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1.
Artigo em Inglês | MEDLINE | ID: mdl-34769687

RESUMO

An under-researched aspect of transgender sex workers in China pertains to their desires and expressions of femininity. Male-to-Female (MTF) transgender sex workers are a high-risk population prone to depression and stress regarding body image, intimate relationships marked by violence, and social stigma, rendering them vulnerable to hate crimes and discrimination. Ethnographic data from in-depth interviews with 49 MTF transgender sex workers indicate that sex, gender and feminine desire are mutable in the construction of self and subjectivity. This study uses the conceptual framework of gender performativity, that is, gender is performative and distinct from physical bodies and binary classifications. It is not only an individual's normative gender expressions which are based on the sex assigned at birth, but it also reinforces the normative gender performances of the gender binary. This article argues that the 49 MTF transgender sex workers are embodiments of gendered performances, displaying femininity to ameliorate hate crimes and discrimination as well as reinforce the masculinity and sexuality of their clients and intimate sex partners. Embracing their femininity constitutes a self-help program, enabling them to build self-confidence and develop a positive self-image in the face of overwhelming social disapproval.


Assuntos
Profissionais do Sexo , Pessoas Transgênero , Transexualidade , Feminino , Feminilidade , Identidade de Gênero , Humanos , Recém-Nascido , Masculino , Masculinidade
2.
Cien Saude Colet ; 26(suppl 3): 5045-5056, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34787197

RESUMO

Minority stress comprehends the relationship between prejudice (perceived, anticipated and internalized) and mental health in people belonging to minority groups, as well as protective factors for stressors. This study evaluated the prevalence of depressive symptoms, suicidal ideation and attempted suicide in Brazilian trans people, and it`s relationship with minority stress, passability, social support and trans identity support. 378 people participated through a questionnaire answered online and in the hospital services they attended. Of these, 67.20% had depressive symptoms, 67.72% suicidal ideation and 43.12% attempted suicide. Three Poisson regression analyzes were performed in two steps, according to the outcomes. In the three outcomes there was a positive association with internalized prejudice and a negative association with social support, which were the only associations in the suicide attempt. Depressive symptoms and suicidal ideation were also positively associated with anticipated prejudice and negatively passability and support for trans identity. The vulnerability of transgender people to negative mental health outcomes and the importance of addressing prejudice on an individual and social level, as well as promoting social support and transgender identity support are perceived.


Assuntos
Grupos Minoritários , Transexualidade , Depressão/epidemiologia , Humanos , Ideação Suicida , Tentativa de Suicídio
3.
Cien Saude Colet ; 26(suppl 3): 5281-5292, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34787219

RESUMO

Transgender and gender non-binary youth are particularly vulnerable to tobacco smoking and susceptible to smoking adverse health outcomes. That is, they are in special risk to start smoking and, after starting, they may face worse outcomes when comparing to their cisgender peers. Therefore, the present study aims to evaluate factors associated with tobacco use among transgender and gender non-binary youth. Brazilian youth aged 16 to 25 who identify as transgender or gender non-binary answered an online questionnaire. Poisson regression with robust variance was run to predict smoking cigarettes based on individual and environmental factors. 14.1% of 206 youth reported smoking cigarettes daily, whereas 9.3% of participants reported smoking e-cigarettes occasionally. Drug use, lack of social support, deprivation, discrimination, the wait for medical gender-affirming procedures and being outside school were associated with smoking cigarettes. Contextual and individual factors should be further explored in causal analysis and taken into consideration when planning smoking prevention and cessation interventions for transgender and gender non-binary youth.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Pessoas Transgênero , Transexualidade , Adolescente , Brasil/epidemiologia , Identidade de Gênero , Humanos , Uso de Tabaco/epidemiologia
4.
Int J Med Inform ; 156: 104601, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34649111

