"We grow older. We also have lots of sex. I just want a doctor who will at least ask about it.": Transgender, non-binary, and intersex older adults in sexual and reproductive healthcare.

Transgender, non-binary, and intersex (TNBI) older adults experience significant disparities in sexual and reproductive healthcare. Utilizing data from 50 semi-structured individual interviews with TNBI older Americans, we examine how TNBI older adults experience and mitigate inequity in sexual and reproductive healthcare. We explore elders' negotiation of inequity through what we term resourcefulness strategies - tactical processes involving marginalized communities obtaining and utilizing resources to minimize inequalities within and beyond healthcare settings. Resourcefulness strategies differ from resiliency insofar as they directly acknowledge the need for social privilege, capital, and resources - on a community level - to overcome difficult situations (e.g., inequalities in healthcare), rather than drawing upon individual coping strategies alone. Our analysis reveals medical providers' lack of cultural competency with TNBI communities and older adults as primary drivers of TNBI older adults' experiences of inequity within sexual/reproductive healthcare settings. Consequently, TNBI older adults aimed to minimize inequity in sexual/reproductive healthcare through particular resourcefulness strategies. Specifically, we found a bifurcation in respondents' strategies, wherein trans men engaged in health service avoidance while trans women and non-binary respondents engaged in health service self-advocacy. These strategies required respondents to assume primary responsibility for transforming (or avoiding) sexual/reproductive health services that were perceived as lacking or actively harmful. We argue that such approaches are neither effective nor structurally-sustainable for attaining older-age and TNBI-affirming, inclusive, and culturally-competent healthcare for TNBI older patients.

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.

Are university health services meeting the needs of transgender college students? A qualitative assessment of a public university.

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.

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.

Transnormativity in the psy disciplines: Constructing pathology in the Diagnostic and Statistical Manual of Mental Disorders and Standards of Care.

The psy disciplines (i.e., psychiatry, psychology, psychoanalysis, and psychotherapy) have played a significant role in shaping understandings of transgender people's lives in ways that are transnormative (i.e., by emphasizing one particular account of what it means to be transgender). This article documents (a) how the rise of the psy disciplines created opportunities for transgender people to access treatment (but that such access often required tacit acceptance of transnormativity), and (b) how transgender people have resisted transnormative accounts within the psy disciplines. More specifically, this article explores how both the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, and what is now the World Professional Association for Transgender Health's Standards of Care, have often enshrined highly regulatory accounts of transgender people's lives, while also changing over time, in part as a result of the contributions of transgender people. The article concludes by considering recent contributions by transgender people in terms of the use of informed consent models of care and clinical research, and highlights the ongoing marginalization of transgender people in terms of access to ethical, transcompetent care. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

LGBTQ College Students' Experiences With University Health Services: An Exploratory Study.

Access to inclusive, equitable health care is central to the wellbeing of all college students yet little is known about LGBTQ students' experiences with university health services. In this article, individual interviews with a convenience sample of 14 LGBTQ students at a large public university were analyzed to explore their perceptions of and experiences with the university's health center and its services. Our findings demonstrate that the university is not adequately meeting their health care needs. Participants' narratives offer insights into how to improve campus-based health services for LGBTQ students.

"I don't like passing as a straight woman": queer negotiations of identity and social group membership.

For decades, sociological theory has documented how our lives are simultaneously produced through and against normative structures of sex, gender, and sexuality. These normative structures are often believed to operate along presumably "natural," biological, and essentialized binaries of male/female, man/woman, and heterosexual/ homosexual. However, as the lives and experiences of transgender people and their families become increasingly socially visible, these normative structuring binaries are called into stark question as they fail to adequately articulate and encompass these social actors' identities and social group memberships. Utilizing in-depth interviews with 50 women from the United States, Canada, and Australia, who detail 61 unique relationships with transgender men, this study considers how the experiences of these queer social actors hold the potential to rattle the very foundations upon which normative binaries rest, highlighting the increasingly blurry intersections, tensions, and overlaps between sex, gender, and sexual orientation in the 21st century. This work also considers the potential for these normative disruptions to engender opportunities for social collaboration, solidarity, and transformation.

Bodies in relation--bodies in transition: lesbian partners of trans men and body image.

Presenting published narratives of transgender and transsexual men (henceforth "trans men"), along with case study interview narratives from five lesbian-identified partners of trans men, I consider how body image issues may surface both individually and interpersonally in relation to the body dysphoria of a trans partner. In addition to self-reports of negatively shifting body image among some interviewees, I also discuss how negative body image may adversely affect these relationships in terms of sexual and non-sexual intimacy, bodily self-expression, and self-confidence. I term these processes and effects relational body image in order to trouble dominant conceptualizations of negative body image as primarily an individual issue arising from external, macro-sociological forces and pressures. I present these cases as a starting point for future sociological theorizing and empirical work with this under-studied population.

Beliefs about the etiology of homosexuality and about the ramifications of discovering its possible genetic origin.

Homosexuality is viewed by many as a social problem. As such, there is a keen interest in elucidating the origins of homosexuality among many scholars, from anthropologists to zoologists, from psychologists to theologians. Research has shown that those who believe sexual orientation is inborn are more likely to have tolerant attitudes toward gay men and lesbians, whereas those who believe it is a choice have less tolerant attitudes. The current qualitative study used in-depth, open-ended telephone interviews with 42 White and 44 Black Americans to gain insight into the public's beliefs about the possible genetic origins of homosexuality. Along with etiological beliefs (and the sources of information used to develop these beliefs), we asked respondents to describe the benefits and dangers of scientists discovering the possible genetic basis for homosexuality. We found that although limited understanding and biased perspectives likely led to simplistic reasoning concerning the origins and genetic basis of homosexuality, many individuals appreciated the complex and interactive etiological perspectives. These interactive perspectives often included recognition of some type of inherent aspect, such as a genetic factor(s), that served as an underlying predisposition that would be manifested after being influenced by other factors such as choice or environmental exposures. We also found that beliefs in a genetic basis for homosexuality could be used to support very diverse opinions including those in accordance with negative eugenic agendas.