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Leal GDC, Júnior JNDBS, Ferreira QR, Ballestero JGDA, Palha PF. Institutional Violence Perpetrated against Transgender Individuals in Health Services: A Systematic Review of Qualitative Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1106. [PMID: 39200715 PMCID: PMC11355012 DOI: 10.3390/ijerph21081106] [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: 07/25/2024] [Revised: 08/06/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024]
Abstract
This review aims to analyze the evidence related to violence perpetrated against transgender individuals in health services based on their narratives. This is a systematic literature review of qualitative studies. A search was carried out in the Scopus, Web of Science, Latin American and Caribbean Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, and MEDLINE databases using the descriptors "transgender people", "violence", and "health services". The eligibility criteria included original qualitative articles addressing the research question, with fully available text, reporting violence specifically by health workers, involving trans individuals aged 18 and above, and published in Portuguese, English, or Spanish. In addition, studies were included that reported experiences of violence suffered by the trans population, through their narratives, in health services. A total of 3477 studies were found, of which 25 were included for analysis. The results highlighted situations such as refusal of service; resistance to the use of social names and pronouns; barriers to accessing health services; discrimination and stigma; insensitivity of health workers; lack of specialized care and professional preparedness; and a system focused on binarism. The analysis of the studies listed in this review highlights the multiple facets of institutional violence faced by the transgender population in health services. It is evident that the forms of violence often interlink and reinforce each other, creating a hostile environment for the transgender population in health services. Thus, there is an urgent need to create strategies that ensure access to dignified and respectful care for all individuals, regardless of their gender identity.
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Affiliation(s)
- Gilberto da Cruz Leal
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil; (J.N.d.B.S.J.); (Q.R.F.); (J.G.d.A.B.); (P.F.P.)
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Mascarenhas RNDS, Santos VVC, Santana BSD, Monteiro AA, Couto TM, Sousa ARD, Pereira DMR, Almeida LCGD. Trans men and paternal pregnancy: experiences during the pregnancy-puerperal period. CIENCIA & SAUDE COLETIVA 2024; 29:e16172023. [PMID: 38655954 DOI: 10.1590/1413-81232024294.16172023] [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: 10/25/2023] [Accepted: 02/29/2024] [Indexed: 04/26/2024] Open
Abstract
This study aims to analyze the experiences of a transgender man during the gestational-puerperal period and the perspective of obstetric nurses in training based on the dynamics and organization of obstetric healthcare in a hospital setting. This qualitative study is based on a case study approach, employing interviews and direct observations to collect data. The analysis was based on the theoretical and normative framework of the Nursing Process, the Theory of Caring, and the theoretical/critical perspective of transfeminism. The results are organized into six categories: Transgender man in the context of pregnancy, childbirth, and postpartum; partnership and parental dimensions; dilemmas faced by the pregnant couple; impressions recorded by the nursing professional; understanding of the case through a theoretical and epistemological lens; implications for healthcare professionals. We underscore the need to promote spaces for continuing education among healthcare professionals and to reformulate legislation in a way that enables the development of public policies based on respect for diversity and equitable care, recognizing the transgender population's specificities in the contexts of pregnancy, childbirth, and postpartum.
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Affiliation(s)
| | | | | | | | - Telmara Menezes Couto
- Escola de Enfermagem, Universidade Federal da Bahia (UFBA). R. Basílio da Gama 241, Canela. 40231-300 Salvador BA Brasil.
| | - Anderson Reis de Sousa
- Escola de Enfermagem, Universidade Federal da Bahia (UFBA). R. Basílio da Gama 241, Canela. 40231-300 Salvador BA Brasil.
