Exploring the Role of Migration Status in Pregnancy Loss Attributions, Experiences, and Support in Australia.

While previous research has explored the impact of migration status on experiences and attributions about pregnancy loss, less common is comparative research examining similarities and differences between migrants and non-migrants. This paper reports on a cross sectional comparative study of 623 culturally and linguistically diverse (CALD) or non-CALD people living in Australia. Participants completed a survey that asked about experiences of pregnancy loss, support, and attributions about pregnancy loss. There were no differences between the two groups in terms of rates of pregnancy loss, though CALD participants reported greater distress following a loss. CALD participants reported greater reliance on partners and faith communities, and found healthcare professionals to be less supportive. CALD participants were more likely to attribute pregnancy loss to spiritual reasons (among others), and non-CALD participants to fetal abnormalities. The paper concludes by calling for awareness campaigns and professional upskilling to better ensure the needs of CALD communities.

The Role of Animal Companions in the Bereavement Experiences of Australian Lesbians and Gay Men.

All too often, humans who experience the death of a partner are directed towards other humans for support, ignoring the important role that animal companions play in the lives of many humans. For lesbians and gay men specifically - whose grief may be disenfranchised - animal companions may play a particularly important role. This paper reports on a secondary analysis of interviews with 10 Australian lesbians or gay men who had lost a partner due to non-HIV related issues. Six of the participants spoke impromptu about the importance of animal companions following the death of a partner. Thematic analysis resulted in the development of three themes: (1) animals provide comfort and company, (2) animals serve as a reminder of partners, and (3) animals give people a reason to go on. The paper concludes by considering the importance of speaking about animals in the context of research and practice related to human bereavement.

"There's Something to Remind You that Everything Is Okay": Australian Trans Young People and the Presence of Animals in Interactions With Healthcare Professionals.

While animals have long been a focus in therapeutic spaces for young people via approaches such as animal-assisted therapies, there is a sense in which such approaches overlook the broader contribution that animals play by being present in young people's lives. In this article, we explore how the presence of animals (both physical and psychological) in interactions with healthcare professionals may hold specific meaning for trans young people living in Australia. Participants were recruited through Parents of Gender Diverse Children. Interviews were conducted in November 2021 with 17 trans young people and one of each of their parents living in Australia. All interviews were audio recorded, transcribed, and analyzed using thematic analysis. Two main themes were developed: (1) how healthcare professionals respond to conversations about animals and (2) the beneficial role of the presence of animals. The article concludes by discussing the importance of thinking about the presence of animals beyond existing frameworks and recognizing the value placed on the presence of animals by trans young people.

Australian Heterosexual Men's Experiences of Pregnancy Loss: The Relationships Between Grief, Psychological Distress, Stigma, Help-Seeking, and Support.

This study explores experiences of pregnancy loss via a questionnaire completed by a convenience sample of 48 Australian cisgender heterosexual men. The questionnaire included measures of support following pregnancy loss, recognition of loss, perceived utility of help-seeking, perceived stigma attached to help-seeking, perinatal grief, and depression and anxiety. The questionnaire also included open-ended questions focused on help-seeking and support. Higher levels of grief were related to higher levels of both depression and anxiety. Perceptions about stigma were related to the perceived utility of help-seeking. While a majority of participants had accessed formal support services, feeling supported was unrelated to either grief or depression. Participants emphasized the utility of men's groups where members have experienced pregnancy loss, though barriers to support were also identified in terms of the unavailability of support or the perceived need to focus on a partner's loss.

Men, trans/masculine, and non-binary people's experiences of pregnancy loss: an international qualitative study.

BACKGROUND: Growing numbers of men, trans/masculine, and non-binary people are becoming gestational parents, yet very little is known about experiences of pregnancy loss among this diverse population. METHODS: The study employed a cross sectional design. Interviews were undertaken with a convenience sample of 51 trans/masculine and non-binary people who had undertaken at least one pregnancy, living in either Australia, the United States, Canada, or the European Union (including the United Kingdom). Participants were recruited by posts on Facebook and Twitter, via researcher networks, and by community members. 16 (31.2%) of the participants had experienced a pregnancy loss and are the focus of this paper. Thematic analysis was used to analyse interview responses given by these 16 participants to a specific question asking about becoming pregnant and a follow up probe question about pregnancy loss. RESULTS: Thematic analysis of interview responses given by the 16 participants led to the development of 10 themes: (1) pregnancy losses count as children, (2) minimizing pregnancy loss, (3) accounting for causes of pregnancy loss, (4) pregnancy loss as devastating, (5) pregnancy loss as having positive meaning, (6) fears arising from a pregnancy loss, (7) experiences of hospitals enacting inclusion, (8) lack of formal support offered, (9) lack of understanding from family, and (10) importance of friends. CONCLUSIONS: The paper concludes by outlining specific recommendations for clinical practice. These include the importance of focusing on the emotions attached to pregnancy loss, the need for targeted support services for men, trans/masculine, and non-binary people who undertake a pregnancy (including for their partners), and the need for ongoing training for hospital staff so as to ensure the provision of trans-affirming medical care.

