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Simmons J, Hartman S, Tanabe KO, Hayden ME. Gender-diverse health on campus: Developing a comprehensive, multidisciplinary gender-diverse care team. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-4. [PMID: 36719789 DOI: 10.1080/07448481.2023.2168545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/16/2022] [Accepted: 01/08/2023] [Indexed: 06/18/2023]
Abstract
Objective: To optimize healthcare for gender-diverse students at a large, public university's Student Health and Wellness (SHW) Center. Methods: SHW professionals from medicine, gynecology, health promotion, counseling, psychiatry, and disability services developed a multidisciplinary gender-diverse care team (GDCT) in 2016. The GDCT's team-based design was created to support a diverse student body and provide extra resources to a vulnerable population, ensuring students engage fully in the University. Results: The GDCT has assisted approximately 93 unique students, in-person or by phone with clinical or supportive care. The number of students presenting with questions pertaining to transgender and gender-diverse health care has increased since 2016. Conclusions: Having a comprehensive, multidisciplinary GDCT available within a university SHW provides transgender and gender-diverse students with access to a safe, inclusive, and resource-rich environment to seek care and serves as a potential model for other college health centers.
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Affiliation(s)
- Jessica Simmons
- Division of Student Affairs, Department of Student Health & Wellness, University of Virginia, Charlottesville, Virginia, USA
| | - Stephanie Hartman
- Division of Student Affairs, Department of Student Health & Wellness, University of Virginia, Charlottesville, Virginia, USA
| | - Kawai O Tanabe
- Division of Student Affairs, Department of Student Health & Wellness, University of Virginia, Charlottesville, Virginia, USA
| | - Meredith E Hayden
- Division of Student Affairs, Department of Student Health & Wellness, University of Virginia, Charlottesville, Virginia, USA
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Devís-Devís J, Pereira-García S, Valencia-Peris A, Vilanova A, Gil-Quintana J. Harassment disparities and risk profile within lesbian, gay, bisexual and transgender Spanish adult population: Comparisons by age, gender identity, sexual orientation, and perpetration context. Front Public Health 2022; 10:1045714. [PMID: 36589994 PMCID: PMC9797955 DOI: 10.3389/fpubh.2022.1045714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
Lesbian, Gay, Bisexual and Transgender (LGBT) harassment disparities have become a public health issue due to discrimination and the effects on these people's health and wellbeing. The purpose was to compare harassment disparities within the Spanish adult LGBT population according to age, gender identity, sexual orientation and the context of perpetration and to describe the harassment risk profile. A sample of 1,051 LGBT adults participated in a cross-sectional study. Frequencies, percentages and Chi-square tests of independence for stablishing significant differences (p < 0.05) were calculated. The corrected standardized residuals allowed to identify the categories in which significant differences emerged. Binomial logistic regression was used to define the probability of the main LGBT groups of suffering harassment. Results show that 54.4% of the participants had experienced harassment. Young adults presented a higher prevalence than the older group. There were significant harassment differences between transgender (67.2%) and cisgender (52.7%) groups, and also between the subgroup of trans women (75.8%) and the subgroups of cis men (60.2%) and cis women (42.9%). The main disparities according to sexual orientation emerged between lesbian trans and the other LGB groups. Most harassment occurred in educational contexts and public spaces. Trans-women and trans non-binary reported a higher rate of harassment than cis LGB persons in all contexts. Trans people with different orientations (especially lesbian and gay trans) differed in harassment from LGB cis in four of the six contexts analyzed. Harassment is likely to diminish between 2 and 3% each year as LGBTs get older in educational contexts and public spaces but increases 1.07 times in the workplace. Trans women, trans non-binary, lesbian cis and trans-men were more likely to suffer harassment than bisexual cis persons. Trans women present the highest risk of harassment in three contexts (workplace, family and public spaces) and trans non-binary in the other three contexts (education, health and sport). Harassment is a serious problem for LGBT adults in Spain, especially among trans people, which differ in characteristics from those of the sexual minorities mainstream. Programs and policies targeted for improving health should therefore consider the differences that came to light in this study.
