Search Results (85)

Existing research highlights that Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) teachers are often exposed to additional stressors in schools which adversely affect their mental health. Some mitigate the effects of these stressors by separating their personal and professional identities while others choose to integrate their identities so that they can be authentic, advance social justice in school contexts or be visible and vocal role models. Less is known about the experiences of pre-service teachers who are undertaking teacher preparation programmes. This systematic literature review presents the results of 20 published papers which represent the global experiences of both pre-service teachers and serving teachers. The findings highlight identity management, experiences of discrimination, agency and lack of confidence of teacher educators. Two new frameworks are presented that lay the foundations for embedding LGBTQ+ inclusion and proposed mandatory elements of curricula for initial teacher training. This systematic literature review has been informed by the following research questions RQ1. What are the experiences of LGBTQ+ pre-service teachers? RQ2. How do LGBTQ+ pre-service teachers negotiate their identities? RQ3. How do LGBTQ+ pre-service teachers disrupt hetero/cis-normative cultures in schools? RQ4: How well does the teacher education programme prepare pre-service teachers for teaching LGBTQ+ inclusive education? Full article

Background/Objectives: Assigned female at birth (AFAB) individuals who identify as transgender or gender-diverse (TGD) with concurrent breast cancer or high-risk genetic mutations represent a unique population, requiring consideration of oncologic and aesthetic goals. These patients sought chest masculinization with oncologic gender-affirming mastectomy (OGAM) or non-binary reconstruction to alleviate gender dysphoria and treat their breast cancer. There is limited literature on surgical techniques in this patient population. Methods: A retrospective chart review of AFAB TGD adults (>18 years of age) who underwent OGAM or non-binary reconstruction at the University of Washington between 2019 and 2023 was conducted. All patients had a consultation with a plastic surgeon for reconstruction and a minimum of one year follow-up. Demographic data, oncologic status, post-operative complications, and revision surgical history were collected. Results: Eight AFAB TGD individuals met the inclusion criteria. The mean age at the time of mastectomy was 35.13 years (SD = 8.04), and the mean BMI was 29.88 (SD = 6.40). Indications for mastectomy included a breast cancer diagnosis (N = 4) or a strong family history of breast cancer or genetic predisposition (N = 4). Two (25%) patients underwent nipple-sparing mastectomies (NSM), two patients (25%) underwent skin-sparing mastectomy with Goldilocks reconstruction, and four patients (50%) underwent simple mastectomy (oncologic gender-affirming mastectomy), flat closure with free nipple graft (FNG). Two patients had staged nipple mastectomy with secondary nipple reduction and fat grafting. Six patients had immediate reconstruction, four (50%) patients underwent immediate double-incision OGAM with FNG, and two (25%) patients underwent Goldilocks procedures—one with and one without FNG. One patient (12.5%) experienced a surgical site infection, and three patients (37.5%) underwent revision surgery. No patients had positive margins following their mastectomy. Conclusions: This case series highlights the importance of a multidisciplinary and highly personalized approach for AFAB and TGD individuals undergoing oncologic gender-affirming mastectomy or non-binary reconstruction. We reviewed reconstructive options performed at our institution, demonstrating safe oncologic and reconstructive techniques that emphasized collaboration between breast and plastic surgeons. Full article

This study examines how societal heteronormative norms influence interactions involving transgender individuals, offering insights into identity formation and mental health. Understanding how societal heteronormative norms shape interactions involving transgender individuals is crucial to the attainment of public health goals related to addressing societal barriers, such as stigma, and promoting mental health. Interviews were conducted at a university in the Southwest United States with 11 self-identified transgender individuals, focusing on three main questions: How do you feel when you interact with someone who does not conform to heteronormative gender roles? When you meet somebody who doesn’t conform to heteronormative gender roles does that cause you to question your own gender identity. Does your body have to match your gender identity? Directed content analysis revealed a divided phenomenon. While some participants experienced discomfort due to societal scrutiny, safety issues concerns, and heightened visibility, others found empowerment and validation in these interactions, affirming their identities and fostering a sense of belonging. Yet another finding pointed to the role of embodiment and lived experiences, highlighting contrasting views on body harmony congruence: some participants prioritized physical alignment for societal acceptance, while others valued internal authenticity over external validation. This underscores the tension between personal agency and societal expectations in shaping gender identity. The study contributes to transidentity-theoretical literature by addressing the diverse outcomes resulting from the copresence of discomfort versus empowerment, internalized stigma, and the interplay of self-perception with societal norms. Clinical implications point to the need for inclusive spaces, supportive interventions, and mental health resources to assist trans individuals in navigating these challenges. Full article