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García-Acosta JM, Castro-Molina FJ, Fernández-Martínez AD, Delgado-Reyes A, Castellano-Fuenmayor MA. Best Nursing Practice: Safe and Inclusive Healthcare Environments for Transgender People: A Systematic Review. NURSING REPORTS 2024; 14:287-302. [PMID: 38391067 PMCID: PMC10885085 DOI: 10.3390/nursrep14010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/10/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
(1) Background: The aim of this study was to review the scope of the existing scientific literature on creating safe and inclusive healthcare environments for transgender people and provide an overview of the resources and nursing skills required to do so. (2) Methods: With the research question in mind, an exploratory search of six databases was conducted to identify all relevant primary studies. After screening and selection of articles based on the inclusion and exclusion criteria, a total of 41 articles were included and reviewed. (3) Results: The results were classified under four headings: the training of health professionals, the creation of safe spaces, the nurse as facilitator, and best care practice. Most of the evidence indicates that it is essential for nurses and other healthcare staff to be trained in specific skills to provide comprehensive, high-quality care to transgender people; however, there is a lack of material and human resources to do so. (4) Conclusions: The trans-inclusive care competent nurse should use neutral language that respects the person's preferred name and pronouns in a safe healthcare environment that offers and ensures warmth, respect, and inclusivity in the care provided. This study was registered with the Open Science Framework (OSF) on 9 January 2024 (osf.io/rpj6a).
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Affiliation(s)
- Jesús Manuel García-Acosta
- The Canary Islands Health Service, Tenerife, 38071 Canary Islands, Spain
- Nuestra Señora de la Candelaria School of Nursing, University of La Laguna, 38010 Canary Islands, Spain
| | - Francisco Javier Castro-Molina
- The Canary Islands Health Service, Tenerife, 38071 Canary Islands, Spain
- Nuestra Señora de la Candelaria School of Nursing, University of La Laguna, 38010 Canary Islands, Spain
| | - Alfredo David Fernández-Martínez
- Department of Education, Vocational Training, Physical Activity and Sport, Regional Government of the Canary Islands, Tenerife, 38010 Canary Islands, Spain
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Paiva AT, Borges FA, Carloni PR, Silveira WJA, Ogata MN, Nóbrega MDPSDS, Lourenção LG, García GC. Performance of Family Health Strategy Nurses in LGBT+ Healthcare. Rev Bras Enferm 2023; 76:e20220514. [PMID: 37820140 PMCID: PMC10561931 DOI: 10.1590/0034-7167-2022-0514] [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: 09/15/2022] [Accepted: 03/27/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE To analyze the role of Family Health Strategy (FHS) nurses in the health care of LGBT+ individuals. METHODS This qualitative study is based on Institutional Analysis. Data was collected in August 2021 through semi-structured interviews with 14 Family Health Strategy nurses from municipalities in the state of São Paulo. The data was processed using the IRaMuTeQ® software and analyzed lexically. RESULTS The textual corpus gave rise to three themes, which addressed the nurses' practice, the difficulties and challenges they face in providing care to LGBT+ individuals, and the direct association of LGBT+ individuals with sexually transmitted infections. CONCLUSION Lack of preparedness, access to information, and the need for expanded listening skills are still gaps in the performance of FHS nurses in caring for LGBT+ individuals. However, fostering acceptance and building strong relationships have been effective strategies in bridging the gap in nursing care for the LGBT+ community.
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Queiroz ABA, Castro AMD, Carvalho ALDO, Pinto CB, Bezerra JDF, Gonçalves DDS, Santos GSD, Santos HDMD. Transsexuality and health demands: representations of nursing students. Rev Gaucha Enferm 2023; 44:e20220046. [PMID: 37283430 DOI: 10.1590/1983-1447.2023.20220046.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/07/2022] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE To analyze the social representations of nursing students about transsexuality and the health demands of transsexual people. METHODS Qualitative, descriptive research with undergraduate nursing students from a public university in Rio de Janeiro/Brazil. The data came from a semi-structured interview and lexical analysis using Alceste 2012 software. RESULTS Transsexuality was represented as a transgression, with the transsexual person being objectified as unnatural because they do not identify with their biological sex. Hormone therapy and sex reassignment surgeries were understood as the main demands, being anchored in a pathologizing and medicalizing health sphere. However, the theme is not addressed during graduation, generating unpreparedness for professional life. FINAL CONSIDERATIONS The need to update the academic curriculum, as well as the way of thinking about the care of transsexual people, is essential and urgent for an integral and equitable care.
