Health practitioner and student attitudes to caring for transgender patients in Tasmania: An exploratory qualitative study.

BACKGROUND AND OBJECTIVES: Healthcare practitioners struggle to provide inclusive and affirming care to transgender (trans) people. This study examined Tasmanian healthcare practitioners' and students' understandings and approaches to trans health. METHOD: The study comprised qualitative semi-structured interviews with 17 healthcare practitioners (doctors, psychologists, nurses and other allied health workers) and students (of medicine, nursing and pharmacy) across Tasmania, Australia. Data were analysed using a reflexive thematic analysis. RESULTS: The authors identified three key themes: lack of training in trans healthcare, limited resources to support trans patients, and the importance and challenges of trans-inclusive language. DISCUSSION: Healthcare practitioners faced challenges providing inclusive and affirming healthcare for trans people due to limited experience with trans patients, and few educational opportunities and referral pathways to support patients. Healthcare practitioners need better support and resources to improve quality of care.

Male allyship in institutional STEMM gender equity initiatives.

This article examines men's involvement in an institutional gender equity award scheme and how their self-concept as allies develops over time. It draws specifically on a subset of qualitative data from the four men participating in a study involving in-depth interviews with university staff involved in the self-assessment team of one Australian institution's Science in Australia Gender Equality (SAGE) Athena SWAN pilot. Data related to the men's experiences is the article's focus. Key themes from the data include: 1) men's motivations for engagement; 2) men's self-understandings as 'champions for change' 3) the barriers/risks associated with male championship; and 4) men's evolving perceptions and critiques of the male champions model. Findings show that men demonstrated personal growth and increased awareness through their participation in the pilot. Yet, their frustration with how equity and diversity was managed in their organisational context highlights pitfalls in the concept of a male 'champion'. This article provides timely guidance for institutions seeking to engage allies in gender equity initiatives.

The Spatial Impacts of COVID-19 Restrictions on LGBTIQ Wellbeing, Visibility, and Belonging in Tasmania, Australia.

International emergency management and disaster risk reduction policies and planning have rarely included lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) people's specific health and wellbeing concerns, despite increasing research showing that these groups face some specific vulnerabilities and additional challenges. Emerging studies in the US and UK noted increased feelings of loneliness, minority stress, and vulnerability to family violence since the outbreak of COVID-19. However, little is known about LGBTIQ people's experiences of COVID-19 in Australia. This article explores the effects of COVID-19 on LGBTIQ mental health and wellbeing in Tasmania, Australia. Drawing on a survey of 231 LGBTIQ respondents aged 14-78, we use the spaces of wellbeing framework to examine the impacts of COVID-19 restrictions on LGBTIQ (in)visibility in relation to the public, private, and online spaces, arguing that COVID-19 restrictions affected LGBTIQ Tasmanians' experiences and use of spaces in ways that detracted from wellbeing, visibility, and belonging.

Tasmanian healthcare professionals' & students' capacity for LGBTI + inclusive care: A qualitative inquiry.

The health disparities and care needs of lesbian, gay, bisexual, transgender and intersex (LGBTI+) patients are becoming well known. However, healthcare practitioners (HCPs) and medical students across the Global North report limited understanding of this population and express concern about their capacity to meet the needs of LGBTI + patients. To address these gaps in literature and practice, this study draws on qualitative interviews with 12 clinicians and five health professional students exploring their understandings and approaches to LGBTI + inclusive practice in Tasmania, Australia. Through a reflexive thematic analysis, we identified that both practicing clinicians and students did not believe that their training adequately prepared them to treat LGBTI + patients. Other key barriers included reduced awareness of LGBTI + community needs due to the lack of exposure to LGBTI + patients and unfamiliarity with appropriate referral pathways in the regional Tasmanian context. Conversely, factors enabling provision of LGBTI + inclusive care included prior experience working with LGBTI + patients and establishing a network of supportive colleagues and local services. Participants who identified as LGBTI + themselves saw their personal experiences as a strength in supporting LGBTI + patients. While awareness of LGBTI + inclusive health practice is increasing, Tasmanian practitioners report insufficient training and practical difficulties with referral as key challenges.

