Transgender Women Research Articles

On the justification for World Rugby’s ban on trans women: assessing key arguments in the debate

ABSTRACT This paper examines the philosophical justification for World Rugby’s ban of trans women athletes from the ‘Women’s’ category at elite level. It is argued that Pike’s lexical priority argument in support of this ban is flawed; that Burke’s partially concessive response to Pike leads Burke to endorse an incoherent position; and that by rejecting Pike’s lexical priority argument, Burke’s view can both be made consistent and can be defended against the two criticisms levelled to it by Imbrišević. A stronger justification for WR’s ban is identified and discussed, and a diagnosis for the debate’s intractability is proposed.

Intimate Partner Violence Among Three Key Populations at Risk of HIV in Panama

This study aims to estimate the prevalence of interpersonal personal violence (IPV) among three key populations at an increased risk of HIV in Panama (namely, transgender women, sex workers, and men who have sex with men [MSM]) and to estimate the positivity rate of four sexually transmitted infections (STIs), including HIV. Participants from the 2018 PEMAR study with a stable primary partner completed a 31-item survey with demographic data, the Spanish version of the four-item HITS questionnaire (being physically Hurt, Insulted, Threatened, or Screamed at; Cronbach’s α = .816), and an optional blood draw for STI testing. Prevalence rates of IPV were estimated with their respective 95% CIs after imputing 3.93% of missing values. The analytic sample (N= 356) included 76.0% MSM, 15.5% sex workers, and 9.3% transgender women, most of whom were in their 30s, married, and Latinx; completed some college; and worked full time. The most frequent forms of IPV were screams and insults. The IPV prevalence rates were estimated for transgender women (19.05%), sex workers (10.53%), and MSM (2.36%). Among participants who consented to blood samples (n= 291), transgender women who experienced IPV had a significantly (P= .03) higher syphilis positivity rate and MSM who did not experience IPV had a significantly (P< .001) higher HIV positivity rate. Among key populations, transgender women experienced the highest rate of IPV and significantly higher syphilis rates. Paradoxically, HIV rates were higher among MSM who do not experience IPV. While societal roles and other contextual factors play a partial role in these syndemic findings, more studies are warranted.

HIV and hepatitis C virus infection and co-infection among trans women in San Francisco, 2020.

Transgender women (hereafter "trans women") face social marginalization, stigma, and discrimination and experience a high burden of HIV. More recently, trans women have been identified as having a high risk for hepatitis C (HCV) infection. The interaction between these two diseases and the risks for HIV/HCV co-infection among trans women are understudied. To characterize epidemiological, behavioral, and socio-structural interactions between HIV and HCV infections among trans women. This cross-sectional study examined data from a community-based survey of trans women in San Francisco recruited through respondent-driven sampling (RDS) in 2019/2020. Face-to-face interviews collected data on demographics, medical history, drug injection practices, sexual behavior, and socio-structural factors (e.g., poverty, housing insecurity, incarceration, social support). HIV and HCV antibodies were detected using oral fluid rapid tests and prior diagnosis and treatment were collected by self-report. Blood specimens were collected to confirm antibodies using ELISA. Multinomial logistic regression analysis characterized factors associated with HIV infection alone, HCV infection alone, and HIV/HCV co-infection compared to neither infection. Among 201 trans women recruited, HIV prevalence was 42.3%; HCV infection by history or current seroprevalence was 28.9%; evidence for both HIV and HCV infection was present for 18.9%. Two-thirds of trans women (67.2%) had been incarcerated; 30.8% had ever injected drugs. History of injection drug use and receiving emotional support from family were factors found in common for HIV infection, HCV infection, and HIV/HCV co-infection compared to no infection. Having a sexual partner who injects drugs was associated with HIV infection alone. Not lacking care due to cost and older age were associated with co-infection. Older age was also associated with HCV infection. Of trans women with HIV infection, 91.8% had accessed HIV care, whereas only 62% with HCV had accessed some form of care. Our study found high levels of HIV, HCV, and HIV/HCV co-infection among trans women in San Francisco. We found common associations between HIV and HCV through injection practices and emotional support, but having a sexual partner who injects drugs was not associated with HCV infection alone or co-infection. We note a substantial gap in the treatment of HCV for trans women, including those in HIV care, that needs to be urgently addressed.