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Affiliation(s)
- José Devís-Devís
- AFES Research Group, Departament d'Educació Física i Esportiva, Universitat de València, València, Spain,*Correspondence: José Devís-Devís
| | - Sofía Pereira-García
- AFES Research Group, Departament d'Educació Física i Esportiva, Universitat de València, València, Spain
| | - Alexandra Valencia-Peris
- AFES Research Group, Departament de Didàctica de l'Educació Física, Artística i Música, Universitat de València, València, Spain
| | - Anna Vilanova
- GISEAFE Research Group, Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona, Barcelona, Spain
| | - Javier Gil-Quintana
- AFES Research Group, Departament d'Educació Física i Esportiva, Universitat de València, València, Spain
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Collins TW, Grineski SE, Morales DX. We Need Environmental Health Justice Research and Action for LGBTQ+ People. Am J Public Health 2022; 112:54-56. [PMID: 34936425 PMCID: PMC8713633 DOI: 10.2105/ajph.2021.306477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Timothy W Collins
- Timothy W. Collins and Sara E. Grineski are with the Center for Natural and Technological Hazards, University of Utah, Salt Lake City. Timothy W. Collins is also with the Department of Geography, University of Utah. Sara E. Grineski is also with the Department of Sociology, University of Utah. Danielle X. Morales is with the Department of Sociology and Anthropology, University of Texas at El Paso
| | - Sara E Grineski
- Timothy W. Collins and Sara E. Grineski are with the Center for Natural and Technological Hazards, University of Utah, Salt Lake City. Timothy W. Collins is also with the Department of Geography, University of Utah. Sara E. Grineski is also with the Department of Sociology, University of Utah. Danielle X. Morales is with the Department of Sociology and Anthropology, University of Texas at El Paso
| | - Danielle X Morales
- Timothy W. Collins and Sara E. Grineski are with the Center for Natural and Technological Hazards, University of Utah, Salt Lake City. Timothy W. Collins is also with the Department of Geography, University of Utah. Sara E. Grineski is also with the Department of Sociology, University of Utah. Danielle X. Morales is with the Department of Sociology and Anthropology, University of Texas at El Paso
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McGarty A, McDaid L, Flowers P, Riddell J, Pachankis J, Frankis J. Mental health, potential minority stressors and resilience: evidence from a cross-sectional survey of gay, bisexual and other men who have sex with men within the Celtic nations. BMC Public Health 2021; 21:2024. [PMID: 34742262 PMCID: PMC8572060 DOI: 10.1186/s12889-021-12030-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gay, bisexual and other men who have sex with men (GBMSM) are at a greater risk of mental health problems, such as anxiety and depression, than heterosexual adults. Numerous factors and stressors have been reported to impact men's mental health, although it has been suggested that resilience could have a protective effect. The aim of this study is to explore mental health, minority stressors, and resilience among a large online cross-sectional survey of GBMSM in the Celtic nations. METHODS Data for this cross-sectional study were collected from the Social Media, GBMSM and Sexual and Holistic Health (SMMASH2) self-report online survey. Participants (n = 3077) were recruited via gay sociosexual media in Scotland, Wales, Northern Ireland, and the Republic of Ireland. Binary logistic regression analyses were conducted to identify factors that increased the odds of moderate-to-severe anxiety and depression. Potentially relevant variables (p < 0.05) were carried forward in hierarchal logistic regression analyses. RESULTS The prevalence of moderate-to-severe anxiety and depression was 19.9 and 14.4%, respectively. Having a disability (OR = 1.73) and having financial worries sometimes/all of the time (OR = 1.93) increased the odds of having moderate-to-severe depression and anxiety, respectively. No minority stressors were associated with depression, whereas experiencing any form of relationship abuse in the last 12 months significantly increased the odds of anxiety (OR = 1.50). Resilience, namely a sense of coherence, had a protective effect and significantly reduced the odds of moderate-to-severe depression (OR = 0.85) and anxiety (OR = 0.89). CONCLUSIONS Disability and financial worries were associated with increased depression and anxiety, respectively, while resilience had a protective effect for GBMSM in the SMMASH2 study. Future research is needed to better understand the role of resilience and the challenges and stresses of everyday life and intersecting health problems. Future research is also needed that incorporates the perspectives of those most affected by mental ill-health to co-develop effective solutions that respond to their contextual surroundings.
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Affiliation(s)
- Arlene McGarty
- Institute of Health & Wellbeing, University of Glasgow, 1st floor Admin Building, Gartnavel Royal Hospital, 1055 Great Western Road, G12 0XH, Glasgow, Scotland, UK.
| | - Lisa McDaid
- grid.1003.20000 0000 9320 7537Institute for Social Science Research, The University of Queensland, Long Pocket Precinct, 80 Meiers Rd, Indooroopilly, Brisbane, QLD 4068 Australia ,grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Top Floor, 200 Renfield Street, G2 3AX, Glasgow, Scotland UK
| | - Paul Flowers
- grid.11984.350000000121138138School of Psychological Sciences & Health, University of Strathclyde, 40 George Street, G1 1QE, Glasgow, UK
| | - Julie Riddell
- grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Top Floor, 200 Renfield Street, G2 3AX, Glasgow, Scotland UK
| | - John Pachankis
- grid.47100.320000000419368710Yale School of Public Health, 60 College St, New Haven, CT USA
| | - Jamie Frankis
- grid.5214.20000 0001 0669 8188School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road G4 0BA, Glasgow, Scotland UK
