1
|
Karakısla FS, Fidanci C, Aydın R, Kabukcuoğlu K. "I Had Attained the Identity I Had Long Desired": A Grounded Theory Study of Experiences of Transgender Men in Türkiye. Issues Ment Health Nurs 2024; 45:906-916. [PMID: 39110854 DOI: 10.1080/01612840.2024.2371940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Transgender individuals form a distinct community that often experiences marginalization within society. This marginalization is particularly pronounced in patriarchal countries, where transgender men encounter various challenges across psychological, medical, legal, and social domains during their transition. The study design to conduct a thorough analysis of the life experiences and perspectives of transgender men in Türkiye. It involved 15 participants and the collected data were subsequently analyzed using the constant comparative method, a key technique within grounded theory methodology. The coding process resulted in three main themes: "Realizing gender identity", "Impact of social support sources", and "The nature of being visible", and six sub-themes were formed, the core category being "… Despite the numerous challenges encountered along the way, when I gazed into the mirror, I realized I had attained the identity I had long desired". Transgender individuals in the study expressed encountering emotional, physical, and psychological challenges throughout their personal journeys. However, despite these difficulties, they reported experiencing a sense of satisfaction and contentment upon reaching the end of their transition process. It is recommended to implement counseling services specifically tailored for transgender individuals and their families and incorporate transgender-related content into the training programs of professionals working with transgender individuals.
Collapse
Affiliation(s)
| | - Cagla Fidanci
- Women's Studies and Gender Issues Research and Application Centre, Akdeniz University, Antalya, Türkiye
| | - Ruveyde Aydın
- Department of Gynecology and Obstetrics Nursing, Health Sciences Faculty, Ondokuz Mayıs University, Samsun, Türkiye
| | - Kamile Kabukcuoğlu
- Department of Gynecology and Obstetrics Nursing, and Department of Gynecology and Obstetrics Nursing, Faculty of Nursing, Akdeniz University, Antalya, Türkiye
| |
Collapse
|
2
|
Rahman E, Rao P, Webb WR, Philipp-Dormston WG, Sayed K, Almeida ART, Mosahebi A, Carruthers JDA, Carruthers A. Embracing Spectrum: Celebrating LGBTQIA+ Journeys in Aesthetic Medicine: A Kaleidoscope of Identity. Aesthetic Plast Surg 2024; 48:2902-2914. [PMID: 38499877 DOI: 10.1007/s00266-024-03923-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/09/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE This synaptic systemised review critically examines the provision of aesthetic medical care to LGBTQIA+ (lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and more) individuals, assessing both the clinical practices and the educational frameworks that guide interactions with LGBTQIA+ patients in aesthetic settings. METHODS Following PRISMA-S guidelines, a comprehensive review was conducted, initially identifying 159 potentially relevant articles. Upon stringent full-text review, 33 studies met the inclusion criteria and were subject to an in-depth thematic analysis. The scope encompassed qualitative studies, quantitative analyses, and a cross section of interdisciplinary research, predominantly from Western settings. RESULTS The analysis distilled four principal themes: the imperative of identity affirmation in aesthetic interventions, substantial barriers to inclusive and empathetic care, the critical need for patient empowerment, and the existing deficiencies within medical education regarding LGBTQIA+ care. These themes highlight a complex interplay between the clinical aspirations of LGBTQIA+ individuals and the current capacity of aesthetic medicine to cater to this diversity. CONCLUSIONS There is a pressing need for a paradigmatic shift towards more inclusive, competent, and sensitive aesthetic medical care for LGBTQIA+ patients. It underscores the necessity of reform in medical education and advocates for policy changes that promote a more equitable healthcare environment. This research serves as a call to action, emphasizing the ethical imperative to integrate comprehensive LGBTQIA+ care competencies into aesthetic medicine curricula and practice. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Collapse
Affiliation(s)
- Eqram Rahman
- Research and Innovation Hub, Innovation Aesthetics, London, WC2H 9JQ, UK.
