 201 transgender patients of ages 18–64 years who presented for primary care between July 1, 2010 and June 30, 2015 (inclusive) at an urban community health center in Boston, MA. Fifty percent in our analyses were trans masculine (TM), 50% trans feminine, and 24% reported a genderqueer/nonbinary gender identity. Regression models were fit to assess demographic, gender identity-related, sexual history, and mental health correlates of gender-affirming surgery and of age of hormone therapy initiation. Results: Overall, 95% of patients were prescribed hormones by their primary care provider, and the mean age of initiation of masculinizing or feminizing hormone prescriptions was 31.8 years (SD=11.1). Younger age of initiation of hormone prescriptions was associated with being TM, being a student, identifying as straight/heterosexual, having casual sexual partners, and not having past alcohol use disorder. Approximately one-third (32%) had a documented history of gender-affirming surgery. Factors associated with increased odds of surgery were older age, higher income levels, not identifying as bisexual, and not having a current psychotherapist. Conclusion: This study extends our understanding of prevalence and factors associated with gender-affirming treatments among transgender adults seeking primary care. Findings can inform future interventions to expand delivery of clinical care for transgender patients. PMID:29159310
Neumann, Mary Spink; Finlayson, Teresa J; Pitts, Nicole L; Keatley, JoAnne
Transgender persons are at high risk for HIV infection, but prevention efforts specifically targeting these people have been minimal. Part of the challenge of HIV prevention for transgender populations is that numerous individual, interpersonal, social, and structural factors contribute to their risk. By combining HIV prevention services with complementary medical, legal, and psychosocial services, transgender persons' HIV risk behaviors, risk determinants, and overall health can be affected simultaneously. For maximum health impact, comprehensive HIV prevention for transgender persons warrants efforts targeted to various impact levels-socioeconomic factors, decision-making contexts, long-lasting protections, clinical interventions, and counseling and education. We present current HIV prevention efforts that reach transgender persons and present others for future consideration.
Full Text Available Rates of depression are higher in transgender women than in the general population, warranting an understanding of the variables related to depression in this group. Results of the literature review of depression in transgender women reveal several variables influencing depression, including social support, violence, sex work, and gender identity. The theoretical constructs of minority stress, coping, and identity control theory are explored in terms of how they may predict depression in transgender women. Depression and depressive symptoms have been used to predict high-risk sexual behaviors with mixed results. The implications of the findings on treating depression in transgender women include taking into account the stress of transition and the importance of supportive peers and family. Future studies should explore a model of depression and high-risk behaviors in transgender women.
Hrabovszky, Zoltan; Hutson, John M
Psychosexual development, gender assignment and surgical treatment in patients with intersex are controversial issues in the medical literature. Some groups are of the opinion that gender identity and sexual orientation are determined prenatally secondary to the fetal hormonal environment causing irreversible development of the nervous system. We reviewed the evidence in animal and human studies to determine the possible role of early postnatal androgen production in gender development. An extensive literature review was performed of data from animal experiments and human studies. RESULTS Many animal studies show that adding or removing hormonal stimulus in early postnatal life can profoundly alter gender behavior of the adult animal. Human case studies show that late intervention is unable to reverse gender orientation from male to female. Most studies have not permitted testing of whether early gender assignment and treatment as female with suppression/ablation of postnatal androgen production leads to improved concordance of the gender identity and sex of rearing. Animal studies support a role for postnatal androgens in brain/behavior development with human studies neither completely supportive nor antagonistic. Therefore, gender assignment in infants with intersex should be made with the possibility in mind that postnatal testicular hormones at ages 1 to 6 months may affect gender identity. A case-control study is required to test the hypothesis that postnatal androgen exposure may convert ambisexual brain functions to committed male behavior patterns.
Thyen, Ute; Richter-Appelt, Hertha; Wiesemann, Claudia; Holterhus, Paul-Martin; Hiort, Olaf
Biologic factors such as genetic and hormonal influences contribute to gender identity, gender role behavior, and sexual orientation in humans, but this relationship is considerably modified by psychologic, social, and cultural factors. The recognition of biologically determined conditions leading to incongruity of genetically determined sex, somatic phenotype, and gender identity has led to growing interest in gender role development and gender identity in individuals with intersex conditions. Sex assignment of children with ambiguous genitalia remains a difficult decision for the families involved and subject to controversial discussion among professionals and self-help groups. Although systematic empirical data on outcomes of functioning and health-related quality of life are sparse, anecdotal evidence from case series and individual patients about their experiences in healthcare suggests traumatic experiences in some. This article reviews the earlier 'optimal gender policy' as well as the more recent 'full consent policy' and reviews published data on both surgical and psychosocial outcomes. The professional debate on deciding on sex assignment in children with intersex conditions is embedded in a much wider public discourse on gender as a social construction. Given that the empirical basis of our knowledge of the causes, treatment options, long-term outcomes, and patient preferences is insufficient, we suggest preliminary recommendations based on clinical experience, study of the literature, and interviews with affected individuals.
Gamarel, Kristi E; Mereish, Ethan H; Manning, David; Iwamoto, Mariko; Operario, Don; Nemoto, Tooru
Research has demonstrated associations between reports of minority stressors and smoking behaviors among lesbian, gay, and bisexual populations; however, little is known about how minority stressors are related to smoking behaviors and cessation attempts among transgender women. The purpose of this study was twofold: (1) to examine the associations between transgender-based discrimination and smoking patterns among a sample of transgender women; and (2) to identify barriers to smoking cessation in a sample of transgender women with a history of smoking. A community sample of 241 transgender women completed a one-time survey. Binary and multinomial logistic regression models examined associations between minority stressors and (1) smoking behaviors and (2) cessation attempts. Both models adjusted for income, education, race/ethnicity, recent sex work, HIV status, depression, alcohol use, and current hormone use. Overall, 83% of participants indicated that they had smoked a cigarette in the last month. Of these women, 62.3% reported daily smoking and 51.7% reported an unsuccessful quit attempt. Discrimination was positively associated with currently smoking (adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI]: 1.01, 1.08). Discrimination was positively associated with unsuccessful cessation (AOR = 1.03, 95% CI: 1.01, 1.18) and never attempting (AOR = 1.04, 95% CI: 1.01, 1.11) compared to successful cessation. Discrimination was also positively associated with never attempting compared to unsuccessful cessation (AOR = 1.01, 95% CI: 1.00, 1.03). Smoking cessation may be driven by unique transgender-related minority stressors, such as discrimination. Future research is warranted to address unique stigmatizing contexts when understanding and providing tailored intervention addressing smoking among transgender women. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2015. This work is written by (a) US Government
Rieger, Gerulf; Rosenthal, Allen M; Cash, Brian M; Linsenmeier, Joan A W; Bailey, J Michael; Savin-Williams, Ritch C
Conflicting evidence exists regarding whether bisexual-identified men are sexually aroused to both men and women. We hypothesized that a distinct characteristic, level of curiosity about sexually diverse acts, distinguishes bisexual-identified men with and without bisexual arousal. Study 1 assessed men's (n=277) sexual arousal via pupil dilation to male and female sexual stimuli. Bisexual men were, on average, higher in their sexual curiosity than other men. Despite this general difference, only bisexual-identified men with elevated sexual curiosity showed bisexual arousal. Those lower in curiosity had responses resembling those of homosexual men. Study 2 assessed men's (n=72) sexual arousal via genital responses and replicated findings of Study 1. Study 3 provided information on the validity on our measure of sexual curiosity by relating it to general curiosity and sexual sensation seeking (n=83). Based on their sexual arousal and personality, at least two groups of men identify as bisexual. Copyright © 2013 Elsevier B.V. All rights reserved.
The categorization of individuals as "male" or "female" is based on chromosome complement and gonadal and genital phenotype. This combined genetic-gonadal-genitals sex, here referred to as 3G-sex, is internally consistent in ~99% of humans (i.e., one has either the "female" form at all levels, or the "male" form at all levels). About 1% of the human population is identified as "intersex" because of either having an intermediate form at one or more levels, or having the "male" form at some levels and the "female" form at other levels. These two types of "intersex" reflect the facts, respectively, that the different levels of 3G-sex are not completely dimorphic nor perfectly consistent. Using 3G-sex as a model to understand sex differences in other domains (e.g., brain, behavior) leads to the erroneous assumption that sex differences in these other domains are also highly dimorphic and highly consistent. But parallel lines of research have led to the conclusion that sex differences in the brain and in behavior, cognition, personality, and other gender characteristics are for the most part not dimorphic and not internally consistent (i.e., having one brain/gender characteristic with the "male" form is not a reliable predictor for the form of other brain/gender characteristics). Therefore although only ~1% percent of humans are 3G-"intersex", when it comes to brain and gender, we all have an intersex gender (i.e., an array of masculine and feminine traits) and an intersex brain (a mosaic of "male" and "female" brain characteristics).
Tallentire, Liz; Smith, Matthew; David, Lee; Roberts, Adam; Bruce; Morrow, Sarah; Withers, Paul; Smith, Ian
This research is about people who have intellectual disabilities and live in a secure hospital. It is about a group of people who meet at a support group. The support group is for people who are lesbian, gay, bisexual or transgender. These people with intellectual disabilities helped with planning, doing, and telling other people about the research. They told their stories about going to the support group. Their stories were joined together into a group story. The story said that the group helped people in lots of different ways. For some people going to the group was difficult at first because it was ?coming out'. This means telling other people you are lesbian, gay, bisexual, or transgender. Then it got easier and people started to feel better about themselves. Then they wanted to help others and this was important in their lives. This group seemed to help people get better. We have given some ideas for setting up other groups and doing more research. © 2016 John Wiley & Sons Ltd.
Gupta, Sarika; Imborek, Katherine L; Krasowski, Matthew D
The transgender community is one of the most marginalized sections of our society. The literature is scarce regarding the pathology and laboratory medicine challenges associated with caring for transgender patients. To summarize the available gender-transitioning options and to discuss healthcare challenges, from a pathology/laboratory medicine perspective, in the care of transgender patients. We reviewed the current terminology and epidemiology relevant to the transgender population in preparing our analysis. The main transgender healthcare challenges in pathology/laboratory medicine practice include the inflexibility of electronic medical records in documenting affirmed gender, unfamiliarity among medical and laboratory professional with the needs of and terminology related to the transgender population, lack of reference ranges for laboratory tests, unclear guidelines regarding gender classification for blood donation eligibility criteria, and paucity of experience in handling and interpreting surgical and cytologic specimens from gender-transitioning individuals. Directed efforts to overcome these shortcomings, coupled with a more welcoming posture, are essential to achieving the highest standards of care for the transgender population. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Veale, Jaimie F; Watson, Ryan J; Peter, Tracey; Saewyc, Elizabeth M
This study documented the prevalence of mental health problems among transgender youth in Canada and made comparisons with population-based studies. This study also compared gender identity subgroups and age subgroups (14-18 and 19-25). A nonprobability sample of 923 transgender youth from Canada completed an online survey. Participants were recruited through community organizations, health care settings, social media, and researchers' networks. Mental health measures were drawn from the British Columbia Adolescent Health Survey and the Canadian Community Health Survey. Transgender youth had a higher risk of reporting psychological distress, self-harm, major depressive episodes, and suicide. For example, 65% of transgender 14- to 18-year olds seriously considered suicide in the past year compared with 13% in the British Columbia Adolescent Health Survey, and only a quarter of participants reported their mental health was good or excellent. Transgender boys/men and nonbinary youth were most likely to report self-harm and overall mental health remained stable across age subgroups. Although a notable minority of transgender youth did not report negative health outcomes, this study shows the mental health disparities faced by transgender youth in Canada are considerable. Copyright Â© 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Greta R. Bauer
Full Text Available Abstract Background Bisexual populations have higher prevalence of depression, anxiety, suicidality and substance use than heterosexuals, and often than gay men or lesbians. The co-occurrence of multiple outcomes has rarely been studied. Methods Data were collected from 405 bisexuals using respondent-driven sampling. Weighted analyses were conducted for 387 with outcome data. Multiple outcomes were defined as 3 or more of: depression, anxiety, suicide ideation, problematic alcohol use, or polysubstance use. Results Among bisexuals, 19.0 % had multiple outcomes. We did not find variation in raw frequency of multiple outcomes across sociodemographic variables (e.g. gender, age. After adjustment, gender and sexual orientation identity were associated, with transgender women and those identifying as bisexual only more likely to have multiple outcomes. Social equity factors had a strong impact in both crude and adjusted analysis: controlling for other factors, high mental health/substance use burden was associated with greater discrimination (prevalence risk ratio (PRR = 5.71; 95 % CI: 2.08, 15.63 and lower education (PRR = 2.41; 95 % CI: 1.06, 5.49, while higher income-to-needs ratio was protective (PRR = 0.44; 0.20, 1.00. Conclusions Mental health and substance use outcomes with high prevalence among bisexuals frequently co-occurred. We find some support for the theory that these multiple outcomes represent a syndemic, defined as co-occurring and mutually reinforcing adverse outcomes driven by social inequity.
Stieglitz, Kimberly A
Transgender youth face unique and complex issues as they confront cultural expectations of gender expression and how these fit with what is natural for them. Striving for balance, learning to cope, questioning, and eventually becoming comfortable with one's gender identity and sexual orientation are of paramount importance for healthy growth and development. Ineffective management of intense challenges over time without adequate social support places youth at risk for a number of unhealthy behaviors, including risk behaviors associated with acquiring HIV. This article explores early foundations of gender identity development, challenges in the development of transgender youth, and the limited data that exist on transgender youth and HIV risks. The concept of resilience is introduced as a counterbalancing area for assessment and intervention in practice and future research with transgender youth.
Ehrenfeld, Jesse; Gridley, Samantha
The ED often is the access point of choice for transgender patients who may be reluctant to interact with providers. Experts say there is a need for training and education of how to present a gender-affirming healthcare environment. Recommended steps include a review of policies, along with corresponding changes to electronic and paper intake forms to ensure that the language used is inclusive of all genders. While blanket discrimination may be declining, experts note that some providers are uncertain about how to interact with a transgender patient. It's always best to ask patients for their preferred name and pronoun and to repeat this exercise every three to six months for return patients, as gender identify can be fluid. To ease anxiety for transgender patients, consider developing a navigator program that will pair any transgender patient who requests the service with a trained advocate who can support and guide the patient through the system.
Herndon, Aaron M; Casal, Margret L; Jaques, John T Scott
This case describes the presentation and management of an 8 yr old phenotypically female intersex male dog presented for evaluation of a mass in the right inguinal region. The right inguinal space was surgically explored, and a large irregular mass resembling a fully developed testicle was identified in the right vaginal tunic. A second mass resembling an atrophied, but anatomically mature testicle, was identified in the left tunic. The larger mass was identified as a Sertoli cell tumor that had replaced all normal testicular tissue. The smaller mass was identified as a testicle that contained a small intratubular seminoma. The patient was diagnosed as having a phenotypic female sex, chromosomal male sex, and a gonadal male sex. Hormone assays completed before and after the gonadectomy and mass removal document an elevation of circulating progesterone presurgically that returned to baseline by 1 mo postsurgically. The source of the progesterone was identified to be the Leydig cells of the atrophied testicle.
Byrd, Rebekah; Hays, Danica G.
Much research has been dedicated to the difficulties LGBTQ individuals face. Further, school counselors have been challenged to assist LGBTQ individuals in the school setting. Being aware of the specific issues and being educated about specific ways to assist these individuals enable school counselors to be more effective clinicians (DePaul,…
Toomey, Russell B.; Ryan, Caitlin; Diaz, Rafael M.; Card, Noel A.; Russell, Stephen T.
Past research documents that both adolescent gender nonconformity and the experience of school victimization are associated with high rates of negative psychosocial adjustment. Using data from the Family Acceptance Project's young adult survey, we examined associations among retrospective reports of adolescent gender nonconformity and adolescent…
Somasundaram, Ottilingam; Tejus Murthy, A. G.
Homosexuality has been present in human civilization from ancient times, and the condition as it existed in the Tamil land is described along with a reference to the terminology, concepts, and description. Some instances appear in the old Tamil classics and poems. The present legal status of this sexual orientation is also mentioned. PMID:28066015
Somasundaram, Ottilingam; Tejus Murthy, A G
Homosexuality has been present in human civilization from ancient times, and the condition as it existed in the Tamil land is described along with a reference to the terminology, concepts, and description. Some instances appear in the old Tamil classics and poems. The present legal status of this sexual orientation is also mentioned.
Full Text Available Homosexuality has been present in human civilization from ancient times, and the condition as it existed in the Tamil land is described along with a reference to the terminology, concepts, and description. Some instances appear in the old Tamil classics and poems. The present legal status of this sexual orientation is also mentioned.
Tama, Aira; Yealta, Den
This study attempts to outline anything program-program undp in legalising lgbt marriage in China.And also will explain how program-program undp in legalising lgbt marriage in China.The methodology used is qualitative study.This study focused to talk about the role in the United Nations DeveopmentProgram ( UNDP ) legalising lgbt in the country tiongkok. Second, researchers feel the need to give time limit to phenomena or problem to check such as in 2014-2016This research use a pluralism persp...
Duke, Thomas Scott
This meta-synthesis of empirical and nonempirical literature analyzed 24 journal articles and book chapters that addressed the intersection of disability, [homo]sexuality, and gender identity/expression in P-12 schools, colleges and universities, supported living programs, and other educational and social contexts in Australia, Belgium, Canada,…
Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities; Board on the Health of Select Populations; Institute of Medicine
... and researchers are faced with incomplete information about their health status. While LGBT populations often are combined as a single entity for research and advocacy purposes, each is a distinct population group with its own specific health needs...
Jacobson, Anita N; Matson, Kelly L; Mathews, Jennifer L; Parkhill, Amy L; Scartabello, Thomas A
To quantify the implementation of inclusive policies and benefits as well as institutional commitment to support LGBT faculty, staff, and students in pharmacy schools nationwide. An anonymous, electronic survey was sent to administrators at 130 pharmacy schools. Forty-four survey responses were received, indicating a 34% response rate. The survey included questions relating to campus climate, inclusive policies and benefits, and institutional commitments to the LGBT community. Approximately half of the survey respondents reported that their school has public written statements about diversity and multiculturalism that include sexual orientation and/or gender identity. About one-fifth of the respondents indicated that their school has inclusive materials for faculty, staff, and student information regarding sexual orientation and gender identity. Nearly one-fourth of schools of pharmacy had participated in a voluntary LGBT training program, such as Safe Zone, Safe Space, or Ally Program. Over half of the respondents reported having access to LGBT organizations on campus, with two schools reporting having pharmacy organizations that specifically focus on LGBT student pharmacists and allies. Less than one-tenth of schools reported offering gender-neutral/single-occupancy restrooms and no schools reported knowledge of LGBT-related scholarships. Room for improvement exists regarding the implementation of inclusive practices to improve campus climate for LGBT students, faculty, and staff. Areas with the largest room for improvement include accessible gender-neutral restrooms and availability of LGBT trainings, scholarships, and events. Copyright © 2016 Elsevier Inc. All rights reserved.