Mpox Recurrence and Tecovirimat Resistance in a Patient With Advanced Human Immunodeficiency Virus Disease.

We present a case of mpox recurrence in a transgender woman with AIDS. Her recurrent lesions required several courses of antiviral therapy over a 5-month period and her monkeypox viral genome was subsequently noted to have tecovirimat resistance mutations. Interestingly, she developed a robust orthopoxvirus-specific T-cell response.

Anti-Trans Attacks: Interrogating “Gender” in Politics and Gender Scholarship

This essay considers the rapid uptick in anti-trans legislation that targets transgender girls and women as an occasion to critically interrogate the ways that gender is conceptualized and operationalized in political science (Murib 2022). I argue that the disciplinary tendency to view gender as a single-axis facet of identity that is static and rooted in biology needs to be reconsidered in light of two problems. First, collapsing biological sex and gender naturalizes the gender of non-trans women and men as static, normal, and self-evident; transgender people, in contrast, are locked into perpetual processes of gendering themselves against this biological baseline (Enke 2012). Second, and as a result of this limited view of gender, political scientists face difficulties anticipating, understanding, and addressing recent mobilizations invested in maintaining White, heterosexual, and reproductive families as the cornerstone of what it means to be a proper citizen (Alexander 1994).

Abstract B092: ‘We’ve got to go to the doctor and we’re scared to death’: Community members perspectives on sexual orientation and gender identity data collection in healthcare settings

Abstract Purpose: Much research is needed to advance our knowledge of LGBTQ cancer disparities, but research is hindered by inconsistency in collection of data on sexual orientation and gender identity (SOGI) across clinical and research settings. Nationally, there have been increased efforts to standardize SOGI data collection. The purpose of this study was to identify potential patient-level barriers and facilitators to SOGI data collection within the catchment area of a midwestern cancer center. Methods: Investigators conducted 4 focus groups in partnership with community-based organizations and stakeholder groups that reflected the catchment area’s diverse populations. Using a semi-structured approach, participants were asked about their experiences with SOGI data collection, barriers and facilitators to this collection, and how they viewed the practice of collecting SOGI data. Focus groups were audio recorded and transcribed. Data was coded and interpreted using applied thematic analysis. Results: Four focus groups were conducted with 32 participants in total. There were 2 LGBTQ groups (one mixed race/ethnicity, one African American), and 2 predominantly non-LGBTQ groups (one African American and one Middle Eastern/North African or MENA). Across all participants, 53% were African American (n=17), 25% identified as MENA (n=8), 28% were White (n=9), 44% of the participants identified as women (n=19), one individual identified as a transgender woman & 2 individuals as non-binary, and 53% reported their sexual orientation as gay/lesbian/same-loving. In all groups, participants emphasized a need to educate both patients and providers about the importance of SOGI data collection, why it is collected, and its relevance to improving medical care. Participants further discussed the quality and depth of the patient-provider relationship as a critical factor in a patient’s comfort and willingness to share SOGI data. Participants also underscored the importance of privacy ownership (i.e., the ownership of one’s own private information) and control in relation to SOGI status, and the desire to minimize potential privacy turbulence of an unexpected and unwelcome disclosure breach. All groups discussed how the potential for harm resulting from SOGI disclosure could deter patients from sharing SOGI information. Those who identified as LGBTQ, recounted both personal experiences and the experiences of others in which disclosure of SOGI information directly led to poor treatment by a healthcare professional. It is this potential for harm and discrimination that led many participants to stress the need for privacy control until a safe environment is established. Conclusions: Findings highlight a number of potential patient barriers to SOGI data collection from community members’ perspectives, including the need for widespread education on this topic and clinical environments in which patients are safe disclosing SOGI status. Future research and practice should consider specific methods to normalize the practice of SOGI data collection in the cancer care context. Citation Format: Ariel Washington, Ali Fakih, Lindsey Toman, Riham Ayoub, Emma Noble, Susan Musto, Brittany Dowe, Scott Ellis, Andrea Sakleh, Hayley S. Thompson, Latonya Riddle-Jones. ‘We’ve got to go to the doctor and we’re scared to death’: Community members perspectives on sexual orientation and gender identity data collection in healthcare settings [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B092.