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Affiliation(s)
- Ana Beatriz Azevedo Queiroz
- Universidade Federal do Rio de Janeiro (UFRJ), Centro de Ciências da Saúde, Escola de Enfermagem Anna Nery. Rio de Janeiro, Rio de Janeiro, Brasil
| | - Alison Malheiros de Castro
- Universidade Federal do Rio de Janeiro (UFRJ), Centro de Ciências da Saúde, Escola de Enfermagem Anna Nery. Rio de Janeiro, Rio de Janeiro, Brasil
| | - Ana Luiza de Oliveira Carvalho
- Universidade Federal do Rio de Janeiro (UFRJ), Centro de Ciências da Saúde, Escola de Enfermagem Anna Nery. Rio de Janeiro, Rio de Janeiro, Brasil
| | - Carina Bulcão Pinto
- Universidade Federal do Rio de Janeiro (UFRJ), Centro Multidisciplinar UFRJ, Instituto de Enfermagem. Macaé, Rio de Janeiro, Brasil
| | - Juliana da Fonsêca Bezerra
- Universidade Federal do Rio de Janeiro (UFRJ), Centro de Ciências da Saúde, Escola de Enfermagem Anna Nery. Rio de Janeiro, Rio de Janeiro, Brasil
| | - Diana da Silva Gonçalves
- Universidade Federal do Rio de Janeiro (UFRJ), Centro de Ciências da Saúde, Escola de Enfermagem Anna Nery. Rio de Janeiro, Rio de Janeiro, Brasil
| | - Gabriela Silva Dos Santos
- Universidade Federal do Rio de Janeiro (UFRJ), Centro Multidisciplinar UFRJ, Instituto de Enfermagem. Macaé, Rio de Janeiro, Brasil
| | - Hannah de Melo Dos Santos
- Universidade Federal do Rio de Janeiro (UFRJ), Centro de Ciências da Saúde, Escola de Enfermagem Anna Nery. Rio de Janeiro, Rio de Janeiro, Brasil
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Webb CC, Zablocki GM. Nurse Educators' Perceptions of Teaching Patient-Centered LGBTQ+ Gender-Affirming Care to Undergraduate Students. Nurs Educ Perspect 2023; 44:175-177. [PMID: 37093696 DOI: 10.1097/01.nep.0000000000000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
ABSTRACT Nurse educators are uniquely positioned to equip students with the knowledge, skills, and attitudes to provide LGBTQ+ persons with culturally congruent inclusive care. Using Quality and Safety Education for Nurses' patient-centered care competency as a framework, this study used a qualitative exploratory-descriptive design to investigate nine undergraduate nurse educators' perceptions of teaching LGBTQ+ gender-affirming care. Three themes emerged from the interviews denoting challenges: importance of patient-centered care, limited knowledge, and barriers to curricular integration. Incorporating LGBTQ+ topics across the undergraduate nursing curriculum is necessary to support the delivery of person-centered care.
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Affiliation(s)
- Cibele C Webb
- About the Authors Cibele C. Webb, PhD, MSNEd, RN, CNE, is an assistant professor, Saint Mary's College Department of Nursing Science, Notre Dame, Indiana. Grace M. Zablocki, BSN, RN, was a nursing student at Saint Mary's College when this study was conducted. Saint Mary's College provided a Student Independent Study and Research grant to support research activities between student Grace M. Zablocki and faculty Cibele C. Webb. The grant also supported travel and related expenses for the student to attend a professional conference. For more information, contact Dr. Webb at
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Altmiller G, Wilson C, Jimenez FA, Perron T. Impact of a Virtual Patient Simulation on Nursing Students' Attitudes of Transgender Care. Nurse Educ 2023; 48:131-136. [PMID: 36383074 DOI: 10.1097/nne.0000000000001331] [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: 11/17/2022]
Abstract
BACKGROUND Transgender individuals experience considerable prejudice and bias, creating barriers to health care. PURPOSE The purpose of this study was to determine the effect of a virtual patient simulation scenario of caring for a transgender adult on nursing students' attitudes and beliefs about transgender people. METHODS A validated 29-item instrument developed to assess an individual's view of transgender identity was administered in a pre-/posttest nonequivalent-groups design to junior- and senior-level nursing students. RESULTS Statistically significant differences were found between the control and treatment groups for the subscale human value. CONCLUSIONS Findings support experiential learning in nursing as an effective tool in teaching cultural competence and sensitivity when caring for transgender patients. Attitudes and beliefs of senior nursing students and junior nursing students toward transgender individuals differed, with senior students being more receptive.