Mallory, Christy; Herman, Jody L.; Badgett, M.V. Lee
This report analyzes evidence of employment discrimination against LGBT people in Oklahoma, and asses the impact of adding sexual orientation and gender identity to the state’s non-discrimination law. We find that LGBT people in Oklahoma face discrimination in the workplace, including lower wages. Evidence also shows that a sexual orientation and gender identity non-discrimination law may have a positive impact on businesses in the state, and will not overwhelm state enforcement agencies or ...
Wells, Michael B; Lang, Sarah N
To explore the needs of and support given to lesbian, gay, bisexual, transgendered and inter-sex parents within the Nordic child health field. The number of lesbian, gay, bisexual, transgendered and inter-sex parents is growing around the world. However, they face fear, discrimination and heteronormativity within the child health field. The Nordic countries (Sweden, Norway, Denmark, Finland and Iceland) rank as the most gender equal countries in the world; therefore, they may support lesbian, gay, bisexual, transgendered and inter-sex parents to a greater extent. Systematic literature review and meta-synthesis. A systematic search was conducted for lesbian, gay, bisexual, transgendered and inter-sex parents' experiences in the child health field, which consists of prenatal, labour and birth, postnatal and child health clinics, using PubMed, PsychInfo, Sociological Abstracts and CINAHL, as well as searching the grey literature, from 2000-2015. Ten articles were included. A quality assessment and a meta-synthesis of the articles were performed. Nearly all studies were qualitative, and most articles had at least one area of insufficient reporting. Only two countries, Sweden and Norway, had lesbian, gay, bisexual, transgendered and inter-sex parents reporting on the child health field. However, gay, bisexual, transgender and inter-sex parents' perspectives were nonexistent in the literature; therefore, the results all relate to same-sex mothers. Five themes were found: Acceptance of Same-sex Mothers, Disclosing Sexual Orientation, Heteronormative Obstacles, Co-mothers are Not Fathers, and Being the Other Parent. Same-sex mothers are generally accepted within the Nordic child health field, but they still face overt and covert heteronormative obstacles, resulting in forms of discrimination and fear. Co-mothers feel invisible and secondary if they are not treated like an equal parent, but feel noticed and important when they are given equal support. Changes at the
Johnson, Emily L; Kaplan, Peter W
Approximately 25 million individuals older than age 15 identify as transgender, representing about 0.3-0.9% of the world's population. The aim of this paper is to identify and describe important medical and social considerations facing transgender persons with epilepsy. We performed literature searches on the following terms: transgender AND epilepsy, transgender AND neurology, gender dysphoria AND epilepsy, gender dysphoria AND neurology. We also performed literature searches for common feminizing or masculinizing treatment regimens, and searched for interactions of those treatment regimens with antiepileptic drugs (AEDs) and with seizures. There are multiple bidirectional interactions between AEDs and the commonly used treatments for aligning external sex characteristics with identified gender. The scope of the transgender population with epilepsy remains to be elucidated. Transgender patients with epilepsy face significant social and medical challenges. Interactions between medical gender-affirming treatments and AEDs are common, and management must depend on knowledge of these interactions to provide appropriate treatment. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.
Virupaksha, H G; Muralidhar, Daliboyina; Ramakrishna, Jayashree
Suicide rate and suicidal tendencies among transgender persons are considerably high compared to general population. Hence, this review is an attempt to understand the issues around the suicide and suicidal behavior among transgender persons. The literature search conducted using three sources, i.e., electronic databases (PubMed, ProQuest, Google Scholar, PsycInfo), manual search (library catalog), and gray literature (consultation with experts). The suicide attempt rate among transgender persons ranges from 32% to 50% across the countries. Gender-based victimization, discrimination, bullying, violence, being rejected by the family, friends, and community; harassment by intimate partner, family members, police and public; discrimination and ill treatment at health-care system are the major risk factors that influence the suicidal behavior among transgender persons. In spite of facing a number of hardships in their day-to-day life, the transgender community holds a number of resiliency factors. Further, this community needs to be supported to strengthen their resiliency factors and draw culturally sensitive and transgender-inclusive suicide prevention strategies and increase protective factors to tackle this high rate of suicidality.
Deacon, Rachel M; Mooney-Somers, Julie
To investigate smoking prevalence trends and correlates among lesbian, bisexual and queer-identifying (LBQ) women in Sydney, Australia. Data from 5007 respondents to a repeated cross-sectional community survey were used to examine smoking trends between 2004 and 2014. Multinomial logistic regression was used to examine smoking correlates. Thirty percent of respondents were current smokers, including 48% of 16 to 24-year-olds. A slight decrease in all-ages smoking over time was not reflected in the youngest age group. LBQ women who smoke have fewer economic, social and psychological resources than both women who never smoke and ex-smokers. High levels of alcohol and illicit drug use are also correlated with current smoking. Population-wide interventions have failed to address the persistently high prevalence of smoking among this sample of LBQ women. Tailored interventions may find utility focusing on personal resilience to deal with general and sexuality-specific stressors, as well as attending to poly-substance use. Acknowledgment of LBQ women as a priority group for tobacco reduction is urgently needed. We call on tobacco control agencies to consider sexuality and gender orientation in policy and partner with lesbian, gay, bisexual and transgender community organisations to develop culturally appropriate interventions. [Deacon RM, Mooney-Somers J Smoking prevalence among lesbian, bisexual and queer women in Sydney remains high: Analysis of trends and correlates Drug Alcohol Rev 2017;36:546-554]. © 2017 Australasian Professional Society on Alcohol and other Drugs.
Lefkowitz, Ayla R F; Mannell, Jenevieve
Transgender youth often face difficulties when accessing sexual health services. However, few studies investigate health service providers' perceptions of transgender youth, and fewer focus on sexual health. To fill this gap, our study draws on social representations theory to examine sexual health service providers' perceptions of transgender youth and how this influences the provision of health services for this marginalised population in England. A thematic analysis of 20 semi-structured interviews with service providers, conducted between March and June 2014, resulted in five main themes centred on: binary representations of transgender; transgender as homosexuality; uncertain bodies; unstable mental states; and too young to know. Of the service providers interviewed, many understood transgender within a male/female binary, and perceived being transgender to be synonymous with being gay. There was confusion among service providers regarding transgender youths' sexual organs, and most of those interviewed saw transgender youth as mentally unstable and confused. Finally, many service providers perceived that transgender youth are too young to know that they are transgender and make decisions about their body. Some of these representations were potentially stigmatising and many conflicted with transgender youths' representations of themselves. Training by transgender people is recommended to help address these misunderstandings. © 2017 John Wiley & Sons Ltd.
Ortiz-Martínez, Yeimer; Ríos-González, Carlos Miguel
Background Recently, lesbian, gay, bisexual, and transgender (LGBT) scientific production is growing, but transgender (TG) people is less considered in the LGBT-related research, highlighting the lack of representative data on this neglected population. To assess the current status of scientific production on TG population, a bibliometric study was performed using the articles on TG people deposited in five databases, including PubMed/Medline, Scopus, Science Citation Index (SCI), Scientific Electronic Library Online (SciELO) and Latin American and Caribbean Health Sciences Literature (LILACS). The PubMed/Medline search retrieved 2370 documents, which represented 0.008% of all articles recorded in Medline. The Scopus search identified 4974 articles. At SCI, 2863 articles were identified. A search of the SciELO database identified 39 articles, whereas the LILACS search identified 44 articles. Most papers were from the US (57.59%), followed by Canada (5.15%), the UK (4.42%), Australia (3.19%), The Netherlands (2.46%) and Peru (1.83%). These six countries accounted for 74.6% of all scientific output. The findings indicate that the TG-related research is low, especially in low-income developing countries, where stigma and discrimination are common. More awareness, knowledge, and sensitivity in healthcare communities are needed to eliminate barriers in health attention and research in this population.
Kattari, Shanna K; O'Connor, Ashley A; Kattari, Leonardo
Transgender-inclusive behaviors are actions and communication supporting transgender individuals. Examples include using language not reinforcing the gender binary, asking for and using correct pronouns, creation of spaces that welcome members of the transgender community, and acknowledging cisgender (non-transgender) privilege. A survey was developed measuring this behavior in individuals to examine the impact of transgender-inclusive behavior and the potential effect of interventions on promoting inclusive behavior. Data were collected utilizing an online survey (N = 1,051). The sample was split in half to run two sets of cases in a principal components analysis. Analysis of the full sample showed Cronbach's alpha to be .93 (n = 918). Findings suggest that the Transgender Inclusive Behavior Scale (TIBS) may be a useful instrument for identifying behaviors related to being inclusive of transgender individuals, groups, and communities. It may also be used to measure behavior change before and after transgender-specific educational and behavioral interventions.
Matthias K Auer
Full Text Available Sexual orientation is usually considered to be determined in early life and stable in the course of adulthood. In contrast, some transgender individuals report a change in sexual orientation. A common reason for this phenomenon is not known.We included 115 transsexual persons (70 male-to-female "MtF" and 45 female-to-male "FtM" patients from our endocrine outpatient clinic, who completed a questionnaire, retrospectively evaluating the history of their gender transition phase. The questionnaire focused on sexual orientation and recalled time points of changes in sexual orientation in the context of transition. Participants were further asked to provide a personal concept for a potential change in sexual orientation.In total, 32.9% (n = 23 MtF reported a change in sexual orientation in contrast to 22.2% (n = 10 FtM transsexual persons (p = 0.132. Out of these patients, 39.1% (MtF and 60% (FtM reported a change in sexual orientation before having undergone any sex reassignment surgery. FtM that had initially been sexually oriented towards males ( = androphilic, were significantly more likely to report on a change in sexual orientation than gynephilic, analloerotic or bisexual FtM (p = 0.012. Similarly, gynephilic MtF reported a change in sexual orientation more frequently than androphilic, analloerotic or bisexual MtF transsexual persons (p =0.05.In line with earlier reports, we reveal that a change in self-reported sexual orientation is frequent and does not solely occur in the context of particular transition events. Transsexual persons that are attracted by individuals of the opposite biological sex are more likely to change sexual orientation. Qualitative reports suggest that the individual's biography, autogynephilic and autoandrophilic sexual arousal, confusion before and after transitioning, social and self-acceptance, as well as concept of sexual orientation itself may explain this phenomenon.
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Galvan, Frank H.; Bazargan, Mohzen
A new report, funded by the Williams Institute, reveals high levels of reported harassment and assault of Latina transgender women by law enforcement agencies and highlights steps that police departments should take to improve relations with the transgender community. The report, “Interactions of Latina Transgender Women with Law Enforcement” is based on interviews with 220 Latina transgender women from the Los Angeles area. BIENESTAR, a non-profit social service organization comm...
Bailey, J V; Farquhar, C; Owen, C; Whittaker, D
To provide data about the sexual histories of a large sample of lesbians and bisexual women, to inform those who provide health care or carry out research with women who may be sexually active with other women. Cross sectional survey. 803 lesbians and bisexual women attending, as new patients, lesbian sexual health clinics, and 415 lesbians and bisexual women from a community sample. Self reported sexual history and sexual practice with both male and female partners. 98% of the whole sample gave a history of sexual activity with women, 83% within the past year, with a median of one female partner in that year. 85% of the sample reported sexual activity with men; for most (70%) this was 4 or more years ago. First sexual experience tended to be with a man (median 18 years old), with first sexual experience with a woman a few years later (median 21 years). Oral sex, vaginal penetration with fingers, and mutual masturbation were the most commonly reported sexual practices between women. Vaginal penetration with penis or fingers and mutual masturbation were the most commonly reported sexual activities with men. These data from the largest UK survey of sexual behaviour between women to date demonstrate that lesbians and bisexual women may have varied sexual histories with both male and female partners. A non-judgmental manner and careful sexual history taking without making assumptions should help clinicians to avoid misunderstandings, and to offer appropriate sexual health advice to lesbians and bisexual women.
Grabenwoeger, F.; Grabenwoeger, M.; Dock, W.; Gherardini, R.; Karnel, F.
The accuracy of genito-urography in the diagnosis of intersex and for the demonstration of the internal genitalia has been studied in 16 patients. If was found tat the radiological appearances agreed in all cases with the surgical findings. Individual malformations of the genitals have been considered with reference to the classification of Shopfner and Prader and the advantages and disadvantages of various examination techniques are discussed. (orig.) [de
Openly? There are 18 countries that allow transgender personnel to serve openly in their mili- taries: Australia, Austria, Belgium, Bolivia , Canada...clinical and cultural competence for the proper care of transgender patients. Surgical procedures quite similar to those used for gender transition...tries that allow transgender personnel to serve openly in their militaries: Austra- lia, Austria, Belgium, Bolivia , Canada, Czech Republic, Denmark
Weinand, Jamie D.; Safer, Joshua D.
Introduction: Some providers report concern for the safety of transgender hormone therapy (HT). Methods: This is a systematic literature review of HT safety for transgender adults. Results: Current literature suggests HT is safe when followed carefully for certain risks. The greatest health concern for HT in transgender women is venous thromboembolism. HT among transgender men appears to cause polycythemia. Both groups experienced elevated fasting glucose. There is no increase in cancer...
Friedman, M Reuel; Dodge, Brian; Schick, Vanessa; Herbenick, Debby; Hubach, Randolph; Bowling, Jessamyn; Goncalves, Gabriel; Krier, Sarah; Reece, Michael
A newly emergent literature suggest that bisexual men and women face profound health disparities in comparison to both heterosexual and homosexual individuals. Additionally, bisexual individuals often experience prejudice, stigma, and discrimination from both gay/lesbian and straight communities, termed "biphobia." However, only limited research exists that empirically tests the extent and predictors of this double discrimination. The Bisexualities: Indiana Attitudes Survey (BIAS) was developed to test associations between biphobia and sexual identity. Using standard techniques, we developed and administered a scale to a purposive online sample of adults from a wide range of social networking websites. We conducted exploratory factor analysis to refine scales assessing attitudes toward bisexual men and bisexual women, respectively. Using generalized linear modeling, we assessed relationships between BIAS scores and sexual identity, adjusting for covariates. Two separately gendered scales were developed, administered, and refined: BIAS-m (n=645), focusing on attitudes toward bisexual men; and BIAS-f (n=631), focusing on attitudes toward bisexual women. Across scales, sexual identity significantly predicted response variance. Lesbian/gay respondents had lower levels of bi-negative attitudes than their heterosexual counterparts (all p-values stereotypes and stigma may lead to dramatic disparities in depression, anxiety, stress, and other health outcomes among bisexual individuals in comparison to their heterosexual and homosexual counterparts. Our results yield valuable data for informing social awareness and intervention efforts that aim to decrease bi-negative attitudes within both straight and gay/lesbian communities, with the ultimate goal of alleviating health disparities among bisexual men and women.
Safer, Joshua D; Coleman, Eli; Feldman, Jamie; Garofalo, Robert; Hembree, Wylie; Radix, Asa; Sevelius, Jae
Transgender persons suffer significant health disparities and may require medical intervention as part of their care. The purpose of this manuscript is to briefly review the literature characterizing barriers to healthcare for transgender individuals and to propose research priorities to understand mechanisms of those barriers and interventions to overcome them. Current research emphasizes sexual minorities' self-report of barriers, rather than using direct methods. The biggest barrier to healthcare reported by transgender individuals is lack of access because of lack of providers who are sufficiently knowledgeable on the topic. Other barriers include: financial barriers, discrimination, lack of cultural competence by providers, health systems barriers, and socioeconomic barriers. National research priorities should include rigorous determination of the capacity of the US healthcare system to provide adequate care for transgender individuals. Studies should determine knowledge and biases of the medical workforce across the spectrum of medical training with regard to transgender medical care; adequacy of sufficient providers for the care required, larger social structural barriers, and status of a framework to pay for appropriate care. As well, studies should propose and validate potential solutions to address identified gaps.
Castilla-Peón, María Fernanda
Transgender or gender nonconforming (GN) persons identify themselves with a gender which is different from that correspondent to their birth sex. The demand for health services by families with transgender children or adolescents tends to increase. The prevalence of GN in children is unknown; however, it has been estimated to be > 1% in adolescents. Transgender persons are at increased risk of depression, suicide, illicit drug abuse, human immunodeficiency virus infection, and non-accidental injury. The most accepted model for the care of transgender persons assumes that these adverse outcomes are the consequence of social margination rather than the GI condition itself. Social and physical gender transition seem to be effective in increasing the well-being of people with GI and reducing associated health risks. Mental health professionals can support the child in the process of social transition. The pediatric endocrinologist may offer puberty blockade and cross-sex induction of puberty. Surgical sex reassignment interventions are reserved for adults. Gender identity, gender expression and sexual orientation are three relatively independent categories that can take any value, which is not necessarily binary (male/female) or fixed. Health professionals should be familiar with these concepts in order to offer the best resources available to optimize the well-being of each transgender child or adolescent with an individualized approach. Copyright: © 2018 Permanyer.
Kozee, Holly B.; Tylka, Tracy L.; Bauerband, L. Andrew
Our study used the construct of congruence to conceptualize the degree to which transgender individuals feel genuine, authentic, and comfortable with their gender identity and external appearance. In Study 1, the Transgender Congruence scale (TCS) was developed, and data from 162 transgender individuals were used to estimate the reliability and…
Full Text Available Background: The present study aims to explore the perceived parenting style among the transgender. Methods: It was a cross-sectional comparative study. Purposive sampling was used for the transgender group and group-matched non-transgender were included in the non-transgender comparative group. A sample of 62 individuals (30 transgender consisting of 22 male to female or MTF transgender and eight female to male or FTM transgender, and 32 non-transgender consisting of 24 males and eight females, male and females, between the age range of 18-40 years, and minimum educational qualification till class eight were selected after a basic interview and screening. They were assessed using the Parental Authority Questionnaire and t-test analysis was computed to analyse the obtained data. Results: Authoritative parenting style was found to be significantly lower for both the parents of the participants in the transgender group. On the contrary, authoritarian parenting was found to be significantly higher for both the parents in the transgender group. Conclusions: The study indicated that among the transgender group, both the parents fail to provide safe and nurturing emotional climate which has been found to be contributory to healthy development and respectful of an individual. Hence, the findings highlight the need that interventions should also focus on family acceptance as it acts as protective factor and promote their well-being.
