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Current Research Trends in Transgender Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 52460

Special Issue Editors


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Guest Editor
Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80138 Napoli, NA, Italy
Interests: clinical psychology; mental health; health promotion; health disparities; gender
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Psychology, Center for LGBTQ Evidence-Based Applied Research (CLEAR), Palo Alto University, Palo Alto, CA 94304, USA
Interests: transgender and non-binary health; LGBTQ psychology; women and gender; same-sex and heterosexual couples; trauma; minority stress; CBT
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on advances in the health of transgender and gender nonconforming (TGNC) individuals. TGNC people represent a community that is diverse with respect to gender, ethnicity, socio-economic status, etc. Notwithstanding these differences, members of the TGNC population share many common experiences, such as belonging to a stigmatized minority. Indeed, although TGNC people represent a strongly resilient community, capable of successfully overcoming negative and adverse life conditions, they still experience high levels of prejudice that negatively affect their health and wellbeing. An increasing body of literature has, in fact, demonstrated that gender-related prejudice and stigma are among the main factors producing health disparities. However, the TGNC population is changing, especially in the younger segment, where a great percentage of people self-identify as non-binary, genderqueer, bigender, and so on, rejecting a binary view of the TGNC identity. Therefore, as researchers, we need to expand our knowledge base and look at TGNC people as a complex and segmented population with specific health needs.

This Special Issue is open to any subject area related to recent advances in TGNC health, with a specific interest in innovative methods, nationally representative data, young TGNC people, health disparities, minority stress, intersectionality, and resilience.

Dr. Cristiano Scandurra
Prof. Kimberly Balsam
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • transgender;
  • non-binary;
  • health disparities;
  • minority stress;
  • intersectionality;
  • sexual health;
  • resilience;
  • individual-, interpersonal-, and community-based interventions;
  • nationally representative data;
  • young TGNC people.

Published Papers (15 papers)

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Research

18 pages, 2529 KiB  
Article
The Adaptation and Validation of the Trans Attitudes and Beliefs Scale to the Spanish Context
by Miguel Ángel López-Sáez, Ariadna Angulo-Brunet, R. Lucas Platero and Oscar Lecuona
Int. J. Environ. Res. Public Health 2022, 19(7), 4374; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19074374 - 05 Apr 2022
Cited by 6 | Viewed by 2837
Abstract
This article examines the reliability and validity of the adaptation of the Trans Attitudes and Beliefs Scale (TABS), an instrument capable of detecting transphobic positions, to the Spanish context. A total of 829 psychology students participated in the adaptation procedure. A confirmatory factor [...] Read more.
This article examines the reliability and validity of the adaptation of the Trans Attitudes and Beliefs Scale (TABS), an instrument capable of detecting transphobic positions, to the Spanish context. A total of 829 psychology students participated in the adaptation procedure. A confirmatory factor analysis was performed to study the fit of the new scale to the factor structure of the original scale (interpersonal comfort, gender identity beliefs, and human value). Convergent validity evidence showed significant correlations and predictive levels with different constructs and sociodemographic variables. The internal consistency of the mean scores was adequate at the global level. The study showed that the TABS is a psychometrically sound instrument for the assessment of attitudes toward trans people, particularly in the context of debates over access to rights and the lack of professional training in disciplines such as psychology. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
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13 pages, 1607 KiB  
Article
Psychomedical Interventions with Transgender People in Portugal and Brazil: A Critical Approach
by Liliana Rodrigues, Matilde Soares and Conceição Nogueira
Int. J. Environ. Res. Public Health 2022, 19(1), 267; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010267 - 27 Dec 2021
Viewed by 2216
Abstract
This study aims to analyze biopsychomedical interventions with transgender people. For this purpose, we carried out 35 semi-structured interviews with people who self-identify as transsexuals and transvestites in Brazil and Portugal. The responses of the study participants were systematized according to a thematic [...] Read more.