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Affiliation(s)
- Gerry Altmiller
- Professor (Drs Altmiller and Perron), The College of New Jersey, Ewing; and Director Education, Research and Design (Dr Wilson) and Psychometrician (Dr Jimenez), Elsevier, Shadow Health, Gainesville, Florida
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Parenti ABH, Ignácio MADO, Buesso TS, Almeida MASD, Parada CMGDL, Duarte MTC. Knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS. CIENCIA & SAUDE COLETIVA 2023. [DOI: 10.1590/1413-81232023281.09882022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract This article aims to study the knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS. Cross-sectional study of 260 women, 81 women who either have sex with women or with men and women (WSW) and 179 women who have sex exclusively with men (WSM). Data were collected in 2019/2020 by means of a form and validated instruments. To study the association between sexual partnership and level of knowledge about Sexually Transmitted Infections and AIDS, multiple Cox regression models were adjusted, producing significant associations of p<0,05. The median percentage of correct answers was lower among WSW when compared to WSM [68% (18-96) vs 75% (14-96); p=0.023]. Having sex with woman [PR=2.36 (1.07-5.21); p=0.033] and less than 11 years of schooling [PR=2.64 (1.12-6.21); p=0.026] were independently associated with low knowledge. WSW had a lower level of knowledge about Sexually Transmitted Infections and AIDS than WSM, and lower education was independently associated with this finding.
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Parenti ABH, Ignácio MADO, Buesso TS, Almeida MASD, Parada CMGDL, Duarte MTC. Knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS. CIENCIA & SAUDE COLETIVA 2023; 28:303. [PMID: 36629574 DOI: 10.1590/1413-81232023281.09882022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/12/2022] [Indexed: 01/10/2023] Open
Abstract
This article aims to study the knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS. Cross-sectional study of 260 women, 81 women who either have sex with women or with men and women (WSW) and 179 women who have sex exclusively with men (WSM). Data were collected in 2019/2020 by means of a form and validated instruments. To study the association between sexual partnership and level of knowledge about Sexually Transmitted Infections and AIDS, multiple Cox regression models were adjusted, producing significant associations of p<0,05. The median percentage of correct answers was lower among WSW when compared to WSM [68% (18-96) vs 75% (14-96); p=0.023]. Having sex with woman [PR=2.36 (1.07-5.21); p=0.033] and less than 11 years of schooling [PR=2.64 (1.12-6.21); p=0.026] were independently associated with low knowledge. WSW had a lower level of knowledge about Sexually Transmitted Infections and AIDS than WSM, and lower education was independently associated with this finding.
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Affiliation(s)
- Ana Beatriz Henrique Parenti
- Departamento de Enfermagem, Faculdade de Medicina, Universidade Estadual Paulista (Unesp). Av. Prof. Mário Rubens Guimarães Montenegro s/n, Campus de Botucatu. 18618-687 Botucatu SP Brasil.
| | - Mariana Alice de Oliveira Ignácio
- Departamento de Enfermagem, Faculdade de Medicina, Universidade Estadual Paulista (Unesp). Av. Prof. Mário Rubens Guimarães Montenegro s/n, Campus de Botucatu. 18618-687 Botucatu SP Brasil.
| | - Thayná Santos Buesso
- Departamento de Enfermagem, Faculdade de Medicina, Universidade Estadual Paulista (Unesp). Av. Prof. Mário Rubens Guimarães Montenegro s/n, Campus de Botucatu. 18618-687 Botucatu SP Brasil.
| | | | - Cristina Maria Garcia de Lima Parada
- Departamento de Enfermagem, Faculdade de Medicina, Universidade Estadual Paulista (Unesp). Av. Prof. Mário Rubens Guimarães Montenegro s/n, Campus de Botucatu. 18618-687 Botucatu SP Brasil.
| | - Marli Teresinha Cassamassimo Duarte
- Departamento de Enfermagem, Faculdade de Medicina, Universidade Estadual Paulista (Unesp). Av. Prof. Mário Rubens Guimarães Montenegro s/n, Campus de Botucatu. 18618-687 Botucatu SP Brasil.