B.A. Ginsberg, MD
Full Text Available Given the complexities of the transitioning process, transgender individuals may face unique dermatologic needs in addition to routine care. Exogenous hormones affect hair and sebum production, gender-confirming surgeries often require dermatologic pre- and postoperative interventions, and postoperative anatomy may show unique presentations of routine skin conditions. Aesthetic techniques that are often used for rejuvenation may have a role in facial feminization and masculinization and unfortunately are too frequently performed by nonmedical personnel with negative consequences. Ultimately, physicians should strive to make their office a more accommodating environment for transgender individuals.
Lee, Peter A; Houk, Christopher P
Data provided by 24 adult men, 20 heterosexual and four homosexual, concerning parental, religious, geographic and explicit sexual innuendos, comments and childhood experiences are presented and discussed in an attempt to consider some of the multiple factors impacting the development of sexual orientation. All of the study subjects were normally developed males and were presumed to have been exposed to normal male levels of androgens prenatally. Since the experiences and perceptions reported are conditioned by a unique social environment that has been superimposed on a normal male typical prenatal CNS differentiation, the experiences of these men suggest that affirmation of masculinity, and openness in the realm of social and sexual interaction, may enhance the formation of a heterosexual orientation. Conversely, sexually explicit feedback with critical implications occurred commonly among the homosexual men, which they interpreted as implying an insufficient masculinity. Both innate factors and social influences impact sexual orientation; in some instances males appear to have been homosexual from early childhood onward, while in other cases there appears to have been some degree of conditioning and choice in sexual orientation. Regarding the intersexed male, this suggests that social interactions, particularly those provided by parents, have a major influence on the development of sexual orientation in the child, while all persons involved in these children's lives and particularly those who nurture must be prepared for any sexual orientation that develops.
Full Text Available Gender and sexuality norms, conscribed under cis/heteropatriarchy, have established violent and unstable social and educational climates for the millennial generation of lesbian, gay, bisexual, transgender, intersex, agender/asexual, gender creative, and questioning youth. While strides have been made to make schools more supportive and queer inclusive, schools still struggle to include lesbian, gay, bisexual, transgender*+, intersex, agender/asexual, gender creative, queer and questioning (LGBT*+IAGCQQ-positive curricula. While extensive studies must be done on behalf of all queer youth, this work specifically focuses on how to support classroom teachers to uptake and apply a pedagogy of refusal that attends to the most vulnerabilized population of queer youth to date, those that are trans*+. A pedagogy of refusal will be explored through an evolving theory of trans*+ness, then demonstrated through a framework for classroom application, followed by recommendations for change.
Leach, Caitlin; Layson-Wolf, Cherokee
1) To measure the general perceptions and attitudes of community pharmacy residents toward transgender patients and health; 2) to identify gaps in didactic education regarding transgender health care among residents; and 3) to evaluate residents' level of support for pharmacists receiving education in transgender health care. This study was a cross-sectional survey delivered online. Community residency directors were e-mailed a cover letter and a 34-question online survey. The directors were asked to forward the survey to their residents for completion within 4 weeks. Responses were anonymous with no identifiers collected on the survey. Survey responses used a combination of open-response, multiple-choice, and Likert-scale questions aimed at gathering respondents' demographic information, perceptions of managing transgender patients and the need for receiving additional education in transgender health care. Overall, the results of the survey indicated that community pharmacy residents support integrating transgender health management into pharmacy education and recognize that the overwhelming barriers to care for these patients include discrimination and lack of provider knowledge. Significant findings include: 82.7% of community residents think that community pharmacists play an important role in providing care for transgender patients; 98.2% think that they have a responsibility to treat transgender patients; and 71.4% were not educated about transgender patient issues in pharmacy school. Only 36.2% of community residents felt confident in their ability to treat transgender patients. Community pharmacy residents list discrimination and lack of provider knowledge as the major barriers to care for transgender patients. Residents do not feel confident in their ability to treat and manage transgender patients. The majority of residents were not educated about transgender patient issues while in pharmacy school and think that community pharmacists need more education
Meyer, Ilan H.; Wilson, Patrick A.
Sampling has been the single most influential component of conducting research with lesbian, gay, and bisexual (LGB) populations. Poor sampling designs can result in biased results that will mislead other researchers, policymakers, and practitioners. Investigators wishing to study LGB populations must therefore devote significant energy and…
Rudin, Joel; Yang, Yang; Ruane, Sinead; Ross, Linda; Farro, Andrea; Billing, Tejinder
Transgender employees may suffer from discrimination due to transphobia. This article evaluates a pedagogical intervention designed to reduce the transphobia of North American undergraduate business students. Participants were enrolled in an organizational behavior course. They resolved a simulated dispute between coworkers over accommodating the…
Heck, Nicholas C.; Sorensen, James L.
Little is known about the needs or characteristics of transgender individuals in substance abuse treatment settings. Transgender (n=199) and non-transgender (cisgender, n=13440) individuals were compared on psychosocial factors related to treatment, health risk behaviors, medical and mental health status and utilization, and substance use behaviors within a database that documented individuals entering substance abuse treatment in San Francisco, CA from 2007–2009 using logistic and linear regression analyses (run separately by identified gender). Transgender men (assigned birth sex of female) differed from cisgender men across many psychosocial factors, including having more recent employment, less legal system involvement, greater incidence of living with a substance abuser, and greater family conflict, while transgender women (assigned birth sex of male) were less likely to have minor children than cisgender women. Transgender women reported greater needle use and HIV testing rates were greater among transgender women. Transgender men and women reported higher rates of physical health problems, mental health diagnoses, and psychiatric medications but there were no differences in service utilization. There were no differences in substance use behaviors except that transgender women were more likely to endorse primary methamphetamine use. Transgender individuals evidence unique strengths and challenges that could inform targeted services in substance abuse treatment. PMID:24561017
Full Text Available This study is the first to report the presence of intersex in invasive round goby Neogobius melanostomus inhabiting the Baltic Sea. The discovery was made in the area of two harbours of the Gulf of Gdańsk (Poland. Macro- and microscopic male gonad analysis revealed the presence of female gametes in testes (testis-ova of single specimens. In addition, a female-like urogenital papilla was observed in one of the intersex fish. These findings might be due to the exposure to estrogenic endocrine disrupting compounds (EDCs however the occurrence of single intersex individuals as a baseline level in investigated population is also possible. In the future, more comprehensive research in the other areas of the Gulf of Gdańsk needs to be carried out in order to determine the extent and to better understand the cause of the observed phenomenon.
'ecart intersexes disparait si l'analyse tient compte de cette connaissance. Sur le plan du temps de reponse, les deux sexes ne se distinguent que lors du trace de la surface de l'eau dans un contenant incline, les garcons reflechissant alors plus longtemps. Le temps mis a produire, puis a verifier un trace, ne differe pas selon le sexe des participants. Dans l'evaluation de l'orientation d'une ligne cependant, les filles ne se distinguent pas des garcons et les participants connaissant le principe d'invariance reussissent mieux que ceux l'ignorant. Par ailleurs, les filles procedent toujours moins rapidement que les garcons. Pour les contenants inclines ou a l'horizontale, si la ligne represente la surface de l'eau, la difference intersexes est annulee quand la connaissance du principe est prise en compte. (Abstract shortened by UMI.)
Abdel-Moneim, Ahmed; Deegan, Daragh; Gao, Jiejun; De Perre, Chloe; Doucette, Jarrod S; Jenkinson, Byron; Lee, Linda; Sepúlveda, Maria S
Over the past decade, studies have shown that exposure to endocrine disrupting chemicals (EDCs) can cause gonadal intersex in fish. Smallmouth bass (Micropterus dolomieu) males appear to be highly susceptible to developing testicular oocytes (TO), the most prevalent form of gonadal intersex, as observed in various areas across the U.S. In this study, prevalence and severity of TO was quantified for smallmouth bass sampled from the St. Joseph River in northern Indiana, intersex biomarkers were developed, and association between TO prevalence and organic contaminants were explored. At some sites, TO prevalence reached maximum levels before decreasing significantly after the spawning season. We examined the relationship between TO presence and expression of gonadal and liver genes involved in sex differentiation and reproductive functions (esr1, esr2, foxl2, fshr, star, lhr and vtg). We found that vitellogenin (vtg) transcript levels were significantly higher in the liver of males with TO, but only when sampled during the spawning season. Further, we identified a positive correlation between plasma VTG levels and vtg transcript levels, suggesting its use as a non-destructive biomarker of TO in this species. Finally, we evaluated 43 contaminants in surface water at representative sites using passive sampling to look for contaminants with possible links to the observed TO prevalence. No quantifiable levels of estrogens or other commonly agreed upon EDCs such as the bisphenols were observed in our contaminant assessment; however, we did find high levels of herbicides as well as consistent quantifiable levels of PFOS, PFOA, and triclosan in the watershed where high TO prevalence was exhibited. Our findings suggest that the observed TO prevalence may be the result of exposures to mixtures of nonsteroidal EDCs. Copyright © 2017 Elsevier Ltd. All rights reserved.
Blazer, V S; Iwanowicz, L R; Iwanowicz, D D; Smith, D R; Young, J A; Hedrick, J D; Foster, S W; Reeser, S J
Intersex, or the presence of characteristics of both sexes, in fishes that are normally gonochoristic has been used as an indicator of exposure to estrogenic compounds. In 2003, during health assessments conducted in response to kills and a high prevalence of skin lesions observed in smallmouth bass Micropterus dolomieu in the South Branch of the Potomac River, the presence of immature oocytes within testes was noted. To evaluate this condition, a severity index (0-4) was developed based on the distribution of oocytes within the testes. Using gonad samples collected from 2003 to 2005, the number of histologic sections needed to accurately detect the condition in mature smallmouth bass was statistically evaluated. The reliability of detection depended on the severity index and the number of sections examined. Examining five transverse sections taken along the length of the gonad resulted in a greater than 90% probability of detecting testicular oocytes when the severity index exceeded 0.5. Using the severity index we compared smallmouth bass collected at selected sites within the South Branch during three seasons in 2004. Seasonal differences in severity and prevalence were observed. The highest prevalence and severity were consistently noted during the prespawn-spawning season, when compared with the postspawn season. In 2005, smallmouth bass were collected at selected out-of-basin sites in West Virginia where fish kills and external skin lesions have not been reported, as well as at sites in the Shenandoah River, Virginia (part of the Potomac drainage), where kills and lesions occurred in 2004-2005. The prevalence of testicular oocytes is discussed in terms of human population and agricultural intensity.
As many gender teachers know, distinctions between and among complex terms in the lesbian, gay, bisexual, trans (gender or sexual), queer (LGBTQ) group are often difficult for students to articulate and identify. In fact, terms like "sex" and "gender" are often conflated in public discourse, and terms like…
Herman, Jody L.
Transgender residents of Massachusetts have reported experiencing discrimination in employment. Loss of employment due to anti-transgender bias often means lost wages, lost health insurance coverage, and housing instability. Therefore, employment discrimination might affect the budget of the Commonwealth of Massachusetts in several ways: reduced income tax revenues, higher public assistance expenditures, and other costs. For instance, if a worker is fired for being transgender and loses wages...
Brown, Taylor NT; Herman, Jody L
The State of Florida spends more than a half million dollars each year as the result of employment discrimination against transgender residents. Currently, 10 counties and 14 cities in Florida have ordinances prohibiting discrimination based on gender identity in public and private sector employment, but nearly 22,000 transgender adult residents are not covered by these laws. Employment discrimination against transgender adults in Florida costs the state an estimated $570,000 annually in stat...
Logie, Carmen H; Lacombe-Duncan, Ashley; Brien, Natasha; Jones, Nicolette; Lee-Foon, Nakia; Levermore, Kandasi; Marshall, Annecka; Nyblade, Laura; Newman, Peter A
Young men who have sex with men (MSM) in Jamaica have the highest HIV prevalence in the Caribbean. There is little information about HIV among transgender women in Jamaica, who are also overrepresented in the Caribbean epidemic. HIV-related stigma is a barrier to HIV testing among Jamaica's general population, yet little is known of MSM and transgender women's HIV testing experiences in Jamaica. We explored perceived barriers and facilitators to HIV testing among young MSM and transgender women in Kingston, Jamaica. We implemented a community-based research project in collaboration with HIV and lesbian, gay, bisexual and transgender (LGBT) agencies in Kingston. We held two focus groups, one with young (aged 18-30 years) transgender women (n = 8) and one with young MSM (n = 10). We conducted 53 in-depth individual semi-structured interviews focused on HIV testing experiences with young MSM (n = 20), transgender women (n = 20), and community-based key informants (n = 13). We conducted thematic analysis to identify, analyze, and report themes. Participant narratives revealed social-ecological barriers and facilitators to HIV testing. Barriers included healthcare provider mistreatment, confidentiality breaches, and HIV-related stigma: these spanned interpersonal, community and structural levels. Healthcare provider discrimination and judgment in HIV testing provision presented barriers to accessing HIV services (e.g. treatment), and resulted in participants hiding their sexual orientation and/or gender identity. Confidentiality concerns included: clinic physical arrangements that segregated HIV testing from other health services, fear that healthcare providers would publicly disclose their status, and concerns at LGBT-friendly clinics that peers would discover they were getting tested. HIV-related stigma contributed to fear of testing HIV-positive; this intersected with the stigma of HIV as a "gay" disease. Participants also anticipated healthcare provider
Nuttbrock, Larry A
Transgender individuals are misunderstood and inadequately treated in many conventional substance abuse treatment programs. This article reviews current concepts regarding the definition and diversity of transgenderism and summarizes the existing literature on the prevalence and correlates of substance use in transgendered populations. Examples of culturally competent and gender-sensitive treatment in specialized settings are cited, with a call to extend these initiatives throughout the gamut of service venues that engage transgender individuals. Cultural competence combined with gender sensitivity should improve the effectiveness of substance abuse treatment for transgender individuals and will contribute to the goal of providing effective services in an increasingly diverse society.
Ayala, George; Santos, Glenn-Milo
Gay and bisexual men and other men who have sex with men are among the small number of groups for whom HIV remains uncontrolled worldwide. Although there have been recent and notable decreases in HIV incidence across several countries, prevalence and incidence is consistently higher or rising among men who have sex with men when compared with other groups. In 2014, MSMGF (the Global Forum on MSM & HIV) conducted its third biennial Global Men's Health and Rights Study, an international, multilingual, web-based cross-sectional survey of men who have sex with men recruited through online convenience sampling. We tested hypothesized correlates (selected a priori ) of successfully achieving each step along the HIV prevention and treatment continuum by fitting separate generalized estimating equation models adjusted for clustering by country in multivariate analyses. All models controlled for ability to meet basic financial needs, age, healthcare coverage, having a regular provider, region and country-level income. Higher provider discrimination and sexual stigma were associated with lower odds of perceived access to services, service utilization and virologic suppression. Conversely, accessing services from community-based organizations focused on lesbian, gay, bisexual and transgender people; greater engagement in gay community; and comfort with healthcare providers were associated with higher odds of achieving steps along the prevention and treatment continuum. To meet accelerated global HIV targets, global leaders must adopt a differentiated and bolder response, in keeping with current epidemiologic trends and community-based research. The HIV-related needs of gay and bisexual men and other men who have sex with men must be addressed openly, quickly and with sufficient resources to support evidence-based, community-led and human rights-affirming interventions at scale.
Full Text Available The government is obliged and responsible to respect, protect, enforce, promote and meets Human Rights stipulated in this Act, other legislation, and the international law on human rights ratified by the Republic of Indonesia, thus the sound is mandated by Article 71 Law of the Republic of Indonesia Number 39 of 1999 on Human Rights. Lesbian, Gay, Bisexual, and Transgender (LGBT lately is still a hot debate in our society. Of course we do not want this polemic causes trouble, inconvenience, and mutual mistrust one another. Upheaval of thought between the pros and cons ensued about the issue. The pros were claimed, that the state and society should campaign for the principle of non-discrimination between men, women, transgender, lovers of the opposite sex (heterosexual or same sex lovers (gay people. Instead, the cons are counter stated that the State and society must strive to carry out preventive measures against LGBT symptoms that will harm Indonesian next generations. For that reason, the strategic position of the government in this situation is needed to deal with LGBT polemic directly so there are no national disintegration.
Reisner, Sari L.; Gamarel, Kristi E.; Nemoto, Tooru; Operario, Don
Background Despite evidence that interpersonal processes shape health behaviors, research concerning the dyadic effects of gender minority stressors on substance use behaviors of transgender people is scarce. The objective of this study was to use dyadic analysis to examine whether transgender discrimination was associated with substance use among transgender women and their male partners. Methods Transgender women and their male partners (N=191 couples; N=382 individuals) completed questionnaires. Participants’ mean age was 37.1; 79.1% were racial/ethnic minority; 61.3% earned transgender-related discrimination and past 30-day non-marijuana illicit drug use adjusting for age, relationship length, financial hardship, and depressive distress among partners in these dyads. Results Illicit drug use was reported by 31.4% of transgender women and 25.1% of their male partners. Perceived transgender discrimination was independently associated with increased odds of illicit drug use for transgender women (actor effect) but not for their male partners. Financial hardship statistically predicted drug use for both partners (actor effects). There were no partner effects for financial hardship on drug use. Overall, 34.5% of dyads had discrepant substance use. Discrimination scores of male partners differentiated dyads who reported discrepant substance use. Discussion Gender minority stressors are critical to understanding substance use among transgender women and their male partners. Integrating socioeconomic status into gender minority stress frameworks is essential. Results have implications for substance use prevention and treatment, including the need to incorporate gender minority stressors into interventions. PMID:25642440
Zucker, Kenneth J
This review provides an update on the epidemiology of gender dysphoria and transgender identity in children, adolescents and adults. Although the prevalence of gender dysphoria, as it is operationalised in the fifth edtion of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), remains a relatively 'rare' or 'uncommon' diagnosis, there is evidence that it has increased in the past couple of decades, perhaps reflected in the large increase in referral rates to specialised gender identity clinics. In childhood, the sex ratio continues to favour birth-assigned males, but in adolescents, there has been a recent inversion in the sex ratio from one favouring birth-assigned males to one favouring birth-assigned females. In both adolescents and adults, patterns of sexual orientation vary as a function of birth-assigned sex. Recent studies suggest that the prevalence of a self-reported transgender identity in children, adolescents and adults ranges from 0.5 to 1.3%, markedly higher than prevalence rates based on clinic-referred samples of adults. The stability of a self-reported transgender identity or a gender identity that departs from the traditional male-female binary among non-clinic-based populations remains unknown and requires further study.
