1
|
Eder C, Roomaney R. Transgender and non-binary people's experience of endometriosis. J Health Psychol 2024:13591053241266249. [PMID: 39127882 DOI: 10.1177/13591053241266249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2024] Open
Abstract
There is a lack of research on gender diverse people's experiences with endometriosis. We explored the experience of 11 transgender and non-binary people with endometriosis using phenomenology. We collected data through multiple interviews and diaries and constructed two themes using hermeneutic analysis: (1) Unhomelikeness of Living with Endometriosis and being Gender Diverse, and (2) Towards a Homelikeness of Living with Endometriosis as a Gender Diverse Individual, which we discussed in relation to Svenaeus Phenomenology of Medicine. Unhomelikeness is an experience of disconnection with our bodies and being-in-the-world as a result of living with a chronic disease. We show how gender diverse people with endometriosis may have additional layers of unhomelikeness due to further diagnostic delays, endometriosis symptoms that may trigger gender dysphoria and experiences with treatment that are not inclusive of their gender identity. We advocate for additional support and awareness for gender diverse people with endometriosis.
Collapse
|
2
|
Sebring JCH, Kelly C, McPhail D, Woodgate RL. Medical invalidation in the clinical encounter: a qualitative study of the health care experiences of young women and nonbinary people living with chronic illnesses. CMAJ Open 2023; 11:E915-E921. [PMID: 37816547 PMCID: PMC10569812 DOI: 10.9778/cmajo.20220212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Medical invalidation is a well-documented phenomenon in the literature on chronic illnesses, yet there is a paucity of research capturing the perspectives of young adults living with chronic illnesses, and especially of those who are gender diverse or from groups that face broader societal marginalization. Our study sought to answer the following question: How do young women and nonbinary adults living with chronic illnesses characterize their experiences of medical invalidation and its impact on their health and well-being? METHODS This was a patient-oriented qualitative study informed by feminist disability theory. Eligibility requirements included self-identifying as having a chronic illness, self-identifying as a woman or nonbinary person receiving health care in Manitoba, and being between the ages of 18 and 35 years. Participants took part in online arts-based workshops and subsequent focus group discussion in November 2021. RESULTS Eight women and 2 nonbinary individuals participated. Medical invalidation was experienced by all of the participants at different points in their illness journeys and took a variety of forms depending on their social location and their particular illness, positioning invalidation as an issue of in/visibility. We identified several consequences of medical invalidation, including internalizing invalidation, overcompensating for their illness, avoiding care and, ultimately, symptom intensification. We also present participants' recommendations to avoid medical invalidation. INTERPRETATION This study provides insight into the phenomenon of medical invalidation, understood as the act of dismissing, minimizing or otherwise not taking patient concerns seriously. We suggest person-centred care may not be enough, and critical reflexivity may help avoid unintentionally invalidating patient experiences.
Collapse
Affiliation(s)
- Jennifer C H Sebring
- Department of Community Health Sciences (Sebring, Kelly, McPhail), Max Rady College of Medicine, and College of Nursing (Woodgate), Helen Glass Centre for Nursing, University of Manitoba, Winnipeg, Man.
