History on repeat: Silencing trans-related health information and violating health professionals’ ethical obligations

Introduction This systematic literature review (SLR) investigates the effects school environments have on the mental health outcomes of transgender and gender diverse students. Current literature highlights the need to support the mental health of transgender and gender diverse students in school, however the research synthesizing the existing research is limited. This SLR brings together existing literature exploring the school experience and mental health outcomes for this cohort in schools. Methods The review followed PRISMA Guidelines and included JBI quality appraisal tools of included studies. Four electronic databases were used, with literature searches conducted on 31 July 2023. Included studies were assessed against predetermined inclusion/exclusion criteria, with included studies written in English, no date or geographical limitations, online full-text availability, peer-reviewed, and relevant to the research question. , full-text review, and quality appraisal were conducted by two independent reviewers. Collected data were synthesized using a revised and three-levelled socio-ecological framework and further thematic analysis within the three categories. Results 15 studies were included for final synthesis with four using qualitative methodologies, and 11 being cross-sectional studies. The final synthesis comprised three themes, exploring structural level, interpersonal level and individual level barriers to optimal mental health outcomes for transgender and gender diverse students in school settings. Findings highlight and support previous findings of an alarmingly high rate of mental health concerns, including self-harm, suicide and suicidal ideation in transgender and gender diverse youth in school settings. Conclusions The current literature highlights the need to explore how denominational affiliations of school environments affect the experiences, challenges and mental health outcomes of transgender and gender diverse youth. Further research needs to comprehensively unpack the unique structural, interpersonal and individual needs of transgender and gender diverse youth in these diverse school environments, to then provide adequate and affirming support enhancing their overall health and wellbeing.

LGBTQ youth mental health during COVID-19: unmet needs in public health and policy

Bullying of sexual and gender diverse youth (SGDY) in our school systems occurs at alarming rates and is associated with mental health and academic concerns including depression, anxiety, suicidality, lower perceived safety and community at school, increased truancy, and poorer grades. Given the prevalence and negative impact of bullying on SGDY, educators must play an important role in preventing bullying and intervening effectively upon witnessing bullying. This chapter will highlight many effective strategies teachers can adopt to help prevent and respond effectively to bullying of SGDY. Methods for creating classroom environments that are safe and affirming of sexual and gender diversity, such as reducing heterosexist and cisgender bias, fostering prosocial and collaborative learning environments, facilitating school connectedness through group-based and service-learning activities supportive of LGBTQ persons, and adopting teaching materials (e.g., textbooks, lessons, vignettes) inclusive of affirming LGBTQ content, will be described. How teachers can serve as role models and support systems for their sexual and gender diverse students (e.g., serving as faculty sponsors of Genders and Sexualities Alliances (GSAs), being knowledgeable of LGBTQ community resources when appropriate, intervening effectively when bullying of SGDY occurs) will also be described.

Transgender and gender-diverse students may experience poorer school outcomes due to a threatening school climate. A rapid review using systematic search found 2,111 studies mentioned LGBTQ + students, but only three were peer-reviewed empirical tests of potential interventions to improve school outcomes among transgender and gender-diverse youth: (a) Sexual orientation, gender identity, and/or gender expression ( SOGIE) inclusive policies were associated with greater school safety, less victimization, less social aggression, and higher teacher support. (b) Among the interventions, the use of the chosen name in school reduced negative health outcomes. (c) Gay–Straight Alliances ( GSA) reduced reports of frequent gender-based bullying. Several implementation facilitators for school interventions included transgender and gender-diverse students, along with informative families, trained teachers, and supportive principals. Randomized controlled trials focusing on this population would contribute greater certainty when developing school interventions. The lack of high-quality studies should serve as a wake-up call to conduct the necessary research.

The third edition of Carole Edelsky’s text remains just as relevant for educational practitioners and language policy administrators today as when it was originally published some 15 years ago. While most of the text is the same (two new chapters have been added, as well as preand post-scripts in almost every chapter), the implications of this work have a new meaning in the present day. The ‘social’ aspect, referenced in the title, centers around the implications of second language and literacy learning in the social world. Recent social, political, and economic changes at both the global and local levels have made this focus even more important today. The ramifications of policy changes have affected students, teachers, and administrators, unfortunately not in positive ways. This text offers up a true picture of the educational landscape as it was and is, and suggestions on how to combat harmful policy with holistic pedagogy. Changes in this edition center on the recent political changes that are affecting education. Educational policy in the United States has undergone a dramatic shift, from being mainly an issue of local control to a federal one. With the implementation of education legislation entitled No Child Left Behind, the federal government has secured their grasp on educational policy, and its implications have been felt nationwide. Increasing pressure to produce, in the form of testing, has become the new focus of federal policy. As a result, teachers and students are deemed successful by their production of high test scores. Neo-liberalism is also at the heart of this current debate. Neo-liberalism is changing the face of education not only through a federal agenda, but also through a corporate agenda. As Edelsky writes, ‘‘It is not a test score gap, then, that accounts for the massive intrusion of the federal government into education but this need to control education to maintain corporate competitiveness in the global market’’ (5). Privatization of public schools is one area of neo-liberalism, currently affecting