Defreyne, Justine; T'Sjoen, Guy; Bouman, Walter Pierre; Brewin, Nicola; Arcelus, Jon
Although research on the relation between testosterone and aggression in humans is inconclusive, guidelines (including the World Professional Association for Transgender Health Standards of Care, edition 7) have warned for an increase in aggression in transgender men taking testosterone treatment. To investigate the association between levels of testosterone and aggression in treatment-seeking transgender people and explore the role of mental health psychopathology (anxiety and depressive symptoms) and social support in aggression in this population. Every transgender person invited for assessment at a national transgender health clinic in the United Kingdom during a 3-year period (2012-2015) completed self-report measures for interpersonal problems, including levels of aggression (Inventory of Interpersonal Problems [IIP-32]), symptoms of anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), social support (Multidimensional Scale of Perceived Social Support), and experiences of transphobia before and 1 year after the initiation of gender-affirming hormonal therapy. Correlations between prospective scores for the IIP-32 factor "too aggressive" and prospective levels of sex steroids, prospective psychological (HADS), and baseline psychosocial measurements were tested. Prospective scores for the factor "too aggressive" were not correlated to prospective serum testosterone levels. Results of 140 people (56 transgender men, 84 transgender women) were analyzed. A prospective increase in scores for the factor "too aggressive" of the IIP-32 in transgender men 1 year after being treated with testosterone treatment or a decrease of the IIP-32 aggression scores in transgender women 1 year after gender-affirming hormonal therapy was not found. However, a positive correlation was found between increasing HADS anxiety scores and increasing scores for the IIP-32 "too aggressive" score in the entire study population and a positive correlation with lower support
VIRAL HEPATITIS Information for Gay and Bisexual Men What is viral hepatitis? Viral hepatitis is an infection of the liver caused by one of several ... each virus is spread in different ways. Are gay and bisexual men at risk for viral hepatitis? ...
American Psychologist, 2012
The "Guidelines for Psychological Practice With Lesbian, Gay, and Bisexual Clients" provide psychologists with (a) a frame of reference for the treatment of lesbian, gay, and bisexual clients and (b) basic information and further references in the areas of assessment, intervention, identity, relationships, diversity, education, training, and…
Taliaferro, Lindsay A.; Gloppen, Kari M.; Muehlenkamp, Jennifer J.; Eisenberg, Marla E.
To address gaps in the literature on bisexual youth, we used the first nationally representative sample of high school students from the United States to determine profiles of behaviors related to depressive symptoms, a suicide attempt, and a medically-serious attempt. We examined the data from 922 bisexual students in grades 9-12 who completed…
Arenas, Alberto; Gunckel, Kristin L.; Smith, William L.
Schools have become ground zero for clashes over transgender rights, and critics are denouncing academic institutions--and more recently, the Obama administration--for supporting transgender students in their right to use restrooms and locker rooms that match their gender identity. This article responds to the seven most common claims made by…
Hancock, Adrienne; Helenius, Lauren
Current research to describe and evaluate effectiveness of voice and communication therapy for male-to-female transgender people is limited to adults. This paper provides rationale, procedures, and outcomes from voice and communication therapy for a male-to-female transgender adolescent 15 years of age. Treatment addressed vocal hygiene, breath…
Jones, Tiffany; Smith, Elizabeth; Ward, Roz; Dixon, Jennifer; Hillier, Lynne; Mitchell, Anne
Over the last decade, there has been an increase in global and local policy protections on the basis of gender identity and expression in education and a recent spate of coverage of transgender students on Australian television and news media. This paper explores the school experiences of Australian transgender and gender diverse students, with…
Johnson, Danielle; Sikorski, Jonathon; Savage, Todd A.; Woitaszewski, Scott A.
This article explores the experiences, perceptions, support systems, and coping strategies on which parents of youth who identify as transgender rely. Based on data gathered via interviews with parents of youth who identify as transgender and analyzed using the consensual qualitative research method, parental challenges and concerns about their…
Effrig, Jessica C.; Bieschke, Kathleen J.; Locke, Benjamin D.
Treatment-seeking and non-treatment-seeking transgender college students were examined with regard to victimization and psychological distress. Findings showed that transgender college students had elevated rates of distress as compared with college students who identified as men or women. Results indicated that treatment-seeking and non-treatment…
The experiences and needs of college students who identify on the transgender spectrum (androgynous, gender nonconforming, genderqueer, transfeminine, transmaculine, transgender, etc.) have begun to be explored in recent years, but this work has largely been limited to four-year colleges and universities. Virtually no research has considered the…
Mintz, Lee M.
Transgender college students face discrimination, harassment, and oppression on college and university campuses; consequently leading to limited academic and social success. Current literature is focused on describing the experiences of transgender students and the practical implications associated with attempting to meet their needs (Beemyn,…
Silveira, Jason M.; Goff, Sarah C.
The purpose of this study was to measure music teachers' attitudes toward transgender individuals and toward school practices that support transgender students. Participants (N = 612) included men and women who teach a variety of music subjects in elementary, middle, and high schools, in urban, suburban, and rural areas. An online questionnaire…
Rands, Kathleen E.
Schools serve as a setting in which students come to understand gender, but transgender students (those who transgress societal gender norms) are largely left out of discussions of education. The high level of harassment that transgender students face poses sizable obstacles to school success. If the field of education is committed to equity and…
Winter, Sam; Diamond, Milton; Green, Jamison; Karasic, Dan; Reed, Terry; Whittle, Stephen; Wylie, Kevan
In this paper we examine the social and legal conditions in which many transgender people (often called trans people) live, and the medical perspectives that frame the provision of health care for transgender people across much of the world. Modern research shows much higher numbers of transgender people than were apparent in earlier clinic-based studies, as well as biological factors associated with gender incongruence. We examine research showing that many transgender people live on the margins of society, facing stigma, discrimination, exclusion, violence, and poor health. They often experience difficulties accessing appropriate health care, whether specific to their gender needs or more general in nature. Some governments are taking steps to address human rights issues and provide better legal protection for transgender people, but this action is by no means universal. The mental illness perspective that currently frames health-care provision for transgender people across much of the world is under scrutiny. The WHO diagnostic manual may soon abandon its current classification of transgender people as mentally disordered. Debate exists as to whether there should be a diagnosis of any sort for transgender children below the age of puberty. Copyright © 2016 Elsevier Ltd. All rights reserved.
Sun, Jianxian; Wang, Chen; Peng, Hui; Zheng, Guomao; Zhang, Shiyi; Hu, Jianying
Previous studies have reported high body burdens of dichlorodiphenyltrichloroethane (DDT) and its metabolites in wild fishes worldwide. This study evaluated the adverse effects of 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE) and o,p'-DDT on gonadal development and reproduction by exposing transgenic Japanese medaka (Oryzias latipes) from hatch for 100 days. While both p,p'-DDE and o,p'-DDT induced intersex in male medaka, the lowest observable effective concentration (LOEC) of o,p'-DDT was 57.7 ng/g ww, about 5-fold lower than that (272 ng/g ww) of p,p'-DDE. Since LOECs of both chemicals were comparable to the body concentrations in wild fish, DDT contamination would likely contribute to the occurrence of intersex observed in wild fish. Exposure to o,p'-DDT resulted in much higher expression of vitellogenin in liver of males than p,p'-DDE, accordant with the higher potency of o,p'-DDT than p,p'-DDE to induce intersex. This phenomenon could be partly explained by the significantly elevated levels of 17β-estradiol in plasma of males exposed to o,p'-DDT, in addition to its estrogenic activity via the estrogen receptor. Significantly lower fertilization (p = 0.006) and hatchability (p = 0.019) were observed in the 13 intersex males. This study for the first time demonstrated the induction of intersex and reproductive effects of p,p'-DDE and o,p'-DDT at environmentally relevant concentrations.
Buer, Liliana; Anderssen, Norman; Malterud, Kirsti
The aim of this study was to investigate the relationships between self-esteem, perception of social acceptance and feeling of loneliness in a sample of young bisexual, lesbian and heterosexual women, including assessing self-esteem longitudinally across 13 years. The analyses were based on self......-completed questionnaires from the longitudinal study “Young in Norway” (13 years follow-up, 1992-2005). N=1,598 female participants at baseline and follow-up (45 bisexual women, 21 lesbian women, 1,532 heterosexual women), age 25-32 years at follow-up. At baseline, there were no differences in self-esteem, but at follow......-up bisexual women reported lower self-esteem, lower levels of perceived acceptance, and higher levels of loneliness. For bisexual women, self-esteem did not increase from adolescence to adulthood. At follow-up, loneliness had a stronger connection with self-esteem among bisexual women compared to lesbian...
Lombardi, E L; Wilchins, R A; Priesing, D; Malouf, D
There is a pervasive pattern of discrimination and prejudice against transgendered people within society. Both economic discrimination and experiencing violence could be the result of a larger social climate that severely sanctions people for not conforming to society's norms concerning gender; as such, both would be strongly associated with each other. Questionnaires were distributed to people either through events or through volunteers, and made available upon the World Wide Web. A sample of 402 cases was collected over the span of 12 months (April 1996-April 1997). We found that over half the people within this sample experienced some form of harassment or violence within their lifetime, with a quarter experiencing a violent incident. Further investigation found that experiencing economic discrimination because one is transgendered had the strongest association with experiencing a transgender related violent incident. Economic discrimination was related to transgendered people's experience with violence. Therefore, both hate crimes legislation and employment protections are needed for transgendered individuals.
Reisner, Sari L.; Honnold, Julie A.; Xavier, Jessica
Objectives. We examined relationships between social determinants of health and experiences of transgender-related discrimination reported by transgender people in Virginia. Methods. In 2005 through 2006, 387 self-identified transgender people completed a statewide health needs assessment; 350 who completed eligibility questions were included in this examination of factors associated with experiences of discrimination in health care, employment, or housing. We fit multivariate logistic regression models using generalized estimating equations to adjust for survey modality (online vs paper). Results. Of participants, 41% (n = 143) reported experiences of transgender-related discrimination. Factors associated with transgender-related discrimination were geographic context, gender (female-to male spectrum vs male-to-female spectrum), low socioeconomic status, being a racial/ethnic minority, not having health insurance, gender transition indicators (younger age at first transgender awareness), health care needed but unable to be obtained (hormone therapy and mental health services), history of violence (sexual and physical), substance use health behaviors (tobacco and alcohol), and interpersonal factors (family support and community connectedness). Conclusions. Findings suggest that transgender Virginians experience widespread discrimination in health care, employment, and housing. Multilevel interventions are needed for transgender populations, including legal protections and training for health care providers. PMID:23153142
Bradford, Judith; Reisner, Sari L; Honnold, Julie A; Xavier, Jessica
We examined relationships between social determinants of health and experiences of transgender-related discrimination reported by transgender people in Virginia. In 2005 through 2006, 387 self-identified transgender people completed a statewide health needs assessment; 350 who completed eligibility questions were included in this examination of factors associated with experiences of discrimination in health care, employment, or housing. We fit multivariate logistic regression models using generalized estimating equations to adjust for survey modality (online vs paper). Of participants, 41% (n = 143) reported experiences of transgender-related discrimination. Factors associated with transgender-related discrimination were geographic context, gender (female-to male spectrum vs male-to-female spectrum), low socioeconomic status, being a racial/ethnic minority, not having health insurance, gender transition indicators (younger age at first transgender awareness), health care needed but unable to be obtained (hormone therapy and mental health services), history of violence (sexual and physical), substance use health behaviors (tobacco and alcohol), and interpersonal factors (family support and community connectedness). Findings suggest that transgender Virginians experience widespread discrimination in health care, employment, and housing. Multilevel interventions are needed for transgender populations, including legal protections and training for health care providers.
Reisner, Sari L; Gamarel, Kristi E; Nemoto, Tooru; Operario, Don
Despite evidence that interpersonal processes shape health behaviors, research concerning the dyadic effects of gender minority stressors on substance use behaviors of transgender people is scarce. The objective of this study was to use dyadic analysis to examine whether transgender discrimination was associated with substance use among transgender women and their male partners. Transgender women and their male partners ( N =191 couples; N =382 individuals) completed questionnaires. Participants' mean age was 37.1; 79.1% were racial/ethnic minority; 61.3% earned discrimination and past 30-day non-marijuana illicit drug use adjusting for age, relationship length, financial hardship, and depressive distress among partners in these dyads. Illicit drug use was reported by 31.4% of transgender women and 25.1% of their male partners. Perceived transgender discrimination was independently associated with increased odds of illicit drug use for transgender women (actor effect) but not for their male partners. Financial hardship statistically predicted drug use for both partners (actor effects). There were no partner effects for financial hardship on drug use. Overall, 34.5% of dyads had discrepant substance use. Discrimination scores of male partners differentiated dyads who reported discrepant substance use. Gender minority stressors are critical to understanding substance use among transgender women and their male partners. Integrating socioeconomic status into gender minority stress frameworks is essential. Results have implications for substance use prevention and treatment, including the need to incorporate gender minority stressors into interventions.
Divan, Vivek; Cortez, Clifton; Smelyanskaya, Marina; Keatley, JoAnne
Introduction The rights of trans people are protected by a range of international and regional mechanisms. Yet, punitive national laws, policies and practices targeting transgender people, including complex procedures for changing identification documents, strip transgender people of their rights and limit access to justice. This results in gross violations of human rights on the part of state perpetrators and society at large. Transgender people's experience globally is that of extreme social exclusion that translates into increased vulnerability to HIV, other diseases, including mental health conditions, limited access to education and employment, and loss of opportunities for economic and social advancement. In addition, hatred and aggression towards a group of individuals who do not conform to social norms around gender manifest in frequent episodes of extreme violence towards transgender people. This violence often goes unpunished. Discussion The United Nations Development Programme (UNDP) views its work in the area of HIV through the lens of human rights and advances a range of development solutions such as poverty reduction, improved governance, active citizenship, and access to justice. This work directly relates to advancing the rights of transgender people. This manuscript lays out the various aspects of health, human rights, and development that frame transgender people's issues and outlines best practice solutions from transgender communities and governments around the globe on how to address these complex concerns. The examples provided in the manuscript can help guide UN agencies, governments, and transgender activists in achieving better standards of health, access to justice, and social inclusion for transgender communities everywhere. Conclusions The manuscript provides a call to action for countries to urgently address the violations of human rights of transgender people in order to honour international obligations, stem HIV epidemics, promote
Divan, Vivek; Cortez, Clifton; Smelyanskaya, Marina; Keatley, JoAnne
The rights of trans people are protected by a range of international and regional mechanisms. Yet, punitive national laws, policies and practices targeting transgender people, including complex procedures for changing identification documents, strip transgender people of their rights and limit access to justice. This results in gross violations of human rights on the part of state perpetrators and society at large. Transgender people's experience globally is that of extreme social exclusion that translates into increased vulnerability to HIV, other diseases, including mental health conditions, limited access to education and employment, and loss of opportunities for economic and social advancement. In addition, hatred and aggression towards a group of individuals who do not conform to social norms around gender manifest in frequent episodes of extreme violence towards transgender people. This violence often goes unpunished. The United Nations Development Programme (UNDP) views its work in the area of HIV through the lens of human rights and advances a range of development solutions such as poverty reduction, improved governance, active citizenship, and access to justice. This work directly relates to advancing the rights of transgender people. This manuscript lays out the various aspects of health, human rights, and development that frame transgender people's issues and outlines best practice solutions from transgender communities and governments around the globe on how to address these complex concerns. The examples provided in the manuscript can help guide UN agencies, governments, and transgender activists in achieving better standards of health, access to justice, and social inclusion for transgender communities everywhere. The manuscript provides a call to action for countries to urgently address the violations of human rights of transgender people in order to honour international obligations, stem HIV epidemics, promote gender equality, strengthen social and
Full Text Available Abstract The categorization of individuals as “male” or “female” is based on chromosome complement and gonadal and genital phenotype. This combined genetic-gonadal-genitals sex, here referred to as 3G-sex, is internally consistent in ~99% of humans (i.e., one has either the “female” form at all levels, or the “male” form at all levels. About 1% of the human population is identified as “intersex” because of either having an intermediate form at one or more levels, or having the “male” form at some levels and the “female” form at other levels. These two types of “intersex” reflect the facts, respectively, that the different levels of 3G-sex are not completely dimorphic nor perfectly consistent. Using 3G-sex as a model to understand sex differences in other domains (e.g., brain, behavior leads to the erroneous assumption that sex differences in these other domains are also highly dimorphic and highly consistent. But parallel lines of research have led to the conclusion that sex differences in the brain and in behavior, cognition, personality, and other gender characteristics are for the most part not dimorphic and not internally consistent (i.e., having one brain/gender characteristic with the “male” form is not a reliable predictor for the form of other brain/gender characteristics. Therefore although only ~1% percent of humans are 3G-“intersex”, when it comes to brain and gender, we all have an intersex gender (i.e., an array of masculine and feminine traits and an intersex brain (a mosaic of “male” and “female” brain characteristics.
This bachelor thesis deals with the transgender issue from a social worker perspective, as an assistant profession. The goal of the thesis is to provide a theoretical background for social workers, who work with transgender clients. It focuses on basic information related to classifying transgender individuals and its specifics. Most of my thesis covers the transsexuals, as the most widespread group within transgender category. The thesis shows contemporary trends in field of transgender than...