RESUMO

OBJECTIVES: To evaluate the linguistic changes of transgender-related resources prior to 1999 to create a comprehensive dataset of resources using an ontology-derived search system, laying a framework for ontology-based reviews to be used in informatics. METHODS: We analyzed 77 bibliographies and 11 databases for transgender resources published prior to 31 December 1999. We used 858 variants of the term "transgender" to identify resources. Individual sources were tagged by subject matter and major conceptual terminology usage. We evaluated the accuracy of a Gender, Sex, and Sexual Orientation (GSSO) ontology-based mechanism on tagging relevant literature searches. RESULTS: We identified 3,058 sources in 19 languages. Primary subjects covered included surgery, psychology, psychiatry, endocrinology, and sexology. The GSSO-based tagging mechanism correctly tagged 97.7% of MEDLINE resources as transgender-related. DISCUSSION: The GSSO-based tagging mechanism was more effective than keyword-specific elucidations of terminologically complex literature and was just as effective at manual identification of subjects discussed within resources. Diverse language relating to transgender persons can be identified using the GSSO, which can also be used for structured literature review based on subject matter thus improving research in the area.


Assuntos
Pessoas Transgênero , Transexualidade , Feminino , Identidade de Gênero , Humanos , Masculino , Medicalização
5.
Arch Sex Behav ; 50(7): 3191-3200, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34613539

RESUMO

Relatively little is known about identity-related resilience factors associated with well-being among transgender and gender non-conforming (TGNC) people. Drawing upon theory on stigma-related stress and resilience and work examining group identification as a buffer against discrimination, the aim of the current study was to model perceived discrimination, transgender identification, and gender identity affirmation as predictors of well-being for TGNC people. We also tested whether the positive association between gender identity affirmation and well-being might be explained by the benefits affirmation has for individual self-concept clarity. Participants were 105 TGNC individuals (42% transgender male, 39% transgender female, 19% other gender non-conforming [e.g., non-binary]) recruited through online forums and support groups in the UK and North America who completed an online survey including self-report measures of key constructs. Results from structural equation models demonstrated that: (1) experiences of discrimination were associated with lower well-being overall, but having a stronger transgender identity moderated this association; (2) after adjustment for discrimination and transgender identification, experiences of gender identity affirmation were independently associated with greater well-being for TGNC people. Secondary analyses demonstrated that gender identity affirmation was linked to well-being through reinforcing a strong, internalized sense of clarity about individual self-concept. Results are discussed in terms of the implications for TGNC health and well-being, particularly with regard to the need for supportive, identity-affirming social environments.


Assuntos
Pessoas Transgênero , Transexualidade , Estudos Transversais , Feminino , Identidade de Gênero , Humanos , Masculino , Estigma Social
6.
Arch Sex Behav ; 50(7): 3287-3295, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34617189

RESUMO

While transgender women have been identified as a global priority population for HIV prevention and treatment, little is known about the cisgender male partners of transgender women, including their sexual behavior and HIV prevalence. Previous research has suggested that these male partners have varied identities and sexual behavior, which make identifying and engaging them in research difficult. This paper describes interviews conducted with fifteen cisgender men who reported recent sexual activity with transgender women in Lima, Peru. The purpose of this research was to explore how these men reported their identities and sexual behavior, to better understand how they would interact with HIV outreach, research, and care. The major themes were sexual orientation and identity; view of transgender partners; social ties to transgender women and other men with transgender women partners; disclosure of relationships; HIV knowledge and risk perception; and attitudes toward interventions. We found that language used to assess sexual orientation was problematic in this population, due to lack of consistency between orientation and reported behavior, and unfamiliarity with terms used to describe sexual orientation. In addition, stigma, lack of knowledge of HIV prevention methods, and fear of disclosure of sexual behavior were identified as barriers that could impact engagement in HIV research, prevention, and care. However, participants reported social relationships with both transgender women and other men who have transgender partners, presenting possible avenues for recruitment into HIV research and healthcare services.


