“I Fear for My Safety, but Want to Show Bravery for Others”: Violence and Discrimination Concerns Among Transgender and Gender-Nonconforming Individuals After the 2016 Presidential Election

Bone Densitometry in Transgender and Gender Non-Conforming (TGNC) Individuals: 2019 ISCD Official Position

To date, there is no literature on orchiectomy as a stand-alone procedure in the transgender surgical context. To propose a simple guide to aid health-care professionals caring for transgender and gender nonconforming individuals seeking bilateral simple orchiectomy. We use expert opinion to provide a novel guide for simple orchiectomy in the transition-related context for health-care professionals caring for transgender and gender nonconforming individuals. A review of relevant literature was also performed focusing on simple orchiectomy and vaginoplasty surgeries for transgender and gender nonconforming individuals. We describe the indications, surgical approach, preoperative and postoperative assessment, and the risks and benefits of bilateral simple orchiectomy in the context of gender surgery. This article is the first, to our knowledge, to describe a structured guide to bilateral simple orchiectomy in the context of gender surgery for health-care professionals caring for transgender and gender nonconforming individuals. Bilateral scrotal orchiectomy is a simple surgical procedure that has a defined role in the surgical management of many transgender individuals. This article provides an approach to simple orchiectomy in the context of gender surgery for health-care professionals. Only guidelines written in English were included. The quality of the included guidelines was not evaluated, but this was beyond the scope of this review. We present a novel guide for health-care professionals caring for transgender and gender nonconforming individuals seeking bilateral simple orchiectomy in the context of gender surgery. Francis C, Grober E, Potter E, etal. A Simple Guide for Simple Orchiectomy in Transition-Related Surgeries. Sex Med Rev 2020;8:492-496.

Transgender and gender nonconforming (TGNC) individuals face negative consequences linked to prejudice, including homelessness and violence. One medium that perpetuates prejudice toward TGNC individuals is our choice in language. Biased language is related to prejudiced attitudes. Use of gender-inclusive language, however, promotes gender equality. Previous research has examined gender-inclusive language use regarding cisgender men and women, but little work has focused on gender-inclusive language use regarding TGNC individuals. Two studies explored the connections between attitudes toward transgender individuals and perceptions of TGNC-inclusive language. Three hierarchical linear regressions and a mini meta-analysis were conducted. Results suggest that people with negative attitudes toward transgender individuals perceive greater difficulty in using gender-inclusive language. These findings suggest that inclusive language use may be indicative of more positive attitudes.

Transgender and gender nonconforming individuals face myriad challenges, indignities, and dangers while incarcerated. Researchers have only recently begun to turn an eye toward issues such as the widespread physical and sexual violence experienced by transgender people held in sex-segregated correctional facilities. Some emerging scholarship also highlights common problems – including discrimination from correctional staff and other residents, denial of necessary medical treatment, and limited access to gender-affirming items (such as gender-appropriate underwear and grooming products) – confronting many incarcerated transgender and gender nonconforming individuals. Though this is a growing area of interest, the experiences of transgender and gender nonconforming individuals in the criminal legal system remain critically understudied. This chapter explores the state of scholarship surrounding the incarceration of transgender and other gender nonconforming individuals, highlighting what little is known, and more importantly what remains unknown, about the realities of life as a transgender or gender nonconforming individual in jail or prison. Additionally, this chapter analyzes the various benefits and drawbacks of correctional strategies premised on increasing the safety and improving the lives of incarcerated transgender and gender nonconforming individuals, including specialized LGBTQ+ housing blocks and widespread use of administrative segregation (i.e., solitary confinement). We rely on both case studies as well as a small number of interviews we conducted with transgender residents in both men’s and women’s prisons, including several we interviewed while they were incarcerated in restricted housing (i.e., solitary confinement) units. Finally, this chapter offers policy recommendations for correctional departments seeking to provide safe, fair, and affirming housing/care for transgender and gender nonconforming individuals.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals face social, economic, legal, health, and health care–related disparities amid evolving threats to sociopolitical advances made in the last decade ([1][1],[2][2]). In response, organizations, including the National Institutes of

