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González-Mendiondo L, Mayor A, Moyano N. The Role of Healthcare Professionals in the Transition Process: A Qualitative Study of Families of Trans Children and Adolescents. Healthcare (Basel) 2024; 12:974. [PMID: 38786386 PMCID: PMC11121463 DOI: 10.3390/healthcare12100974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/21/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
The aim of this study was to explore the role that healthcare professionals, such as pediatricians, psychologists, psychiatrists and sexologists, play in supporting trans children and adolescents in their transition processes. To this end, 22 life stories written by parents of trans children and adolescents who had undergone social transition were collected, and a qualitative analysis was carried out using MAXQDA software. For this purpose, three key periods were considered in the stories: before, during and after the transition. Among other aspects, the stories highlight a major lack of understanding on the part of the professionals who should support trans children and adolescents, and their families, in their transition processes. Parents described the attitude of those professionals who actively listened to their children's needs and were cooperative as positive, even if they do not have the necessary training. The need for specific training in diversity is one of the main conclusions of this study.
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Affiliation(s)
| | - Aingeru Mayor
- Departamento de e Lenguajes y Sistemas Informáticos, Universidad del País Vasco, 48940 San Sebastián, Spain;
| | - Nieves Moyano
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Jaén, 23071 Jaén, Spain
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de Abreu PD, Palha PF, Andrade RLDP, de Almeida SA, Nogueira JDA, Monroe AA. Integral health care for transgender adolescents: subsidies for nursing practice. Rev Lat Am Enfermagem 2022; 30:e3810. [PMID: 36449927 PMCID: PMC9695282 DOI: 10.1590/1518-8345.6276.3810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/15/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE to analyze the integral health care for transgender adolescents from the perspective of their guardians. METHOD qualitative research based on the Social Network framework proposed by Lia Sanicola, developed with 22 guardians of transgender adolescents in Brazil through semi-structured individual online interviews. The empirical material was analyzed using the content analysis technique, thematic modality. RESULTS lack of ambience was observed, in addition to technical unpreparedness of health professionals in relation to the theme at all levels of care, transphobia, centralization of care in scarce qualified services for transgender children and youth, absence of family support, lack of health promotion actions within the community, especially in the school environment, and the common support from non-governmental initiatives. CONCLUSION the centralization of actions in scarce specialized services in the country, and the structural transphobia can compromise the integral health care for transgender adolescents. There is an urgent need for a network of care capable of assisting the joint action by multi and interdisciplinary teams, with greater proactivity of the nurse with the transgender adolescent and their guardians in individual and collective actions; ambience; health promotion in schools for visibility and support in Primary Health Care since childhood. HIGHLIGHTS (1) Need for a network of care concerning integral health care for transgender adolescents.(2) Centralization and scarce qualified services for transgender children and youth.(3) Invisible families, lack of health promotion within the community.(4) Unpreparedness of health professionals and disarticulation of the health care network.(5) Need for qualification of nurses when caring for transgender people.
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Affiliation(s)
- Paula Daniella de Abreu
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Pedro Fredemir Palha
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Rubia Laine de Paula Andrade
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | | | | | - Aline Aparecida Monroe
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Abreu PD, Andrade RLP, Maza ILS, Faria MGBF, Valença ABM, Araújo EC, Palha PF, Arcêncio RA, Pinto IC, Ballestero JGA, Almeida SA, Nogueira JA, Monroe AA. Support for Mothers, Fathers, or Guardians of Transgender Children and Adolescents: A Systematic Review on the Dynamics of Secondary Social Networks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148652. [PMID: 35886503 PMCID: PMC9319694 DOI: 10.3390/ijerph19148652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/09/2022] [Accepted: 07/12/2022] [Indexed: 12/10/2022]
Abstract
Mothers', fathers', or guardians' support for disclosures of diverse gender identity has significant relationships with decreased suicidality for transgender children and adolescents. They play an essential role in facing transphobia, protecting trans children, and strengthening the expression of their identity. These guardians need structural, emotional, and informative support; they need to be prepared to recognize and manage of their own feelings, as well as deal with the challenges that come with new social contexts of transphobia in schools, health institutions, and other community spaces. This study aimed to analyze the scientific evidence on the dynamics of secondary social networks to support mothers, fathers, or guardians of transgender children and adolescents. This is a systematic review of qualitative studies, guided by PRISMA guidelines. Controlled and free vocabularies were used to survey the primary studies in the following databases: EMBASE; Scopus; MEDLINE; Cumulative Index to Nursing and Allied Health Literature (CINAHL); PsycInfo; Latin American and Caribbean Literature in Health Sciences (LILACS); and Web of Science. A total of 28 articles made up the final sample of this review. Secondary social networks were described as fragile, characterized by conflicting and broken ties with healthcare services and professionals, isolation and unpreparedness from schools, and emotional and informational support from peer groups and some qualified healthcare professionals. The literature shows the potential of the dynamics of secondary social support networks; however, it presented the unpreparedness of professionals and institutional policies for welcoming transgender children and adolescents and their families, with the peer group being the main emotional and informative support network.