Assuntos
Infecções por HIV , Pessoas Transgênero , Transexualidade , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Comportamento Sexual
7.
Arch Sex Behav ; 50(7): 3201-3222, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34697692

RESUMO

Despite experiencing high rates of sexual violence, there is limited research that explores coping and support needs among trans women of color and those from migrant backgrounds. This article examines the impact of sexual violence, as well as responses and support needs in relation to sexual violence, among 31 trans women of color, aged between 18-54 years, living in Australia. Women were recruited using purposive and snowball sampling, local LGBTQI + networks, and social media. Study advertisements invited participation from people 18 years and older, who identified as a "trans woman of color" or "trans woman from a non-English speaking background," to take part in a study about their lives as trans women of color and experiences of sexual violence. In-depth interviews and photovoice took place between September 2018 and September 2019. Findings were analyzed through thematic analysis, drawing on intersectionality theory. Sexual violence was reported to be associated with fear, anxiety, and depression, and, for a minority of women, self-blame. While women reported hypervigilance and avoiding going out in public as measures to anticipate and protect themselves from sexual violence, they also demonstrated agency and resilience. This included putting time and effort into appearing as a cisgender woman, naming violence, seeking support, rejecting self-blame, and engaging in self-care practices to facilitate healing. Trans women highlighted the need for multi-faceted sexual violence prevention activities to encourage education, empowerment and cultural change across the general population and support services, in order to promote respect for gender, sexuality and cultural diversity.


Assuntos
Delitos Sexuais , Migrantes , Transexualidade , Adolescente , Adulto , Feminino , Identidade de Gênero , Humanos , Pessoa de Meia-Idade , Comportamento Sexual , Adulto Jovem
8.
Urol Clin North Am ; 48(4): 437-460, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34602167

RESUMO

Transgender people may choose to affirm their gender identity with gender-affirming hormone therapy (GAHT) and/or gender-affirming surgery (GAS). The effects of GAHT and GAS on sexual health in transgender people have not been well elucidated. This systematic review aimed to appraise the current scientific literature regarding sexual desire, arousal, orgasm, pain, and satisfaction in transmen and transwomen before, during, and after gender transition. Overall, sexual dysfunction is common in both transmen and transwomen. GAHT and GAS may help to improve sexual satisfaction. More studies that focus on sexual health in the transgender population are urgently needed.


Assuntos
Procedimentos de Readequação Sexual , Disfunções Sexuais Fisiológicas/etiologia , Transexualidade/complicações , Transexualidade/terapia , Feminino , Humanos , Masculino , Guias de Prática Clínica como Assunto
9.
Artigo em Inglês | MEDLINE | ID: mdl-34682595

RESUMO

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.


Assuntos
Pessoas Transgênero , Transexualidade , Percepção Auditiva , Identidade de Gênero , Humanos , Saúde Mental , Estados Unidos
10.
Microsurgery ; 41(8): 787-791, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34655246

RESUMO

Revision surgery after gender-affirming genitoplasty is becoming more and more common as more patients gain access to surgical treatment. The complexity of genitoplasty and extensive dissection of delicate tissues predisposes patients to necrosis of the flap(s) employed, which can leave patients with complications ranging from poor aesthetics to total lack of genital sensation. The purpose of this report is to detail the revision surgery of a 32-year-old transgender woman who underwent vaginoplasty at an outside institution and presented to our clinic for clitoral reconstruction following necrosis and near-total loss of the neoclitoris. Physical exam showed extensive necrosis, and 3-Tesla magnetic resonance (MRI) revealed significant scarring of the pudendal nerve branches at the level of the pubic symphysis. Healthy nerve was identified at the level of the right inferior pubic ramus, and total clitoral reconstruction with an innervated first dorsal web space free flap anastamosed to the deep inferior epigastric vessels was performed. Complications included donor site cellulitis with partial loss of the skin graft and formation of hypertrophic scar tissue. This was treated 6 months postoperatively with excision of scar tissue in the webspace and placement of an additional full-thickness skin graft. At follow-up, the patient reported tactile and erogenous sensation of the neoclitoris itself and subjective satisfaction with the aesthetic outcome. Our results provide evidence that this flap is a feasible option to create an aesthetic and sensate neoclitoris in the setting of previous neoclitoral necrosis. This case report also describes the novel use of 3-Tesla MRI in target selection for nerve coaptation.


