Search Results (87)

Lesbian, Gay, Bisexual, Transgender, Questioning, or Queer (LGBTQ) students with disabilities face unique challenges in the educational environment, and educators must provide support based on intersectionality. However, research on LGBTQ students in special needs education is limited, and the extent of educators’ awareness and support is not well documented. Therefore, this study explored the awareness, knowledge, and support practices of special needs school educators regarding LGBTQ students. We conducted a nationwide survey of educators in special needs schools in Japan, and 2024 valid responses were analyzed using multiple correspondence and cluster analyses. The results revealed that many educators lacked an understanding of basic LGBTQ terminology and may have been unaware of their discriminatory behaviors. Additionally, most educators had never encountered LGBTQ students with disabilities, potentially hindering these students’ opportunities to seek support. Furthermore, educators who had received LGBTQ training reported higher awareness and being more proactive in supporting LGBTQ students than those who had not. Thus, training may be associated with support-related attitudes. This highlights the need for ongoing training programs that address LGBTQ identity and disability, considering their intersectionality. These preliminary findings suggest the potential for creating an inclusive environment for LGBTQ students with disabilities; nevertheless, structural barriers remain. Full article

Gender-independent, intersex, non-binary, and transgender (GIaNT) youth have puberty health and sex education needs that are different from cisgender youth. Unfortunately, this population has historically been excluded from curricula pertaining to these issues in schools throughout the U.S. and Canada. While sex education programs are limited for all youth, and navigating puberty can range from exciting to scary for all youth, GIaNT youth are particularly vulnerable to facing negative outcomes by being omitted from such curricula. Because they are not able to access adequate information in schools and in their family/friend networks, a majority of GIaNT youth turn to the internet to seek out resources for education on puberty health and sex education. To this end, our team is in the process of creating an online educational resource (OER) that is age-appropriate and affirming for GIaNT youth to be provided with resources that are personalized to users’ unique needs. This literature review discusses content suggestions for inclusion of comprehensive puberty health and sex education that caters to GIaNT youth and their unique needs. Full article

Objectives: Health disparities among transgender and gender-diverse individuals are partly attributed to the limited knowledge and preparedness of healthcare providers. This study aims to assess the level of knowledge of transgender health among residents in obstetrics and gynecology and family medicine. Methods: A multicenter, cross-sectional study was conducted with obstetrics and gynecology (OBGYN) and family medicine (FM) residents from two different centers. Data were collected using a 21-item questionnaire. The questionnaire assessed participants’ demographic information, knowledge of sexual orientation and gender identity, clinical and anatomical effects of gender-affirming hormone therapy, knowledge of gender-affirming surgery, and knowledge of risk-based screening for TGD individuals. Results: The study, which included 85 residents (62 FM, 23 OBGYN), found that 76.6% of respondents indicated that SOGI should be routinely assessed. However, 68.3% of the participants reported inadequate knowledge regarding the clinical implications of gender-affirming hormone therapy, and 74.1% reported insufficient knowledge about gender-affirming surgeries. Furthermore, 62.4% of the participants indicated that they had not received any health education specifically tailored to address the needs of transgender individuals. Only 23.5% reported receiving training during their residency programs. Notably, 84.7% of the participants expressed a desire for formal education in this area. Conclusions: FM and OBGYN residents have significant knowledge gaps regarding TGD health. The integration of TGD health topics into the curricula of medical schools and residency programs is needed to improve access to healthcare for individuals with TGD. Full article

The literature details the healthcare needs of migrant people living with chronic illnesses and the consequent economic, social, and healthcare needs of their caregivers. Similarly, some studies have underscored the social and healthcare needs of 2SLGBTQIA+ (two-spirit, lesbian, gay, bisexual, transgender, queer, and intersex individuals, including diverse sexual and gender identities under the “+” symbol) adults living with chronic illnesses and their caregivers. This narrative review presents the context of migrant 2SLGBTQIA+ unpaid caregivers and how their intersecting identities influence their caregiving roles for family members with chronic illnesses. In this article, caregivers are defined as family members or chosen families who provide unpaid support that may last for three months or longer for people living with chronic illnesses. Most studies and policies overlook 2SLGBTQIA+ migrants who are also unpaid caregivers of individuals living with chronic illnesses, leaving them unsupported through discrimination at the intersection of racism, homophobia, transphobia, ageism, and ableism, forcing them to remain vulnerable to increased emotional and physical strain. There is a presence of pervasive systemic barriers, including a lack of training and education among social and healthcare providers, about the needs of migrant 2SLGBTQIA+ unpaid caregivers. Additional challenges stem from inadequate policies and insufficient targeted resources, particularly for caregivers from marginalized racial and ethnic backgrounds. The findings of this study highlight the necessity for a call to action to address these gaps and improve support systems for these highly marginalized communities. Full article

