Search Results (482)

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

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

Adult entertainment work may be associated with increased vulnerability to sexually transmitted infections, particularly HIV. In Brazil, pre-exposure prophylaxis (PrEP) for HIV infection has been available through the Brazilian Unified Health System (SUS) since November 2017, representing a significant advancement in public sexual health policy. The objective of this study was to understand the individual and social determinants that promote PrEP use among adult entertainment workers. This was a cross-sectional, analytical, and quantitative study. A multivariate modeling approach was employed to identify factors independently associated with PrEP use. The study included 254 adult entertainment workers using oral PrEP through the SUS, predominantly young adults (141; 55.5%), SUS users (248; 97.6%), single (213; 83.9%), non-white (142; 55.9%), cisgender (148; 58.3%), and heterosexual (152; 59.8%). Factors independently associated with greater PrEP use included having adult entertainment as the main source of income (aPR: 2.69; 95% CI: 1.86–3.95), prior use of PEP (aPR: 2.49; 95% CI: 1.63–3.81), undergoing any type of health treatment (aPR: 1.56; 95% CI: 1.15–2.12), and having a history of STIs (aPR: 1.51; 95% CI: 1.10–2.08). Conclusion: PrEP use in this population was strongly influenced by structural and contextual factors, indicating that the availability of the technology alone does not ensure its effectiveness. Full article

Background: Gender dysphoria refers to the psychological distress arising from a mismatch between an individual’s physical embodiment and their internal sense of gender. Gender-affirming mastectomies can be a pivotal component of gender affirmation for transgender, non-binary, and gender expansive individuals assigned female at birth. The impact of obesity on the outcomes of gender-affirming mastectomies has yet to be fully defined. Methods: A retrospective review of 205 gender-affirming mastectomies performed by the senior author was conducted. Patients were categorized into obese (BMI ≥ 30) and non-obese groups. Baseline characteristics, intraoperative variables, and complication rates were compared. Univariate and multivariate models were performed to evaluate the association between obesity and postoperative complications. Results: Obese patients had higher mean resection weights and liposuction volumes (p < 0.001). Significant differences were observed in the prevalence of fibromyalgia, prior chest surgeries, and hormone therapy usage (p = 0.002, 0.002, and 0.03, respectively). However, no statistically significant differences were found in overall complication rates between obese and non-obese groups in the univariate or multivariate analyses. Conclusions: Our study suggests that obesity is not a significant risk factor for complications in gender-affirming mastectomies patients. The varying impact of high BMI and obesity on surgical outcomes in different surgical fields highlights the importance of patient-centered care and a holistic and individual approach for each patient. 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

Background: Teen dating violence (TDV) is a serious public health concern, with sexual and gender minority youth (SGMY) at elevated risk due to minority stress and systemic inequalities. This systematic review examines individual, relational, and contextual risk factors for TDV among SGMY. Methods: A systematic search was conducted in Scopus, Web of Science, and APA PsycInfo on 10 December 2024. Studies published between 2014 and 2024 focusing on teen dating violence (TDV) as an outcome among sexual and gender minority youth (SGMY) aged 13–19 were included. Study selection was independently performed by multiple reviewers using Rayyan. Risk of bias was assessed using the JBI Critical Appraisal Tools. Due to heterogeneity in the study design and measurement tools, a narrative synthesis was conducted. Results: Six risk domains emerged: (1) Demographic/Identity (e.g., gender, orientation, or race); (2) Psychological/Behavioral (e.g., distress or substance use); (3) Violence/Bullying (e.g., cyberbullying or exclusion); (4) Family/Sexual Abuse (e.g., family rejection); (5) Relational/Social (e.g., partner outing); and (6) School/Community (e.g., non-inclusive environments). Bisexual, pansexual, transgender, and racialized youth showed heightened vulnerability. Most studies were conducted in the USA and relied on non-validated TDV measures and cross-sectional designs, limiting comparability and causal inference. Conclusions: SGMY face unique, often overlooked TDV risks. There is a need for intersectional, longitudinal research and inclusive, developmentally appropriate prevention efforts that address both relational and structural factors. This review received no external funding and was not registered. Full article

