Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Ingraham N, Wingo E, Roberts SCM. Inclusion of LGBTQ persons in research related to pregnancy risk: a cognitive interview study. BMJ Sex Reprod Health 2018;44:bmjsrh-2018-200097. [PMID: 30217959 DOI: 10.1136/bmjsrh-2018-200097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/04/2018] [Accepted: 08/21/2018] [Indexed: 05/28/2023]

For:	Ingraham N, Wingo E, Roberts SCM. Inclusion of LGBTQ persons in research related to pregnancy risk: a cognitive interview study. BMJ Sex Reprod Health 2018;44:bmjsrh-2018-200097. [PMID: 30217959 DOI: 10.1136/bmjsrh-2018-200097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/04/2018] [Accepted: 08/21/2018] [Indexed: 05/28/2023]

Number

Cited by Other Article(s)

Scott D, Derrett S, Rupel VP, Jelsma J, Gurung G, Oduro GY, Withey-Rila C. He/She/They - gender inclusivity in developing and using health-related questionnaires: a scoping review. Qual Life Res 2024:10.1007/s11136-024-03765-2. [PMID: 39207629 DOI: 10.1007/s11136-024-03765-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 09/04/2024]

Bowler S, Vallury K, Sofija E. Understanding the experiences and needs of LGBTIQA+ individuals when accessing abortion care and pregnancy options counselling: a scoping review. BMJ SEXUAL & REPRODUCTIVE HEALTH 2023:bmjsrh-2022-201692. [PMID: 36635070 DOI: 10.1136/bmjsrh-2022-201692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]

Abstract

BACKGROUND

Safe, accessible, and inclusive abortion care and pregnancy options counselling are essential components of sexual and reproductive health and rights. Research has documented LGBTIQA+ people are as likely, or more than likely, as the general population to experience an abortion in their lifetime yet face significant barriers to accessing abortion and related care, which undermines well-being.

AIMS

The present study undertakes a scoping review of research on the needs and experiences of the LGBTIQA+ population (representing lesbian, gay, bisexual, transgender, gender diverse, intersex, queer, asexual, and questioning) when accessing abortion care, pregnancy options, and post-abortion counselling to support improved understanding of pregnant people's preferences, needs, and experiences.

METHODS

The reporting of this scoping review is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension of Scoping Reviews (PRISMA-ScR). Academic databases were searched using terms relating to gender identity and sexuality, abortion, pregnancy options, and post-abortion counselling to identify peer reviewed papers published in English. Seven publications were included in the review that described experiences of LGBTIQA+ people accessing abortion-related care.

RESULTS

The included studies were predominantly conducted in the USA using quantitative and qualitative research designs. Thematic analysis highlighted participants' experiences of discrimination and exclusion in healthcare settings, healthcare avoidance, unsafe abortion, non-disclosure to providers, and poor health outcomes for LGBTIQA+ people.

CONCLUSIONS

Gender-inclusive services and training for health providers is necessary to provide safe and accessible abortion care and overcome generations of mistrust held by the LGBTIQA+ community. Research into the needs of LGBTIQA+ people when accessing pregnancy options counselling is critically needed.

Collapse

Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2022;23:S1-S259. [PMID: 36238954 PMCID: PMC9553112 DOI: 10.1080/26895269.2022.2100644] [Citation(s) in RCA: 758] [Impact Index Per Article: 379.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]

Abstract

Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.

Collapse

Affiliation(s)

