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Berrian K, Exsted MD, Lampe NM, Pease SL, Akré ERL. Barriers to quality healthcare among transgender and gender nonconforming adults. Health Serv Res 2024. [PMID: 38988141 DOI: 10.1111/1475-6773.14362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVE To determine the barriers transgender and gender nonconforming (TGNC) adults face when accessing or receiving healthcare in the United States. DATA SOURCES AND STUDY SETTING Primary data were collected between September 2022 and March 2023 from a purposive sample of TGNC adults (N = 116 participants) using an online survey with a series of open-ended and closed-ended questions. STUDY DESIGN Thematic analysis was employed to extract and analyze participants' responses to an open-ended question about challenges they experienced when accessing or receiving healthcare. Two members of the research team conducted qualitative data analyses using Dedoose. The quality of each analysis was subsequently reviewed by a third research team member. DATA COLLECTION/EXTRACTION METHODS Data were collected from responses to one open-ended question that asked about participants' healthcare barriers as a TGNC individual. PRINCIPAL FINDINGS Five main themes surrounding healthcare barriers emerged from the content analysis: (1) acceptability, (2) accommodation, (3) affordability, (4) availability, and (5) accessibility. First, participants who noted acceptability issues reported explicit discriminatory treatment from providers, providers not using their chosen names and pronouns (e.g., misgendering), and provider refusal to provide gender-affirming care. Second, participants who experienced accommodation challenges identified provider medical training gaps on TGNC patient needs and administrative barriers to care. Third, participants explained affordability issues due to a lack of adequate health insurance coverage. Fourth, participants described availability challenges with accessing hormone therapy prescriptions. Finally, participants noted accessibility issues with obtaining TGNC-specific care at LGBTQ+-affirming clinics. CONCLUSIONS There is a growing interest in the needs of TGNC adults within healthcare settings. This requires that health policies are enacted to ensure that TGNC adults have access to healthcare that is accommodating and accepting/affirming. Study findings may provide insight into the potential impact of current legislation on transgender access and availability.
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Affiliation(s)
- Kedryn Berrian
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Marci D Exsted
- Center for Applied Research and Educational Improvement, College of Education and Human Development, University of Minnesota, St Paul, Minnesota, USA
| | - Nik M Lampe
- Department of Mental Health Law & Policy, University of South Florida, Tampa, Florida, USA
| | - Sayer L Pease
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Ellesse-Roselee L Akré
- Department of Health Policy and Management, Bloomberg School of Public Health Johns Hopkins University, Baltimore, Maryland, USA
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Maoto M, Davis B. Breaking barriers: How transwomen meet their healthcare needs. Afr J Prim Health Care Fam Med 2024; 16:e1-e6. [PMID: 38949443 PMCID: PMC11220124 DOI: 10.4102/phcfm.v16i1.4598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 05/23/2024] [Accepted: 05/23/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Transgender women - individuals assigned male at birth but who identify as female - are disproportionately affected by, among others, human immunodeficiency virus (HIV), other sexually transmitted diseases (STIs) and mental health issues. Studies show that transgender women often encounter discrimination and stigma when seeking healthcare from health facilities. AIM This study assessed the healthcare needs of transgender women, their experiences of the mainstream healthcare system and alternative strategies for navigating the healthcare system. SETTING The study was carried out in the City of Ekurhuleni Metropolitan Council in South Africa's Gauteng province. METHODS A case study design was followed. Participants were purposively selected and included 10 transgender women aged 26-50. Individual semi-structured interviews were conducted over 2 months. RESULTS Participants expressed a need for hormone replacement therapy, HIV treatment and prevention and treatment for STIs. Experiences of participants within the healthcare system were predominantly negative, with instances of discrimination, stigma and privacy violations being commonplace. Alternative strategies to meet their healthcare needs included the use of self-medication, consulting traditional healers and utilising non-governmental organisations. CONCLUSION There is an urgent need for equitable and inclusive health management of transgender women in South Africa.Contribution: This study provided a first look in a South African context into how and to what extent transwomen employ alternative healthcare strategies such as self-medication and utilising non-governmental organisations when faced with mainstream healthcare access barriers. The use of traditional doctors was identified as a novel, alternative strategy used by transwomen to access healthcare and treatment.
