The right of transgender people to be resilient!

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

Nineteen trans youth participated in a phenomenological study of their resilience strategies for navigating stressors in their lives. The authors identified 5 supports and 6 threats to participants’ resilience. The 5 themes of resilience were: (a) ability to self‐define and theorize one's gender, (b) proactive agency and access to supportive educational systems, (c) connection to a trans‐affirming community, (d) reframing of mental health challenges, and (e) navigation of relationships with family and friends. The 6 major threats to participants’ resilience were: (a) experiences of adultism, (b) health care access challenges, (c) emotional and social isolation, (d) employment discrimination, (e) limited access to financial resources, and (f) gender policing.

Gender-Affirming Hormone Therapy Linked to Better MH in Trans Youth

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

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

Review: <i>Transforming Prejudice: Identity, Fear, and Transgender Rights</i>, by Melissa R. Michaelson and Brian F. Harrison

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

Disclosure: D. Stroumsa: None. E.E. Marsh: None. P.N. Pfeiffer: None. C. Jiang: None. A. Vrolijk: None. M.B. Moravek: None. Bridging the Gap: Utilization of Emergency Services by Transgender People in the United States, 2006-2018Introduction: Transgender or nonbinary (Trans) people face significant health disparities, including in access to primary and preventive care. These disparities are driven by structural, interpersonal, and individual stigma, which lead to barriers accessing care and avoidance of primary care, and to increased reliance on emergency care. We aimed to characterize ED use by Trans patients, and changes in such use over time. Methods: Data was obtained from the Nationwide Emergency Department Sample (NEDS) , which is a weighted stratified sample of hospital-based ED visits. Using gender-dysphoria related ICD-9 and ICD-10 diagnostic codes, we compared visits among trans people to those without such a diagnosis, adjusting for age, region, urbanicity, primary payer, and income quartile. We evaluated rates of chronic condition and mental health conditions as primary diagnosis at presentation and at admission. Presence of chronic conditions was assessed using the ICD-9 Chronic Condition Indicator for 2006-2014. Results: There was a rapid temporal increase in the proportion of visits with a trans-related diagnosis, from 0.001% of visits in 2006 to 0.016% in 2018. There were significant demographic differences between trans people and others. Trans people were significantly more likely to be admitted, adjusting for payment, age group, region, income and mental health condition (overall 52.4% vs. 17.3%, adjusted OR= 7.368 95% CI (6.771, 8.017)). A large proportion of ED visits by trans individuals was associated with a mental health diagnosis (28.7%, compared with 3.9% for others, p&amp;lt;0.001; adjusted OR =2.01, 95% CI 1.91-2.11) and/or with a chronic condition (58.2% vs. 19.2%, p&amp;lt;0.001; adjusted OR =3.65, 95% CI 3.61-3.69). Similarly, hospital admission among trans people was much more likely to be linked to a mental health condition (37.2% vs. 5.3% , p&amp;lt;0.001; adjusted OR = 2.78, 95% CI 2.44-3.16) or chronic condition (67.3% vs 41.3%, p&amp;lt;0.001; adjusted OR = 2.21, 95% CI 1.78-2.75) Discussion: The high admission rates, and high proportion of trans people with a chronic condition or with mental illness, may represent worse overall health due lack of primary care, or a delay in seeking emergency care among Trans people. Lastly, these findings could be a manifestation of a higher likelihood of a trans-related diagnostic code being charted among trans people at admission, or bias towards higher likelihood of trans people receiving a mental-health related diagnosis. There is a need for increasing access to affirming primary and mental health care among trans people, and increased training of emergency clinicians. Presentation Date: Saturday, June 17, 2023

Across countries, demand for gender-affirming care is rising at unprecedented rates. 1 Services are struggling to adapt and some are failing to protect transgender health in fundamental ways. Given the complexity of this situation, both medically and politically, it is perhaps unsurprising that gender identity services have neglected to expand beyond addressing individual needs of transgender people themselves to integrate members of transgender people's social networks throughout care. Relational partners (e.g., parents, romantic partners,

Transgender (trans) people (including non-binary persons) experience high rates of violence and discrimination regarding their gender identity and expression, necessitating a deeper understanding of trans peoples’ perceptions of safety within their communities and their perspectives on well-being. The purpose of this study was to gather insight into the perceptions of safety and community inclusion among trans people, through the lens of Meyer’s Minority Stress Model. Thirty-three trans individuals residing in a mid-sized urban and rural region, 100 kms west of Toronto, Canada, were interviewed for a larger study focused on experiences of discrimination. For this paper, we conducted a thematic analysis using NVivo (version 12), that included 18 participants from the larger study, including trans men, trans women, and non-binary individuals. Both experiences of prejudice and anticipations of prejudice resulted in participants feeling unsafe. This negatively affected their well-being, consistent with Meyer’s Minority Stress Model. Additionally, we found that environments absent of prejudice or considered supportive, such as places participants received social gender affirmation and LGBT-connectedness, fostered feelings of safety and positive well-being. Our study indicates a need to address not only the external events of prejudice towards trans people, but also the stress associated with the anticipation of prejudice.