| | - Parinitha Rao
- Aesthetic Dermatology Practice, The Skin Address, Bangalore, India
| | | | | | - Karim Sayed
- Nomi Clinic, Oslo, Norway
- University of South East Norway, Notodden, Norway
| | - Ada R T Almeida
- Dermatologic Clinic, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | | | - Jean D A Carruthers
- Department of Ophthalmology, University of British Columbia, Vancouver, BC, Canada
| | - Alastair Carruthers
- Department of Dermatology, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
3
|
Littman AJ, Jeon A, Fort CL, Dashtestani K, Korpak A, Kauth MR, Shipherd JC, Jasuja GK, Wolfe HL, Neira PM, Caballero J, Garcia S, Williamson C, Collongues B, Simpson TL. Receipt of Gender-Affirming Surgeries Among Transgender and Gender Diverse Veterans. J Gen Intern Med 2024:10.1007/s11606-024-08917-1. [PMID: 39060784 DOI: 10.1007/s11606-024-08917-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Gender-affirming surgery (GAS) can be an important part of comprehensive care for transgender and gender diverse (TGD) individuals, but this care is not provided by the Department of Veterans Affairs (VA) because of an exclusion in the medical benefits package. OBJECTIVE To describe the receipt of GAS by veterans and assess the associations between key sociodemographic characteristics and receipt of chest ("top") and genital ("bottom") surgeries. DESIGN Cross-sectional national survey (the GendeR Affirming Care Evaluation (GRACE)), among TGD Veterans conducted between September 2022 and July 2023. PARTICIPANTS A total of 6653 Veterans (54% response rate) completed the survey. MAIN MEASURES Self-reported "top" and "bottom" GAS were key outcomes. Covariates included gender identity, sex assigned at birth, age, race, ethnicity, income, employment status, education, relationship status, sexual orientation, and geographic region. KEY RESULTS Among all respondents, 39% had ≥ 1 GAS. Among the 4430 veterans interested in top surgery, 38% received it; 23% of 3911 veterans interested in bottom surgery had received it. In multivariable models, older age (50 + vs. 18-39) was associated with higher receipt of top and bottom surgery while nonbinary gender identity (vs. binary gender identity), lower household income (< $50,000 vs. > $75,000), less education (less than a college graduate vs. Master's degree or more), sexual orientations other than heterosexual, and residing in a region other than the Pacific were associated with lower receipt of top and bottom surgery. Individuals assigned male (vs. assigned female) at birth had lower receipt of top surgery and higher receipt of bottom surgery. CONCLUSIONS GAS receipt was low and there were important disparities by gender, sex, income, education, sexual orientation, and region. By removing the exclusion to providing GAS, VA could reduce barriers to accessing GAS and decrease disparities among TGD veterans.
Collapse
Affiliation(s)
- Alyson J Littman
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
- Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA.
| | - Amy Jeon
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Carolyn L Fort
- Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Krista Dashtestani
- Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Anna Korpak
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Michael R Kauth
- Office of Patient Care Services, Department of Veterans Affairs, LGBTQ+ Health Program, Washington, DC, USA
- Department of Psychiatry, TH Chan School of Medicine, UMass Chan Medical School, Worcester, MA, USA
| | - Jillian C Shipherd
- Office of Patient Care Services, Department of Veterans Affairs, LGBTQ+ Health Program, Washington, DC, USA
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Guneet K Jasuja
- Center for Healthcare Organization & Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA
- Section of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Hill L Wolfe
- VA Pain Research, Informatics, Multi-Morbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Biomedical Informatics & Data Science, Yale School of Medicine, New Haven, CT, USA
| | - Paula M Neira
- Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, USA
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Josie Caballero
- National Center for Transgender Equality, Washington, DC, USA
- Transgender American Veterans Association, Washington, DC, USA
| | - Sady Garcia
- Transgender American Veterans Association, Washington, DC, USA
| | | | | | - Tracy L Simpson
- VA Puget Sound Center of Excellence in Substance Addiction Treatment and Education, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| |
Collapse
|
4
|
Turan Ş, Özulucan MT, Karataş U, Kavla Y, Koyuncu O, Durcan E, Durcan G, Bağhaki S. The effects of gender-affirming hormone therapy and mastectomy on psychopathology, body image, and quality of life in adults with gender dysphoria who were assigned female at birth. Qual Life Res 2024; 33:1937-1947. [PMID: 38656406 PMCID: PMC11176246 DOI: 10.1007/s11136-024-03664-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Individuals with gender dysphoria (GD) may request hormone therapy and various surgical operations to change their physical characteristics. The present study aimed to investigate the effects of two treatments, mastectomy and gender-affirming hormone therapy (GAHT), on adults with GD who were assigned female at birth (GD AFAB). METHODS In this cross-sectional study, we gathered data from a total of 269 individuals in three groups: (a) untreated group (n = 121), (b) GAHT group (n = 84) who had been receiving treatment for at least 6 months, and (c) GAHT-MAST group (n = 64) who had been using GAHT for at least 6 months and had undergone mastectomy at least 3 months prior. All participants were asked to complete the Symptom Checklist-90-Revised (SCL-90-R), the Body Uneasiness Test (BUT), and the World Health Organization's Quality of Life Questionnaire- Brief Form, Turkish Version (WHOQOL-BREF-Tr). RESULTS We found that individuals in the untreated group had higher psychopathological symptoms and body uneasiness scores, and lower quality of life scores compared to both GAHT and GAHT-MAST groups. There was no difference in psychopathology between the GAHT-MAST group and the GAHT group, but body uneasiness scores were lower, and quality of life scores were higher in the GAHT-MAST group. CONCLUSION Our study suggests that individuals receiving GAHT improved mental health, body satisfaction, and overall quality of life. Combining mastectomy with GAHT may further enhance these benefits.
