Transgender health and medicine – Are radiological devices prepared?

Care of transgender patients by diagnostic radiographers: What can be learnt from the literature

INTRODUCTION

Transgender patients have described negative healthcare experiences, including discrimination and feeling unwelcome. Additionally, these patients are at risk of inadequate or unsafe care due to healthcare providers being unable to obtain and record transgender patients' correct gender and assigned birth sex. This literature review aims to review radiology and radiographer articles published since 2018 about transgender healthcare issues and make recommendations that can be applied by diagnostic radiographers, their managers and diagnostic radiography programme providers.

METHOD

A literature search used multiple databases containing peer-reviewed articles. Boolean operators and key words were utilised. Identified articles were searched to identify any articles not found by searching the databases. Themes and sub-themes from each paper were identified and discussed.

RESULTS

Three key themes were identified: education, systems and environment. Education sub-themes were knowledge and awareness. Systems sub-themes were recording gender correctly and discriminating/stigmatising policies. Environment sub-themes were transgender-friendly symbols and environmental dysphoria.

CONCLUSION

Transgender patients still face barriers to equitable care. Several recommendations were made based on the thematic discussion that could be applied by diagnostic radiographers, student radiographers, radiology managers, University training providers, and professional body organisations. Diagnostic radiography programmes should include training on both clinical topics and cultural competence. Radiology managers should display transgender-positive symbols in their departments and ensure their policies are non-discriminatory and non-stigmatising. Radiology hardware and software providers should provide the ability to record non-binary genders and birth-assigned sex.

IMPLICATIONS FOR PRACTICE

Transgender patients have the right to receive equitable care from diagnostic radiographers during their imaging examination and radiology attendance, and that any risks relating to their transgender status should be correctly managed with appropriate sensitivity.

Understanding the needs of women undergoing breast ultrasound: Are male radiologists still needed?

INTRODUCTION

A trend towards less male radiologists specializing in breast ultrasound was observed. A common notion in the field of breast radiology is, that female patients feel more comfortable being treated by female radiologists. The aim of the study was to understand and report the needs of women undergoing breast ultrasound with regards to the sex of the radiologist performing the investigation.

METHODS

Informed consent was obtained from all patients prior to inclusion in a prospective bi-center quality study. At center 1 (72 patients), the women were examined exclusively by female radiologists, at center 2 (100 patients) only by male radiologists. After the examination the patients were asked about their experiences and their wishes for the future.

RESULTS

Overall, women made no distinction between female and male radiologists; 25% of them wanted a female radiologist and 1.2% wanted a male radiologist. The majority (74%) stated that it made no difference whether a female or male radiologist performed the examination. The majority of women in group 2, who were investigated exclusively by male radiologists, stated that they had no preferences with regard to the sex of the radiologist (93%); 5% of the women wished to be investigated solely by a female radiologist and 2% exclusively by a male radiologist.

DISCUSSION

The majority of women undergoing breast ultrasound are unconcerned about the radiologist's sex. It would appear that women examined by male radiologists are less selective about the sex of the examining radiologist.

TRIAL REGISTRATION

Written informed consent was obtained from all patients. All patient data were anonymized. The physicians had no access to any further personal data. National regulations did not require dedicated ethics approval with anonymized lists or retrospective questionnaires.

Gender-inclusive practice in pregnancy determination for transgender, gender diverse and non-binary patients in medical imaging

In recent years, there has been an increased awareness and understanding of the varying gender identities within our society. Consequently, there has also been a need for healthcare providers to be cognizant of the unique needs of a gender-diverse population. Determining the pregnancy status of transgender, gender-diverse and non-binary patients in medical imaging settings has been poorly handled, and there is a lack of standardisation in the Australian and Aotearoa New Zealand setting. The potential risk of exposing a gender-diverse pregnant patient to ionising radiation increases the need for guidance to ensure potentially pregnant persons are not missed during screening questionnaires. This review article explores various approaches to pregnancy status determination for gender-diverse patients, recognising the complexities involved and emphasising the need for future work to establish a widely accepted solution.