Assuntos
Nervo Pudendo , Transexualidade , Adulto , Clitóris/cirurgia , Estética , Feminino , Humanos , Nervo Pudendo/cirurgia , Retalhos Cirúrgicos
11.
J Craniofac Surg ; 32(7): 2397-2400, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705385

RESUMO

BACKGROUND: The demand for facial feminization surgery (FFS) amongst transgender women is on the rise, and requests for a single-stage full FFS (F-FFS) are becoming more frequent. The specific aim of this article is to present our institutional experience with both partial-FFS (P-FFS) and F-FFS with a specific emphasis on safety of each approach. METHODS: We examined the electronic medical record of all patients with the diagnosis of gender dysphoria that were referred to the senior author for FFS consultation at our institution, between June 2017 and October 2020. Patients were sub-grouped into those who underwent F-FFS (upper, middle, and lower facial thirds in a single anesthetic event) and those who underwent P-FFS. Univariate analysis was used to assess for difference in postoperative complications. RESULTS: We identified 77 patients who underwent 382 total procedures. The mean follow-up time was 7.5 months (Sd = 7.3) (interquartile range 1.75-12.0 months). Fifty-one (71.4%) patients underwent F-FFS and 21 (28.6%) patients underwent P-FFS. Compared to P-FFS, F-FFS was not associated with an increase in postoperative complication (1 out of 21 [4.8%] versus 4 out of 51 [7.8%]) ( P < 0.556). When comparing characteristics of patients with postoperative complications to patients with no postoperative complications, the average body mass index was significantly higher (30.9 versus 25.4, respectively). ( P < 0.029). CONCLUSIONS: Full-FFS is a set of procedures that has gained increased popularity among male-to-female transgender patients. Our results support the understanding that F-FFS is a safe and reliable approach, which may be preferable to patients and providers alike.


Assuntos
Disforia de Gênero , Transexualidade , Face/cirurgia , Feminino , Feminização , Disforia de Gênero/cirurgia , Humanos , Masculino , Estudos Retrospectivos , Transexualidade/cirurgia
12.
JAAPA ; 34(10): 51-53, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34582387

RESUMO

ABSTRACT: Premenopausal transgender men who retain internal female reproductive organs, who use exogenous testosterone, and who are sexually active with cisgender men are often capable of conception. This article discusses the potential for fecundity in transgender men, as well as appropriate reproductive care depending on whether the patient prefers to avoid conception or to become pregnant.


Assuntos
Pessoas Transgênero , Transexualidade , Feminino , Fertilidade , Humanos , Masculino , Gravidez
13.
Curr Pharm Teach Learn ; 13(10): 1351-1357, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34521531

RESUMO

BACKGROUND AND PURPOSE: Increased student pharmacist education on health issues and concerns of the underserved Lesbian, gay, bisexual, transgender, and queer (LGBTQ) population is needed. We incorporated pharmacy-specific, transgender-focused education into the curriculum and sought to identify whether pharmacy students' knowledge and attitudes towards LGBTQ individuals were affected by: (1) required online module or in-class lecture and (2) student demographics. Educational activity and setting: Pharmacy student attitudes and perceptions towards transgender individuals and the LGBTQ population were assessed before and after online (video) and in-person education using a modification of the Attitudes towards Lesbian Gay Bisexual Transgender Patients Scale. Wilcoxon test for non-parametric paired data was used to test for statistically significant changes between the pre- and post-education surveys, while two-way analysis of variance was used to analyze correlations between student demographics and responses. FINDINGS: Changes in students' knowledge and attitudes were observed after exposure to either online or in-person education. Increases in students' perceived competence to provide care to patients identifying as LGBTQ were associated with both teaching methods. Significant demographic associations were seen with specific attitudes; female students and students who knew a transgender person were more likely to strongly disagree that discussing sexual behavior with LGBTQ patients is challenging. SUMMARY: Delivery of transgender-focused education produced observable changes in student pharmacist perceptions and attitudes towards working with the LGBTQ patient population. Demographic characteristics, such as being female or knowing a transgender individual, positively correlated with student pharmacists' feeling more comfortable discussing sexual behavior with LGBTQ persons.