Collapse
Affiliation(s)
- Şenol Turan
- Department of Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Türkiye.
| | - Mahmut Taha Özulucan
- Graduate School of Health Science, Neuroscience PhD Program, Koç University, Istanbul, Türkiye
| | - Uğur Karataş
- Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Yasin Kavla
- Department of Psychiatry, Hınıs State Hospital, Erzurum, Türkiye
| | - Oğuzhan Koyuncu
- Department of Child and Adolescent Psychiatry, Medeniyet University, Istanbul, Türkiye
| | - Emre Durcan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Gizem Durcan
- Department of Child and Adolescent Psychiatry, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Semih Bağhaki
- Department of Plastic, Reconstructive and Aesthetic Surgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| |
Collapse
|
5
|
Van de Cauter J, Van de Velde D, Motmans J, Clays E, Braeckman L. Exploring Work Absences and Return to Work During Social Transition and Following Gender-Affirming Care, a Mixed-Methods Approach: 'Bridging Support Actors Through Literacy'. JOURNAL OF OCCUPATIONAL REHABILITATION 2024; 34:425-446. [PMID: 37865621 PMCID: PMC11180020 DOI: 10.1007/s10926-023-10139-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE Research on return to work (RTW) following transition-related gender-affirming care (GAC) is lacking. We aim to study the RTW outcomes and experiences of transgender and gender diverse (TGD) people during social and medical transition to understand their needs better and provide tailored support. METHODS In this convergent mixed-methods study, the questionnaires of 125 employed TGD people, who took steps in transition (social and GAC), were analyzed for personal- and work characteristics, medical work absences, RTW, support at work, and health literacy. In-depth interviews were held with twenty TGD people to explore perceived facilitators and barriers to RTW. RESULTS One hundred and nine participants reported an average of 38 sick days after GAC. The majority (90.2%) resumed their job at the same employer. Although TGD workers felt supported, their health literacy (55.1%) was lower compared to the general population. The qualitative data analysis revealed four major themes: (1) the need and access to information; (2) having multidisciplinary TGD allies; (3) the influence of the occupational position; (4) the precarious balance between work, life, and GAC. Especially participants with a low health literacy level experienced RTW barriers by struggling: (1) to find and/or apply information; (2) to navigate (occupational) health and insurance services. CONCLUSION Our research has shown that RTW for TGD individuals is a multifaceted process, affected by personal factors, work-related elements, and the characteristics of the healthcare and social insurance system. Enhancing support for TGD people at work and their RTW requires a high need for centralized information and promoting health literacy while engaging relevant stakeholders, such as prevention services and employers.
Collapse
Affiliation(s)
- Joy Van de Cauter
- Department of Public Health and Primary Care, Unit of Occupational and Insurance Medicine, Faculty of Medicine and Health Sciences, Ghent University, 10 Corneel Heymanslaan, 9000, Ghent, Belgium.
| | - Dominique Van de Velde
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, 10 Corneel Heymanslaan, 9000, Ghent, Belgium
| | - Joz Motmans
- Center for Sexology and Gender, Ghent University Hospital, 10 Corneel Heymanslaan, 9000, Ghent, Belgium
| | - Els Clays
- Department of Public Health and Primary Care, Unit of Epidemiology and Prevention, Faculty of Medicine and Health Sciences, Ghent University, 10 Corneel Heymanslaan, 9000, Ghent, Belgium
| | - Lutgart Braeckman
- Department of Public Health and Primary Care, Unit of Occupational and Insurance Medicine, Faculty of Medicine and Health Sciences, Ghent University, 10 Corneel Heymanslaan, 9000, Ghent, Belgium
| |
Collapse
|
6
|
Phillips TM, Austin G, Sanders T, Martin M, Hudson J, Fort A, Excell T, Mullens AB, Brömdal A. Depression and thoughts of self-harm or suicide among gender and sexually diverse people in a regional Australian community. Health Promot J Austr 2024. [PMID: 38566268 DOI: 10.1002/hpja.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/14/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
ISSUES ADDRESSED There is a paucity of data regarding depression and thoughts of self-harm or suicide among gender and sexually diverse (GSD) people living within Australian regional/rural locations. This study aims to elucidate these issues and fill a critical gap. METHODS The sample included 91 GSD people from a regional community in South-West Queensland utilising the PHQ-9 to determine presence/severity of depression and self-harm/suicide ideation. These data were drawn from a larger health and wellbeing survey. Raw mean scores were calculated to determine prevalence/severity of clinical symptoms. Bayesian ordinal regression models were employed to analyse between-subgroup differences in depression and self-harm/suicide ideation. RESULTS Overall, 80.2% of GSD sample experienced depression (35.2% severe, 45.1% mild/moderate) and 41.8% experienced self-harm/suicide ideation in the past two-weeks. Trans and nonbinary people experienced higher levels of depressions than sexually diverse cisgender people. Pansexual and bisexual people experienced higher levels of depression than gay people. Trans people experienced higher prevalence of self-harm/suicide ideation than cisgender and nonbinary people, with no differences between sexuality subgroups. CONCLUSIONS These findings contribute to deeper and more nuanced insights regarding clinically salient depressive and self-harm/suicide ideation symptoms among trans, nonbinary, bisexual, pansexual and queer people in regional Australian communities, with the aim to ultimately reduce mental health prevalence, improve mental health outcomes and health promotion among GSD people. SO WHAT?: The current findings revealed GSD people experience high prevalence of depression and self-harm/suicide ideation indicating tailored mental health awareness-raising, training and health promotion is warranted to enhance psychological support.