Background/Objectives: Transgender individuals face significant healthcare disparities, often exacerbated by provider prejudice and knowledge gaps. Nurses, as frontline providers, play a critical role in promoting inclusive care. This study aimed to evaluate the levels and predictors of transphobia and attitudes toward transgender individuals among nurses in Türkiye. Methods: A cross-sectional survey was conducted with 100 registered nurses. Participants completed the Transphobia Scale, the Attitudes Toward Transgender Individuals Scale, and the Hudson & Ricketts Homophobia Scale. Additional measures included perceived knowledge, prior education on transgender health, familial attitudes, and comfort levels when working with transgender patients. Multiple linear regression analyses identified predictors of transphobia and attitudes. Results: The mean Transphobia Scale score was 41.53 (SD = 12.67), and the mean Attitudes Toward Transgender Individuals Scale score was 57.45 (SD = 16.42). Greater homophobia, negative parental attitudes, and higher perceived knowledge significantly predicted higher transphobia scores (Adjusted R²= 0.327). Prior education on transgender health was also associated with lower transphobia. Lower comfort with transgender patients was marginally associated with higher transphobia. More positive attitudes toward transgender individuals were predicted by lower transphobia, lower homophobia, and prior education (Adjusted R² = 0.526). Conclusions: Findings underscore the urgent need for structured transgender health education and culturally sensitive interventions among nurses. Addressing sociocultural factors and training gaps could enhance equitable healthcare delivery for transgender populations, particularly in culturally conservative settings like Türkiye. Full article

Background: Brazil’s Unified Health System (Sistema Único de Saúde—SUS) has played a crucial role in reducing health disparities by providing universal and free healthcare to a diverse population. However, the COVID-19 pandemic exposed significant barriers to healthcare access among vulnerable groups, particularly due to the intersection of multiple vulnerabilities. This study aimed to examine how intersectionality—specifically sex/gender, race/ethnicity, and education level—has influenced inequalities in healthcare service utilization among vulnerable populations during the COVID-19 pandemic in Brazil. Methods: This cross-sectional study is part of the “COVID-19 Social Thermometer in Brazil” project, conducted between May 2022 and October 2023 in Brazil’s state capitals and the Federal District, focusing on populations considered socially vulnerable during the pandemic. Participants were selected using sequential sampling and completed a structured questionnaire. Statistical analyses—performed using Excel, RStudio (version 4.3.2), and ArcGIS—included sociodemographic profiling, the construction of the Jeopardy Index (a measure of social vulnerability), and binary logistic regression to explore associations between Jeopardy Index and healthcare service utilization. Results: 3406 participants, the majority were men (60%), aged 30 to 59 years (65.1%), and identified as Black or Brown (72.2%). Most participants were concentrated in the Northeast (26.6%) and North (22.3%) macroregions. A high reliance on public healthcare services (SUS) was observed, particularly in the Southeast (96%). According to the Jeopardy Index, the most socially vulnerable groups—such as women, transgender individuals, Black people, and those with no formal education—were significantly more likely to rely on SUS (OR = 3.14; 95% CI: 1.34–7.35) and less likely to use private healthcare (OR = 0.07; 95% CI: 0.02–0.20), reflecting a 214% higher likelihood of SUS use and a 93% lower likelihood of private service utilization compared to the most privileged group. Conclusions: Our findings reveal that individuals experiencing intersecting social vulnerabilities face marked inequalities in healthcare access. Without SUS, these populations would likely have been excluded from essential care. Strengthening SUS and implementing inclusive public policies are critical to reducing disparities and ensuring equitable healthcare access for historically marginalized groups. Full article