A Systematic Review of Inflammatory Bowel Disease Epidemiology and Health Outcomes in Sexual and Gender Minority Individuals

This article examines patterns of popular trust in political and public institutions in Nepal. We ask to what extent such trust is linked, on one hand, to citizens’ social and political identities, and on the other hand, to citizens’ perceptions of institutional performance. Our findings demonstrate that trust in public institutions varies extensively. Trust is high for a number of professional institutions, such as schools and hospitals. It is also quite high for local government institutions. Trust in the parliament and the government is much lower. Furthermore, the analysis reveals a weak relationship between institutional trust and identity variables. Demographic and social characteristics of participants, such as caste, and religious and political affiliations, have little significance in explaining the level of citizens’ trust in political and public institutions. Such trust primarily depends upon how citizens assess the performance of these institutions. Hence, patterns of institutional trust depend on how participants evaluate the current macro-political situation in Nepal, whether recent political changes are judged to have gone in the right direction. In a more general and comparative perspective our findings from Nepal fit with a performance-based theory of institutional trust, while, to a large extent, they disconfirm identity-based explanations.

As more young people find language to describe their gendered experiences, education as a field is reckoning with how to best support and affirm them in schools. Research centering on the experiences of transgender and gender diverse students (TGDSs) has brought to light many issues that impact on their school experiences, such as lack of curricular visibility, in-school support, and lack of appropriate facilities, illuminating the systemic forces at play that hamper TGDS participation and livability in schools and drawing attention to the violence that is enacted against them through erasure and overt transphobia. Examining the pervasive violence that TGDSs face at school through a framework of epistemic injustice provides an entry point conceptualizing of violence as extending beyond direct physical or verbal victimization to include the harm done when an individual is disqualified by others as a knower of their own experience. Cultural cisgenderism, the systemic erasure of TGD people in all aspects of society, is the vehicle by which epistemic injustice organizationally and instructionally informs and creates school climates where TGDSs come to be subject to verbal and physical aggression. Understanding the violence that impacts on every aspect of TGDSs’ academic trajectories as expressions of cultural cisgenderism and epistemic violence provides educators with options for intentionally examining the ways in which school systems are complicit in the production of a silence and invisibility around gender diversity which cultivates unsafe gender climates and thus facilitates more overt forms of harm. Examining the more insidious and normalized forms of epistemic violence opens up space to probe more deeply into how a positive—not merely bearable—school experience might be imagined for and with TGDSs.

Using findings from a qualitative investigation based on in-depth asynchronous online interviews with 425 self-identified LGB Portuguese individuals (73.9 % gay, 12.3 % lesbian, and 13.8 % bisexual), this paper explores the role of political and legislative changes in the everyday lives of LGB individuals after the implementation of recent political and legislative changes in the country, such as the 2010 law allowing same-sex couples to marry and the 2016 law allowing same-sex couples to adopt and joint-adopt children. Participants were asked to complete a structured interview online, which consisted of socio-demographic questions concerning age, sexual orientation, gender, occupation, education, relationship status, and knowledge of the legislation that affected them as an LGB person. Participants were also asked to write a response to a single open-ended and fundamental question: “As an LGB person, what was the most important thing that happened to you over the last year because of the political and legislative changes concerning LGB rights implemented in Portugal?” The content analysis of the major findings was structured around the following main thematic areas: relationships and family, coming out issues, health issues, happiness and personal development, and social and political changes. The paper concludes by highlighting the importance of political and legislative changes in the everyday lives of LGB people, as delivering this type of knowledge is a very important tool to fight discrimination against LGB individuals.

Relative socio-economic position and meaning and purpose in life in adolescents: An intangible cost of social inequalities.

What Ethical Responsibilities Do I Have With Regard to Radiographs for My Patients?