Collapse
Affiliation(s)
- Tania M Phillips
- Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
| | - Gavin Austin
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, Australia
| | - Tait Sanders
- Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
| | - Margaret Martin
- Lifeline Darling Downs & South West Queensland, Toowoomba, Australia
| | - Jacqueline Hudson
- Lifeline Darling Downs & South West Queensland, Toowoomba, Australia
| | - Alexandra Fort
- Lifeline Darling Downs & South West Queensland, Toowoomba, Australia
| | - Tarra Excell
- Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
| | - Amy B Mullens
- Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Annette Brömdal
- Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
- School of Education, University of Southern Queensland, Toowoomba, Australia
| |
Collapse
|
7
|
Wuest J, Last BS. Agents of scientific uncertainty: Conflicts over evidence and expertise in gender-affirming care bans for minors. Soc Sci Med 2024; 344:116533. [PMID: 38401237 DOI: 10.1016/j.socscimed.2023.116533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 12/06/2023] [Accepted: 12/18/2023] [Indexed: 02/26/2024]
Abstract
Globally, as medical and mental health associations increasingly have expressed support for the gender-affirming care model for trans and gender expansive youth, this model has been paradoxically banned across the United States. Ban proponents have deemed the science behind gender-affirming care to be dangerously uncertain. Examining the first gender-affirming care ban for minors, Arkansas's Save Adolescents from Experimentation (SAFE) Act of 2021, we addressed the following two questions: 1) who are the scientists, clinicians, and political organizations that promote SAFE and similar bans?; and 2) what are the scientific arguments they make to defend SAFE in federal court? First, we developed a typology of the various "agents of scientific uncertainty" behind these bans, drawing on literature from the sociology and history of science and medicine as well as the political economy of scientific doubt. Second, we created and qualitatively analyzed a dataset featuring 375 unique citations referenced throughout federal litigation over SAFE to identify these agents of scientific uncertainty's arguments. We sorted these arguments into eight categories, which reveal how agents distorted scientific evidence and exaggerated real uncertainties and risks in gender-affirming care. This case study establishes a frame for understanding the growing prevalence and legal impact of scientific arguments against gender-affirming care.
Collapse
Affiliation(s)
- Joanna Wuest
- Department of Politics, Mount Holyoke College, Skinner Hall #204, South Hadley, MA, 01075, USA.
| | - Briana S Last
- Department of Psychology, Psychology B, Stony Brook University, Stony Brook, NY, 11794, USA
| |
Collapse
|
8
|
Dalzell LG, Pang SC, Brömdal A. Gender affirmation and mental health in prison: A critical review of current corrections policy for trans people in Australia and New Zealand. Aust N Z J Psychiatry 2024; 58:21-36. [PMID: 37638610 PMCID: PMC10756016 DOI: 10.1177/00048674231195285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Trans people in prison experience disproportionate rates of harm, including negative mental health outcomes, and thus require special protections. Instead, corrections policies have historically further marginalised them. This critical policy review aimed to compare corrections policies for trans people in Australia and New Zealand with human rights standards and consider their mental health impact. METHODS Online searches were conducted on corrections websites for each state/territory in Australia and New Zealand. Drawing on the Nelson Mandela Rules and Yogyakarta Principles, 19 corrections policies relevant to placement, naming, appearance and gender-affirming healthcare for trans people were reviewed. The potential mental health impact of these policies on incarcerated trans people was discussed using the Gender Minority Stress and Resilience framework. RESULTS Australian and New Zealand corrections policies have become more concordant with human rights standards in the past 5 years. However, gender-related discrimination and human rights violations were present in corrections policies of all jurisdictions. New South Wales and Victorian policies had the highest concordance with human rights standards, while Queensland and South Australian policies had the lowest. CONCLUSION Policies that contribute to discrimination and minority stress may increase risk of mental health problems and suicide for incarcerated trans people. Mental health professionals working in prisons need to be aware of these risks to provide safe and accessible mental healthcare for trans people. Collaborative policy development with trans people is essential to protect the safety and rights of incarcerated trans people and consider models beyond the gender binary on which correctional systems have been founded.