Childhood sexual abuse (CSA) is a prevalent form of violence against children, associated with profound negative impacts on survivors’ health and well-being. In Bangladesh, sociocultural and economic barriers hinder CSA prevention and intervention, particularly for vulnerable populations such as transgender individuals. This study explores the experiences of CSA among Bangladeshi transgender individuals, focusing on their coping mechanisms and resilience-building strategies. A qualitative narrative approach was employed, using life story-telling interviews with four transgender CSA survivors, and data were analyzed thematically. The findings reveal significant challenges, including social exclusion, humiliation, and lack of family support. Participants reported experiencing physical injuries, mental trauma, and loss of trust due to CSA, while the conservative nature of Bangladeshi society often prevented them from disclosing their abuse or seeking healthcare. These barriers exacerbate health inequalities among gender-minority children. Despite these adversities, participants described engaging in resilience-building strategies such as self-care, personal development, advocacy, and efforts to derive meaning from their experiences, while highlighting the perceived importance of family support. This study provides insights into the unique experiences of transgender CSA survivors in Bangladesh and calls for efforts towards gender-inclusive education, mental health support, and further research to address CSA-related adversity, encourage disclosure, and promote health equity for gender-minority groups. Full article

Background and Objectives: Gender affirmation surgery significantly improves the quality of life and psychological well-being of transgender women. Among various techniques, sigmoid vaginoplasty is widely performed due to its ability to provide adequate vaginal depth and intrinsic lubrication. However, it carries risks, with neovaginal perforation being a serious yet underreported complication. Materials and Methods: This review examines the etiology, clinical manifestations, diagnosis, and management of neovaginal perforation. A literature review was conducted to analyze reported cases and treatment strategies. Additionally, we present a case from our institution to highlight diagnostic and therapeutic challenges. Results: Neovaginal perforation arises from mechanical trauma, ischemia, infection, or structural weaknesses in the sigmoid segment. Common risk factors include improper dilation, introital stenosis, and vascular compromise. Symptoms range from mild pelvic discomfort to peritonitis and sepsis. Computed tomography (CT) is the gold standard for diagnosis. Conservative management is effective in mild cases, whereas severe cases require surgical repair. Conclusions: Neovaginal perforation is rare but potentially life-threatening. Future research should refine surgical techniques, dilation protocols, and tissue engineering solutions. Standardized guidelines and patient education are essential for prevention and improved outcomes. Full article

Background: The Coronavirus disease (COVID-19) pandemic profoundly impacted education, causing uncertainty and constant changes for teachers, including new teaching modalities, increased workloads, and limited rest periods. Global studies have reported mental health issues such as anxiety and depression among educators during and after the pandemic, primarily in Asia, Europe, and North America. However, these existing studies often show increased anxiety and depression rather than considering school-based predictors that may contribute to increasing rates. Aims: Despite these global findings, there are few investigations of the impact of COVID-19 on teachers in Latin America and Spain. To address these notable global and regional research gaps, this study examined the prevalence and predictors of depression and anxiety symptoms among teachers in Latin America and Spain. Method: An online survey collected data on demographics, work-related characteristics, COVID-19 experiences, and measures of mental health from teachers in 19 Latin American countries and Spain using a snowball sampling approach. The sample comprised 2004 teachers, with 81.8% female participants and a mean age of 44.46 years (SD = 9.8). Descriptive statistics and hierarchical multiple linear regressions were conducted with depression and anxiety as outcome variables. Results: Consistent predictors of increased anxiety and depression symptomology included being female or transgender, being younger, having lower socioeconomic status, having pre-existing mental health conditions or chronic illness, having increased workload during the pandemic, being dissatisfied with teaching resources, and having negative changes in relationships with students, parents, or colleagues. The predictors collectively explained 16.4% of the variance in depression and 17.5% of the variance in anxiety symptoms. Conclusions: The significant mental health needs of teachers in Latin America and Spain during the COVID-19 pandemic highlight the pressing necessity of prioritizing the mental health needs of educators to improve their psychological health and children’s educational environments. These results also suggest the practical need to provide teachers with additional school-based supports and resources for future transitions to online learning or disruptions to traditional instruction. Full article