Transgender and non-binary Australians' experiences with healthcare professionals in relation to fertility preservation.

While transitioning gender historically precluded many transgender people from conceiving (more) children, there is now the option to undertake fertility preservation. However, the uptake of this option to date has been low. In order to extend existing limited research on the topic, this paper draws on responses to a questionnaire survey provided by 409 transgender and non-binary adults in Australia, which explored their experiences related to fertility preservation. The paper specifically focuses on the experiences of 295 participants who responded to open-ended questions about their experiences with, and views of, healthcare professionals in regard to fertility preservation. A thematic analysis indicated that healthcare professionals undertake a range of roles with regard to fertility preservation, some viewed positively (e.g. as providers of information), and some viewed negatively (e.g. as potential gatekeepers). The paper concludes by arguing that professionals need to ensure that transgender and non-binary people are provided with enough information, support and opportunity to make an informed decision about fertility preservation. The discussion includes a consideration of interweaving factors, particularly costs, and recommendations for further research that may inform clinical guidelines and training.

Service provider recognition of the significance of animal companionship among trans and cisgender women of diverse sexualities.

Extensive literature reveals the many health benefits animal companions can bring to the humans who live with them. However, much of this work has taken place with heterosexual and cisgender populations. To address this gap, we conducted qualitative interviews with 19 trans and cisgender women of diverse sexualities in Australia who reported having significant relationships with animal companions. In this article, we explore the benefits of healthcare providers (e.g. doctors, counsellors) recognising the potential significance of interspecies companionship for the health of trans and cisgender women of diverse sexualities. Findings relating to interactions with animal service providers are used to further illustrate themes of recognition and non-recognition as they relate to the women's genders, sexualities, and relationships with animal companions. In the discussion we consider some of the contextual challenges for such recognition to occur in service provision. Suggestions are then offered in relation to how providers might think about service provision which is both inclusive of all women and takes into account close connections with animal companions.

The transition to parenthood for Australian heterosexual couples: expectations, experiences and the partner relationship.

BACKGROUND: The perinatal period precipitates significant intra- and inter- personal changes. How heterosexual couples understand and account for such changes, however, has received relatively little attention. METHODS: Semi-structured individual interviews were undertaken as part of a longitudinal study on planned first-time parenthood. This article reports on an inductive thematic analysis of a data corpus focused on six interview questions (three from interviews conducted during pregnancy, and three from interviews conducted six months after the birth of the child), derived from interviews with eight individuals (4 women and 4 men) comprising four couples. RESULTS: In antenatal interviews, the theme of intrapersonal changes differentiated participants by two sub-themes that were then linked to postpartum experiences. Those who 'prepared for the worst' reported positive experiences after the arrival of a child, whilst participants who during pregnancy viewed life after the arrival of a child as 'an unknown' experienced challenges. Similarly in terms of the theme of interpersonal change, antenatal interviews were linked to postpartum experiences by two sub-themes, such that participants who approached the impending arrival of a child as a team effort reported that the arrival of a child cemented their relationship, whilst participants who expected that the couple relationship would buffer child-related stressors experienced challenges. CONCLUSIONS: Findings highlight the importance of a focus in antenatal education on the psychological effects of new parenthood, and support for the couple relationship during the perinatal period.

Fertility preservation decision making amongst Australian transgender and non-binary adults.

