Care For Transgender People Research Articles

Attitudes and behaviours of mental health professionals in the care of transgender people: A qualitative study.

INTRODUCTION: Transgender people face against significant barriers in accessing mental health services due to, among other reasons, discrimination and a lack of expertise among professionals. To explore the beliefs and attitudes of professionals in the mental health network of the region of Murcia towards transgender people, focusing on aspects such as knowledge, perceptions, and prejudices about gender identity. We carried out a qualitative study involving 14 participants, conducting semi-structured interviews based on prior knowledge of the topic. We asked the professionals about their experiences and challenges in their clinical interaction with transgender users and followed an inductive-deductive process to analyse the data. Two main themes were identified from the interviews, which were sub-categorised into different sub-themes: (a) beliefs about transgender people: underlying factors and origins of gender diversity, health needs, and stereotypes about the demand for health care; (b) attitudes and behaviours of professionals towards transgender people: pathologization and attitudes towards decision-making. Our findings suggest that mental health professionals tend to oversimplify the factors underlying gender diversity and hold certain stereotypical beliefs about these users that oversimplify the complexity of their experiences.

A survey of Irish dermatologists' confidence in caring for people who identify as transgender patients in dermatology settings.

We surveyed Irish dermatologists’ confidence in caring for people who identify as transgender patients. The majority of respondents had not previously received education around the care of transgender people in dermatology, and most agreed they would benefit from this.

P.91 Putting the ‘T’ in Inclusivity - improving perinatal care for transgender people

P.91 Putting the ‘T’ in Inclusivity - improving perinatal care for transgender people

A Content Analysis of Osteopaths' Attitudes for a More Inclusive Clinical Practice towards Transgender People.

Objectives. The aim of this qualitative study was to explore the attitudes, beliefs, and preferences of Italian osteopaths regarding the management of transgender patients through a content analysis of emergent data from semi-structured interviews. Methods. This study was a content analysis based on the Standards for Reporting Qualitative Research guidelines. Purposive sampling of 10 Italian osteopaths was applied. Data were collected through semi-structured interviews, from March to April 2021, and subsequently transcribed verbatim with the content analysis carried out as an iterative process. Results. One participant was excluded during the first interview due to them being unsuitable for this study. Data saturation was reached after two interviews with the remaining nine participants. Data analysis revealed four main themes: microaggressions, acceptance and non-judgement, person-centered treatment, and education implementation. Conclusions. This study presents cisgender Italian osteopaths’ attitudes in the care of transgender people, revealing the desire to embrace and apply osteopathic tenets regardless of the patient’s gender identity.

The pharmacist’s role on transgender care: findings from a literature review

Transgender is a broad-spectrum term referring to people who do not match their assigned sex at birth. Several issues, including social detachment, poor access to healthcare services, and the lack of social/economic opportunities, have historically affected this population. In this scenario, pharmacists - not mentioned in national and international clinical guidelines/protocols regarding transgender care - might be key professionals to serve and care for this population. The main goal of this literature review was to identify the pharmacists’ role in the care of transgender people. The articles were retrieved from scientific databases. After applying filters (e.g., language, full-text availability, and coverage of the research question), seven articles were included in this review. The articles did not present pharmaceutical experiences or practices regarding transgender healthcare. Instead, some articles stressed the inadequate or inappropriate use of hormones and their side effects, also covering the role of this issue in professional development, gaps, and potential opportunities for research and pharmaceutical services. Pharmacists, included in a multi-professional team, could be a key element to promote access to healthcare and the well-being of the transgender population.

Should clinicians make chest surgery available to transgender male adolescents?

