Search Results (166)

Transgender and gender-diverse teachers occupy a precarious position within educational spaces, often facing increased scrutiny and regulation aimed at disciplining their gender expression. This article brings to light original and significant insights by exploring how transgender and gender-diverse teachers resist and subvert cisnormative dress codes, as acts of self-affirmation and resistance within their professional educational contexts. Through an unconventional lens of Barad’s feminist new materialism combined with Wieringa’s continuum of symbolic subversion, our analysis offers an important theoretical contribution by interpreting how these individuals negotiate and challenge institutional cisnormativity, unsettling the tacit expectations of gendered professionalism in their trans embodiment. Drawing on the experiences of three transgender and gender-diverse teacher participants, a group often overlooked, this paper integrates findings from two distinct qualitative studies which used a participatory-focused ‘object-interview’ methodology. Findings from these in-depth studies reveal that transgender and gender-diverse teachers trouble dress code regulations by simultaneously embodying resistance and compliance, effectively reshaping and disrupting gendered expectations and institutional norms. While some forms of self-affirmation expressed by participants remained unseen, others materialised as embodied subversions of normative organisational expectations. Additionally, the degree of agency these teachers have in resisting binary dress code constraints is contingent on the entanglements of the teachers themselves, students, school policies, leadership and institutional climates. Unexpectedly, this research suggests that schools can act as sites of visibility and safety for transgender and gender-diverse teachers, where gender expression is validated and extends beyond the classroom. This article concludes by recognising that, when transgender and gender-diverse teachers resist uniformity and dress code norms, they embody their affirmed identities and, in doing so, offer vital representation for transgender and gender-diverse students, providing a sense of belonging, possibility, and authenticity within educational spaces. Full article

Objective: The objective of this research is to explore the healthcare access experiences of trans and gender-diverse adolescents in the Region of Murcia (Spain). Methodology: An exploratory qualitative study was conducted using an interpretative phenomenological approach, consisting of semi-structured interviews with adolescents and their families. The study sample consisted of 20 participants: 10 trans and gender-diverse adolescents residing in the Region of Murcia and their respective mothers. Interview dyads (adolescent and mother) were incorporated sequentially until data saturation was reached. Transcription and data pre-analysis were conducted simultaneously, following the steps outlined in Interpretative Phenomenological Analysis (IPA). Results: The results are structured based on personal barriers of the participants, perceived barriers in interactions with professionals, and institutional barriers to receiving quality healthcare. Conclusions: This study helps raise awareness about the situation faced by trans adolescents in healthcare settings. It is essential for healthcare professionals to receive greater training and awareness regarding transgender health and for centers to have action protocols, services, and facilities tailored to these patients. Full article

This study critically examines the civil–religious influence of Korean conservative Protestantism, which mobilizes heteronormative strategies to oppose anti-discrimination and family rights legislation, through the lens of Christian normativity. These movements justify heteronormative values by appealing to the immutability of the “creation order” in Genesis. Yet such literalist interpretations disregard contemporary findings in evolutionary biology and animal behavior that document same-sex phenomena across species, thereby framing creation and evolution in rigid opposition. Imported from American fundamentalism, “creation science” has further fueled an anti-intellectual public sentiment that naturalizes heterosexuality as divine law. The absolutism of the creation order and special revelation exposes deep theological contradictions when confronted with the existence of diverse sexual and gender identities. In response, this study turns to process theology, which reimagines creation as open-ended, dynamic, and co-creative. Engaging Catherine Keller’s apophatic theology to reopen theological space for sexual minorities, it further develops Justin Sabia-Tanis’s interpretation of transgender transformation as a process of co-evolution, in dialogue with Donna Haraway’s notion of cyborg hybridity. Moreover, drawing on John B. Cobb Jr.’s “persuasive political theology,” it argues that participation in divine co-creation must be expanded into the socio-political sphere. Ultimately, this study seeks to resist anti-intellectualism and advocate for a transformative Christian civil religion in Korea—one oriented toward justice, inclusion, and continual co-creation. Full article