BACKGROUND: Historically, transitioning gender was seen as precluding transgender people from having children in the future. However, there are now increased reproductive options available to transgender people, with such options also available to non-binary people (i.e., people whose gender is not exclusively male or female). These options include undertaking fertility preservation if genetic children may be desired in the future. Despite these increased options, there is still only a limited amount of international research exploring the views of transgender and non-binary people on fertility preservation. METHODS: This mixed-methods study draws on a convenience sample of Australian transgender and non-binary adults, focused on their decision making about fertility preservation. The questionnaire was constructed by the authors, drawing on previous research. Participants were recruited via Australian organisations and groups made up of and/or working with people who are transgender or non-binary. The questionnaire was open from January-February 2018. The final sample included 409 participants. Statistical analyses were conducted on the closed-ended responses. Open-ended responses were analysed via a conventional content analysis. RESULTS: Decisions about fertility preservation were influenced by views on the importance of genetic relatedness, willingness to delay transition, economic resources, already having children or desiring children in the future, and the views of significant others. Advice or counselling prior to decision making was received only by a minority of participants. Very few participants (7%) had undertaken fertility preservation, although 95% said that fertility preservation should be offered to all transgender and non-binary people. Participants who viewed genetic relatedness as important were more likely to have undertaken fertility preservation. CONCLUSIONS: The findings indicate that fertility preservation should be made available as an option to all transgender or non-binary people prior to undertaking treatment which may impact on fertility. However, it should also be recognised that not all people who are transgender or non-binary will want to undertake fertility preservation, and that not all people may be able to afford to.

Support for family diversity: a three-country study.

OBJECTIVE: To understand levels of support for differences between families in terms of sexuality and mode of family formation across three countries. BACKGROUND: Previous research has found that attitudes towards family diversity continue to improve over time, although differences remain. METHODS: Subjects were 1605 people living in Australia, the United Kingdom or the United States who completed a questionnaire which sought to explore levels of support for a diverse range of family forms and modes of family formation. RESULTS: Religiosity, political leanings and beliefs about the importance of genetic relatedness were all correlated with level of support. Gender of participant was a predictor of level of support. Cluster analysis indicated three clusters (unsupportive, neutral and supportive) for level of support, for which both sexuality and parent status were predictors. CONCLUSION: Findings highlight the normative status of reproductive heterosex, and demonstrate the considerable value accorded to genetic relatedness.

The impact of pregnancy loss on men's health and wellbeing: a systematic review.

BACKGROUND: Research indicates that men's psychological and physical health outcomes after pregnancy loss differ from those of women. Our goal was to identify all literature with a focus on men's experiences of pregnancy loss in order to outline current evidence concerning men's wellbeing. METHODS: A systematic review of literature on men and pregnancy loss was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Joanna Briggs Institute (JBI) and Social Care Institute for Excellence (SCIE) guidelines. Literature was sourced from PsycINFO, PubMed, Scopus, CINAHL, and Google Scholar. Inclusion criteria were 1) studies that focused on pregnancy loss (including miscarriage, stillbirth, and ectopic pregnancy, 2) that men's voices were specifically represented, and 3) that studies were of primary data. RESULTS: A final sample of 29 articles was identified, of which 16 were quantitative, 10 qualitative, and 3 mixed methods. Quantitative and mixed methods studies indicated that while men tended to have less intense and less enduring levels of negative psychological outcomes than women, they are more likely to engage in compensatory behaviours, such as increased alcohol consumption. Qualitative studies indicated that men often feel that their role is primarily as a 'supporter' to their female partner, and that this precludes recognition of their own loss. These studies also reported that men may feel overlooked and marginalised in comparison to their female partners, whose pain is typically more visible. CONCLUSIONS: Further research is needed on men's experiences of pregnancy loss, focusing on cultural differences. The experience of gay and/or transgender men who face pregnancy loss is overlooked in the literature to date.

A systematic review of research on psychiatric mother-baby units.

Psychiatric mother-baby units (MBUs) are currently viewed as best practice, particularly in the UK, Australia and France, for improving outcomes for mothers and babies when the former are experiencing severe forms of mental illness. A growing number of publications have examined MBUs, but to date, there has not been a comprehensive review of these studies. As such, the systematic review reported in this paper sought to address this gap. A systematic search was conducted for peer-reviewed research and grey literature published in English between 2000 and 2015. A final sample of 44 publications were identified that reported on empirical findings with regard to MBUs. Three quarters of the studies focused on individual MBUs and most studies were quantitative. A thematic analysis of the studies identified three major themes: (1) admissions data, (2) outcomes for mothers, and (3) programmes and interventions. The analysis also identified four secondary themes: (i) follow-up after discharge, (ii) separation of mothers and babies after discharge, (iii) client satisfaction with MBUs, and (iv) partners of women admitted to MBUs. The findings of the review highlight gaps in knowledge about MBUs and provide suggestions for future research.

Healthcare experiences of gender diverse Australians: a mixed-methods, self-report survey.