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Sousa ARD, Machuca-Contreras FA, Morais AVCD, Araújo RDDD, Silva GWDS, Camargo CLD, Oliveira JFD, Carvalho ESDS. Rupturas biográficas por la pandemia del COVID-19 en adolescentes y jóvenes hombres trans y transmasculinos: demandas para la enfermería. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6243.3752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Resumen Objetivo: comprender las rupturas biográficas provocadas por la pandemia del COVID-19 en adolescentes y jóvenes hombres trans y personas transmasculinas en el contexto de Brasil. Método: estudio cualitativo - encuesta en línea - multicéntrico. Participaron 97 hombres trans y 22 personas transmasculinas autoidentificadas, que respondieron un formulario semiestructurado en dos etapas. Los datos se sometieron al Análisis de Contenido Temático Reflexivo. La interpretación se realizó sobre una base sociológica a partir del concepto de ruptura biográfica. Resultados: surgieron cinco categorías: interrupción de la terapia hormonal, cirugías y seguimiento especializado; malestares precipitados por la interrupción de las características masculinas, autoimagen, autopercepción e identidad; vulnerabilidad por la pérdida de familiares y seres queridos, empleo y debilitamiento de las redes de apoyo; aparición de problemas psicoemocionales, como la pérdida del sentido de la vida; demandas de atención de enfermería y valoración de la vida de adolescentes y jóvenes transexuales en el pospandemia. Conclusión: las rupturas biográficas provocadas por la pandemia amenazaron las identidades de los hombres trans y personas transmasculinas adolescentes y jóvenes, produjeron degradación y discontinuidad de las biografías, llevándolas a perder el sentido de la vida. Los profesionales de enfermería pueden ser estratégicos e imprescindibles en la superación de estas amenazas al promover una intervención anticipada.
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Sousa ARD, Machuca-Contreras FA, Morais AVCD, Araújo RDDD, Silva GWDS, Camargo CLD, Oliveira JFD, Carvalho ESDS. Biographical ruptures by the COVID-19 pandemic on adolescent and young trans men and transmasculine people: demands for nursing. Rev Lat Am Enfermagem 2022; 30:e3753. [DOI: 10.1590/1518-8345.6243.3753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/25/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract Objective: to understand the biographical ruptures caused by the COVID-19 pandemic on adolescent and young trans men and transmasculine people in the Brazilian context. Method: qualitative study - multicenter, online survey. A total of 97 self-identified trans men and 22 transmasculine people participated and completed a semi-structured form in two stages. The data was subjected to Reflective Thematic Content Analysis. The interpretation was made on a sociological basis, based on the concept of biographical rupture. Results: five categories were derived: interruption of hormonization, surgeries and specialized follow-up; discomforts caused by the rupture of masculine characteristics, self-image, self-perception, and identity; vulnerability from the losses of family members and significant people, employment, and weakening of support networks; emergence of psycho-emotional problems, such as loss of meaning in life; demands for nursing care and valuing the life of transmasculine adolescents and young men in post-pandemic times. Conclusion: the biographical ruptures caused by the pandemic threatened the identities of trans and transmasculine people of adolescents and youth, degraded and interrupted biographies, leading them to the loss of meaning in life. Nursing professionals can be strategic and essential in overcoming threats by intervening early.