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Newman PA, Reid L, Tepjan S, Akkakanjanasupar P. LGBT+ inclusion and human rights in Thailand: a scoping review of the literature. BMC Public Health 2021; 21:1816. [PMID: 34625045 PMCID: PMC8501542 DOI: 10.1186/s12889-021-11798-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 09/10/2021] [Indexed: 12/04/2022] Open
Abstract
Background Globally, LGBT+ people continue to struggle to achieve full realization of their human rights. Amid reported health and mental health disparities, and economic insecurity, we conducted a scoping review to explore the breadth of the literature, map and summarize the evidence, and identify knowledge gaps on LGBT+ inclusion and human rights in Thailand. Methods We conducted a scoping review in accordance with the methodology developed by the Joanna Briggs Institute and PRISMA-ScR guidelines. We systematically searched 16 databases for peer-reviewed literature, and government and nongovernmental organization websites for grey literature, published in English or Thai from January 1, 2000–August 21, 2020. Two reviewers independently screened studies according to pre-set criteria. We abstracted and analyzed data on publication characteristics and focal populations, and synthesized findings in six domains of LGBT+ inclusion: political and civic participation, education, family, personal security and violence, economic well-being, and health. Results The review captured 3327 results in total, which was scoped to 76 peer-reviewed articles and 39 grey literature sources, the majority published after 2010. Gay men and transgender women were the primary focal populations in the peer-reviewed literature, LGBT+ people as a whole in the grey literature. Health was the predominant domain across publications. Key findings include the absence of generalized antidiscrimination legislation for LGBT+ individuals and lack of recourse for transgender individuals to change their legal gender; multifaceted stigma and discrimination in the educational system; social isolation and exclusion in families; disproportionate prevalence of sexual violence and reluctance to report to police; discrimination and marginalization in employment; and LGBT+ disparities in health and mental health. Conclusions Future research and programmatic initiatives on LGBT+ inclusion in Thailand should aim to address: 1) understudied populations—lesbian and bisexual women, transmasculine persons; 2) underrepresented topics, including constraints to LGBT+ advocacy; 3) strategic policy initiatives around anti-discrimination laws and legal recognition of same-sex marriage and families; and 4) the need for consistent collection of disaggregated data on LGBT+ persons in education, family, economic, personal security/violence, and health domains in order to assess indicators of inclusion and progress in advancing human rights for LGBT+ people in Thailand. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11798-2.
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Affiliation(s)
- Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, M5S1V4, Canada. .,VOICES-Thailand Foundation, Chiang Mai, Thailand.
| | - Luke Reid
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, M5S1V4, Canada
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Hisle-Gorman E, Schvey NA, Adirim TA, Rayne AK, Susi A, Roberts TA, Klein DA. Mental Healthcare Utilization of Transgender Youth Before and After Affirming Treatment. J Sex Med 2021; 18:1444-1454. [PMID: 37057453 DOI: 10.1016/j.jsxm.2021.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/12/2021] [Accepted: 05/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Transgender and gender-diverse (TGD) adolescents experience increased mental health risk compared to cisgender peers. Limited research suggests improved outcomes following gender-affirmation. This study examined mental healthcare and psychotropic medication utilization among TGD youth compared to their siblings without gender-related diagnoses and explored utilization patterns following gender-affirming care. METHOD This retrospective cohort study used military healthcare data from 2010-2018 to identify mental healthcare diagnoses and visits, and psychotropic medication prescriptions among TGD youth who received care for gender dysphoria before age 18, and their siblings. Logistic and Poisson regression analyses compared mental health diagnosis, visits, and psychotropic prescriptions of TGD youth to their siblings, and compared healthcare utilization pre- and post-initiation of gender-affirming pharmaceuticals among TGD adolescents. RESULTS 3,754 TGD adolescents and 6,603 cisgender siblings were included. TGD adolescents were more likely to have a mental health diagnosis (OR 5.45, 95% CI [4.77-6.24]), use more mental healthcare services (IRR 2.22; 95% CI [2.00-2.46]), and be prescribed more psychotropic medications (IRR = 2.57; 95% CI [2.36-2.80]) compared to siblings. The most pronounced increases in mental healthcare were for adjustment, anxiety, mood, personality, psychotic disorders, and suicidal ideation/attempted suicide. The most pronounced increased in psychotropic medication were in SNRIs, sleep medications, anti-psychotics and lithium. Among 963 TGD youth (Mage: 18.2) using gender-affirming pharmaceuticals, mental healthcare did not significantly change (IRR = 1.09, 95% CI [0.95-1.25]) and psychotropic medications increased (IRR = 1.67, 95% CI [1.46-1.91]) following gender-affirming pharmaceutical initiation; older age was associated with decreased care and prescriptions. CONCLUSION Results support clinical mental health screening recommendations for TGD youth. Further research is needed to elucidate the longer-term impact of medical affirmation on mental health, including family and social factors associated with the persistence and discontinuation of mental healthcare needs among TGD youth. Hisle-Gorman E, Schvey NA, Adirim TA, et al. Mental Healthcare Utilization of Transgender Youth Before and After Affirming Treatment. J Sex Med 2021;18:1444-1454.
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Affiliation(s)
- Elizabeth Hisle-Gorman
- Department of Pediatrics, Uniformed Services University, Bethesda, MD; Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, USA.
