Individual Face Discrimination Research Articles

“Agricultural to Non-agricultural” Ways and Chinese Labor Market Differentiation: Endowment Difference or Identity Discrimination?

Abstract Different methods of transforming rural migrants’ household registration can affect their integration into citizenship. This study assesses the impact of different rural-to- urban hukou conversion methods on labor market wages and job entry, utilizing empirical analysis with China General Social Survey (CGSS) data. Rural migrants transitioning to urban hukou are categorized as active or passive “agricultural to non-agricultural” groups. Wage disparities between these groups are analyzed using the Oaxaca-Blinder decomposition method, revealing that 50% of the wage gap remains unexplained by individual characteristics. Additionally, this paper explores factors contributing to wage and job entry differences using OLS regression analysis. Empirical findings indicate that discrimination significantly contributes to the wage and job entry gap between passive and active groups, with primary mechanisms including statistical bias, information acquisition differences, and identity challenges. These results underscore the inevitable transition of the agricultural population to urban areas in emerging nations’ development trajectory. However, challenges may arise during this transformation, particularly in China, where passive “agricultural to non-agricultural” individuals face discrimination. Addressing the rights and interests of this group is crucial for ensuring smooth urbanization in China and offers insights to improve urbanization efforts in developing nations.

Co-Designing Digital Health Intervention for Monitoring Medication and Consultation Among Transgender People in Underserved Communities: Collaborative Approach.

In many parts of the world, men who have sex with men and transgender individuals face criminalization and discrimination. As a result, they are less likely to seek medical help, despite experiencing higher rates of HIV/AIDS, mental health issues, and other health problems. Reaching key populations (KPs) with essential testing, care, and treatment services can be challenging, as they often have a higher likelihood of contracting and spreading the virus. They have limited access to antiretroviral (ARV) therapy (ART) services, which means that KPs may continue to serve as reservoirs for new HIV infections if they do not receive effective HIV programming. This ongoing issue complicates efforts to control the epidemic. Therefore, modeling a digital health system to track ARV medication access and use is crucial. This paper advocates for the use of digital interventions to manage the health of KPs in underserved regions, using Nigeria as a case study. This study aims to assess digital health interventions for monitoring medication and consultations among transgender people in underserved communities. It also sought to determine whether a system exists that could support ART adherence in Nigeria. Additionally, the study evaluated design strategies to address privacy and confidentiality concerns, aiming to reduce nonadherence to ARV medications among KPs in Nigeria. A qualitative approach was adopted for this research, involving a thematic analysis of information collected from interviews with clinicians and other health practitioners who work directly with these communities, as well as from an interactive (virtual) workshop. The findings from the thematic analysis indicate a need to increase attendance at ART therapy sessions through the implementation of an intensive care web app. Unlike previous solutions, this study highlights the importance of incorporating a reminder feature that integrates with an in-app telemedicine consultancy platform. This platform would facilitate discussions about client challenges, such as adverse drug effects, counseling sessions with clinical psychologists, and the impact of identity discrimination on mental health. Other data-driven health needs identified in the study are unique drug request nodes, client-led viral load calculators, remote requests, and drug delivery features within the web app. Participants also emphasized the importance of monitoring medication compliance and incorporating user feedback mechanisms, such as ratings and encouragement symbols (eg, stars, checkmarks), to motivate adherence. The study concludes that technology-driven solutions could enhance ART adherence and reduce HIV transmission among transgender people. It also recommends that local governments and international organizations collaborate and invest in health management services that prioritize health needs over identity.

Educational Initiatives to Improve the Cancer-Related Disparities Facing Transgender and Gender Diverse (TGD) Individuals.

Transgender and gender diverse (TGD) individuals face discrimination and experience disparate healthcare, and cancer care, in particular. Our team has developed four initiatives to start to mitigate the disparities facing TGD individuals, including (1) improving identification of TGD individuals with cancer in oncology clinics, (2) identifying rates and predictors of cancer screening among TGD individuals, (3) building a TGD patient-centric oncology clinic, and (4) developing prospective research that is dedicated to addressing the needs of TGD Individuals with cancer. Clinician-focused educational initiatives are integral aspects of this work to improve cancer care for TGD individuals.