Introduction: Access of transgender and gender diverse (TGD) youth to gender-affirming medical care (GAMC) has become a contentious topic in the West, with many members of the general population, politicians, and even some experts and academic researchers voicing concerns about possible adverse effects of GAMC on the mental and physical health of TGD youth. Due to these concerns, recent years have seen a significant rise in legislation restricting TGD youth from accessing GAMC in countries such as the United States, the United Kingdom, and Canada. However, in this critical review of the literature on the psychological (e.g., anxiety, depression, suicide, and body satisfaction) and physical (e.g., bone health, cognitive function, and fertility) health outcomes associated with GAMC among TGD youth, we argue that, given the state of current research, youth should not be restricted from accessing GAMC. Conclusions: Our findings reinforce the importance of close monitoring by doctors, counselling for TGD youth with respect to potential risks, and increased studies on the topic, especially those focusing on reproductive health. Full article

We aim to provide a translational model to investigate the reproductive consequences of pubertal delay using the GnRH agonist triptorelin in transgender girls, tested in particular on testicular maturation in peripubertal rats. A total of 30 Sprague Dawley rats were utilized, with 10 subjects assigned to each of three groups from day P30 postpartum (prepubertal) until day P95 (postpubertal), mimicking treatment timing in patients. Rats received triptorelin at three time points (P30, P50, and P71), or only at P30 and P50. Control rats were injected with vehicle. Plasma testosterone levels were determined using MRM analysis. Testes and epididymides were examined histologically. There were significantly lower testosterone levels at postnatal day 48 in treated rats, indicating delayed puberty, with further reductions by day 69. By day 93, testosterone levels had recovered in rats given vehicle at P71 but remained low in the triptorelin-continuous group, suggesting the reversibility of the treatment. Treated rats had smaller testes; however, the majority of the testicular parenchyma was unaffected, with most seminiferous tubules displaying complete spermatogenesis. However, focal atrophic changes were observed in 1–30% of the parenchyma. One-third of the short-term group and half of the long-term group were classified as atrophic. Despite these changes, all treated rats had mature sperm in the epididymis, ensuring their fertility. In conclusion, triptorelin treatment promotes a decline in testosterone levels accompanied by discrete atrophy of the seminiferous tubules, which is partially reversible and compatible with sperm production and fertility preservation. Triptorelin could be an appropriate treatment prior to estrogen therapy for patients seeking gender transition. 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

This study examines the trends, impacts, and challenges of HIV in Bangladesh from 2000 to 2024, with a focus on its epidemiology, demographic distribution, and socioeconomic determinants. Despite maintaining one of the lowest HIV prevalence rates globally (<0.1%), Bangladesh faces a concentrated epidemic among high-risk populations, including people who inject drugs (PWID), men who have sex with men (MSM), sex workers, transgender individuals, and migrant workers. Analysis reveals a steady increase in reported infections, attributed to enhanced diagnostic capacities and public awareness. The 25–49 year age group remains the most affected, accounting for over 65% of cases, underscoring the vulnerability of the economically active population. Gender disparities persist, with males representing the majority of infections but lower ART coverage among females and transgender individuals. While interventions such as PMTCT programs, ART expansion, and targeted awareness campaigns have contributed to improved outcomes, barriers such as stigma, healthcare inequities, and limited rural access hinder progress. The study also evaluates Bangladesh’s progress toward the 95-95-95 targets, highlighting significant strides in treatment and viral suppression but gaps in diagnosis. Future research must address behavioral trends, stigma reduction, and integration of HIV services for marginalized populations. This paper emphasizes the need for evidence-based strategies to ensure equitable healthcare delivery and sustainable progress in combating HIV. Full article