Policy and prejudice: The impact of Trump-era executive orders on transgender employees

An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients

"Either/Or" and "Both/Neither": Discursive Tensions in Transgender Politics -- TEST

Transgender and gender nonconforming people defy society’s preconceived notions and norms of gender identity. As a result, they embark on a journey of self-discovery and risk rejection by society in general and their loved ones in particular. Although some may make their journey without substantial obstacles, many struggle mentally and have the additional burden of stigma and discrimination. Most policies now seem to bend toward justice. But counter examples exist; just witness the fear and backlash from legislators about who can and who cannot use which bathroom. Such legislation can cause stress and anguish, adding to any suffering that transgender and gender nonconforming people already experience. Prohibitive legislation, born of ignorance, echoes past policies about who could and who could not use bathrooms based on race. If, as healers, we accept that our role is to reduce suffering and increase wellness, it is imperative that we learn as much as we can about the trials, tribulations, and triumphs of transgender and gender nonconforming people. This issue of Psychiatric Annals, guest edited by Drs. Laura Erickson-Schroth and Tamar C. Carmel, is a great way to start. In what ways are transgender and gender nonconforming people marginalized? In the first article, Dr. Hilary Maia Grubb counts the ways by starting with the many definitions and combinations of anatomical birth sex and gender, sexual orientation, and gender identity. The author then discusses issues of access to care, barriers to insurance, discrimination and stigma, and assumptions by health care providers. It’s a moral issue of equity. What are the roles of psychiatrists working with transgender people? In his article, Dr. Jack Pula discusses how psychiatrists can help transgender people with the specific transitions (social, medical, surgical) and how psychotherapy can be helpful while avoiding harm. What mental health issues are faced by transgender people? In their article, the guest editors discuss trauma, discrimination, violence, mood disorders, self-harm, elevated suicide risk (especially in young people) as well as resilience. What are the gender diagnoses in both the Diagnostic and Statistical Manual of Mental Disorders2 and the International Statistical Classification of Diseases and Related Health Problems?3 In his article, Dr. Jack Drescher discusses how to use criteria to understand standard diagnoses. In the final article of this issue, Dr. Nathaniel Sharon discusses psychiatry’s role in supporting The Psychiatrist’s Role in Transgender Mental Health

The author of the chapter provides an overview of critical issues for transgender, nonbinary, or gender nonconforming people starting with defining transgender/nonbinary/gender nonconforming people for shared understanding. Next, the chapter’s author explores histories of oppressive forensic systems designed to target transgender or gender nonconforming people through their interactions with the police, the courts, and correctional institutions. Several key issues are overviewed that transgender people face in forensic systems include access to identity documents, criminal justice system mistrust, continuous cycles of system engagement, forensic systems failures, and double hard time. Subsequently, the author closes the chapter with observations and commentary about the current state of affairs governing transgender and gender nonconforming people’s interactions with forensic institutions as well as recommendations for forensic social work practice with transgender, nonbinary, or gender nonconforming people.

Transgender and gender non-conforming (TGNC) people are a highly stigmatized population experiencing high rates of minority stress and adverse health outcomes. Notwithstanding that, they are able to use adaptive coping strategies to buffer the effect of stigma on their health. Recently, vocational experiences of TGNC individuals were connected to minority stressors, highlighting the effects that stigma have on vocational outcomes. Through the lens of the minority stress theory, this study aimed at exploring the emotional and psychological implications of the gender transition process in the workplace in two male-to-female and six female-to-male Italian TGNC individuals taking part in the study "Re-interpreting organizations through transgender and gender non-conforming narratives". Participants sent their narratives to the editorial board of the PuntOorg International Journal (PIJ). Narratives were analyzed through the thematic inductive analysis. Three macro-categories were identified, each containing core themes, as follows: 1) Minority stressors (a. Transphobia and rejection; b. Felt stigma and stigma anticipation; c. Internalized transphobia; d. Passing as an obstacle); 2) Protective factors (a. Passing as a resource; b. Coming out, visibility, and intimacy with colleagues; c. Resilience); 3) Effect of minority stress on health (a. Depression; b. Anger and suicide ideation). Results and organizational implications are discussed.