Nahata, Leena; Tishelman, Amy C; Caltabellotta, Nicole M; Quinn, Gwendolyn P
Research demonstrates a negative psychosocial impact of infertility among otherwise healthy adults, and distress among adolescents facing the prospect of future infertility due to various medical conditions and treatments that impair reproductive health. Guidelines state that providers should counsel transgender youth about potential infertility and fertility preservation (FP) options prior to initiation of hormone therapy. The purpose of this study was to examine the rates of fertility counseling and utilization of FP among a cohort of adolescents with gender dysphoria seen at a large gender clinic. An Institutional Review Board-approved retrospective review of electronic medical records was conducted of all patients with ICD-9/10 codes for gender dysphoria referred to Pediatric Endocrinology for hormone therapy (puberty suppression and/or cross-sex hormones) from January 2014 to August 2016. Seventy-eight patients met inclusion criteria. Five children were prepubertal, no hormone therapy was considered, and they were therefore excluded. Of the remaining 73 patients, 72 had documented fertility counseling prior to initiation of hormone therapy and 2 subjects attempted FP; 45% of subjects mentioned a desire or plan to adopt, and 21% said they had never wanted to have children. Utilization rates of FP are low among transgender adolescents. More research is needed to understand parenthood goals among transgender youth at different ages and developmental stages and to explore the impact of gender dysphoria on decision-making about FP and parenthood. Discussions about infertility risk, FP, and other family building options should be prioritized in this vulnerable adolescent population. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Karhunen-Enckell, Ulla; Kolehmainen, Maija; Kääriäinen, Minna; Suominen, Sinikka
For a female-to-male transgender person, mastectomy is the most important procedure making the social interaction easier. Along with the size of the breasts, the quantity and quality of skin will influence the selection of surgical technique. Although complications are rare, corrective surgery is performed for as many as 40% of the patients. Of male-to-female transsexual persons, 60 to 70% opt for breast enlargement. Breast enlargement can be carried out by using either silicone implants or fat transplantation. Since the surgical procedures on breasts are irreversible, their implementation requires confirmation of the diagnosis of transsexualism by a multidisciplinary team.
Tinney, Jean; Dow, Briony; Maude, Phillip; Purchase, Rachel; Whyte, Carolyn; Barrett, Catherine
LGBT is an acronym used to describe people from diverse sexual orientation or gender identity, people that are gay, lesbian, bisexual, or transgender. LGBT people do not constitute a single group nor does each individual "group" constitute a homogeneous unity. However, as higher rates of depression and/or anxiety have been observed in older LGBT people, compared to their heterosexual counterparts (Guasp, 2011) there is a need to raise the profile of mental health issues amongst these groups. The additional letter I is also often included in the acronym LGBTI as intersex people are often included as another gender diverse group. However, there is very little research that includes intersex people and none on older intersex people's mental health so this editorial is restricted to consideration of older LGBT people.
Full Text Available In May 2016, two events epitomized the complexities of working for global transgender youth rights. First, United Nations Educational Scientific and Cultural Organisation (UNESCO hosted a ministerial event in which education ministers from around the world released a call to action for protection of students on the basis of their gender identity and expression in schools. Second, the United Nations (UN hosted an event celebrating the family, attended by conservative ministers and activists who mobilized family protectionist discourse against transgender students. This article contemplates, in light of transgender activist Raewyn Connell’s Southern Theory contributions, the complexity of global research and work for transgender youth. It considers key informant interviews with 50 stakeholders in the global push for transgender student rights in education, including members of government and non-government organisations, and academics from Northern and Southern countries. Problems in aiding transgender youth at the global level included safety concerns, the impacts of conservative advocates and media backlash (within family and national protectionist discourses, cultural complexities hampering engagement and translation, dissemination hindrances pertaining to established publishing biases, and financial and collaboration barriers. Solutions including virtual work; multi-level leadership; alliance-building; representation; visibility of transgender youth citizenship and family membership; and legal, financial and capacity-building aid are considered.
Ali, Nareesa; Fleisher, William; Erickson, Julie
Gender minority groups, such as transgender individuals, frequently encounter stigma, discrimination, and negative mental health outcomes, which can result in contact with mental health professionals. Recent studies suggest that negative attitudes toward transgender individuals are prevalent and measurable within the general population. The Genderism and Transphobia scale (GTS) measures anti-transgender feelings, thoughts, and behaviors. The purpose of this study was to use the GTS to conduct an investigation of psychiatrists' attitudes toward transgender individuals. A cross-sectional survey of n = 142 faculty members and residents from the Department of Psychiatry at the University of Manitoba was conducted. Respondents completed an online survey consisting of demographic questions and the GTS. Responses were analyzed descriptively and compared to previously published data on the GTS. There was a trend for psychiatrists and psychiatry residents within this sample to endorse less negative attitudes toward transgender people compared to other published data using a sample of undergraduate students. Descriptive analyses suggest that psychiatrists' and psychiatry residents' GTS scores may be related to gender identity, political ideology, religiosity, and levels of both professional and personal contact. These data evoke optimism regarding psychiatrists' and psychiatry residents' attitudes toward transgender individuals. Additional larger-scale studies comparing this medical specialty group with other specialty groups will further elucidate factors that modify physician attitudes toward this patient population. These findings may contribute to the development of educational strategies to ensure that the transgender population receives medical treatment without stigma or attitudinal compromise.
Ross, Lori E; O'Gorman, Laurel; MacLeod, Melissa A; Bauer, Greta R; MacKay, Jenna; Robinson, Margaret
Bisexuality is consistently associated with poor mental health outcomes. In population-based data, this is partially explained by income differences between bisexual people and lesbian, gay, and/or heterosexual individuals. However, the interrelationships between bisexuality, poverty, and mental health are poorly understood. In this paper, we examine the relationships between these variables using a mixed methods study of 302 adult bisexuals from Ontario, Canada. Participants were recruited using respondent-driven sampling to complete an internet-based survey including measures of psychological distress and minority stress. A subset of participants completed a semi-structured qualitative interview to contextualize their mental health experiences. Using information regarding household income, number of individuals supported by the income and geographic location, participants were categorized as living below or above the Canadian Low Income Cut Off (LICO). Accounting for the networked nature of the sample, participants living below the LICO had significantly higher mean scores for depression and posttraumatic stress disorder symptoms and reported significantly more perceived discrimination compared to individuals living above the LICO. Grounded theory analysis of the qualitative interviews suggested four pathways through which bisexuality and poverty may intersect to impact mental health: through early life experiences linked to bisexuality or poverty that impacted future financial stability; through effects of bisexual identity on employment and earning potential; through the impact of class and sexual orientation discrimination on access to communities of support; and through lack of access to mental health services that could provide culturally competent care. These mixed methods data help us understand the income disparities associated with bisexual identity in population-based data, and suggest points of intervention to address their impact on bisexual mental
Vaughn, Allison A; Teeters, Stacy A; Sadler, Melody S; Cronan, Sierra B
The utility of the Stereotype Content Model (Fiske, Cuddy, Glick, & Xu, 2002) and the Behaviors from Intergroup Affect and Stereotypes map (Cuddy, Fiske, & Glick, 2007) were examined in the context of heterosexuals' attitudes toward sexual minorities. Heterosexual adults completed a survey measuring stereotypes, emotions, and behavioral tendencies toward lesbians, gay men, bisexual women, and bisexual men. Stereotype content differed across groups and showed "gendered" and "valenced" effects on emotions and behavioral tendencies. Competence predicted behaviors for men, whereas warmth and competence predicted behaviors for women, and, for the most part, more was better. Admiration and contempt mediated most of these relationships across most subgroups, but pity and envy played smaller roles for some subgroups. Across all groups, competence played a more predictive role than warmth.
Comparing men who have sex with men and transgender women who use Grindr, other similar social and sexual networking apps, or no social and sexual networking apps: Implications for recruitment and health promotion.
Sun, Christina J; Sutfin, Erin; Bachmann, Laura H; Stowers, Jason; Rhodes, Scott D
Researchers and public health professionals have increased their attention to GPS-based social and sexual networking applications (apps) tailored to gay, bisexual, other men who have sex with men (MSM) and transgender women. These populations continue to be disproportionately affected by HIV in the United States, therefore these apps, in particular Grindr, have become an important sampling venue for the recruitment of HIV-related research participants. As such, it is essential to identify differences among app users to avoid potential sampling bias. This paper seeks to identify differences in MSM and transgender women who use Grindr and those who use other similar apps. A community-based participatory research (CBPR) approach was used to recruit participants online who then completed a 25-item anonymous survey. Five domains were assessed: sociodemographics, HIV testing, sexual risk, substance abuse, and use of GPS-based social and sexual networking apps. 457 participants completed surveys. There were significant differences in the sociodemographic characteristics by app use, including age, race/ethnicity, sexual orientation, and outness. After adjusting for the sociodemographic characteristics associated with app use, there were significant differences in HIV risk and substance use between the groups. This paper is the first to report on findings that compare MSM and transgender women who report using Grindr to MSM and transgender women who report using other similar apps. GPS-based social and sexual networking apps may offer a valuable recruitment tool for future HIV research seeking to recruit populations at increased risk for HIV or those living with HIV for therapeutic trials. Because of the differences identified across users of different apps, these findings suggest that if researchers recruited participants from just one app, they could end up with a sample quite different than if they had recruited MSM and transgender women from other apps.
Mereish, Ethan H; Katz-Wise, Sabra L; Woulfe, Julie
Bisexual individuals are at higher risk for poor mental health outcomes compared to heterosexual as well as lesbian and gay individuals and experience minority stressors, such as discrimination, from both heterosexual and sexual minority communities. However, there is little research examining the negative effects of bisexual-specific minority stressors on bisexual individuals' mental health as well as psychological factors that might help explain minority stressors' deleterious effects. This research examined the effects of distal minority stressors (i.e., anti-bisexual experiences from both heterosexual as well as lesbian and gay people) and proximal stressors (i.e., internalized heterosexism and sexual orientation concealment) on psychological distress and suicidality among bisexual adults (N = 503). Building on the relational framing of the minority stress model, we also tested one relational factor (i.e., loneliness) as a mediator of the associations between distal and proximal minority stressors and poor mental health (i.e., psychological distress and suicidality). Structural equation modeling analyses were used to test the mediating effects of loneliness on the associations between minority stressors and psychological distress and suicidality. Although distal and proximal minority stressors were not associated with each other, loneliness mediated the effects of distal and proximal minority stressors on psychological distress and suicidality. The results of this study underscore the importance of targeting bisexual-specific minority stressors as well as loneliness in preventive interventions to improve the mental health of bisexual individuals.
Austin, Ashley; Craig, Shelley L; Alessi, Edward J
Although there is growing awareness in contemporary society regarding transgender and gender nonconforming (TGNC) identities, transgender people continue to be highly marginalized and subject to transphobic discrimination and victimization. As a result, authentically expressing and navigating a TGNC identity can be difficult. Psychiatrists and other mental health professionals can play a key role in supporting TGNC client health and well-being through the use of trans-affirmative approaches. Trans-affirmative practice recognizes all experiences of gender as equally healthy and valuable This article focuses on transgender affirmative cognitive behavior therapy. Copyright © 2016 Elsevier Inc. All rights reserved.
Gonzales, Gilbert; Henning-Smith, Carrie
Policy Points: Transgender and gender nonconforming (GNC) adults may experience barriers to care for a variety of reasons, including discrimination and lack of awareness by providers in health care settings. In our analysis of a large, population-based sample, we found transgender and GNC adults were more likely to be uninsured and have unmet health care needs, and were less likely to have routine care, compared to cisgender (nontransgender) women. Our findings varied by gender identity. More research is needed on transgender and GNC populations, including on how public policy and provider awareness affects health care access and health outcomes differentially by gender identity. Very little population-based research has examined health and access to care among transgender populations. This study compared barriers to care between cisgender, transgender, and gender nonconforming (GNC) adults using data from a large, multistate sample. We used data from the 2014-2015 Behavioral Risk Factor Surveillance System to estimate the prevalence of having no health insurance, unmet medical care needs due to cost, no routine checkup, and no usual source of care for cisgender women (n = 183,370), cisgender men (n = 131,080), transgender women (n = 724), transgender men (n = 449), and GNC adults (n = 270). Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for each barrier to care while adjusting for sociodemographic characteristics. Transgender and GNC adults were more likely to be nonwhite, sexual minority, and socioeconomically disadvantaged compared to cisgender adults. After controlling for sociodemographic characteristics, transgender women were more likely to have no health insurance (OR = 1.60; 95% CI = 1.07-2.40) compared to cisgender women; transgender men were more likely to have no health insurance (OR = 2.02; 95% CI = 1.25-3.25) and no usual source of care (OR = 1.84; 95% CI = 1.18-2.88); and GNC
Seelman, Kristie L.; Colón-Diaz, Matthew J.P.; LeCroix, Rebecca H.; Xavier-Brier, Marik; Kattari, Leonardo
Abstract Purpose: There are many barriers to reliable healthcare for transgender people that often contribute to delaying or avoiding needed medical care. Yet, few studies have examined whether noninclusive healthcare and delaying needed medical care because of fear of discrimination are associated with poorer health among transgender adults. This study aims to address these gaps in the knowledge base. Methods: This study analyzed secondary data from a statewide survey of 417 transgender adults in the Rocky Mountain region of the United States. Independent variables included noninclusive healthcare from a primary care provider (PCP) and delay of needed medical care because of fear of discrimination. Dependent variables assessed general health and mental health. Results: Transgender individuals who delayed healthcare because of fear of discrimination had worse general health in the past month than those who did not delay or delayed care for other reasons (B=−0.26, pdiscrimination, having a noninclusive PCP was not significantly associated with either general health or mental health. Conclusion: This study suggests a significant association between delaying healthcare because of fear of discrimination and worse general and mental health among transgender adults. These relationships remain significant even when controlling for provider noninclusivity, suggesting that fear of discrimination and consequent delay of care are at the forefront of health challenges for transgender adults. The lack of statistical significance for noninclusive healthcare may be related to the measurement approach used; future research is needed to develop an improved tool for measuring transgender noninclusive healthcare. PMID:28861545
Katz-Wise, Sabra L.; Budge, Stephanie L.; Fugate, Ellen; Flanagan, Kaleigh; Touloumtzis, Currie; Rood, Brian; Perez-Brumer, Amaya; Leibowitz, Scott
Background A growing body of research has examined transgender identity development, but no studies have investigated developmental pathways as a transactional process between youth and caregivers, incorporating perspectives from multiple family members. The aim of this study was to conceptualize pathways of transgender identity development using narratives from both transgender and gender nonconforming (TGN) youth and their cisgender (non-transgender) caregivers. Methods The sample included 16 families, with 16 TGN youth, ages 7–18 years, and 29 cisgender caregivers (N = 45 family members). TGN youth represented multiple gender identities, including trans boy (n = 9), trans girl (n = 5), gender fluid boy (n = 1), and girlish boy (n = 1). Caregivers included mothers (n = 17), fathers (n = 11), and one grandmother. Participants were recruited from LGBTQ community organizations and support networks for families with transgender youth in the Midwest, Northeast, and South regions of the United States. Each family member completed a one-time in-person semi-structured qualitative interview that included questions about transgender identity development. Results Analyses revealed seven overarching themes of transgender identity development, which were organized into a conceptual model: Trans identity development, sociocultural influences/societal discourse, biological influences, family adjustment/impact, stigma/cisnormativity, support/resources, and gender affirmation/actualization. Conclusions Findings underscore the importance of assessing developmental processes among TGN youth as transactional, impacting both youth and their caregivers. PMID:29527139
Alisa L. Rich
Full Text Available An increasing number of children are born with intersex variation (IV; ambiguous genitalia/hermaphrodite, pseudohermaphroditism, etc.. Evidence shows that endocrine-disrupting chemicals (EDCs in the environment can cause reproductive variation through dysregulation of normal reproductive tissue differentiation, growth, and maturation if the fetus is exposed to EDCs during critical developmental times in utero. Animal studies support fish and reptile embryos exhibited IV and sex reversal when exposed to EDCs. Occupational studies verified higher prevalence of offspring with IV in chemically exposed workers (male and female. Chemicals associated with endocrine-disrupting ability in humans include organochlorine pesticides, polychlorinated biphenyls, bisphenol A, phthalates, dioxins, and furans. Intersex individuals may have concurrent physical disorders requiring lifelong medical intervention and experience gender dysphoria. An urgent need exists to determine which chemicals possess the greatest risk for IV and the mechanisms by which these chemicals are capable of interfering with normal physiological development in children.
Verre, MC; Peinado, J; Segura, ER; Clark, JC; Gonzales, P; Benites, C; Cabello, R; Sanchez, J; Lama, JR
The association of socialization patterns with unprotected anal intercourse (UAI) and HIV/STI prevalence remains underexplored in men who have sex with men (MSM) and transgender women (TW) in developing country settings. We evaluated the correlation of UAI, HIV, and syphilis with MSM/TW venue attendance and social network size among high-risk MSM and TW in Peru according to self-reported sexual identity. Frequency of venue attendance and MSM/TW social network size were lowest among heterosexual MSM and highest among TW respondents. Attendance (frequent or occasional) at MSM/TW venues was associated with increased odds of insertive UAI among heterosexual participants. Frequent venue attendance was associated with increased odds of receptive UAI among gay/homosexual, bisexual, and TW participants. Further investigation of the differing socialization patterns and associations with HIV/STI transmission within subgroups of Peruvian MSM and TW will enable more effective prevention interventions for these populations. PMID:24788782
Wahlert, Lance; Gill, Sabrina
This article addresses the precarious place of transgender and gender non-cis persons in relation to their discrimination-protections in recent legal, medical, and ethical policies in the United States. At present, there exists a contradiction such that trans persons are considered "pathological" enough that they are included in the latest iteration of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-V) as "gender dysphoric," but they are not included in the category of "disabled" under the Americans with Disabilities Act (ADA). As such, trans persons in America are subject to the stigma of pathology (albeit with medical treatment) without the full protections of the ADA. By contrast, transgender and non-cis-gender Americans find their queer cohorts who are HIV-positive to be fully protected by the ADA. We ask whether transgender and non-cis-gender persons should embrace their (already pathologized) personhood as a disability. Sometimes "choosing disability" affords more rights than it deploys stigma.
... organization devoted to the treatment of transgender people, publishes The Standards of Care , which offers recommendations for ... Jill Davidson, PhD, NCSP; J. Rhodes Perry, Associate Director of Policy & Programs, Parents, Families, and Friends of ...