Abstract B168: A qualitative examination of how state policy and sociopolitical environmental influence experiences of cancer care for minoritized sexual and gender populations who have experienced breast cancer

Abstract Introduction: A growing body of literature is investigating how structural barriers, including policies, impact cancer outcomes among marginalized populations, including the 2SLGBTQ+ (two spirit, lesbian, gay, bisexual, transgender, queer, asexual, intersex, and gender non- conforming or gender non-binary)(sexual and gender minoritized (SGM)) communities. An underresearched area is how the state-level policy and sociopolitical environment shape the experiences and outcomes of SGM people who have experienced breast cancer. Using data from the Elsie Study, this research examines how SGM people who have experienced breast cancer are impacted by their state’s policies and sociopolitical context. To the authors' knowledge, this study is the first of its kind to examine these experiences of breast cancer care for SGM people. Methods: The Elsie Study is the largest qualitative survey of SGM people who have experienced cancer conducted within the U.S. To date the Elsie Study at the University of Minnesota has conducted 60-90 minute semi-structured interviews with thirteen sexally and gender minoritized people who have experienced breast cancer. Our participants were recruited from advertising campaigns on social dating applications, including HER, and community organizations. Interviews were conducted nationwide over Zoom and phone beginning in June 2023 and continuing through June 2024. Summary of data: Our participants who have experienced breast cancer have diverse sexual orientations, gender identities, and racial and ethnic backgrounds. Among the thirteen sexually and gender minoritized participants who experienced breast cancer, their sexual orientations encompass those who identify as lesbian, gay, bisexual, queer, or some of these interchangeably. Participants’ gender identities include identifying as cisgender woman, genderqueer, non-binary, transgender man, and transgender woman. Participants’ racial and ethnic backgrounds are white, Black or African American, Latino/a/x, and Asian. Participants at the intersections of marginalized identities noted substantial difficulties in receiving culturally competent care during breast cancer treatment. A majority of SM and GM women and non-binary participants mentioned the importance of living in a “queer and trans friendly state,” liberal cities, or states with marriage equality for aspects such as accessing culturally competent cancer care and participating in cancer research. Conclusions: Narratives such as those expressed by our SGM participants who experienced cancer are important for understanding how state policy and sociopolitical contexts shape access to healthcare and even cancer research. Our study has wide implications for how affirming state policy and sociopolitical climates may afford more equity in cancer care for SGM people. Citation Format: Courtney Sarkin, Alexandra M. Ecklund, Ben Weideman, Rhea Alley, B.R. Simon Rosser, G. Nic Rider. A qualitative examination of how state policy and sociopolitical environmental influence experiences of cancer care for minoritized sexual and gender populations who have experienced breast cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B168.

Abstract B118: “When people don’t look at you as human, then it’s down from there…”: Experiences of 2SLGBTQIA+ people treated for cancer and implications for research participation