Transgender health: an opportunity for global health equity

Transgender media studies is a fairly recent area of scholarship emerging at the intersections of communication studies, cultural studies, digital media studies, film studies, gender studies, media studies, television studies, and transgender studies. The earliest scholarship in this field primarily consisted of analyses of portrayals of transsexual characters on the screen. With the gradual broadening of LGBTQ scholarship facilitating coverage of trans issues, the growing global visibility of trans, transgender, non-binary, and gender non-conforming people, and the intermittent expansion of trans legal and human rights, transgender media studies began to develop as a vibrant area of study of its own. Transgender media scholarship moved from pathologizing approaches to victimizing approaches to resilience-focused approaches while keeping the empirically documented and often legally enshrined marginalization and discrimination of transgender people in public consciousness. At this moment, transgender media scholarship continues to examine the portrayals of transgender characters on screen, but the methodological and epistemological approaches to transgender media have greatly expanded to include, for example, how transgender people use media to organize, how print and digital media influence transgender identity development, how media can be used to educate publics and provide support, how cisgender people respond to transgender portrayals in digital, print, and broadcast media; and how researchers can help challenge normativity, pay attention to intersectionality, and surface marginalization. Early dominant portrayals of transgender people consisted of white, middle-class, middle-aged heteronormative transgender women, and scholarship reflected these dominant portrayals. In the 21st century, transgender media discourse has mostly broadened to include transgender men and gender non-conforming people, people of color and Two-Spirit people, people of a range of sexual orientations and gender identities, young people and seniors. Arguably, much of the increased diversity in transgender media research is attributable to the fact that transgender and gender non-conforming researchers came out publicly and/or entered the academy and brought forth research agendas informed by lived experience. This bibliography is not exhaustive. It seeks to reflect the range of transgender media scholarship at this point in time, acknowledging that “transgender media” as a conceptual category captures a particular moment in time only. As social and biological understandings of “gender” and “sex” begin to shift and loosen, it is likely that media scholarship will present a more holistic approach to the complex relationships between (trans)gender and media.

In my article in Radical History Review 138, “The Very Quintessence of Persecution: Queer Anti-Fascism in 1970s Western Europe,” I argued that “transgender and gender-nonconforming people and cisgender lesbians” led the way within 1970s European LGBT+ movements in connecting queer liberation, anti-fascism, and anticapitalism, and developing what I argue was a uniquely queer anti-fascism.1 I would like to clarify after publication that this was also the case for West Germany’s Homosexuelle Aktion Westberlin (HAW). On page 69 of my article, I referred to HAW queer anti-fascists as “trans and cis lesbian feminists,” “lesbians and trans people,” and “trans and cis feminists.”2 I intended to include gender-nonconforming activists in these formulations (within a broad notion of trans), but I have since received feedback that my formulation was confusing and led some to believe I was calling the Homosexuelle Aktion Westberlin’s Feminist Group (Femnistengruppe) a transgender women’s group or a cisgender lesbian’s group, neither of which would be accurate.The Feminist Group is an example of how gender-nonconforming queers led the way, along with transgender women and cisgender lesbians, in developing queer anti-fascism within HAW and in other European queer movements. The Feminist Group was founded as an organizing and social space for gender-nonconforming femmes who embraced revolutionary Marxism and reclaimed the German term Tunten for themselves. Tunten is historically a German slur, similar to English words such as sissy, used against effeminate queers. It connotes that the person being verbally attacked is specifically an effeminate man and is therefore usually used against gay men and as a transphobic slur against trans women and non-binary people. Members of the Feminist Group wore femme clothes and took femme names but most did not identify as trans women at this time. That does not say or mean anything about how they may have identified later. It is of course possible that some may have later come out or identified as trans women, trans*, non-binary, genderfluid, or another gender identity. This question is beyond the scope of my research here, but the Feminist Group itself was not founded as a trans women’s group. The Feminist Group was also not a cis lesbian group. Cis lesbians mostly, but not exclusively, organized within the HAW Women’s Group (Frauengruppe).3The members of the Feminist Group saw their own femme gender presentation as a challenge to bourgeois morality and therefore capitalism itself because they argued that fixed gender roles were a product, at least in part, of heteropatriarchal capitalism. They rejected gender roles and expectations all together in a way that they understood to be revolutionary and confrontational.4 They were not the only group where queer anti-fascists organized within HAW. Cis lesbian anti-fascists organized within the Women’s Group before queer socialists and intersectional activists were pushed out, and HAW’s explicitly revolutionary communist political position meant that queer anti-fascism was a part of discussions at regular plenary and group meetings at least before the cis male majority moved the organization away from political radicalness in the mid-1970s.Defining the gender and sexual identities of historical queer groups is never simple. Transgender studies problematizes rigid definitions of gender and distinctions between transsexuality, gender nonconformity, and gender variance today and in the past.5 I understand the members of the Feminist Group to be gender nonconforming, and in this paragraph on page 69 of my article, I attempted to include them under the umbrella of “trans” in line with what Susan Stryker has called “transgender phenomena,” which she has used to get at diverse gender practices including “transsexuality and crossdressing, some aspects of intersexuality and homosexuality, cross-cultural and historical investigations of human gender diversity, [and] myriad specific subcultural expressions of ‘gender atypictality.’”6 However, I regret my formulation here because it caused confusion and was out of step with the relatively clearer formulation I had used in my introduction and elsewhere (“transgender and gender non-conforming people and cisgender lesbians”7) and which I further defined in endnote 4 where I clarified that “transgender, lesbian, and gender-nonconforming are not exclusive terms. The reference highlights the contributions of overlapping identities marginalized within the LGBT+ movement.”8

