This document discusses enhancing health care for transgender individuals. It begins by outlining some of the health issues transgender people face, such as discrimination, lack of access to care, and high HIV rates. It then discusses challenges to care like insensitivity from providers and lack of coverage for transition-related needs. Finally, it proposes strategies to improve care, such as acknowledging transgender identities, advocating for research and innovation, and limiting unnecessary surgeries on intersex infants. The overall goal is to make health care more culturally sensitive and address the actual needs of transgender communities.
Transgender Identity And HIV : Resilience In The Face Of StigmaSanté des trans
Il s'agit d'un article de Walter Bockting, publié en 2008 dans Focus, une publication du AIDS Health Project, affilié à l'University of California, San Francisco.
Transgender Health : Findings From Two Needs Assessment Studies In PhiladelphiaSanté des trans
Transgender Health: Findings from Two Needs Assessment Studies in Philadelphia.
Il s'agit d'un article de Gretchen P. Kenagy, paru dans la revue Health and Social Work (volume: 30. Issue: 1) en 2005.
Il présente les résultats de deux enquêtes de recueil des besoins des trans en matière de santé à Philadelphie.
Transgender Female Youth And Sex Work HIV Risk And A Comparison Of Life Facto...Santé des trans
This study examined factors associated with engagement in sex work among 151 transgender female youth ages 15-24 in Los Angeles and Chicago. The researchers found that 67% had engaged in sex work and 19% self-reported being HIV positive. Lower education, homelessness, street drug use, and lower perceived social support were significantly associated with sex work when controlling for other factors. The findings suggest a need for research on sex work initiation and HIV prevention programs that address the complex individual, social, and community challenges faced by transgender female youth.
Transgender Clients : We Need Effective Care Too!Santé des trans
Il s'agit d'une présentation powerpoint de la Directrice du Center of excellence for transgender HIV prevention de l'UCSF, qui passe en revue l'ensemble des enjeux liés à l'épidémie de sida parmi les trans, ainsi que les déterminants de santé globaux. Date inconnue.
Plan de l'intervention
Getting on the Same Page:
Establishing a Common Language
What Are the Facts?
What is the HIV Prevalence among Trans People in the US?
Effects of Stigma & Discrimination on Trans Communities
What are the Barriers and Challenges?
What Are We Going To Do?
Addressing Transphobia
Action Steps & Recommendations
Where do we go for help?
This chapter provides a literature review of previous research on Hijra communities. One study used ethnographic research to show that Hijras in Bangladesh live in extreme social exclusion without recognition as a separate gender beyond the male-female binary. This social exclusion damages their self-esteem and prevents effective safer sex interventions. Another study examined how Hijras are excluded from schools, families, work and social institutions their whole lives, putting them at risk for risky sexual behaviors due to limited access to information and resources. The literature recommends addressing structural exclusion of Hijras and working with mainstream society, policymakers and civil society to create an environment where Hijras can live fulfilling lives on equal footing with men and women.
This presentation provides an overview of gender identity and the transgender community. It begins with key definitions such as gender identity, transgender, and cisgender. It then discusses the importance of self-acceptance for transgender individuals and the role of support groups. Major challenges faced by the transgender community are outlined, including discrimination, violence, and lack of access to healthcare and other resources. Health issues like higher rates of suicide and substance abuse are also summarized. Finally, several solutions are presented, such as improving education, healthcare training, advocacy, and implementing inclusive policies to reduce stigma and discrimination.
Using ethnography to generate culturally based interventions_schensul_5.3.12CORE Group
The document describes how ethnography was used to inform culturally-based interventions in India. It summarizes how ethnographic research identified key cultural concepts in local communities, such as "gupt rog" among men and "safed pani" among women, which were used as entry points for public health programs. Focusing on these emic perspectives allowed the design of interventions that were salient, engaged community participation, and had potential for sustainability.
Trans 101, Know Your Chicago 2014; Transitioning: Challenging Our Understandi...Graham_School
This document provides information about an organization that provides services to transgender and gender non-conforming individuals, including a TransLife Center, TransHealth, TransHousing, TransSafe, TransLegal, and TransWorks. It discusses definitions of terms like transgender, transition, and cisgender. It also summarizes research on challenges facing the transgender community like higher rates of poverty, violence, suicide attempts, and HIV infection. The document provides best practices for inclusive and affirming services, including using preferred names and pronouns and avoiding inappropriate questions.
Transgender Identity And HIV : Resilience In The Face Of StigmaSanté des trans
Il s'agit d'un article de Walter Bockting, publié en 2008 dans Focus, une publication du AIDS Health Project, affilié à l'University of California, San Francisco.
Transgender Health : Findings From Two Needs Assessment Studies In PhiladelphiaSanté des trans
Transgender Health: Findings from Two Needs Assessment Studies in Philadelphia.
Il s'agit d'un article de Gretchen P. Kenagy, paru dans la revue Health and Social Work (volume: 30. Issue: 1) en 2005.
Il présente les résultats de deux enquêtes de recueil des besoins des trans en matière de santé à Philadelphie.
Transgender Female Youth And Sex Work HIV Risk And A Comparison Of Life Facto...Santé des trans
This study examined factors associated with engagement in sex work among 151 transgender female youth ages 15-24 in Los Angeles and Chicago. The researchers found that 67% had engaged in sex work and 19% self-reported being HIV positive. Lower education, homelessness, street drug use, and lower perceived social support were significantly associated with sex work when controlling for other factors. The findings suggest a need for research on sex work initiation and HIV prevention programs that address the complex individual, social, and community challenges faced by transgender female youth.
Transgender Clients : We Need Effective Care Too!Santé des trans
Il s'agit d'une présentation powerpoint de la Directrice du Center of excellence for transgender HIV prevention de l'UCSF, qui passe en revue l'ensemble des enjeux liés à l'épidémie de sida parmi les trans, ainsi que les déterminants de santé globaux. Date inconnue.
Plan de l'intervention
Getting on the Same Page:
Establishing a Common Language
What Are the Facts?
What is the HIV Prevalence among Trans People in the US?
Effects of Stigma & Discrimination on Trans Communities
What are the Barriers and Challenges?
What Are We Going To Do?
Addressing Transphobia
Action Steps & Recommendations
Where do we go for help?
This chapter provides a literature review of previous research on Hijra communities. One study used ethnographic research to show that Hijras in Bangladesh live in extreme social exclusion without recognition as a separate gender beyond the male-female binary. This social exclusion damages their self-esteem and prevents effective safer sex interventions. Another study examined how Hijras are excluded from schools, families, work and social institutions their whole lives, putting them at risk for risky sexual behaviors due to limited access to information and resources. The literature recommends addressing structural exclusion of Hijras and working with mainstream society, policymakers and civil society to create an environment where Hijras can live fulfilling lives on equal footing with men and women.