This study aims to analyze biopsychomedical interventions with transgender people. For this purpose, we carried out 35 semi-structured interviews with people who self-identify as transsexuals and transvestites in Brazil and Portugal. The responses of the study participants were systematized according to a thematic analysis, which led to the emergence of the following three main themes: “institutional power”, “expectations of trans-bodies”, and “experiences in health services”. This study demonstrates how some trans people perform bodily modifications to fight the transphobia they experience throughout their lives. In addition, they believe that, by making their bodies conform to each other, they may become more attractive and desirable. The process of cisnormativity is, furthermore, conveyed by the idea present in the answers of some respondents: that having “integrated” bodies means facing less discrimination and that they will, therefore, obtain more satisfactory ways of personally and socially experiencing their identities. This study contributes to a deepening critical reflection on the experiences/exclusions of trans people, especially in the psychomedical context of “normalization” devices. Hence, just as social structures produce and sustain transphobia, the same structures are responsible for combating it. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
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15 pages, 1054 KiB  
Article
Experiences of Life and Intersectionality of Transgender Refugees Living in Italy: A Qualitative Approach
by Fau Rosati, Valentina Coletta, Jessica Pistella, Cristiano Scandurra, Fiorenzo Laghi and Roberto Baiocco
Int. J. Environ. Res. Public Health 2021, 18(23), 12385; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182312385 - 25 Nov 2021
Cited by 11 | Viewed by 3507
Abstract
Transgender refugees are at risk of experiencing increased minority stress due to experiences of trauma in their country of origin, and the intersection of multiple marginalized identities in their host country. Adopting a transfeminist and decolonial approach, the present study aimed at exploring [...] Read more.
Transgender refugees are at risk of experiencing increased minority stress due to experiences of trauma in their country of origin, and the intersection of multiple marginalized identities in their host country. Adopting a transfeminist and decolonial approach, the present study aimed at exploring transgender refugees’ experiences of life and migration. A semi-structured interview protocol was developed, grounded in the perspectives of minority stress and intersectionality. Participants were five transgender refugees (four women and one non-binary) from different cultural/geographic contexts, professing different religions. Using thematic analysis, the researchers identified three themes: pre- and post-migration minority stress and transphobia; religion as a protective factor for gender affirmation; and individuation and the synthesis of social identities. Participants reported traumatic experiences and the inability to openly live out their gender identity in their country of origin as the main push factors to migration. They also reported feelings of isolation and experiences of victimization during interactions with the Italian asylum services, due to a lack of adequate training, racial prejudice, and transphobia. Participants demonstrated positive individuation, linked to gender affirmation treatments and religious protective factors. The interview protocol may be used by social operators to support the claims of transgender asylum seekers, and to clinically assess transgender people with an immigrant background. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
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14 pages, 1052 KiB  
Article
Usability of Virtual Visits for the Routine Clinical Care of Trans Youth during the COVID-19 Pandemic: Youth and Caregiver Perspectives
by Carolina Silva, Alex Fung, Michael A. Irvine, Shabnam Ziabakhsh and Brenden E. Hursh
Int. J. Environ. Res. Public Health 2021, 18(21), 11321; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111321 - 28 Oct 2021
Cited by 4 | Viewed by 2156
Abstract
We evaluated families’ perspectives on the usability of virtual visits for routine gender care for trans youth during the COVID-19 pandemic. An online survey, which included a validated telehealth usability questionnaire, was sent to families who had a virtual Gender Clinic visit between [...] Read more.
