Gender Minority Groups Research Articles

A Preliminary Exploratory Factor Analysis of the BDSM Counselor Competency Scale.

BDSM practitioners represent a large sexual minority group often overlooked, misunderstood, and unnecessarily pathologized by mental health clinicians. Although developing cultural competence for diverse and marginalized populations is widely understood to be a core component of delivering efficacious therapeutic services that can counteract these stigmatizing mental healthcare experiences, no measures currently exist that assess clinicians' self-reported competence to work with BDSM practitioners. Previous measurement work has been done to establish self-report competency scales for clinicians working with other sexual and gender minority groups, but no such scales exist for working with BDSM practitioners. In the current study, we adapted a version of the Sexual Orientation Counselor Competency Scale (SOCCS) to measure clinicians' self-reported competence to work with BDSM practitioners and did a preliminary exploratory factor analysis of the new scale (n = 124). After an initial 24-item administration, principal axis factoring of our final 17-item solution revealed two latent factors (attitudes and skills/knowledge) consistent with the 2013 SOCCS and the theoretical constructs of cultural competency. The BDSM Counselor Competency Scale (BDSM-CCS) can help clinicians, practices, agencies, and training programs track self-reported cultural competence with the BDSM population. Future research directions for scale development and clinical and training applications are discussed.

Abstract HUP2: Brain Health Outcomes in Sexual and Gender Minority Groups

Background: There is mounting evidence that sexual and gender minority (SGM) groups experience health disparities, but research on brain health status of this underrepresented group is limited. We evaluated whether SGM persons are at higher risk of adverse brain health outcomes compared to cisgender heterosexual (non-SGM) individuals. Methods: We conducted a cross-sectional study in the All of Us Research Program, a population study focused on health disparities enrolling 1 million Americans. We used baseline questionnaires to identify participants from sexual minorities (non-straight e.g., gay, lesbian, bisexual) and gender minorities (gender identity different from sex assigned at birth). We further divided gender minorities into gender diverse (e.g., non-binary) and transgender. The primary outcome was a composite of stroke, dementia, and late-life depression. In secondary analyses, we analyzed SGM subgroups and diseases separately. We used multivariate logistic regression to assess the link between SGM groups and brain health outcomes. Results: We included 393,041 participants (mean age 51, female sex at birth 62%), of whom 39,632 (10%) belonged to SGM groups. Of these, 4,431 (1%) belonged to a gender minority (2,212 [50%] gender diverse and 2,219 [50%] transgender) and 38,528 (10%) to a sexual minority. Full results are shown in the Figure. Compared to non-SGM, SGM individuals had 19% higher odds of the brain health composite outcome (OR 1.19, 95%CI 1.13-1.25). These results were consistent across all SGM subgroups (p<0.05). When assessing individual diseases, all SGM groups had higher odds of late-life depression, all SGM except transgender persons had higher odds of dementia, and gender minority groups had higher odds of stroke. Conclusion: In a large US population study, SGM individuals had a higher rate of adverse brain health outcomes. Further research should explore the structural causes of inequity to advance inclusive and diverse neurological care.

Abstract 71: Brain Health Outcomes in Sexual and Gender Minority Groups

Background: There is mounting evidence that sexual and gender minority (SGM) groups experience health disparities, but research on brain health status of this underrepresented group is limited. We evaluated whether SGM persons are at higher risk of adverse brain health outcomes compared to cisgender heterosexual (non-SGM) individuals. Methods: We conducted a cross-sectional study in the All of Us Research Program, a population study focused on health disparities enrolling 1 million Americans. We used baseline questionnaires to identify participants from sexual minorities (non-straight e.g., gay, lesbian, bisexual) and gender minorities (gender identity different from sex assigned at birth). We further divided gender minorities into gender diverse (e.g., non-binary) and transgender. The primary outcome was a composite of stroke, dementia, and late-life depression. In secondary analyses, we analyzed SGM subgroups and diseases separately. We used multivariate logistic regression to assess the link between SGM groups and brain health outcomes. Results: We included 393,041 participants (mean age 51, female sex at birth 62%), of whom 39,632 (10%) belonged to SGM groups. Of these, 4,431 (1%) belonged to a gender minority (2,212 [50%] gender diverse and 2,219 [50%] transgender) and 38,528 (10%) to a sexual minority. Full results are shown in the Figure. Compared to non-SGM, SGM individuals had 19% higher odds of the brain health composite outcome (OR 1.19, 95%CI 1.13-1.25). These results were consistent across all SGM subgroups (p<0.05). When assessing individual diseases, all SGM groups had higher odds of late-life depression, all SGM except transgender persons had higher odds of dementia, and gender minority groups had higher odds of stroke. Conclusion: In a large US population study, SGM individuals had a higher rate of adverse brain health outcomes. Further research should explore the structural causes of inequity to advance inclusive and diverse neurological care.