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD, USA
| | - Terry A Adirim
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD; Department of Defense, Washington, DC, USA
| | - Anna K Rayne
- Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Apryl Susi
- Department of Pediatrics, Uniformed Services University, Bethesda, MD; Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, USA
| | - Timothy A Roberts
- Division of Adolescent Medicine, Children's Mercy Kansas City; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - David A Klein
- Department of Pediatrics, Uniformed Services University, Bethesda, MD; Department of Family Medicine, Uniformed Services University, Bethesda, MD, USA
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Rice CE, Fish JN, Russell ST, Lanza ST. Sexual Minority-related Discrimination across the Life Course: Findings from a National Sample of Adults in the United States. JOURNAL OF HOMOSEXUALITY 2021; 68:252-268. [PMID: 31524103 PMCID: PMC7073284 DOI: 10.1080/00918369.2019.1648083] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
In the United States, sexual minority (SM) status is associated with a number of health disparities. Based on mounting evidence, stigma and discrimination have been cited as key barriers to health equity for this population. We estimated the prevalence of three types of discrimination as a function of age among SM adults from the National Epidemiological Study of Alcohol Use and Related Conditions III (NESARC-III) (2012-2013). Among SM adults, reports of past-year general discrimination, victimization, and healthcare discrimination varied by age, with peaks in early adulthood and again in midlife. Age trends varied by biological sex, with males experiencing significantly more general discrimination, victimization, and healthcare discrimination at specific ages. Age trends also varied by sexual identity, as LGB-identifying SMs were significantly more likely to experience all forms of discrimination across all ages. Policies preventing homophobic discrimination and victimization are necessary given the pervasiveness of these experiences across adulthood.
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Affiliation(s)
- Cara Exten Rice
- The Methodology Center, Pennsylvania State University , University Park, Pennsylvania, USA
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland , College Park, Maryland, USA
| | - Stephen T Russell
- Population Research Center, Human Development & Family Sciences, University of Texas at Austin , Austin, Texas, USA
| | - Stephanie T Lanza
- Department of Biobehavioral Health, Pennsylvania State University , University Park, Pennsylvania, USA
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Santos TC, Mann ES, Pfeffer CA. Are university health services meeting the needs of transgender college students? A qualitative assessment of a public university. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:59-66. [PMID: 31483216 DOI: 10.1080/07448481.2019.1652181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 07/28/2019] [Accepted: 07/31/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This exploratory study sought to assess transgender college students' experiences accessing primary, gynecological, and/or mental health care through university health services (UHS). PARTICIPANTS AND METHODS Individual interviews were conducted with eleven transgender undergraduate students attending a large public university in the United States in Spring 2017. RESULTS The structure, organization, and practices of UHS are not adequately meeting transgender college students' health care needs. Students reported being repeatedly misgendered and addressed by the incorrect name by staff at UHS. Some providers asked inappropriate and irrelevant questions about their gender identity during clinical encounters. These and related experiences deterred many participants from returning to UHS for health care services. CONCLUSION UHS could improve health care delivery to transgender college students by adopting standardized and inclusive practices consistent with those recommended by The Fenway Institute.
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Affiliation(s)
- Theodore C Santos
- South Carolina Honors College, University of South Carolina, Columbia, SC, USA
| | - Emily S Mann
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
- Women's and Gender Studies Program, University of South Carolina, Columbia, SC, USA
| | - Carla A Pfeffer
- Women's and Gender Studies Program, University of South Carolina, Columbia, SC, USA
- Department of Sociology, University of South Carolina, Columbia, SC, USA
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Stroumsa D, Crissman HP, Dalton VK, Kolenic G, Richardson CR. Insurance Coverage and Use of Hormones Among Transgender Respondents to a National Survey. Ann Fam Med 2020; 18:528-534. [PMID: 33168681 PMCID: PMC7708284 DOI: 10.1370/afm.2586] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 04/14/2020] [Accepted: 05/11/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE We undertook a study to assess the associations between barriers to insurance coverage for gender-affirming hormones (either lack of insurance or claim denial) and patterns of hormone use among transgender adults. METHODS We used data from the US Transgender Survey, a large national sample of 27,715 transgender adults, collected from August to September 2015. We calculated weighted proportions and performed multivariate logistic regression analyses. RESULTS Of 12,037 transgender adults using hormones, 992 (9.17%) were using nonprescription hormones. Among insured respondents, 2,528 (20.81%) reported that their claims were denied. Use of nonprescription hormones was more common among respondents who were uninsured (odds ratio = 2.64; 95% CI, 1.88-3.71; P <.001) or whose claims were denied (odds ratio = 2.53; 95% CI, 1.61-3.97; P <.001). Uninsured respondents were also less likely to be using hormones (odds ratio = 0.37; 95% CI, 0.24-0.56; P <.001). CONCLUSIONS Lack of insurance coverage for gender-affirming hormones is associated with lower overall odds of hormone use and higher odds of use of nonprescription hormones; such barriers may thus be linked to unmonitored and unsafe medication use, and increase the risks for adverse health outcomes. Ensuring access to hormones can decrease the economic burden transgender people face, and is an important part of harm-reduction strategies.