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Affiliation(s)
- Millicent Maoto
- Africa Centre for HIV/Aids Management, Faculty of Economics and Management Sciences, Stellenbosch University, Stellenbosch.
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3
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Bosse JD, Jackman KB, Connolly S, Von Visger TT. Response to 'Transgender people in nursing discourse: An integrative review' by Padhila and colleagues (2022). J Adv Nurs 2024. [PMID: 38623027 DOI: 10.1111/jan.16179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/17/2024]
Affiliation(s)
- Jordon D Bosse
- College of Nursing, University of Rhode Island, South Kingstown, Rhode Island, USA
| | - Kasey B Jackman
- Columbia University School of Nursing, Columbia University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
| | - Somatra Connolly
- College of Nursing, University of Rhode Island, South Kingstown, Rhode Island, USA
- University Counseling Services, Boston College, Chestnut Hill, Massachusetts, USA
| | - Tania T Von Visger
- School of Nursing, State University of New York at Buffalo, Buffalo, New York, USA
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4
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Trinh MH, Quint M, Coon D, Bhasin S, Tocci B, Reisner SL. Transgender Patients Report Lower Satisfaction with Care Received than Cisgender Patients Receiving Care in an Academic Medical Care System. LGBT Health 2024; 11:202-209. [PMID: 38100315 DOI: 10.1089/lgbt.2023.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Purpose: Transgender and gender diverse (TGD) patients experience challenges in health care settings, including stigma, lack of culturally competent providers, and suboptimal gender-affirming care. However, differences in patient satisfaction between TGD patients compared with cisgender patients have been inadequately studied. This study aimed to assess such differences in patient satisfaction with care received in a large academic medical care system in Boston, Massachusetts. Methods: Routine patient satisfaction surveys were fielded from January to December 2021 and were summarized. Logistic regression models compared low net promoter scores (NPS; ≤6) between gender identity groups (cisgender women, transmasculine and nonbinary/genderqueer people assigned female at birth [AFAB], transfeminine and nonbinary/genderqueer people assigned male at birth) relative to cisgender men, adjusting for age, race, ethnicity, education, inpatient/outpatient service delivery, and distance from medical center. Results: Of 94,810 patients, 246 (0.3%) were TGD and 94,549 (99.7%) were cisgender. The mean age was 58.3 years (standard deviation = 16.6). Of the total sample, 17.0% of patients were people of color, 6.6% were Hispanic/Latinx, 48.6% were college graduates, and 2.6% had received inpatient care. In general, patient satisfaction with health care received was lower for TGD patients than for cisgender patients (7.3% vs. 4.5% reporting low NPS; adjusted odds ratio [aOR] = 1.14; 95% confidence interval [CI] = 0.70-1.85). Transmasculine and nonbinary/genderqueer patients AFAB had elevated odds of low NPS compared with cisgender men (8.8% vs. 3.6%; aOR = 1.71; 95% CI = 1.02-2.89). Conclusion: Future research is warranted to better understand factors driving lower ratings among TGD patients. Health care quality improvement efforts are needed to address gender identity inequities in care.
