1
|
Carroll R, Sepulveda B, McLeod L, Stephenson C, Carroll RW. Characteristics and gender affirming healthcare needs of transgender and non-binary students starting hormone therapy in a student health service in Aotearoa New Zealand. J Prim Health Care 2023; 15:106-111. [PMID: 37390028 DOI: 10.1071/hc23040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/26/2023] [Indexed: 07/02/2023] Open
Abstract
Introduction Traditionally, gender-affirming hormonal therapy (GAHT) is initiated in secondary care, but a primary care based approach has been developed to reduce access barriers. Aim We aim to describe the demographics, hormone choices, and additional referrals made for young people initiating GAHT in a primary care setting in Aotearoa New Zealand. Methods Clinical notes were reviewed for all patients who commenced GAHT between 1 July 2020 to the end of 2022 at a tertiary education health service. Data were collected on age, ethnicity, gender, type of hormones prescribed, and any additional referrals. Results Eighty five patients commenced GAHT during the review period (64% assigned male at birth and starting oestrogen-based GAHT, 36% assigned female at birth and commencing testosterone-based GAHT). Fourty seven percent of patients identified as transgender female, 38% as non-binary, and 15% as transgender male. Spironolactone was the most common choice of testosterone blocker (81%). The choice of oestrogen formulation was fairly equal between patches (54%) and tablets (46%). Eighty percent of those assigned male at birth chose to preserve fertility, 54% requested voice therapy, and 87% of those assigned female at birth requested top surgery. Discussion There is a need for improved understanding of non-binary gender-affirmation needs, in particular those of Māori and Pasifika youth. An informed consent approach in primary care can reduce barriers and distress for transgender youth seeking GAHT. The high unmet need for top surgery for transgender people assigned female at birth requires attention.
Collapse
Affiliation(s)
- Rona Carroll
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand; and Mauri Ora Student Health and Counselling Service, Victoria University of Wellington, New Zealand
| | - Bianca Sepulveda
- Mauri Ora Student Health and Counselling Service, Victoria University of Wellington, New Zealand
| | - Lane McLeod
- University of Otago Medical School, Wellington, New Zealand
| | | | - Richard W Carroll
- Endocrine, Diabetes and Research Centre, Te Whatu Ora Capital, Coast and Hutt Valley
| |
Collapse
|
2
|
du Plessis C, Halliwell SD, Mullens AB, Sanders T, Gildersleeve J, Phillips T, Brömdal A. A trans agent of social change in incarceration: A psychobiographical study of Natasha Keating. J Pers 2023; 91:50-67. [PMID: 35715895 PMCID: PMC10108085 DOI: 10.1111/jopy.12745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 04/30/2022] [Accepted: 06/13/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This psychobiography focuses on the advocacy work of Natasha Keating, a trans woman incarcerated in two male prisons in Australia between 2000 and 2007. Incarcerated trans women are a vulnerable group who experience high levels of victimization and discrimination. However, Natasha advocated for her rights while incarcerated and this advocacy contributed to substantial changes in the carceral system. This psychobiography uses psychological understandings of resilience as well as the Transgender Resilience Intervention Model (TRIM) to investigate the factors that enabled this advocacy. METHOD Data consisted of an archive of letters written by Natasha and interviews with individuals who knew her well. This psychobiography was guided by du Plessis' (2017) 12-step approach and included the identification of psychological saliencies and the construction of a Multilayered Chronological Chart. RESULTS Natasha's life is presented in four chapters, with each chapter including a discussion of resilience based on the TRIM. CONCLUSIONS The TRIM suggests that during incarceration, Natasha was able to access more group-level resilience factors than at any other time in her life. This, combined with individual resilience factors, enabled her advocacy. This finding has implications for advocacy in general as it highlights the importance of both individual- and group-level factors in enabling individuals to effectively advocate for change in their environments.
Collapse
Affiliation(s)
- Carol du Plessis
- School of Psychology and Wellbeing, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Sherree D Halliwell
- School of Humanities and Communication, Faculty of Business, Education, Law and Arts, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Amy B Mullens
- School of Psychology and Wellbeing, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Tait Sanders
- School of Psychology and Wellbeing, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Jessica Gildersleeve
- School of Humanities and Communication, Faculty of Business, Education, Law and Arts, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Tania Phillips
- School of Psychology and Wellbeing, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Annette Brömdal
- School of Education, Faculty of Business, Education, Law and Arts, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| |
Collapse
|
3
|
Newman CE, Smith AKJ, Duck-Chong E, Vivienne S, Davies C, Robinson KH, Aggleton P. Waiting to be seen: social perspectives on trans health. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2021; 30:1-8. [PMID: 33622203 DOI: 10.1080/14461242.2020.1868900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- Christy E Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Anthony K J Smith
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | - Son Vivienne
- Thorne Harbour Health, Melbourne, Australia
- Transgender Victoria, Melbourne, Australia
| | - Cristyn Davies
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Kerry H Robinson
- School of Social Sciences, Western Sydney University, Sydney, Australia
| | - Peter Aggleton
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
- School of Sociology, The Australian National University, Canberra, Australia
| |
Collapse
|