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Affiliation(s)
- Daphna Stroumsa
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan .,Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor, Michigan
| | - Halley P Crissman
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Vanessa K Dalton
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.,Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor, Michigan.,Program on Women's Healthcare Effectiveness Research (PWHER), University of Michigan, Ann Arbor, Michigan
| | - Giselle Kolenic
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Caroline R Richardson
- Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor, Michigan.,Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
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Salter CA, Nascimento B, Terrier JE, Taniguchi H, Bernie H, Miranda E, Jenkins L, Schofield E, Mulhall JP. Defining the impact of Peyronie's disease on the psychosocial status of gay men. Andrology 2020; 9:233-237. [PMID: 32909401 DOI: 10.1111/andr.12899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/21/2020] [Accepted: 08/31/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little sexual health research has been conducted in gay men. Anecdotally, this population seems to experience more bother related to Peyronie's disease (PD). OBJECTIVES To examine the impact of PD on psychosocial factors in gay vs straight men. MATERIALS AND METHODS All PD patients who were seen in the sexual medicine clinic were included. They completed three instruments: the PD questionnaire (PDQ), Self-Esteem and Relationship (SEAR) questionnaire, and a depression questionnaire (CES-D). We described demographics and sexual variables by sexual orientation. We then compared PDQ items and summary scores by sexual orientation, using a series of independent samples t tests. RESULTS 34 consecutive gay and 464 straight men were included. Age and baseline characteristics were similar between the two cohorts, with the exception that fewer gay men were partnered (56% vs 87%, P < .01), and those with a partner had a shorter relationship duration: 109 ± 9 months vs 262 ± 175 months, P < .01. For the SEAR questionnaire, gay men demonstrated a more significant psychosocial impact of PD overall with lower SEAR sums (41 vs 57, P = .01) and a lower sexual relationship subdomain score (28 vs 47, P < .01). 41% of gay men vs 26% of straight men had CES-D scores consistent with depression as defined by a score of ≥16 (P = .09). In the PDQ domains, gay men scored less favorably with regard to bother scores (7 vs 5, P = .03) and pain scores (8 vs 4, P = .04). DISCUSSION Gay men with PD experience significantly more psychosocial impact as evidenced by less favorable SEAR sum and sexual relationship scores, CES-D scores, and PDQ pain and bother domain scores. CONCLUSION The psychosocial impact of PD is significant in all men, but it appears to be greater in gay men.
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Affiliation(s)
- Carolyn A Salter
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bruno Nascimento
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jean-Etienne Terrier
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hisanori Taniguchi
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Helen Bernie
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eduardo Miranda
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lawrence Jenkins
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John P Mulhall
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Characteristics of Transgender Patient Cases Managed by a Toxicologist: an Analysis of the Toxicology Investigator's Consortium (ToxIC) Registry: January 2017-June 2019. J Med Toxicol 2020; 17:16-26. [PMID: 32557176 DOI: 10.1007/s13181-020-00789-1] [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: 02/21/2020] [Revised: 05/21/2020] [Accepted: 05/23/2020] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION The Toxicology Investigators Consortium (ToxIC) database, created in 2010 by the American College of Medical Toxicology (ACMT), compiles data recorded by medical toxicologists. In January 2017, the data field for transgender (and if transgender, male-to-female or female-to-male) was added to the ToxIC form. Little is known regarding trends in poisonings among transgender patients. We sought to review consultations managed by a bedside toxicologist and provide descriptive data in trends among types of exposures within the transgender demographic. METHODS A retrospective ToxIC database evaluation of cases in which the patient identified as transgender were reviewed from January 2017-June 2019 and descriptive demographics reported. RESULTS The registry contained 113 cases that involved transgender patients. Of those with complete data, 41 (36.6%) were male-to-female, 68 (60.7%) were female-to-male, and 3 (2.7%) identified as gender non-conforming. Of those with complete data, the most common reason for encounter was intentional use of a pharmaceutical drug (N = 97, 85.8%), of which 85 (87.6%) were classified as intentional pharmaceutical use intended for self-harm. Analgesics were the most common class of drugs used out of those reported (N = 24, 22%). Forty-six (90.2%) patients aged 13-18 with complete data were identified as encounters due to self-harm. Attempt at self-harm was the most common reason for intentional pharmaceutical encounter among the sample of transgender patients with complete data (N = 85, 87.6%); with female-to-male patients having an N = 53 (77.9%). CONCLUSION Among transgender patients in the ToxIC registry, the most common primary reason for the encounter was intentional use of a pharmaceutical drug intended for self-harm. In this small cohort, there were some age and transition differences in prevalence. These findings may inform poisoning prevention practices as well as sex- and gender-based management of patients in this vulnerable population.
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McDaid LM, Flowers P, Ferlatte O, McAloney-Kocaman K, Gilbert M, Frankis J. Informing theoretical development of salutogenic, asset-based health improvement to reduce syndemics among gay, bisexual and other men who have sex with men: Empirical evidence from secondary analysis of multi-national, online cross-sectional surveys. SSM Popul Health 2019; 10:100519. [PMID: 31853476 PMCID: PMC6911981 DOI: 10.1016/j.ssmph.2019.100519] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/16/2019] [Accepted: 11/18/2019] [Indexed: 12/21/2022] Open
Abstract
Globally, gay, bisexual and other men who have sex with men (GBMSM) experience an increased burden of poor sexual, mental and physical health. Syndemics theory provides a framework to understand comorbidities and health among marginalised populations. Syndemics theory attempts to account for the social, environmental, and other structural contexts that are driving and/or sustaining simultaneous multiple negative health outcomes, but has been widely critiqued. In this paper, we conceptualise a new framework to counter syndemics by assessing the key theoretical mechanisms by which pathogenic social context variables relate to ill-health. Subsequently, we examine how salutogenic, assets-based approaches to health improvement could function among GBMSM across diverse national contexts. Comparative quantitative secondary analysis of data on syndemics and community assets are presented from two international, online, cross-sectional surveys of GBMSM (SMMASH2 in Scotland, Wales, Northern Ireland and the Republic of Ireland and Sex Now in Canada). Negative sexual, mental and physical health outcomes were clustered as hypothesised, providing evidence of the syndemic. We found that syndemic ill-health was associated with social isolation and the experience of stigma and discrimination, but this varied across national contexts. Moreover, while some of our measures of community assets appeared to have a protective effect on syndemic ill-health, others did not. These results present an important step forward in our understanding of syndemic ill-health and provide new insights into how to intervene to reduce it. They point to a theoretical mechanism through which salutogenic approaches to health improvement could function and provide new strategies for working with communities to understand the proposed processes of change that are required. To move forward, we suggest conceptualising syndemics within a complex adaptive systems model, which enables consideration of the development, sustainment and resilience to syndemics both within individuals and at the population-level. Gay and other men who have sex with men experience syndemics in varied contexts. Some salutogenic community assets have a protective effect on syndemic ill-health. Conceptualising syndemics within a complex adaptive systems model is required.