Nutrition is a cornerstone of public health, yet the unique nutrition needs and considerations of lesbian, gay, bisexual, transgender, and others (LGBT+) communities remain largely invisible in the field of dietetics. These populations face disproportionate burdens of obesity, eating disorders, body dysmorphia, metabolic risks, and food insecurity, often driven by stigma, minority stress, and structural inequities. This narrative review aimed to synthesize current evidence on nutrition-related disparities among LGBT+ populations and identify opportunities for dietitians to advance equity in care. A comprehensive search of PubMed, Scopus, and Web of Science was conducted for studies addressing diet quality, obesity, eating disorders, food insecurity, and metabolic health in sexual and gender minorities. Evidence indicates clear subgroup differences: lesbian and bisexual women are more likely to experience obesity and food insecurity; gay and bisexual men report lower BMI but greater body image concerns and disordered eating; transgender individuals face nutritional challenges linked to gender-affirming therapy and high rates of food insecurity; and people living with HIV encounter additional metabolic risks associated with treatment. Despite these findings, LGBT+ health remains rarely reflected in dietary guidelines or professional training. Embedding inclusivity into dietetic education and clinical encounters, adopting culturally competent and structurally aware practices, and tailoring interventions to subgroup-specific needs are key priorities. Inclusive, equity-driven, and person-centered nutrition care is essential to closing health gaps for LGBT+ populations and ensuring that every patient receives guidance that affirms their identity and lived experience. Full article

Gender dysphoria stems from incongruence between gender identity and assigned sex, often causing significant distress related to breast anatomy in transmasculine individuals. Gender-affirming hormone therapy typically precedes mastectomy, which is a fundamental intervention in transgender healthcare. Surgical challenges arise in patients with large breasts on lean frames, requiring customized techniques to achieve a natural, proportional, androgynous chest. This case report describes a 23-year-old transmasculine patient with macromastia and a tall, lean build who underwent gender-affirming mastectomy with free nipple grafts and muscular sculpture aimed at an androgynous esthetic. Pre- and postoperative evaluations showed marked improvements in body image, physical strength performance, and emotional well-being. Psychological assessments revealed significant reductions in body uneasiness and gender dysphoria, while human figure drawings demonstrated increasing bodily integration and identity congruence. A general improvement in physical performance over time was reported, particularly in upper body strength, with minor fluctuations potentially related to the surgical intervention and recovery phase. The narrative literature review supports these outcomes, highlighting satisfaction rates above 90%, minimal regret, and consistent gains in psychosocial functioning and sexual and mental health, including reduced anxiety and depression. This evidence reinforces that gender-affirming mastectomy is medically necessary, particularly when tailored to individual anatomical and esthetic needs, affirming identity and alleviating distress. Full article

The persistence of a binary biomedical framework in healthcare has become increasingly inadequate to address the realities of human diversity. Recent literature highlights how this dichotomous model reinforces inequities for transgender and intersex populations, sustaining barriers to access, stigmatisation, and poorer health outcomes. In this Perspective, I critically reflect on the limitations of the binary paradigm and draw on developments in science, clinical practice, education, and policy to propose a future-oriented approach to health equity. Emerging evidence underscores the complexity of sexual development as a spectrum and the urgent need to move from pathological frameworks toward affirming care based on rights. Key advances include the adoption of affirmative care models, reforms in medical curriculum, and the rise of inclusive research methodologies that capture gender diversity beyond binaries. However, structural barriers—such as rigid clinical protocols, outdated educational content, and insufficient policy alignment—continue to hinder meaningful change. This article advocates for systemic transformation in healthcare education, practice, and research. I outline strategic priorities for the field are the implementation of gender diversity in medical training, the implementation of rights-based clinical guidelines, and the design of inclusive methodologies that remove structural discrimination. These actions are essential to build a more precise, ethical and universally inclusive health system. Ultimately, ensuring sustainable and equitable outcomes requires bridging scientific innovation with human rights principles and focussing on the lived experiences of transgender and intersex individuals. Full article

Personal identity is a multidimensional, universal, and ever-developing construct that forms primarily during youth. One domain of identity—gender—manifests quite clearly in terms of developmental course and psychosocial components in the lives of transgender individuals. Members of this population often initiate various social and medical transitions to rework their gendered characteristics to align more authentically with their internal selves. Consequently, healthcare and social service professionals express growing interest in facilitating and fostering the psychological health of transgender youth. Rather than focus on adversity (e.g., depression, suicidality, mental illness), the current study addresses this concern by describing positive components of the gender identity of 120 transmasculine youth participants. To this end, we operationalized gender identity health through three overarching constructs: developmental process, psychological functioning, and the positive outcomes of being a transgender person. Further, we investigate how these components interrelate, plus compare responses by age and gender identity cohorts. For age, we compared adolescent responses to the identity measures to those of transgender emerging adults (n = 166; 20–29 years) and adults (n = 53; 30–39 years). For gender, we partitioned the adolescent participants into binary (n = 91) versus non-binary (n = 29) identities. The descriptive results demonstrated that identity is reasonably developed, functional, and positive in this adolescent sample. Moreover, the three hypothetical components of transgender identity demonstrated modest overlap with each other. The youth did not differ in identity development, functionality, or positivity compared to older cohorts. Binary transmen scored slightly higher on gender authenticity and commitment than their non-binary transmasculine counterparts, but the two gender groups were the same on the other identity components. We discuss some practical implications of these findings as focus areas for healthcare providers and support systems to continue to foster healthy identity development. Full article