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Sousa ARD, Machuca-Contreras FA, Morais AVCD, Araújo RDDD, Silva GWDS, Camargo CLD, Oliveira JFD, Carvalho ESDS. Rupturas biográficas pela pandemia da COVID-19 sobre adolescentes e jovens homens trans e transmasculinos: demandas para a enfermagem. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6243.3754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Resumo Objetivo: compreender as rupturas biográficas causadas pela pandemia da COVID-19 sobre adolescentes e jovens homens trans e pessoas transmasculinas no contexto do Brasil. Método: estudo qualitativo - survey on-line, multicêntrico. Participaram 97 homens trans e 22 pessoas transmasculinas, autoidentificados, que responderam formulário semiestruturado em duas etapas. Os dados foram submetidos à Análise de Conteúdo Temática Reflexiva. Realizou-se a interpretação com base sociológica, a partir do conceito de ruptura biográfica. Resultados: derivadas cinco categorias: interrupção da hormonização, cirurgias e acompanhamento especializado; desconfortos precipitados pela ruptura das características masculinas, autoimagem, autopercepção e identidade; vulnerabilidade a partir das perdas de familiares e pessoas significativas, emprego e fragilização das redes de apoio; emergência de problemas psicoemocionais, como perda do sentido da vida; demandas para o cuidado de enfermagem e valorização da vida de adolescentes e jovens transmasculinos no pós-pandemia. Conclusão: as rupturas biográficas provocadas pela pandemia ameaçaram as identidades de homens trans e pessoas transmasculinas de adolescentes e jovens, produziram degradação e descontinuidade das biografias, conduzindo-os à perda de sentido da vida. Profissionais de enfermagem podem ser estratégicos e essenciais na superação das ameaças, intervindo antecipadamente.
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Souza ESD, Tanaka LH. Healthcare: action research with trans people living on the streets. Rev Bras Enferm 2021; 75Suppl 2:e20210016. [PMID: 34787278 DOI: 10.1590/0034-7167-2021-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/02/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze the representations of healthcare provided to trans people living on the streets. METHODS ten women (three trans) and three cisgender men participated in this action research. Popular health education groups, focus groups, seminars and interviews were held, the data of which were organized in the software Nvivo®, submitted to content analysis and interpreted in the light of intersectionality theory. RESULTS healthcare was represented by the technical, relational, structural and citizenship dimensions. The relationship between gender and poverty determines the specific health needs of trans people living on the streets. FINAL CONSIDERATIONS the need to expand conceptions and practices on healthcare to meet the specific health needs of trans people living on the streets was evidenced. Nursing, with competence and cultural sensitivity, can contribute to positive health outcomes and, consequently, break with the logic of exclusion, illness and poverty.
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Affiliation(s)
- Eduardo Sodré de Souza
- Universidade Anhembi Morumbi. São Paulo, São Paulo, Brazil.,Universidade de São Paulo. São Paulo, São Paulo, Brazil
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The Impact of Training in Transgender Care on Healthcare Providers Competence and Confidence: A Cross-Sectional Survey. Healthcare (Basel) 2021; 9:healthcare9080967. [PMID: 34442104 PMCID: PMC8391671 DOI: 10.3390/healthcare9080967] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 11/17/2022] Open
Abstract
All studies to date demonstrate a lack of access to care for transgender people. A few educational efforts in providing care to transgender people have been successful. However, one challenge in administering training is that there is almost no research on the need of healthcare providers (HCP) to acquire knowledge, as well as on the effect of training on their level of competence and confidence in working with transgender people. Results from an online survey of a convenience sample of HCP across four different European countries (N = 810) showed that 52.7% reported experiences with some form of training on transgender people. The mean confidence level for all HCP (with or without training) in working with transgender people was 2.63, with a significant effect of training on confidence. 92.4% of HCP believed that training would raise their competence, and this belief was significantly higher among HCP with training experience, HCP working in Serbia and Sweden and/or among those HCP who belong to a sexual minority group. General practitioners had the lowest confidence levels of all professions involved. The study provided strong support for the use of training in improving healthcare conditions for transgender people, not only to raise awareness among HCP, but also to increase knowledge, competence and confidence levels of HCP in working with transgender people.