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Affiliation(s)
- Lisa M McDaid
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK
| | - Paul Flowers
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK
| | - Olivier Ferlatte
- Department of Social and Preventative Medicine, School of Public Health, University of Montreal, 7101 Avenue du Parc (3rd Floor), Montreal, Quebec, H3N 1X9, Canada.,Community Based Research Centre for Gay Men's Health, 1007-808 Nelson Street, Vancouver, British Columbia, V6Z 2H2, Canada
| | | | - Mark Gilbert
- Community Based Research Centre for Gay Men's Health, 1007-808 Nelson Street, Vancouver, British Columbia, V6Z 2H2, Canada.,School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Jamie Frankis
- Department of Health & Community Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
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Operario D, Nemoto T. On Being Transnational and Transgender: Human Rights and Public Health Considerations. Am J Public Health 2019; 107:1537-1538. [PMID: 28902560 DOI: 10.2105/ajph.2017.304030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Don Operario
- Don Operario is with the School of Public Health, Brown University, Providence, RI. Tooru Nemoto is with the Public Health Institute, Oakland, CA
| | - Tooru Nemoto
- Don Operario is with the School of Public Health, Brown University, Providence, RI. Tooru Nemoto is with the Public Health Institute, Oakland, CA
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Mendez IM, Averett PE, Lee JGL. Messaging Lesbian, Gay, Bisexual, and Transgender Health Inequities: A Qualitative Exploration. Health Promot Pract 2018; 20:18-21. [PMID: 30371097 DOI: 10.1177/1524839918809009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There are substantial health inequities for lesbian, gay, bisexual, and transgender (LGBT) people compared to their straight/cisgendered counterparts. As evidence of these inequities has become unequivocal, better strategies to address them are needed. One approach is to leverage communications and media advocacy efforts to raise awareness about inequities. However, some research suggests that highlighting health inequities can have negative consequences. This study aimed to explore how LGBT leaders view communication about health inequities. METHOD We used an inductive qualitative approach and conducted 12 semistructured phone interviews with LGBT community leaders in North Carolina between September and October 2017. RESULTS Four themes emerged in the data. There was support for reporting health differences between LGBT and straight/cisgendered people to raise awareness of health issues facing LGBT communities. However, participants were concerned about the stigmatizing effects of messages and worried about their effectiveness. CONCLUSION Emphasizing health differences between LGBT and straight people can be problematic; our findings suggest that health educators (1) must be cautious, (2) must be aware of the audience, and (3) should consider focusing messages on finding a solution to the identified problem. Future work should explore how to best craft messages that address health inequities for LGBT communities.
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15
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Bristowe K, Hodson M, Wee B, Almack K, Johnson K, Daveson BA, Koffman J, McEnhill L, Harding R. Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study. Palliat Med 2018; 32:23-35. [PMID: 28502218 PMCID: PMC5758934 DOI: 10.1177/0269216317705102] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. AIM To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. DESIGN Semi-structured in-depth qualitative interviews analysed using thematic analysis. SETTING/PARTICIPANTS In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer ( n = 21), non-cancer ( n = 16) and both a cancer and a non-cancer conditions ( n = 3). RESULTS In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals' preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. CONCLUSION Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.
