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Le K, Trivedi A, Needleman A, Hunter K, Gaughan J, Gutmann J, Fischer R. The availability and type of lesbian, gay, bisexual, transgender, and queer content on sperm, oocyte, and embryo provider websites. J Assist Reprod Genet 2023:10.1007/s10815-023-02867-z. [PMID: 37410222 PMCID: PMC10371958 DOI: 10.1007/s10815-023-02867-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/19/2023] [Indexed: 07/07/2023] Open
Abstract
PURPOSE To evaluate and quantify the character and amount of lesbian, gay, bisexual, transgender, and queer (LGBTQ +) content on sperm, oocyte, and embryo provider websites in the USA. METHODS Websites with LGBTQ + information were categorized into "minimal," "moderate," and "significant" content. The presence and type (category) of LGBTQ + content were assessed in its relationship to geographic regions, in vitro fertilization (IVF) cycles/year, and website types. Interobserver reliability was assessed for the categorization system created. RESULTS Out of 373 unique websites, 191 (51.2%) had LGBTQ + content of any kind. Regarding the amount of content, websites were categorized as "none" (48.8%), "minimal" (8.0%), "moderate" (28.4%), and "significant" (14.8%). "Private fertility clinic" websites were more likely to have LGBTQ + content and a significantly increased amount of content compared to other website types ("academic hospital" and "sole sperm, oocyte, and embryo provider" websites) (p < 0.0001). Fertility clinics with more IVF cycles/year were more likely to have increased amount of LGBTQ + content compared to those with fewer IVF cycles/year (OR = 4.280; 95% CI, 1.952-9.388). Northeast, West, South, and Midwest regions showed no statistically significant difference in presence and type of content (p = 0.06 and p = 0.13, respectively). CONCLUSION Approximately half of websites had LGBTQ + content. Private fertility clinics and fertility clinics with increased IVF cycles/year show a positive relationship to the presence and type of LGBTQ + content, while LGBTQ + website content was similar across four geographic regions.
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Affiliation(s)
- Kyle Le
- Obstetrics & Gynecology, Cooper University Healthcare, Camden, NJ, USA.
- Cooper University Healthcare, 1301 N Front St., Unit D, Philadelphia, PA, 19122, USA.
| | - Aditi Trivedi
- Obstetrics & Gynecology, Virtua Health, Vorhees Township, NJ, USA
| | | | - Krystal Hunter
- Research & Statistics, Cooper University Healthcare, Camden, NJ, USA
| | - John Gaughan
- Research & Statistics, Cooper University Healthcare, Camden, NJ, USA
| | - Jacqueline Gutmann
- Reproductive Endocrinology and Infertility, Reproductive Medical Associates, Philadelphia, PA, USA
| | - Richard Fischer
- Obstetrics & Gynecology, Cooper University Healthcare, Camden, NJ, USA
- Cooper University Healthcare, 1301 N Front St., Unit D, Philadelphia, PA, 19122, USA
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Pomputius A, Ansell M, Morgan-Daniel J. Mapping Pregnancy Resources Available Online to LGBTQIA+ Health Consumers. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2022. [DOI: 10.1080/15398285.2022.2136916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Ariel Pomputius
- Health Science Center Libraries, University of Florida, Gainesville, Florida, USA
| | - Margaret Ansell
- Health Science Center Libraries, University of Florida, Gainesville, Florida, USA
| | - Jane Morgan-Daniel
- Health Science Center Libraries, University of Florida, Gainesville, Florida, USA
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Gregory KB, Mielke JG, Neiterman E. Building Families Through Healthcare: Experiences of Lesbians Using Reproductive Services. J Patient Exp 2022; 9:23743735221089459. [PMID: 35372679 PMCID: PMC8966110 DOI: 10.1177/23743735221089459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The use of assisted human reproduction (AHR) represents a meaningful and important life event for lesbians wishing to create biologically related families. Despite increasing numbers of lesbians utilizing AHR services, barriers to access persist. This qualitative study investigated the experiences of lesbians and their interactions with reproductive services in Ontario, Canada, where limited public funding is available for all AHR patients and where the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community makes up to 30% of clientele. Eleven semi-structured interviews were conducted, and findings revealed a wide range of experiences. Lesbian patients expressed a desire for more support from their care providers in navigating a complex and costly medical journey through a system largely designed for the needs of heterosexual patients. Additionally, private fertility clinics, as the environment for accessing publicly funded services, were felt to contribute pressure to pay out-of-pocket for add-on medical procedures. To improve the quality of care, participants recommended providing more high-level information on the medical journey and taking an individual approach with lesbian patients, in particular, assuming a patient has sufficient fertility until proven otherwise.