Abstract Background: Recent U.S. estimates show 20 million+ people identify as two-spirit, lesbian, gay, bisexual, transgender, queer, intersex, or asexual (2SLGBTQIA+). Despite heightened risk factors for cancer, 2SLGBTQIA+ people are an underserved population and have rarely been included in cancer research. Further, cancer-related mortality and quality of life measures for this population remain unknown. The Elsie Study uses in-depth interviews to better understand the experiences of 2SLGBTQIA+ people who have been treated for cancer and explore recruitment considerations to improve their research participation. Methods: We conducted 60-90 minute one-on-one semi-structured interviews with 2SLGBTQIA+ adults who have been previously treated for cancer. We recruited participants through targeted creative advertising campaigns on dating apps (HER, Scruff, Jack’d, Grindr) and through community organizations, community events, and the study website. Questions explored cancer treatment experiences, intersectional identities and experiences, research participation decision-making, recruitment strategies, and trusted sources of information. We recorded, transcribed, and de-identified interviews, and used thematic approaches for qualitative analysis. Results: Between June 2023-June 2024, we completed 65 interviews with sexually diverse cisgender women (n=17), cisgender men (n=16), transgender women (n=11), transgender men (n=4), and nonbinary, gender-expansive, and two spirit people (n=17). Participants were located throughout the U.S. in rural and urban areas with differing levels of cancer treatment access, social support, and structural support. Participants were treated for many types of cancer, with the most common being breast, prostate, and blood cancers. Among the sample, 38.5% were American Indian or Alaska Native, African American, or Asian/Asian American, and 13.8% identified as Hispanic. Notably, racially/ethnically marginalized 2SLGBTQIA+ participants described the emotional toll of dehumanization and how it impacted their cancer care treatment as individuals with multiple marginalized identities. For example, one participant said “Although I’m going through this physical pain, it’s emotionally painful to have to explain myself and my identifications to people who don’t know and don’t want to know either… What’s the point?” Another participant said, “When people don’t look at you as human, then it’s down from there unfortunately."Most participants had not previously participated in health research, but all interviewees affirmed they wanted to know the results from the study and wanted to be notified about future research opportunities with our team. The use of dating apps and community organizations as recruitment methods was noted as novel and trustworthy. Conclusion: People of all genders and sexual orientations get cancer, and 2SLGBTQIA+ people represent an increasing number of oncology patients. It is imperative that the perspectives of 2SLGBTQIA+ people be considered in cancer care and cancer research. Citation Format: Alexandra M. Ecklund, Ben Weideman, Rhea Alley, Courtney Sarkin, B.R. Simon Rosser, G. Nic Rider. “When people don’t look at you as human, then it’s down from there…”: Experiences of 2SLGBTQIA+ people treated for cancer and implications for research participation [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B118.

‘All the dykes I know drink beer’: Sexuality and gender performance through alcohol consumption among lesbian, bisexual, and queer women in Australia

This article explores the relationship between gender, sexuality and alcohol consumption among lesbian, bisexual, and queer (LBQ) women in Australia. On average, LBQ women consume alcohol at a higher rate than heterosexual women, yet the use of alcohol and its gendered meanings in this population remain under-explored. We conducted semi-structured interviews with 42 cisgender women, 10 transgender women, and 8 non-binary people who identify as lesbian, bisexual, and/or queer. Participants were aged 18–72. Interviews explored participants' experiences with alcohol, gender, and sexuality. Interviews were thematically analysed, informed by a critical alcohol and other drug scholarship lens. While ‘minority stress’ is often cited as a key factor in explaining LBQ women's high rates of alcohol consumption, our findings suggest a more complex relationship between drinking, gender and sexuality. Drinking is gendered for LBQ women, enabling both performance of and resistance to gendered norms. Additionally, alcohol emerged as a tool for navigating gendered vulnerability in public spaces, with some participants shaping their alcohol intake to their environment. Our findings highlight the need for approaches to LBQ women's health that recognise alcohol as a social tool that can facilitate confidence, pleasure, and community connection. Rather than focusing solely on risk and vulnerability, policies and health promotion efforts should consider the diverse ways in which LBQ women use alcohol to navigate their identities and social environments.

The burden of chronic pain in transgender and gender diverse populations: Evidence from a large US clinical database