This presentation provides an overview of gender identity and the transgender community. It begins with key definitions such as gender identity, transgender, and cisgender. It then discusses the importance of self-acceptance for transgender individuals and the role of support groups. Major challenges faced by the transgender community are outlined, including discrimination, violence, and lack of access to healthcare and other resources. Health issues like higher rates of suicide and substance abuse are also summarized. Finally, several solutions are presented, such as improving education, healthcare training, advocacy, and implementing inclusive policies to reduce stigma and discrimination.
Using ethnography to generate culturally based interventions_schensul_5.3.12CORE Group
The document describes how ethnography was used to inform culturally-based interventions in India. It summarizes how ethnographic research identified key cultural concepts in local communities, such as "gupt rog" among men and "safed pani" among women, which were used as entry points for public health programs. Focusing on these emic perspectives allowed the design of interventions that were salient, engaged community participation, and had potential for sustainability.
Trans 101, Know Your Chicago 2014; Transitioning: Challenging Our Understandi...Graham_School
This document provides information about an organization that provides services to transgender and gender non-conforming individuals, including a TransLife Center, TransHealth, TransHousing, TransSafe, TransLegal, and TransWorks. It discusses definitions of terms like transgender, transition, and cisgender. It also summarizes research on challenges facing the transgender community like higher rates of poverty, violence, suicide attempts, and HIV infection. The document provides best practices for inclusive and affirming services, including using preferred names and pronouns and avoiding inappropriate questions.
Four Steps to Providing Health Care to Transgendered PeopleCésar E. Concepción
The document outlines four steps for providing healthcare to transgender people based on a needs assessment of healthcare providers. It discusses recognizing the range of gender expressions and desires for surgical/hormonal interventions. It also discusses distinguishing between gender identity and sexual orientation, finding local expertise and referral protocols, and establishing transgender-friendly policies within healthcare agencies.
Transgender individuals face significant barriers to receiving adequate healthcare, including insensitivity, condescension, verbal abuse, and refusal of treatment from medical providers. Nursing organizations have failed to issue guidelines for caring for transgender patients. As leaders, nurses must advocate for transgender healthcare policies and guidelines, promote transgender care education, and work to create a welcoming environment for transgender patients and staff. Developing solidarity around transgender issues and participating in policy development are key leadership strategies for improving transgender healthcare.
This document provides an introduction to transgender equality. It discusses that gender is a social construct distinct from sex assigned at birth. It describes gender dysphoria and the spectrum of transgender identity. It notes that transgender people exist in all cultures and seek to live authentically. It discusses challenges transgender people face, like lack of support and high rates of suicide attempts. It outlines UK legislation and the medical process for transition. It emphasizes the need for respect, support and inclusion of transgender people in healthcare, housing, and society in general.
Evidence Based Care of Transgender Patients discusses guidelines for the evidence-based care of transgender patients. It introduces key terminology used in transgender care and outlines recommendations for preventative care, hormonal therapy, and surgical options based on levels of evidence. Hormone therapy is recommended for treatment of gender dysphoria, with protocols outlining initiation and monitoring of hormone therapy for both MTF and FTM patients. Screening and preventative care recommendations are also provided based on a patient's anatomy and hormone use.
Working with the Transgender Population: what you need to knowKnoll Larkin
This document provides an overview of issues related to working with transgender populations. It begins with definitions of key terms and concepts. It then discusses myths and facts about transgender identity, models of medical and social transition, barriers to care, and best practices for making healthcare services transgender-friendly. The goal is to increase awareness and understanding of transgender experiences.
This document provides information on culturally competent care for transgender individuals. It begins by defining key terms like transgender, transman, and transwoman. It then discusses barriers to healthcare transgender people often face, like discrimination and lack of provider competence. The document outlines a behavioral health approach to counseling transgender clients, including assessment, goals, and common concerns addressed in therapy. It also reviews primary medical treatment options like hormone replacement therapy and gender confirmation surgery. Case studies are presented to demonstrate how to approach medical transitioning while considering any comorbid psychological or medical conditions. Resources for both providers and transgender individuals are provided.
The document discusses several challenges faced by transgender individuals, including high rates of stress during transition, unemployment, disability, and suicide attempts. It notes that transgender people often lose social support and experience discrimination. Additionally, the quality of healthcare services for transgender individuals is often poor. The document advocates for improving access to specialized healthcare providers and services to better meet the needs of the transgender community and reduce health disparities.
Empirical studies on the use of seclusion and restraint in psychiatric facilities have found mixed results. Several studies show higher rates of restraint for younger patients and those with psychosis or abnormal EEGs. Findings on the influence of sex and race are contradictory across studies. Facility characteristics like length of stay and patient census have also shown contradictory correlations with restraint rates. While seclusion and restraint can prevent injury in dangerous situations, they may cause physical and psychological trauma to both patients and staff.
SAMHSA webinar series on Promoting Alternatives to Seclusion and RestraintAllison Wohl
As part of its ongoing effort to promote alternatives to seclusion and restraint and other forms of coercive interventions among special populations, SAMHSA’s Promoting Alternatives to Seclusion and Restraint through Trauma-informed Practices, will host a 6-part webinar series to be followed by an ongoing virtual dialogue with presenters and experts in the field through SAMHSA’s BHTalk web site and subsequent written brief to inform the field on promising practices.
For more information along with the schedule and registration information, view the attached document.
Competency Orientation within Companies: The Challenge of Different Requirem...Andreas Schmidt
The document discusses the challenges of competency modeling within companies. It notes that competency definitions are contextual, purpose-driven, and need to evolve over time. It also addresses how to define a framework that allows for evolution while maintaining some interoperability between use cases, and how to account for emerging requirements and enable smooth transitions between uses.
Mhr submission to the mhc on seclusion and restraint reduction strategy finalGatewayMHProject
The document outlines a draft strategy and 18 actions to reduce the use of seclusion and physical restraint in mental health facilities in Ireland. Key aspects of the strategy include developing seclusion and restraint reduction plans for each facility, examining alternatives to seclusion like removing seclusion rooms, improving staffing levels, increasing staff training, involving advocates and service users, using data to monitor seclusion and restraint episodes, and improving debriefing practices. Facilities are asked to provide updates to the Mental Health Commission on their implementation of the strategy.
Position Paper - a case for change - restrictive practices in mental healthJackie Crowe
This document provides recommendations for reducing and eliminating the use of seclusion, restraint, and restrictive practices in mental health services. It begins with definitions of seclusion, restraint, and restrictive practices. It then outlines 4 recommendations: 1) educate practitioners about alternative strategies; 2) agree on uniform definitions, targets, and reporting; 3) evaluate seclusion and restraint interventions; and 4) take a national approach to regulating seclusion and restraint. Background information is also provided on the incidence of seclusion and restraint, the complexity of issues around their use, and contributions from those with lived experience.
The Department of Education today issued a resource document that present and describe 15 principles for state, district, and school staff; parents; and other stakeholders to consider when states, localities, and districts develop policies and procedures which should be in writing on the use of restraint and seclusion. This resource document discusses the context within which these principles were developed, lists the principles, and highlights the current state of practice and implementation considerations for each principle.