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Affiliation(s)
- Kelly B Gregory
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - John G Mielke
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Elena Neiterman
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Documentary quality versus veracity of information of the websites on syphilis and gonorrhea. Scientometrics 2021. [DOI: 10.1007/s11192-021-04123-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AbstractObjective: Analyze the possible relation between the documentary quality (DQ) versus the veracity of information (VI) on the syphilis and gonorrhea web pages. Methods: Descriptive cross-sectional study of websites containing information about syphilis and gonorrhea, by accessing this population through a Google. The quality was studied by using 8 variables belonging to DQ and 7 variables of the VI. Results: A total of 440 active websites mainly belonging to mass media and private entities was assessed. The fulfillment of DQ gave the following results: Mean 3.46 ± 0.07, median 4 and range from 0 to 7. The VI result was: median 4.07 ± 0.09, median 4 and range from 0 to 7. According to the search athwart syphilis or gonorrhea, the contrast of the median of the two indicators was: 3.55 vs 3.37 p = 0.181 and 4.14 vs 4.00 p = 0.442. No correlation was verified amid the data of DQ and VI (R = 0.04); p = 0.368. Similarly, no significance was observed when segregating data by disease, in the case of syphilis R = -0.03; p = 0.625 and on gonorrhea R = 0.12; p = 0.064. Conclusions: The DQ and VI bestowed low outcomes, which implies poor quality of syphilis and gonorrhea websites. According to infection (syphilis or gonorrhea), there were no meaningful differences amid the median values of the two indicators. Being acquainted with the authorship and affiliation of a website and the fact that it is tied to a prestigious web may be a factor to be deemed when predicting the VI of a website. The correlation amid the two indicators did not demonstrate an association, thus, knowing the DQ does not imply having the security of an adequate VI.
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Fertility health information seeking among sexual minority women. Fertil Steril 2021; 117:399-407. [PMID: 34674826 DOI: 10.1016/j.fertnstert.2021.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/10/2021] [Accepted: 09/16/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To qualitatively explore and describe fertility information-seeking experiences of sexual minority women (SMW) couples using assisted reproduction. DESIGN Qualitative thematic analysis of 30 semistructured, in-depth individual and dyadic interviews with SMW couples. SETTING Video conferencing. PATIENT(S) Twenty self-identified lesbian, bisexual, and queer women comprising 10 same-sex cisfemale couples (10 gestational and 10 nongestational partners) using assisted reproduction technology in the United States. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) We describe how SMW came to learn about ways to achieve pregnancy through information seeking, acquisition, appraisal, and use. RESULT(S) Analysis revealed three primary themes. First, uncertainty and information scarcity: SMW have basic knowledge about how to conceive but uncertainty persists due to information scarcity regarding how same-sex couples navigate assisted reproduction. Second, women attempt to collect fragmented information from disparate sources. The participants discussed a mixture of formal and informal, online, textual (books), and in-person seeking, finding, and synthesizing information that ranged from reliable to unreliable and from accurate to inaccurate. Finally, persistent heteronormative communication focused on the needs and conditions of male-female couples who experienced subfertility or infertility, rather than barriers related to social constraints and the absence of gametes that SMW sought to overcome. CONCLUSION(S) These findings support and extend existing evidence that has focused primarily on online fertility information seeking. Our findings suggest that shifts in fundamental assumptions about who seeks assisted reproductive support and why, together with improvements in fertility-related health communication, may result in more inclusive care for this population.