Nadal, Kevin L; Davidoff, Kristin C; Fujii-Doe, Whitney
Because transgender people face discrimination on systemic, institutional, and interpersonal levels, the previous literature has supported that many transgender women view the sex work industry as their only viable career option. The current article reviews the literature on discrimination against transgender people, explores how discrimination influences their participation in sex work, and discusses how institutional discrimination against transgender women manifests within the criminal justice system. Furthermore, recommendations are provided for advocating for the rights of transgender people while promoting healthy behaviors and higher quality of life. Throughout the article, quotes from previous qualitative research are used to illustrate the experiences of transgender women through their own voices and perspectives.
Baguso, Glenda N.; Gay, Caryl L.; Lee, Kathryn A.
Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the U.S. report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transg...
Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J
To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of prostate cancer (CaP) in transgender women. In addition, this article aims to present a recent case report of a transgender woman with a unique presentation at the author's institution. An electronic nonsystematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer," "male to female transsexual," "transgender patient," "androgen + prostate cancer," "estrogen therapy + prostate cancer," and "health care barrier." In addition, a clinical case managed at our institution was reviewed and critically discussed. Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective as initially thought. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a nontransgender men. Barriers to care in the transgender female population include accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs pathologizing transgender patients, financial restrictions of the patient, and health system determinants. Although rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development are unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients. Published by Elsevier Inc.
Hughes-Hassell, Sandra; Overberg, Elizabeth; Harris, Shannon
The purpose of this study was to determine if young adults have access through school libraries to LGBTQ-themed literature. The library collections in 125 high schools in one Southern U.S. state were examined for the inclusion of LGBTQ-themed fiction, nonfiction, and biographies, including a core collection of 21 recommended titles. Results showed…
In the UK there is a crisis in the provision of healthcare for LGBT people. This is due, in part, by the lack of focused medical, health and social care curricula content about LGBT healthcare generally. Teaching has tended to position heterosexuality and gender normativity—people conforming to social standards of what is ‘appropriate’ feminine and masculine behavior—as the primary context in which health and illness is viewed. Models of health care that promote these views of sexuality and g...
Alexander J Martos
Full Text Available LGBT community organizations in the United States have been providing health services since at least the 1970s. However, available explanations for the origins of LGBT health services do not sufficiently explain why health in particular has been so closely and consistently linked to LGBT activism. Little is also known regarding how LGBT health services may have evolved over time with the growing scientific understanding of LGBT health needs.This study begins with a review of the early intersections of sexuality and health that led to an LGBT health movement in the United States, as well as the evolution of LGBT health services over time. Informed by this, an asset map displaying the location and types of services provided by "LGBT community health centers" today in relation to the population density of LGBT people was explored. An online search of LGBT community health centers was conducted between September-December, 2015. Organizational details, including physical addresses and the services provided, were confirmed via an online database of federally-registered non-profit organizations and organizational websites. The locations and types of services provided were analyzed and presented alongside county-level census data of same-sex households using geographic information system (GIS software ArcGIS for Desktop.LGBT community health centers are concentrated within urban hubs and coastal states, and are more likely to be present in areas with a high density of same-sex couples. LGBT community health centers do not operate in 13 states. The most common health services provided are wellness programs, HIV/STI services, and counseling services.LGBT community health centers have adapted over time to meet the needs of LGBT people. However, significant gaps in service remain in the United States, and LGBT community health centers may require significant transformations going forward in order to continue serving LGBT people.
Kosciw, Joseph G.; Greytak, Emily A.; Giga, Noreen M.; Villenas, Christian; Danischewski, David J.
The Gay, Lesbian and Straight Education Network (GLSEN) "National School Climate Survey" is our flagship report on the school experiences of LGBTQ youth in schools, including the extent of the challenges that they face at school and the school-based resources that support LGBTQ students' well-being. The survey has consistently indicated…
The success of a team relies as much on the relationship between coaches and players as it does on athletic skill. Coaches, at times, become surrogate parental figures in the lives of their athletes and teammates become siblings who all work together towards a common goal. Athletes at the National Collegiate Athletic Association (NCAA) Division I…
N. Bruce Baskerville
This scoping review identified a large research gap in the area of prevention and cessation interventions for LGBTQ youth and young adults. There is a need for effective, community-informed, and engaged interventions specific to LGBTQ+ youth and young adults for the prevention and cessation of tobacco.
Martos, Alexander J; Wilson, Patrick A; Meyer, Ilan H
LGBT community organizations in the United States have been providing health services since at least the 1970s. However, available explanations for the origins of LGBT health services do not sufficiently explain why health in particular has been so closely and consistently linked to LGBT activism. Little is also known regarding how LGBT health services may have evolved over time with the growing scientific understanding of LGBT health needs. This study begins with a review of the early intersections of sexuality and health that led to an LGBT health movement in the United States, as well as the evolution of LGBT health services over time. Informed by this, an asset map displaying the location and types of services provided by "LGBT community health centers" today in relation to the population density of LGBT people was explored. An online search of LGBT community health centers was conducted between September-December, 2015. Organizational details, including physical addresses and the services provided, were confirmed via an online database of federally-registered non-profit organizations and organizational websites. The locations and types of services provided were analyzed and presented alongside county-level census data of same-sex households using geographic information system (GIS) software ArcGIS for Desktop. LGBT community health centers are concentrated within urban hubs and coastal states, and are more likely to be present in areas with a high density of same-sex couples. LGBT community health centers do not operate in 13 states. The most common health services provided are wellness programs, HIV/STI services, and counseling services. LGBT community health centers have adapted over time to meet the needs of LGBT people. However, significant gaps in service remain in the United States, and LGBT community health centers may require significant transformations going forward in order to continue serving LGBT people.
Schneider, Margaret; Dimito, Anne
This study investigated the experiences of 132 LGBT and heterosexual teachers and school administrators in Ontario, Canada. Participants completed a survey that asked about their comfort addressing LGBT issues in the school setting, how safe they felt, how active they were, and their perceptions of barriers. There were few differences between the…
Wilson, Patrick A.; Meyer, Ilan H.
Background LGBT community organizations in the United States have been providing health services since at least the 1970s. However, available explanations for the origins of LGBT health services do not sufficiently explain why health in particular has been so closely and consistently linked to LGBT activism. Little is also known regarding how LGBT health services may have evolved over time with the growing scientific understanding of LGBT health needs. Methods This study begins with a review of the early intersections of sexuality and health that led to an LGBT health movement in the United States, as well as the evolution of LGBT health services over time. Informed by this, an asset map displaying the location and types of services provided by “LGBT community health centers” today in relation to the population density of LGBT people was explored. An online search of LGBT community health centers was conducted between September–December, 2015. Organizational details, including physical addresses and the services provided, were confirmed via an online database of federally-registered non-profit organizations and organizational websites. The locations and types of services provided were analyzed and presented alongside county-level census data of same-sex households using geographic information system (GIS) software ArcGIS for Desktop. Findings LGBT community health centers are concentrated within urban hubs and coastal states, and are more likely to be present in areas with a high density of same-sex couples. LGBT community health centers do not operate in 13 states. The most common health services provided are wellness programs, HIV/STI services, and counseling services. Conclusions LGBT community health centers have adapted over time to meet the needs of LGBT people. However, significant gaps in service remain in the United States, and LGBT community health centers may require significant transformations going forward in order to continue serving LGBT people. PMID:28692659
Proctor, Kimberly; Haffer, Samuel C.; Ewald, Erin; Hodge, Carla; James, Cara V.
Abstract Purpose: To identify and describe the transgender population in the Medicare program using administrative data. Methods: Using a combination of International Classification of Diseases ninth edition (ICD-9) codes relating to transsexualism and gender identity disorder, we analyzed 100% of the 2013 Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service (FFS) “final action” claims from both institutional and noninstitutional providers (∼1 billion claims) to identify individuals who may be transgender Medicare beneficiaries. To confirm, we developed and applied a multistage validation process. Results: Four thousand ninety-eight transgender beneficiaries were identified, of which ∼90% had confirmatory diagnoses, billing codes, or evidence of a hormone prescription. In general, the racial, ethnic, and geographic distribution of the Medicare transgender population tends to reflect the broader Medicare population. However, age, original entitlement status, and disease burden of the transgender population appear substantially different. Conclusions: Using a variety of claims information, ranging from claims history to additional diagnoses, billing modifiers, and hormone prescriptions, we demonstrate that administrative data provide a valuable resource for identifying a lower bound of the Medicare transgender population. In addition, we provide a baseline description of the diversity and disease burden of the population and a framework for future research. PMID:28861539
Blosnich, John R; Cashy, John; Gordon, Adam J; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Fine, Michael J
Transgender individuals are vulnerable to negative health risks and outcomes, but research remains limited because data sources, such as electronic medical records (EMRs), lack standardized collection of gender identity information. Most EMR do not include the gold standard of self-identified gender identity, but International Classification of Diseases (ICDs) includes diagnostic codes indicating transgender-related clinical services. However, it is unclear if these codes can indicate transgender status. The objective of this study was to determine the extent to which patients' clinician notes in EMR contained transgender-related terms that could corroborate ICD-coded transgender identity. Data are from the US Department of Veterans Affairs Corporate Data Warehouse. Transgender patients were defined by the presence of ICD9 and ICD10 codes associated with transgender-related clinical services, and a 3:1 comparison group of nontransgender patients was drawn. Patients' clinician text notes were extracted and searched for transgender-related words and phrases. Among 7560 patients defined as transgender based on ICD codes, the search algorithm identified 6753 (89.3%) with transgender-related terms. Among 22 072 patients defined as nontransgender without ICD codes, 246 (1.1%) had transgender-related terms; after review, 11 patients were identified as transgender, suggesting a 0.05% false negative rate. Using ICD-defined transgender status can facilitate health services research when self-identified gender identity data are not available in EMR.
Frye, Victoria; Hirshfield, Sabina; Chiasson, Mary Ann; Lucy, Debbie; Usher, DaShawn; McCrossin, Jermaine; Greene, Emily; Koblin, Beryl
Background Promoting consistent HIV testing is critical among young, Black Men Who Have Sex With Men (MSM) and transgender women who are overrepresented among new HIV cases in the United States. New HIV test options are available, including mobile unit testing, one-minute testing, at home or self-testing and couples HIV testing and counseling (CHTC). In the context of these newer options, the objective of this study was to explore whether and how preferences for specific characteristics of the tests acted as barriers to and/or facilitators of testing in general and consistent testing specifically among young Black MSM and transgender women aged 16 to 29. Methods We conducted 30 qualitative, semi-structured, in-depth interviews with young, Black, gay, bisexual or MSM and transgender women in the New York City metropolitan area to identify preferences for specific HIV tests and aspects of HIV testing options. Participants were primarily recruited from online and mobile sites, followed by community-based, face-to-face recruitment strategies to specifically reach younger participants. Thematic coding was utilized to analyze the qualitative data based on a grounded theoretical approach. Results We identified how past experiences, perceived test characteristics (e.g., accuracy, cost, etc.) and beliefs about the “fit” between the individual, and the test relate to preferred testing methods and consistent testing. Three major themes emerged as important to preferences for HIV testing methods: the perceived accuracy of the test method, venue characteristics, and lack of knowledge or experience with the newer testing options, including self-testing and CHTC. Conclusions These findings suggest that increasing awareness of and access to newer HIV testing options (e.g., free or reduced price on home or self-tests or CHTC available at all testing venues) is critical if these new options are to facilitate increased levels of consistent testing among young, Black MSM and
Frye, Victoria; Wilton, Leo; Hirshfield, Sabina; Chiasson, Mary Ann; Lucy, Debbie; Usher, DaShawn; McCrossin, Jermaine; Greene, Emily; Koblin, Beryl
Promoting consistent HIV testing is critical among young, Black Men Who Have Sex With Men (MSM) and transgender women who are overrepresented among new HIV cases in the United States. New HIV test options are available, including mobile unit testing, one-minute testing, at home or self-testing and couples HIV testing and counseling (CHTC). In the context of these newer options, the objective of this study was to explore whether and how preferences for specific characteristics of the tests acted as barriers to and/or facilitators of testing in general and consistent testing specifically among young Black MSM and transgender women aged 16 to 29. We conducted 30 qualitative, semi-structured, in-depth interviews with young, Black, gay, bisexual or MSM and transgender women in the New York City metropolitan area to identify preferences for specific HIV tests and aspects of HIV testing options. Participants were primarily recruited from online and mobile sites, followed by community-based, face-to-face recruitment strategies to specifically reach younger participants. Thematic coding was utilized to analyze the qualitative data based on a grounded theoretical approach. We identified how past experiences, perceived test characteristics (e.g., accuracy, cost, etc.) and beliefs about the "fit" between the individual, and the test relate to preferred testing methods and consistent testing. Three major themes emerged as important to preferences for HIV testing methods: the perceived accuracy of the test method, venue characteristics, and lack of knowledge or experience with the newer testing options, including self-testing and CHTC. These findings suggest that increasing awareness of and access to newer HIV testing options (e.g., free or reduced price on home or self-tests or CHTC available at all testing venues) is critical if these new options are to facilitate increased levels of consistent testing among young, Black MSM and transgender women. Addressing perceptions of
Full Text Available Promoting consistent HIV testing is critical among young, Black Men Who Have Sex With Men (MSM and transgender women who are overrepresented among new HIV cases in the United States. New HIV test options are available, including mobile unit testing, one-minute testing, at home or self-testing and couples HIV testing and counseling (CHTC. In the context of these newer options, the objective of this study was to explore whether and how preferences for specific characteristics of the tests acted as barriers to and/or facilitators of testing in general and consistent testing specifically among young Black MSM and transgender women aged 16 to 29.We conducted 30 qualitative, semi-structured, in-depth interviews with young, Black, gay, bisexual or MSM and transgender women in the New York City metropolitan area to identify preferences for specific HIV tests and aspects of HIV testing options. Participants were primarily recruited from online and mobile sites, followed by community-based, face-to-face recruitment strategies to specifically reach younger participants. Thematic coding was utilized to analyze the qualitative data based on a grounded theoretical approach.We identified how past experiences, perceived test characteristics (e.g., accuracy, cost, etc. and beliefs about the "fit" between the individual, and the test relate to preferred testing methods and consistent testing. Three major themes emerged as important to preferences for HIV testing methods: the perceived accuracy of the test method, venue characteristics, and lack of knowledge or experience with the newer testing options, including self-testing and CHTC.These findings suggest that increasing awareness of and access to newer HIV testing options (e.g., free or reduced price on home or self-tests or CHTC available at all testing venues is critical if these new options are to facilitate increased levels of consistent testing among young, Black MSM and transgender women. Addressing
White Hughto, Jaclyn M; Reisner, Sari L; Pachankis, John E
Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. This critical review aims to integrate the literature on stigma towards transgender people in the U.S. This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.
White Hughto, Jaclyn M.; Reisner, Sari L.; Pachankis, John E.
Rationale Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. Objective This critical review aims to integrate the literature on stigma towards transgender people in the US. Results This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Conclusion Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. PMID:26599625
Lehavot, Keren; Katon, Jodie G; Simpson, Tracy L; Shipherd, Jillian C
Transgender individuals are overrepresented among Veterans. However, little is known regarding their satisfaction with Veterans Administration (VA) care and unmet health needs. This study examined transgender Veterans' satisfaction with VA medical and mental health care, prevalence of delaying care, and correlates of these outcomes. We used data from transgender Veterans collected in 2014 through an online, national survey. In total, 298 transgender Veterans living in the United States. We assessed patient satisfaction with VA medical and mental health care and self-reported delays in seeking medical and mental health care in the past year. Potential correlates associated with these 4 outcomes included demographic, health, and health care variables. Over half of the sample used VA (56%) since their military discharge. Among transgender Veterans who had used VA, 79% were satisfied with medical care and 69% with mental health care. Lower income was associated with dissatisfaction with VA medical care, and being a transgender man was associated with dissatisfaction with VA mental health care. A substantial proportion reported delays in seeking medical (46%) or mental (38%) health care in the past year (not specific to VA). Screening positive for depression and/or posttraumatic stress disorder was associated with delays in seeking both types of care. Although the majority of transgender Veterans are satisfied with VA health care, certain subgroups are less likely to be satisfied with care. Further, many report delaying accessing care, particularly those with depression and/or posttraumatic stress disorder symptoms. Adapting health care settings to better engage these vulnerable Veterans may be necessary.
Mizuno, Yuko; Frazier, Emma L; Huang, Ping; Skarbinski, Jacek
Little has been reported from population-based surveys on the characteristics of transgender persons living with HIV. Using Medical Monitoring Project (MMP) data, we describe the characteristics of HIV-infected transgender women and examine their care and treatment needs. We used combined data from the 2009 to 2011 cycles of MMP, an HIV surveillance system designed to produce nationally representative estimates of the characteristics of HIV-infected adults receiving medical care in the United States, to compare demographic, behavioral, and clinical characteristics, and met and unmet needs for supportive services of transgender women with those of non-transgender persons using Rao-Scott chi-square tests. An estimated 1.3% of HIV-infected persons receiving care in the United States self-identified as transgender women. Transgender women were socioeconomically more marginalized than non-transgender men and women. We found no differences between transgender women and non-transgender men and women in the percentages prescribed antiretroviral therapy (ART). However, a significantly lower percentage of transgender women compared to non-transgender men had 100% ART dose adherence (78.4% vs. 87.4%) and durable viral suppression (50.8% vs. 61.4%). Higher percentages of transgender women needed supportive services. No differences were observed in receipt of most of supportive services, but transgender women had higher unmet needs than non-transgender men for basic services such as food and housing. We found little difference between transgender women and non-transgender persons in regards to receipt of care, treatment, and most of supportive services. However, the noted disparities in durable viral suppression and unmet needs for basic services should be explored further.