We evaluated families’ perspectives on the usability of virtual visits for routine gender care for trans youth during the COVID-19 pandemic. An online survey, which included a validated telehealth usability questionnaire, was sent to families who had a virtual Gender Clinic visit between March and August 2020. A total of 87 participants completed the survey (28 trans youth, 59 caregivers). Overall, usability was rated highly, with mean scores between “quite a bit” and “completely” in all categories (usefulness, ease of use, interface and interaction quality, reliability, and satisfaction). Caregivers reported higher usability scores compared to trans youth [mean (SD) 3.43 (0.80) vs. 3.12 (0.93), p = 0.01]. All families felt that virtual visits provided for their healthcare needs. A total of 100% of youth and caregivers described virtual appointments as safer or as safe as in-person visits. A total of 94% of participants would like virtual visits after the pandemic; families would choose a mean of two virtual and one yearly in-person visit with a multidisciplinary team. Overall, virtual gender visits for trans youth had impressive usability. Participants perceived virtual visits to be safe. For the future, a combination of virtual and in-person multidisciplinary visits is the most desired model. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
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12 pages, 317 KiB  
Article
Listening to Transgender Patients and Their Providers in Non-Metropolitan Spaces: Needs, Gaps, and Patient-Provider Discrepancies
by Michelle Teti, L. A. Bauerband, Tyler W. Myroniuk and Erica Koegler
Int. J. Environ. Res. Public Health 2021, 18(20), 10843; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010843 - 15 Oct 2021
Cited by 7 | Viewed by 1682
Abstract
Trans and gender non-conforming (TGNC) patients need better care; providers need TGNC focused medical trainings. TGNC health conferences can help, yet these events occur mostly in urban centers. Meanwhile, patients in non-metropolitan areas often face significant discrimination and notably poor access to TGNC [...] Read more.
Trans and gender non-conforming (TGNC) patients need better care; providers need TGNC focused medical trainings. TGNC health conferences can help, yet these events occur mostly in urban centers. Meanwhile, patients in non-metropolitan areas often face significant discrimination and notably poor access to TGNC care. This study explores the ongoing needs of TGNC patients and their providers following a one-day TGNC health conference in a small town in the American Midwest. Exploratory semi-structured interviews were used to gather in-depth information from TGNC conference attendees (N = 25). Theme analysis methods were used to identify areas of need for future trainings. Providers reported that they needed more exposure to TGNC patients, judgement-free opportunities to learn the basics about TGNC care, and ongoing trainings integrated into their medical school and ongoing education credits. Patients needed better access to care, more informed providers, and safer clinics. They cited lack of specialty care (e.g., mental health, surgery) as particularly problematic in a non-metropolitan setting. TGNC patients, and their providers in non-metropolitan areas, urgently need support. Patients lack specialized care and often possess greater knowledge than their health care teams; providers, in these areas, lack opportunities to work with patients and stay up to date on treatments. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
14 pages, 373 KiB  
Article
Exploring Trans People’s Narratives of Transition: Negotiation of Gendered Bodies in Physical Activity and Sport
by Sofía Pereira-García, José Devís-Devís, Elena López-Cañada, Jorge Fuentes-Miguel, Andrew C. Sparkes and Víctor Pérez-Samaniego
Int. J. Environ. Res. Public Health 2021, 18(18), 9854; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189854 - 18 Sep 2021
Cited by 5 | Viewed by 3158
Abstract
This paper explores how trans people who make transitions negotiate their gendered bodies in different moments of this process, and how their narrative storylines are emplotted in physical activity and (non)organized sports (PAS) participation. A qualitative semi-structured interview-based study was developed to analyze [...] Read more.
This paper explores how trans people who make transitions negotiate their gendered bodies in different moments of this process, and how their narrative storylines are emplotted in physical activity and (non)organized sports (PAS) participation. A qualitative semi-structured interview-based study was developed to analyze the stories of eight trans people (three trans women, two trans men, and three nonbinary persons) who participated in PAS before and during their gender disclosure. A thematic analysis was conducted to identify the patterns in the transition process and the structural analysis of the stories from the interviews. Three transition moments (the closet, opening up, and reassuring) were identified from the thematic analysis. Most participants showed difficulties in achieving their PAS participation during the two earlier moments. The predominance of failure storylines was found particularly in men, while success was more likely to appear in women because their bodies and choices fitted better with their PAS gender ideals. The nonbinary trans persons present alternative storylines in which corporeality has less influence on their PAS experiences. The knowledge provided on the moments and the stories of transition help to explain trans people’s (non)involvement in PAS and to guide policymaking and professional action in PAS fields. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
14 pages, 374 KiB  
Article
Gender Identity Milestones, Minority Stress and Mental Health in Three Generational Cohorts of Italian Binary and Nonbinary Transgender People
by Cristiano Scandurra, Agostino Carbone, Roberto Baiocco, Selene Mezzalira, Nelson Mauro Maldonato and Vincenzo Bochicchio
Int. J. Environ. Res. Public Health 2021, 18(17), 9057; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179057 - 27 Aug 2021
Cited by 28 | Viewed by 3643
Abstract
Transgender and gender nonconforming (TGNC) people experience high rates of minority stress and associated risk for negative health outcomes. However, during the last years, significant positive socio-cultural changes have happened, and younger cohorts of TGNC individuals are having diverse experiences compared to older [...] Read more.