AbstractBackgroundChronic pain, affecting approximately 20% of the global population, is the leading cause of disability worldwide. Transgender individuals are disproportionately exposed to chronic pain risk factors compared with the cisgender population. This study compares the incidence of chronic pain between transgender and cisgender individuals and examines the impact of gender affirming hormone therapy, anxiety, and depression on chronic pain.MethodsThe study analysed medical records data of 56,470 transgender men and 41,882 transgender women in the TrinetX database. Six cohorts were created: transgender women either receiving oestrogen or no intervention, transgender men receiving testosterone or no intervention and cohorts of cisgender males and females. Unmatched age‐adjusted incidence rates were calculated. Then cohorts were matched on 22 chronic pain‐associated covariates and the rate of new chronic pain diagnoses was compared between those receiving hormone therapy and those without.ResultsWe observed significantly higher rates of chronic pain among transgender individuals compared with cisgender counterparts. Transgender men on testosterone therapy and transgender women on oestrogen therapy exhibited an increased likelihood of chronic pain diagnoses compared with those not receiving hormone therapy. Individuals with anxiety and depression were more likely to be diagnosed with chronic pain.ConclusionThis study demonstrates a significant burden of chronic pain in transgender individuals, with an increased risk among those receiving hormone therapy. Our study, the first to assess chronic pain in a large cohort of transgender patients, provides support for a potential association between hormone therapy and risk of chronic pain diagnosis. Further research is required to understand causal mechanisms and to develop improved screening and management of chronic pain in transgender populations.Significance StatementOur study, featuring the largest cohort of Transgender and Gender Diverse (TGD) individuals assembled to date, reveals critical disparities in chronic pain among TGD populations, notably those on hormone therapy, compared with the cisgender population. It highlights the urgent need for specialized screening and treatment for this vulnerable population, and research into hormone therapy's impact on pain. These insights aim to foster more effective, personalized healthcare, enhancing the well‐being and quality of life for the TGD community.

The potential of a hygiene-based message, preferred learning modalities, and *iLubricarte, Liberarte, Lavarte+!" or L 3 + for the prevention of HIV/STI in Peru.

Hygiene-based practices of lubrication, genital cleansing, postcoital urination, and rectal douching are common behaviors among populations at higher risk of human immunodeficiency virus (HIV)/sexually transmitted infections (STI). Yet, the role these behaviors have on HIV/STI risk has not been well elucidated, especially among transgender women (TW) and gay, bisexual, and other men who have sex with men (GBMSM). Additionally, advances in biomedical strategies have heralded a new era of HIV/AIDS prevention that may be accompanied by behavioral changes that lead to decreases in condom usage and subsequent changes to STI sequelae. Nevertheless, many people at higher risk are not benefiting equally from these options, strengthening the need for more sustainable, evidence-based methods. This study explored the knowledge, attitudes, and behaviors of hygiene-based practices, proven preventative methods, and preferred learning methods among Peruvian TW and GBMSM. 30 interviews and 50 questionnaires were conducted with TW (N=35), GBMSM (N=35), healthcare providers (N=5), and key community informants (N=5). Most participants perceived hygiene-based practices to be common behaviors and a significant aspect of sexual wellbeing. Educational materials utilizing social media and hosting in-person events were also viewed favorably, with value to enhancing HIV/STI knowledge. Several barriers to autonomy surfaced in the data, including systemic disparities to adequate HIV/STI services, top vs. bottom social dynamics, and PrEP accessibility issues. Continued work is needed to address the barriers to the acceptability, feasibility, and potential efficacy of hygiene-based practices, biomedical/barrier strategies, and L 3 +.

Induced lactation in a transgender woman: case report

BackgroundBreastfeeding offers significant health benefits, but its practice and success can vary. While research on induced lactation in cisgender women has been documented, there is limited research on lactation induction in transgender women.Case presentationA 50-year-old transgender woman undergoing hormone therapy and living with a pregnant partner sought to co-feed using induced lactation. After approval by the hospital ethics committee, a regimen of estradiol, progesterone, and domperidone was initiated, accompanied by nipple stimulation. Lactation was successfully induced and maintained, with milk composition analysis indicating high levels of protein and other key nutrients. This case, the seventh reported, highlights the complexity of lactation induction in transgender women, considering factors such as age, obesity, and insulin resistance. The nutrient profile of the milk suggests its suitability for infant feeding, despite some differences from typical human milk.ConclusionsInduced lactation is feasible in transgender women, expanding the understanding of non-puerperal lactation and its potential in diverse family structures. Further research is warranted to optimize lactation induction protocols in transgender women.