Background/Objectives: Bias-based bullying is widely recognised as having a detrimental impact on child and adolescent health. One form of bias-based bullying that is directed at transgender and non-binary students more specifically is misnaming, whereby someone is referred to by their birth name rather than their chosen name. While there have been some studies exploring the experiences of young LGBTQ+ people’s experiences of bias-based bullying, and a number looking at misnaming more specifically, there has been very little research on the issue in the Swedish school context. The aim of this study is to address this lacuna in knowledge by focusing on LGBTQ+ students’ experiences of misnaming in Swedish schools. Methods: The findings are based on 21 semi-structured interviews with LGBTQ+ young people aged 15–25 from around Sweden. The interviews were analysed with reflexive thematic analysis and in relation to the concepts of orientations and affect. Results: The findings highlight how misnaming negatively impacts the health of those who are subjected to it through disorientation and by triggering negative emotions such as anger, sadness, anxiety, and hurt. The findings also illustrate how the affects of misnaming extend beyond individuals and accumulate as collective emotional experiences that negatively transform schools into sites of personal and social tension. Conclusions: The article demonstrates not only the importance of recognising misnaming as a pernicious form of bias-based bullying that negatively impacts the health of students, but also the need for schools to actively review their administrative systems to ensure that misnaming is not institutionalised and perpetuated within schools. 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

The high HIV prevalence among men who have sex with men and transgender women (TW) in Peru calls for innovative HIV prevention strategies to modify social norms, increase social support and promote empowerment and community mobilization. This qualitative article presents the synergistic processes that generated community mobilization throughout Generación Actual (GA, Current Generation in English), an HIV prevention intervention with gay men (GM) and TW in Lima South based on Mpowerment, a U.S.-model intervention program. We conducted 24 interviews with GM and TW participants, informed by observations of GA and the perceptions of its implementing coordinators, and complemented by the number/types of GA activities. Four significant processes occurred throughout GA: (1) high participant engagement, community building and empowerment; (2) an effect on HIV prevention and treatment; (3) the integration of GM and TW and (4) GA’s community center becoming a safe space for socializing, support and information. These processes helped produce positive changes related to self-empowerment, personal agency and the participants’ health, suggesting an impact of GA on HIV prevention, stigma reduction and care engagement. Community mobilization strategies that ensure active community participation and involvement may constitute relevant aspects for an effective approach to HIV prevention for TW and GM in Peru. Full article

Institutional violence against transgender individuals in healthcare is a structural phenomenon with multifactorial roots and is embedded in social, cultural, political, and economic dynamics. Drawing on Michel Foucault’s concept of the microphysics of power, this study analyzes how such violence unfolds within Brazil’s healthcare system. For Foucault, power is not solely exercised through centralized institutions but is diffuse and present in everyday practices, relationships, and discourses. Institutional violence, while often manifesting in individual acts, is defined by its persistence and systematic occurrence over time. In healthcare settings, this violence assumes symbolic, structural, psychological, and physical forms ranging from neglect and verbal abuse to sexual violence. Foucault’s framework allows for a deeper understanding of how power relations perpetuate exclusionary and dehumanizing practices. By interpreting these dynamics through the Microphysics of Power, the study reveals that institutional violence against transgender individuals extends beyond explicit acts, encompassing routine interactions that reproduce inequality and restrict access to fundamental rights such as healthcare. These practices sustain a logic of control and exclusion that operates subtly but effectively within healthcare systems, reinforcing the marginalization of trans people and undermining their right to dignified and equitable care. 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