BACKGROUND: To date the healthcare experiences of gender diverse Australians have received little attention. Previous international research indicates a range of both negative and positive healthcare experiences amongst this diverse population, with negative experiences being those most frequently reported. METHOD: An online survey was designed to examine the healthcare experiences of gender diverse Australians. The survey included Likert scales asking participants to rate their mental and physical health, and their experiences with psychiatrists, general practitioners and surgeons (in terms of perceived comfort, discrimination and information provision). Open-ended questions provided the opportunity for participants to further elaborate on their experiences. Data were collected between June 2012 and July 2013. Quantitative data analysis was conducted utilising SPSS 17.0, including ANCOVAs and correlations to examine the relationships between variables. Qualitative data were coded by the authors in terms of negative or positive responses and the validity of ratings were assessed utilising Cohen's kappa. RESULTS: 110 people assigned male at birth (MAAB) and 78 people assigned female at birth (FAAB) completed two separate surveys. All identified as gender diverse as defined in this paper. 70% of participants had accessed a psychiatrist. Participants MAAB rated their experiences with psychiatrists more highly than participants FAAB. 80% of participants had accessed a general practitioner. Comfort with, and respect from, general practitioners were both positively correlated with mental health, whilst discrimination was negatively correlated with mental health. 42.5% of participants had undertaken sex-affirming surgery. Those who had such surgery reported higher levels of physical and mental health than those who had not undertaken surgery. Participants MAAB reported more positive experiences of surgery than did participants FAAB. CONCLUSIONS: Findings highlight the need for increased education of medical practitioners in regards to engaging with gender diverse clients.

Characteristics of men willing to act as sperm donors in the context of identity-release legislation.

BACKGROUND: Although ongoing legislative changes are important to protect the rights of all involved in assisted reproductive technologies, it cannot be guaranteed that legislation will ensure the successful operation of reproductive health clinics, as is indicated by ongoing reports of a dearth of donor sperm in clinics in some countries. METHODS: Data were 1428 profiles taken from a website that aims to facilitate relationships between those seeking donor sperm and men willing to donate their sperm. Data were coded as three independent variables: age, relationship status and country, and four dependent variables: motivation to donate, willingness to be identified, willingness to be involved with children conceived of donations and beliefs about who should determine the level of involvement. RESULTS: Non-parametric testing indicated that men aged under 26 or over 46, and who were either single or in a same-sex relationship, were most likely to be willing to be identified to children (P< 0.05), and to desire involvement with children (P< 0.01). A significant proportion of men aged between 26 and 46 years of age (P< 0.001) were motivated by a desire to procreate and were unwilling to be identified, as were a significant number of men in opposite-sex relationships (P< 0.001). CONCLUSIONS: Although limited by its reliance upon a sample constituted by men living in western countries who completed a self-report profile and who had not received counselling about their potential role as donors, this study draws attention to the potential impact of age and sexual orientation upon intentions to donate.

Animals in Disaster Social Work: An Intersectional Green Perspective Inclusive of Species.

Disasters do not just affect humans. And humans do not only live with, care for or interact with other humans. In this conceptual article, we explain how animals are relevant to green and disaster social work. Power, oppression and politics are our themes. We start the discussion by defining disasters and providing examples of how three categories of animals are affected by disasters, including in the current COVID-19 pandemic. They are: companion animals (pets), farmed animals (livestock) and free-living animals (wildlife), all of whom we classify as oppressed populations. Intersectional feminist, de-colonising and green social work ideas are discussed in relation to disaster social work. We argue that social work needs to include nonhuman animals in its consideration of person-in-environment, and offer an expanded version of feminist intersectionality inclusive of species as a way forward.

Expanding and improving trans affirming care in Australia: experiences with healthcare professionals among transgender young people and their parents.

Access to medical care is significant for many transgender young people and their families, which involves interactions with healthcare professionals. While a trans affirming model is used across Australian paediatric gender clinics, this does not automatically mean that all transgender young people and their parents experience the care they receive as affirming. This article considers the experiences and views of transgender young people (aged 11-17) and their parents in relation to healthcare professionals inside and outside of gender clinics in Australia. Ten qualitative interviews were conducted with parent-child dyads in two Australian states. Key themes relating to healthcare professionals were: differing levels of healthcare professional knowledge and affirmation, quality of service is dependent on individual healthcare professionals, and lack of connected services and referral pathways. The discussion explores specific issues arising from the findings that suggest implications for training for healthcare professionals so as to be better equipped to provide trans affirming clinical care.