Overall Satisfaction with Cancer Care Among Sexual and Gender Minority People and Their Utilization of Identity-Tailored Health Education Materials.

Purpose: This study was conducted to understand whether health education materials made specifically for members of sexual and gender minority (SGM) groups play a pivotal role in SGM cancer survivors' care satisfaction and experiences. Methods: We identified 2250 SGM cancer survivors who completed the "OUT: National Cancer Survey," conducted by the National LGBT Cancer Network in 2020-2021, and classified participants by their self-reported satisfaction with overall cancer care. We examined care satisfaction in relation to use of SGM-tailored health education resources and factors surrounding their SGM identities, which may influence their satisfaction, including feelings of safety with care teams. Results: Regardless of satisfaction with overall care, substantial proportions of survivors reported lacking vital health education resources specific to their SGM identities in areas of mental health (69%), physical activity (91%), tobacco use cessation (89%), and alcohol consumption (86%), despite attributing value to these materials. Contextualizing SGM survivor satisfaction with care, it was notable that among SGM survivors who felt safe with members of their care team knowing their SGM identity, only 3% were less than satisfied with their overall cancer care, compared to 38% who felt unsafe. Conclusion: SGM survivors value tailored information and health education resources that incorporate their intersectional identities. More research must be done to elucidate why SGM survivors do not receive these materials, while creating spaces where they feel safe receiving care. Increased delivery of SGM-tailored materials and prioritization of SGM safety in health care may have implications for overall cancer care satisfaction among SGM survivors.

Hurting myself to cope: Using network analysis to understand the association between perceived stigma and non-suicidal self-injury functions among men who have sex with men in China

Prior studies have demonstrated that perceived stigma is robustly associated with risky and life-threatening behaviors, including non-suicidal self-injury (NSSI), among men who have sex with men (MSM). However, studies regarding the relationship between perceived stigma and NSSI are limited. The present study aimed to investigate the network structure of perceived stigma and NSSI functions, along with bridge nodes, to elucidate how they co-exist. A sample of 2610 Chinese MSM (mean age = 23.99, age range: 18–68 years) was recruited from an online survey platform. All participants completed a web-based survey with measures of perceived stigma and NSSI functions. Results indicated that ‘negative attitudes towards homosexuality’ and ‘disappointment in gay son’ were identified as the most central nodes in the perceived stigma network, whereas ‘seeking attention’ and ‘influencing others to change’ ranked highest on centrality in the NSSI network. Two bridge connections were exhibited within the combined perceived stigma and NSSI network model: ‘unwelcoming in public’ and ‘avoiding unpleasant tasks’ from perceived stigma and NSSI communities, respectively. This is among the first studies investigating the co-occurrence between perceived stigma and NSSI from the network approach. Our findings provide an empirically-based perspective on the importance of family- and community-based interventions, with potential clinical implications for reducing NSSI among sexual and gender minority groups.