This paper details how, in partnership with young people, community workshops centred on queer joy can offer queer and trans youth sexuality education (SE) that is relevant to their experiences, lived realities, and desires. In the data, young people discuss how tailored content, queer pedagogies, youth-centric approaches, and affirming spaces that are responsive to their questions might improve their sexuality knowledge as well as their mental health. A total of 22 youth participants from a mid-size Canadian city, the vast majority of whom identified as queer and/or trans, registered in a weekend workshop to evaluate SE video lessons created by educators enrolled in our partner organization’s sexuality education training program. Through this process, young people leaned on both their expertise and experience to critically reflect on the content and pedagogies employed by the educators. Additionally, 14 youth participated in post-workshop interviews where they continued these conversations and reflected on their SE experiences. In contrast to queer and trans young people’s more violent experiences in classrooms, public spaces, and political discourses, this community intervention workshop cultivated community, knowledge, power, and solidarity between and among youth participants. As they used and created memes to laugh in the face of structures and situations that attempt to erase their bodies and experiences, young people reached for a vision of sexuality education that not only includes them but centres on their desires and curiosities. Full article

Due to several interpersonal, social, and organizational challenges, dental health has been occasionally compromised in the transgender population. There is a lack of awareness among transgender persons to access affordable trans-competent oral health care. More information is required to identify and assess the oral health condition of this population in order to encourage better access to oral healthcare and effectively influence public health policy and practice. This systematic review aims to provide evidence about the status of oral health and hygiene of the transgender population across the globe. A systematic literature search using keywords and MESH search terms was conducted using PubMed, Medline, Google Scholar, and EBSCO online databases. The references of included journal articles were manually searched and appropriate studies were included, which were then critically appraised using the Joanna Briggs Institute (JBI) tool and the Newcastle–Ottawa protocol for the risk of bias assessment of prevalence studies, with each study assessed by two independent reviewers. Based on the search procedures, a total of 2026 articles were initially screened and, after evaluation, 20 were included in the systematic review. Transgender persons often face stigma and discrimination in dental healthcare settings, which affects their oral health status. A greater prevalence of substance abuse stemming from anxiety, lack of adequate education, and poor socioeconomic status leads to an increased prevalence of oral health diseases in this marginalized population. There is a need for policies and reforms to appraise their oral health and hygiene status and improve access to oral health services in this population. Full article

Narrative therapy and expressive writing interventions have been found to improve health and wellbeing among vulnerable populations; however, few have been conducted with young lesbian, gay, bisexual, transgender, and queer people, and those of other diverse sexual orientations and gender identities (LGBTQ+). This study aimed to determine how young LGBTQ+ people in Australia might make meaning of themselves and their experiences through life writing and the implications for health and wellbeing. A study was conducted with 20 LGBTQ+-identifying participants, aged 16 to 20, in or around Melbourne, Australia. The participants attended one of two writing workshops held at a public library in Melbourne in October 2019 and February 2020, where they were taught creative nonfiction writing techniques. They were asked to submit pieces of life writing (“narratives”) and reflections about participating in the study. Fifteen participants submitted one or more narratives in response to a prompt, and 10 participants provided reflections. Thematic analysis was used to code the data and identify themes that emerged. The participants’ processes of meaning-making were analysed using a performativity lens. This article explores the theme “sex and relationships” that emerged and the related sub-themes. The participants’ writing provided insights into sociocultural norms, discourses, and tropes, including those present in school-based sexuality education and in the media, that may impact the developing sexual subjectivities of young LGBTQ+ people in Australia. Engaging in life writing provided an outlet for developing self-knowledge, agency, and subjectivity. The findings can be used to promote the use of creative, youth-centred and queer-affirming practices and interventions for LGBTQ+ youth in school and community settings, including peer support and community health approaches. They indicate the need for de-pathologising the medicalised risk- and prevention-based interventions for LGBTQ+ youth in health and education research and policy, particularly around sexual and mental health. Full article