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Affiliation(s)
- Mai-Han Trinh
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Meg Quint
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Devin Coon
- Center for Transgender Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Shalender Bhasin
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Center for Transgender Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Benjamin Tocci
- Office of Patient Experience, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sari L Reisner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Center for Transgender Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, and Brigham and Women's Hospital, Boston, Massachusetts, USA
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5
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Wang L, Harris R, Simoni JM, Yue Q, Fu J, Zheng H, Ning Z, Xavier Hall CD, Burns PA, Wong FY. Health Service Utilization and Its Associations with Depression and Sexual Risk Behaviors Among Transgender Women in Shanghai, China. Transgend Health 2023; 8:516-525. [PMID: 38130986 PMCID: PMC10732171 DOI: 10.1089/trgh.2021.0009] [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: 11/12/2022] Open
Abstract
Purpose Given the limited research on health care utilization among transgender women in China, we described the use of primary health care and gender-affirming health care, and the associations between utilization of gender-affirming health care and depression and sexual risk behaviors. Methods We conducted a cross-sectional survey in 2017 among a purposive sample of transgender women in Shanghai, China (N=199). We examined correlates of health care utilization and its association with depression and sexual risk behaviors with Chi-square (χ2), Fisher's exact tests, and analysis of variance. Results The majority of the sample (78.5%) only had physician appointments when having an illness, while about one-fifth of the sample had physician appointments for yearly checkups. Nineteen out of 199 participants (9.5%) received gender-affirming surgery, among which only five used hormone therapy prescribed by a doctor (26.3%). Receiving some form of gender-affirming surgery was associated with higher depression scores [Welch's F(2, 12.22)=4.16, p=0.04], engagement in sex work (p=0.001), having 7 or more male sexual partners in the last 30 days (p=0.003), lifetime unprotected sex with a man (p=0.050), and unprotected sex with a main partner (p=0.043). Compared with transgender women who received both breast augmentation and vulvo-vaginoplasty (mean=5.86), those who received breast augmentation only (mean=12.33) scored higher on depression (p=0.04). Conclusions Access to gender-affirming health care is low among transgender women in this study. The utilization of gender-affirming surgery is associated with depression and sexual risk behaviors. Findings suggest China should establish national guidelines on transgender-related health care and set up more clinics to provide consultation and services for the transgender population in China.
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Affiliation(s)
- Liying Wang
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Rachel Harris
- Center for Population Sciences and Health Equity, Florida State University, Tallahassee, Florida, USA
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Jane M. Simoni
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Qing Yue
- Department of HIV/STD Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jie Fu
- Department of HIV/STD Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Huang Zheng
- Shanghai Piaoxue Multicultural Media Ltd., Shanghai, China
| | - Zhen Ning
- Department of HIV/STD Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH), Northwestern University, Evanston, Illinois, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Paul A. Burns
- Department of Population Health Science, John D. Bower School of Population Health, University Mississippi Medical Center, Jackson, Mississippi, USA
| | - Frank Y. Wong
- Center for Population Sciences and Health Equity, Florida State University, Tallahassee, Florida, USA
- Department of Population Health Science, John D. Bower School of Population Health, University Mississippi Medical Center, Jackson, Mississippi, USA
- Department of Psychology, University of Hawaiʽi at Mānoa, Honolulu, Hawaiʽi, USA
- School of Public Health, Fudan University, Shanghai, China
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6
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Roman Laporte RL, De Santis JP. Concept Analysis: LGBT+ Inclusive Health Care. ANS Adv Nurs Sci 2023; 46:410-423. [PMID: 36728300 DOI: 10.1097/ans.0000000000000467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Clients who identify as lesbian, gay, bisexual, transgender, queer/questioning (LGBT+) may experience barriers in health care access and services. LGBT+ clients want a welcoming, inclusive, and affirming encounter with nurses and other health care providers. This concept analysis used a modified Walker and Avant method to clarify the concept of LGBT+ inclusive health care. Antecedents, attributes, and consequences of LGBT+ inclusive health care were identified from the literature. The results of this concept analysis of LGBT+ inclusive health care can inform future research, policy, education, and practice to address the health care needs of this population.