Lesbian, gay, bisexual, transgender, and queer health-related educational experiences in undergraduate medical curricula among Thai medical schools (LEAD-IN)

Purpose In Thailand, Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) individuals face significant health disparities and discrimination in healthcare. A primary cause is the lack of knowledge among doctors and their negative attitudes towards LGBTQ people. The purpose of this study was to explore the current undergraduate medical curricula of medical schools in Thailand concerning learning outcomes, contents, teaching and learning methods, and assessment methods in the field of LGBTQ health. It also sought to gather opinions from principal stakeholders in curriculum development. Methods The authors employed a mixed-methods approach with a convergent design to conduct the research. Quantitative data were collected from 23 deputy deans of educational affairs using a standardized interview form, and qualitative data were obtained through in-depth interviews with key stakeholders including 16 LGBTQ healthcare receivers, 22 medical students, and three medical teachers. Both datasets were analyzed simultaneously to ensure consistency. Results The findings indicate that none of the medical schools had established learning objectives related to LGBTQ healthcare within their curricula. Of the institutions surveyed, 8 out of 15 (53.3%) offered some form of teaching on this topic, aligning with the qualitative data which showed 7 out of 17 institutions (41.2%) provided such education. The most frequently covered topics were gender identity and sexual orientation. Lectures were the predominant teaching method, while multiple-choice questions were the most common assessment format. There was a unanimous agreement among all principal stakeholders on the necessity of integrating LGBTQ healthcare into the M.D. program and the professional standards governed by the Thai Medical Council. Conclusions Although some Thai medical schools have begun to incorporate LGBTQ health into their curricula, the approach does not fully address the actual health issues faced by LGBTQ individuals. Future teaching should emphasize fostering positive attitudes towards LGBTQ people and enhancing communication skills, rather than focusing solely on the cognitive aspects of terminology. Importantly, medical educators should serve as role models in providing competent and compassionate care for LGBTQ patients.

Transgender and gender diverse curriculum in medical imaging programs: a case study

BackgroundTransgender and gender diverse (TGD) individuals face barriers, including harassment and discrimination, when accessing healthcare services. Medical imaging procedures require personal information to be shared, such as date of last menstrual cycle and/or pregnancy status; some imaging exams are also invasive or intimate in nature. Terminology is based on binary sex creating an inherently cis-heteronormative environment. TGD patients fear being outed and often feel a need to function as educators and advocates for their care. Incorporation of inclusive healthcare curriculum related to TGD populations is an effective means of educating new health providers and promotes safer and more inclusive spaces in healthcare settings. Educators face barriers which hinder the creation and implementation of TGD content. The purpose of this study was to examine the impacts educators are faced with when creating and delivering TGD content in their medical imaging curriculum.MethodsA case study of medical imaging programs at a Canadian post-secondary institute was undertaken. Data was collected via semi-structured interviews with faculty. Relevant institutional documents such as strategic plans, policies/procedures, websites, and competency profiles were accessed. Framework analysis was used to analyze the data.ResultsThe study found seven themes that influence the development of TGD curriculum as follows: familiarity and comfort with the curriculum and content change process; collaboration with other healthcare programs; teaching expertise; management of course workload and related. duties; connections to the TGD community; knowledge of required TGD content and existing gaps in curriculum; and access to supports.ConclusionsUnderstanding educators’ perspectives can lead to an increased sense of empowerment for them to create and incorporate TGD curriculum in the future. Many post- secondary institutions are incorporating an inclusive lens to educational plans; this research can be used in future curriculum design projects. The goal is improved medical imaging experiences for the TGD population.