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Sundus A, Shahzad S, Younas A. Ethical and culturally competent care of transgender patients: A scoping review. Nurs Ethics 2021; 28:1041-1060. [PMID: 33706609 DOI: 10.1177/0969733020988307] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Transgender individuals experience discrimination, stigmatization, and unethical and insensitive attitudes in healthcare settings. Therefore, healthcare professionals must be knowledgeable about the ways to deliver ethical and culturally competent care. ETHICAL CONSIDERATIONS No formal ethical approval was required. AIM To synthesize the literature and identify gaps about approaches to the provision of ethical and culturally competent care to transgender populations. DESIGN A Scoping Review. LITERATURE SEARCH Literature was searched within CINAHL, Science Direct, PubMed, Google Scholar, EMBASE, and Scopus databases using indexed keywords such as "transgender," "gender non-conforming," "ethically sensitive care," and "culturally sensitive care." In total, 30 articles, which included transgender patients and their families and nurses, doctors, and health professionals who provided care to transgender patients, were selected for review. Data were extracted and synthesized using tabular and narrative summaries and thematic synthesis. FINDINGS Of 30 articles, 23 were discussion papers, 5 research articles, and 1 each case study and an integrative review. This indicates an apparent dearth of literature about ethical and culturally sensitive care of transgender individuals. The review identified that healthcare professionals should educate themselves about sensitive issues, become more self-aware, put transgender individual in charge during care interactions, and adhere to the principles of advocacy, confidentiality, autonomy, respect, and disclosure. CONCLUSIONS The review identified broad approaches for the provision of ethical and culturally competent care. The identified approaches could be used as the baseline, and further research is warranted to develop and assess organizational and individual-level approaches.
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Affiliation(s)
| | | | - Ahtisham Younas
- 7512Memorial University of Newfoundland, Canada; CareGivers, Canada; Swat College of Nursing, Pakistan
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Abstract
With a shift in the cultural, political, and social climate surrounding gender and gender identity, an increase in the acceptance and visibility of transgender individuals is expected. Anesthesiologists are thus more likely to encounter transgender and gender nonconforming patients in the perioperative setting. Anesthesiologists need to acquire an in-depth understanding of the transgender patient's medical and psychosocial needs. A thoughtful approach throughout the entirety of the perioperative period is key to the successful management of the transgender patient. This review provides anesthesiologists with a culturally relevant and evidence-based approach to transgender patients during the preoperative, intraoperative, and postoperative periods.
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Florêncio LLF, de Souza KR, Oliveira ECDS, Cabral JDR, Silva FPD, Silva RAD, Frazão IDS, de Oliveira RC, Abrão FMDS. Therapeutic itinerary of transsexual people in light of human rights. Nurs Ethics 2020; 28:704-713. [PMID: 33325303 DOI: 10.1177/0969733020968864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The therapeutic itinerary is not limited to the identification and availability of health services offered, but relates to the different individual searches and sociocultural and economic possibilities of each patient. In this study, we discuss the therapeutic itinerary of transsexual people seeking healthcare, from the user's perspective. OBJECTIVE The aim of this study was to discuss the therapeutic itinerary of transsexual people seeking healthcare, from the user's perspective. DESIGN AND PARTICIPANTS Individual interviews were performed with 10 transsexuals at the Trans Space of a University Hospital of Pernambuco, using the Universal Declaration of Human Rights as the theoretical reference and the Bardin's thematic content analysis as the reference methodological framework. ETHICAL CONSIDERATIONS This study was approved by the Human Research Ethics Committee at the Federal University of Pernambuco under protocol no. 91284218.5.0000.5208. FINDINGS The comprehensive care for transsexual people was evidenced through four categories analyzed: low demand of transsexuals in health services; use of social name in health services; care permeated by prejudiced and discriminatory attitudes; and health system and professionals who are not able to meet transgender health issues. DISCUSSION Transsexual people are stigmatized and experience prejudice in their daily health, in a way they do not enjoy fundamental rights, as if they had fewer rights, or infringe the principle of universality of access to health. Thus, for effective and comprehensive care, the health team must keep up to date on the public policies existing in the healthcare of transsexual people and reconstruct what they understand by gender. CONCLUSION Knowledge about the therapeutic itinerary of transgender people may support evaluation processes of health service networks to ensure the access to and reorganization of these services. Understanding this dynamic allows fostering discussions about the structure of health services at all care levels for the care of this population.