Supporting Transgender Students Mental Health (Outright 2011)Morganne Ray
1) The document discusses supporting the mental health of transgender students and outlines reasons why transgender youth may choose to access mental health care, such as supporting their coming out process or accessing medical transition services.
2) It addresses dominant assumptions about transgender youth and identities, such as assumptions that they will later regret transitions or that they must identify with the opposite gender from an early age.
3) Guidelines for therapists around supporting social and medical transitions are provided, including requirements for therapy, parental consent, and levels of physical transitioning such as hormones or surgery. Barriers to care and ways to support transgender youth are also discussed.
Seclusion and physical restraint reduction knowledge reviewGatewayMHProject
This document presents the Mental Health Commission's draft strategy to reduce the use of seclusion and physical restraint in approved mental health centres in Ireland. It provides background information on existing regulations around seclusion and restraint, international initiatives to reduce their use, and the strategy's methodology. The main body of the document identifies interventions shown by research to be effective in reducing seclusion and restraint, such as policy changes, leadership, staff training, use of data for monitoring, and involving patients. It then discusses applying these interventions in an Irish context and outlines specific actions for the Commission's strategy.
Information-seeking Behaviour of LGBTQ health professionalsMartin Morris
LGBTQ health professionals have information needs that may not be fully addressed by current online medical resources. The researchers conducted an online survey of 120 LGBTQ health professionals to understand their perspectives and information seeking behaviors. The survey found that over half believe online resources lack accurate LGBTQ health coverage. While attitudes have improved, many respondents still prefer discussing LGBTQ health topics with LGBTQ librarians due to perceived greater understanding. The researchers aim to continue analysis and interviews to improve library services and resources for this community.
The document discusses guidelines for the use of restraint and seclusion in healthcare settings. It defines restraint and seclusion and provides guidance on their appropriate uses in emergency situations. Risks of restraint are outlined, including injury, psychological impacts, and reduced mobility. Alternatives to restraint are recommended, including environmental changes, observation, and personal assistance devices. Medical and behavioral indications for restraint are described, along with safe application, monitoring, and discontinuation procedures.
This document outlines a hospital's policy on the use of restraints and seclusion. It defines restraint and seclusion, provides exceptions, and discusses preventing and guidelines for their use. Physician orders are required, including a face-to-face evaluation within 1 hour of initiation. Alternatives to restraint/seclusion are assessed initially, including patient-identified techniques. Staffing levels aim to minimize restraint/seclusion use.
P R E V E N T I N G T H E U S E O F E X C L U S I O N A N D R E S T R A...Steve Vitto
The document discusses seclusion and restraint in schools, providing definitions and examples of incidents that resulted in student deaths. It notes that over 85% of restraints are in response to noncompliance, and that forced compliance is not an effective behavior strategy. The state board of education adopted standards restricting seclusion and restraint to emergencies only, and requiring positive behavior support systems to prevent their use when possible. Districts must provide training to ensure emergency incidents are properly handled.
Why Transsexuals Are Separated from Rest of Humanity - and Explanationmarinakrugov
The Medico-legal construction of transsexualism as a syndrome and the socio-legal construction of the transsexual as a person, the inadequacy of current legal thinking clarified. Explanation on why a transsexual person separated out from the rest of humanity and afforded special discriminatory treatment by the law, through their being ‘non-human’ and my view on that account.
Providing Culturally Sensitive Care For Transgender PatientsSanté des trans
Providing Culturally Sensitive Care for Transgender Patients.
Cet article est paru en 2005 dans la revue Cognitive And Behavioral Practice. Il présente les résultats d'une enquête qualitative menée auprès de MtF sur leur parcours de vie et de transition.
Il plaide pour la fourniture de soins de santé "trans friendly", fondés sur une meilleure connaissance par les professionnels de santé des problématiques de vie des personnes trans.
Four Steps to Providing Health Care to Transgendered PeopleCésar E. Concepción
The document outlines four steps for providing healthcare to transgender people based on a needs assessment of healthcare providers. It discusses recognizing the range of gender expressions and desires for surgical/hormonal interventions. It also discusses distinguishing between gender identity and sexual orientation, finding local expertise and referral protocols, and establishing transgender-friendly policies within healthcare agencies.
Transgender individuals face significant barriers to receiving adequate healthcare, including insensitivity, condescension, verbal abuse, and refusal of treatment from medical providers. Nursing organizations have failed to issue guidelines for caring for transgender patients. As leaders, nurses must advocate for transgender healthcare policies and guidelines, promote transgender care education, and work to create a welcoming environment for transgender patients and staff. Developing solidarity around transgender issues and participating in policy development are key leadership strategies for improving transgender healthcare.
This document provides an introduction to transgender equality. It discusses that gender is a social construct distinct from sex assigned at birth. It describes gender dysphoria and the spectrum of transgender identity. It notes that transgender people exist in all cultures and seek to live authentically. It discusses challenges transgender people face, like lack of support and high rates of suicide attempts. It outlines UK legislation and the medical process for transition. It emphasizes the need for respect, support and inclusion of transgender people in healthcare, housing, and society in general.
Evidence Based Care of Transgender Patients discusses guidelines for the evidence-based care of transgender patients. It introduces key terminology used in transgender care and outlines recommendations for preventative care, hormonal therapy, and surgical options based on levels of evidence. Hormone therapy is recommended for treatment of gender dysphoria, with protocols outlining initiation and monitoring of hormone therapy for both MTF and FTM patients. Screening and preventative care recommendations are also provided based on a patient's anatomy and hormone use.
Working with the Transgender Population: what you need to knowKnoll Larkin
This document provides an overview of issues related to working with transgender populations. It begins with definitions of key terms and concepts. It then discusses myths and facts about transgender identity, models of medical and social transition, barriers to care, and best practices for making healthcare services transgender-friendly. The goal is to increase awareness and understanding of transgender experiences.
This document provides information on culturally competent care for transgender individuals. It begins by defining key terms like transgender, transman, and transwoman. It then discusses barriers to healthcare transgender people often face, like discrimination and lack of provider competence. The document outlines a behavioral health approach to counseling transgender clients, including assessment, goals, and common concerns addressed in therapy. It also reviews primary medical treatment options like hormone replacement therapy and gender confirmation surgery. Case studies are presented to demonstrate how to approach medical transitioning while considering any comorbid psychological or medical conditions. Resources for both providers and transgender individuals are provided.
The document discusses several challenges faced by transgender individuals, including high rates of stress during transition, unemployment, disability, and suicide attempts. It notes that transgender people often lose social support and experience discrimination. Additionally, the quality of healthcare services for transgender individuals is often poor. The document advocates for improving access to specialized healthcare providers and services to better meet the needs of the transgender community and reduce health disparities.
Empirical studies on the use of seclusion and restraint in psychiatric facilities have found mixed results. Several studies show higher rates of restraint for younger patients and those with psychosis or abnormal EEGs. Findings on the influence of sex and race are contradictory across studies. Facility characteristics like length of stay and patient census have also shown contradictory correlations with restraint rates. While seclusion and restraint can prevent injury in dangerous situations, they may cause physical and psychological trauma to both patients and staff.