Impact of Covid-19 pandemic on HIV testing, recent infections and annualized incidence among cisgender men who have sex with men and transgender women in Brazil

Background: The Covid-19 pandemic had great impact on HIV care and prevention worldwide, including in Brazil. We compared HIV testing, recent infection, and annualized incidence according to Covid-19 pandemic period among men who have sex with men (MSM) and transgender women (TGW). Setting: HIV/STI testing, prevention and treatment referral service in Rio de Janeiro, Brazil Methods: We used Maxim HIV-1 Limiting Antigen Avidity EIA as part of recent infection testing algorithm to identify recent HIV infections and estimate annualized HIV incidences in pre- (March/2018-February/2020) and post-Covid-19 pandemic onset period (March/2020-January 2022). Multivariable logistic regression model assessed factors associated with recent HIV infection. Results: Among 4590 MSM and TGW, 593 (12.9%) tested positive for HIV and 119 (2.6%) were identified as having recent infection. Percentage of recent HIV infection did not differ between Covid-19 periods. Overall annualized HIV incidence rates were 6.0% (95%CI:4.2-7.7) and 6.6% (95%CI:4.3-9.0) in pre- and post-Covid-19 periods, respectively. During the post-Covid-19 period, higher incidence rates were observed among TGW (8.4%[95%CI:2.9-13.9]), those aged 18-24 years (7.8%[ 95%CI:4.0-11.7]), Black race (7.9%[95%CI:3.8-12.0]), and with <12 years of schooling (7.8%[95%CI:4.8-10.8]). Incidence rates were significantly higher in the post-Covid-19 period for those aged>30 years and TGW, and lower for those with more years of schooling. Conclusion: HIV incidence estimates remain high among MSM and TGW in Brazil, especially among the most vulnerable. The consequences of the Covid-19 pandemic on the HIV epidemic will likely persist and contribute to worsening HIV outcomes.

Woman: Concept, Prototype and Stereotype

ABSTRACT Drawing on previous work, I argue that a family resemblance account of the concept woman has several beneficial consequences. Namely, it promotes hermeneutical justice, and, in time, it may serve to change the prototypes and stereotypes people tend unreflectively to associate with woman. I claim that only at that point will full hermeneutical justice be achieved. To this end, I propose a reconceptualization of the notion of hermeneutical injustice, first presented by Fricker (2007). First, I present the family resemblance account of woman. Accordingly, that concept isn’t identified by a set of necessary and (jointly) sufficient conditions, but, roughly, by different criteria. Second, I show how concepts, prototypes and stereotypes relate to one another and how they may contribute to hermeneutical injustice. Finally, I show how the proposed account of woman may in time foster a change in the associated prototype and stereotypes, which will ameliorate societies by doing more justice to the lived experience of trans women – that is, by promoting full hermeneutical justice.

Knowledge, attitudes and practices related to AIDS amongst transgender women in Chongqing, China: a cross-sectional study

BackgroundTransgender women (TGWs) constitute one of the key populations for HIV prevention and control and constitute a high-risk group due to a lack of health services. The aim of this study was to investigate knowledge, attitudes and practices (KAPs) related to HIV and knowledge access and needs amongst transgender women in Chongqing, China.MethodsA cross-sectional study was conducted from October 2022 to March 2023. A total of 128 self-identified TGWs were recruited in Chongqing, China, via snowball sampling, and a KAP-related questionnaire was completed via Questionnaire Star.ResultsFor the 128 TGWs surveyed effectively, the total knowledge of AIDS-related knowledge was 82.03%, with significant differences in age, education level, marital status, occupation and average monthly income (p < 0.05). Significant differences were obtained in terms of personal attitudes toward AIDS and place of domicile and literacy (p < 0.05) and subjective norms in terms of literacy (p < 0.05). No significant difference was observed between the groups in terms of HIV-related practices. The corresponding values were assigned to knowledge, attitudes or practices. The total scores of the three aspects were 6.77 ± 1.47 (95% confidence interval [CI]: 3.89–9.65) (range: 0–8), 14.22 ± 2.37 (95% CI: 9.57–18.87) (range: 0–18) and 6.66 ± 1.79 (95% CI: 3.16–10.17) (range: 0–9), respectively. The main approaches for TGWs to acquire AIDS knowledge are ‘Internet/smartphone’ (81.68%), ‘TV/radio’ (49.62%) and ‘special education on AIDS prevention in schools’ (48.09%). TGW is more inclined to accept promotional activities such as ‘WeChat push’ (58.02%), ‘peer education’ (44.27%) and ‘mobile app management’ (37.40%). AIDS knowledge indicates that TGW needs to strengthen publicity, including ‘transmission routes’ (71.76%), ‘voluntary counselling and testing knowledge’ (67.94%) and ‘virus-related knowledge’ (64.89%).ConclusionsFirst, the knowledge rate of AIDS amongst TGWs in Chongqing, China, still has room for improvement, and there is a gap between knowledge and behavior. Second, TGWs are tolerant of AIDS and people living with AIDS and have a strong awareness of AIDS prevention. Third, the health department should attach importance to the group of TGW over 35 years old, low-income, and low-educated, and promote social organizations and network platforms to further strengthen the health education and publicity of AIDS from the perspectives of knowledge acquisition and needs.