Converging evidence indicates transgender and gender non-conforming (TGNC) individuals generally experience poorer health than their cisgender counterparts. Less is known about TGNC health across gender identity subgroups. Extant work has yielded mixed findings, precluding conclusions regarding the comparative health of transgender women, transgender men, and gender non-conforming individuals. Additionally, this work is limited methodologically, e.g., utilizing convenience samples and operationalizing “transgender” differently across studies. This study aims to improve upon these limitations, and more broadly add to the literature on within-group health differences among TGNC individuals. We used 2016 U.S. population-level data (N = 1,117), conducting MANCOVA (multivariate analysis of covariance) and logistic regression to compare the health of transgender women, transgender men, and GNC individuals. Health outcomes of mental and physical health, substance use, and healthcare access/utilization were selected based on empirical and theoretical support for their relevance to TGNC health. We also completed interaction analyses to test the intersectional effects on health of gender identity and emergent sociodemographic variables, e.g. race/ethnicity. Across TGNC subgroups, individuals reported similar alcohol use, mental health, and healthcare access/utilization. Transgender men reported worse physical health than their counterparts, and GNC individuals reported lower smoking prevalence than their counterparts. Interaction analyses by race/ethnicity indicated Hispanic transgender women reported worse physical health than other Hispanic TGNC individuals, while Black transgender men, Multiracial GNC individuals, and Hispanic transgender women reported worse mental health than some of their intra-racial/ethnic TGNC counterparts. Findings add to the growing literature on TGNC health and highlight TGNC subgroups that may be vulnerable regarding mental and physical health.

Transgender individuals' cancer prevalence and transgender cancer survivors' health needs have received scarce attention. The current study compared transgender and cisgender individuals' cancer prevalence and described the health needs of transgender cancer survivors. The authors used Behavioral Risk Factor Surveillance System data on 95,800 cisgender and transgender individuals who self-reported a cancer diagnosis. Using multiple logistic regression, they estimated cancer prevalence and calculated odds ratios with 95% confidence intervals of physical, psychological, overall health, and health behaviors of transgender survivors compared with cisgender survivors. After adjusting for confounders, transgender men had a significantly higher (>2-fold) number of cancer diagnoses compared with cisgender men, but not cisgender women. Cancer prevalence among gender nonconforming individuals and transgender women was not significantly different from that of cisgender men and cisgender women. Gender nonconforming survivors had significantly greater physical inactivity, heavy episodic alcohol use, and depression compared with cisgender men and cisgender women. Transgender men survivors were significantly more likely to report poor physical health and greater medical comorbidities and were less likely to report smoking compared with cisgender men and cisgender women. Transgender women survivors were significantly more likely to report diabetes compared with cisgender men and cisgender women and were more likely to report cardiovascular disease compared with cisgender women. Clinicians should be aware of the higher prevalence of cancer among transgender men and a potential survivorship bias among transgender individuals. Transgender survivors have considerable variation in their risk profile. Clinicians and health services can target gender nonconforming survivors' depression and health behaviors to improve survival and should address the complex comorbidities of transgender men and transgender women.

ABSTRACTThe goal of the study was to examine the association between depression and perceived community tolerance after controlling for various demographic and personal characteristics, treatment receipt, and past experiences with abuse or discrimination. An online survey assessed depressive symptoms among transgender and gender nonconforming individuals. Depression was assessed using the 7-item Beck Depression Inventory for Primary Care (BDI-PC) and the 10-item Center for Epidemiologic Studies Depression (CESD-10) scale. The prevalence ratios (95% confidence intervals) comparing depression in persons who did and did not perceive their area as tolerant were 0.33 (0.20–0.54) for BD-PC and 0.66 (0.49–0.89) for CESD-10. Other factors associated with depression were experience with abuse or discrimination, lower education, and unfulfilled desire to receive hormonal therapy. Depression was common in this sample of transgender and gender nonconforming individuals and was strongly and consistently associated with participants’ perceptions of community tolerance, even after adjusting for possible confounding. The association between desire to receive hormonal therapy and depression is a finding that warrants further exploration. Future research should also assess depression and changes in perception of community tolerance in transgender individuals before and after initiation of gender confirmation treatment.

