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1.
Artigo em Inglês | MEDLINE | ID: mdl-31917883

RESUMO

Research has identified discrimination and a lack of knowledgeable providers as major barriers for transgender and gender diverse (TGD) individuals seeking care, which contributes to greater stress and significant health disparities affecting this population. However, research involving TGD youth is limited. The aim of this study, therefore, was to describe TGD adolescents' experiences, concerns and needs in healthcare settings, including their feedback on themes previously identified by healthcare providers (i.e. discomfort with gender-related topics, reasons for not asking patients about gender and previous training regarding gender diversity). The authors conducted semi-structured interviews with 12 TGD-identified adolescents aged 14-17, living in Minnesota, USA in 2017-2018. Inductive thematic analysis was used to summarise participant comments into themes and subthemes. Two main themes were directly relevant to concerns and needs of TGD youth in healthcare settings and their views on healthcare providers' concerns: (a) asking about gender and pronouns and (b) training for healthcare providers. Findings suggest the need for revisions to clinic materials, infrastructure and protocols. Adding training to all general medical and nursing education to increase knowledge, comfort and competence around gender identity would further improve care and ultimately reduce healthcare disparities affecting TGD youth.

2.
J Dermatolog Treat ; : 1-8, 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31668100

RESUMO

Purpose: Hair removal procedures, including electrolysis and laser hair removal, are the most commonly pursued gender-affirmative medical interventions by transfeminine people, but previous empirical studies have not examined their relationship to psychological well-being. Materials and Methods: Participants were 281 transfeminine adults in the United States who responded to an online questionnaire. Results: Satisfaction with one's current state of hair removal was negatively correlated with situational body image dysphoria, depression symptoms, anxiety symptoms, and negative affect, and positively correlated with positive affect. Conclusions: Results of this study suggest that hair removal is associated with both decreased distress but also increased subjective well-being (e.g. higher positive affect). Though the construct of 'gender euphoria' has been introduced in previous publications, it has thus far not been rigorously defined or operationalized within health research. These results suggest that gender euphoria can be understood in terms of increased subjective well-being associated with gender affirmation, including gender-affirmative medical interventions. This study demonstrates a significant association between hair removal services and depression symptoms, anxiety symptoms, situational body image dysphoria, positive affect, and negative affect in transfeminine adults. These findings cast significant doubt on the assertion that hair removal services for transfeminine people are 'cosmetic.'

3.
J Pediatr ; 211: 172-178, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31079853

RESUMO

OBJECTIVE: To compare social connectedness factors that facilitate use of primary, dental, and mental healthcare services among transgender and gender nonconforming (TGNC) and cisgender adolescents. METHODS: Data from the cross-sectional 2016 Minnesota Student Survey were used to examine protective social connectedness factors associated with use of different healthcare services among matched samples of 1916 TGNC and 1916 cisgender youth. Stratified, logistic regression analyses were used to examine background characteristics and social connectedness factors (parent connectedness, connections to other nonparental adults, teacher-student relationships, and friend connections) associated with use of each healthcare service within the last year. RESULTS: For TGNC youth, but not for cisgender youth, higher levels of parent connectedness were associated with receipt of primary (OR, 2.26; 95% CI, 1.40-3.66) and dental (OR, 3.01; 95% CI, 1.78-5.08) care services, and lower levels of connectedness to nonparental adults was associated with receipt of mental healthcare (OR, 0.55; 95% CI, 0.33-0.93). Among cisgender youth, no protective factors were significantly associated with receipt of primary care services, higher levels of friend connections were associated with receipt of dental services (OR, 1.85; 95% CI, 1.10-3.09), and lower levels of parent connectedness were associated with receipt of mental healthcare (OR, 0.20; 95% CI, 0.10-0.40). CONCLUSIONS: To promote the health of TGNC youth, clinicians should understand the distinct factors associated with obtaining healthcare among this population such as the need for tailored efforts focused on strengthening connectedness between TGNC youth and their parents to facilitate receipt of needed care.

4.
J Pediatr Health Care ; 33(4): 379-385, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30827755

RESUMO

INTRODUCTION: Nurses and physicians receive minimal training about providing competent care to transgender and gender-diverse (TGD) patients, and training specific to TGD youth is particularly lacking. This qualitative study examined health care providers' experiences and attitudes about working with TGD youth to identify specific training needs. METHOD: Semistructured interviews were conducted with 14 nurses and physicians who work with adolescents. Thematic analysis was used to characterize participants' responses. RESULTS: Five themes summarized participants' responses to interview questions: Training Regarding Gender Diversity, Discomfort With Gender-Related Topics, Reasons for Not Asking About Gender, Talking About Gender With Patients, and Need for Resources. DISCUSSION: Findings highlight multiple opportunities to improve provider education and care experiences of TGD youth. Specific training is needed to help providers manage discomfort with gender-related topics and simultaneously develop their knowledge of and skills for discussing gender issues.