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Affiliation(s)
- Paula D. Abreu
- Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto 14040-902, Brazil; (P.D.A.); (I.L.S.M.); (M.G.B.F.F.); (P.F.P.); (R.A.A.); (I.C.P.); (J.G.A.B.); (A.A.M.)
| | - Rubia L. P. Andrade
- Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto 14040-902, Brazil; (P.D.A.); (I.L.S.M.); (M.G.B.F.F.); (P.F.P.); (R.A.A.); (I.C.P.); (J.G.A.B.); (A.A.M.)
- Correspondence: ; Tel.: +55-16-3315-3407
| | - Israel L. S. Maza
- Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto 14040-902, Brazil; (P.D.A.); (I.L.S.M.); (M.G.B.F.F.); (P.F.P.); (R.A.A.); (I.C.P.); (J.G.A.B.); (A.A.M.)
| | - Mariana G. B. F. Faria
- Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto 14040-902, Brazil; (P.D.A.); (I.L.S.M.); (M.G.B.F.F.); (P.F.P.); (R.A.A.); (I.C.P.); (J.G.A.B.); (A.A.M.)
| | - Ana B. M. Valença
- Nursing Department, Federal University of Pernambuco, Recife 50670-901, Brazil; (A.B.M.V.); (E.C.A.)
| | - Ednaldo C. Araújo
- Nursing Department, Federal University of Pernambuco, Recife 50670-901, Brazil; (A.B.M.V.); (E.C.A.)
| | - Pedro F. Palha
- Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto 14040-902, Brazil; (P.D.A.); (I.L.S.M.); (M.G.B.F.F.); (P.F.P.); (R.A.A.); (I.C.P.); (J.G.A.B.); (A.A.M.)
| | - Ricardo A. Arcêncio
- Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto 14040-902, Brazil; (P.D.A.); (I.L.S.M.); (M.G.B.F.F.); (P.F.P.); (R.A.A.); (I.C.P.); (J.G.A.B.); (A.A.M.)
| | - Ione C. Pinto
- Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto 14040-902, Brazil; (P.D.A.); (I.L.S.M.); (M.G.B.F.F.); (P.F.P.); (R.A.A.); (I.C.P.); (J.G.A.B.); (A.A.M.)
| | - Jaqueline G. A. Ballestero
- Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto 14040-902, Brazil; (P.D.A.); (I.L.S.M.); (M.G.B.F.F.); (P.F.P.); (R.A.A.); (I.C.P.); (J.G.A.B.); (A.A.M.)
| | - Sandra A. Almeida
- Clinical Nursing Department, Federal University of Paraiba, Joao Pessoa 58051-900, Brazil; (S.A.A.); (J.A.N.)
| | - Jordana A. Nogueira
- Clinical Nursing Department, Federal University of Paraiba, Joao Pessoa 58051-900, Brazil; (S.A.A.); (J.A.N.)
| | - Aline A. Monroe
- Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto 14040-902, Brazil; (P.D.A.); (I.L.S.M.); (M.G.B.F.F.); (P.F.P.); (R.A.A.); (I.C.P.); (J.G.A.B.); (A.A.M.)
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Dynamics of Primary Social Networks to Support Mothers, Fathers, or Guardians of Transgender Children and Adolescents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137941. [PMID: 35805599 PMCID: PMC9265819 DOI: 10.3390/ijerph19137941] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/20/2022] [Accepted: 06/24/2022] [Indexed: 01/27/2023]
Abstract
Mothers, fathers, or guardians of children and adolescents who do not identify with the gender they were assigned at birth face barriers in their social network to recognize their children’s gender identity. This study aimed to analyze the scientific evidence on the dynamics of primary social networks to support mothers, fathers, or guardians of transgender children and adolescents. This is a systematic review of qualitative studies guided by the PRISMA guidelines. Controlled and free vocabulary were used to survey the studies in the EMBASE, Scopus, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Latin American and Caribbean Literature in Health Sciences (LILACS), and Web of Science databases. A total of 21 studies composed the final sample. Primary social networks were described as fragile and conflicting family/blood relationship ties with disapproval, isolation, rejection, a lack of understanding, and feelings of exclusion were expressed. Some have lost friends, reported tension in marriage and with relatives, and were commonly treated with hostility and harassment. Social transition does take place in the mutual context of struggle and resistance which demands a support network for parents or guardians.