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7
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von der Warth R, Metzner G, Körner M, Farin-Glattacker E. Exploring communication preferences of trans and gender diverse individuals-A qualitative study. PLoS One 2023; 18:e0284959. [PMID: 37611052 PMCID: PMC10446207 DOI: 10.1371/journal.pone.0284959] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/12/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Trans and gender-diverse individuals experience adverse health outcomes that might be due, in addition to other factors, to stigma and discrimination in the health care sector. At the same time, the concept of person-centred care acknowledges the role of patient-physician communication in health care outcomes. This study aims to explore patient-physician communication preferences in trans and gender-diverse individuals. METHOD A qualitative interview study was conducted, including N = 10 participants between February and March 2022. Participants were interviewed using a semi-structured interview guideline, based on previous knowledge in person-centred care and sample specific communication. Participants were asked about their experiences and wishes in patient-physician centeredness. Analyses were conducting using a qualitative content analysis strategy. RESULTS Mean age was 29.3 years; n = 6 participants identified themselves within the binary gender concept, while n = 4 identified themselves with a non-binary gender. Communication preferences for patient-physician communication were categorised into four themes: general communication aspects (e.g. active listening); the role of gender during appointments (e.g. appropriate/inappropriate addressing); gender-neutral language (e.g. experiences use of gender neutral language by physicians); own communication style (e.g. early outing and justification). Furthermore, possible contextual factors of patient-physician communication where found (e.g. trusting relationship). CONCLUSION Adding knowledge to communication preferences of trans and gender-diverse individuals, this study was able to identify preferences that are specific to the sample as well as preferences that differ from the cis-gendered population. However, it remains unclear how the patient-physician communication preferences affects health care utilization and outcomes. TRIAL REGISTRATION German Clinical Trial Register (DRKS00026249).
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Affiliation(s)
- Rieka von der Warth
- Section of Health Care Research and Rehabilitation Research, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg; Germany
| | - Gloria Metzner
- Section of Health Care Research and Rehabilitation Research, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg; Germany
| | - Mirjam Körner
- Institute of Medical Psychology and Medical Sociology, University of Freiburg, Freiburg, Germany
| | - Erik Farin-Glattacker
- Section of Health Care Research and Rehabilitation Research, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg; Germany
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8
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Lee JL, Huffman M, Rattray NA, Carnahan JL, Fortenberry JD, Fogel JM, Weiner M, Matthias MS. "I Don't Want to Spend the Rest of my Life Only Going to a Gender Wellness Clinic": Healthcare Experiences of Patients of a Comprehensive Transgender Clinic. J Gen Intern Med 2022; 37:3396-3403. [PMID: 35112278 PMCID: PMC8809217 DOI: 10.1007/s11606-022-07408-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/07/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Transgender individuals are less likely to have had a primary care visit in the last year than cisgender individuals. While the importance of multidisciplinary clinics for transgender care has been established, little is known about the healthcare experiences of transgender patients with these clinics. OBJECTIVE To describe how patients experience transgender clinics and how these experiences compare to those experiences in other settings. PARTICIPANTS Twenty-one adult patients of a gender health program. DESIGN AND APPROACH Semi-structured interviews of transgender patients. The interviews focused on two domains: healthcare experiences and relationships with healthcare providers. KEY RESULTS Overall, transgender patients expressed a need for healthcare services, particularly for primary care, that are partially met by the comprehensive care clinic model. Limitations in access included the lack of willing providers, where the patients live, and long wait times for appointments. Participants recounted a range of experiences, both positive and negative, with providers outside of the transgender clinic, but only positive experiences to share about providers from the transgender clinic. CONCLUSION Outside specialty transgender settings, many patients had negative experiences with providers who were unwilling or unable to provide care. This study speaks to the need for primary care providers who can and will treat transgender patients, as well as the need for healthcare spaces that feel safe to transgender patents.