Transgender and gender nonconforming (TGNC) people experience high rates of minority stress and associated risk for negative health outcomes. However, during the last years, significant positive socio-cultural changes have happened, and younger cohorts of TGNC individuals are having diverse experiences compared to older cohorts. By integrating the minority stress theory and the life course perspective, this cross-sectional, web-based study aimed to explore in 197 Italian TGNC people aged 18 to 54 years (M = 29.82, SD = 9.64) whether the average ages of gender identity milestones (i.e., first insights about being TGNC, self-labeling as a TGNC person, and coming out), minority stress, and mental health vary among three generational cohorts (i.e., Generation Z, Millennials, and Generation X). Compared with older cohorts, younger participants: (a) were more likely to be in the trans-masculine spectrum; (b) self-labeled as TGNC and came out earlier; (c) had more negative expectations and lower levels of disclosure; and (d) had higher levels of mental health problems. No generational differences related to first insights about being TGNC and distal minority stressors were found. Furthermore, compared with binary individuals, participants with a non-binary identity: (a) reported later ages for the gender identity milestones; (b) had higher negative expectations; and (c) had higher levels of mental health problems. Overall, our findings indicated that changes in the social environments have a limited impact on stigmatization processes and mental health of Italian TGNC people. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
12 pages, 624 KiB  
Article
Buffering against Depressive Symptoms: Associations between Self-Compassion, Perceived Family Support and Age for Transgender and Nonbinary Individuals
by Steven Samrock, Kai Kline and Ashley K. Randall
Int. J. Environ. Res. Public Health 2021, 18(15), 7938; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18157938 - 27 Jul 2021
Cited by 8 | Viewed by 2879
Abstract
Transgender and gender nonbinary (TGNB) individuals often report higher levels of depression compared to cisgender individuals. Higher levels of depression in TGNB populations may be partially attributed to a lack of family support, which may be particularly salient for younger individuals. However, two [...] Read more.
Transgender and gender nonbinary (TGNB) individuals often report higher levels of depression compared to cisgender individuals. Higher levels of depression in TGNB populations may be partially attributed to a lack of family support, which may be particularly salient for younger individuals. However, two possible protective factors that may mitigate depressive symptoms are self-compassion, defined as an attitude of kindness and understanding towards one’s own imperfections, and perceived support, especially from family. The present study aimed to explore whether self-compassion was negatively associated with self-reported depressive symptoms, and whether perceived family support moderated this association, especially for younger individuals. Participants who were (1) at least 18 years of age, (2) identified as TGNB, and (3) experienced gender dysphoria were eligible for this study. Cross-sectional data from 148 individuals were collected online during May 2020. In support of the hypotheses, self-compassion was negatively associated with depressive symptoms, and perceived family support furthered this association. Additionally, results showed that younger participants (ages 18–24) with lower family support reported the highest levels of depressive symptoms. Taken together, these results suggest that self-compassion and perceived family support may be significant protective factors against depressive symptoms for TGNB individuals, although longitudinal research is needed. Taking a strengths-based perspective, mental health clinicians working with TGNB individuals may consider interventions geared toward increasing self-compassion in daily life and working with clients’ families to increase support. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
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13 pages, 486 KiB  
Article
Feasibility, Safety, and Satisfaction of Combined Hysterectomy with Bilateral Salpingo-Oophorectomy and Chest Surgery in Transgender and Gender Non-Conforming Individuals
by Ilaria Mancini, Davide Tarditi, Giulia Gava, Stefania Alvisi, Luca Contu, Paolo Giovanni Morselli, Giulia Giacomelli, Alessandra Lami, Renato Seracchioli and Maria Cristina Meriggiola
Int. J. Environ. Res. Public Health 2021, 18(13), 7133; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137133 - 03 Jul 2021
Cited by 1 | Viewed by 2213
Abstract
The demand for masculinizing breast surgery and hysterectomy with bilateral salpingo-oophorectomy (HBSO) from transmen has increased. With a multidisciplinary approach, these surgeries can be performed in a single session. The objective of this study was to retrospectively evaluate the feasibility, safety, and satisfaction [...] Read more.