Assuntos
Estudantes de Farmácia , Pessoas Transgênero , Transexualidade , Atitude do Pessoal de Saúde , Feminino , Educação em Saúde , Humanos
14.
PLoS One ; 16(9): e0257194, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34506559

RESUMO

OBJECTIVE: Transgender and non-binary individuals frequently engage with healthcare services to obtain gender-affirming care. Little data exist on the experiences of young people accessing gender care. This systematic review and meta-ethnography aimed to identify and synthesise data on youths' experiences accessing gender-affirming healthcare. METHOD: A systematic review and meta-ethnography focusing on qualitative research on the experiences of transgender and non-binary youth accessing gender care was completed between April-December 2020. The following databases were used: PsychINFO, MEDLINE, EMBASE, and CINAHL. The protocol was registered on PROSPERO, international prospective register of Systematic Reviews (CRD42020139908). RESULTS: Ten studies were included in the final review. The sample included participants with diverse gender identities and included the perspective of parents/caregivers. Five dimensions (third-order constructs) were identified and contextualized into the following themes: 1.) Disclosure of gender identity. 2.) The pursuit of care. 3.) The cost of care. 4.) Complex family/caregiver dynamics. 5.) Patient-provider relationships. Each dimension details a complicated set of factors that can impact healthcare navigation and are explained through a new conceptual model titled "The Rainbow Brick Road". CONCLUSION: This synthesis expands understanding into the experience of transgender and non-binary youth accessing gender-affirming healthcare. Ryvicker's behavioural-ecological model of healthcare navigation is discussed in relation to the findings and compared to the authors' conceptual model. This detailed analysis reveals unique insights on healthcare navigation challenges and the traits, resources, and infrastructure needed to overcome these. Importantly, this paper reveals the critical need for more research with non-binary youth and research which includes the population in the design.


Assuntos
Pessoas Transgênero/estatística & dados numéricos , Feminino , Identidade de Gênero , Acesso aos Serviços de Saúde , Humanos , Masculino , Transexualidade
15.
Am J Epidemiol ; 190(9): 1928-1934, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34467408

RESUMO

We sought to operationalize and validate data-driven approaches for identifying transgender individuals in the Veterans Health Administration (VHA) of the US Department of Veterans Affairs (VA) through a retrospective analysis using VA administrative data from 2006-2018. Besides diagnoses of gender identity disorder (GID), a combination of non-GID data elements was used to identify potentially transgender veterans, including 1) an International Classification of Diseases (Ninth or Tenth Revision) code of endocrine disorder, unspecified or not otherwise specified; 2) receipt of sex hormones not associated with the sex documented in the veteran's records (gender-affirming hormone therapy); and 3) a change in the veteran's administratively recorded sex. Both GID and non-GID data elements were applied to a sample of 13,233,529 veterans utilizing the VHA of the VA between January 2006 and December 2018. We identified 10,769 potentially transgender veterans. Based on a high positive predictive value for GID-coded veterans (83%, 95% confidence interval: 77, 89) versus non-GID-coded veterans (2%, 95% confidence interval: 1, 11) from chart review validation, the final analytical sample comprised only veterans with a GID diagnosis code (n = 9,608). In the absence of self-identified gender identity, findings suggest that relying entirely on GID diagnosis codes is the most reliable approach for identifying transgender individuals in the VHA of the VA.