Unveiling sex-disparities and the impact of gender-affirming hormone therapy on periodontal health

IntroductionAs personalized medicine advances, the need to explore periodontal health across different sexes and gender identities becomes crucial. This narrative review addresses the gap in understanding how biological sex and gender-affirming hormone therapy (GAHT) influence periodontitis risk.ResultsResearch has uncovered significant sex-based immunological disparities driven by X and Y chromosome gene expression and sex-hormones, which may influence susceptibility to periodontitis. Additionally, preliminary findings suggest that GAHT, particularly testosterone therapy in transgender men, could exacerbate pro-inflammatory cytokine production and alter immune cell responses, which may exacerbate inflammatory pathways crucial in the progression of periodontitis. Conversely, the effects of estrogen therapy in transgender women, although less extensively studied, suggest modifications in B cell functionality. These observations highlight the complex role of GAHT in modulating immune responses that are central to the development and exacerbation of periodontal disease.DiscussionThe review highlights a complex interaction between sex hormones, gene expression patterns, immune responses, and periodontitis risk. While cisgender males show increased susceptibility to periodontitis that could be linked to specific immune pathways, GAHT appears to modify these pathways in transgender individuals, potentially altering their risk and disease progression patterns.ConclusionThere is a critical need for more focused research on the direct impacts of GAHT on periodontal health. Understanding the nuances of immune modulation by GAHT will aid in crafting personalized periodontal care for transgender individuals, aligning with the broader goals of inclusive and effective healthcare.

“When men were men”: the effects of Gender Nostalgia on bias against trans men and women

ABSTRACT In recent years, many people have expressed opposition to the increased public representation of trans men and women. This opposition often includes a sentimental longing for a bygone past wherein ‘men were men, and women were women’. Across three studies (N = 860), we investigated the causes and consequences of this longing, herein called Gender Nostalgia. In Study 1, we developed a measure of Gender Nostalgia, and found it to be a uniquely strong predictor of extreme forms of anti-trans bias such as acceptance of anti-trans violence. Critically, Gender Nostalgia predicted acceptance of anti-trans violence above-and-beyond other direct measures of anti-trans bias and relevant demographics. Study 2 replicated Study 1 and investigated predictors of Gender Nostalgia, finding that Gender Nostalgia was strongly predicted by participants’ self-reported gender essentialism (e.g. the belief that men and women are discretely separate social categories). Study 3 experimentally manipulated participants’ perceptions of the degree to which traditional masculinity/femininity has changed over time. Results indicated that among participants high, but not low, in gender essentialism, considering eroding traditional masculinity/femininity increased Gender Nostalgia and acceptance of anti-trans violence. Discussion surrounds the importance of considering Gender Nostalgia when investigating people’s bias against trans men and women.