SAMHSA webinar series on Promoting Alternatives to Seclusion and RestraintAllison Wohl
As part of its ongoing effort to promote alternatives to seclusion and restraint and other forms of coercive interventions among special populations, SAMHSA’s Promoting Alternatives to Seclusion and Restraint through Trauma-informed Practices, will host a 6-part webinar series to be followed by an ongoing virtual dialogue with presenters and experts in the field through SAMHSA’s BHTalk web site and subsequent written brief to inform the field on promising practices.
For more information along with the schedule and registration information, view the attached document.
Competency Orientation within Companies: The Challenge of Different Requirem...Andreas Schmidt
The document discusses the challenges of competency modeling within companies. It notes that competency definitions are contextual, purpose-driven, and need to evolve over time. It also addresses how to define a framework that allows for evolution while maintaining some interoperability between use cases, and how to account for emerging requirements and enable smooth transitions between uses.
Mhr submission to the mhc on seclusion and restraint reduction strategy finalGatewayMHProject
The document outlines a draft strategy and 18 actions to reduce the use of seclusion and physical restraint in mental health facilities in Ireland. Key aspects of the strategy include developing seclusion and restraint reduction plans for each facility, examining alternatives to seclusion like removing seclusion rooms, improving staffing levels, increasing staff training, involving advocates and service users, using data to monitor seclusion and restraint episodes, and improving debriefing practices. Facilities are asked to provide updates to the Mental Health Commission on their implementation of the strategy.
Position Paper - a case for change - restrictive practices in mental healthJackie Crowe
This document provides recommendations for reducing and eliminating the use of seclusion, restraint, and restrictive practices in mental health services. It begins with definitions of seclusion, restraint, and restrictive practices. It then outlines 4 recommendations: 1) educate practitioners about alternative strategies; 2) agree on uniform definitions, targets, and reporting; 3) evaluate seclusion and restraint interventions; and 4) take a national approach to regulating seclusion and restraint. Background information is also provided on the incidence of seclusion and restraint, the complexity of issues around their use, and contributions from those with lived experience.
The Department of Education today issued a resource document that present and describe 15 principles for state, district, and school staff; parents; and other stakeholders to consider when states, localities, and districts develop policies and procedures which should be in writing on the use of restraint and seclusion. This resource document discusses the context within which these principles were developed, lists the principles, and highlights the current state of practice and implementation considerations for each principle.
Supporting Transgender Students Mental Health (Outright 2011)Morganne Ray
1) The document discusses supporting the mental health of transgender students and outlines reasons why transgender youth may choose to access mental health care, such as supporting their coming out process or accessing medical transition services.
2) It addresses dominant assumptions about transgender youth and identities, such as assumptions that they will later regret transitions or that they must identify with the opposite gender from an early age.
3) Guidelines for therapists around supporting social and medical transitions are provided, including requirements for therapy, parental consent, and levels of physical transitioning such as hormones or surgery. Barriers to care and ways to support transgender youth are also discussed.
Seclusion and physical restraint reduction knowledge reviewGatewayMHProject
This document presents the Mental Health Commission's draft strategy to reduce the use of seclusion and physical restraint in approved mental health centres in Ireland. It provides background information on existing regulations around seclusion and restraint, international initiatives to reduce their use, and the strategy's methodology. The main body of the document identifies interventions shown by research to be effective in reducing seclusion and restraint, such as policy changes, leadership, staff training, use of data for monitoring, and involving patients. It then discusses applying these interventions in an Irish context and outlines specific actions for the Commission's strategy.
Information-seeking Behaviour of LGBTQ health professionalsMartin Morris
LGBTQ health professionals have information needs that may not be fully addressed by current online medical resources. The researchers conducted an online survey of 120 LGBTQ health professionals to understand their perspectives and information seeking behaviors. The survey found that over half believe online resources lack accurate LGBTQ health coverage. While attitudes have improved, many respondents still prefer discussing LGBTQ health topics with LGBTQ librarians due to perceived greater understanding. The researchers aim to continue analysis and interviews to improve library services and resources for this community.
The document discusses guidelines for the use of restraint and seclusion in healthcare settings. It defines restraint and seclusion and provides guidance on their appropriate uses in emergency situations. Risks of restraint are outlined, including injury, psychological impacts, and reduced mobility. Alternatives to restraint are recommended, including environmental changes, observation, and personal assistance devices. Medical and behavioral indications for restraint are described, along with safe application, monitoring, and discontinuation procedures.
This document outlines a hospital's policy on the use of restraints and seclusion. It defines restraint and seclusion, provides exceptions, and discusses preventing and guidelines for their use. Physician orders are required, including a face-to-face evaluation within 1 hour of initiation. Alternatives to restraint/seclusion are assessed initially, including patient-identified techniques. Staffing levels aim to minimize restraint/seclusion use.
P R E V E N T I N G T H E U S E O F E X C L U S I O N A N D R E S T R A...Steve Vitto
The document discusses seclusion and restraint in schools, providing definitions and examples of incidents that resulted in student deaths. It notes that over 85% of restraints are in response to noncompliance, and that forced compliance is not an effective behavior strategy. The state board of education adopted standards restricting seclusion and restraint to emergencies only, and requiring positive behavior support systems to prevent their use when possible. Districts must provide training to ensure emergency incidents are properly handled.
Why Transsexuals Are Separated from Rest of Humanity - and Explanationmarinakrugov
The Medico-legal construction of transsexualism as a syndrome and the socio-legal construction of the transsexual as a person, the inadequacy of current legal thinking clarified. Explanation on why a transsexual person separated out from the rest of humanity and afforded special discriminatory treatment by the law, through their being ‘non-human’ and my view on that account.
Providing Culturally Sensitive Care For Transgender PatientsSanté des trans
Providing Culturally Sensitive Care for Transgender Patients.
Cet article est paru en 2005 dans la revue Cognitive And Behavioral Practice. Il présente les résultats d'une enquête qualitative menée auprès de MtF sur leur parcours de vie et de transition.
Il plaide pour la fourniture de soins de santé "trans friendly", fondés sur une meilleure connaissance par les professionnels de santé des problématiques de vie des personnes trans.
GENDER SOCIAL STUDIES -TERMINOLOGIES .pptxShiellaMaeQuio
gender terminology- this presentation can help learners or teachers to understand the different terminologies when they want to learn about gender studies. you don't have to search another sources because this presentation is updated and complete. ewfkhqewilfgqiewurfhiqewurfhijweguqieyrgfweruigqerjkhewrjigyuqeirgtuiertyqeuirtyiqeruq weyriqyyruieyteuirty ertye uuertyiewurrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrroruweo4tr8934tyqernb iuuweoiurb ooutt ueferouothe gsdkir usslerh hwueywuyri uweuiwrghj hwrweeriutyoierghkjdfgnmd,nf jjerhwerwuiy
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The document discusses several key issues in the transgender debate:
1. Whether individuals should determine their own sexual identity or if sex and gender should be understood as synonymous.
