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Kearns S, Hardie P, O’Shea D, Neff K. Instruments used to assess gender-affirming healthcare access: A scoping review. PLoS One 2024; 19:e0298821. [PMID: 38829881 PMCID: PMC11146745 DOI: 10.1371/journal.pone.0298821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/30/2024] [Indexed: 06/05/2024] Open
Abstract
PURPOSE The overall aim of this scoping review was to identify, explore and map the existing literature pertaining to healthcare access for transgender and non-binary individuals. DESIGN The scoping review followed Arksey and O'Malley's methodological framework, and the reporting adhered to the guidelines provided by the PRISMA Extension for Scoping Reviews. METHODS To gather relevant articles, a comprehensive search strategy was employed across four electronic databases, with the assistance of a university librarian. In addition, manual and internet searches were conducted for grey literature. From the initial search, a pool of 2,452 potentially relevant articles was retrieved, which was supplemented by an additional 23 articles from the supplemental search. After an independent review by two researchers, 93 articles were assessed, resulting in the inclusion of 41 articles in the review. RESULTS The literature highlights the identification of barriers and enablers, spanning across 32 individual data sets that affect healthcare accessibility for transgender and non-binary individuals. Leveque's five dimensions of healthcare access, namely approachability, acceptability, availability and accommodation, affordability, and appropriateness, were utilized to categorise these 42 factors. Some of the key themes that emerged in these dimensions include challenges in accessing information about services, concerns about acceptance from family and peers, past experiences of discrimination in healthcare settings, considerations related to cost and insurance, and the difficulty in finding appropriately trained competent providers. CONCLUSIONS The review focused on the most commonly researched aspects of healthcare access and identified gaps in research and opportunities for future studies. The findings provide recommendations for policy and practice, which could guide the development of interventions aimed at addressing the barriers faced by transgender individuals seeking gender-affirming care.
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Affiliation(s)
- Seán Kearns
- School of Medicine, University College Dublin, Dublin, Ireland
- St Columcille’s Hospital, Dublin, Ireland
| | - Philip Hardie
- Nursing Programme, Hibernia College, Dublin, Ireland
| | - Donal O’Shea
- School of Medicine, University College Dublin, Dublin, Ireland
- St Columcille’s Hospital, Dublin, Ireland
| | - Karl Neff
- School of Medicine, University College Dublin, Dublin, Ireland
- St Columcille’s Hospital, Dublin, Ireland
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Lozano-Verduzco I, Vega-Cauich J, Mendoza-Pérez JC, Craig SL. Perceived Social Support and Mental Health Indicators of a Mexican LGBT Sample During the COVID-19 Pandemic. Int J Ment Health Addict 2023:1-18. [PMID: 37363771 PMCID: PMC10153024 DOI: 10.1007/s11469-023-01064-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 06/28/2023] Open
Abstract
The COVID-19 pandemic created mental health challenges for LGBTQ + communities worldwide, however there is a paucity of research on Mexican populations. Existing data show that LGBTQ + people in Mexico experience acute forms of violence and discrimination that impact their mental health. This article explores the relationship between social support, discrimination, and mental health for LGBTQ + populations in Mexico (N = 1525) during the COVID-19 lockdown. Utilizing social media recruitment strategies, participants answered an online survey exploring five mental health indicators: depression, anxiety, stress, suicidal ideation, and suicide attempt during lockdown. Mediating, and multiple regression analyses revealed that neuroticism is the most important variable in predicting poor mental health, and that perceived social support plays a mediating role in the case of depression. Discomfort with one's own family holds positive correlations with mental health indicators, showing that the greater the discomfort, higher levels of depression, anxiety, stress, and suicidal ideation. Results also showed that discrimination, and drug use hold significant relationships to suicidal attempt. Practice recommendations for Mexican LGBTQ + communities are offered.