Assuntos
Disforia de Gênero/epidemiologia , Pessoas Transgênero/estatística & dados numéricos , Transexualidade/epidemiologia , Saúde dos Veteranos/estatística & dados numéricos , Veteranos/estatística & dados numéricos , Adulto , Idoso , Feminino , Disforia de Gênero/diagnóstico , Humanos , Classificação Internacional de Doenças , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Procedimentos de Readequação Sexual/estatística & dados numéricos , Transexualidade/diagnóstico , Estados Unidos/epidemiologia
16.
Fertil Steril ; 116(4): 936-942, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34481638

RESUMO

Gender-affirming hormone therapy (GAHT) is often provided to transgender people. In this review of the literature, the current knowledge of ovarian, breast, and metabolic changes (body composition, insulin resistance, bone density, cardiovascular risk factors such as lipids, blood pressure, and hematocrit) observed following GAHT in adult transgender men is discussed. A body of literature concurs to describe that long-term androgen therapy in transgender men exerts atrophic effects on the breast. There is currently no evidence of an increased risk of breast cancer. Long-term testosterone treatment induces ovarian effects that become visible after 6 months of therapy. These changes consist of both macroscopic and microscopic alterations of ovarian morphology that mimic the typical ovarian aspect encountered in women with polycystic ovary syndrome but without an effect on antral follicle count. Metabolic effects of long-term androgen treatment in transgender men put them at par with cisgender men in terms of lipid profile, insulin resistance, and overall mortality. Body composition changes as desired after testosterone administration in most transgender men, and insulin resistance decreases with virilization. There are no detrimental effects on bone mineral density. Cardiometabolic risk and morbidity data are currently reassuring, even if certain studies show conflicting results. An increase in blood pressure and a decrease in high-density lipoprotein cholesterol have been reported as risk factors, whereas polycythemia is rare and treatable. Most available data are observational and based on biochemical markers instead of the more direct measures of cardiovascular damage. An explanation for these observed changes is mostly lacking. Psychological stress and lifestyle factors are often forgotten in a much needed integrated approach.


Assuntos
Androgênios/uso terapêutico , Mama/efeitos dos fármacos , Metabolismo Energético/efeitos dos fármacos , Ovário/efeitos dos fármacos , Procedimentos de Readequação Sexual , Testosterona/uso terapêutico , Pessoas Transgênero , Transexualidade/cirurgia , Androgênios/efeitos adversos , Composição Corporal/efeitos dos fármacos , Densidade Óssea/efeitos dos fármacos , Mama/metabolismo , Mama/patologia , Feminino , Disforia de Gênero/psicologia , Identidade de Gênero , Humanos , Resistência à Insulina , Masculino , Ovário/metabolismo , Ovário/patologia , Fatores de Risco , Procedimentos de Readequação Sexual/efeitos adversos , Testosterona/efeitos adversos , Fatores de Tempo , Pessoas Transgênero/psicologia , Transexualidade/fisiopatologia , Transexualidade/psicologia , Resultado do Tratamento
17.
Fertil Steril ; 116(4): 922-923, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34579827

RESUMO

The medical profession is deeply involved in designating and amending the sex designations on legal records that themselves are not used clinically. The assumptions inherent in the current legal sex designation system and the criteria for amending such are being reexamined. The harms of the current legal sex designation system, especially for transgender people, have become increasingly recognized. Consequently, the appropriateness of the health care professional's participation in recording legal sex designations has been called into question. Herein, we describe the medicolegal challenges surrounding legal sex designations and their potential solutions.