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Affiliation(s)
- Katherine Bristowe
- 1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, UK
| | | | - Bee Wee
- 3 Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Kathryn Almack
- 4 Nottingham Centre for the Advancement of Research into Supportive, Palliative and End-of-Life Care, The University of Nottingham, Nottingham, UK
| | - Katherine Johnson
- 5 School of Applied Social Science, University of Brighton, Brighton, UK
| | - Barbara A Daveson
- 1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, UK
| | - Jonathan Koffman
- 1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, UK
| | | | - Richard Harding
- 1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, UK
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16
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Cochran SD, Mays VM. A Strategic Approach to Eliminating Sexual Orientation-Related Health Disparities. Am J Public Health 2017; 106:e4. [PMID: 27509288 DOI: 10.2105/ajph.2016.303271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Susan D Cochran
- Susan D. Cochran is with the departments of Epidemiology and Statistics, University of California, Los Angeles (UCLA) Fielding School of Public Health, Los Angeles. Vickie M. Mays is with the departments of Psychology and Health Policy and Management, UCLA. Both authors are also with the UCLA Center for Bridging Research Innovation, Training and Education for Minority Health Disparities Solutions, Los Angeles
| | - Vickie M Mays
- Susan D. Cochran is with the departments of Epidemiology and Statistics, University of California, Los Angeles (UCLA) Fielding School of Public Health, Los Angeles. Vickie M. Mays is with the departments of Psychology and Health Policy and Management, UCLA. Both authors are also with the UCLA Center for Bridging Research Innovation, Training and Education for Minority Health Disparities Solutions, Los Angeles
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17
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Collins TW, Grineski SE, Morales DX. Environmental injustice and sexual minority health disparities: A national study of inequitable health risks from air pollution among same-sex partners. Soc Sci Med 2017; 191:38-47. [PMID: 28888127 DOI: 10.1016/j.socscimed.2017.08.040] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 06/23/2017] [Accepted: 08/31/2017] [Indexed: 11/17/2022]
Abstract
Air pollution is deleterious to human health, and numerous studies have documented racial and socioeconomic inequities in air pollution exposures. Despite the marginalized status of lesbian, gay, bisexual, and transgender (LGBT) populations, no national studies have examined if they experience inequitable exposures to air pollution. This cross-sectional study investigated inequities in the exposure of same-sex partner households to hazardous air pollutants (HAPs) in the US. We examined cancer and respiratory risks from HAPs across 71,207 census tracts using National Air Toxics Assessment and US Census data. We calculated population-weighted mean cancer and respiratory risks from HAPs for same-sex male, same-sex female and heterosexual partner households. We used generalized estimating equations (GEEs) to examine multivariate associations between sociodemographics and health risks from HAPs, while focusing on inequities based on the tract composition of same-sex, same-sex male and same-sex female partners. We found that mean cancer and respiratory risks from HAPs for same-sex partners are 12.3% and 23.8% greater, respectively, than for heterosexual partners. GEEs adjusting for racial/ethnic and socioeconomic status, population density, urban location, and geographic clustering show that living in census tracts with high (vs. low) proportions of same-sex partners is associated with significantly greater cancer and respiratory risks from HAPs, and that living in same-sex male partner enclaves is associated with greater risks than living in same-sex female partner enclaves. Results suggest that some health disparities experienced by LGBT populations (e.g. cancer, asthma) may be compounded by environmental exposures. Findings highlight the need to extend the conceptual framework for explaining LGBT health disparities beyond psycho-behavioral mechanisms translating social stress into illness to include environmental mechanisms. Because psycho-behavioral and environmental factors may together exacerbate health disparities, we call for a shift toward interdisciplinary research on LGBT health that takes into account cumulative risks, including the role of environmental exposures.
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Affiliation(s)
- Timothy W Collins
- Department of Sociology & Anthropology, University of Texas at El Paso, 500 West University Avenue, El Paso, TX, 79968, USA.
| | - Sara E Grineski
- Department of Sociology & Anthropology, University of Texas at El Paso, 500 West University Avenue, El Paso, TX, 79968, USA.
| | - Danielle X Morales
- Department of Sociology & Anthropology, University of Texas at El Paso, 500 West University Avenue, El Paso, TX, 79968, USA.
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Hunt J, Bristowe K, Chidyamatare S, Harding R. 'They will be afraid to touch you': LGBTI people and sex workers' experiences of accessing healthcare in Zimbabwe-an in-depth qualitative study. BMJ Glob Health 2017; 2:e000168. [PMID: 28589012 PMCID: PMC5435254 DOI: 10.1136/bmjgh-2016-000168] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 03/02/2017] [Accepted: 03/03/2017] [Indexed: 11/20/2022] Open
Abstract
Objectives To examine experiences of key populations (lesbian, gay, bisexual, trans and intersex (LGBTI) people, men who have sex with men (MSM) and sex workers) in Zimbabwe regarding access to, and experiences of, healthcare. Design Qualitative study using in-depth interviews and focus groups, with thematic analysis. Participants Sixty individuals from key populations in Zimbabwe. Setting Participants were recruited from four locations (Harare, Bulawayo, Mutare, Beitbridge/Masvingo). Results Participants described considerable unmet needs and barriers to accessing basic healthcare due to discrimination regarding key population status, exacerbated by the sociopolitical/legal environment. Three main themes emerged: (1) key populations' illnesses were caused by their behaviour; (2) equal access to healthcare is conditional on key populations conforming to ‘sexual norms’ and (3) perceptions that healthcare workers were ill-informed about key populations, and that professionals' personal attitudes affected care delivery. Participants felt unable to discuss their key population status with healthcare workers. Their healthcare needs were expected to be met almost entirely by their own communities. Conclusions This is one of very few studies of healthcare access beyond HIV for key populations in Africa. Discrimination towards key populations discourages early diagnosis, limits access to healthcare/treatment and increases risk of transmission of infectious diseases. Key populations experience unnecessary suffering from untreated conditions, exclusion from healthcare and extreme psychological distress. Education is needed to reduce stigma and enhance sensitive clinical interviewing skills. Clinical and public health implications of discrimination in healthcare must be addressed through evidence-based interventions for professionals, particularly in contexts with sociopolitical/legal barriers to equality.