E Coleman Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
A E Radix Callen-Lorde Community Health Center, New York, NY, USA Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
W P Bouman Nottingham Centre for Transgender Health, Nottingham, UK School of Medicine, University of Nottingham, Nottingham, UK
G R Brown James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA James H. Quillen VAMC, Johnson City, TN, USA
A L C de Vries Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
M B Deutsch Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA UCSF Gender Affirming Health Program, San Francisco, CA, USA
R Ettner New Health Foundation Worldwide, Evanston, IL, USA Weiss Memorial Hospital, Chicago, IL, USA
L Fraser Independent Practice, San Francisco, CA, USA
M Goodman Emory University Rollins School of Public Health, Atlanta, GA, USA
J Green Independent Scholar, Vancouver, WA, USA
A B Hancock The George Washington University, Washington, DC, USA
T W Johnson Department of Anthropology, California State University, Chico, CA, USA
D H Karasic University of California San Francisco, San Francisco, CA, USA Independent Practice at dankarasic.com
G A Knudson University of British Columbia, Vancouver, Canada Vancouver Coastal Health, Vancouver, Canada
S F Leibowitz Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
H F L Meyer-Bahlburg New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, Columbia University, New York, NY, USA
S J Monstrey Ghent University Hospital, Gent, Belgium
J Motmans Transgender Infopunt, Ghent University Hospital, Gent, Belgium Centre for Research on Culture and Gender, Ghent University, Gent, Belgium
L Nahata Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
T O Nieder University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany
S L Reisner Harvard Medical School, Boston, MA, USA Harvard T. H. Chan School of Public Health, Boston, MA, USA
C Richards Regents University London, UK Tavistock and Portman NHS Foundation Trust, London, UK
L S Schechter Rush University Medical Center, Chicago, IL, USA
V Tangpricha Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA Atlanta VA Medical Center, Decatur, GA, USA
A C Tishelman Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA
M A A Van Trotsenburg Bureau GenderPRO, Vienna, Austria University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria
S Winter School of Population Health, Curtin University, Perth, WA, Australia
K Ducheny Howard Brown Health, Chicago, IL, USA
N J Adams University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada Transgender Professional Association for Transgender Health (TPATH)
T M Adrián Asamblea Nacional de Venezuela, Caracas, Venezuela Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela
L R Allen University of Nevada, Las Vegas, NV, USA
D Azul La Trobe Rural Health School, La Trobe University, Bendigo, Australia
H Bagga Monash Health Gender Clinic, Melbourne, Victoria, Australia Monash University, Melbourne, Victoria, Australia
K Başar Department of Psychiatry, Hacettepe University, Ankara, Turkey
D S Bathory Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA
J J Belinky Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina
D R Berg National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
J U Berli Oregon Health & Science University, Portland, OR, USA
R O Bluebond-Langner NYU Langone Health, New York, NY, USA Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA
M-B Bouman Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
M L Bowers Icahn School of Medicine at Mount Sinai, New York, NY, USA Mills-Peninsula Medical Center, Burlingame, CA, USA
P J Brassard GrS Montreal, Complexe CMC, Montreal, Quebec, Canada Université de Montreal, Quebec, Canada
J Byrne University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
L Capitán The Facialteam Group, Marbella International Hospital, Marbella, Spain
C J Cargill Independent Scholar
J M Carswell Harvard Medical School, Boston, MA, USA Boston's Children's Hospital, Boston, MA, USA
S C Chang Independent Practice, Oakland, CA, USA
G Chelvakumar Nationwide Children's Hospital, Columbus, OH, USA The Ohio State University, College of Medicine, Columbus, OH, USA
T Corneil School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
K B Dalke Penn State Health, PA, USA Penn State College of Medicine, Hershey, PA, USA
G De Cuypere Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
E de Vries Nelson Mandela University, Gqeberha, South Africa University of Cape Town, Cape Town, South Africa
M Den Heijer Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
A H Devor University of Victoria, Victoria, BC, Canada
C Dhejne ANOVA, Karolinska University Hospital, Stockholm, Sweden Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
A D'Marco UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas D M A R C O Organization, Nassau, The Bahamas
E K Edmiston University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
L Edwards-Leeper Pacific University, Hillsboro, OR, USA Independent Practice, Beaverton, OR, USA
R Ehrbar Whitman Walker Health, Washington, DC, USA Independent Practice, Maryland, USA
D Ehrensaft University of California San Francisco, San Francisco, CA, USA
J Eisfeld Transvisie, Utrecht, The Netherlands
E Elaut Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium
L Erickson-Schroth The Jed Foundation, New York, NY, USA Hetrick-Martin Institute, New York, NY, USA
J L Feldman Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
A D Fisher Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
M M Garcia Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA
L Gijs Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
S E Green Mermaids, London/Leeds, UK
B P Hall Duke University Medical Center, Durham, NC, USA Duke Adult Gender Medicine Clinic, Durham, NC, USA
T L D Hardy Alberta Health Services, Edmonton, Alberta, Canada MacEwan University, Edmonton, Alberta, Canada
M S Irwig Harvard Medical School, Boston, MA, USA Beth Israel Deaconess Medical Center, Boston, MA, USA
L A Jacobs Independent Practice, New York, NY, USA
A C Janssen Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA Northwestern Feinberg School of Medicine, Chicago, IL, USA
K Johnson RMIT University, Melbourne, Australia University of Brighton, Brighton, UK
D T Klink Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
B P C Kreukels Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
L E Kuper Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA Department of Endocrinology, Children's Health, Dallas, TX, USA
E J Kvach Denver Health, Denver, CO, USA University of Colorado School of Medicine, Aurora, CO, USA
M A Malouf Malouf Counseling and Consulting, Baltimore, MD, USA
R Massey WPATH Global Education Institute Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
T Mazur Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA John R. Oishei Children's Hospital, Buffalo, NY, USA
C McLachlan Professional Association for Transgender Health, South Africa Gender DynamiX, Cape Town, South Africa
S D Morrison Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
S W Mosser Gender Confirmation Center, San Francisco, CA, USA Saint Francis Memorial Hospital, San Francisco, CA, USA
P M Neira Johns Hopkins Center for Transgender Health, Baltimore, MD, USA Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA
U Nygren Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
J M Oates La Trobe University, Melbourne, Australia Melbourne Voice Analysis Centre, East Melbourne, Australia
J Obedin-Maliver Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA Department of Epidemiology and Population Health, Stanford, CA, USA
G Pagkalos Independent PracticeThessaloniki, Greece Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece
J Patton Talkspace, New York, NY, USA CytiPsychological LLC, San Diego, CA, USA
N Phanuphak Institute of HIV Research and Innovation, Bangkok, Thailand
K Rachlin Independent Practice, New York, NY, USA
T Reed Gender Identity Research and Education Society, Leatherhead, UK
G N Rider National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
J Ristori Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
S Robbins-Cherry Nottingham Centre for Transgender Health, Nottingham, UK
S A Roberts Harvard Medical School, Boston, MA, USA Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA
K A Rodriguez-Wallberg Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
S M Rosenthal Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA UCSF Child and Adolescent Gender Center
K Sabir FtM Phoenix Group, Krasnodar Krai, Russia
J D Safer Icahn School of Medicine at Mount Sinai, New York, NY, USA Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA
A I Scheim Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
L J Seal Tavistock and Portman NHS Foundation Trust, London, UK St George's University Hospitals NHS Foundation Trust, London, UK
T J Sehoole Iranti, Johannesburg, South Africa
K Spencer National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
C St Amand University of Houston, Houston, TX, USA Mayo Clinic, Rochester, MN, USA
T D Steensma Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
J F Strang Children's National Hospital, Washington, DC, USA George Washington University School of Medicine, Washington, DC, USA
G B Taylor Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA
K Tilleman Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
G G T'Sjoen Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium Department of Endocrinology, Ghent University Hospital, Gent, Belgium
L N Vala Independent Practice, Campbell, CA, USA
N M Van Mello Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
J F Veale School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
J A Vencill Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
B Vincent Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK
L M Wesp College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA Health Connections Inc., Glendale, WI, USA
M A West North Memorial Health Hospital, Robbinsdale, MN, USA University of Minnesota, Minneapolis, MN, USA
J Arcelus School of Medicine, University of Nottingham, Nottingham, UK Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain