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Affiliation(s)
- Joy L Lee
- Indiana University School of Medicine, Indianapolis, IN, USA. .,Regenstrief Institute, Inc., Indianapolis, IN, USA.
| | | | - Nicholas A Rattray
- Indiana University School of Medicine, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA.,Center for Health Information and Communication, U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Jennifer L Carnahan
- Indiana University School of Medicine, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA
| | | | - Janine M Fogel
- Indiana University School of Medicine, Indianapolis, IN, USA.,Gender Health Program, Eskenazi Health, Indianapolis, IN, USA
| | - Michael Weiner
- Indiana University School of Medicine, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA.,Center for Health Information and Communication, U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Marianne S Matthias
- Indiana University School of Medicine, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA.,Center for Health Information and Communication, U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
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9
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Wright D, Campedelli A. Pilot Study: Increasing Medical Student Comfort in Transgender Gynecology. MEDEDPUBLISH 2022; 12:8. [PMID: 36168535 PMCID: PMC9370083 DOI: 10.12688/mep.18990.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/20/2022] Open
Abstract
Background:
The purpose of this study was to use survey data to better understand medical students’ comfort in taking care of transgender patients and to determine whether this is an area that needs to be expanded upon in their curriculum. Methods
:
Eight pre-clerkship medical students participated in a virtual two-week course about gynecologic transgender care which included a mix of self-paced learning combined with two days of interactive faculty-led sessions. Students were asked to complete a pre and post course survey evaluating their comfort in caring for transgender individuals. Results: We had an 100% response rate to our pre and post course survey. Students’ knowledge about the gynecologic needs of transgender individuals significantly improved after taking the course with the average student rating before and after the course being 2.38 ± 0.74 (p<0.05) and 4.25 ± 0.46 (p<0.05), respectively. In addition, 100% of students “agreed” or “strongly agreed” that this course built their confidence in taking care of transgender patients in the clinical setting. Conclusions: This study highlights a potential gap in medical education while also emphasizing that knowledge on this special population can enhance physician confidence when caring for transgender individuals.
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Affiliation(s)
- Danielle Wright
- Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Alexandra Campedelli
- Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
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Klotzbaugh R, Hopwood R, Spencer G. She came to me for care, why would I say no? Survey results of advanced practice nurses caring for transgender and gender diverse patients. J Am Assoc Nurse Pract 2022; 34:893-900. [PMID: 35652797 DOI: 10.1097/jxx.0000000000000735] [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: 01/03/2022] [Accepted: 04/13/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Literature has recognized deficient knowledge of transgender or gender diverse (TGD) patient needs that can negatively affect health care. Prior research on education has shown little progress responsive to TGD health care needs from nursing. Findings from this demonstrate some improvement, however slight. This study examined the education of family nurse practitioners (FNPs) providing care to TGD patients. PURPOSE The purposes of this study were to describe the relationship between location of practice and TGD patient care and to identify emerging themes related to the care of TGD individuals. METHODS Surveys were sent to 3,500 FNPs. Surveys were completed by 356. RESULTS No significant results were found between location of practice and TGD patient care or between location of education and TGD curricular inclusion. Statistical significance was found between inclusion of TGD content and participants' year of graduation. Those graduating in or after 2011 were more likely to report receiving content. Themes emerged in four areas related to practice area, role, location, and education. This study highlights inadequacy of curricular inclusion of TGD health needs. Findings underscored ways FNPs sourced best practices to provide health care to TGD people. IMPLICATIONS FOR CLINICAL PRACTICE These findings provide additional support for the need to educate FNPs to reduce barriers for TGD persons in accessing affirming health care.