Resilience and Vulnerability: Lesbian, Bisexual and Transgender Women Managing LGBTphobia in Rural Israel

Neoliberal discourses associate resilience with active stances and independence. Conceptualizing the relationship between vulnerability and resilience, this paper discusses lesbian, bisexual, and transgender (LBT) women’s experiences of LGBTphobia in Israeli rural space. Addressing the 67th Commission on the Status of Women (CSW) challenge to describe intersectional issues, this paper reveals alternative negotiations of LBT women’s vulnerabilities. Using a theory of vulnerability, we claim that LBT women express resilience even in situations of marginalization and vulnerability. The paper shows how resilience, embedded within vulnerability, is constructed through the management of LGBTphobia via three strategies: construction of alternative spaces, advocacy, and direct resistance to acts of violence.

Reproductive health in trans and gender diverse patients: Transgender medicine: contextual trans gynecology.

This manuscript aims to promote an understanding of the special needs of transgender and gender-diverse people by putting trans gynecology into context. By definition, medical interventions for transgender people are not different from the treatment of cisgender people but cannot be singled out as gender-affirmative treatment. Treatment is dedicated to an overarching goal beyond medicine, namely to enable and maintain social functioning under the signs of the social gender. It is therefore that this narrative overview intensively deals with the requirements of trans gynecology. Also, various gynecological disorders are touched upon, provided they are relevant to trans people. The different significance of gynecological symptoms for either trans men or trans women, and the effects of supraphysiological androgen treatment on hormone-sensitive tissue, are stressed. Transgender health care is not just gender-affirmative transitional care but is committed to a superior objective, often beyond a medical perspective: to create and maintain physical conditions for social functioning under the signs of the individually appropriate sex and to contribute to significantly reducing gender dysphoria. For these purposes, it is a prerequisite to have a distinct contextual understanding of the complex reality of transpeople and knowledge about the numerous facets of transgender healthcare. Gynecology for transgender and gender-diverse people does not differ greatly from gynecology for cisgender female patients except in goals and context. Relief from complaints derived from genital organs is, of course important, but for transpeople there always is an overarching gender dimension that sometimes complicates treatment and might give rise to misunderstandings. Also, minority stress caused by societal factors frequently impacts the mental and physical state of health negatively and needs to be considered. This paper focuses on the context of trans gynecology and addresses various contentual aspects for both transmale patients having left genital organs in situ and transfemale patients with gynecological demands. Gynecological topics are addressed, highlighting their relevance for transgender and gender-diverse people (TGD), including the effects of supra-physiological androgen exposure on ovaries and uterus, vaginal bleeding, pelvic pain under testosterone treatment, screening policies, and benign gynecological disorders as clinical manifestations may appear differently and treatment may be more burdensome.

Barriers to HIV Care among Transgender Sex Workers of Colour in the USA and Canada: An Intersectional Scoping Review

Objectives In 2018, HIV prevalence among transgender women of color in the USA was 14.11%, with similar severe trends observed in Canada. This highlights the persistent challenge of HIV/AIDS in both countries, particularly for transgender sex workers of color (TSWOC), who face significant barriers to accessing crucial HIV/AIDS care services due to stigma, systemic discrimination, and biased healthcare practices. To address these issues, a scoping review was undertaken to explore the specific barriers to HIV/AIDS care experienced by TSWOC in the United States and Canada. Methods After various database searches (MEDLINE, PubMed, and Google Scholar) using the PRISMA-ScR methodology, 47 studies were extracted. Studies were then screened on Covidence by using the set inclusion and exclusion criteria. After screening, fifteen studies met the criteria. Results The results were thematically organized using an intersectionality-grounded socio-ecological model. Results revealed individual-level challenges of internalized stigma, interpersonal issues with biased healthcare providers, and community-level problems such as lack of support and enduring stigma. Notable structural barriers, consistent across studies, included homelessness, economic marginalization, and institutional transphobia. Institutionalized cisnormativity in healthcare was also found to exacerbate these challenges. Conclusions The findings underscore a feedback loop intensifying HIV/AIDS burdens within TSWOC due to intersecting stigmas and structural disparities. The review advocates for trans-specific and trans-inclusive HIV/AIDS services to address unique challenges, emphasizing the imperative for holistic, trauma-informed HIV care for this underserved population.