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McCann E, Brown MJ. Homeless experiences and support needs of transgender people: A systematic review of the international evidence. J Nurs Manag 2020; 29:85-94. [PMID: 32978830 DOI: 10.1111/jonm.13163] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/12/2020] [Accepted: 09/12/2020] [Indexed: 01/19/2023]
Abstract
AIM To examine the experiences and support needs of homeless transgender people by synthesizing the existing evidence. BACKGROUND Transgender people face many challenges in society in terms of people's knowledge, understanding and acceptance of a person's gender identity. Evidence regarding the homelessness experiences and available supports to transgender people remains sparse. METHODS A systematic review was undertaken and included qualitative and quantitative studies. A total of twelve papers were included in the review, utilizing the PRISMA method. Methodological quality was evaluated using the Mixed Methods Assessment Tool (MMAT). RESULTS Following analysis, the themes that emerged were (a) pathways into homelessness, (b) experiences whilst homeless and (c) routes out of homelessness. CONCLUSION It has become increasingly clear that the distinct needs of this group are complex and multifaceted. In order to adequately address the issues and concerns comprehensively, coordinated and effective collaborations need to be in place. IMPLICATIONS FOR NURSING MANAGEMENT Clinical nurses need to recognize and respond to the distinct needs of trans homeless people. Nurse managers need to provide leadership to promote the needs of homeless trans people and ensure that policies and procedures are in place that are responsive to issues and concerns.
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Affiliation(s)
- Edward McCann
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Michael J Brown
- School of Nursing and Midwifery, Queen's University Belfast, UK
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Silva NL, Lopes ROP, Bitencourt GR, Bossato HR, Brandão MAG, Ferreira MA. Social identity of transgender persons: concept analysis and proposition of nursing diagnoses. Rev Bras Enferm 2020; 73:e20200070. [DOI: 10.1590/0034-7167-2020-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/13/2020] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To analyze the concept of social identity of transgender persons and develop nursing diagnoses related to it. Methods: A concept analysis according to the Walker and Avant model. A scope review was carried out with a search of eight databases, a portal and two information systems, during June and July 2019. Articles, theses, and dissertations were analyzed in Portuguese, English, and Spanish, with no time frame definition. Results: Of the 6.847 productions, 10 were included, and the concept of social identity was described in 4 of them. Critical, prior, and consequential attributes for the social identity of transgender persons were identified, and the analysis of the concept substantiated the proposal of the diagnosis: Willingness to improve the social identity of the transgender person. Conclusion: Social identity establishes a relationship with health, and the proposed nursing diagnosis strengthens the sense of belonging of transgender people, enhancing their rights as citizens.
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Santos JSD, Silva RND, Ferreira MDA. Health of the LGBTI+ Population in Primary Health Care and the Insertion of Nursing. ESCOLA ANNA NERY 2019. [DOI: 10.1590/2177-9465-ean-2019-0162] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To reflect on the approaches to the health of the LGBTI+ population, Primary Health Care and Nursing in the care of this population. Method: The reflection is based on a brief characterization of the LGBTI+ population and their health, an analysis of the nurses' work in Primary Health Care (PHC), and a debate about particularities of the nursing care for the LGBTI+ population in the PHC. Results: The LGBTI+ population is composed of many populations defined by the diversity of gender identity and expression, sexual orientation, and biological sex. In Family Health teams, nurses must know the main demands of this population. The institutional reorientation of PHC imposes new challenges to the enjoyment of the right to health of the LGBTI+ population. Conclusion and implications for practice: Although the National LGBT Health Policy is seven years old, studies are still scarce, foremost in Nursing. Considering that the LGBTI+ population is also under the Nursing responsibility in the PHC, it is up to this professional category to provide integral assistance with a view to minimizing the inequalities suffered by this population.
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