Lived Experience of Acne and Acne Treatment in Transgender Patients

While acne is common in transgender and gender-diverse people and is associated with gender-affirming hormone therapy, little research has examined these factors and their impact in gender minority groups. To examine the lived experiences of acne and acne treatment in transgender and gender-diverse participants. This mixed-methods analysis was conducted at a multidisciplinary gender center at a public safety-net hospital and endocrinology and dermatology clinics at a tertiary academic center from January 4, 2021, to April 7, 2022, using semistructured interviews and surveys. Participants were transgender or gender-diverse adults who had received gender-affirming hormone therapy. Data analysis was performed from November 11, 2021, to March 31, 2023. Current diagnosis of acne. Interviews exploring the experience of acne and acne treatment were audio recorded, transcribed verbatim, coded using minority stress theory and the socioecological model, and analyzed using thematic analysis. Themes were triangulated with survey data on gender, self-reported acne severity, skin-specific quality-of-life impact, and treatment experience. A total of 32 participants were included in the study (mean [range] age, 32 [18-57] years; 17 transgender men, 11 transgender women, and 4 nonbinary participants). Ten participants (31%) self-rated their skin as currently clear or almost clear, 11 (34%) reported mild acne, and 11 (34%) had moderate to severe acne. Participants described experiences of rejection and bullying related to acne and admitted avoiding social interactions in which they anticipated acne-related discrimination, which led to feelings of depression and anxiety. Acne worsened body appearance dissatisfaction. Transgender women reported acne interfering with feminine gender expression. Transgender men often normalized acne development, sometimes viewing acne positively as an early sign of testosterone action. Most participants tried over-the-counter acne treatments and commonly sought acne treatment advice from physicians, peers, online forums, and social media. Barriers to acne treatments included cost, lack of multidisciplinary care, mistrust toward the health care system, and lack of transgender-specific acne care education. In this mixed-methods study, transgender and gender-diverse individuals reported experiencing acne-related stigma and facing barriers to acne treatment. Multilevel changes, such as developing strategies to reduce acne stigma, providing transgender-specific acne care education, facilitating multidisciplinary acne care, and expanding transgender-friendly clinical environments, are recommended to reduce the impact of acne in transgender individuals.

How can women entrepreneurs overcome funding challenges: the role of digitalization and innovation

ABSTRACT Entrepreneurs must overcome various hurdles that pose a threat to starting or growing their businesses. For example, women entrepreneurs face challenges including gender differences, entrepreneurial financing, innovation processes, and commercialization of technology. One avenue to enhance the accessibility of financial support and promote entrepreneurship via digitalization is to counteract or diminish the biases seen in traditional sources of funding for entrepreneurs belonging to ethnic or gender minority groups, including women-owned small and medium-sized enterprises. We propose that additional research is needed to account for the context of the Fourth Industrial Revolution and multi-level factors that may influence a women entrepreneur’s decision to obtain financing including digital skills and women-focused resource groups. We outline a typology of attributes and subsequent impacts for how to obtain financing and extend the discussion of how the evolving entrepreneurial ecosystem include a multitude of financing alternatives. Future research and policies should incorporate the evolving and expansive investment opportunities within the context of the digital entrepreneurial environment to help the advancement of women-led businesses.

Cognitive Impairment in Sexual and Gender Minority Groups: A Scoping Review of the Literature.

Purpose: The purpose of this review was to synthesize evidence on differences in cognitive impairment by sexual orientation/gender identity (SOGI) status. Methods: A scoping review of the literature was conducted. Five databases (PubMed/Medline, Cumulated Index to Nursing and Allied Health Literature, Web of Science, PsycInfo, and Embase) were searched for primary articles comparing incidence or prevalence of cognitive impairment among sexual and gender minority (SGM) groups versus non-SGM groups. Two reviewers independently screened articles and conducted risk-of-bias assessment on eligible articles. Results: Fifteen primary studies were eligible. Most studies (n = 13) were cross-sectional, with moderate to critical risk of bias. Among eight studies examining self-reported cognitive impairment, seven reported a higher prevalence among some SGM groups versus non-SGM groups. Among seven studies using objective measures of cognitive impairment, three examined prevalence of clinician-documented diagnosis of dementia, of which two reported a higher prevalence specifically among transgender versus cisgender individuals. Among the other four studies examining objective measures, two reported poorer cognitive performance or memory, one reported better performance, and another reported no difference. Comparisons across studies were challenging due to inconsistencies in how SOGI and cognitive impairment were operationalized, and the factors used for statistical adjustment; some studies adjusted for putative intermediary factors that potentially explain differences in cognitive impairment. Conclusions: Whereas most published studies identified a positive relationship between SOGI status and self-reported cognitive impairment, evidence is mixed with regard to objective cognitive performance. Well-designed longitudinal, observational studies are needed, using objective measures of cognitive function, with careful consideration of confounding versus intermediary risk factors.

A Suicide Prevention Intervention for Emerging Adult Sexual and Gender Minority Groups: Protocol for a Pilot Hybrid Effectiveness Randomized Controlled Trial.