Background: The Gender Variance Scale (GVS) was developed to assess self-perceived masculinity and femininity across diverse gender identities, including binary and non-binary experiences. To date, no validated Italian version was available. Methods: A total of 356 participants (192 transgender and gender-diverse [TGD], 164 cisgender) completed the Italian GVS and the SF-12 Health Survey. Translation and cultural adaptation followed international guidelines. Psychometric evaluation included confirmatory factor analysis (CFA), internal consistency, test–retest reliability (n = 63), convergent validity with health-related quality of life, and group comparisons across gender identity categories. Results: CFA supported the original two-factor model (CFI = 0.916, TLI = 0.905, RMSEA = 0.076, SRMR = 0.053). Internal consistency was high (α = 0.89). The GVS distinguished between gender identity groups: TGD participants scored higher than cisgender peers, and non-binary individuals reported significantly lower scores than both binary groups. Test–retest reliability was strong (r = 0.87–0.99; ICC = 0.992–0.996). Conclusions: The Italian GVS is a valid and reliable measure of gender variance. It provides clinicians, researchers, and educators with a culturally appropriate tool to assess gender expression and support inclusive practices in both community and clinical contexts. Full article

Adverse childhood experiences (ACEs) are critical determinants of long-term psychological and physiological health outcomes. Transgender and gender nonconforming (TGNC) individuals are at increased risk for ACEs, including family rejection, peer victimization, and systemic discrimination. Despite the growing body of research on this topic, an updated synthesis of recent literature is needed to understand the evolving landscape of ACE-related risks and protective factors in TGNC populations. This systematic review, conducted according to PRISMA guidelines, examined studies published between 2020 and 2024 that were related to the association between ACEs and mental health outcomes in TGNC individuals. A comprehensive database search yielded 6124 articles, 42 of which met the inclusion criteria. Data extraction focused on the type of ACEs reported, associated mental health outcomes, resilience factors, and clinical implications. The results showed that TGNC individuals are significantly more likely to experience childhood maltreatment, including emotional, physical, and sexual abuse, as well as transphobia-specific ACEs such as forced gender conformity and identity denial. These experiences are associated with an increased risk of depression, PTSD, suicidality, and substance use disorders. Family rejection was found to be a critical risk factor, while social support, gender-specific care, and self-efficacy showed protective effects. The reviewed studies emphasize the urgent need for trauma-informed and gender-affirming mental health interventions to mitigate the effects of ACEs on TGNC individuals. Limitations and future research directions are discussed. Full article

LGBTQ+ individuals face substance use disparities linked to minority stress. While community belongingness may buffer stress, its role is complex. This study examined divergent associations between belongingness within the LGBTQ+ community and lifetime illicit drug use versus past-year alcohol frequency among LGBTQ+ adults in Kentucky (n = 2953), a region with notably high rates of substance use. Methods: Cross-sectional online survey data were analyzed. We measured LGBTQ+ belongingness, lifetime use of cocaine/crack/heroin/methamphetamine, and past-year alcohol frequency. Logistic and linear regressions controlled for age, education, gender identity, and income. Results: Greater belongingness predicted significantly higher odds of lifetime illicit drug use (OR = 1.24) but lower past-year alcohol consumption frequency (B = −0.094). Transgender and gender expansive identity predicted significantly higher illicit drug use odds and higher alcohol frequency. Conclusions: In this Kentucky sample, LGBTQ+ belongingness showed divergent substance use associations: it was protective against frequent alcohol use but, unexpectedly, was associated with higher odds of lifetime illicit drug use. Findings highlight belongingness’s complex, context-dependent nature and the need for nuanced research and interventions considering substance type and specific vulnerabilities, particularly for TGE individuals. Full article