2. Whether states should allow individuals to select bathrooms according to their preferred gender identity or assigned sex at birth. This has led to various state laws and court cases.
3. Whether Christians should address transgender individuals by their preferred gender or sex assigned at birth. The document discusses a heated debate on this issue.
4. Whether welfare programs should cover sex reassignment surgery for individuals seeking gender affirmation procedures.
This document provides information on creating inclusive practices for transgender and gender nonconforming clients. It begins by noting the lack of research and literature on serving TGNC individuals, couples and families in marriage and family therapy. It emphasizes using accurate terminology, addressing personal biases, and making the therapy space safe and respectful for all genders. The document recommends understanding gender as a continuum rather than a binary, being mindful of language, and normalizing gender diversity and exploration.
Gendered Verbal communication (Gender and Society)Adrian Divino
Research shows that men and women are more likely to exhibit different styles of verbal communication. Men are more prone to adopt what is called “report talk”, while women gravitate more toward
Gender identity and sexual orientation developmentamong younMatthewTennant613
Gender identity and sexual orientation development
among young adult transgender men sexually active with
cisgender men: ‘I had completely ignored my sexuality
… that’s for a different time to figure out’
Jane Heretha,b, Dana J. Pardeec and Sari L. Reisnerc,d�
aSchool of Social Service Administration, University of Chicago, Chicago, IL, USA; bAnn & Robert H.
Lurie Children’s Hospital of Chicago, Chicago, IL, USA; cThe Fenway Institute, Fenway Health, Boston,
MA, USA; dDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
ABSTRACT
As awareness of issues faced by transgender individuals increases,
many young people have been exposed to a dominant narrative
about gender identity. Often these narratives are based on binary
constructions about both sexual orientation and gender identity.
The lack of diverse, representative cultural narratives has implica-
tions for identity development and sexual health. Transgender men
who have sex with cisgender men in particular represent an under-
studied and overlooked population who likely experience unique
developmental tasks related to the intersection of socially stigma-
tised sexual orientation and gender identities. This study explores
sexual orientation and gender identity development among a sam-
ple of young adult transgender men who have sex with men. In-
depth interviews using a modified life history method were con-
ducted with 18 young men. Interview transcripts were coded using
open, narrative and focused coding methods. Participants discussed
milestones in the development of their sexuality and gender identity
that map onto existing models, but also described ways in which
these processes overlap and intersect in distinct ways. Findings high-
light the need for human development models of sexual orientation
and gender identity that integrate multiple identity processes.
Implications for future research and practice to increase support for
young adult transgender men are discussed.
ARTICLE HISTORY
Received 11 January 2019
Accepted 17 June 2019
KEYWORDS
LGBTQ; transgender;
sexuality; gender; identity
development
Introduction
Telling one’s life story is part of a meaning-making process that allows us to make
sense of past experiences (McAdams 1993; McAdams 2001). Often life stories fit into
CONTACT Jane Hereth [email protected]
�Division of General Pediatrics, Boston Children’s Hospital, Boston, MA, USA; Pediatrics, Harvard Medical School,
Boston, MA, USA.
This article is part of a special issue on Transformative Approaches to Gender Justice in Sexual and Reproductive Health,
led and sponsored by the University of California Global Health Institute Center of Expertise on Women’s Health,
Gender and Empowerment.
� 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives
License (http://creativecommons.org/lice ...
This document discusses sex and gender from a cross-cultural anthropological perspective. It explores how gender roles vary across cultures and how biology interacts with cultural constructions of gender. Key topics covered include the cultural construction of gender, multiple gender identities in some native cultures, the gendered division of labor, and factors that influence gender stratification like gender ideologies. Examples from cultures such as the US, Mbuti, and Minangkabau are provided.
The document provides information about human sexuality and reproductive health. It defines key terms like gender identity, sexual health, and biological sex. It describes the male and female reproductive systems and lists objectives like understanding sexual identity, terminology, and sexually transmitted diseases. The document also discusses factors influencing human sexuality, types of sexual orientation like homosexuality and heterosexuality, and sexually transmitted diseases and their prevention.
Sex refers to the biological and physical differences between males and females such as genetics and anatomy assigned at birth. Gender refers to the social and cultural roles, expressions, and identities of being a man, woman, or non-binary. While sex is generally defined as male or female, gender exists on a spectrum and some individuals' gender does not align with their sex. Transgender people experience a mismatch between their sex assigned at birth and their gender identity.
The feminist movement has occurred in three waves. The first wave in the late 19th/early 20th century focused on rights like voting, property ownership, and divorce. The second wave from the 1960s-1980s extended civil rights to include things like equal pay, education, reproductive healthcare, and more women in politics. The third wave since the 1990s challenges some assumptions of the second wave and focuses on a more nuanced understanding of gender, sexuality, and identity.
Sex and gender a cross cultural perspectivedwessler
This document discusses sex and gender from a cross-cultural perspective. It begins by outlining some key questions about the influence of biology on gender and similarities/differences in gender roles across cultures. It then discusses how anthropology and feminism have influenced each other, with feminism shifting the focus to androcentrism and studying areas from a gender perspective. Key topics covered include the cultural construction of gender, concepts of multiple genders, the sexual division of labor, and gender stratification across societies.
The document discusses several key concepts related to sex, gender, and sexuality:
- Sex is defined by biological characteristics like genitalia and chromosomes, but exists on a spectrum rather than a strict male-female binary.
- Gender encompasses social and cultural roles, expressions, and identities separate from sex. It exists on a spectrum beyond male and female.
- Gender identities include cisgender, transgender, non-binary, genderqueer, and more.
- Sexuality refers to orientations, attractions, and identity shaped by biological and socio-cultural factors. It involves heterosexual, homosexual, bisexual identities.
- Discourse emphasizes diversity, inclusion, and challenging stereotypes regarding
This document provides an overview of key concepts and terms related to gender and society, including:
- It defines sex as biological characteristics determined at birth, while gender is the social and cultural roles, behaviors, and identities associated with one's sex.
- It explores concepts like gender equality, gender equity, and differences between gender vs. women's rights.
- It examines LGBTQ+ identities and terms including lesbian, gay, bisexual, transgender, and asexual.
- It discusses patterns of gender inequality in areas like political participation, economic opportunities, education, and violence.
Sex refers to the physical and biological traits used to classify people as male, female or intersex. Gender refers to the social and cultural roles, behaviors and identities associated with being a man, woman, or gender non-conforming. Key terms in gender and development include sex-disaggregated data, which separates data by sex, gender norms which are societal expectations of masculinity and femininity, and gender identity which is one's inner sense of belonging to a particular gender. Gender awareness in development means addressing both women and men's specific needs and strengths and involving them as participants and decision-makers.