Older Lesbians' experiences of ageing in place in rural Tasmania, Australia: An exploratory qualitative investigation.

While there is increasing awareness of the specific health and aged care needs of older lesbian and gay people, little is known about their needs and experiences of ageing in rural communities. In Australia, older people are over-represented in regional and rural areas, however, rural communities face particular challenges to age friendliness, including infrastructure and transport limitations, reduced health and social services. In this context, few studies explore older lesbians' gendered experiences of ageing in place. To address this gap in the literature, this article draws on qualitative interviews with 13 rural Tasmanian lesbians over the age of 55, exploring their perceived barriers and enablers for 'healthy ageing' in their communities. Findings reveal that geographical isolation was a literal barrier to accessing specialist healthcare and lesbian-inclusive services, which may be absent in rural areas. The women perceived community health initiatives and social activities aimed at 'healthy ageing' in rural towns as heteronormative and unappealing for lesbians. In some cases women reported experiencing homophobic discrimination in these social groups. In contrast, rural communities were positively associated with a good quality of life derived from closeness to nature and feelings of reciprocity with rural neighbours and communities. These findings suggest that specific approaches to lesbian-inclusive rural health and social care are required. Rural communities are well-placed to build on community strengths to ensure higher quality of place-based health and social care for isolated older people, including those of diverse genders and sexualities.

What does inclusive sexual and reproductive healthcare look like for bisexual, pansexual and queer women? Findings from an exploratory study from Tasmania, Australia.

Increased awareness of the health disparities faced by lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people has driven the need for LGBTIQ-inclusive medical practices internationally. However, despite bisexual, pansexual and queer women's increased sexual health risks and reduced engagement with health services, there is little qualitative research examining their healthcare experiences. In addition, healthcare practitioners continue to report lack of awareness and competence in inclusive practice, particularly regarding these groups. To address these gaps in the literature and practice, this study draws on 21 qualitative interviews with women and general practitioners, comparing and contrasting their understandings and experiences of inclusive sexual and reproductive healthcare. Findings reveal that women value practitioners who take a non-judgemental approach, use inclusive language and are knowledgeable or willing to self-educate about LGBTIQ issues. Practitioners describe prioritising visual indicators of inclusivity, using inclusive language and embracing professional development. However, women and doctors both identify knowledge gaps among healthcare providers and the need for additional training opportunities to support effective inclusive practice.

Young bisexual women's sexual health care experiences in Australian rural general practice.

OBJECTIVE: To examine how young bisexual women in rural Tasmania experience routine sexual health care in general practice settings. DESIGN: Semi-structured interviews with bisexual women were used for this study. Self-selected and purposive sampling were used to recruit women in 2015. Participants were recruited via community social media pages and a not-for-profit organisation supporting same-sex attracted rural youth. Data were analysed thematically. SETTING: Regional and rural areas in the north and south of Tasmania, Australia. PARTICIPANTS: Fifteen bisexual women, 18-26 years of age, with experience seeking sexual health care in Tasmania. MAIN OUTCOME MEASURE(S): Semi-structured interviews explored women's experiences of inclusive sexual health care. RESULTS: Four key themes emerged from the thematic analysis: (a) issues of health care accessibility in rural Tasmania; (b) the importance of visual signs of inclusivity in rural clinics; (c) practitioner attitudes; and (d) use of inclusive, gender-neutral language. CONCLUSIONS: Rural bisexual women prefer practitioners who make meaningful efforts to be inclusive and take a non-judgmental approach to sexual health care. Additional resources are needed to support rural communities and their health care providers to prioritise inclusive health practices.

Navigating unintelligibility: Queer Australian young women's negotiations of safe sex and risk.

Australian public health promotion positions safe sex as a biomedical, heteronormative concept. Consequently, there is a dearth of scholarly research examining queer young women's sexual health. To fill this knowledge gap, this article considers how Australian bisexual and queer young women understand 'safe sex' and conceptualise 'good' sexual citizenship. Drawing on qualitative interviews with 15 participants in Tasmania, findings reveal that although queer women understand heterosexual safe sex, there is little awareness of safer sexual practices with female partners. We argue that gendered sexual scripts shape perceptions of sexual health risk whereby queer women adopt multiple situation-dependent approaches to safer sex.