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Abreu PDD, Palha PF, Andrade RLDP, Almeida SAD, Nogueira JDA, Monroe AA. Atención integral a la salud de los adolescentes transgénero: subsidios para la práctica de la Enfermería. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6276.3809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Resumen Objetivo: analizar la atención integral a la salud de los adolescentes transgénero desde la perspectiva de sus responsables. Método: estudio cualitativo basado en el marco de la Red Social propuesto por Lia Sanicola, desarrollado con 22 responsables de adolescentes transgénero en Brasil a partir de entrevistas en línea individuales semiestructuradas. El material empírico fue analizado mediante la técnica de análisis de contenido, modalidad temática. Resultados: se ha evidenciado la falta de ambiente y preparación técnica de los profesionales de la salud con relación al tema en todos los niveles de atención, transfobia, centralización del cuidado en los pocos servicios habilitados para personas trans en el período infantojuvenil, invisibilidad del apoyo a la familia, ausencia de acciones de promoción de la salud en el ámbito comunitario, especialmente en la escuela, y la acogida comúnmente por las iniciativas no gubernamentales. Conclusión: la centralización de acciones en los pocos servicios especializados del país y la transfobia estructural pueden comprometer la atención integral en salud de los adolescentes trans. Urge una línea de cuidado capaz de auxiliar la acción conjunta de un equipo multi e interdisciplinario, con mayor proactividad del enfermero con el adolescente transgénero y sus responsables en acciones individuales y colectivas; ambiente; promoción de la salud en las escuelas para la visibilidad y acogida en la Atención Primaria de la Salud desde la infancia.
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Abreu PDD, Palha PF, Andrade RLDP, Almeida SAD, Nogueira JDA, Monroe AA. Atenção integral à saúde dos adolescentes transgêneros: subsídios para a prática da Enfermagem. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6276.3811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Resumo Objetivo: analisar a atenção integral à saúde dos adolescentes transgêneros na perspectiva dos seus responsáveis. Método: estudo qualitativo fundamentado no referencial Rede Social proposto por Lia Sanicola, desenvolvido com 22 responsáveis por adolescentes transgêneros no Brasil por meio de entrevistas online individuais semiestruturadas. O material empírico foi analisado com a utilização da técnica de análise de conteúdo na modalidade temática. Resultados: Foram evidenciados a falta de ambiência e despreparo técnico de profissionais da saúde em relação à temática em todos os níveis de atenção, transfobia, centralização do cuidado em escassos serviços habilitados para pessoas trans no período infantojuvenil, invisibilidade do apoio à família, ausência de ações de promoção da saúde no âmbito comunitário, sobretudo, escolar, e, ainda, o acolhimento promovido, comumente, pelas iniciativas não governamentais. Conclusão: a centralização de ações em escassos serviços especializados no país e a transfobia estrutural podem comprometer a atenção integral à saúde dos adolescentes trans. Urge a necessidade de uma linha de cuidado capaz de auxiliar a atuação conjunta por equipe multi e interdisciplinar com maior proatividade do enfermeiro junto ao adolescente trans e seus responsáveis por meio de ações individuais e coletivas; ambiência; promoção da saúde nas escolas para visibilidade e acolhimento na Atenção Primária à Saúde desde a infância.
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Scandurra C, Carbone A, Baiocco R, Mezzalira S, Maldonato NM, Bochicchio V. Gender Identity Milestones, Minority Stress and Mental Health in Three Generational Cohorts of Italian Binary and Nonbinary Transgender People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9057. [PMID: 34501646 PMCID: PMC8430636 DOI: 10.3390/ijerph18179057] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/21/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022]
Abstract
Transgender and gender nonconforming (TGNC) people experience high rates of minority stress and associated risk for negative health outcomes. However, during the last years, significant positive socio-cultural changes have happened, and younger cohorts of TGNC individuals are having diverse experiences compared to older cohorts. By integrating the minority stress theory and the life course perspective, this cross-sectional, web-based study aimed to explore in 197 Italian TGNC people aged 18 to 54 years (M = 29.82, SD = 9.64) whether the average ages of gender identity milestones (i.e., first insights about being TGNC, self-labeling as a TGNC person, and coming out), minority stress, and mental health vary among three generational cohorts (i.e., Generation Z, Millennials, and Generation X). Compared with older cohorts, younger participants: (a) were more likely to be in the trans-masculine spectrum; (b) self-labeled as TGNC and came out earlier; (c) had more negative expectations and lower levels of disclosure; and (d) had higher levels of mental health problems. No generational differences related to first insights about being TGNC and distal minority stressors were found. Furthermore, compared with binary individuals, participants with a non-binary identity: (a) reported later ages for the gender identity milestones; (b) had higher negative expectations; and (c) had higher levels of mental health problems. Overall, our findings indicated that changes in the social environments have a limited impact on stigmatization processes and mental health of Italian TGNC people.
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Affiliation(s)
- Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy;
| | - Agostino Carbone
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (R.B.)
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (R.B.)
| | - Selene Mezzalira
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, 35139 Padova, Italy;
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy;
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, 87036 Cosenza, Italy;
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