Constructions of Masulinity among Transgender MenTaylor Briggs
This paper discusses constructions of masculinity among transgender men and compares experiences of white and black transgender men. It summarizes several scholarly sources that examine how transgender men navigate masculinity in a patriarchal society and face pressure to conform to dominant masculine ideals. The paper notes that sources often focus on white transgender men and fail to adequately address how race impacts experiences. It argues that transgender men offer a unique perspective on gender norms but are frequently excluded from discussions. The paper maintains transgender communities must address racism and consider intersections of gender and race.
The term 'hermaphrodite' is no longer used scientifically, and is replaced by 'intersex' to describe individuals with biological traits of both sexes, such as ambiguous genitalia or hormone levels. Intersex is a natural biological variation, not a disorder, and individuals experience it uniquely. Current focus is on supporting intersex autonomy and informed consent regarding their own bodies and identities.
What does it all mean!? This foundational workshop provides an introduction to the vocabulary of trans inclusion. Attendees will develop an understanding of common terms as they are used by the transgender community, and how they apply in a library context.
This document discusses research methods used to study gender and society. It describes quantitative methods like descriptive statistics, surveys, and experiments that gather measurable data. It also discusses qualitative methods like textual analysis and ethnography that aim to understand experiences. Critical research methods identify inequalities to motivate change, and mixed methods combine approaches. Gender studies draw from various disciplines like sociology, anthropology, history, and more. Studying gender enhances appreciation of diversity, awareness of cultural expectations, and ability to engage with others in society.
TRT-5 - Rapport consultation communautaire PrEP (final)Santé des trans
Engagé dans l'élaboration d'un essai de traitement antirétroviral donné en prophylaxie pré-exposition (PrEP), le groupe interassociatif de lutte contre le sida TRT-5 (www.trt-5.org) a coordonné une consultation communautaire sur l'essai.
Les données issues de ce processus mené au printemps 2010 figurent dans ce rapport.
This document provides an overview of the epidemiology of transgender populations including estimates of prevalence, challenges with data collection, and HIV risk factors. Key points include:
- There are no reliable estimates of the transgender population due to lack of data collection and social stigma. Estimates range from 1 in 30,000 to 1 in 1,000 for MTF individuals and 1 in 100,000 to 1 in 33,800 for FTM individuals.
- HIV prevalence among transgender women averages 28% according to a meta-analysis, with the highest rates among African American transgender women. Risk factors driving transmission include social stigma, gender identity validation through sex, and survival sex work.
- Very little data exists on transgender
Il s'agit d'une fiche technique sur la prévention du VIH parmi les trans.
Non datée, elle est le fruit du travail de Rita Melendez, de la San Francisco State University, Valerie Spencer de la Charles R. Drew University, et David Whittier, du Centers for Disease Control and Prevention.
HIV Prevention And Health Service Needs Of The Transgender Community In San F...Santé des trans
This document summarizes the findings of focus groups conducted with 100 transgender individuals in San Francisco to understand their HIV risk behaviors and access to prevention and health services. Key findings include:
1) Sex work was commonly discussed and seen as necessary due to discrimination, though it increased HIV risk. Unprotected sex was also common due to low self-esteem and desire for validation.
2) Participants reported barriers like insensitivity of providers and fear of discrimination prevented access to services.
3) Recommendations included hiring transgender staff and training providers to be more sensitive.
Access To Health Care For Transgendered Persons In Greater BostonSanté des trans
Il s'agit du rapport de l'enquête réalisée en 2000 par l'organisme JSI Research & Training Institute dans le cadre du projet "GLTB Health Access".
Menée auprès de personnes trans recrutées à Boston et dans les environs, l'enquête a investigué les facteurs pouvant contribuer à un meilleur accès aux soins des trans et à la fourniture de services de santé adaptés.
Ce document de la National Coalition for LGBT Health américaine est le fruit du travail de son "Eliminating Disparities Working Group", publié en 2004.
Il présente les chantiers identifiés de sorte à faire reconnaître et mieux prendre en compte les enjeux de santé des trans. Il balaie un large spectre de déterminants de santé : violences, VIH/sida et des autres IST, usage abusif de produits psychoactifs, santé et bien-être mental, couverture maladie, traitements hormonaux, modifications corporelles auto-réalisées, formation des professionnels de santé, tabac etc.
Transgender Primary Medical Care Suggested Guidelines For Clinicians in Bri...Santé des trans
Transgender Primary Medical Care Suggested Guidelines For Clinicians in British Columbia
Il s'agit de recommandations de bonnes pratiques destinées aux soignants de Colombie britannique publiées en janvier 2006. Elles sont le fruit de la collaboration entre trois organisations : Vancouver Coastal Health, Transcend Transgender Support & Education Society, and the Canadian Rainbow Health Coalition.
Cette publication a pour objectif de fournir aux soignants de cette province canadienne des clefs de compréhension et des outils nécessaires à la prise en compte des enjeux de santé des personnes trans dans leur globalité, y compris leurs spécificités.
Trans : les oublié-e-s de la Conférence de TorontoSanté des trans
Il s'agit d'un article publié dans le numéro spécialement consacré à la Conférence mondiale de lutte contre le sida de Toronto (2006) de la revue Transcriptases (n° 129, octobre 2006).
A travers une revue des résumés soumis à la Conférence en vue d'y obtenir la possibilité d'y présenter des recherches ou des programmes, l'auteur souligne la quasi-invisibilité des enjeux des personnes trans au sein de la Conférence. Il envisage les questions soulevées par les acteurs de la lutte contre le sida : prévalence du VIH, connaissance des comportements et des déterminants de santé, actions spécifiques de prévention et de soutien, santé sexuelle, droits humains bien entendu.
Rencontre du CRIPS / Act Up-Paris "Personnes trans : quels enjeux de santé ?"...Santé des trans
Le 26 juin 2007 se tenait la 67ème Rencontre du CRIPS Île-de-France, en partenariat avec Act Up-Paris, consacrée au thème : "Personnes trans : quels enjeux de santé ?".
Il s'agit du dossier documentaire constitué à cette occasion. Il comporte nombre d'articles et documents qui sont autant d'outils et de ressources utiles à la réflexion, et à l'action militante.
Estimating HIV prevalence and risk behaviors of transgender persons in the Un...Santé des trans
Cet article, paru en 2008 dans la revue AIDS and Behavior, présente une synthèse des données disponibles dans la littérature scientifique concernant la prévalence du VIH parmi les trans aux Etats-Unis et leurs facteurs de risque comportementaux par rapport à la transmission du virus.
Il s'agit d'un "fact sheet" (fiche d'information, fiche technique) publiée (19 juin 2007) par le Center for Diseases Control, organisme public en charge de la veille épidémiologique et de la prévention aux Etats-Unis.
Il fait le point sur les connaissances disponibles sur le VIH/sida chez les personnes transgenres aux Etats-Unis. Il présente les éléments qui font penser que l'épidémie sévit sévèrement parmi elles.