Treating Family Members of Transgender and Gender-Nonconforming People: An Interview With Eric Yarbrough, M.D.

ObjectivesTransgender and gender non-conforming people may face elevated rates of shame and self-criticism in light of minority stress. Compassion-focused therapy has a growing evidence base in addressing trans-diagnostic processes in mental health difficulties, including shame and self-criticism. The objective of the present study was to explore the experience of an initial pilot compassion-focused therapy group delivered online in a Gender Service during the COVID-19 pandemic.MethodsSix transgender people completed a semi-structured interview after attending an 8-week compassion-focused therapy group in a national Gender Service. Inductive thematic analysis was used to identify themes in the data.ResultsFour themes were identified from the data: Transition Needs Compassion; Acceptability of the Compassion-Focused Approach; Being in a group with other transgender people; and Online delivery works despite its challenges. Participants reported that the compassion-focused framework was an appropriate and helpful way of understanding their experiences of stigma and that both the content and process of the group had benefitted them. Being with other transgender people raised some anxieties, such as comparisons or fear of offending, but also enabled seeing the self in more positive and accepting ways. While online delivery had some challenges, participants largely felt it was an effective mode of delivery, aided by the experiential nature of the group.ConclusionsCompassion-focused therapy seems to be a feasible and acceptable approach for transgender and gender non-conforming people. Group processes may be helpful in increasing self-acceptance. Further quantitative exploration of therapy process and outcomes is warranted.

Sari Reisner—making transgender health visible

Conduct a systematic review of abuse of transgender and gender nonconforming (TGNC) people in childhood. Scopus, PubMed, PsychInfo databases were searched. Articles included in final analysis were those with respondents who reported childhood abuse and were either transgender adults or described gender nonconforming traits in childhood. Of 186 articles originally identified, 14 are included in the final review. Research on TGNC individuals and child abuse varied in how populations were identified and methodology used. Those who are transgender and those who display gender nonconforming traits in childhood are at risk for child abuse and sequelae. Research should use the two-step methodology of identifying transgender people. Recalled Childhood Gender Identity Scale should be used. Providers should screen for child abuse.

Improving Research Methodology in Adolescent Sexual Health Research

Visibility for transgender and gender nonconforming people and the elderly is growing; however, thus far the overlap of the two groups has rarely been considered. Trans persons therefore remain largely invisible in the context of older people’s care and medicine. The discrimination faced by this group is at least twofold: they are the targets of aggression incited by transphobia, and also by ageism. Although older trans and gender nonconforming people exist as a greatly marginalized group within another already marginalized group, even the field of theological ethics has neglected to grant them ethical attention. This leads to especially harsh consequences for elderly transgender and gender nonconforming people due to their specific vulnerabilities. There are reports from trans persons who have resolved never to make use of health services again due to regular experiences of transphobia in medical settings. There are religious components within transgender and gender nonconforming issues that should not be overlooked in this context. On the one hand, medical staff, in the name of their Christian beliefs, have refused to provide trans persons with basic medical care. On the other hand, demands for places of visibility, and spaces for the individual, are regularly made in trans-positive studies, and can be linked to discussions within theological ethics about giving space. Some ethical formulas within the Hebrew and Christian traditions focus on the creation of space in which other beings may exist, as found in concepts like brother–sisterhood, friendship, and Sabbath. By casting light on elderly trans and gender nonconforming people, and on their demands for space, via reflections on ethical concepts of space-making, this study develops a specific understanding of space for elderly trans persons. The paper aims to develop an understanding of trans-positive spaces within theological ethics and applied ethics. Spaces that assume a withdrawal or contraction by all those who have previously taken up trans spaces through ignorance, contempt, or violence, should not thereby become spaces of absence: indeed, elderly trans and gender nonconforming people might be in need of both kinds of spaces, those where otherness enables withdrawal, and those where the helping presence of others continues.

Considerations for Providing Pediatric Gender-Affirmative Care During the COVID-19 Pandemic