Collapse

Rodriguez-Wallberg K, Obedin-Maliver J, Taylor B, Van Mello N, Tilleman K, Nahata L. Reproductive health in transgender and gender diverse individuals: A narrative review to guide clinical care and international guidelines. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2022;24:7-25. [PMID: 36713139 PMCID: PMC9879176 DOI: 10.1080/26895269.2022.2035883] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]

Abstract

Background

Hormonal treatments and surgical interventions practiced with the aim to affirm gender identity in transgender and gender diverse patients may impact their future reproductive ability, family building, and family planning options. Whereas it is recommended by international guidelines to discuss the potential risks of infertility and to present fertility preservation (FP) options to transgender individuals and their families prior to initiating any of these treatments, many barriers still remain. Further, transgender and gender diverse individuals often experience barriers to accessing contraception, abortion, pre-conception care, and comprehensive perinatal care.

Aims

In this review we summarize the current literature on reproductive healthcare issues reported in transgender people including fertility issues, fertility preservation (FP), contraception, pregnancy and lactation and perinatal health.

Methods

A narrative literature search of major databases (Pubmed, Medline, PsycInfo, Google Scholar, Web of Science) was conducted. Given the paucity and heterogeneity of studies, summative review tactics were not available. The literature was critically reviewed by international experts in the field with focus on the impact of gender-affirming medical interventions on future fertility, current FP options and reproductive health issues in transgender people.

Results

The current literature supports that transgender and gender diverse individuals may wish to have genetically related children in the future, rendering the issue of FP relevant to this patient group. The cryopreservation of mature gametes is an efficacious option for FP for post-pubertal adolescents and adults. It is recommended to discuss these options at time of planning for gender-affirming hormonal therapy (GAHT) or engaging with other gender-affirming procedures that can limit future fertility. Discontinuation of GAHT may allow individuals to undergo FP later, but data are limited and there is the concern of symptoms and consequences of stopping GAHT. For pre-pubertal and early pubertal children, FP options are limited to the cryopreservation of gonadal tissue. At present the tissue can become functional only after re-transplantation, which might be undesirable by transgender individuals in the future. Preconception counseling, prenatal surveillance, perinatal support, contraceptive, and pregnancy termination related healthcare need to be meaningfully adapted for this patient population, and many knowledge gaps remain.