Christian, Robin; Mellies, Amy Anderson; Bui, Alison Grace; Lee, Rita; Kattari, Leo; Gray, Courtney
Transgender people, those whose gender identity does not match their sex assigned at birth, face barriers to receiving health care. These include discrimination, prohibitive cost, and difficulty finding transgender-inclusive providers. As transgender identities are not typically recognized in public health research, the ability to compare the health of the transgender population to the overall population is limited. The Colorado Transgender Health Survey sought to explore current disparities and their effects on the health of transgender people in Colorado. The Colorado Transgender Health Survey, based on the Behavioral Risk Factor Surveillance System (BRFSS), was developed by the Colorado Department of Public Health and Environment, transgender advocates, and transgender community members. Outreach was targeted to transgender-inclusive events and organizations. Responses to the 2014 Colorado Transgender Health Survey were compared side by side to Colorado 2014 BRFSS data. Results from 406 transgender or gender-nonconforming adults who live in Colorado were included in the analysis. Forty percent of respondents report delaying medical care due to cost, inadequate insurance, and/or fear of discrimination. Respondents report significant mental health concerns, with 43% reporting depression, 36% reporting suicidal thoughts, and 10% attempting suicide in the past year. Respondents with a transgender-inclusive provider were more likely to receive wellness exams (76 versus 48%), less likely to delay care due to discrimination (24 versus 42%), less depressed (38 versus 54%), and less likely to attempt suicide (7 versus 15%) than those without. The transgender community in Colorado faces significant disparities, especially around mental health. However, a transgender-inclusive provider is associated with improved mental and physical health and health behaviors. Further population-level research and provider education on transgender health should to be incorporated into
Wester, Stephen R.; McDonough, Tracy A.; White, Maureen; Vogel, David L.; Taylor, Lareena
Ignoring gender socialization while counseling transgender clients neglects a significant aspect of the transgender experience. To address this, the authors review the literature on gender role conflict (GRC) theory as it pertains to the transgender experience of biological males whose authentic self is female. They explore the main types of…
Few non-pathologizing models of transgender identity development currently exist. This study uses an adaptation of the D'Augelli (1994) lifespan model of sexual orientation identity development to consider the lives of transgender college students. Interviews with two transgender-identified students find that they have developmental experiences in…
Swanbrow Becker, Martin A.; Nemeth Roberts, Stacey F.; Ritts, Sam M.; Branagan, William Tyler; Warner, Alia R.; Clark, Sheri L.
This study examines the experiences of transgender college students in coping with stress in comparison to their cisgender peers. Undergraduate and graduate students from 73 colleges, totaling 26,292 participants, of which 47 identified as transgender completed an online survey. Transgender students reported greater exposure to trauma and higher…
Budge, Stephanie L.; Adelson, Jill L.; Howard, Kimberly A. S.
Objective: The purpose of the current study was to examine facilitative and avoidant coping as mediators between distress and transition status, social support, and loss. Method: A total of 351 transgender individuals (n = 226 transgender women and n = 125 transgender men) participated in this study. Participants completed measures on transgender…
Vijay, Aishwarya; Earnshaw, Valerie A.; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M.; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L.; Wickersham, Jeffrey A.
Purpose: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia.
Muñoz-Laboy, Miguel; Garcia, Jonathan; Wilson, Patrick A; Parker, Richard G; Severson, Nicolette
Our analyses address the question of how bisexual Latino men organize their sexual partnerships. Heteronormativity can be understood as the set of social norms and normative structures that guide sexual partnering among men and women. We provide descriptive statistics to describe bisexual Latino men's sexual partnerships. Logistic and linear regression modeling were used to explore bivariate and multivariate relationships. Of our total sample (N = 142), 41.6 % had unprotected vaginal intercourse 2 months prior to the interview; 21.8 % had unprotected anal intercourse with female partners; 37.5 % had unprotected insertive anal intercourse with male partners; and 22.5 % had unprotected receptive anal intercourse with male partners. In our multivariate model, machismo was directly associated with meeting female partners through formal spaces (workplace, school, and/or church), but inversely associated with meeting male partners in formal spaces. Machismo was positively associated with meeting male sex partners through social networks (i.e., friendship and kinship networks). The more comfortable men were with homosexuality the less likely they were to meet men online and the more likely they were to meet men through social networks of friends and kinship. Interventions to reduce sexually transmitted diseases that target bisexual behavior as an epidemiological "bridge" of transmission from homosexual to heterosexual networks might very well benefit from a more complex understanding of how Latino bisexuality is patterned. Thus, this exploratory analysis might lead to a rethinking of how to address risk and vulnerability among Latino bisexual men and their sexual networks.
MacKay, Jenna; Robinson, Margaret; Pinder, Sarah; Ross, Lori E
Bisexual people constitute the largest sexual minority group in North America and experience significant mental health disparities in relation to heterosexuals, gays, and lesbians. In this article, we will examine the process and experience of help seeking among bisexuals. This was a community-based study that collected qualitative interview data from 41 diverse bisexual people from across Ontario, Canada. We analyzed the interview data using grounded theory and constructed an understanding of bisexuals' experiences of help seeking. We have conceptualized an overarching model that illustrates 4 interrelated stages: (a) the consideration of services, (b) the process of finding services, (c) barriers and facilitators to accessing services, and (d) experience of service utilization. This model is nonlinear, in that participants do not necessarily move through stages in sequence. Although many stages are experienced at the individual level, they are simultaneously informed by multiple factors at interpersonal and system levels. Our findings suggest a need for interventions at the policy, service and provider levels to improve accessibility of culturally competent services for this population. Understanding the mental health experiences of bisexual people will allow mental health professionals to build competencies working with this population and thereby contribute to a reduction in mental health disparities. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Stephenson, Rob; Riley, Erin; Rogers, Erin; Suarez, Nicolas; Metheny, Nick; Senda, Jonathan; Saylor, Kate M; Bauermeister, José A
There is a general paucity of research concerning the sexual health of transgender individuals, and most existing research focuses on transgender women. A scoping review concerning the sexual health of transgender men was conducted to identify gaps in the literature and to highlight opportunities for future research and intervention. A comprehensive search of seven databases was conducted. The Joanna Briggs Institute Reviewers' Manual was used as a framework. Some 7,485 articles were initially identified using a search strategy applied to seven online databases: 54 articles were identified as relevant to the research questions and reviewed in detail; of those, 33 were included in the final analysis. Studies were conceptualized into four broad themes: sexual behaviors, sexual identity, sexual pleasure and sexual function, and transactional sex. Besides an overall lack of research, existing studies were often characterized by small convenience samples that do not allow for generalization to the larger population of transgender men. Significant gaps in the literature regarding sexual coercion, sexual and intimate partner violence, and relationship quality and functioning among transgender men exist. There is a need to improve the scope and depth of research examining the sexual health of this population, especially concerning sexual risk behaviors and structural barriers to sexual health care access.
SUMMARY This 1992 New Zealand survey of discrimination against 261 lesbian and bisexual women found comparable rates of public abuse and workplace discrimination to those reported by surveys in other developed countries. The women reported higher rates of assault in public places than a random sample of New Zealand women. Indigenous Maori women reported higher rates of assault, threats, verbal abuse, and workplace discrimination than the non-Maori women surveyed. Aggression against the women was often in response to public expression of affection for another woman or to rejection of men's public sexual advances. The respondents reported hostile educational environments that coincided with peer harassment of students attracted to their own gender. Around two-thirds of the women had hidden their sexuality on some occasions at work to avoid discrimination. No significant differences between the discrimination experiences of lesbian and bisexual women emerged, although the bisexual sample was too small for statistical analysis.
Kerr, Dianne L; Ding, Kele; Chaya, Julie
To compare self-identified lesbian, gay, and bisexual (LGB) college students to heterosexual peers and to each other on alcohol, tobacco and other drug (ATOD) measures and alcohol use consequences. Preexisting data (Falls 2009-2011) from the American College Health Association-National College Health Assessment (ACHA-NCHA-II) were analyzed. Bisexual college students had greater odds of ATOD use than heterosexual and gay/lesbian students. Bisexual women had the highest levels of use. LGB students had more serious consequences due to alcohol use. ATOD use among LGB students was more prevalent than heterosexuals during the past 30 days, year, and life-time. LGB students report more negative alcohol consequences.
Witten, Tarynn M
This study is the first to examine the experiences and needs of an international sample of current, English-speaking, lesbian, transgender-identified (trans-lesbian) adults around a number of later life and end-of-life perceptions, preparations, and concerns. I analyzed a subset (n = 276) of the cross-sectional data collected from the online Trans MetLife Survey on Later-Life Preparedness and Perceptions in Transgender-Identified Individuals (N = 1,963). I assessed perceptions and fears around aging, preparation for later life, and end-of-life as well as numerous demographic and psycho-social variables. Despite the overall feeling that they have aged successfully, the respondent trans-lesbian population harbors significant fears about later life. I found that this population, while better-prepared than the overall respondent trans-identified population, is still ill-prepared for the major legalities and events that occur in the later to end-of-life time periods.
Padula, William V; Baker, Kellan
Many transgender Americans continue to remain uninsured or are underinsured because of payers' refusal to cover medically necessary, gender-affirming healthcare services-such as hormone therapy, mental health counseling, and reconstructive surgeries. Coverage refusal results in higher costs and poor health outcomes among transgender people who cannot access gender-affirming care. Research into the value of health insurance coverage for gender-affirming care for transgender individuals shows that the health benefits far outweigh the costs of insuring transition procedures. Although the Affordable Care Act explicitly protects health insurance for transgender individuals, these laws are being threatened; therefore, this article reviews their importance to transgender-inclusive healthcare coverage.
Shumer, Daniel E; Nokoff, Natalie J; Spack, Norman P
Children and adolescents with gender dysphoria are presenting for medical attention at increasing rates. Standards of Care have been developed which outline appropriate mental health support and hormonal interventions for transgender youth. This article defines terminology related to gender identity, reviews the history of medical interventions for transgender persons, outlines what is known about gender identity development, and reviews mental health disparities faced by this patient population. We provide an overview of medical management options for transgender adolescents meeting diagnostic criteria for gender dysphoria including pubertal suppression, cross-sex hormones, longitudinal screening and anticipatory guidance. We describe current challenges in the field and provide information about how care is currently being provided in the US and Canada. We conclude with 5 brief case examples. PMID:27426896
Bockting, W O; Rosser, B R; Scheltema, K
Virtually no HIV prevention education has specifically targeted the transgender community. To fill this void, a transgender HIV prevention workshop was developed, implemented and evaluated. A 4 h workshop, grounded in the Health Belief Model and the Eroticizing Safer Sex approach, combined lectures, videos, a panel, discussion, roleplay and exercises. Evaluation using a pre-, post- and follow-up test design showed an increase in knowledge and an initial increase in positive attitudes that diminished over time. Due to the small sample size (N = 59) and limited frequency of risk behavior, a significant decrease in unsafe sexual or needle practices could not be demonstrated. However, findings suggested an increase in safer sexual behaviors such as (mutual) masturbation. Peer support improved significantly. Future prevention education should make special efforts to target the more difficult-to-reach, high-risk subgroups of the transgender population.
Shi, Yu; Liu, Wenguang; He, Maoxian
Bivalve mollusks exhibit hermaphroditism and sex reversal/differentiation. Studies generally focus on transcriptional profiling and specific genes related to sex determination and differentiation. Few studies on sex reversal/differentiation have been reported. A combination analysis of gonad proteomics and transcriptomics was conducted on Chlamys nobilis to provide a systematic understanding of sex reversal/differentiation in bivalves. We obtained 4258 unique peptides and 93,731 unigenes with good correlation between messenger RNA and protein levels. Candidate genes in sex reversal/differentiation were found: 15 genes differentially expressed between sexes were identified and 12 had obvious sexual functions. Three novel genes (foxl2, β-catenin, and sry) were expressed highly in intersex individuals and were likely involved in the control of gonadal sex in C. nobilis. High expression of foxl2 or β-catenin may inhibit sry and activate 5-HT receptor and vitellogenin to maintain female development. High expression of sry may inhibit foxl2 and β-catenin and activate dmrt2, fem-1, sfp2, sa6, Amy-1, APCP4, and PLK to maintain male function. High expression of sry, foxl2, and β-catenin in C. nobilis may be involved in promoting and maintaining sex reversal/differentiation. The downstream regulator may not be dimorphic expressed genes, but genes expressed in intersex individuals, males and females. Different expression patterns of sex-related genes and gonadal histological characteristics suggested that C. nobilis may change its sex from male to female. These findings suggest highly conserved sex reversal/differentiation with diverged regulatory pathways during C. nobilis evolution. This study provides valuable genetic resources for understanding sex reversal/differentiation (intersex) mechanisms and pathways underlying bivalve reproductive regulation.
Young, Brian Jonathan; López, Gabriela Carina; Cristos, Diego Sebastián; Crespo, Diana Cristina; Somoza, Gustavo Manuel; Carriquiriborde, Pedro
The aim of the present study was to assess the responses of the gonopodium morphology and the gonadal and liver histology of adult male Cnesterodon decemmaculatus to sublethal long-term exposure concentrations of 17α-ethinylestradiol (EE2). Two experiments were conducted exposing the fish to waterborne concentrations of EE2 ranging from 20 ng/L to 200 ng/L for 8 wk, 12 wk, and 16 wk. Intersex gonads were observed after 8 wk and 16 wk in fish exposed to 200 ng EE2/L and 100 ng EE2/L, respectively. Oocytes' development from testis germ cells and replacement of the efferent duct periodic acid-Schiff-positive secretion surrounding spermatozeugmata by parenchymal tissue and duct structure alterations were the major observed changes in the gonads. In contrast, no response was observed in the gonopodium morphology. Liver histology was also altered, showing increasing steatosis, single-cell necrosis to generalized necrosis, and disruption of acinar organization from 100 ng EE2/L to 200 ng EE2/L. In summary, the present results showed that although EE2 was not able to alter the morphology of a developed gonopodium, it was capable of inducing development of testicular oocytes in adult male C. decemmaculatus at environmentally relevant concentrations. Thus, externally normal but intersex C. decemmaculatus males would be expected in the wastewater-receiving streams that the species inhabits. According to the literature, the present study would be the first indicating estrogen-induced intersex in adult male poeciliid. Environ Toxicol Chem 2017;36:1738-1745. © 2016 SETAC. © 2016 SETAC.
Goldman, Randi H; Kaser, Daniel J; Missmer, Stacey A; Farland, Leslie V; Scout; Ashby, Rachel K; Ginsburg, Elizabeth S
The purposes of this study were to evaluate public opinion regarding fertility treatment and gamete cryopreservation for transgender individuals and identify how support varies by demographic characteristics. This is a cross-sectional web-based survey study completed by a representative sample of 1111 US residents aged 18-75 years. Logistic regression was used to calculate odd ratios (ORs) and 95% confidence intervals (CIs) of support for/opposition to fertility treatments for transgender people by demographic characteristics, adjusting a priori for age, gender, race, and having a biological child. Of 1336 people recruited, 1111 (83.2%) agreed to participate, and 986 (88.7%) completed the survey. Most respondents (76.2%) agreed that "Doctors should be able to help transgender people have biological children." Atheists/agnostics were more likely to be in support (88.5%) than Christian-Protestants (72.4%; OR = 3.10, CI = 1.37-7.02), as were younger respondents, sexual minorities, those divorced/widowed, Democrats, and non-parents. Respondents who did not know a gay person (10.0%; OR = 0.20, CI = 0.09-0.42) or only knew a gay person without children (41.4%; OR = 0.29, CI = 0.17-0.50) were more often opposed than those who knew a gay parent (48.7%). No differences in gender, geography, education, or income were observed. A smaller majority of respondents supported doctors helping transgender minors preserve gametes before transitioning (60.6%) or helping transgender men carry pregnancies (60.1%). Most respondents who support assisted and third-party reproduction also support such interventions to help transgender people have children.
van Alphen, Elise C J
Scholars of bisexuality commonly agree that bisexuality as a distinct sexual identity remained invisible for epistemic reasons until the 1970s. This article examines this dominant explanation for the late invention of bisexual identity by discussing how bisexuality functioned in the homosexual movement in the Netherlands from 1946 to the early 1970s. This historical case study shows that in the Netherlands bisexuality as an identity existed in the movement in the first postwar decades and was erased in the late 1960s, not only for epistemic reasons but also for tactical ones. The article aims to contribute to a better insight into the history of bisexuality and the politics in the Dutch postwar homosexual movement.
Schibler, Laurent; Cribiu, Edmond P.; Oustry-Vaiman, Anne; Furet, Jean-Pierre; Vaiman, Daniel
To clone the goat Polled Intersex Syndrome (PIS) gene(s), a chromosome walk was performed from six entry points at 1q43. This enabled 91 BACs to be recovered from a recently constructed goat BAC library. Six BAC contigs of goat chromosome 1q43 (ICC1–ICC6) were thus constructed covering altogether 4.5 Mb. A total of 37 microsatellite sequences were isolated from this 4.5-Mb region (16 in this study), of which 33 were genotyped and mapped. ICC3 (1500 kb) was shown by genetic analysis to encompa...