Evaluation of services provided in a gender health clinic

BackgroundTransgender and gender diverse (TGD) individuals face discrimination and mistreatment in healthcare spaces, resulting in poor health. The Mountain Area Health Education Center (MAHEC) Gender Health Clinic was launched in September of 2022 to meet the healthcare needs of TGD patients. ObjectiveDescribe services provided in and patient satisfaction with an interdisciplinary Gender Health Clinic serving TGD patients. Practice DescriptionThe Gender Health Clinic is a subspecialty clinic of the MAHEC Family Health Center in Asheville, North Carolina. The clinic offers interdisciplinary services to TGD patients, including primary care, gynecology, and medication management. Practice InnovationThe interdisciplinary clinic team was assembled to create a safe environment for TGD patients to receive medical care. The pharmacy team facilitated provider training, consolidated clinical references, and provided comprehensive patient education on hormone therapy. Evaluation MethodsA quantitative description of services and patient demographic information was evaluated through a retrospective chart review of the first six months of the clinic. Patient satisfaction was evaluated through anonymous questionnaires. ResultsForty-four patient encounters were evaluated for 23 unique patients. The mean age was 26.6 years, and 65.2% of patients were assigned female at birth. Gender identities were distributed across male (39.1%), female (34.8%), and non-conforming (26.1%). Nearly all patients (97.7%) received documented general education from any provider. Most patients (79.6%) received prescriptions for hormone therapy. More than one-third (38.7%) of patients had a documented pharmacist interaction. Twenty-one questionnaires were completed out of 23 unique patients. All respondents rated their overall experience as “Excellent” or “Very Good.” Highly rated positive clinical interactions included courteous clinical staff (4.9) and having needs met (4.8). Ease of scheduling an appointment (4.3) was rated lowest among all questionnaire items. ConclusionThe positive patient experiences and level of services provided suggest a promising start to MAHEC’s Gender Health Clinic.

Social Inclusion of Transgender People in Intercollegiate Sports—A Scoping Review

Transgender individuals face discrimination and exclusion in various areas of society, including sports. Notably, intercollegiate athletics suffer criticism for their lack of inclusivity towards transgender athletes. Despite the increasing visibility of transgender individuals and ongoing efforts towards greater inclusivity, there is a significant lack of research on their social integration within college sports. This scoping review aimed to explore the then-current state of research on the social integration of transgender individuals in intercollegiate athletics, identify gaps in the literature, and suggest areas for further investigation. The study examined articles published between 2013 and 2023, using databases such as PubMed, ERIC, and EBSCO Essentials, as well as relevant citations from selected articles. The inclusion criteria for articles were their focus on the social integration of transgender individuals in sports events, publication in English, and relevance to the research question. A standardized technique based on the PRISMA flow diagram 2020 was used to locate, assess, and extract information from eligible research. The results of the study are expected to inform policy and strategy in transgender participation in college sports and promote greater inclusivity for transgender individuals in sports institutions and groups.

Primary Care Practice for Gender-Diverse Patients Using Gender-Affirming Hormone Therapy

Transgender and gender-diverse individuals face discrimination, bias, stigma, socioeconomic barriers, lack of knowledgeable, and/or supportive gender-affirming health care across the nation. Many primary care providers have not been educated about gender-affirming hormone therapy and the health care considerations using these necessary hormones for patients ≥16 years old. This review highlights basic gender-affirming hormone therapy management with monitoring parameters and some common primary care practice applications for transgender and gender-diverse patients. Evidence-based guidelines, resources, and advocacy links are provided and in alignment with the latest version of the World Professional Association for Transgender Health Standards of Care.

Imigrantes LGBT+ em Florianópolis/SC: O Papel das Redes Sociais no Processo de Identificação Sexual

The LGBT+ individuals face prejudice and discrimination in their places of origin, which can lead to the migratory process. The LGBT+ immigrant is often unable to use alreadyestablished social networks for fear of stigmatization. Thus, they migrate to places that they believe to be LGBTfriendly. This investigation aims to analyze the migratory trajectories ofthe gay population and the configuration of their social networks. It also investigates whether the use of already established social networks favors the process of identifying the “coming out of the closet”. The investigation was carried out using qualitative and quantitative methods as complementary approaches.

Mental Health Outcomes Among Transgender Veterans and Active-Duty Service Members in the United States: A Systematic Review.