Discussion

Specialized FP reproductive healthcare for transgender and gender diverse individuals is in early evolution. Research should be conducted to examine effects of medical interventions on fertility, timing of FP, gamete preservation and outcome of the fertility treatments. Strategies to inform and educate transgender and gender diverse patients can lead to optimization of reproductive care and counseling and decision making of FP for this population.

Collapse

Forsberg H, Eliason MJ. Healthcare Providers' Pregnancy Prevention Counseling of Trans and Non-Binary Assigned Female at Birth (TNB/AFAB) Patients. JOURNAL OF HOMOSEXUALITY 2022;69:356-383. [PMID: 32960736 DOI: 10.1080/00918369.2020.1819713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]

Culturally humble fertility care: education and advocacy. Fertil Steril 2021;115:1177-1178. [PMID: 33707066 DOI: 10.1016/j.fertnstert.2021.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 11/22/2022]

Moseson H, Lunn MR, Katz A, Fix L, Durden M, Stoeffler A, Hastings J, Cudlitz L, Goldberg E, Lesser-Lee B, Letcher L, Reyes A, Flentje A, Capriotti MR, Lubensky ME, Obedin-Maliver J. Development of an affirming and customizable electronic survey of sexual and reproductive health experiences for transgender and gender nonbinary people. PLoS One 2020;15:e0232154. [PMID: 32365110 PMCID: PMC7197812 DOI: 10.1371/journal.pone.0232154] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 04/07/2020] [Indexed: 11/19/2022] Open

Affiliation(s)

Heidi Moseson Ibis Reproductive Health, Oakland, CA, United States of America
Mitchell R. Lunn The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, United States of America Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
Anna Katz Ibis Reproductive Health, Oakland, CA, United States of America
Laura Fix Ibis Reproductive Health, Cambridge, Massachusetts, United States of America
Mary Durden Ibis Reproductive Health, Oakland, CA, United States of America
Ari Stoeffler Planned Parenthood League of Massachusetts, Boston, Massachusetts, United States of America
Jen Hastings Department of Family and Community Medicine, University of California San Francisco, San Francisco, California, United States of America
Lyndon Cudlitz Lyndon Cudlitz Consulting, Education & Training, Albany, New York, United States of America
Eli Goldberg Robert Larner M.D. College of Medicine, University of Vermont, Burlington, Vermont, United States of America
Bori Lesser-Lee Independent consultant, Malden, Massachusetts, United States of America
Laz Letcher University of New Mexico, Albuquerque, New Mexico, United States of America
Aneidys Reyes Edgewood College, Madison, Wisconsin, United States of America
Annesa Flentje The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, United States of America Department of Community Health Systems, University of California, San Francisco, San Francisco, California, United States of America Alliance Health Project, Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
Matthew R. Capriotti The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, United States of America Department of Psychology, San José State University, San Jose, California, United States of America
Micah E. Lubensky The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, United States of America
Juno Obedin-Maliver The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, United States of America Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, United States of America

Collapse

Greene MZ, Carpenter E, Hendrick CE, Haider S, Everett BG, Higgins JA. Sexual Minority Women's Experiences With Sexual Identity Disclosure in Contraceptive Care. Obstet Gynecol 2019;133:1012-1023. [PMID: 30969215 PMCID: PMC6483879 DOI: 10.1097/aog.0000000000003222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]

Abstract

OBJECTIVE

To describe a group of young sexual minority women's experiences with and preferences for sexual identity disclosure in the context of contraceptive care.

METHODS

In Chicago, Illinois, Salt Lake City, Utah, and Madison, Wisconsin, investigators conducted five focus groups (n=22) and 11 interviews with women aged 20-30 years who identified as something other than heterosexual. Focus groups explored social norms regarding contraceptive care; interviews documented individual experiences with contraceptive care. Using a qualitative descriptive approach and combined deductive and inductive content analysis, investigators coded transcripts for themes related to disclosing sexual orientation to contraceptive providers.

RESULTS

Participants described the process of sexual identity disclosure in contraceptive care in three stages: 1) listening for whether, when, and how health care providers asked about sexual orientation, 2) deciding whether or not to disclose sexual identity to providers, and 3) evaluating responses from providers after disclosure. Participants wanted providers to: avoid assumptions and ask about both sexual identity and sexual behaviors, signal their openness and competence around the health of sexual minority women during contraceptive encounters, and focus discussions on the individual patient's priorities and needs for contraceptive care.

CONCLUSION

Decisions made by sexual minority women about sexual identity disclosure in contraceptive contexts are influenced by previous and current interactions with health care providers. Contraceptive providers should ask all patients about sexual identity and sexual behavior, avoid assumptions about use of and need for contraception, and acknowledge the prevalence of marginalization, discrimination, and stigma experienced by sexual minority women and their communities in health care contexts.

Collapse