5.
J Gambl Stud ; 35(1): 79-92, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30343416

RESUMO

Most gambling research utilizes general youth samples and focuses on binary gender categories; few studies examine and compare gambling behaviors between transgender and gender diverse (TGD) youth and their cisgender peers. The current study used population-based data from the 2016 Minnesota Student Survey to compare the prevalence of gambling behaviors and problem gambling among TGD versus cisgender adolescents, in addition to examining differences by birth-assigned sex. The analytic sample consisted of 80,929 students (including, n = 2168 [2.7%] TGD) in 9th and 11th grades. Chi-square tests and Cohen's d effect sizes were used for all comparisons. TGD youth reported greater involvement in most gambling behaviors and problem gambling compared to cisgender youth. In comparisons by birth-assigned sex, TGD youth assigned male at birth were particularly at risk for gambling involvement and problem gambling. TGD youth assigned female at birth also reported higher rates of problem gambling than both cisgender youth assigned male and female at birth. Results suggest that examining rates of gambling behavior and problem gambling as well as identifying disparities in vulnerable youth populations is crucial in order to develop culturally responsive and gender inclusive prevention, intervention, and outreach programs.


Assuntos
Comportamento do Adolescente/psicologia , Comportamento Aditivo/psicologia , Jogo de Azar/psicologia , Identidade de Gênero , Pessoas Transgênero/psicologia , Adolescente , Feminino , Humanos , Masculino , Grupo Associado , Estudantes/estatística & dados numéricos , Inquéritos e Questionários
6.
Am J Prev Med ; 55(6): 787-794, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30344037

RESUMO

INTRODUCTION: Important mental and physical health disparities exist for transgender and gender diverse youth compared with cisgender youth (i.e., those whose birth-assigned sex and gender identity align), yet little is known about factors that protect transgender and gender diverse youth from health problems. The objective of this paper is to identify modifiable protective factors in the lives of transgender and gender diverse adolescents, with the goal of informing efforts to eliminate disparities in depression, suicidality, and substance use in this population. METHODS: Secondary data analysis of the 2016 Minnesota Student Survey examined associations between eight protective factors (connectedness to parents, adult relatives, friends, adults in the community, and teachers; youth development opportunities; and feeling safe in the community and at school) and depression, suicidality, and substance use (alcohol, binge drinking, marijuana, nicotine) among 2,168 adolescents who identified as transgender, genderqueer, genderfluid, or questioning their gender. Logistic regressions assessed the role of each protective factor separately and simultaneously. RESULTS: Each protective factor was associated with lower odds of emotional distress and substance use. When protective factors were examined simultaneously, parent connectedness was protective for all measures. Feeling safe at school and connected to adults in one's community protected against depression and suicidality; teacher connectedness buffered risk of substance use. CONCLUSIONS: Given that transgender and gender diverse youth report lower levels of connectedness and safety, bolstering an explicitly transgender and gender diverse-friendly network of caring parents, safe and supportive schools, and connections to adults in the community may support efforts to eliminate disparities in depression, suicidality, and substance use.


Assuntos
Fatores de Proteção , Estresse Psicológico/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Pessoas Transgênero , Adolescente , Feminino , Humanos , Masculino , Minnesota , Ideação Suicida , Inquéritos e Questionários
7.
Curr Sex Health Rep ; 10(4): 246-254, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31057341

RESUMO

Purpose of review: This paper examines recent research on bullying victimization among lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth to identify critical issues and advocate for future research priorities. Recent findings: Recent studies have begun to document the importance of bullying in general, and bias-based bullying (rooted in stigma) in particular, on the health and wellbeing of this vulnerable subgroup of adolescents, as well as drivers of disparities. Current research demonstrates the role of multiple identities for and important differences among LGBTQ youth and has begun to identify protective factors for youth who are the targets of bullying. Summary: Researchers, clinicians, and those working with and on behalf of LGBTQ youth must measure and acknowledge the multiple reasons for which LGBTQ youth are the targets of bullying. Intervention and prevention efforts should focus on improving the supportiveness of the climates within which LGBTQ youth live.

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