Transgender and gender non-conforming (TGNC) individuals face high levels of discrimination and mistreatment, including within social and medical service settings, which may lead to negative health and psychosocial sequelae. Given the many barriers to competent care, we sought to determine points of intervention by assessing the current needs, satisfaction, and health care utilization of TGNC individuals in New York City as reported by TGNC individuals. In January 2013, fifty TGNC individuals were recruited via flyers and direct referrals from healthcare professionals within community spaces and pertinent venues. We administered a brief survey and conducted four focus groups exploring participants' health care utilization and perceived barriers to care, routine care, hormone and silicone use, and recommendations for improving transgender services. Participants were 18- to 64-years-old, racially/ethnically diverse, and the majority were medically insured, underwent routine health care in the last year, and received an HIV test in their lifetime. A significant proportion reported taking hormones prescribed by a medical provider and were in the care of knowledgeable providers. Participants perceived four areas where barriers persisted: utilization of preventive services, access to transition-related procedures, access to legal assistance, and inclusion of TGNC individuals in public health education and campaigns. Structural interventions are needed, such as comprehensive provider training programs for all level staff to better serve the needs of TGNC individuals, increase service utilization and improve wellbeing, while effecting lasting institutional change. Service provision establishments should hire more TGNC staff and integrate transgender care into existing practices.

Given the increasing diversity among older adults and changes in health policy, knowledge is needed on potential barriers to health care for transgender and gender non-conforming (GNC) individuals. Using the 2010 National Transgender Discrimination Survey (NTDS), logistic regression models test differences between age groups (below 35, 35-49, 50-64, and 65 and above) in lifetime experience of anti-transgender discrimination, harassment, and victimization within health care settings while considering the influences of insurance status, level of passing, time of transition, and other socio-demographic factors. Although more than one fifth of transgender and GNC individuals of all ages reported health discrimination, harassment, or victimization, significant age differences were found. Insurance status and level of passing were also influential. Medicare policy changes and this study's findings prompt further consideration for revising other health insurance policies. In addition, expanded cultural competency trainings that are specific to transgender and GNC individuals are crucial.

Introduction: Gender-nonconforming people undergo unimaginable sexual and physical abuse. This leads to stress and other stress-related disorders which can be easily determined by salivary stress biomarkers. Early life stress has an association with the immune system linked with stress. Transgenders and gender nonconforming people are prone to sexual abuse in early life more compared to normal people. This study aims to know about the association between sexual and physical abuse experience and salivary stress biomarkers in Transgender and gender-nonconforming individuals. Materials and Methods: This study was a cross-sectional epidemiological study. A snowball sampling design was adopted. The study was conducted in various places in Thozhi Shelter for Transgenders, Chetpet, Chennai among Gender non-conforming individuals and Transgenders. This study was conducted in April 2022. MDA and IL-6 levels were determined from their saliva using the passive drool method. Result: Interleukin L 6 and MDA levels were significantly higher in the GNC Group than in the control group. 63.64% of Transgender and gender non-conforming individuals experienced sexual abuse whereas 73% of them have experienced physical abuse in their lifetime. Conclusion: Transgender and gender non-conforming individuals who experienced physical/sexual abuse have increased IL 6 levels and decreased MDA levels in saliva when compared to the non-transgender individuals.