Suicide attempts and suicide death disproportionately affect sexual and gender minority emerging adults (age 18-24 years). However, suicide prevention strategies tailored for emerging adult sexual and gender minority (EA-SGM) groups are not widely available. The Safety Planning Intervention (SPI) has strong evidence for reducing the risk for suicide in the general population, but it is unclear how best to support EA-SGM groups in their use of a safety plan. Our intervention (Supporting Transitions to Adulthood and Reducing Suicide [STARS]) builds on content from an existing life skills mobile app for adolescent men who have sex with men (iREACH) and seeks to target core risk factors for suicide among EA-SGM groups, namely, positive affect, discrimination, and social disconnection. The mobile app is delivered to participants randomized to STARS alongside 6 peer mentoring sessions to support the use of the safety plan and other life skills from the app to ultimately reduce suicide risk. We will pilot-test the combination of peer mentoring alongside an app-based intervention (STARS) designed to reduce suicidal ideation and behaviors. STARS will include suicide prevention content and will target positive affect, discrimination, and social support. After an in-person SPI with a clinician, STARS users can access content and activities to increase their intention to use SPI and overcome obstacles to its use. EA-SGM groups will be randomized to receive either SPI alone or STARS and will be assessed for 6 months. Guided by the RE-AIM (reach, efficacy, adoption, implementation, and maintenance) framework, we will recruit and enroll a racially and ethnically diverse sample of 60 EA-SGM individuals reporting past-month suicidal ideation. Using a type-1 effectiveness-implementation hybrid design, participants will be randomized to receive SPI (control arm) or to receive SPI alongside STARS (intervention arm). We will follow the participants for 6 months, with evaluations at 2, 4, and 6 months. Preliminary effectiveness outcomes (suicidal ideation and behavior) and hypothesized mechanisms of change (positive affect, coping with discrimination, and social support) will serve as our primary outcomes. Secondary outcomes include key implementation indicators, including participants' willingness and adoption of SPI and STARS and staff's experiences with delivering the program. Study activities began in September 2021 and are ongoing. The study was approved by the institutional review board of the University of Pennsylvania (protocol number 849500). Study recruitment began on October 14, 2022. This project will be among the first tailored, mobile-based interventions for EA-SGM groups at risk for suicide. This project is responsive to the documented gaps for this population: approaches that address chosen family, focus on a life-course perspective, web approaches, and focus on health equity and provision of additional services relevant to sexual and gender minority youth. ClinicalTrials.gov NCT05018143; https://classic.clinicaltrials.gov/ct2/show/NCT05018143. DERR1-10.2196/48177.

Human mpox in People Living with HIV: Epidemiologic and Clinical Perspectives from Nigeria.

Sub-Saharan Africa (SSA) is disproportionately affected by mpox and HIV. We described epidemiologic trends and clinical experiences in the management of mpox in people living with HIV (PLWH) in Nigeria and further examined how the rapidly accumulating body of knowledge from the 2022 global mpox outbreak might be explored to improve mpox care in PLWH in SSA. During the 2017/2018 Nigerian mpox outbreak, we reported that 9/40 (22.5%) hospitalized mpox patients with known HIV status were PLWH. In the 2022 global mpox outbreak, 52% of confirmed mpox cases with known HIV status were PLWH, predominantly sexual and gender minority groups. However, substantial missing data on HIV status of confirmed mpox cases highlights a critical gap in HIV testing as a component of mpox management. Before 2022, sexual activity was not commonly linked to mpox transmission, but this was identified as a major driver of transmission during the 2022 mpox outbreak. Notable sexual history observed in Nigerian mpox patients in 2017/2018 suggests that the contribution of sexual activity in human-to-human mpox transmission might have been underappreciated for years. Our cohort of PLWH with mpox, predominantly individuals with advanced or uncontrolled HIV, were significantly more likely to experience severe mpox manifestations and prolonged disease compared with those without HIV. This contrasts with the generally less remarkable differences in mpox presentation between people with and without HIV in Western countries, an observation that can be at least partially explained by more stable HIV disease. The unavailability of mpox antiviral drugs and vaccines in SSA highlights global inequity in mpox response, which requires an urgent attention. As mpox countermeasures become available in SSA, lessons learned from their use in Western countries could provide important guidance for care providers in SSA. Public health measures to mitigate stigmatization in PLWH with mpox is also critical.

Elucidating Intimate Partner Violence Rate Disparities Between Same- and Opposite-Sex Couples: A Demographic Approach.

