LGBTQs and the DSM-5: a critical queer response

Measuring Quality Care for Adult ADHD Patients: How Much Does Gender and Gender Identity Matter?

OBJECTIVE

Studies show adult ADHD presents differently in men and women, however few studies contrast ADHD in cisgender and gender diverse adults. We assessed care differences between these groups using previously identified quality measures (QMs).

METHODS

Using EHR data, we matched a group of male ADHD patients to a female group. We followed the same procedure with a cisgender group and one identified as gender diverse through a gender dysphoria diagnosis. QM achievement was measured using logistic regression models.

RESULTS

Most QMs exhibited increasing achievement over time for all groups. Variations in care quality between males and females persisted, with female patients achieving QMs more often. There were no appreciable differences between the cisgender and gender diverse groups.

CONCLUSION

Though quality care for adult ADHD improved from 2010 to 2020, differences between male and female patients lingered. This effect was not observed in cisgender and gender diverse patients.

Compassionate Discourses: A Qualitative Study Exploring How Compassion Can Transform Healthcare for 2SLGBTQ+ People

Compassion can be seen as a necessary, but often lacking, concept and practice in healthcare. Due to the cis-heteronormative nature of societies, people who identify as Two-Spirit, lesbian, gay, bisexual, transgender, queer (2SLGBTQ+) often experience health disparities and disparities in accessing compassionate healthcare. We aimed to explore the meanings of compassion in healthcare for Canadian 2SLGBTQ+ people. Using a poststructuralist framework, 20 self-identifying 2SLGBTQ+ participants were interviewed. Data was analyzed through discourse analysis. Three main discursive considerations are discussed, including (1) meanings and expectations of compassion in healthcare, (2) compassionate healthcare is not guaranteed, and (3) prescription for care: self-compassion for healing and health. The results provide insights into how compassionate healthcare is framed for 2SLGBTQ+ participants and how compassion is often lacking for them due to discourses of cis-heteronormativity and healthism.

Transgender data collection in the electronic health record: Current concepts and issues

There are over 1 million transgender people living in the United States, and 33% report negative experiences with a healthcare provider, many of which are connected to data representation in electronic health records (EHRs). We present recommendations and common pitfalls involving sex- and gender-related data collection in EHRs. Our recommendations leverage the needs of patients, medical providers, and researchers to optimize both individual patient experiences and the efficacy and reproducibility of EHR population-based studies. We also briefly discuss adequate additions to the EHR considering name and pronoun usage. We add the disclaimer that these questions are more complex than commonly assumed. We conclude that collaborations between local transgender and gender-diverse persons and medical providers as well as open inclusion of transgender and gender-diverse individuals on terminology and standards boards is crucial to shifting the paradigm in transgender and gender-diverse health.

Normas, disputas e negociações: debates sobre a despatologização

Resumo: Este artigo parte de uma etnografia realizada no Núcleo Trans e no Ambulatório de Atenção Integral à Pessoa Trans, órgão da Universidade Federal de São Paulo (Unifesp) que tem como objetivo acompanhar e analisar as disputas em torno das mudanças do Código Internacional de Doenças e Problemas Relacionados à Saúde 10 para o Código Internacional de Doenças e Problemas Relacionados à Saúde 11, além das mudanças do Manual Diagnóstico e Estatístico de Doenças Mentais e das normativas do Conselho Federal de Medicina brasileiro. Com base nessas discussões, o texto aponta que o diagnóstico permanece interpelando a lógica de cuidados dos profissionais de saúde, usuários e integrantes dos movimentos sociais, mesmo na sua suposta ausência ou recusa.

Innovations, Reviews and Proposals on the DSM-5: the Case of Sexual Dysfunctions, Gender Dysphoria and Paraphilic Disorders

Human behaviours have different meanings according to the historical moment and context. In this article sexual behaviours are taken as a category in order to analyse how psychiatric nosology is structured, as manifested in texts such as the DSM-5. The development of these diagnostic manuals are tools that are far from being free of subjectivities and interference of elements of power, expressed in the way health, illness, mental health, and mental disorders, are assumed; in short, the normal and pathological. Each new diagnosis, or even its elimination, and the recomposing of the different diagnostic criteria, especially in the field of sexual behaviour, present visions of how individual and collective human life is conceived, as well as an expression of accurate attempts to control human sexualities through the medicalisation of behaviour, coupled with moral, religious, and even legal considerations. Categories such as gender dysphoria, paraphilia or paraphilic disorders are examples of how the limits intended to establish a biomedical perspective are also incomplete and imprecise. These violate individual and social construction of sexualities and the conception of mental health, showing persistent difficulties and controversies that are evident in the way psychiatric classifications are made.

Sexual Minority Health: A Bibliography and Preliminary Study of the Book Literature

The literature on health in people who identify as sexual minorities is scattered in many types of resources and disciplines. To help address the need for relevant, well-organized information for lesbian, gay, bisexual, and transgender people and health care providers, this study first identified books published in a ten-year period and then examined the topics, the number of books published per year, most prolific authors, and primary publishers. A wide range of publishers published a relatively small number of books (521). Most were about mental health or relationships and 24% were personal accounts. There were many subject deficiencies in the published book corpus.