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Affiliation(s)
- Ralph Klotzbaugh
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania
- The Danielsen Institute at Boston University, Hopwood Counseling and Consulting, LLC
- Community Health Nursing, Binghamton University, Decker School of Nursing
| | - Ruben Hopwood
- The Danielsen Institute at Boston University, Hopwood Counseling and Consulting, LLC
| | - Gale Spencer
- Community Health Nursing, Binghamton University, Decker School of Nursing
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11
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Mckay M, De Santis J, Valdes B, Salani D. Prelicensure Baccalaureate Nursing Students' Attitudes, Beliefs, and Willingness to Care for Transgender Clients. J Nurs Educ 2022; 61:322-325. [PMID: 35667106 DOI: 10.3928/01484834-20220404-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Transgender clients report experiencing discrimination and differential treatment by health care providers in clinical settings. This pilot study assessed prelicensure nursing students' attitudes, beliefs, and willingness to provide care for transgender individuals. METHOD Participants enrolled in an adult health nursing course were asked to complete a demographic questionnaire, the Transgender Attitudes and Beliefs Survey, and a Willingness to Provide Clinical Care questionnaire. RESULTS Almost all of the participants reported positive attitudes toward transgender clients. Almost all of the participants reported a willingness to provide nursing skills; one participant was unwilling to perform genital or anal-related care. CONCLUSION The majority of the prelicensure nursing students in this pilot study indicated they were willing to provide nursing care for transgender clients. More research is needed to assess prelicensure nursing students' learning needs regarding the provision of nursing care for transgender individuals. [J Nurs Educ. 2022;61(6):322-325.].
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Restriction of Access to Healthcare and Discrimination of Individuals of Sexual and Gender Minority: An Analysis of Judgments of the European Court of Human Rights from an Ethical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052650. [PMID: 35270340 PMCID: PMC8909593 DOI: 10.3390/ijerph19052650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 01/27/2023]
Abstract
Individuals of sexual and gender minority (SGM) form a vulnerable group with specific healthcare needs that might be prone to experience discrimination and restrictions regarding their access to healthcare. As the judgments of the European Court of Human Rights (ECtHR) offer a normative perspective on these issues, we analyzed them systematically (1) to identify whether and in what manner ECtHR's judgments concern restriction of access to healthcare for SGM individuals and (2) to identify and categorize the ways of discrimination to which SGM individuals are exposed. We conducted a systematic search of the database of the ECtHR's judgments with the use of specified search terms. Descriptive statistics were performed on the identified judgments. Subsequently, we analyzed the judgments with the use of a qualitative method of thematic analysis. We identified n = 73 cases relevant for our study. In n = 7 (9.59%) of judgments, we found limitations of access to healthcare for SGM individuals, e.g., in cases of restrictions for transsexual individuals to receive hormone or surgical therapy. We regard this as a specific form of discrimination. Furthermore, we identified five other categories of discrimination: restriction of parental rights, failure to respect one's gender identity/sexual orientation, discrimination by jurisdiction, prohibition of promotion, and verbal/physical attacks. The ECtHR proves to have a balanced view on the sensitive topic of sexual self-determination condemning any form of discrimination or restriction of access to healthcare. However, there is a need for further research on discriminatory acts by other individuals, e.g., healthcare providers, rather than by public authorities.
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13
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Wright D, Campedelli A. Medical student Interest in expanded transgender gynecologic education. MEDEDPUBLISH 2022. [DOI: 10.12688/mep.18990.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The purpose of this study was to use survey data to better understand medical students’ comfort in taking care of transgender patients and to determine whether this is an area that needs to be expanded upon in their curriculum. Methods: Eight pre-clerkship medical students participated in a virtual two-week course about gynecologic transgender care which included a mix of self-paced learning combined with two days of interactive faculty-led sessions. Students were asked to complete a pre and post course survey evaluating their comfort in caring for transgender individuals. Results: Students’ knowledge about the gynecologic needs of transgender individuals significantly improved after taking the course with the average student rating before and after the course being 2.38 ± 0.74 (p<0.05) and 4.25 ± 0.46 (p<0.05), respectively. In addition, 100% of students “agreed” or “strongly agreed” that this course built their confidence in taking care of transgender patients in the clinical setting. Conclusions: This study highlights a potential gap in medical education while also emphasizing that knowledge on this special population can enhance physician confidence when caring for transgender individuals.
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