The Link Between Domestic Violence and Abuse and Animal Cruelty in the Intimate Relationships of People of Diverse Genders and/or Sexualities: A Binational Study.

Over the past three decades, a growing body of research has focused on experiences of domestic violence and abuse (DVA) among people of diverse genders and/or sexualities. Missing, however, has been a focus on what is known as "the link" between DVA and animal cruelty with regard to people of diverse genders and/or sexualities. The present article reports on a study of 503 people living in either Australia or the United Kingdom, who reported on both their intimate human relationships and their relationships with animals, including relationships that were abusive. In terms of "the link," a fifth of respondents who had experienced violence or abuse also reported that animal cruelty had been perpetuated by the violent or abusive partner. Statistical interactions were found between having witnessed animal cruelty perpetrated by a partner, gender and sexuality, and both psychological distress and social connectedness. Female participants who had witnessed animal cruelty reported greater psychological distress and lower levels of social support, and both lesbian and bisexual participants who had witnessed animal cruelty reported lower levels of social support. The article concludes by considering the implications of these findings for future research and service provision.

Men, trans/masculine, and non-binary people negotiating conception: Normative resistance and inventive pragmatism.

BACKGROUND: Growing numbers of men, trans/masculine, and non-binary people are undertaking pregnancies, yet relatively little is known about the experiences of this diverse population in regard to conception. AIMS: This study sought to examine men's, trans/masculine, and non-binary people's experiences of pregnancy, including conception. METHODS: Interviews were conducted with 51 men, trans/masculine, and non-binary people who were gestational parents living in Australia, Canada, the European Union (including the United Kingdom), and the United States. Thematic analysis was undertaken, focusing on accounts of conception. Pfeffer's conceptual frameworks of normative resistance and inventive pragmatism were used as an analytic tool. RESULTS: Themes developed focused on: 1) choosing a clinic donor, 2) kinship with donors, 3) conceiving via intercourse with a partner, 4) negotiating receipt of donor sperm, 5) challenges associated with known donors, 6) challenges associated with fertility clinics, and 7) experiences of conception. DISCUSSION: The forms of normative resistance and inventive pragmatism identified suggest that men, trans/masculine, and non-binary people who are gestational parents seek to normalize their experiences of conception, while also acknowledging the specific challenges they face.

Masculinity, Injury, and Death: Implications for Anti-Knife-Carrying Messages.

Although knives are the most common homicide instrument in Britain, factors that influence knife-carrying tolerance (i.e., the extent to which it is seen as acceptable and justified) and perceptions of anti-knife messages (i.e., slogans and posters aimed at reducing knife crime) have not been examined, which the current article will cover by featuring progressively related studies. In Study 1, 227 men took part in a study on factors associated with knife-carrying. In Study 2, 200 participants took part in an experimental study on anti-knife slogans. In Study 3, 169 men took part in a study on existing anti-knife injury posters. In Study 4, 151 men took part in a study on anti-knife CGI posters featuring an avatar with different types of knife injury. Study 1 proposes a structural equation model that shows the intercorrelations between physical defense ability, limited trust in authority, limited control over one's status and the need for respect, and how they predict aggressive masculinity (i.e., macho culture), which, in turn, predicts knife-carrying tolerance. The model also reveals two significant latent factors: saving face inter-male competition (i.e., honor) and perceived social ecological constraints (i.e., socioeconomic limitations). Study 2 shows that the injury slogan was rated as most persuasive. Study 3 shows that the fresh injury poster was rated as most persuasive, emotional, and believable. Study 4 shows that it was the eye injury that was rated as most persuasive, emotional, and believable. The article supports protection motivation theory and offers practical insights into tackling knife crime.

Formal and informal support and counselling for embryo donation and receipt: An Australian qualitative study.

Despite growing numbers of people engaging in embryo donation for the purposes of family building, public access to information about the process may be limited. As such, support and counselling - both formal (i.e. through clinics) and informal (i.e. through online communities) - can play an important role in information provision. This article draws on a sub-sample of nine people from a qualitative study of embryo donation and receipt in Australia undertaken in 2017-2018. Themes developed suggest that formal support and counselling provided by clinics can be useful, though can require persistence to access and may not sufficiently address needs. In terms of informal support, themes developed suggest that sharing lived experiences in online communities can be important; however, there may also be challenges associated with differing viewpoints and threats to anonymity. The article concludes with a discussion of the ongoing importance of formal support and counselling while also suggesting that informal support is an avenue requiring further investigation.