Background: LGBTQ+ persons with cancer and their families consistently face discriminatory care. In addition, clinicians report inadequate population-specific knowledge and communication skills to effectively promote LGBTQ+ inclusion. To fill this gap, we designed a communication skills training based on extant literature; multidisciplinary perspectives; and patient, family, and clinician expert engagement. Methods: Training content comprised didactic information, including exemplar videos of communication strategies, and experiential learning roleplay opportunities with standardized patient and family member actors. Two training sessions were conducted virtually with invited multidisciplinary clinicians using convenience sampling. Each training was followed by a one-hour, semi-structured focus group to solicit feedback on participants’ experiences and recommendations for improvement. Focus group transcripts were thematically analyzed using a constant comparative approach. Results: Two major themes were identified: key takeaways from the training and recommendations for improvement. Participants reported favorable learning experiences and believed the training would have a positive influence on future clinical interactions. We synthesized recommendations into five discrete pieces of feedback related to (1) the advanced level of training material; (2) diversity throughout the training; (3) complexity of family dynamics; and (4) recovery from communication mistakes; and (5) additional topics for future training. Based on feedback, corresponding changes for each item and a refined communication skills blueprint are provided. Conclusions: Our innovative training on inclusive cancer care for LGBTQ+ patients’ families will provide both knowledge-based and experiential learning opportunities to advance clinicians’ confidence in communicating empathically with members of diverse sexual orientation and gender identities. The training is poised for feasibility and efficacy testing. Full article

Background/Objectives: Sexual and gender minority (SGM) adults are at an increased risk for suicide and suicidal ideation compared with cisgender/heterosexual adults. Due to the complexity of suicidal ideation, individual, social, and systemic factors must be considered. The purpose of this study was to identify determinants of suicidal ideation among SGM adults using constructs from the Social–Ecological Model (SEM). Methods: This was a cross-sectional study of data collected from 1034 SGM adults between 27 January and 7 February 2022, and variables reflected the four constructs of the SEM, including individual, family, community, and societal levels. Hierarchical multiple linear regression was used to enter the variables in blocks. Results: The final model explained 55% of the variance in suicidal ideation, and determinants of suicidal ideation were identified at all four levels. At the individual level, factors were depression (p < 0.001, β = 0.231), anxiety (p < 0.001, β = 0.279), vigilance distress (p = 0.036, β = 0.157), not being out/open (p = 0.046, β = 1.136), having some college education (p = 0.002, β = −1.875), and personal strength (p = 0.012, β = −0.131). Family of origin discrimination distress was significant at the family level (p = 0.016, β = 0.174). Social resources (p < 0.001, β = −0.113), victimization distress (p < 0.001, β = 0.795), and harassment/discrimination distress (p = 0.035, β = 0.179) were significant at the community level. At the social level, SGM protective state law score (p = 0.43, β = −0.35) and having a proposed or enacted transgender sports ban (p = 0.027, β = 1.480) were significant. Conclusions: Understanding the factors across the various levels of the SEM that influence suicidal ideation allows for the development of multi-level, social-ecological suicide prevention programs. Such programs can address the unique needs of SGM individuals and help mitigate suicidal ideation. Full article

Objectives of Paediatric and Adolescent Gynaecology (PAG): PAG aims to foster a collaborative environment that bridges knowledge from various disciplines to ensure the highest quality of care for children and adolescents with gynaecological issues. The European Association of PAG and HellenicPAG, like all National PAG Societies, support research and education to advance new insights, improve health outcomes, enhance quality of life, and protect future fertility. Additionally, PAG promotes international cooperation by proposing guidelines for good clinical practice in terms of prevention, diagnosis, procedures, and treatment. Scientific Program and Highlights: The scientific committee curated a comprehensive program featuring renowned experts and researchers from across Europe. Over four days, participants explored a wide range of topics through lectures, panel discussions, case studies, debates, video presentations, and workshops. The conference attracted professionals from various disciplines, including gynaecology, paediatrics, paediatric endocrinology, psychology, plastic surgery, and paediatric surgery. The collaboration between the European Association of Paediatric and Adolescent Gynaecology and the Hellenic Society of Paediatric and Adolescent Gynaecology resulted in a cutting-edge scientific program. World-renowned experts (^{Appendix A}) presented on all aspects of paediatric and adolescent gynaecology, with a particular focus on emerging topics such as abortion, global rights, transgender care, teenage pregnancy, and more. Theme—Individualized Care in an Evolving World: The congress theme aligned perfectly with the evolving landscape of PAG. By presenting high-quality, evidence-based topics, the program aimed to equip the next generation of specialists with the knowledge and skills needed to provide individualized care in a rapidly changing world. Full article