Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

International Journal of Transgender Health, Год журнала: 2022, Номер 23(sup1), С. S1 - S259

Опубликована: Авг. 19, 2022

Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in number and visibility of transgender gender diverse (TGD) people seeking support gender-affirming medical treatment parallel with significant rise scientific literature this area. The World Professional Association for Health (WPATH) international, multidisciplinary, professional association whose mission to promote evidence-based care, education, research, public policy, respect health. One main functions WPATH highest standards health care TGD through Standards Care (SOC). SOC was initially developed 1979 version (SOC-7) published 2012. view increasing evidence, commissioned new Care, SOC-8.

Язык: Английский

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Transgender data collection in the electronic health record: Current concepts and issues

Journal of the American Medical Informatics Association, Год журнала: 2021, Номер 29(2), С. 271 - 284

Опубликована: Июнь 18, 2021

Abstract There are over 1 million transgender people living in the United States, and 33% report negative experiences with a healthcare provider, many of which connected to data representation electronic health records (EHRs). We present recommendations common pitfalls involving sex- gender-related collection EHRs. Our leverage needs patients, medical providers, researchers optimize both individual patient efficacy reproducibility EHR population-based studies. also briefly discuss adequate additions considering name pronoun usage. add disclaimer that these questions more complex than commonly assumed. conclude collaborations between local gender-diverse persons providers as well open inclusion individuals on terminology standards boards is crucial shifting paradigm health.

Язык: Английский

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Correlations between healthcare provider interactions and mental health among transgender and nonbinary adults

SSM - Population Health, Год журнала: 2019, Номер 10, С. 100525 - 100525

Опубликована: Ноя. 29, 2019

Transgender and nonbinary patients have a wide array of experiences when attempting to access healthcare, including discrimination having educate providers about trans people. This study examines the mental health factors connected transgender patients' experience with determine likelihood or receiving respectful care after provider knows patient's gender identity, people, controlling for sociodemographic factor. Using data from 2015 United States Trans Survey (

Язык: Английский

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Understanding Legal Frameworks Concerning Transgender Healthcare in the Age of Dynamism

Electronic Journal of Social & Strategic Studies, Год журнала: 2022, Номер 03(01), С. 56 - 65

Опубликована: Янв. 1, 2022

The topic of LGBTQ rights has sparked fierce debate both at national and global level for a long time. While the country undoubtedly progressed toward greater inclusivity because expansion certain legal protections community rising societal acceptance engagement in LGBTQ-inclusive discourse, continues to face discrimination workplace, education, healthcare. In recent years, against people been more obvious hospital setting. Patients reported variety experiences with prejudice, including being-denied reproductive treatment, counselling, regular screening, even paediatric care their children. For transgender people, health involves prevention, diagnosis, treatment physical mental illnesses, as well sex reassignment procedures. Gender variation, therapy, hazards particularly connection violence access healthcare Trans persons various nations throughout world are all topics covered care. Many governmental programmes commercial insurance plans continue specifically exclude transition-related Even once these restrictions gone, one must fight ensure that individuals have meaningful, complete care, free costly needless preconditions limitations on sorts can be delivered. Transgender Persons (Protection Rights) Act, 2019 enacted provide protection welfare matters.

Язык: Английский

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Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments

JAMA Network Open, Год журнала: 2022, Номер 5(7), С. e2224717 - e2224717

Опубликована: Июль 25, 2022

Importance

Medical education, research, and clinical guidelines are available to support the initiation of gender-affirming care for transgender nonbinary people. By contrast, little is known about experiences those who discontinue or seek reverse medical surgical interventions due a change in gender identity, often referred asdetransition.

Objective

To examine physical mental health people initiated detransition inform practice.

Design, Setting, Participants

Using constructivist grounded theory as qualitative approach, data were collected form in-depth interviews. Data analyzed using an inductive 2-stage coding process categorize interpret detransition-related Between October 2021 January 2022, individuals living Canada aged 18 years older with experience stopping, shifting, reversing transition invited partake semistructured virtual Study advertisements circulated over social media, clinicians, within participants' networks. A purposive sample 28 participants discontinued, shifted, reversed interviewed.

Main Outcomes Measures

In-depth, narrative descriptions discontinued sought prior and/or interventions.

Results

Among participants, (64%) assigned female at birth 10 (36%) male birth; 2 (7%) identified Jewish White, 5 (18%) having mixed race ethnicity (which included Arab, Black, Indigenous, Latinx, South Asian), 21 (75%) White. Participants initially gender-affirmation wide range ages (15 [56%] between 24 years). Detransition occurred various reasons, such evolving understanding identity concerns. reported divergent perspectives their past treatments. Some felt regrets, but majority pleased results was experienced physically psychologically challenging, yet avoidance common. described experiencing stigma interacting clinicians unprepared meet needs.