It has been shown that veterans and active-duty service members may experience worse mental health outcomes compared with civilians and nonveterans. In addition, transgender veterans and service members face unique challenges. We conducted a systematic review of articles presenting data on mental health outcomes in transgender veterans and active-duty service members. Outcomes examined in this review include symptoms of depression, anxiety, and posttraumatic stress disorder, suicidality, substance use, and military sexual trauma. In the military, transgender individuals face stigma and discrimination. Transgender veterans and service members have worse mental health outcomes and higher odds of suicidality compared with their cisgender counterparts. Drug and alcohol use disorders are more prevalent among transgender veterans compared with cisgender veterans. Transgender veterans are also more likely to report military sexual trauma than cisgender veterans. In the literature, evidence exists that transgender veterans and service members experience worse mental health outcomes than their cisgender counterparts. Additional research is required to measure the effect of gender-affirming care on health outcomes among transgender veterans and active-duty service members to better serve this population and provide optimal care.

A Trauma-Informed and Gender-Inclusive Medical Nomenclature.

Transgender individuals face discrimination in several contexts and spaces, which exacerbates dysphoria and disparities in mental and physical well-being. Gender-exclusionary environments in the health care system lead to limitations in access to care and unaddressed health care needs. The full spectrum of gender is often not recognized in the field of medicine, which is predicated on the binary of male and female. Obstetrics and gynecology is societally viewed as a field for cisgender women, but transgender individuals can, and do, benefit from services offered by obstetricians and gynecologists. It is imperative that all specialties consider which aspects of care can be altered to promote the safety and health care of medically marginalized groups, including transgender patients. Alternative vocabulary to gendered language commonly used in medicine is discussed in three contexts: patient counseling, medical records, and institutional language. Understanding and using gender-inclusive language is an important step to create safer, respectful, affirming spaces for transgender people to receive medical care.

The importance of providing gender-affirming care in pharmacy practice

Transgender and gender diverse (TGD) individuals face bias and discrimination across many health care settings including pharmacy. While there is evidence of successful interventions to increase provider awareness of the needs of TGD individuals in medicine, nursing, and social work, little work has been done by the pharmacy profession to recognize and meet the needs of this population. This commentary examines the gaps in pharmacy practice and pharmacy research with regards to the needs of TGD individuals and looks at allied health fields for potential solutions that can be adapted by the pharmacy profession.We first examine the social pressures that TGD individuals face in multiple social contexts and describe how bias and discrimination spill over into their interactions with providers and health care systems. Solutions for improving pharmacy practice research's ability to identify TGD individuals and their needs follows as a measure that will lead to solutions for improving pharmacy practice. A discussion of TGD individuals' responses to actual and perceived discrimination by pharmacists is discussed next, and why their avoidance of pharmacy care can be problematic to their health. The remainder of the paper focuses on how pharmacy education can train future pharmacists to provide inclusive care to TGD individuals, and how interprofessional education and continuing education can enhance future and practicing pharmacists' ability to provide high quality care to TGD individuals.

Climate, knowledge, comfort related to LGBTQ+ health and healthcare

AimConduct a college level assessment of the perspective of staff, faculty and students on the climate, educational adequacy, and understanding on LGBTQ+ health and healthcare. BackgroundLGBTQ+ individuals face health disparities and discrimination. Inadequate educational preparation allows students to enter their professions with inadequate knowledge and biases. DesignCross-sectional study of faculty, staff, students (N = 343) in a college of health and human services college in the Midwest. MethodsData were gathered via anonymous internet surveys focused on LGBTQ+ climate, knowledge, and comfort. Descriptive statistics and chi square were used for analysis. ResultsWitnessing or experiencing LGBTQ+ harassment was more common in the community (33%, n = 115) than the university campus (5.6%), classrooms (2.9%, n = 10), clinical areas (0.3%, n = 1). While the majority (81.4-100%) correctly answered knowledge-based health questions regarding the LGBTQ+ population, 21% noted that they experienced more discomfort discussing sexual health with LGBTQ+ patients compared to non-LGBTQ+ patients.