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Jia RM, Du JT, Zhao YC. Characteristics of the health information seeking behavior of LGBTQ+ individuals: a systematic review on information types, information sources and influencing factors. JOURNAL OF DOCUMENTATION 2021. [DOI: 10.1108/jd-03-2021-0069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose
Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ+) individuals' health information seeking is an important topic across multiple disciplines and areas. The aim of this systematic review is to create a holistic view of sexual and gender minority individuals' health information seeking reported in multidisciplinary studies, with regard to the types of health information LGBTQ+ individuals sought and information sources they used, as well as the factors influencing their health information seeking behavior.
Design/methodology/approach
The review is based on the literature search in 10 major academic databases. A set of inclusion and exclusion criteria was applied to identify studies that provide evidence on LGBTQ+ individuals' health information seeking behavior. The studies were first screened by title and abstract to determine whether they met the inclusion criteria. The full texts of each relevant study were obtained to confirm whether the exclusion criteria were met. The reference lists of the included studies were manually scanned. The relevant information was then extracted from selected articles and analyzed using thematic content analysis.
Findings
A seed set of 3,122 articles published between 1997 and 2020 was evaluated, and 46 total articles were considered for further analysis. The review results show that two major categories of health information sought by LGBTQ+ individuals were sexual and nonsexual, which were further classified into 17 specific types. In terms of health information sources, researchers have reported that online resources, interpersonal sources and traditional media were frequently used. Moreover, 25 factors affecting LGBTQ+ individuals' health information seeking were identified from the literature.
Originality/value
Through evidence-based understanding, this review preliminarily bridged the knowledge gap in understanding the status quo of studies on LGBTQ+ individuals' health information seeking and proposed the potential research directions that information science researchers could contribute to this important area.
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Lai TC, Davies C, Robinson K, Feldman D, Elder CV, Cooper C, Pang KC, McDougall R. Effective fertility counselling for transgender adolescents: a qualitative study of clinician attitudes and practices. BMJ Open 2021; 11:e043237. [PMID: 34011585 PMCID: PMC8137211 DOI: 10.1136/bmjopen-2020-043237] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Fertility counselling for trans and gender diverse (TGD) adolescents has many complexities, but there is currently little guidance for clinicians working in this area. This study aimed to identify effective strategies for-and qualities of-fertility counselling for TGD adolescents based on clinicians' experiences. DESIGN We conducted qualitative semi-structured individual interviews in 2019 which explored clinician experiences and fertility counselling practices, perspectives of the young person's experience and barriers and facilitators to fertility preservation access. Data were analysed using thematic analysis. SETTING This qualitative study examined experiences of clinicians at the Royal Children's Hospital-a tertiary, hospital-based, referral centre and the main provider of paediatric TGD healthcare in Victoria, Australia. PARTICIPANTS We interviewed 12 clinicians from a range of disciplines (paediatrics, psychology, psychiatry and gynaecology), all of whom were involved with fertility counselling for TGD adolescents. RESULTS Based on clinician experiences, we identified five elements that can contribute to an effective approach for fertility counselling for TGD adolescents: a multidisciplinary team approach; shared decision-making between adolescents, their parents and clinicians; specific efforts to facilitate patient engagement; flexible personalised care; and reflective practice. CONCLUSIONS Identification of these different elements can inform and hopefully improve future fertility counselling practices for TGD adolescents, but further studies examining TGD adolescents' experiences of fertility counselling are also required.