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

Trans people—and particularly trans youth—have come to the forefront of political and educational discussions, especially as legislation has aimed to ensure that school personnel act as enforcers of state-level policies targeting trans youth. For this reason, and because research demonstrates that youth in schools form attachments to and receive support from school personnel, our research looks at school personnel’s development as allies. By analyzing focus group data following a training workshop, we explore how participants understand their roles as allies to trans and gender non-conforming youth. We found that trans issues were salient and participants expressed new knowledge about and openness towards transgender youth, as well as care and concern for their wellbeing. Nonetheless, many participants retained frames of understanding that relied on trans people as Other and that situated their roles as allies through the frameworks of protection and care. We argue that these understandings of trans youth and the role of allies reinforces cisnormativity, and we push for a more nuanced understanding of allyship that moves beyond knowledge, beliefs, attitudes and intended behaviors as markers of allyship to ensure that allies do not reproduce cisnormativity even in their support of trans and gender non-conforming youth.

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

Transgender (hereafter: trans) people are rarely included in human trafficking research. This empirical study presents narratives of trans individuals who report experiences consistent with the Palermo Protocol’s definition of trafficking, access to anti-trafficking services for trans individuals, and attitudes of anti-trafficking advocates and law enforcement toward trans people. Ethnographic fieldwork conducted for 30 months between March 2017 and August 2019 in Los Angeles and New York City included in-depth interviews with sex workers and trafficked persons (n = 50), of whom 26 were trans, and key informants (n = 17) from law enforcement and social services. Most trans participants who reported exploitation did not self-identify as victims of trafficking nor were they identified by police or anti-trafficking organizations as victims. Law enforcement gatekeeping was identified by anti-trafficking advocates as a barrier to meeting the needs of trans clients because they were viewed as “less exploitable” than cisgender women. Discriminatory law enforcement practices resulted in the exclusion and hyper-criminalization of trans migrants and people of color who were profiled not only by gender, but also race/ethnicity and immigration status.

BackgroundStudies of HIV-related risk in trans (transgender, transsexual, or transitioned) people have most often involved urban convenience samples of those on the male-to-female (MTF) spectrum. Studies have detected high prevalences of HIV-related risk behaviours, self-reported HIV, and HIV seropositivity.MethodsThe Trans PULSE Project conducted a multi-mode survey using respondent-driven sampling to recruit 433 trans people in Ontario, Canada. Weighted estimates were calculated for HIV-related risk behaviours, HIV testing and self-reported HIV, including subgroup estimates for gender spectrum and ethno-racial groups.ResultsTrans people in Ontario report a wide range of sexual behaviours with a full range of partner types. High proportions – 25% of female-to-male (FTM) and 51% of MTF individuals – had not had a sex partner within the past year. Of MTFs, 19% had a past-year high-risk sexual experience, versus 7% of FTMs. The largest behavioural contributors to HIV risk were sexual behaviours some may assume trans people do not engage in: unprotected receptive genital sex for FTMs and insertive genital sex for MTFs. Overall, 46% had never been tested for HIV; lifetime testing was highest in Aboriginal trans people and lowest among non-Aboriginal racialized people. Approximately 15% of both FTM and MTF participants had engaged in sex work or exchange sex and about 2% currently work in the sex trade. Self-report of HIV prevalence was 10 times the estimated baseline prevalence for Ontario. However, given wide confidence intervals and the high proportion of trans people who had never been tested for HIV, estimating the actual prevalence was not possible.ConclusionsResults suggest potentially higher than baseline levels of HIV; however low testing rates were observed and self-reported prevalences likely underestimate seroprevalence. Explicit inclusion of trans people in epidemiological surveillance statistics would provide much-needed information on incidence and prevalence. Given the wide range of sexual behaviours and partner types reported, HIV prevention programs and materials should not make assumptions regarding types of behaviours trans people do or do not engage in.