Assuntos
Disforia de Gênero/psicologia , Identidade de Gênero , Serviços de Saúde para Pessoas Transgênero/legislação & jurisprudência , Direitos Humanos/legislação & jurisprudência , Procedimentos de Readequação Sexual , Pessoas Transgênero/legislação & jurisprudência , Transexualidade/cirurgia , Feminino , Humanos , Masculino , Pessoas Transgênero/psicologia , Transexualidade/fisiopatologia , Transexualidade/psicologia
18.
J Sch Health ; 91(11): 883-893, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34533210

RESUMO

BACKGROUND: Transgender youth report high rates of negative experiences in schools. Using a lens of minority stress, this study sought to examine in-school experiences of transgender youth to understand youth coping and to identify key opportunities for improving school environments for transgender youth. METHODS: Participants included 41 youth across 33 in-depth interviews (Mage  = 21.7) and two focus groups (N = 8; Mage  = 17.3). Thematic analysis was used to analyze data. Themes related to stress, coping, and facilitators/barriers to stress/coping were derived and coded. RESULTS: Distal stressors, such as structural discrimination and prejudice events, were found to contribute to the exclusion of transgender youth from school life, while proximal stressors, such as concealment and expectations of rejection, reinforced transgender youth's feelings of personal isolation. Participants expressed coping with both challenges by advocating for inclusion through direct action with teachers and administrators and seeking/finding connection with trusted staff and peers. CONCLUSIONS: Findings suggest that creating safe and supportive environments at school for transgender youth is an attainable goal, as all identified barriers to inclusivity and connection were modifiable. By considering the needs of transgender youth in policies and programming, schools may improve climate for and wellbeing of transgender students.


Assuntos
Pessoas Transgênero , Transexualidade , Adaptação Psicológica , Adolescente , Adulto , Humanos , Instituições Acadêmicas , Estudantes , Adulto Jovem
19.
J Hist Med Allied Sci ; 76(4): 392-416, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34553224

RESUMO

This article explores the history of what the German-American endocrinologist Harry Benjamin labeled in 1966, "the transsexual phenomenon." By mid-century, a growing number of individuals in both Europe and America were approaching physicians such as Benjamin searching for answers and means to change their bodies to match their gender. This phenomenon had started in Europe in the 1930s, when the Danish painter Einar Wegener underwent a series of operations that transformed a body defined at birth as male into the female body of Lili Elbe. The news of Elbe's transformation ignited interest and discussion among physicians as well as the public on the capacity science had to alter bodies to fit their intended selves. The case of Elbe combines the three main aspects studied in this article-the medicalization of the homosexual, the birth of the transsexual, and the physician-patient relationship in transsexual narratives. The study of physician and patient narratives allow us to see how the transsexual phenomenon was in fact created out of the intersection of interests from both physicians and their transsexual patients.


Assuntos
Médicos , Transexualidade , Feminino , Identidade de Gênero , Homossexualidade , Humanos , Recém-Nascido , Masculino , Medicalização
20.
Artigo em Inglês | MEDLINE | ID: mdl-34501809

RESUMO

Transgender and gender diverse (TGD) youth experience health disparities due to stigma and victimization. Gender-affirming healthcare mitigates these challenges; yet, we have limited understanding of TGD youth's healthcare experiences in the U.S. Midwest and South. Using a multiple case study design, we aimed to develop an in-depth and cross-contextual understanding of TGD youth healthcare experiences in one Midwestern state. Families with a TGD child under 18 were recruited with the goal of cross-case diversity by child age, gender, race, and/or region of the state; we obtained diversity in child age and region only. Four white families with TGD boys or non-binary youth (4-16) in rural, suburban, and small towns participated in interviews and observations for one year; public data were collected from each family's community. Thematic analysis was used within and across cases to develop both family-level understanding and identify themes across families. Findings include a summary of each family as it relates to their child's TGD healthcare experiences as well as the themes identified across cases: accessibility and affirming care. Although limited by a small sample with lack of gender and race diversity, this study contributes to our understanding of TGD youth healthcare in understudied regions.


Assuntos
Pessoas Transgênero , Transexualidade , Adolescente , Criança , Atenção à Saúde , Identidade de Gênero , Instalações de Saúde , Humanos , Masculino
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