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

Telemedicine has transformed obstetrics and gynecology (OB/GYN), accelerated by the COVID-19 pandemic. This study aims to synthesize evidence on the adoption, effectiveness, barriers, and technological innovations of telemedicine in OB/GYN across diverse healthcare settings. This scoping review synthesized 63 peer-reviewed studies (2010–2023) using PRISMA-ScR guidelines to map global applications, outcomes, and challenges. Key modalities included synchronous consultations, remote monitoring, AI-assisted triage, tele-supervision, and asynchronous communication. Results demonstrated improved access to routine care and mental health support, with outcomes for low-risk pregnancies comparable to in-person services. Adoption surged >500% during pandemic peaks, stabilizing at 9–12% of services in high-income countries. However, significant disparities persisted: 43% of rural Sub-Saharan clinics lacked stable internet, while socioeconomic, linguistic, and cultural barriers disproportionately affected vulnerable populations (e.g., non-English-speaking, transgender, and refugee patients). Providers reported utility but also screen fatigue (41–68%) and diagnostic uncertainty. Critical barriers included fragmented policies, reimbursement variability, data privacy concerns, and limited evidence from conflict-affected regions. Sustainable integration requires equity-centered design, robust policy frameworks, rigorous longitudinal evaluation, and ethically validated AI to address clinical complexity and systemic gaps. Full article

Purpose: This paper examines the differences between transgender persons who self-identify as bisexual (n = 4129) and those who self-identify as pansexual (n = 5056) when it comes to experiencing anti-transgender harassment, discrimination, and violence, serious psychological distress, and suicidal ideation. Methods: Data from the 2015 U.S. National Transgender Survey were used to evaluate the differences between bisexual and pansexual persons in a sample of transgender Americans aged 18 or older. The Kessler-6 scale assessed psychological distress, and a dichotomous measure of past-year suicidal ideation was used. A 20-item scale assessed the extent to which people experienced anti-transgender harassment, discrimination, and violence. Multivariate analysis and structural equation analysis were used to analyze the data. Results: Compared to their bisexual counterparts, pansexual persons experienced more anti-transgender harassment, discrimination, and violence, were more likely to experience serious psychological distress, and were more likely to report suicidal ideation. A structural equation analysis revealed that the bisexual–pansexual distinction is important when understanding transgender persons’ likelihood of experiencing suicidal ideation. It operates indirectly through its direct impact on the number of anti-transgender experiences incurred. Conclusions: Pansexual individuals fare more poorly than their bisexual counterparts on measures of anti-transgender experiences, serious psychological distress, and suicidal ideation. The bisexual–pansexual distinction is a meaningful one when trying to understand the transgender persons’ odds of thinking about dying by suicide. 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

Introduction: This study aimed to better understand patient-reported human papillomavirus (HPV) vaccination rates and barriers to vaccination among transgender patients receiving care at a gender-affirming clinic in urban New York. Methods: All patients with arrived appointments at the Center for Transgender Care at Northwell Health from 1 January 2020 through 14 July 2021, aged 14 and up, were invited to participate. Participants were sent an online consent form followed by a survey that assessed HPV knowledge, personal vaccination history, and reasons for or against vaccination. Data were collected in RedCap and analyzed using descriptive and basic inferential statistics. We received 79 completed consent forms and 70 completed surveys. Results: At least 68 of the 70 participants identified as transgender or gender diverse. Only 61.4% (43/70) of participants reported ever being offered the HPV vaccine and 55.7% (39/70) reported ever receiving at least one dose. Common reasons in favor of vaccination included doctor recommendation and decreasing cancer risk. Common reasons mentioned against HPV vaccination included sexual inactivity, concern over side effects, and assumption of low-risk HPV status. Of unvaccinated participants, 58.1% (18/31) reported they were more likely to get vaccinated after completing the survey. Conclusions: The HPV vaccination rate in this study was higher than the rates seen in previous studies involving sexual and gender minority participants. Provider recommendation was found to be important in promoting vaccination. 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