Collapse
Affiliation(s)
- Laura G Dalzell
- Victorian Institute of Forensic Mental Health (Forensicare), Clifton Hill, VIC, Australia
| | - Sam C Pang
- Victorian Institute of Forensic Mental Health (Forensicare), Clifton Hill, VIC, Australia
| | - Annette Brömdal
- School of Education, Faculty of Business, Education and Law and Centre for Health Research, Institute of Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia
| |
Collapse
|
9
|
Sitas Z, Peters K, Luck L, Einboden R. Erasure of the young trans person: A critical discursive review of contemporary health care literature. J Nurs Scholarsh 2024; 56:103-118. [PMID: 37393606 DOI: 10.1111/jnu.12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 05/03/2023] [Accepted: 05/23/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION Trans youth experience significantly higher rates of societal violence and ill-health compared to their cisgender peers. Although recent clinical guidelines for trans young people in health have paved the way for revolutionizing care, many trans young people still experience adversity in clinical settings. This discursive literature review provides a novel approach in exploring why trans young people experience violence in health care despite the availability of evidence-based resources and guidelines. DESIGN Databases (CINAHL and Scopus) were systematically searched to identify qualitative literature on the experiences of trans young people (<18 years) in health care settings. METHOD Rather than synthesizing and presenting the literature, Fairclough's (2001) CDA methodology was used to critically analyze the literature as texts in a data corpus. The authors engaged with the data from a critical social theory perspective. RESULTS Fifteen qualitative articles and one report (n = 16) on the experiences of trans young people (3-24 years) in health care settings were included. Two key discourses were identified in the literature. First, discourses that constituted the trans young person were identified in the definitions of 'trans' as a pathological incongruence and as alternate, self-determined ways of being. Further discourses were identified in the constitution of trans young people as victims, extra-pathological, and alternatively problematised as socially dysphoric. Second, discourses in health provider responses were identified in dismissive, gatekeeping, regulatory, and respectful practices. DISCUSSION The discursive constitution of the trans young person as incongruent, vulnerable, and pathological is constituted and generated by dismissive, gatekeeping, and regulatory practices of health care providers. The analysis reveals how trans young people are considered pathological and deemed treatable (at the site of the body), in the interest of 'protecting' them from a perceived abject future of trans adulthood. The logic and violence of cisgenderism is uncovered as the foundation of these dominant discourses, whereby growing up cisgender is often presented as the only option in health care settings. The dominant discourses that constitute the trans young person in health care as incongruent, pathological, and vulnerable, alongside the reifying health care responses of dismissal, gatekeeping, and regulation contribute to the erasure of the young trans person. CONCLUSION This paper identified key discourses in the literature in how trans young people are constituted and regulated in health care. This review highlights an urgent need for further critical scholarship in trans health by trans researchers, from critical perspectives. Furthermore, it provides a starting point for critical reflection of health care provider and researcher practices and the re-imagination of trans-futurity for all young people in health care. CLINICAL RELEVANCE Nurses are situated at the forefront of health care delivery and play a crucial role in the advocacy and provision of culturally safe care. With this ideal proximity to clients, nurses can powerfully affect change through better understanding and reflecting on how regulatory practices constitute and position trans young people in health care. Nursing knowledge, such as cultural safety, can offer novel approaches in working towards safer ways of meeting the needs of trans young people.
Collapse
Affiliation(s)
- Zoë Sitas
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Kath Peters
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Lauretta Luck
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Rochelle Einboden
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario (CHEO) and CHEO Research Institute, Ottawa, Ontario, Canada
| |
Collapse
|
10
|
Franks N, Mullens AB, Aitken S, Brömdal A. Fostering Gender-IQ: Barriers and Enablers to Gender-affirming Behavior Amongst an Australian General Practitioner Cohort. JOURNAL OF HOMOSEXUALITY 2023; 70:3247-3270. [PMID: 35759651 DOI: 10.1080/00918369.2022.2092804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
While the visible population of trans and gender diverse Australians has grown significantly in recent years, primary health-care access remains hindered by a lack of practitioner competency and stigmatization. This article draws on qualitative research of purposively selected gender-affirming general practitioners (GPs) in Australia to explore barriers, and enablers when treating trans and gender diverse patients. Perspectives and behaviors during the gender-affirming clinical encounter were theoretically informed through minority stress theory, and master narrative frameworks. Reflexive thematic analysis facilitated a rich description of exemplary gender-affirming primary care. A considerable gap exists between structural, clinical, and cultural behaviors among competent gender-affirming GPs in Australia, and the majority of practitioners evidenced in the literature. This critical analysis contributes to better understanding how gender-affirming Australian GPs diffuse minority stress, negotiate cis-normative biases, and foster a person-centered longitudinal therapeutic relationship with their trans and gender diverse patients. An encounter the article argues may also provide an essential buffer for GPs in Australia against the risk of professional burnout. Gender-affirming practice should be taught as a core competency and be required as professional development for GPs in Australia, to ensure a beneficial clinical encounter for the growing trans and gender diverse population.