Transsexuel(le)s : conditions et style de vie, santé perçue et comportements ...Santé des trans
Transsexuel(le)s : conditions et style de vie, sante perçue et comportements sexuels. Résultats d'une enquête exploratoire par Internet, 2007
Il s'agit de la publication, dans le Bulletin Epidémiologique Hebdomadaire en date du 1er juillet 2007, des résultats de l'enquête exploratoire menée par le CRIPS Île-de-France et Act Up-Paris avec le soutien de France Lert (Inserm) à l'occasion de la rencontre organisée en juin de la même année sur les enjeux de santé des personnes trans.
Antirétroviraux et traitements hormonaux chez les personnes transSanté des trans
Il s'agit d'un article de Nicolas Hacher, endocrinologue, paru dans la revue Transcriptases, éditée par l'association Pistes.
Ce texte a également été publié dans l'édition 2006 du rapport d'experts sur la prise en charge médicale des personnes vivant avec le VIH (rapport dit Yeni), afin de promouvoir la prise en compte des interactions possibles entre antirétroviraux et traitements hormonaux chez les personnes trans séropositives.
Rencontre du CRIPS / Act Up-Paris : "Personnes trans : quels enjeux de santé ...Santé des trans
Le 28 juin 2007 se tenait la 67ème Rencontre du CRIPS Île-de-France, en partenariat avec Act Up-Paris, consacrée au thème : "Personnes trans : quels enjeux de santé ?".
Ce document est le compte-rendu des présentations et des débats qui s'y sont déroulé-e-s.
Lors de la Rencontre, ont été présentés les résultats de l'enquête menée par Internet au cours des semaines précédentes auprès de personnes trans sur leur "situation au regard de la santé".
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
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Histololgy of Female Reproductive System.pptxAyeshaZaid1
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- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
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The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
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1. Enhancing Transgender Health Care
A B S T R A C T Emilia Lombardi, PhD
As awareness of transgender men Transgender health issues are beginning the sake of uniformity within this commen-
and women grows among health care to come to the attention of many health prac- tary, however, the label transgender is used
educators, researchers, policymakers, titioners and researchers. In fact, the desire in a global sense, encompassing transvestites,
and clinicians of all types, the need to to improve the treatment experienced by transsexuals, and self-identified transgender
create more inclusive settings also transgender individuals led the American individuals.
grows. Public Health Association to pass a resolu- Generally, people can be categorized
Greater sensitivity and relevant in- tion on transgender health issues during its across 4 characteristics: biological sex, legal–
formation and services are required in 1999 annual meeting.1 Acknowledging health institutional sex, social gender, and psycho-
dealing with transgender men and care discrepancies is only a start, however. To logic gender. Biological sex is usually deter-
women. These individuals need their provide much-needed services to this popu- mined by people’s genitals but can encom-
identities to be recognized as authentic, lation, researchers, educators, and health care pass other factors such as chromosomes,
they need better access to health care professionals of all types need concrete, com- hormonal makeup, secondary sex character-
resources, and they need education and prehensible information about transgender istics, and other physiologic variations. Fur-
prevention material appropriate to their individuals. thermore, there are intersexed conditions that
experience. Gender variations have been documented can create problems in regard to categorizing
In addition, a need exists for ac- for many years. Generally, female-to-male infants as male or female (e.g., children born
tivities designed to enhance under- gender transgression has been described as with ambiguous genitalia, androgen sensitiv-
standing of transgender health issues resulting from the inequality found between ity syndrome). These children may undergo
and to spur innovation. (Am J Public women and men and women’s desire for sta- surgical intervention so that their genitals
Health. 2001;91:869–872) tus and resources, whereas male-to-female more clearly resemble those found on tradi-
transgression has been explained as resulting tionally male or female children.
from the need to express an inner desire or Legal–institutional sex refers to people’s
has been eroticized.2 More recent explana- designation on identification, forms, and even
tions have been based on the medical model. questionnaires. There may be ways for people
The term transvestite was used early in to change their legal–institutional sex; fre-
the 20th century to describe people (prima- quently this requires some sort of professional
rily men) who dress in women’s clothing for intervention (i.e., needing to submit a letter
their own interests (usually erotic).3 Later, from one’s surgeon to change one’s birth cer-
transsexualism (listed as gender identity dis- tificate). However, different areas of the coun-
order in the fourth edition of the American try (and across the world) have different reg-
Psychiatric Association’s Diagnostic and Sta- ulations allowing for such changes.
tistical Manual of Mental Disorders4) was Social gender refers to how people pre-
used to describe a population of individuals sent themselves in public: the clothing they
whose feelings concerning their gender in- wear, their hairstyle, their physical character-
volved more than a desire to dress in a par- istics, even how they act and talk. Different
ticular set of clothes and a stronger identifi- cultures have different ways of explaining and
cation with gender values contrary to societal dealing with gender variance; some Native
expectations.5 American cultures refer to two-spirit people
Transgender was originally used to dif- (aspects of both genders), and Hindu cultures
ferentiate those who seek medical intervention include hidras (neither man nor woman). So-
in changing their gender from those who do cial gender can also be influenced by med-
not; however, this term later changed to en- ical interventions used to change aspects of
compass a range of possible identities and be- people’s appearance. Many people go to great
haviors, including transvestitism and trans- lengths to change aspects of their appearance
sexualism (the way in which transgender (some of which is necessary to change their
evolved in usage has not been examined fully). legal sex). In addition, individuals may be
Currently, transgender, transvestite, and trans- consistent or inconsistent in their gender pre-
sexual are at times used interchangeably to sentation. People may have an inconsistent
describe individuals whose identities and so- social gender because one aspect of their gen-
cial lives are very similar. It is likely, how- der is used for performances, fun, or even sex-
ever, that many people will not fit into tradi- ual behavior.
tional conceptions of transvestite, transsexual,
or transgender. The author is with the Drug Abuse Research Cen-
The use of terminology has not been con- ter, University of California, Los Angeles.
sistent across time and among writers. The Requests for reprints should be sent to Emilia
Lombardi, PhD, UCLA–DARC, 11075 Santa Mon-
meaning of such terms varies among indi-
ica Blvd, Suite 200, Los Angeles, CA 90025 (e-mail:
viduals as well, and as a result there is little un- redemmie@earthlink.net).
derstanding of what people mean when they This commentary was accepted February 14,
say they are transgender or transsexual. For 2001.