Transgender and Gender Diverse (TGD) students and online education in Australia

Global health research for America's vital interest

On 30 March 2011, Myanmar's ruling junta, the State Peace and Development Council (SPDC), handed power to a new government led by President Thein Sein that had come into being in the wake of elections held in November 2010. Because all administrative and legislative bodies--both at the central and local levels--were controlled by members of the military-backed Union Solidarity and Development Party (USDP), political activists and Myanmar watchers did not expect more than superficial changes under the new government. Although President Thein Sein mentioned his plan to introduce administrative and economic reforms and to launch an anti-corruption campaign in his inaugural speech doubts remained that the president would actually be able to deliver on his promises. However, on 19 August 2011, to the surprise of many people, President Thein Sein met Aung San Suu Kyi, leader of the main opposition party, the National League for Democracy (NLD), at his official residence. Two days earlier, the President had invited exiled activists to return to the country. Aung San Suu Kyi publicly stated that she was very encouraged by her meeting with Thein Sein and that she had trust in his determination to bring about positive political change to the country. (1) The United States and some members of the European Union (EU) welcomed the meeting. On the other hand, several exiled activists had reservations about the sincerity of the President, with some going so far as to say that what Thein Sein had done was little more than a publicity stunt and that there was little difference between the new government and its predecessor. This article, drawing on interviews with serving and retired government officials, and political activists including leading NLD members, argues that since the new government has taken office a new era of political openness has begun in Myanmar. It goes on to illustrate that in order to understand recent political changes, one should pay attention to shifts in the internal power structure of the government. However, it is not a given that Myanmar will become a full-fledged democracy any time soon. Indeed this article suggests that the country is at a critical juncture, and that the expansion of political openness in the country will depend on whether liberals within the government and those from the pro-democracy movement can work together to further political changes without prompting the country's armed forces, the tatmadaw, to stage a coup. The Power Structure and Political Change in the SLORC/SPDC Government The military government that ruled Myanmar between late 1988 and early 2011 was formed in response to the nation-wide pro-democracy movement against the military-dominated socialist government led by General Ne Win. Although the junta, which was initially known as the State Law and Order Restoration Council (SLORC) and later renamed the SPDC, held multi-party elections in 1990, it refused to transfer power to the NLD even after the latter had won a landslide victory. Instead, the junta convened a decade long National Convention (NC) to adopt guidelines for a new constitution. Although opposition groups and the international community called for the transfer of power to the NLD, the SLORC ignored these calls. In fact, after the 1990 elections Myanmar's military leaders decided to defer political change for as long as possible. Political activists, on the other hand, continued to campaign for swift political change. As Huntington and many others have pointed out, democratization under an authoritarian regime might take place under the following conditions: when the regime is toppled by a social movement or seriously weakened by a crisis; when reformers from within the regime and liberals from the movement find a way to work together; or when the regime feels that it cannot survive without initiating political reform. (2) Some activists had hoped for a split in the government and tried to identify liberal officials they could work with. …

BackgroundMaking high-quality health and care information available to members of the general public is crucial to support populations with self-care and improve health outcomes. While attention has been paid to how the public accesses and uses health information generally (including personal records, commercial product information or reviews on healthcare practitioners and organisations) and how practitioners and policy-makers access health research evidence, no overview exists of the way that the public accesses and uses high quality health and care information.PurposeThis scoping review aimed to map research evidence on how the public accesses and uses a specific type of health information, namely health research and information that does not include personal, product and organisational information.MethodsElectronic database searches [CINAHL Plus, MEDLINE, PsycInfo, Social Sciences Full Text, Web of Science and SCOPUS] for English language studies of any research design published between 2010–2022 on the public’s access and use of health research or information (as defined above). Data extraction and analysis was informed by the Joanna Briggs Institute protocol for scoping reviews, and reported in accordance with the PRISMA extension for scoping reviews.ResultsThe search identified 4410 records. Following screening of 234 full text studies, 130 studies were included. One-hundred-and-twenty-nine studies reported on the public’s sources of health-research or information; 56 reported the reasons for accessing health research or information and 14 reported on the use of this research and information. The scoping exercise identified a substantial literature on the broader concept of ‘health information’ but a lack of reporting of the general public’s access to and use of health research. It found that ‘traditional’ sources of information are still relevant alongside newer sources; knowledge of barriers to accessing information focused on personal barriers and on independent searching, while less attention had been paid to barriers to access through other people and settings, people’s lived experiences, and the cultural knowledge required.ConclusionsThe review identified areas where future primary and secondary research would enhance current understanding of how the public accesses and utilises health research or information, and contribute to emerging areas of research.