Bioethicists are increasingly engaged in considering the ethical issues associated with the care of transgender people. One such issue facing paediatric clinicians is requests for chest surgery from transgender male adolescents. For transgender young people who identify as male but have already progressed through the mid to late stages of puberty, hormone treatment will not reverse breast development. Some of these young people are distressed by their chest, and request surgery to remove this tissue. Demand for this surgery during adolescence is increasing. However, few paediatric hospitals make this intervention available to adolescents. This paper focuses on the following ethical question: Should clinicians make chest surgery available to transgender male adolescents? We argue that making chest surgery available to transgender male adolescents under some circumstances is ethically justifiable for three reasons, based on the concepts of beneficence, privacy, and non-discrimination. Firstly, the limited evidence to date suggests that chest surgery is beneficial to transgender male adolescents who seek this intervention. Secondly, chest surgery protects transgender adolescents' privacy by enabling them to better control disclosure of their transgender identity. Thirdly, chest surgery is already performed on other adolescent males for psychosocial reasons, such as in the case of gynaecomastia; non-discrimination thus provides a further reason for making chest surgery available to transgender male adolescents whose male gender identity is consistent. We suggest that the ethical justifiability of chest surgery in any specific transgender adolescent's case will depend on the individual patient's circumstances.

HIV Antiretroviral Treatment and Pre-exposure Prophylaxis in Transgender Individuals.

HIV prevalence is elevated among transgender populations with an estimated 13.7% of transgender adults living with HIV in the USA. In addition, transgender people experience significant disparities in biomedical HIV prevention and treatment. The efficacy of topical microbicides for prevention of HIV acquisition have not been tested among transgender people and may be impacted by hormonal therapies and/or surgeries undertaken by some transgender people to align their anatomy with their gender identity. Low pre-exposure prophylaxis (PrEP) uptake and adherence as well as potential drug-hormone interactions impact the efficacy of PrEP among transgender women. Few transgender men have been engaged in the PrEP continuum, and they have been largely excluded from PrEP research until very recently. Prioritisation of hormone therapy over HIV treatment as well as concerns about drug-hormone interactions may impact transgender women's adherence to antiretroviral therapy. More research is needed to clarify the clinical significance of identified drug-hormone interactions and better inform interventions to improve HIV prevention and care for transgender people.

Clinician and client perspectives regarding transgender health: a North Queensland focus

Background: Healthcare encounters are important in ensuring safe access to medical or surgical care for transgender people. Previous literature suggests many transgender people have had negative encounters with healthcare professionals. In Australia, there is limited research about this population and their healthcare, and less from regional locations.Aims: This study primarily aimed to explore both transgender client and clinician perspectives and experiences of healthcare interactions. A secondary aim was to investigate increased presentations to sexual health clinics in North Queensland by people wishing to transition.Methods: Semi-structured, in-depth interviews were used to gather data from 23 participants. Interview transcripts were inductively analyzed and themes developed. Results: Four themes emerged relating to healthcare encounters and the regional setting of North Queensland. These showed that support from family and peers is important for transgender mental health and wellbeing, and that person-centered clinicians who acknowledge a holistic approach to transgender care also form part of the support network for transgender individuals particularly in the regional setting. The internet was found to play a significant role in this study’s findings.Discussion: A collaborative holistic approach to transgender healthcare should be taken by client and clinician to best support the transgender individual during transition. The establishment of Australian guidelines and online peer support groups would facilitate this approach, particularly in rural or regional areas where specialist services are limited.

Current approaches to gender dysforia management: an endocrinologist’s perspective

Understanding of people with impaired gender identity in society, academic and science world is constantly changing due to increased awareness, openness and availability of the information on transgender people and their life. It is known that the social and psychological state of transgenders depends at a great extent on the quality of their medical care, including hormonal treatment. Unfortunately, until recently the awareness of this problem among many physicians (clinical psychologists, psychiatrists, endocrinologists, etc.) in the Russian Federation remained insufficient, and no unified standards of medical and psychological care for transgender people in Russia have been developed. As a result, when referring to various specialists, people with impaired gender identity commonly do not receive adequate recommendations and proper comprehensive medical follow-up. An endocrinologist, who prescribes hormonal treatment and performs long-term (usually life-long) follow-up and monitoring of adverse events, is one of the key team members to provide medical care to transgender patients. The article presents current views on definitions, diagnostic criteria and principles of endocrine therapy for gender dysphoria and gender incongruence, as well as highlights medical risks, associated with hormonal treatment, and a monitoring plan for patients receiving corrective therapy.