Studies on intimate partner violence (IPV) rates typically find higher rates for same-sex couples than opposite-sex couples. Regardless of sexual orientation, the risk for IPV perpetration is concentrated among young adults. Given that the HIV/AIDS epidemic significantly lowered the life expectancy of sexual minority men and that recent social movements have encouraged more youths to "come out," population age differences may contribute to the observed differences in IPV rates between same- and opposite-sex couples. The present study applies direct age standardization and decomposition techniques to data from the National Incident-Based Reporting System and the American Community Survey to examine this possibility across 2,584 same-sex male, 4,029 same-sex female, and 284,614 opposite-sex physical IPV incidents. The results of the direct standardization procedures indicate physical IPV rates for same-sex male and same-sex female households would be 11.8% and 27.3% lower, respectively, if they had the same population age structure as opposite-sex households. The results of the decompositions indicate that differences in population age structure contribute 48% and 44% of the elevation in IPV rates in same-sex male and same-sex female households, respectively, compared to opposite-sex households. These findings demonstrate the promise of demographic methods to explain differences in offending rates between groups. These results suggest the need for prevention and intervention strategies aimed at youths. Future studies should be conducted with data on sexual orientation and gender identity to better elucidate the contribution of population age structure among various sexual and gender minority groups. Research comparing trends among sexual minority populations to the heterosexual population in particular should account for age where possible.

Mapping gender and sexual minority representation in cancer research: a scoping review protocol.

Addressing the risk of people from gender and sexual minority (GSM) groups experiencing inequities throughout the cancer continuum requires a robust evidence base. In this scoping review, we aim to map the literature on cancer outcomes among adults from GSM groups and the factors that influence them along the cancer continuum. This mixed-methods scoping review will follow the approach outlined by JBI. We will systematically search electronic databases for literature in collaboration with a health sciences librarian. Two reviewers will screen titles and abstracts to determine eligibility based on inclusion criteria, and then retrieve full text articles for data extraction. Results will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Quantitative data will be qualitized through a narrative interpretation and pooled with qualitative data. We will use meta-aggregation to synthesize findings. This protocol was developed in collaboration with GSM patient and public advisors. We will engage people from GSM groups, community organizations and knowledge users in disseminating results. This review will direct future research efforts by expanding the wider body of research examining cancer disparities across the cancer continuum that GSM groups experience, identifying literature gaps and limitations, and highlighting relevant social determinants of health that influence cancer outcomes for adults from GSM groups.

Cancer survivors' health behaviors and outcomes: a population-based study of sexual and gender minorities.

Most case-control studies compare cancer survivors with general population controls without considering sexual orientation or gender identity. This case-control analysis compared health risk behaviors and health outcomes among sexual and gender minority cancer survivors to those of matched sexual and gender minority participants without cancer (controls). Using data from the 2014-2021 Behavioral Risk Factor Surveillance System, a population-based sample of 4507 cancer survivors who self-identified as transgender, gay men, bisexual men, lesbian women, or bisexual women were 1:1 propensity score matched, using age at survey, race and ethnicity, marital status, education, access to health care, and US census region. Within each sexual and gender minority group, behaviors and outcomes were compared between survivors and participants without cancer, and survivors' odds ratios and 95% confidence intervals calculated. Gay male survivors had higher odds of depression, poor mental health, limited usual activities, difficulty concentrating, and fair or poor health. Few differences were observed between bisexual male survivors and participants without cancer. Compared with controls, lesbian female survivors had greater odds of overweight-obese status, depression, poor physical health, and fair or poor health. Bisexual female survivors had the highest rates of current smoking, depression, poor mental health, and difficulty concentrating across all sexual and gender minority groups. Statistically significantly different from transgender controls, transgender survivors had greater odds of heavy alcohol use, physical inactivity, and fair or poor health. This analysis revealed an urgent need to address the high prevalence of engaging in multiple health risk behaviors and not following guidelines to avoid second cancers, additional adverse outcomes, and cancer recurrences among sexual and gender minority cancer survivors.

Sexual and Gender Minorities Inclusion and Uptake of Sexual and Reproductive Health Services: A Scoping Review of Literature.