The demand for masculinizing breast surgery and hysterectomy with bilateral salpingo-oophorectomy (HBSO) from transmen has increased. With a multidisciplinary approach, these surgeries can be performed in a single session. The objective of this study was to retrospectively evaluate the feasibility, safety, and satisfaction of HBSO and chest surgery in transmen. A cohort of 142 subjects who underwent HBSO alone or combined with chest surgery at Sant’Orsola Hospital was analyzed. Intra and post operation events were evaluated. Subjective post-intervention satisfaction, acceptability, and impact of intervention were assessed via a semi-structured interview. Nineteen transmen underwent HBSO alone and 123 underwent combined surgery. HBSO was performed laparoscopically in 96.5% of transmen (137/142). As expected, length of hospital stay and blood loss were significantly higher in the combined surgery group. A total of 13 intra or post-operative complications occurred in the combined surgery group (10.5%) with thoracic hematoma being the most frequent complication (7.6%). Only one rare complication occurred in the HBSO group (omental herniation through a laparoscopic breach). The overall subjective satisfaction score was 9.9 out of 10 for both groups. Positive changes in all areas of life were reported, with no significant differences. We found that the combined surgery appears to be well tolerated, safe, and feasible in transmen and satisfaction with the combined procedure was high in all subjects. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
12 pages, 910 KiB  
Article
Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now?
by Hale M. Thompson, Clair A. Kronk, Ketzel Feasley, Paul Pachwicewicz and Niranjan S. Karnik
Int. J. Environ. Res. Public Health 2021, 18(12), 6599; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126599 - 19 Jun 2021
Cited by 18 | Viewed by 3737
Abstract
In 2015, the United States Department of Health and Human Services instantiated rules mandating the inclusion of sexual orientation and gender identity (SO/GI) data fields for systems certified under Stage 3 of the Meaningful Use of Electronic Health Records (EHR) program. To date, [...] Read more.
In 2015, the United States Department of Health and Human Services instantiated rules mandating the inclusion of sexual orientation and gender identity (SO/GI) data fields for systems certified under Stage 3 of the Meaningful Use of Electronic Health Records (EHR) program. To date, no published assessments have benchmarked implementation penetration and data quality. To establish a benchmark for a U.S. health system collection of gender identity and sex assigned at birth, we analyzed one urban academic health center’s EHR data; specifically, the records of patients with unplanned hospital admissions during 2020 (N = 49,314). Approximately one-quarter of patient records included gender identity data, and one percent of them indicated a transgender or nonbinary (TGNB) status. Data quality checks suggested limited provider literacy around gender identity as well as limited provider and patient comfort levels with gender identity disclosures. Improvements are needed in both provider and patient literacy and comfort around gender identity in clinical settings. To include TGNB populations in informatics-based research, additional novel approaches, such as natural language processing, may be needed for more comprehensive and representative TGNB cohort discovery. Community and stakeholder engagement around gender identity data collection and health research will likely improve these implementation efforts. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
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16 pages, 413 KiB  
Article
Condom-Protected Sex and Minority Stress: Associations with Condom Negotiation Self-Efficacy, “Passing” Concerns, and Experiences with Misgendering among Transgender Men and Women in Brazil
by Ramiro Figueiredo Catelan, Alexandre Saadeh, Maria Inês Rodrigues Lobato, Daniel Augusto Mori Gagliotti and Angelo Brandelli Costa
Int. J. Environ. Res. Public Health 2021, 18(9), 4850; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094850 - 01 May 2021
Cited by 7 | Viewed by 3625
Abstract
This cross-sectional exploratory study aims to verify associations between condom-protected sex, condom negotiation self-efficacy, self-esteem, and four minority stressors (experiences with misgendering, “passing” concerns, anticipated prejudice, and perceived prejudice) among transgender men (TM) and transgender women (TW). 260 individuals (192 TW and 68 [...] Read more.