June 2001, Vol. 91, No. 6 American Journal of Public Health 869
2. Psychologic gender refers to a person’s during the injection of hormones or drugs is are regarded as authoritative by providers but
self-indentification as a man or a woman. How- also a risk factor.8–11 These individuals may be as restrictive by many clients.21,22 In addition,
ever, these may not be the only options. Again, difficult to target through traditional preven- these guidelines have given rise to small
different cultures may allow for other alterna- tion campaigns, and they may fear discrimi- groups of “experts” within specific areas
tives in the way people identify themselves. In nation should they seek services such as HIV/ whose services are sought by all transgender
addition, individuals may create alternative AIDS education and testing.13,14 Insensitivity persons wishing to medically change their
identities. Some people who are part of a of health care professionals has been cited as gender; those living in isolated areas may not
“queer” or “alternative” subculture may use a reason that these and other services are not have ready access to such “experts” and may
identities other than simply man or woman.6 accessed.15 Indeed, reports of insensitive be- have to find other ways to go about their tran-
The preceding is only a short summary havior among health care providers (e.g., re- sition. Current constraints on access to med-
of the factors that can be used to describe sex ferring to transgender women as “he” and ical care related to gender changes may place
and gender and to understand the ways in “him” and not acknowledging or respecting people at risk by forcing them to seek unsafe
which they can vary. There are many other their identity) suggest that services are se- methods of making these changes (e.g., using
factors that can influence people, some of verely lacking in terms of provision of cul- hormones bought off the street, sharing nee-
which have already been mentioned. Race, turally sensitive interventions and, potentially, dles while injecting hormones).
ethnicity, or culture can influence how people provision of HIV-related health care.13,14 The constraints for transgender youths
identify themselves and the social roles that Health care service providers have found are even greater; often, such youths are de-
they desire or have access to. Similarly, a per- that helping transgender individuals obtain the nied the ability to change their social gender
son’s area of residence can involve variations services they need (e.g., substance use treat- in any way within institutional settings, which
in how sex is institutionalized and how legal ment, housing, health care) is difficult because may force them back into situations that can
sex can be changed. other service providers may not want to work place them at great risk. There is some support
Finally, the resources available to peo- with transgender clients.15 Furthermore, lack for allowing transgender youths to begin the
ple can influence their ability to pay for med- of sensitivity on the part of health care pro- process of changing their gender; many do so
ical interventions in addition to other strate- viders who do not respect the expressed gen- without trouble.21,23
gies used to change their social gender or legal der identity of transgender persons can ad-
sex (or both). It is not enough to know the versely influence whether these individuals
definitions of labels (e.g., What is a cross- will access and stay in treatment.14,16,17 Cultural Relevancy
dresser? What is a transsexual?); it is more Transgender persons may be resistant to
important to know that aspects of a person’s seeking help because other transgender indi- Finally, health-related research, policies,
gender and physical form can vary widely and viduals have reported past discriminatory treat- and materials do not (except for rare excep-
be influenced by different factors. Health care ment on the part of service providers. Focus tions at the expense of local agencies) men-
educators, researchers, policymakers, and cli- group research conducted in San Francisco tion or deal with the actual lives of transgen-
nicians need to know that transgender indi- and Minneapolis has shown evidence of dis- der persons.13,14,21 Simply adding transgender
viduals can vary widely but that, in general, crimination against transgender men and materials to existing materials is not enough,
all are still at risk for problems in accessing women within HIV/AIDS programs.13,14 Many nor is using materials or programs originally
and receiving health care. programs are not sensitive to the needs of created for other populations. Research, poli-
transgender individuals.13,14 Furthermore, stud- cies, and materials need to be culturally rele-
ies have shown that doctors have somewhat vant and specific. The differences in identities,
Health Care Issues negative opinions of transsexual women.18,19 experiences, and physical form among trans-
Overall, individuals who do not conform to gender individuals relative to nontransgender
Transgender individuals are likely to ex- traditional conceptions of sex and gender are populations create very different needs and
perience some form of discrimination or vi- likely to be at risk for many health-related strategies, and efforts must be directed toward
olence sometime in their lives. A study of problems, including, unfortunately, discrimi- the actual experiences of transgender people.
transgender individuals within the United nation within the treatment setting. An example of a culturally relevant educa-
States showed that approximately 60% had tional tool with regard to prevention of HIV
experienced some form of harassment or vi- and other sexually transmitted diseases among
olence and that 37% had experienced some Access to Care transgender women is shown in Figure 1.
form of economic discrimination.7 In addi-
tion, focus group research conducted in San Often, transgender people have 2 differ-
Francisco showed that among transgender ent sets of health care providers: one involved Intersexed Issues
persons, a street lifestyle, lack of education with gender transition and one involved with
and job opportunities, and low self-esteem all regular health care visits. In addition to the The term intersexed refers to people born
contributed to drug and alcohol abuse.8 problems experienced by transgender men with physical differences that will result in
Increasing evidence demonstrates that and women within health care settings, tradi- their being difficult to classify as either bio-
the rate of HIV infection among transgender tional health care plans (public and private) logically male or biologically female. This
women is high and that in California the risk do not cover the costs related to changing condition can assume various forms and in-
of infection may even surpass that for bisex- one’s gender, leaving people to find other volve the structure of one’s genitals, the exis-
ual and homosexual men.9–12 Reported sero- ways to fund their transition from one gender tence or nonexistence of specific reproduc-
prevalence rates exceed 20% and have been to another.20 tive organs, and chromosomes other than XX
shown to be as high as 60% among African Individuals both within and allied to the and XY. Sometimes these physical differences
Americans. Many transgender women (i.e., transgender community believe that the stan- are life threatening (e.g., affecting the ability
male to female) are at risk primarily because dards of care imposed by the Harry Benjamin to pass urine from the body) and require sur-
of risky sexual behaviors, but sharing needles International Gender Dysphoria Association gical intervention. Other times, however, the
870 American Journal of Public Health June 2001, Vol. 91, No. 6
3. differences are aesthetic, and surgery is done 6. Advocate for more and better promo-
so that the child can be more readily identified tion of transgender-related research and for
as either male or female.24 more innovation within transgender health
Today, such aesthetically motivated sur- care practices.
geries are the focus of criticism from many 7. Advocate for greater awareness of
intersexed individuals. The Intersexed Society intersexed individuals and against the prac-
of North America (http://www.isna.org) was tice of surgically altering children and infants
formed in response to the individual cases of for solely aesthetic reasons. This would in-
trauma caused by many of these surgeries. clude conducting more research on the effects
The goals of this organization are to reform (both short- and long-term) of medical in-
the treatment of intersexed individuals, to limit terventions on intersexed infants and children
the practice of surgical interventions to those and taking a critical stand against surgically
that are medically necessary, and to limit sur- altering children and infants purely for aes-
geries performed on children purely for the thetic reasons.
sake of aesthetics.
Acknowledgments
Suggestions for Improving the I wish to thank Rosalyne Blumenstein, MSW, of
Health of Transgender the Gender Identity Project, Lesbian and Gay Com-
munity Services Center, New York City, for the use
Individuals of the phallic woman figure and the Lesbian, Gay,
Bisexual, and Transgender Caucus of Public Health
The American Public Health Associa- Workers, American Public Health Association.
tion’s 1999 resolution concluded by stating
the need for health care providers and re-
searchers of all types to provide transgender References
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and Gender. Philadelphia: University of Penn-
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gender individuals.25–27 the Erotic Drive to Cross-Dress. New York,
NY: Prometheus Books; 1993.
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gender individuals’ identities and lives in all Disorders, Fourth Edition. Washington, DC:
areas (policy, research, and clinical practice). American Psychiatric Association; 1994.
When in doubt, inquire in a respectful man- 5. Benjamin H. Transsexualism and transvestism
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