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Affiliation(s)
- Timothy Chwan Lai
- Austin Health, Heidelberg, Victoria, Australia
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Cristyn Davies
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kerry Robinson
- School of Social Sciences, Western Sydney University, Kingswood, New South Wales, Australia
| | - Debi Feldman
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Charlotte Victoria Elder
- Austin Health, Heidelberg, Victoria, Australia
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Charlie Cooper
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Ken C Pang
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Rosalind McDougall
- The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
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Cultural competence in fertility care for lesbian, gay, bisexual, transgender, and queer people: a systematic review of patient and provider perspectives. Fertil Steril 2021; 115:1294-1301. [PMID: 33610322 DOI: 10.1016/j.fertnstert.2020.12.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To characterize the patient and provider perspectives on cultural competence in lesbian, gay, bisexual, transgender, and queer (LGBTQ+) fertility care. DESIGN Systematic review. SETTING Not applicable. PATIENT(S) LGBTQ+ patients and their partners treated for fertility-related care; fertility providers who treat LGBTQ+ patients. INTERVENTION(S) We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines of six databases: Medline-OVID, EMBASE, CINAHL, Cochrane Library, ClinicalTrials.Gov, and PsycInfo. Citations of full-text articles were hand-searched using the Scopus database. Eligible studies were assessed using the Risk of Bias Instrument for Cross-Sectional Surveys of Attitudes and Practices, as well as the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. All screening, extraction, and appraisal were completed in duplicate with two independent reviewers. MAIN OUTCOME MEASURE(S) Patient-reported or provider-reported views on LGBTQ+ cultural competence in fertility care, including barriers and facilitators to inclusive care. RESULT(S) Of the 1,747 original database citations, we included 25 studies that met the inclusion criteria. Of the 21 studies that evaluated patient perspectives, 13 studies targeted same-sex cisgender couples while the remainder targeted transgender and gender-nonconforming participants (n = 6) or any individual who identified as a sexual or gender minority (n = 2). Key barriers for LGBTQ+ participants included gender dysphoria, heteronormativity, stigmatization, and psychological distress. The lack of tailored information for LGBTQ+ populations was repeatedly highlighted as a concern. Promising solutions included tailored information, psychosocial interventions, gender-neutral language, and inclusive intake processes. CONCLUSION(S) LGBTQ+ individuals face unique barriers in fertility care, as described by both patients and providers. This review describes a number of implementable solutions for equitable care, which should be given priority for both research and hospital interventions.
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Fix L, Durden M, Obedin-Maliver J, Moseson H, Hastings J, Stoeffler A, Baum SE. Stakeholder Perceptions and Experiences Regarding Access to Contraception and Abortion for Transgender, Non-Binary, and Gender-Expansive Individuals Assigned Female at Birth in the U.S. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2683-2702. [PMID: 32385584 DOI: 10.1007/s10508-020-01707-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 04/03/2020] [Accepted: 04/05/2020] [Indexed: 05/28/2023]
Abstract
Sexual and reproductive health (SRH) care often excludes the needs and experiences of transgender, non-binary, and gender-expansive (TGE) individuals. This study aimed to collect diverse stakeholder perspectives on barriers and facilitators to contraception and abortion for TGE individuals assigned female at birth (AFAB), assess knowledge and attitudes about unintended pregnancy prevention in these populations, and identify recommendations for improving SRH services for people of all genders. Between October 2017 and January 2018, we conducted 27 in-depth interviews with SRH stakeholders, including five TGE individuals who had obtained contraception or abortion care, and 22 clinicians, researchers, and advocates experienced in transgender healthcare. We iteratively developed a codebook and conducted thematic analysis to capture the spectrum of perspectives across interviews. Stakeholders reported a range of barriers to contraception and abortion access for TGE people AFAB, including inability to afford services, lack of gender-affirming clinicians, difficulty obtaining insurance coverage, and misconceptions about fertility and unplanned pregnancy risk. Deterrents to care-seeking included gendered healthcare environments, misgendering, and discrimination. Stakeholders described provider knowledge gaps and a perceived lack of medical education relevant to the SRH needs of TGE people. Recommendations included using gender-inclusive language and gender-affirming patient education materials and improving provider training on gender-affirming SRH care. Stakeholders identified substantial barriers to high-quality contraception and abortion care for TGE AFAB people in the U.S. They recommended specific interventions at the provider and institutional levels to improve experiences with care for TGE people and ensure broader access to gender-affirming SRH services.
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Affiliation(s)
- Laura Fix
- Ibis Reproductive Health, 2067 Massachusetts Avenue, Cambridge, MA, 02140, USA.
| | | | - Juno Obedin-Maliver
- Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA
| | | | - Jen Hastings
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Ari Stoeffler
- Planned Parenthood League of Massachusetts, Boston, MA, USA
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