Missing Ethical Discussions in Gender Care for Transgender and Non‐binary People: Secondary Sex Characteristics

Experiences of body image in the gender non-binary community: A qualitative analysis

Body image concerns are prevalent within transgender communities - many transgender people engage in disordered eating to suppress or accentuate secondary sex characteristics and reduce gender dysphoria. However, this research has mostly been conducted with binary transgender people. Here, we examine how non-binary people experience and relate to their bodies. Semi-structured one-on-one interviews were conducted with 13 gender non-binary individuals living in Australia. Photo elicitation techniques were utilised, and the transcribed interview data were analysed using reflexive thematic analysis. Six themes were identified: Expansive Understandings of Body Image, Body Image can be Linked to Gender Dysphoria, Cultivating a Preferred Body can Lead to Gender Euphoria, Appreciating Diversity in Non-Binary Body Ideals, The Androgynous Body Ideal is not Universally Accepted, and Experiencing the Body as Functional rather than Aesthetic. The present findings highlight the diversity of experiences of body image for non-binary people. The non-binary concept of body image was found to be expansive, stressing various physical attributes involved in social gender recognition and physiological sources of gender dysphoria. Some participants valued gender-affirming medical intervention, others were accepting of their bodies as they are, attributing their body confidence to the process of affirming their non-binary gender.

Hospitals as total institutions

The image of the hospital is presented to the public as a place of healing. Though the oft-criticized total institutions of the past have been notably dismantled, the totalizing practices therein are now operationalized in the health care system. Through the lens of Erving Goffman, this article offers ways in which health care institutions operationalize totalizing practices, contributing to the mortification of patients and nurses alike in service to the bureaucratic machine. This article examines the ways in which totalizing practices may disrupt the agency of both patients and nurses alike.

Ethics, health disparities, and discourses in oncology nursing's research: If we know the problems, why are we asking the wrong questions?

AIMS AND OBJECTIVES

To disrupt conflations between 'health disparities research' and critical engagement with racism, whiteness, other oppressions and our profession's ongoing roles in white supremacy.

BACKGROUND

In Oncology Nursing Society's (ONS) 2019-2023 research agenda, health disparities are highlighted as a top priority for nursing knowledge generation and intervention. The document concludes needs for increased 'minority and vulnerable population' participation in cancer clinical trials, reduced financial toxicity, behavioural interventions for risk reduction, incorporation of social determinants of health and technology to promote rural access to high-quality care.

DESIGN

In this critical resistive, theoretical and ethical analysis on current discourses on health disparities research in oncology nursing, we ask: (a) What forces (stated and unstated) shape current oncology nursing discourses about health disparities?; (b) What assumptions about health and power are embedded in these discourses?; (c) Are we, as nurses and scientists, asking the right questions?

METHODS

Line-by-line analysis of the ONS Research Agenda for 2019-2023 'Health Disparities' section.

RESULTS

The health disparities described in this report are not new to the literature, nor are many of the proposed solutions. As noted, disparities such as disproportionate cancer-related morbidity and mortality across identities (gender, race and sexual orientation) have not improved and some have worsened over several decades.

CONCLUSIONS

That discourses on prioritising cancer-related health disparities persist while disparity-related outcomes remain largely unchanged presents challenges-both moral and pragmatic. We must ask, 'Rather than the concept of "health disparities," as presently understood in cancer nursing, what is the better approach to examine health equity and ethical nursing research practices?'

RELEVANCE TO CLINICAL PRACTICE

This paper offers several starting places for nurses, especially with the following questions: 'Who does this harm?' Answer then revise: 'Who might this harm now?' Answer then revise: 'Are these harms worth the activity?' And repeat this process.