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Affiliation(s)
- Ignacio Lozano-Verduzco
- Academic Area 3, National Pedagogic University, Carretera al Ajusco No. 24 Col. Héroes de Padierna, Tlalpan, Mexico City, 14200 Mexico
| | - Julio Vega-Cauich
- School of Education, Autonomous University of Yucatan, Mérida, Yucatán Mexico
| | - Juan Carlos Mendoza-Pérez
- Department of Public Health, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Shelley L. Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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3
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Sweileh WM. Research Publications on the Mental Health of Transgender People: A Bibliometric Analysis Using Scopus Database (1992–2021). Transgend Health 2022. [DOI: 10.1089/trgh.2022.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Waleed M. Sweileh
- Department of Physiology, Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Fresán A, Domínguez-Martínez T, Castilla-Peón MF, Robles R, Hernández O, Vélez T, Muñoz C. Confirmatory Factor Analysis of the Transgender Knowledge, Attitudes, and Beliefs (T-KAB) Scale for the Mexican Population. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1959-1966. [PMID: 35414147 DOI: 10.1007/s10508-021-02259-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
Transphobia is a result of the widespread lack of knowledge among the general population, together with prejudice based on irrational fear and hatred, of those who do not fit the dominant, socially established gender categories. Little is known about transgender-related knowledge, attitudes, and beliefs among the Mexican population, due to the lack of reliable, valid Spanish-language instruments. This study presents a Spanish translation of the Transgender Knowledge, Attitudes, and Beliefs (T-KAB) Scale and examines its psychometric properties for the Mexican population. A cohort of 501 adult subjects, 337 (67.3%) women and 161 (32.1%) men, drawn from the general population, answered the T-KAB in an anonymous online survey. A confirmatory factor analysis (CFA) and internal consistency measure were used to determine whether its dimensions were reliable and valid for use in a Mexican Spanish language and cultural context. A CFA including the three original dimensions proposed and excluding one item from the T-KAB Scale showed appropriate goodness of fit indices (χ2(180) = 389.41; χ2/df = 2.16, RMSEA = 0.048, CI [0.042, 0.055]; CFI = 0.971; TLI = 0.966), with Cronbach's alpha values over 0.85. The psychometric properties exhibited by the Spanish version of the T-KAB support its use for the assessment of knowledge, attitudes, and beliefs regarding transgender people in the Mexican cultural context. This instrument offers researchers a brief, reliable, valid, and easy self-report measure to use in further studies in Spanish-speaking populations.
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Affiliation(s)
- Ana Fresán
- Laboratorio de Epidemiología Clínica. Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Tecelli Domínguez-Martínez
- Centro de Investigación en Salud Mental Global, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco # 101, Col. San Lorenzo Huipulco. Tlalpan, C.P. 14370, Mexico City, Mexico.
| | | | - Rebeca Robles
- Centro de Investigación en Salud Mental Global, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México Xochimilco # 101, Col. San Lorenzo Huipulco. Tlalpan, C.P. 14370, Mexico City, Mexico
| | - Omar Hernández
- Estudiante de Posgrado en Psicología con Residencia en Medicina Conductual, Facultad de Psicología, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Tania Vélez
- Estudiante de Posgrado en Psicología con Residencia en Medicina Conductual, Facultad de Psicología, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Carolina Muñoz
- Estudiante de Posgrado en Psicología con Residencia en Medicina Conductual, Facultad de Psicología, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Discrimination, Mental Health, and Suicidal Ideation among Sexual Minority Adults in Latin America: Considering the Roles of Social Support and Religiosity. TRAUMA CARE 2021. [DOI: 10.3390/traumacare1030013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Despite the high rates of discrimination and mental health issues experienced by lesbian, gay, bisexual, and transgender (LGBT) adults at an international level, very little research has focused on this population in Latin America. As a result, the purpose of this study was to explore relationships among discrimination experiences, mental health (i.e., anxiety and depressive symptoms), suicidal ideation, religiosity, and social support in LGBT adults in Latin America. A sample of 99 participants from the region completed an online survey assessing these constructs. Results suggested that 51.5% of the sample reported lifetime suicidal ideation. Experiences with harassment/rejection-type discrimination predicted suicidal ideation, while work/school-type discrimination predicted mental health problems (anxiety and depression). Depressive symptoms predicted suicidal ideation, while anxiety symptoms alone did not. Further, depressive symptoms mediated relationships between work/school discrimination and suicidal ideation, as well as between harassment/rejection discrimination and suicidal ideation. Moderated mediation analyses suggested that high, but not low or moderate levels of social support and religiosity buffered LGBT adults in Latin America against discrimination, specifically by weakening links among discrimination, depressive symptoms, and suicidal ideation. Clinical intervention research with LGBT adults in Latin America should focus on increasing social support networks for this population and on helping LGBT adults reconcile conflicts between religious identities and sexual or gender minority identities, as healthy religiosity may serve as a protective factor against mental health problems generally, and suicidal ideation specifically.