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Affiliation(s)
- Jennifer Hunt
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, UK
| | - Katherine Bristowe
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, UK
| | - Sybille Chidyamatare
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, UK
| | - Richard Harding
- King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, UK
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Gowin M, Taylor EL, Dunnington J, Alshuwaiyer G, Cheney MK. Needs of a Silent Minority: Mexican Transgender Asylum Seekers. Health Promot Pract 2017; 18:332-340. [PMID: 28187690 DOI: 10.1177/1524839917692750] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mexican male to female transgender asylum seekers in the United States suffer from serious health issues that can be attributed to stressors related to their transgender, ethnic minority, and socioeconomic status. This study explored these stressors, the resulting health issues, and the needs of this particularly vulnerable population. Asylum seekers' (n = 45) sworn declarations and psychological evaluations were examined by a multidisciplinary research team using a systematic document review process. The review identified stressors that occurred both in Mexico and the United States: verbal, physical, and sexual assaults; unstable environments; fear for safety/security; hiding undocumented status; and economic insecurity. The health issues that resulted in part from these stressors include posttraumatic stress disorder, depression, anxiety, sleep issues, isolation, avoidance, drug/alcohol use, and suicidal tendencies. Despite suffering from multiple health issues, asylum seekers rarely sought health or social services. Health promotion practitioners can play an important role in serving this silent minority by (1) expanding community-based research focused on the intersection of transgender, ethnic minority, and socioeconomic status; (2) using trusted community members to connect this population to necessary resources; (3) providing communication training/resource development for health care providers; and (4) creating a network of service organizations that understand the needs of transgender asylum seekers.
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Affiliation(s)
- Mary Gowin
- 1 University of Oklahoma, Norman, OK, USA
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Cochran SD, Meyer IH, Mays VM. Advancing the Health of Lesbian, Gay, and Bisexual Adults. JAMA Intern Med 2017; 177:288. [PMID: 28166347 PMCID: PMC6226239 DOI: 10.1001/jamainternmed.2016.8629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Susan D Cochran
- Departments of Epidemiology and Statistics, University of California, Los Angeles Fielding School of Public Health, Los Angeles
| | - Ilan H Meyer
- Williams Institute, University of California School of Law, Los Angeles
| | - Vickie M Mays
- Departments of Psychology and Health Policy and Management, University of California, Los Angeles, Los Angeles
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Talan AJ, Drake CB, Glick JL, Claiborn CS, Seal D. Sexual and Gender Minority Health Curricula and Institutional Support Services at U.S. Schools of Public Health. JOURNAL OF HOMOSEXUALITY 2017; 64:1350-1367. [PMID: 28459307 DOI: 10.1080/00918369.2017.1321365] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Limited research has examined the ways in which public health training programs equip students to address health disparities affecting the lesbian, gay, bisexual, and transgender (LGBT) community and other sexual and gender minority (SGM) populations. This study outlines the availability of public health curricula on SGM health topics, and the prevalence of LGBT and SGM-inclusive institutional support services across CEPH-accredited U.S. schools of public health. Content analysis of all course offerings related to gender and sexuality revealed a limited focus on sexual and gender minority health: just 4.7% of courses contained keywords indicating that LGBT or SGM health topics were covered. Similar analysis of institutional support services available at U.S. schools of public health found that only 25% of schools had LGBT student organizations, and just 19% had an office of diversity that specifically advertised LGBT or SGM-inclusive programming or services on the institution's Web site. Finally, only two of 52 schools offered an educational certificate centered on LGBT health. These findings illustrate a significant need for enhanced curricular content and institutional support services that equip public health students to address SGM health disparities. Improvement in this area may encourage future health care professionals to work to reduce these disparities, to improve SGM persons' experiences in health care settings, and to generate further research in this area.
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Affiliation(s)
- Ali J Talan
- a Department of Global Community Health and Behavioral Sciences , Tulane School of Public Health and Tropical Medicine , New Orleans , Louisiana , USA
- b Department of Medicine , NYU School of Medicine , New York , New York , USA
| | - Carolyn B Drake
- a Department of Global Community Health and Behavioral Sciences , Tulane School of Public Health and Tropical Medicine , New Orleans , Louisiana , USA
- b Department of Medicine , NYU School of Medicine , New York , New York , USA
| | - Jennifer L Glick
- a Department of Global Community Health and Behavioral Sciences , Tulane School of Public Health and Tropical Medicine , New Orleans , Louisiana , USA
- b Department of Medicine , NYU School of Medicine , New York , New York , USA
| | - Camilla Scott Claiborn
- a Department of Global Community Health and Behavioral Sciences , Tulane School of Public Health and Tropical Medicine , New Orleans , Louisiana , USA
- b Department of Medicine , NYU School of Medicine , New York , New York , USA
| | - David Seal
- a Department of Global Community Health and Behavioral Sciences , Tulane School of Public Health and Tropical Medicine , New Orleans , Louisiana , USA
- b Department of Medicine , NYU School of Medicine , New York , New York , USA
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