Collapse
Affiliation(s)
- Nia Franks
- School of Psychology and Wellbeing, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, 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, Ipswich, Queensland, Australia
| | - Stuart Aitken
- Queensland Children's Gender Service, Queensland Children's Hospital, Brisbane, 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
|
11
|
Daken K, Excell T, Clark KA, Hughto JMW, Sanders T, Debattista J, du Plessis C, Mullens AB, Phillips TM, Gildersleeve J, Brömdal A. Correctional staff knowledge, attitudes and behaviors toward incarcerated trans people: A scoping review of an emerging literature. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2023; 25:149-166. [PMID: 38681490 PMCID: PMC11044747 DOI: 10.1080/26895269.2023.2265386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Background: Trans people are incarcerated at disproportionately high rates relative to cisgender people and are at increased risk of negative experiences while incarcerated, including poor mental health, violence, sexual abuse, dismissal of self-identity, including poor access to healthcare. Aims: This scoping review sought to identify what is known about the knowledge, attitudes, and behaviors of correctional staff toward incarcerated trans people within the adult and juvenile justice systems. Method: This scoping review was conducted in accordance with the five-stage iterative process developed by Arksey and O'Malley (2005), utilizing the PRISMA guidelines and checklist for scoping reviews and included an appraisal of included papers. A range of databases and grey literature was included. Literature was assessed against predetermined inclusion and exclusion criteria, with included studies written in English, online full text availability, and reported data relevant to the research question. Results: Seven studies were included with four using qualitative methodologies, one quantitative, and two studies employing a mixed methods approach. These studies provided insights into the systemic lack of knowledge and experience of correctional staff working with trans people, including staff reporting trans issues are not a carceral concern, and carceral settings not offering trans-affirming training to their staff. Within a reform-based approach these findings could be interpreted as passive ignorance and oversights stressing the importance of organizational policies and leadership needing to set standards for promoting the health and wellbeing of incarcerated trans persons. Conclusions: From a transformational lens, findings from this study highlight the urgent need to address the underlying structural, systemic, and organizational factors that impact upon the knowledge, attitudes, and behaviors staff have and hold in correctional, and other health and community settings to meaningfully and sustainably improve health, wellbeing, and gender-affirming treatment and care for trans communities, including make possible alternative methods of accountability for those who do harms.
Collapse
Affiliation(s)
- Kirstie Daken
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Tarra Excell
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Kirsty A. Clark
- Department of Medicine, Health & Society, Institute for Public Policy Studies, Vanderbilt University, Nashville, Tennessee, USA
| | - Jaclyn M. W. Hughto
- Departments of Behavioral and Social Sciences and Epidemiology, Brown School of Public Health, Centre for Health Equity Research, Brown University, Providence, Rhode Island, USA
| | - Tait Sanders
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital & Health Service, Brisbane, Queensland, Australia
| | - Carol du Plessis
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Amy B. Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Tania M. Phillips
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Jessica Gildersleeve
- School of Humanities and Communication, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Annette Brömdal
- School of Education, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| |
Collapse
|
12
|
Coswosck KHC, Marques-Rocha JL, Moreira JA, Guandalini VR, Lopes-Júnior LC. Quality of life of transgender people under the lens of social determinants of health: a scoping review protocol. BMJ Open 2023; 13:e067575. [PMID: 37524549 PMCID: PMC10391788 DOI: 10.1136/bmjopen-2022-067575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION There is an urgent need for knowledge about the transgender population to inform the development of clinical protocols and training of health professionals on the unique issues affecting this population. Discussing transgender quality of life (QoL) through the lens of social determinants of health (SDOHs) would enable gender-specific health interventions. Here, we aimed to review the evidence on the QoL of transgender people from an SDOH perspective. METHODS AND ANALYSIS A scoping review (ScR) protocol following the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews statement and guided by the Joanna Briggs Institute was used. MEDLINE/PubMed, Cochrane Library, Embase, PsycINFO, Web of Science, Scopus and registry sites such as ClinicalTrials.gov and WHO ICTRP will be searched. Additional sources to be searched include ProQuest Dissertations/Theses Global, British Library, Google Scholar and Preprints for Health Sciences-medRXiv. Two independent researchers will carry out the selection, data charting and data synthesis. No date restriction will be applied in this ScR. The search will be restricted to articles published in English, Spanish and Portuguese. The results will be presented in tables, narrative summaries and graphs and will be graded on the type of data presented and the results. The search strategy will be updated in April 2023. The expected completion date of this ScR is July 2023. ETHICS AND DISSEMINATION This ScR protocol does not require ethical approval. Dissemination plans include peer-reviewed publications, conference presentations to be shared with experts in the field, and advisory groups to inform discussions on future research. It is hoped that our findings will be of interest to practitioners, researchers, stakeholders, public and private managers, and the general population concerned with this emerging public health issue. TRIAL REGISTRATION NUMBER osf.io/9ukz6.
