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Clay T, Callen EF, Alai J, Goodman DW, Adler LA, Faraone SV. Measuring Quality Care for Adult ADHD Patients: How Much Does Gender and Gender Identity Matter? J Atten Disord 2024; 28:364-376. [PMID: 38156652 DOI: 10.1177/10870547231218449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
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.
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Affiliation(s)
- Tarin Clay
- American Academy of Family Physicians, Leawood, KS, USA
- DARTNet Institute, Aurora, CO, USA
| | - Elisabeth F Callen
- American Academy of Family Physicians, Leawood, KS, USA
- DARTNet Institute, Aurora, CO, USA
| | - Jill Alai
- American Academy of Family Physicians, Leawood, KS, USA
- DARTNet Institute, Aurora, CO, USA
| | - David W Goodman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Lenard A Adler
- Departments of Psychiatry and Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
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Campo-Arias A, Reyes-Rojas M. Gender incongruence or dysphoria: More of the same in ICD-11 and DSM-5-TR. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2024; 53:5-7. [PMID: 38677943 DOI: 10.1016/j.rcpeng.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 04/29/2024]
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3
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Logie CH, van der Merwe LLA, Scheim A. Measuring sex, gender, and sexual orientation: one step to health equity. Lancet 2022; 400:715-717. [PMID: 35908554 DOI: 10.1016/s0140-6736(22)01425-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada; Centre for Gender and Sexual Health Equity, Vancouver, BC, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; United Nations University Institute for Water, Environment and Health, Hamilton, ON, Canada.
| | - L Leigh Ann van der Merwe
- Social Health Empowerment Feminist Collective of Transgender Women of Africa, East London, South Africa
| | - Ayden Scheim
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
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Joy P, Thomas A, Aston M. Compassionate Discourses: A Qualitative Study Exploring How Compassion Can Transform Healthcare for 2SLGBTQ+ People. QUALITATIVE HEALTH RESEARCH 2022; 32:1514-1526. [PMID: 35739090 PMCID: PMC9411689 DOI: 10.1177/10497323221110701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
- Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Andrew Thomas
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, NS, Canada
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Kronk CA, Everhart AR, Ashley F, Thompson HM, Schall TE, Goetz TG, Hiatt L, Derrick Z, Queen R, Ram A, Guthman EM, Danforth OM, Lett E, Potter E, Sun SD, Marshall Z, Karnoski R. Transgender data collection in the electronic health record: Current concepts and issues. J Am Med Inform Assoc 2022; 29:271-284. [PMID: 34486655 PMCID: PMC8757312 DOI: 10.1093/jamia/ocab136] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/13/2021] [Accepted: 06/18/2021] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Clair A Kronk
- Center for Medical Informatics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Avery R Everhart
- Population, Health, and Place Program, Spatial Sciences Institute, University of Southern California, Los Angeles, California, USA
- Center for Applied Transgender Studies, Chicago, Illinois, USA
| | - Florence Ashley
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- Faculty of Law and Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada
| | - Hale M Thompson
- Department of Psychiatry and Behavioral Science, Rush University Medical Center, Chicago, Illinois, USA
| | - Theodore E Schall
- Berman Institute of Bioethics, Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Teddy G Goetz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laurel Hiatt
- University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Zackary Derrick
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Roz Queen
- Health Information Science, School of Human and Social Development, University of Victoria, Victoria, British Columbia, Canada
| | - A Ram
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
| | - E Mae Guthman
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey, USA
| | - Olivia M Danforth
- Department of Family Medicine, Samaritan Health Services Geary St. Clinic, Albany, Oregon, USA
| | - Elle Lett
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Emery Potter
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Simón(e) D Sun
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- Center for Neural Science, New York University, New York, New York, USA
- Department of Neuroscience and Physiology, Neuroscience Institute, NYU Grossman Medical Center, New York, New York, USA
| | - Zack Marshall
- School of Social Work, McGill University, Montreal, Quebec, Canada
| | - Ryan Karnoski
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- School of Social Welfare, University of California, Berkeley, Berkeley, California, USA
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Tshisa N, van der Walt F. Discrimination challenges and psychological well-being of black African queer employees. SA JOURNAL OF INDUSTRIAL PSYCHOLOGY 2021. [DOI: 10.4102/sajip.v47i0.1835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Mulé NJ. Mental health issues and needs of LGBTQ+ asylum seekers, refugee claimants and refugees in Toronto, Canada. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.1913443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Nick J. Mulé
- School of Social Work, School of Gender, Sexuality & Women's Studies, York University, Toronto, Canada
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Girotto LC, Teixeira FDB, Miskolci R, Pereira PPG. Normas, disputas e negociações: debates sobre a despatologização. REVISTA ESTUDOS FEMINISTAS 2021. [DOI: 10.1590/1806-9584-2021v29n371934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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.
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Garrett CL. Finding natural variation: assembling underdetermined evidence of gender dysphoria, doing trans therapeutics. BIOSOCIETIES 2020. [DOI: 10.1057/s41292-020-00201-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Agana MG, Greydanus DE, Indyk JA, Calles JL, Kushner J, Leibowitz S, Chelvakumar G, Cabral MD. Caring for the transgender adolescent and young adult: Current concepts of an evolving process in the 21st century. Dis Mon 2019; 65:303-356. [DOI: 10.1016/j.disamonth.2019.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Campo-Arias A, Herazo E. Innovations, Reviews and Proposals on the DSM-5: the Case of Sexual Dysfunctions, Gender Dysphoria and Paraphilic Disorders. ACTA ACUST UNITED AC 2018; 47:56-64. [PMID: 29428123 DOI: 10.1016/j.rcp.2016.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/25/2016] [Indexed: 11/18/2022]
Abstract
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.
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Affiliation(s)
- Adalberto Campo-Arias
- Instituto de Investigación del Comportamiento Humano (Human Behavioral Research Institute), Bogotá, Colombia; Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Colombia.
| | - Edwin Herazo
- Instituto de Investigación del Comportamiento Humano (Human Behavioral Research Institute), Bogotá, Colombia
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Abstract
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.
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13
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Sadomasochism in Sickness and in Health: Competing Claims from Science, Social Science, and Culture. CURRENT SEXUAL HEALTH REPORTS 2015. [DOI: 10.1007/s11930-014-0039-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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