Despite the efforts to ensure that sexual and reproductive health services are integrated into global, regional, and national initiatives, a significant number of countries are overwhelmed by frames of exclusion and violations of fundamental human rights, particularly for sexual and gender minority groups such as lesbians, gays, bisexuals, and transgender people. This study sought to review the literature on access and barriers faced by sexual and gender minorities. A scoping literature review was conducted on literature that focused on sexual and gender minorities and sexual and reproductive health services and published in the English language. Studies were independently screened and coded, categorizing themes such as policies, uptake of services, barriers to sexual and reproductive health access, and strategies to aid the uptake of services. The search yielded 1,148 literature sources, of which 39 met the inclusion criteria and were reviewed. The average sexual and reproductive health service uptake was generally low overall and was influenced by factors such as clinical settings, punitive laws, and availability of services specific to sexual and gender minorities. Noted strategies to aid sexual and reproductive health uptake include education, friendly health care facilities, availability of specific services, and legislative reform. The sexual and reproductive health program is an important component of short-term and long-term sexual and reproductive health needs. Health intervention initiatives targeted at improving or increasing sexual and reproductive health uptake must be supported by suitable legal and regulatory framework contexts and based on context-specific evidence.

Designing and pilot-testing SmokefreeSGM: a text-based smoking cessation intervention for sexual and gender minority groups.

Although the prevalence of smoking is significantly higher among sexual and gender minorities (SGM) than the general population, no text-based smoking cessation intervention has been specifically tailored to this group. The objective of this phase of our study was to develop SmokefreeSGM, an SGM-tailored text-based smoking cessation program, and pilot test its design to inform the refinement of the program. SmokefreeSGM was adapted from SmokefreeTXT, the National Cancer Institute's text-based smoking cessation program, to respond to the needs of SGM smokers. In addition to tailored text messages, SmokefreeSGM includes a new keyword, STRESS, to address the unique psychosocial stressors of SGM smokers. Text messages were distributed to users over a 6-week period, and participants were provided with nicotine patches to aid their efforts to quit smoking. Demographic and tobacco use information was collected at baseline. Quantitative (related to engagement and usability) and qualitative (related to usability and acceptability) data was also collected at the 1-month assessment. A total of 18 SGM smokers were recruited for the pilot test. 38.9% of participants were male, 38.9% were female, and 22.2% were nonbinary. 27.8% of participants identified as gay, 11.1% as lesbians, 27.8% as bisexual females, 16.7% as bisexual males, and the remaining 16.7% as other. At baseline, two-thirds (66.7%) were moderate to highly dependent on nicotine and 44.4% had made more than five attempts to quit smoking. The average engagement rate for bidirectional text messages was 63.8%. However, the response rate to the tailored text messages (54%) was higher than the non-tailored text messages (41.9%). Nine participants completed the 1-month assessment and interview (50% retention rate). The System Usability Scale (SUS) score was 81.67 (±15.46). Furthermore, four major themes emerged from our qualitative analysis of the interviews (i.e., appreciation for the intervention, program, content, and drawbacks). Findings from the pilot test of SmokefreeSGM are not only encouraging in terms of engagement, usability and acceptability, but have also informed the refinement of the program prior to launching a feasibility trial.

Approaching sexuality in LGBTQIAP + patients with cancer: scoping review

BackgroundWhen individuals in the SGM group are diagnosed with cancer and undergo treatment, they experience changes in physical, mental, sexual and spiritual dimensions, which can negatively impact sexual desire, as well as satisfaction and sexual health as a whole. This study aims to examine the existing scientific literature on how healthcare professionals approach sexuality in cancer patients who belong to the SGM group. The SGM group is particularly vulnerable, and the challenges they face in terms of psychosocial and emotional health are further exacerbated by the oncological treatment they receive. Therefore, specialized attention and support are necessary to address their unique needs.MethodTo conduct this study, a scoping review was performed following the guidelines established by the Joanna Briggs Institute. By synthesizing the available evidence, this study aims to provide insights and recommendations for healthcare professionals to improve the care and support provided to SGM individuals with cancer. Guiding question: “how do health professionals approach sexuality in cancer patients in a minority group?”. The search was carried out in PubMed, Science Direct, Scopus, Web of Science, Virtual Health Library, Embase databases and Google Scholar in addition. Specific criteria were used for Evidence source selection, Data mapping, assurance, analysis, and presentation.ResultsFourteen publications were included in this review for the final synthesis, which indicated that the approach to the sexuality of sexual and gender minority groups is based on research whose character is limited in terms of producing care and health care that is congruent in gender and sexuality. The analysis of scientific articles showed that one of the biggest challenges and priorities of health services today is to reduce disparities and promote equity in health for SGM people.ConclusionsThis study reveals a significant gap in addressing the sexuality of SGM groups within cancer care. Inadequate research impedes the provision of consistent and inclusive care for SGM individuals, which has a negative impact on their overall wellbeing. Reducing disparities and promoting healthcare equity for SGM individuals must be a top priority for health services.