Collapse
Affiliation(s)
| | - Jose Luiz Marques-Rocha
- Graduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | - Juliana Almeida Moreira
- Graduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | - Valdete Regina Guandalini
- Graduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | | |
Collapse
|
13
|
Tan KKH, Byrne JL, Treharne GJ, Veale JF. Unmet need for gender-affirming care as a social determinant of mental health inequities for transgender youth in Aotearoa/New Zealand. J Public Health (Oxf) 2023; 45:e225-e233. [PMID: 36468999 PMCID: PMC10273389 DOI: 10.1093/pubmed/fdac131] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/06/2022] [Accepted: 10/19/2022] [Indexed: 01/02/2024] Open
Abstract
BACKGROUND Past studies have demonstrated better mental health and well-being among transgender youth who had accessed gender-affirming care. However, few existing studies have assessed unmet need for gender-affirming care as a social determinant of mental health inequities. METHODS Data on unmet need for gender-affirming care, distress and suicidality were analysed from the 2018 Counting Ourselves nationwide community-based survey of transgender people in Aotearoa/New Zealand. Associations between unmet need for gender-affirming care and mental health indicators were tested for transgender youth within the sample (aged 14-26 years; n = 608; Mage = 20.5). RESULTS Transgender youth reported unmet needs ranging from 42% for gender-affirming hormone to 100% for feminizing surgeries and voice surgeries. Overall unmet need for gender-affirming care was associated with worse mental health. Trans men with an unmet need for chest reconstruction (84%) scored an average of 7.13 points higher on the K10 Psychological Distress Scale relative to those whose need had been met. Participants reporting unmet need for hormones (42%) had twice the odds (adjusted odds ratios = 2.01; CI = 1.02-3.98) of having attempted suicide in the last 12 months. CONCLUSIONS Dismantling barriers to accessing gender-affirming care could play a crucial role in reducing mental health inequities faced by transgender youth.
Collapse
Affiliation(s)
- Kyle K H Tan
- Trans Health Research Lab, School of Psychology, University of Waikato, Hamilton 3240, New Zealand
- Faculty of Māori and Indigenous Studies, University of Waikato, Hamilton 3240, New Zealand
| | - Jack L Byrne
- Trans Health Research Lab, School of Psychology, University of Waikato, Hamilton 3240, New Zealand
| | - Gareth J Treharne
- Department of Psychology, University of Otago, Dunedin 9054, New Zealand
| | - Jaimie F Veale
- Trans Health Research Lab, School of Psychology, University of Waikato, Hamilton 3240, New Zealand
| |
Collapse
|
14
|
Kearns S, Hardie P, O'Shea D, Neff K. Instruments used to assess gender-affirming healthcare access: a scoping review protocol. HRB Open Res 2023; 6:14. [PMID: 37384116 PMCID: PMC10293796 DOI: 10.12688/hrbopenres.13689.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Internationally, the demand for gender-affirming care has increased exponentially in recent years. The clinical presentation of those seeking care has changed with an increase in transmasculine and non-binary identities and a decrease in the average age of those seeking care. Healthcare navigation remains complicated for this population and warrants further investigation in light of ongoing changes in the field. This paper presents a protocol for a scoping review to map and synthesise the academic and grey literature on instruments used to assess healthcare navigation and access for transgender and non-binary individuals seeking gender-affirming care. METHODS This review will search databases (PsychINFO, CINAHL, Medline, and Embase.) and grey literature sources. In line with the methodological framework for scoping reviews, the following six stages will be undertaken: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating, summarising and reporting results and (6) consultation. The PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation will be utilised and reported. The research team will undertake the study as outlined in this protocol and an expert panel of young transgender and non-binary youth will oversee the project through patient and public involvement. Conclusions: This scoping review has the potential to inform policy, practice, and future research through enhanced understanding of the complex interplay of factors that impact healthcare navigation for transgender and non-binary people seeking gender-affirming care. The results from this study will inform further research into healthcare navigation considerations generally and will inform a research project entitled "Navigating access to gender care in Ireland-a mixed-method study on the experiences of transgender and non-binary youth".