“My Dude, Are You Tired? I’m Tired:” An Intersectional Methodological Intervention

This manuscript is a methodological intervention that addresses ethical considerations associated with conducting research in outdoor spaces, particularly with communities of color and other marginalized communities. The core issue is that BIPOC individuals, LGBTQIA + individuals, and disabled individuals face discrimination and violence in outdoor/recreational spaces. By investigating these issues, scholars can intensify the problem. We hope that our perspectives can assist ethical decision-making processes in methodology, advocacy, and interaction with outdoor communities of color.

Transgender and Gender Non-Binary Healthcare Coverage in State Medicaid Programs: Recommendations for More Equitable Approaches

Transgender and gender non-binary (TGNB) individuals face discrimination in healthcare settings and barriers to healthcare access, resulting in health disparities. These inequities are compounded by the intersection of lower socioeconomic status and geography. To understand the differences in how states provide healthcare to TGNB individuals in poverty, we ask: What are state Medicaid programs offering TGNB residents, and how can coverage be more equitable across jurisdictions? To answer these questions, we examine medical services covered by 15 diverse Medicaid programs and compare them to the services recommended by the World Professional Association for Transgender Health (WPATH). Unsurprisingly, the analysis reveals inconsistent TGNB health coverage across states. While some states include coverage for TGNB-related care, some do not, and others place access to services in the hands of medical providers. These coverage disparities leave many TGNB Medicaid recipients across the U.S. without coverage for medically necessary services, prompting equity questions for both research and practice.

Prenatal Genetic Testing for Intersex Conditions in Canada.

Intersex individuals face human rights violations, discrimination, and stigmatization worldwide. Diagnosis in infants is uncommon, with between 1 in 2000 and 1 in 4500 infants born with ambiguous external genitalia sufficient to warrant genetic and endocrine studies. However, estimates of the actual proportion of the population falling under the broader umbrella of intersex, including sexual variation at the chromosomal, gonadal, hormonal, or genital level, are as high as 1.7%. As the rise of non-invasive prenatal screening (NIPS) capable of identifying intersex conditions at the fetal stage has increased the potential for prenatal detection, there is an urgent need for attention to the potential ethical challenges that may arise from earlier and more frequent detection. There has been growing attention in recent years to the harms faced by intersex individuals at the hands of the medical community. In the prenatal context, genetic counseling is one avenue by which prospective parents might be helped to understand the full spectrum of intersexuality and form realistic expectations for their children. However, best practices and medical policies to prevent stigmatization and discrimination against intersex individuals remain underdeveloped. There is presently a lack of Canadian-specific guidance or explicit legal protections for intersex individuals to guide health care providers in their relationship with these patients and their families. In this commentary, we argue that this gap calls for increased training for health care providers that incorporates the voices and concerns of the intersex community.

Discriminatory experiences predict neuroanatomical changes and anxiety among healthy individuals and those at clinical high risk for psychosis

Individuals face discrimination based on characteristics including race/ethnicity, gender, age, and disability. Discriminatory experiences (DE) are associated with poor psychological health in the general population and with worse outcomes among individuals at clinical high risk for psychosis (CHR). Though the brain is sensitive to stress, and brain structural change is a well-documented precursor to psychosis, potential relationships between DE and brain structure among CHR or healthy individuals are not known. This report assessed whether lifetime DE are associated with cortical thinning and clinical outcomes across time, after controlling for discrimination-related demographic factors among CHR individuals who ultimately do (N = 57) and do not convert to psychosis (N = 451), and healthy comparison (N = 208) participants in the North American Prodrome Longitudinal Study 2. Results indicate that DE are associated with thinner cortex across time in several cortical areas. Thickness in several right hemisphere regions partially mediates associations between DE and subsequent anxiety symptoms, but not attenuated positive symptoms of psychosis. This report provides the first evidence to date of an association between DE and brain structure in both CHR and healthy comparison individuals. Results also suggest that thinner cortex across time in areas linked with DE may partially explain associations between DE and cross-diagnostic indicators of psychological distress.