This cross-sectional exploratory study aims to verify associations between condom-protected sex, condom negotiation self-efficacy, self-esteem, and four minority stressors (experiences with misgendering, “passing” concerns, anticipated prejudice, and perceived prejudice) among transgender men (TM) and transgender women (TW). 260 individuals (192 TW and 68 TM) residing in two Brazilian states participated in the study. Data was collected online and in two hospital programs for transgender people and included sociodemographic data, condom-protected sex, the Trans-Specific Condom/Barrier Negotiation Self-Efficacy (T-Barrier) Scale, the Rosenberg Self-Esteem Scale, and four minority stressors. Measures that were significantly associated with condom-protected sex were tested as independent variables in a linear regression model. The main results suggest that lower condom negotiation self-efficacy, higher “passing” concerns, and higher experiences with misgendering were predictors of lower frequency of condom-protected sex. These negative outcomes were found among both TM and TW, which justifies their inclusion in public health policies. Structural strategies and clinical interventions are suggested to address condom negotiation self-efficacy and “passing” concerns in transgender populations. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
15 pages, 328 KiB  
Article
Gender Diverse Children and Adolescents in Italy: A Qualitative Study on Specialized Centers’ Model of Care and Network
by Guido Giovanardi, Alexandro Fortunato, Marta Mirabella, Anna Maria Speranza and Vittorio Lingiardi
Int. J. Environ. Res. Public Health 2020, 17(24), 9536; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249536 - 19 Dec 2020
Cited by 6 | Viewed by 2784
Abstract
In recent years, Italy, similar to many other countries, has witnessed an increase in children and adolescents presenting gender incongruence. This trend has led to the development and implementation of specialized centers providing care and support for these youths and their families. The [...] Read more.
In recent years, Italy, similar to many other countries, has witnessed an increase in children and adolescents presenting gender incongruence. This trend has led to the development and implementation of specialized centers providing care and support for these youths and their families. The present study aimed at investigating the functioning of agencies specialized in working with transgender and gender non-conforming youths in the Italian territory. Professionals in these agencies were interviewed about their perspectives on their agency’s functioning, networks with other services, and work with trans* youths and their families. A semi-structured interview was developed and administered to professionals in specialized centers and associations dedicated to trans * youths, and deductive thematic analysis was applied to the transcripts. Eight professionals were interviewed: six working in specialized centers and two working in associations. The qualitative analyses of transcripts revealed four main themes, pertaining to service referrals, assessment protocols and intervention models, psychological support for youths and families, and agency shortcomings. The study explored the functioning of Italian agencies specialized in caring for transgender and gender non-conforming youths, from the perspective of professionals working in these agencies. While several positive aspects of the work emerged, the study highlighted a lack of uniformity across the Italian territory and the need for better networks between agencies and other medical professionals. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
18 pages, 1645 KiB  
Article
Longitudinal Use of the Consolidated Framework for Implementation Research to Evaluate the Creation of a Rural Center of Excellence in Transgender Health
by Pamela J. Tinc, Christopher Wolf-Gould, Carolyn Wolf-Gould and Anne Gadomski
Int. J. Environ. Res. Public Health 2020, 17(23), 9047; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17239047 - 04 Dec 2020
Cited by 2 | Viewed by 2097
Abstract
Background: Transgender people face numerous barriers to accessing care, particularly in rural settings. Transportation, travel time, a lack of providers offering transgender care, and discrimination all contribute to these barriers. The Gender Wellness Center was established in New York State, USA, to fill [...] Read more.