Collapse
Affiliation(s)
- Seán Kearns
- UCD School of Medicine,, University College Dublin,, Belfield,, Dublin 4, D04 V1W8, Ireland
- National Gender Service,, St Columcille's Hospital,, Loughlinstown, Co.Dublin, D18 E365, Ireland
| | - Philip Hardie
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
| | - Donal O'Shea
- UCD School of Medicine,, University College Dublin,, Belfield,, Dublin 4, D04 V1W8, Ireland
- National Gender Service,, St Columcille's Hospital,, Loughlinstown, Co.Dublin, D18 E365, Ireland
| | - Karl Neff
- UCD School of Medicine,, University College Dublin,, Belfield,, Dublin 4, D04 V1W8, Ireland
- National Gender Service,, St Columcille's Hospital,, Loughlinstown, Co.Dublin, D18 E365, Ireland
| |
Collapse
|
15
|
Sanders T, du Plessis C, Mullens AB, Brömdal A. Navigating Detransition Borders: An Exploration of Social Media Narratives. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1061-1072. [PMID: 36821061 PMCID: PMC10101886 DOI: 10.1007/s10508-023-02556-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 05/11/2023]
Abstract
Detransition, a relatively recent phenomenon within academic discourse and mainstream media, refers to individuals who transition from the gender they transitioned into. Experiences of detransition, including those shared on social media, are poorly understood. Drawing upon narratives of gender detransition as shared on a global social media site, this analysis explores and seeks to better understand how detransition experiences are shared; and the effect of detransition narratives on gendered embodiment and belonging. Employing Butler's (Undoing gender. Routledge, 2004) notion of livable lives and Crawford's (Seattle J Soc Justice 8(2):515-539, 2010) conception of trans architecture, this analysis theoretically extends trans conversations to include discourses and narratives of detransition. A total of 130 archival posts by 36 contributors relating to detransition were collected from a popular global social media site where the engagement of reflexive thematic analysis contributed to the development of three themes: Contemplating transformation; Experiences of detransition; and Prominent discourses for detransition. Study findings suggest that detransition narratives expressed on this social media site demonstrate the multifaceted and complex ways in which non-normative gendered lives are rendered unlivable. In response, this analysis problematizes gender by conceptualizing detransition as a transformation toward a trans space outside a cisnormative frame contributing to making gendered lives more livable.
Collapse
Affiliation(s)
- Tait Sanders
- School of Psychology and Wellbeing, Faculty of Health, Sciences and Engineering, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, 4305, Australia.
| | - Carol du Plessis
- School of Psychology and Wellbeing, Faculty of Health, Sciences and Engineering, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, 4305, Australia
| | - Amy B Mullens
- School of Psychology and Wellbeing, Faculty of Health, Sciences and Engineering, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, 4305, 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, QLD, 4350, Australia
| |
Collapse
|
16
|
Kearns S, Hardie P, O'Shea D, Neff K. Instruments used to assess gender-affirming healthcare access: a scoping review protocol. HRB Open Res 2023. [DOI: 10.12688/hrbopenres.13689.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Background: Internationally, the demand for gender-affirming care has increased exponentially in recent years. The clinical presentation of those seeking care has changed with an increase in transmasculine and non-binary identities and a decrease in the average age of those seeking care. Healthcare navigation remains complicated for this population and warrants further investigation in light of ongoing changes in the field. This paper presents a protocol for a methodological scoping review that aims to systematically map and synthesise the extent and nature of the peer-reviewed, published academic literature on the instruments used to assess factors relating to healthcare navigation and healthcare access for transgender and non-binary individuals seeking gender-affirming healthcare. Methods: This review will search databases (PsychINFO, CINAHL, Medline, and Embase.) and grey literature sources. In line with the methodological framework for scoping reviews, the following six stages will be undertaken: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating, summarising and reporting results and (6) consultation. The PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation will be utilised and reported. The research team will undertake the study as outlined in this protocol and an expert panel of young transgender and non-binary youth will oversee the project through patient and public involvement. Conclusions: This scoping review has the potential to inform policy, practice, and future research through enhanced understanding of the complex interplay of factors that impact healthcare navigation for transgender and non-binary people seeking gender-affirming care. The results from this study will inform further research into healthcare navigation considerations generally and will inform a research project entitled “Navigating access to gender care in Ireland—a mixed-method study on the experiences of transgender and non-binary youth”.
Collapse
|
17
|
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] [MESH Headings] [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 RegionsUniversity of Southern QueenslandToowoombaQueenslandAustralia
| | - Sherree D. Halliwell
- School of Humanities and Communication, Faculty of Business, Education, Law and Arts, Centre for Health Research, Institute for Resilient RegionsUniversity of Southern QueenslandToowoombaQueenslandAustralia
| | - Amy B. Mullens
- School of Psychology and Wellbeing, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient RegionsUniversity of Southern QueenslandToowoombaQueenslandAustralia
| | - Tait Sanders
- School of Psychology and Wellbeing, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient RegionsUniversity of Southern QueenslandToowoombaQueenslandAustralia
| | - Jessica Gildersleeve
- School of Humanities and Communication, Faculty of Business, Education, Law and Arts, Centre for Health Research, Institute for Resilient RegionsUniversity of Southern QueenslandToowoombaQueenslandAustralia
| | - Tania Phillips
- School of Psychology and Wellbeing, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient RegionsUniversity of Southern QueenslandToowoombaQueenslandAustralia
| | - Annette Brömdal
- School of Education, Faculty of Business, Education, Law and Arts, Centre for Health Research, Institute for Resilient RegionsUniversity of Southern QueenslandToowoombaQueenslandAustralia
| |
Collapse
|