EEG frequency-tagging demonstrates increased left hemispheric involvement and crossmodal plasticity for face processing in congenitally deaf signers

In humans, face-processing relies on a network of brain regions predominantly in the right occipito-temporal cortex. We tested congenitally deaf (CD) signers and matched hearing controls (HC) to investigate the experience dependence of the cortical organization of face processing. Specifically, we used EEG frequency-tagging to evaluate: (1) Face-Object Categorization, (2) Emotional Facial-Expression Discrimination and (3) Individual Face Discrimination. The EEG was recorded to visual stimuli presented at a rate of 6 Hz, with oddball stimuli at a rate of 1.2 Hz. In all three experiments and in both groups, significant face discriminative responses were found. Face-Object categorization was associated to a relative increased involvement of the left hemisphere in CD individuals compared to HC individuals. A similar trend was observed for Emotional Facial-Expression discrimination but not for Individual Face Discrimination. Source reconstruction suggested a greater activation of the auditory cortices in the CD group for Individual Face Discrimination. These findings suggest that the experience dependence of the relative contribution of the two hemispheres as well as crossmodal plasticity vary with different aspects of face processing.

0378 Social Well-Being as a Longitudinal Mediator of the Association Between Discrimination and Sleep Quality

Abstract Introduction Discrimination is a risk factor for poor sleep outcomes. Physiological activation is one mechanism tying the experience of discrimination to disturbed sleep. Discrimination, however, can also impact psychosocial well-being, which is a necessary precursor for healthy sleep. Feelings of safety derived from social connections can be threatened when individuals face discrimination. The objective of the current study was to examine the role of social well-being as a factor underlying the longitudinal association between discrimination and sleep quality. Methods An archival analysis was conducted with 937 adults participating in the longitudinal Midlife in the United States (MIDUS) study. Data was collected at three time points across 10 years. Perceived daily discrimination and overall social well-being were assessed via self-report. Sleep quality was assessed via the Pittsburgh Sleep Quality Index, Global Sleep Quality score. Results The overall model accounted for 15.6% of variance in global sleep quality. Controlling for multiple covariates, more frequent experiences of discrimination predicted worse global sleep quality 10 years later (β=.06, p=.03). Worse overall social well-being was a significant mediator of the discrimination-global sleep quality association (95% CI [.0001, .0118]), such that more frequent discrimination predicted lower overall social well-being, which, in turn, was associated with worse global sleep quality. Conclusion Given the persistence of sleep disparities among stigmatized and marginalized groups and the importance of sleep as a means of health disparity reduction, there is a need to identify mechanisms linking discrimination to poor sleep outcomes. Daily experiences of discrimination, such as being given less respect or treated as though less intelligent, have long-lasting associations with social well-being. Furthermore, social well-being is a predictor of future sleep quality. In addition to addressing discriminatory practices, targeting the effects of social well-being on sleep is a direction for future research. Support N/A

Literature for building an inclusive society: Ungendered narrative and its impact on the daily life of queer individuals


 When a reader encounters a character, fictional or not, in any medium (print or electronic), that reader will mentally add the character to the scene by first cataloguing gender, and gradually adding appearance, attire and mannerisms. But what if the author were to keep the character’s gender secret? The result would certainly be a more disorienting reading experience than usual, in which the reader would be barred from a complete image of the character. Even if the author chose to use inventive gender-neutral pronouns (which the reader may or may not know) to introduce the character, it would likely only further complicate the matter. We are conditioned to think of gender as of utmost importance in learning about a person in any situation. Gender non-conforming and queer individuals face stigma, discrimination and rejection, owing to their ambiguous gender expression. Hence, once the reader overcomes the initial confusion, reading ungendered narrative can help to generate a gender-inclusive environment by forcing the reader to ask, “Does gender really matter?” If readers were able to come to terms with ungendered characters and familiarity with gender-neutral pronouns in fictional narratives, perhaps it would not matter whether the person sitting next to them on a bus were transgender or a gender-fluid person. The person would be simply a human being, deserving of the same respect and care as any other. We might then become sufficiently comfortable using gender-neutral pronouns in our daily conversation. Thus, ungendered narrative holds significant promise for queer individuals, and its popularity and wide reach among readers could bring greater acceptance in real life of individuals with non-normative gender.