Background: Transgender people face numerous barriers to accessing care, particularly in rural settings. Transportation, travel time, a lack of providers offering transgender care, and discrimination all contribute to these barriers. The Gender Wellness Center was established in New York State, USA, to fill a gap in rural transgender care and was subsequently awarded a Robert Wood Johnson Foundation grant to establish a Center of Excellence. This study examined the implementation of the Center of Excellence, a complex intervention, to assess barriers and facilitators to implementation over 18 months. Methods: The Consolidated Framework for Implementation Research (CFIR) was used to develop baseline and follow-up surveys. These were distributed to members of the core implementation team at the Gender Wellness Center at the midpoint and conclusion of the Robert Wood Johnson Foundation grant. Responses were largely open-ended and analyzed qualitatively. Results: Results are presented in terms of CFIR domains and constructs, as well as the relative outlook (positive or negative) of implementation. Overall, there were improvements over time, with more encouraging feedback and examples of success at follow-up. Though true, organizational culture and individual beliefs about the provision of transgender care challenged implementation of the Center of Excellence throughout the project. Conclusions: This study highlights the importance of organizational culture on implementation efforts, as well as the need for complex, multifaceted interventions to overcome such challenges in order to improve care for marginalized populations. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
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15 pages, 347 KiB  
Article
Transition Trajectories: Contexts, Difficulties and Consequences Reported by Young Transgender and Non-Binary Spaniards
by Mariana Magalhães, Marta E. Aparicio-García and Isidro García-Nieto
Int. J. Environ. Res. Public Health 2020, 17(18), 6859; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17186859 - 19 Sep 2020
Cited by 8 | Viewed by 3273
Abstract
The transition process can have a significant impact on young transgender and non-binary individuals (TNBI), especially regarding their mental health. As such, this study aimed to explore the encountered difficulties and expectations of 225 young adults, between 14 and 25 years old, who [...] Read more.
The transition process can have a significant impact on young transgender and non-binary individuals (TNBI), especially regarding their mental health. As such, this study aimed to explore the encountered difficulties and expectations of 225 young adults, between 14 and 25 years old, who identify themselves as TNBI. Four different aspects were analyzed: difficulties related to the transition process; main current difficulties; if the current difficulties are due to the participants’ sexual orientation or gender identity; and if participants feel the need of changing something in their lives. Several obstacles either before, during or after the transition process were identified; and these obstacles have serious consequences in TBNI’s mental health. Questions regarding legislation, discrimination, transphobia, lack of social support, the pathologization of transgenderism, low self-esteem, anxiety symptomatology, among others, were pointed out by the participants. The narratives collected and analyzed in the present study appear as important inputs to the literature, which can be translated into the basis of further investigations and the improvement of professional practices in the health field. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
16 pages, 386 KiB  
Article
Personality Disorders and Personality Profiles in a Sample of Transgender Individuals Requesting Gender-Affirming Treatments
by Annalisa Anzani, Chiara De Panfilis, Cristiano Scandurra and Antonio Prunas
Int. J. Environ. Res. Public Health 2020, 17(5), 1521; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17051521 - 27 Feb 2020
Cited by 25 | Viewed by 8498
Abstract
The study aims to explore the personality patterns of a group of transgender individuals who accessed an Italian gender clinic to undergo gender affirming treatments, by evaluating both dimensional personality domains proposed by the Alternative Model of Personality Disorders and categorical DSM-IV personality [...] Read more.
The study aims to explore the personality patterns of a group of transgender individuals who accessed an Italian gender clinic to undergo gender affirming treatments, by evaluating both dimensional personality domains proposed by the Alternative Model of Personality Disorders and categorical DSM-IV personality disorder (PD) diagnoses. Eighty-seven participants (40 transgender women and 47 transgender men) completed the Personality Inventory for DSM-5 and the Structured Clinical Interview for DSM-IV Axis II personality disorders. Scores obtained were compared to those of the normative samples of cisgender women and men. Results indicated that transgender women scored lower than cisgender women on two main domains (Negative Affectivity and Psychoticism) and on seven facets. As for transgender men, lower scores than cisgender men were found on Antagonism and on five facets. Transgender men scored higher than cisgender men on Depressivity. Nearly 50% of participants showed at least one PD diagnosis, with no gender differences in prevalence. Borderline PD was the most frequent diagnosis in the overall sample. Self-report measures provide a less maladaptive profile of personality functioning than the clinician-based categorical assessment. Results are interpreted in the light of the Minority Stress Model and support the need for a multi-method assessment of personality in medicalized transgender people. Full article
(This article belongs to the Special Issue Current Research Trends in Transgender Health)
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