O Acesso das Pessoas Transexuais e Travestis à Atenção Primária à Saúde: uma revisão integrativa

Introdução: Travestis, transexuais e transgêneros (trans) fazem parte das minorias sexuais. São vítimas de estigmatização, discriminação e violência desde a infância, o que os leva muitas vezes à marginalização. Posto isso, se faz necessário políticas públicas que lhes forneçam condições para o exercício da cidadania. O presente trabalho apresenta os resultados de uma revisão integrativa sobre o acesso das pessoas trans aos serviços de saúde da atenção básica. Métodos: Coleta de dados realizada em dezembro de 2017 nas plataformas MEDLINE, SciELO e LILACS, utilizando os descritores em associação: transexual, transgênero ou travesti, acesso e atenção primária, atenção básica ou saúde. Os estudos deveriam ser publicados a partir de 2007 e estarem disponíveis gratuitamente. Resultados: Dos 578 estudos encontrados (incluídos as repetições) foram selecionados 6, provenientes do Brasil, EUA e África do Sul. Cinco com metodologia qualitativa e uma revisão sistemática. O acesso à Atenção Primária à Saúde (APS) por parte da população trans encontra barreiras multidimensionais. Há entraves políticos, socioeconômicos, organizacionais, técnicos e simbólicos, porém as barreiras técnicas são as mais impactantes ao acesso. Conclusão: Para que haja um acesso equitativo, livre de preconceitos e de discriminação, e cuidado pautados na empatia e compaixão, faz-se necessário incluir a temática diversidade sexual e de gênero na formação dos profissionais de saúde na graduação, na pós-graduação e, principalmente, na educação permanente daqueles implicados aos cuidados das pessoas trans. A APS, ao fazer valer seus atributos, mostra-se como o cenário ideal para o cuidado longitudinal destas pessoas.

Nursing Care for the transgender population: genders from the perspective of professional practice.

To describe and analyze the national and international scientific production on Nursing care for the transgender or gender-variance population. Integrative review of the literature, conducted throughout the Virtual Health Library, Cumulative Index to Nursing and Allied Health Literature, Public Medline and Web of Science databases, without pre-established periods of time and using the descriptors "Transgender AND 'Nursing Assistance'" and "Transgender AND 'Nursing care'". We included 11 articles, published between 2005 and 2016, broadly North American with only one Brazilian, so categorized: I- Fragility in the care of transgender people; II - Health of the transgender population: general and specific demands; III- Public health policies for transgender people. Transgender people have not found yet answers to their health demands; they are victims of prejudices and violence in services and seek care in extreme cases of sickness. Understanding their needs is primordial to build knowledge and practices that support nursing care.

Mental health nursing for transgender people: are we caring?

Transgender people experience widespread prejudice in society and health professionals are often complicit in this discrimination. Transgender people are at a greater risk of depression, anxiety, self-harm and suicide than the majority of the population. This article presents a literature review that explores issues for mental health nursing and the care of transgender people. The literature identifies that nurses display negative assumptions about transgender people, there is a lack of appropriate education and limited evidence to support practice. Mental health nurses have extensive experience in caring for stigmatised populations; with appropriate knowledge and education, a healthcare environment can be provided that is open, welcoming and safe to transgender people, and steps can be made towards closing the gap in healthcare disparities.

Trans-Specific Health Care: Challenges in the Context of New Policies for Transgender People

ABSTRACTThis study aims to understand transgender people’s access to the Brazilian public health care system in light of the new public policies for this group in Brazil. Our ethnographic study involved interviews with transgender women at a nongovernmental organization and a direct participant-observation study conducted 2 years later to observe how a new specialized service was providing health care for transgender people. Transgender people reported difficult personal life trajectories, marked by discrimination and binary standards, in their struggle to become recognized as women/men. At the specialized service, gender norms and stereotyping were observed being put into operation by untrained service providers. This dominance of pathologizing models ended up not decreasing transgender patients’ access to unsafe care outside of the public sector. The promotion and protection of the right to health thus depends on cultural changes. This may well include changes in technical-scientific discourse regarding the transgender experience to account for the depathologization and gender fluidity recognition.