Conclusions Relevance

This study's suggest that further research guidance required address unmet needs this population

Язык: Английский

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Emphasizing Sexual Orientation and Gender Identity Data Capture for Improved Cardiovascular Care of the LGBTQ+ Population

JAMA Cardiology, Год журнала: 2024, Номер 9(3), С. 295 - 295

Опубликована: Янв. 24, 2024

Importance The rising self-identifying lesbian, gay, bisexual, transgender, and queer (LGBTQ+) population makes understanding the unique health care needs of sexual gender minoritized patients an urgent one. interaction between minority stress cardiovascular disease has been well described among underrepresented populations. underrepresentation populations in clinical research is partly responsible for worse outcomes these absence orientation identity expression (SOGIE) data it difficult to understand LGBTQ+ adults, thereby widening disparities this population. Advancing equity must begin with careful accurate SOGIE collection. Observations Current capture remains inadequate despite federal mandates. Challenges collection include political regulatory discrimination, patient/practitioner hesitancy, lack supportive guidance on collection, improper terminology, inertia, often incorrect integration into electronic records (EHRs). Additional challenges grouping participants as “others” statistical significance. inclusion demonstrated impact other fields like cancer survivorship surgery. same be done cardiology. Conclusions Relevance Potential solutions improving much-needed (1) implementing inclusive policies, (2) integrating EHR, (3) educating professionals relevance patient-centered care, (4) creating a diverse workforce. These steps can substantially enhance ability collect address disparities.

Язык: Английский

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The AFFIRM Framework for gender-affirming care: qualitative findings from the Transgender and Gender Diverse Health Equity Study

BMC Public Health, Год журнала: 2025, Номер 25(1)

Опубликована: Фев. 6, 2025

Abstract Background Transgender, nonbinary, and gender diverse (TGD) people experience stigma in healthcare settings impacting utilization, including avoidance of care due to anticipated discrimination. Gender-affirming refers for medical affirmation, such as gender-affirming hormones surgery, well general that affirms respects TGD patients. This study sought explore the experiences adults inform delivery develop an actionable framework practice. Methods Between May–October 2021, one-time individual in-depth interviews were conducted with 27 receiving any greater Boston Massachusetts area gather data about care. Interviews semi-structured, explored prior current ideal models, virtually via a secure Zoom platform. Analyses using immersion crystallization reflexive thematic analysis; interview transcripts double coded by two coders. Results Participants had mean age 28.5, ranging 18–45 years, were: 7 transgender men, 6 women, 8 3 genderqueer, 1 agender, 2 not specified. Themes coalesced into acronym AFFIRM: (1) Affirms interactions: called affirmation identity, lived expertise, competent providers staff. (2) Flexible accessible: expressed need be available beyond urban population-specific clinics, timely fashion without long wait lists, community-centered manner offering non-traditional times settings. (3) Fights systemic oppression: emphasized health systems eliminate gatekeeping practices create models resist intersecting oppressive racism cisgenderism. (4) Interacts community: Patients desired intentional interaction community holistically address unmet needs. (5) Retains patients care: shared collaboratively identify problem-solve obstacles optimize TGD-specific retention strategies. (6) Multidisciplinary: interdisciplinary teams co-located services primary mental letter-writing surgical care, incorporation peer navigators meet broader social, health, well-being needs people. Conclusions Findings from this AFFIRM Framework which emerged patient narratives can applied improve set benchmarks high-quality

Язык: Английский

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Training in LGBTQ-affirmative cognitive behavioral therapy: A randomized controlled trial across LGBTQ community centers.

Journal of Consulting and Clinical Psychology, Год журнала: 2022, Номер 90(7), С. 582 - 599

Опубликована: Июль 1, 2022

This randomized controlled trial examined whether an 11-week synchronous (i.e., real-time) online training in lesbian, gay, bisexual, transgender, queer, and other sexual or gender diverse (LGBTQ)-affirmative cognitive behavioral therapy (CBT) could lead to increased uptake of this practice at LGBTQ community centers across 20 U.S. states internationally.

Язык: Английский

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Health Care Avoidance and Delay in the Transgender Population: A Systematic Review Exploring Associations with Minority Stress

Transgender Health, Год журнала: 2024, Номер unknown

Опубликована: Фев. 12, 2024

Purpose: A wide body of research explores the substantial issue health care avoidance and delay (HAD) in transgender population, much focus has been given to minority stress model exploration associated factors. This review addresses gaps literature by investigating cumulative evidence for association between HAD stress, further examining individual facets stress. secondary aim this is examine how operationalization may impact our understanding findings.

Язык: Английский

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Experiences of and resistance to multiple discrimination in health care settings among transmasculine people of color

BMC Health Services Research, Год журнала: 2022, Номер 22(1)

Опубликована: Март 21, 2022

Research shows that transmasculine people experience discrimination based on their gender identity and/or expression (i.e., cissexism) while obtaining health care. However, studies examining the of other forms in care settings among diverse subgroups individuals, including those from minoritized racial/ethnic backgrounds, are very limited. Guided by intersectionality, we designed a qualitative research study to explore how color experience-and resist-multiple, intersecting settings. purposive sampling strategy, selected 19 young adults aged 18-25 years participate 5 mini-focus groups conducted between February and May 2019 Boston, MA. Focus group transcripts were analyzed using template style approach thematic analysis involved both deductive inductive coding codebook. Coded text fragments pertaining participants' experiences clustered into themes sub-themes. Transmasculine described experiencing notable challenges accessing physical mental as result structural barriers identifying providers with expertise transgender health, finding who share one or more social positions lived experiences, financial resources cover high costs. Further, participants discussed anticipating multiple interpersonal discrimination-both independently simultaneously-in settings, cissexism, racism, weight-based discrimination, ableism. Moreover, negative impact utilization, quality care, health. Lastly, various strategies resist multiple, they encounter setting boundaries providers, seeking competent shared positions, engaging self-advocacy, drawing peer support during visits, information through networks. Efforts needed address ableism, clinical encounters, institutions systems, society general advance multiply marginalized groups.

Язык: Английский

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