Religious reactions to gender identity: a comparative analysis of select Canadian and Australian Catholic schools

ABSTRACT Determining the depth of discrimination against gender and sexual minority groups in Catholic schools of selected western nations is best undertaken from an international-comparative perspective. In this article, we compare the Canadian case of Alberta’s ‘washroom wars’ and a ‘gender row’ over uniform changes in an Australian Catholic high school. In each case, practises inclusive of gender diversity in Catholic schools were framed as a departure from Catholic doctrine. To explore how oppressive structures exist and operate within schools, we examine media accounts of each case using Critical Discourse Analysis and contextualize this analysis by examining Canadian and Australian educational and legal settings. We find that despite differing legal frameworks, some Catholic schools continue to place Canonical law above the rights of transgender and gender-diverse students in both countries. We therefore argue that it is the Catholic system’s institutional stance on gender and sexual diversity that perpetuates discrimination.

Orthorexia nervosa symptomatology in the LGBTQ community: Gender and sexual orientation differences

This study investigated whether gender and sexual minority groups exhibit differences in orthorexia nervosa (ON) symptomatology compared to cisgender, straight individuals. A sample of 441 non-clinical participants (65 % White, mean age = 27) reported their gender (104 cisgender men, 229 cisgender women, 28 transgender men, 27 transgender women, 53 nonbinary) and sexual orientation (144 straight, 45 gay, 54 lesbian, 105 bisexual/pansexual, 68 queer), and completed the Orthorexia Nervosa Inventory. The LGBTQ group exhibited greater ON symptomatology compared to the cisgender, straight group. ANOVAs demonstrated significant group differences according to gender and sexual orientation. Post-hoc tests revealed that transgender women exhibited greater ON symptomatology than cisgender men and cisgender women. However, nonbinary individuals exhibited lower ON symptomatology than cisgender women, transgender men, and transgender women. Additionally, lesbians exhibited greater ON symptomatology than straight individuals. Our findings suggest that individuals with an LGBTQ identity, particularly transgender women and lesbians, may experience greater ON symptomatology than cisgender, straight individuals. However, nonbinary individuals appear to experience lower ON symptomatology, which may relate to a lack of alignment with masculine or feminine ideals, such that these individuals may feel a lack of need to conform to a certain appearance ideal based on gender norms.

Strengthening the Residential Care Workforce: Exploring the Role of Organizational Climate and Culture and Staff Intention to Stay or Leave

ABSTRACT Staff turnover in youth residential treatment centers (RTC) has immense potential to disrupt the therapeutic environment and prompt an increase in mistrust, aggressive and anti-therapeutic behaviors, and feelings of abandonment and worthlessness among residents. The current study examined factors associated with intent to leave the workplace at an RTC in the southeastern United States, focusing on staff role and identity presentation and their effects on workplace culture and climate. Results suggest that indicated job satisfaction, burnout, and perceptions of culture and climate are the best predictors of turnover and retention. Dimensions of culture and climate were rated lower by specific underrepresented minority groups in the organization, highlighting the importance of the agency’s imperative to protect racial, sexual, and gender minority groups to promote retention and a diverse workforce reflecting the demographics of the youth it serves.

Clinical, psychosocial, and sociodemographic factors of sexual and gender minority groups with cancer: A systematic review.

Psychosocial health varies depending on demographic and clinical factors and the social context in which individuals grow and live. Sexual and gender minority (SGM) populations experience health disparities due to systemic factors that privilege cisgender and heterosexual identities. We reviewed the literature on the psychosocial, sociodemographic, and clinical factors in SGM groups with cancer and described the associations among these factors. We conducted a systematic review according to Fink's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines in the PubMed, PsycInfo, Cumulative Index of Nursing and Allied Health Literature, and LGBTQ+ Life databases. Quantitative articles published in English or Spanish were included. Grey literature and studies with participants in hospice care were excluded. The quality of the publications was assessed with the Joanna Briggs Institute criticalappraisal tools. The review included 25 publications. In SGM groups, systemic cancer treatment was associated with worse psychosocial outcomes; and older age, employment, and higher income were associated with better psychosocial outcomes. SGM groups with cancer are different from their heterosexual cisgender peers in sociodemographic, psychosocial, and clinical factors. Clinical and sociodemographic factors are associated with psychosocial outcomes among SGM individuals with cancer.