| | - Christine Kelly
- Department of Community Health Sciences (Sebring, Kelly, McPhail), Max Rady College of Medicine, and College of Nursing (Woodgate), Helen Glass Centre for Nursing, University of Manitoba, Winnipeg, Man
| | - Deborah McPhail
- Department of Community Health Sciences (Sebring, Kelly, McPhail), Max Rady College of Medicine, and College of Nursing (Woodgate), Helen Glass Centre for Nursing, University of Manitoba, Winnipeg, Man
| | - Roberta L Woodgate
- Department of Community Health Sciences (Sebring, Kelly, McPhail), Max Rady College of Medicine, and College of Nursing (Woodgate), Helen Glass Centre for Nursing, University of Manitoba, Winnipeg, Man
| |
Collapse
|
3
|
Fruchart M, El Idrissi F, Lamer A, Belarbi K, Lemdani M, Zitouni D, Guinhouya BC. Identification of early symptoms of endometriosis through the analysis of online social networks: A social media study. Digit Health 2023; 9:20552076231176114. [PMID: 37228486 PMCID: PMC10204053 DOI: 10.1177/20552076231176114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
Objective Endometriosis is a complex full-body inflammation disease with an average time to diagnosis of 7-10 years. Social networks give opportunity to patient to openly discuss about their condition, share experiences, and seek advice. Thus, data from social media may provide insightful data about patient's experience. This study aimed at applying a text-mining approach to online social networks in order to identify early signs associated with endometriosis. Methods An automated exploration technique of online forums was performed to extract posts. After a cleaning step of the built corpus, we retrieved all symptoms evoked by women, and connected them to the MedDRA dictionary. Then, temporal markers allowed targeting only the earliest symptoms. The latter were those evoked near a marker of precocity. A co-occurrence approach was further applied to better account for the context of evocations. Results Results were visualised using the graph-oriented database Neo4j. We collected 7148 discussions threads and 78,905 posts from 10 French forums. We extracted 41 groups of contextualised symptoms, including 20 groups of early symptoms associated with endometriosis. Among these groups of early symptoms, 13 were found to portray already known signs of endometriosis. The remaining 7 clusters of early symptoms were limb oedema, muscle pain, neuralgia, haematuria, vaginal itching, altered general condition (i.e. dizziness, fatigue, nausea) and hot flush. Conclusion We pointed out some additional symptoms of endometriosis qualified as early symptoms, which can serve as a screening tool for prevention and/or treatment purpose. The present findings offer an opportunity for further exploration of early biological processes triggering this disease.
Collapse
Affiliation(s)
- Mathilde Fruchart
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille,
France
- Univ. Lille, CHU Lille, ULR 2694 – METRICS, Lille, France
| | - Fatima El Idrissi
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille,
France
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
| | - Antoine Lamer
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille,
France
- Univ. Lille, CHU Lille, ULR 2694 – METRICS, Lille, France
| | - Karim Belarbi
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
- Univ. Lille, Inserm, CHU-Lille, Lille Neuroscience & Cognition, Lille,
France
| | - Mohamed Lemdani
- Univ. Lille, CHU Lille, ULR 2694 – METRICS, Lille, France
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
| | - Djamel Zitouni
- Univ. Lille, CHU Lille, ULR 2694 – METRICS, Lille, France
- Univ. Lille, UFR 3S, Faculté de Pharmacie, Lille, France
| | - Benjamin C Guinhouya
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille,
France
- Univ. Lille, CHU Lille, ULR 2694 – METRICS, Lille, France
| |
Collapse
|
4
|
Lunde CE, Spigel R, Gordon CM, Sieberg CB. Beyond the Binary: Sexual and Reproductive Health Considerations for Transgender and Gender Expansive Adolescents. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:670919. [PMID: 36304055 PMCID: PMC9580725 DOI: 10.3389/frph.2021.670919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/31/2021] [Indexed: 01/10/2023] Open
Abstract
Awareness and visibility of transgender individuals have grown exponentially. However, conceptualizing sexual and reproductive health (SRH) as “women's” or “men's” health services further marginalizes transgender and gender-expansive (TGE) youth. Multiple reviews and commentaries have been published on the topic of SRH care for adults under the umbrella term of sexual and gender minorities, all with a call to action for more inclusive care and the need for more clinical research involving TGE individuals, and notably, TGE youth. Results from adult TGE studies are often translated to describe adolescent models. However, models specific to adolescent TGE populations are needed to understand their unique SRH needs. This review will describe the current literature relating to SRH needs of TGE youth and adults, highlighting key areas with significant disparities in need of further research. This comprehensive summary will also provide recommendations for clinicians and researchers with the goal of improving SRH care and obtaining wider representation in both clinical settings and research directed toward TGE youth.
Collapse
Affiliation(s)
- Claire E. Lunde
- Biobehavioral Pediatric Pain Lab, Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, United States
- Pain & Affective Neuroscience Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
- Nuffield Department of Women's and Reproductive Health, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Rebecca Spigel
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Catherine M. Gordon
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Christine B. Sieberg
- Biobehavioral Pediatric Pain Lab, Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, United States
- Pain & Affective Neuroscience Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- *Correspondence: Christine B. Sieberg
| |
Collapse
|