Transgender and gender nonconforming (TGNC) individuals interact with mental health care systems at high rates and experience substantial barriers to care. Rural TGNC individuals face additional disparities in accessing appropriate mental health services. Little research has focused on the mental health care providers who work with TGNC individuals in underserved areas. The current study sought to describe the mental health care services delivered by providers perceived as affirming by TGNC community members in the Central Great Plains. We conducted qualitative interviews with 10 providers to understand how providers seek cultural competency and conceptualize and work with their TGNC clients given the barriers to care. Providers held diverse theoretical orientations and described challenges to working with TGNC clients, including the impact of stigma and marginalization and financial and structural barriers to care. Emphasis was placed on individualizing care, helping clients to manage stigma and build resiliency, connecting clients to resources (when available) and support systems, and navigating the intersections of physical health care and mental health care, such as writing letters for medical transition. Providers largely educated themselves on TGNC topics and had previous experience working with marginalized populations. Overall, the providers' approaches to working with TGNC clients mapped onto models of cultural competency, but few providers described their work in the context of an evidence-based model. Implications for increasing the quality and availability of mental health care services for TGNC individuals in underserved areas are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Transgender and gender nonconforming (TGNC) individuals are at heightened risk for psychological distress, including social anxiety (SA). The current study aimed to examine whether gender-affirming medical interventions (GAMIs) are associated with lower SA among TGNC individuals. Two hundred ninety-one transfeminine and 424 transmasculine participants completed the Trans Health Survey, which assessed SA and interest in or utilization of GAMIs (genital surgery, chest surgery, hormone use, speech therapy, tracheal shave or Adam's apple removal, hair removal). Transfeminine individuals who had completed genital surgery, chest surgery, tracheal shave or Adam's apple removal, hair removal, hormone treatment, or speech therapy reported lower SA than those planning to undergo the intervention, and those who had completed genital or chest surgery reported lower SA than those considering it. Transmasculine individuals who had completed chest surgery, a hysterectomy, or used hormones reported lower SA than those who were planning to do so, and those who had completed genital surgery had lower SA than those considering it. Among those expressing interest, utilization of GAMIs is associated with less SA. GAMIs may result in greater conformity to societal expectations regarding binary gender norms, thus decreasing discrimination, rejection, victimization, and nonaffirmation. Increased alignment of physical characteristics and gender identity may increase self-esteem. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Transgender individuals have unique experiences with the law. Legal protections against pervasive discrimination have come slowly and, in some cases, not at all. Through litigation, attorneys in the United States have challenged the law’s conceptualization of gender and its definition of sex. Some of these cases have served to fortify protections against discrimination and victimization for transgender individuals. Despite this progress, transgender individuals continue to experience discrimination that affects their physical, psychological, and socioeconomic health. The following chapter discusses a few of the landmark U.S. cases and changes in legislative policy that have been crucial in determining the rights of transgender and gender nonconforming individuals.

Purpose: Transgender individuals experience barriers to healthcare, including discrimination in care provision and lack of knowledge about transgender health. We assessed New York City (NYC) transgender and gender nonconforming individuals' sexual and reproductive health (SRH) needs, access to services, and interest in receiving services from Planned Parenthood of NYC (PPNYC).Methods: We conducted an anonymous Internet-based survey of transgender individuals residing in NYC from September to December 2014 by using snowball sampling.Results: Data were analyzed from 113 surveys. Although 74% (71/96) of respondents avoided or delayed healthcare in the past year, most respondents adhered to medically indicated SRH screenings. In the past year, 64% (45/70) and 67% (46/69) of respondents were tested for HIV and other sexually transmitted infections, respectively. In the past 3 years, 80% (39/49) of respondents received clinical breast/chest examinations and 83% (35/42) of eligible individuals received Pap tests. Respondents most often received care at LGBT specialty clinics (35% [37/105]) or at private doctors' offices (31% [32/105]). Eighteen percent (19/107) had ever been to a Planned Parenthood health center. On a four-point scale, respondents rated the following factors as most influential on whether they would seek care at PPNYC: assurance that staff received transsensitivity training (mean 3.8), the existence of gender identity nondiscrimination policies (mean 3.7), and the availability of transgender-specific services, such as hormone therapy (mean 3.7).Conclusions: Although the majority of transgender individuals in our sample received recommended SRH screenings, respondents reported barriers to accessing needed medical care. Healthcare organizations interested in better serving the transgender community should ensure a high level of training around transsensitivity and explore the provision of transgender-specific services.