Gender-neutral terms such as “sex work” and “sex worker” have gained prominence in academic, activist, and policy discourses. Unlike terms such as ‘prostitutes’ and ‘prostitution,’ these terms serve to reduce stigma and emphasize the labor involved in sex work. However, numerous studies suggest that these terms carry different meanings across cultural contexts, and their impact is experienced differently by various sub-groups of sex workers. Although originally coined by American activist Carol Leigh to unify sex workers across genders and sectors, these terms are, in some settings—including Kolkata, India—met with silence, coded language, or secrecy, particularly among transient sex workers, including cisgender and transgender women. As researchers with two decades of ethnographic research with 46 cisgender and 37 transgender women engaged in sex work in Kolkata and Eastern India, the authors argue that such silence and non-verbal forms of communication should not be interpreted merely as ignorance or disengagement but rather as strategic/willful acts of agency or resistance. These practices enable sex workers situated in different contexts to navigate unequal power dynamics within NGOs, manage respectability, mitigate structural violence, and foster communal identity. By examining how diverse groups of sex workers employ silence and secrecy, this study contributes to a more nuanced and empathetic understanding of the complexities surrounding the former’s lives and their agency. The study results indicate that it is essential for scholars, advocates and activists to employ strengths-based, context-specific language and research practices to be able to hear the stories of subaltern groups like commercial sex workers. It is also suggested that training of service providers and helping professionals focus on accepting and honoring the language people use to identify themselves in varied spaces and contexts. Full article

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

HIV disproportionately affects key populations (MSM, transgender people, sex workers and psychoactive substance users), who face greater social vulnerability and limited healthcare access. This study aimed at analyzing sexual orientation and gender identity and their association with sexual practices, sexually transmitted infections and psychoactive substance use among PrEP users. Method: A cross-sectional study was conducted between January 2018 and June 2021 with 736 Brazilian PrEP users from a health service in São Paulo. Sociodemographic data, sexual behaviors, STI history (past 3 months) and psychoactive substances use (past 3 months) were extracted from clinical records. The associations were analyzed using binomial logistic regression (p < 0.05). Results: Most of the participants were cisgender men (93.4%) and homosexual (84.8%), with a mean age of 34.9 years old. Condomless sex was reported by 98.5%, and 18.4% had some recent sexually transmitted infection, mainly syphilis. Psychoactive substance use was reported by 55.4%, especially marijuana, club drugs, erectile stimulants and poppers. Transgender and cisgender women were more likely to report sex work and crack use. Homosexual and bisexual participants had higher odds of using erectile stimulants. Conclusions: The study reveals key links between gender, sexual orientation and risk behaviors, highlighting the need for inclusive, targeted prevention. Full article

There has been a growing trend of young people coming out as Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) in recent years. Research on the relationship between LGBTQ grandchildren and their grandparents is limited and primarily focuses on the grandchildren’s perspective. This pilot study seeks to understand the relationship between grandparents and their LGBT grandchildren, from the grandparents’ perspective. Six Israeli grandparents were interviewed using a qualitative methodology, guided by a semi-structured interview protocol. Analysis of the interviews revealed three main themes: grandparents’ exposure to the grandchildren’s sexual orientation and their gender identity; the shattering of the grandparents’ dream and concern for the grandchild; and the relations between the grandparents and their LGBT grandchildren. The research findings in this pilot study indicate that the relations remained close and did not change following disclosure of the sexual orientation. However, some grandparents needed time to resume their regular relationship. The insights learned from the research findings regarding the process undergone by the grandparents upon discovering their grandchildren’s sexual orientation can help professionals treat and counsel family members, when necessary, how to bridge the gaps, and rebuild the relations between the grandparent and the grandchild, as these relations are important for the well-being of both. Full article

This paper presents the development and validation of the Transgender Health, Resilience, Inner Well-Being, Vitality, and Empowerment (THRIVE) Scale. It offers insights into the well-being of transgender and gender-diverse (TGD) individuals, by considering their unique experiences and challenges. TGD individuals often experience significant health disparities, including mental health issues, substance abuse, physical health problems, and difficulty with providers knowing about their needs. A comprehensive quality-of-life assessment could aid in identifying contributions to poor quality of life (QOL) and knowing which resources are needed to address this effectively. Assessments attempting to address these challenges often have not been studied adequately and/or have limitations of being for one-time use, surgery-focused, lengthy, emotionally taxing, and not inclusive of non-binary individuals’ specific needs. Validated among a sample of TGD individuals (N = 61), the THRIVE scale displayed good internal consistency reliability (α = 0.87), as well as convergent and divergent validity. It had significant negative correlations with measures of psychological symptoms and identity distress and positive correlations with measures of life satisfaction and well-being. The THRIVE scale represents a critical advancement in assessing the QOL of TGD individuals and could be an effective tool for individualized care, research, and conversation with these populations. Full article