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Hoetger C, Rabinovitch AE, Henry RS, Aguayo Arelis A, Rabago Barajas BV, Perrin PB. Characterizing substance use in a sample of lesbian, gay, bisexual, and transgender adults in Mexico. J Addict Dis 2020; 39:96-104. [PMID: 33118855 DOI: 10.1080/10550887.2020.1826102] [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: 10/23/2022]
Abstract
Background: Research from high-income countries on substance use among lesbian, gay, bisexual, and transgender (LGBT) adults is growing; however, limited empirical research exists on LGBT adults in Mexico. Filling this gap is critical as LGBT adults experience unique stressors that may place them at risk for substance use-related health outcomes. Objectives: This study sought to characterize substance use prevalence and magnitude among a convenience sample of Mexican LGBT adults. Methods: A cross-sectional online survey was conducted using a sample of Spanish-speaking, self-identified LGBT adults (n = 92) residing in Mexico who were recruited through online forums of LGBT-focused organizations. Descriptive and frequency analyses were conducted. Results: Participants predominantly identified as cisgender men (n = 44) and gay/lesbian (n = 68). Participants reported high rates of past 90-day legal substance use (>93% for alcohol and >57% for tobacco). The most commonly reported illicit drug used in the past 90 days was marijuana (>29%). Conclusions: While the sample reported lower prevalence and magnitude of substance use relative to other Mexican or United States LGBT samples, the findings highlight that legal and illicit substance use presents health risks for Mexican LGBT individuals. LGBT identity-affirming substance use treatment may reduce substance use-related health burden among this population.
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Affiliation(s)
- Cosima Hoetger
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Annie E Rabinovitch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Richard S Henry
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Adriana Aguayo Arelis
- Department of Neurosciences, CUCS, University of Guadalajara, Guadalajara, JAL, Mexico.,Department of Psychology, Enrique Diaz de Leon University, Guadalajara, JAL, Mexico
| | | | - Paul B Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Domínguez-Martínez T, Rebeca RG, Fresán A, Cruz J, Vega H, Reed GM. Risk factors for violence in transgender people: a retrospective study of experiences during adolescence. PSYCHOLOGY & SEXUALITY 2020. [DOI: 10.1080/19419899.2020.1802772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Tecelli Domínguez-Martínez
- Global Mental Health Research Center, Directorate of Epidemiological and Psychosocial Research, ‘Ramón de la Fuente Muñiz’ National Institute of Psychiatry, Ministry of Health, Mexico
| | - Robles García Rebeca
- Global Mental Health Research Center, Directorate of Epidemiological and Psychosocial Research, ‘Ramón de la Fuente Muñiz’ National Institute of Psychiatry, Ministry of Health, Mexico
| | - Ana Fresán
- Sub Directorate of Clinical Research, “Ramón De La Fuente Muñiz” National Institute of Psychiatry, Ministry of Health, Mexico City, Mexico
| | - Jeremy Cruz
- Comprehensive Transgender Care Center, Mexico City, Mexico
| | - Hamid Vega
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Geoffrey M. Reed
- Global Mental Health Program, Columbia University, College of Physicians and Surgeons and Research Foundation for Mental Hygiene, New York, NY, USA
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