Adeogun, Aina O.; Onibonoje, Kolawole; Ibor, Oju R.; Omiwole, Roseline A.; Chukwuka, Azubuike V.; Ugwumba, Alex O.; Ugwumba, Adiaha A.A.; Arukwe, Augustine
Highlights: • Occurrence and severity of intersex in Nigerian aquatic environment. • Estrogenic and reproductive developmental effects of effluents from a University community. • Biomarker of endocrine disruption in fish from a developing country. • Relationship between estrogenic responses and sediment contaminants burden in a dam used for University domestic water supply and for fisheries. • Possible health consequences of environmental contamination - Abstract: In the present study, the occurrence of endocrine disruptive responses in Tilapia species from Awba Dam has been investigated, and compared to a reference site (Modete Dam). The Awba Dam is a recipient of effluents from University of Ibadan (Nigeria) and several other anthropogenic sources. A total of 132 Tilapia species (Sarotherodon malenotheron (n = 57 and 32, males and females, respectively) and Tilapia guineensis (n = 23 and 20, males and females, respectively)) were collected from June to September 2014. At the reference site, samples of adult male and female S. melanotheron (48 males and 47 females) and T. guineensis (84 males and 27 females) were collected. Gonads were morphologically and histologically examined and gonadosomatic index (GSI) was calculated. Hepatic mRNA transcriptions of vitellogenin (Vtg) and zona radiata protein (Zrp) genes were analyzed using validated RT-qPCR. Significant increase in Vtg and Zrp transcripts were observed in male tilapias from Awba Dam, compared to males from the reference site. In addition, male tilapias from Awba Dam produced significantly higher Vtg and Zrp mRNA, compared to females in June and July. However, at the natural peak spawning period in August and September, females produced, significantly higher Vtg and Zrp mRNA, compared to males. Fish gonads revealed varying incidence of intersex with a striking presence of two (2) pairs of testes and a pair of ovary in S. melanotheron from Awba Dam. The entire fish population examined at Awba Dam
Adeogun, Aina O.; Onibonoje, Kolawole; Ibor, Oju R.; Omiwole, Roseline A.; Chukwuka, Azubuike V.; Ugwumba, Alex O.; Ugwumba, Adiaha A.A. [Department of Zoology, University of Ibadan, Ibadan (Nigeria); Arukwe, Augustine, E-mail: email@example.com [Department of Biology, Norwegian University of Science and Technology (NTNU), 7491 Trondheim (Norway)
Highlights: • Occurrence and severity of intersex in Nigerian aquatic environment. • Estrogenic and reproductive developmental effects of effluents from a University community. • Biomarker of endocrine disruption in fish from a developing country. • Relationship between estrogenic responses and sediment contaminants burden in a dam used for University domestic water supply and for fisheries. • Possible health consequences of environmental contamination - Abstract: In the present study, the occurrence of endocrine disruptive responses in Tilapia species from Awba Dam has been investigated, and compared to a reference site (Modete Dam). The Awba Dam is a recipient of effluents from University of Ibadan (Nigeria) and several other anthropogenic sources. A total of 132 Tilapia species (Sarotherodon malenotheron (n = 57 and 32, males and females, respectively) and Tilapia guineensis (n = 23 and 20, males and females, respectively)) were collected from June to September 2014. At the reference site, samples of adult male and female S. melanotheron (48 males and 47 females) and T. guineensis (84 males and 27 females) were collected. Gonads were morphologically and histologically examined and gonadosomatic index (GSI) was calculated. Hepatic mRNA transcriptions of vitellogenin (Vtg) and zona radiata protein (Zrp) genes were analyzed using validated RT-qPCR. Significant increase in Vtg and Zrp transcripts were observed in male tilapias from Awba Dam, compared to males from the reference site. In addition, male tilapias from Awba Dam produced significantly higher Vtg and Zrp mRNA, compared to females in June and July. However, at the natural peak spawning period in August and September, females produced, significantly higher Vtg and Zrp mRNA, compared to males. Fish gonads revealed varying incidence of intersex with a striking presence of two (2) pairs of testes and a pair of ovary in S. melanotheron from Awba Dam. The entire fish population examined at Awba Dam
Rodriguez, Amanda; Agardh, Anette; Asamoah, Benedict Oppong
Discrimination has long been tied to health inequality. Rejected by families and communities because of their gender identity and gender-role behavior, transgender individuals are often socially marginalized. This study aimed to assess discrimination in health-care settings among persons self-identifying as transgender in the U.S. in relation to their recognizability as transgender, operationalized as how often they experienced that others recognized them as transgender. Data were obtained from the National Transgender Discrimination Survey (n = 6106 participants, assigned sex at birth = 3608 males, 2480 females, respectively). Binary logistic regressions were performed to examine associations between transgender recognizability and discrimination in health-care settings. Being recognized as transgender to any extent had a significant effect on perceived discrimination in health care. Always recognized as transgender showed significant associations with discrimination in a health-care setting (OR 1.48) and the following individualized health-care settings: social service settings (rape crisis and domestic violence centers, OR 5.22) and mental health settings (mental health clinic and drug treatment program, OR 1.87). Sex work and other street economy, which are known experiential factors affected by discrimination, were also significantly associated with discrimination in health-care settings. Discrimination in health-care settings is pervasive for transgender who are recognized as transgender. Public health efforts to improve access to equitable health care for transgender individuals may benefit from consideration of demographic, experiential, and medical risk factors to more fully understand the source of the seemingly excess risk of discrimination among persons recognized by others as being transgender.
Vijay, Aishwarya; Earnshaw, Valerie A.; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M.; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L.
Abstract Purpose: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia. Methods: A total of 436 physicians at two major university medical centers in Kuala Lumpur, Malaysia, completed an online survey. Sociodemographic characteristics, stigma-related constructs, and intentions to discriminate against transgender people were measured. Bivariate and multivariate linear regression were used to evaluate independent covariates of discrimination intent. Results: Medical doctors who felt more fearful of transgender people and more personal shame associated with transgender people expressed greater intention to discriminate against transgender people, whereas doctors who endorsed the belief that transgender people deserve good care reported lower discrimination intent. Stigma-related constructs accounted for 42% of the variance and 8% was accounted for by sociodemographic characteristics. Conclusions: Constructs associated with transgender stigma play an important role in medical doctors' intentions to discriminate against transgender patients. Development of interventions to improve medical doctors' knowledge about and attitudes toward transgender people are necessary to reduce discriminatory intent in healthcare settings. PMID:29227183
Vijay, Aishwarya; Earnshaw, Valerie A; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L; Wickersham, Jeffrey A
Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia. A total of 436 physicians at two major university medical centers in Kuala Lumpur, Malaysia, completed an online survey. Sociodemographic characteristics, stigma-related constructs, and intentions to discriminate against transgender people were measured. Bivariate and multivariate linear regression were used to evaluate independent covariates of discrimination intent. Medical doctors who felt more fearful of transgender people and more personal shame associated with transgender people expressed greater intention to discriminate against transgender people, whereas doctors who endorsed the belief that transgender people deserve good care reported lower discrimination intent. Stigma-related constructs accounted for 42% of the variance and 8% was accounted for by sociodemographic characteristics. Constructs associated with transgender stigma play an important role in medical doctors' intentions to discriminate against transgender patients. Development of interventions to improve medical doctors' knowledge about and attitudes toward transgender people are necessary to reduce discriminatory intent in healthcare settings.
Poteat, Tonia; Malik, Mannat; Scheim, Ayden; Elliott, Ayana
The purpose of this review is to summarize the available evidence-based HIV prevention interventions tailored for transgender people. A limited number of evidence-based HIV prevention interventions have been tested with transgender populations. Most existing interventions target behavior change among transgender women, with only one HIV prevention program evaluated for transgender men. Studies addressing biomedical interventions for transgender women are ongoing. Few interventions address social and structural barriers to HIV prevention, such as stigma, discrimination, and poverty. Evidence-based multi-level interventions that address the structural, biomedical, and behavioral risks for HIV among transgender populations, including transgender men, are needed to address disparities in HIV prevalence. Future research should address not only pre-exposure prophylaxis uptake and condom use but also structural barriers that limit access to these prevention strategies.
Transgender individuals face harassment, discrimination, and rejection within our society. Lack of awareness, knowledge, and sensitivity in health care communities eventually leads to inadequate access to, underutilization of, and disparities within the health care system for this population. Although the care for these patients is often managed by a specialty team, obstetrician–gynecologists should be prepared to assist or refer transgender individuals with routine treatment and screening as well as hormonal and surgical therapies. The American College of Obstetricians and Gynecologists opposes discrimination on the basis of gender identity and urges public and private health insurance plans to cover the treatment of gender identity disorder.
Keo-Meier, Colton L; Fitzgerald, Kara M
Neither consensus on best practice nor validated neuropsychological, intelligence, or personality testing batteries exist for assessment and psychological testing on the transgender population. Historically, assessment has been used in a gate-keeping fashion with transgender clients. There are no firm standards of care when considering the content and appropriateness of evaluations conducted presurgically. These evaluations are discussed in the setting of other presurgical evaluations, with a recommendation to move toward a competency to make a medical decisions model. Additional considerations are discussed, such as effects of transition on mood and how to interpret scores in a field where normative data are often gender stratified. Copyright © 2016 Elsevier Inc. All rights reserved.
Auerback, Sandra; Moser, Charles
Found groups for wives of gay and bisexual men to be an effective therapeutic intervention for the problems that arise when a husband makes a disclosure to his wife that he is interested in pursuing homosexual relationships. The groups helped wives resolve the issues of the marriage and to make positive changes in their lives. (Author)
Daugelli, Anthony R.; Grossman, Arnold H.; Starks, Michael T.
This study used a sample of 293 lesbian, gay, and bisexual youth to examine factors that differentiated youth whose parents knew of their sexual orientation from youth whose parents did not know. Earlier awareness and disclosure of same-gender attractions, greater childhood gender atypicality, and less internalized homophobia were characteristic…
van Bergen, Diana; Bos, Henny M.W.; van Lisdonk, jantine; Keuzenkamp, S; Sandfort, T.G.M
We examined Netherlands Institute for Social Research data, collected between May and August 2009, on 274 Dutch lesbian, gay, and bisexual youths. The data showed that victimization at school was associated with suicidal ideation and actual suicide attempts. Homophobic rejection by parents was also
Deborah A. Gust
Full Text Available There is increased emphasis on physician attention to the overall health and wellness of homosexual and bisexual men, though little is known about the health-related attitudes of these groups. This study determined factors associated with the health attitudes of homosexual and bisexual men and identified preferred sources of health information. For this study, the 2008 ConsumerStyles panel survey was used to create three health attitude scales and to determine factors associated with each scale. The three scales were labeled: (1 health motivation; (2 relationship with health care provider; and (3 self-perception of health literacy. In addition to other factors, higher scores for health motivation and relationship with health care provider were associated with black compared with white men. In contrast, lower scores for self-perception of health literacy were associated with black compared with white men. For information on an unfamiliar health condition, most homosexual and bisexual men chose the Internet. Black homosexual and bisexual men reported being motivated to be healthy and working well with their health care provider to manage their health. However, their perception of their own health motivation was low compared with the white men. Attempts to improve health literacy through Internet sites may be helpful in improving health attitudes and reducing negative health outcomes.
Goldfried, Marvin R.
Illustrates how clinical and research writings on gay, lesbian, and bisexual (GLB) issues remain invisible to mainstream psychology in such areas as life span development and aging, teen suicide, substance abuse, victimization, and family and couple relationships, examining determinants of wellbeing among GLBs and discussing what mainstream…
Parnell, Martha Keeton; Lease, Suzanne H.; Green, Michael L.
This study examined career-related barriers that gay, lesbian, and bisexual (GLB) individuals had encountered in the past and anticipated in the future and the degree of hindrance associated with future barriers. Two hundred forty-one GLB participants (126 women and 115 men) completed the Career Barriers Inventory-Revised and 11 additional items…
Struble, Corrie Barnett; Lindley, Lisa L.; Montgomery, Kara; Hardin, James; Burcin, Michelle
Objective: To estimate and compare the prevalence of overweight and obesity among self-identified lesbian, bisexual, and heterosexual college age women. Methods: A secondary analysis of the Spring 2006 National College Health Assessment was conducted with 31,500 female college students (aged 18 to 25 years) to compare body mass index (calculated…
van Bergen, D.D.; Bos, H.M.W.; van Lisdonk, J.; Keuzenkamp, S.; Sandfort, T.G.M.
We examined Netherlands Institute for Social Research data, collected between May and August 2009, on 274 Dutch lesbian, gay, and bisexual youths. The data showed that victimization at school was associated with suicidal ideation and actual suicide attempts. Homophobic rejection by parents was also
van Bergen, D.D.; Bos, H.M.W.; van Lisdonk, J.; Keuzenkamp, S.; Sandfort, T.G.M.
We examined Netherlands Institute for Social Research data, collected between May and August 2009, on 274 Dutch lesbian, gay, and bisexual youths. The data showed that victimization at school was associated with suicidal ideation and actual suicide attempts. Homophobic rejection by parents was also
Geraudie, Perrine; Gerbron, Marie; Minier, Christophe
Among the chemicals found in the aquatic environment, some have been reported to interact with the endocrine system of organisms and have been identified as endocrine disrupting compounds. In this study, we have assessed the biological effects due to environmental estrogenic compounds in adult male roach (Rutilus rutilus). Wild fish were collected in the Seine River, and one of its affluent, the Epte River in Normandy, France and impacts on endocrine and reproductive functions have been assessed. This study provides innovative data on the intersex condition in wild fish that are crucial to understand estrogenic contamination impacts and maintenance of sustainable fish population. The biomarker responses found in fish from contaminated sites included high plasmatic vitellogenin concentrations, altered steroid levels, histopathological and up to 50% intersex fish among the male. However, the overall sex ratio of the roach population indicated sign of feminization with some sites showing only 20% of males. The chemical organic contamination at the different location sites has been characterized by the levels of PAHs, PCBs and phthalates and total estrogenic activity was measured by the YES in vitro assay. Copyright © 2017 Elsevier Inc. All rights reserved.
Besnier, N.; Alexeyeff, K.
Transgender identities and other forms of gender and sexuality that transcend the normative pose important questions about society, culture, politics, and history. They force us to question, for example, the forces that divide humanity into two gender categories and render them necessary,
In this paper, I discuss [transgender] young men's social, physical and embodied experiences of sport. These discussions draw from interview research with two young people who prefer to self-identify as "male" and not as "trans men", although they do make use of this term. Finn and Ed volunteered to take part in the research…
Kaiser, Matthew M.; Seitz, Keshia M.; Walters, Elizabeth A.
Ritha Smith, assistant superintendent, and Seth Hanson, principal, are faced with a difficult decision. Taylor Harper is a transgender student who identifies as male and is openly attracted to females. Taylor's parents, Lane and Morgan Harper, are lesbians; they are fully supportive of their child's identification and are well versed in their…
This essay discusses ways in which people attempt to reconcile or resolve their own cognitive dissonance engendered by transgender people in a society in which gender is perceived as both binary (male OR female) and immutable (an unalterable state or condition). The author suggests these cognitive dissonance reduction methods may be utilized in…
Roberts, Tiffany K; Fantz, Corinne R
The transgender community is arguably the most marginalized and underserved population in medicine. A special issue focusing on men's health would be incomplete without mention of this vulnerable population, which includes those transitioning to and from the male gender. Transgender patients face many barriers in their access to healthcare including historical stigmatization, both structural and financial barriers, and even a lack of healthcare provider experience in treating this unique population. Historical stigmatization fosters a reluctance to disclose gender identity, which can have dire consequences for long-term outcomes due to a lack of appropriate medical history including transition-related care. Even if a patient is willing to disclose their gender identity and transition history, structural barriers in current healthcare settings lack the mechanisms necessary to collect and track this information. Moreover, healthcare providers acknowledge that information is lacking regarding the unique needs and long-term outcomes for transgender patients, which contributes to the inability to provide appropriate care. All of these barriers must be recognized and addressed in order to elevate the quality of healthcare delivered to the transgender community to a level commensurate with the general population. Overcoming these barriers will require redefinition of our current system such that the care a patient receives is not exclusively linked to their sex but also considers gender identity. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Office of Safe and Healthy Students, US Department of Education, 2016
It has come to the Department of Education's (ED's) attention that many transgender students (i.e., students whose gender identity is different from the sex they were assigned at birth) report feeling unsafe and experiencing verbal and physical harassment or assault in school, and that these students may perform worse academically when they are…
Eliza Steinbock toont aan dat transgender belichaming en filmbeelden mogelijkerwijs een eigenschap met elkaar gemeen hebben. Zij beschrijft die als glinsterend. ‘Glinstering’ is het heen en weer te gaan tussen transseksuele lichamelijkheid aan de ene kant en het medium film aan de andere, en tussen
Vance, Stanley R; Halpern-Felsher, Bonnie L; Rosenthal, Stephen M
To explore providers' clinical experiences, comfort, and confidence with and barriers to providing care to transgender youth. An online survey was administered to members of the Society for Adolescent Health and Medicine and the Pediatric Endocrine Society with items querying about clinical exposure to transgender youth, familiarity with and adherence to existing clinical practice guidelines, perceived barriers to providing transgender-related care, and comfort and confidence with providing transgender-related care. The response rate was 21.9% (n = 475). Of the respondents, 66.5% had provided care to transgender youth, 62.4% felt comfortable with providing transgender medical therapy, and 47.1% felt confident in doing so. Principal barriers to provision of transgender-related care were lack of the following: training, exposure to transgender patients, available qualified mental health providers, and insurance reimbursement. This study suggests that more training in transgender-related care, available qualified mental health providers, and insurance reimbursement for transgender-related care are needed. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Bishop, Bryan M
Transgender and transsexual individuals have unique health care needs and risks compared with the population at large. It is estimated that 1 in 100,000 individuals in the United States is a transgender woman and 1 in 400,000 is a transgender man, although these estimates of prevalence are likely conservative. Transgender individuals are at an increased risk of tobacco, alcohol, and substance abuse; they have an increased lifetime suicide attempt risk; and they are more likely to experience significant stressors in their lives. Transgender patients may elect to transition their appearance to the gender with which they identify. Hormone treatment (and possibly sex reassignment surgery) is a significant part of this transition, and pharmacists must understand the pharmacotherapeutic principles involved so they can better recommend therapeutic agents, provide dosing recommendations, and anticipate and manage adverse effects. It is critical to be culturally sensitive when providing care for transgender patients including using their preferred gender identity, preferred names, and preferred pronouns. It is also essential to be able to identify transgender and transsexual patients correctly within electronic health records to ensure that appropriate care and monitoring are provided. For pharmacists, this means they should know the biologic sex for performing calculations such as creatinine clearance and to prevent teratogenic agents from reaching a transgender or transsexual man who could be pregnant or is capable of becoming pregnant. Promoting knowledge of transgender health issues will enable pharmacists to provide better, more holistic care to their transgender patients. © 2015 Pharmacotherapy Publications, Inc.
Kanamori, Yasuko; Cornelius-White, Jeffrey H D; Pegors, Teresa K; Daniel, Todd; Hulgus, Joseph
In recent years, issues surrounding transgender have garnered media and legal attention, contributing to rapidly shifting views on gender in the U.S. Yet, there is a paucity of data-driven studies on the public's views of transgender identity. This study reports the development and validation of the Transgender Attitudes and Beliefs Scale (TABS). After constructing an initial 96-item pool from consulting experts and existing scales, Phase 1 of the study was launched, involving an exploratory factor analysis of 48 items. The initial factor analysis with 295 participants revealed three factors across 33 items-16 items on interpersonal comfort, 11 on sex/gender beliefs, and 6 on human value. The internal consistency of each factor was high-α = .97 for Factor 1, α = .95 for Factor 2, and α = .94 for Factor 3. A confirmatory factor analysis was conducted in the second phase with an independent sample consisting of 238 participants. The Attitudes Toward Transgender Individual Scale and the Genderism and Transphobia Scale were also included to test for convergent validity, and the Rosenberg Self-Esteem Scale and the short form of the Marlowe-Crowne Social Desirability Scale were utilized to test discriminant validity. Both of the data collection phases employed MTurk, a form of online sampling with increased diversity compared to college student samples and more generalizability to the general U.S. TABS represents an addition to the literature in its ability to capture a more nuanced conceptualization of transgender attitude not found in previous scales.