Browsing by Subject "Transgender"

Now showing 1 - 8 of 8
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    Adolescent transgender health: Awareness does not equal resources
    (Springer Verlag, 2016-12) Chen, Melinda; Fuqua, John; Pediatrics, School of Medicine
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    Characteristics of Referrals for Gender Dysphoria Over a 13-Year Period
    (Elsevier, 2016-03) Chen, Melinda; Fuqua, John; Eugster, Erica A.; Department of Pediatrics, IU School of Medicine
    PURPOSE: Our Pediatric Endocrinology Clinic has seen a sharp increase in referrals for gender dysphoria (GD) during recent years. However, the frequency and characteristics of referrals have not been objectively examined. METHODS: A retrospective chart review of referrals for GD during the past 13 years was performed. Variables analyzed included numbers of referrals per year, patient characteristics, comorbid conditions, and hormonal therapy. Timing of referral and eligibility for treatment were measured against established recommendations. RESULTS: Of 38 patients, 74% were referred during the last 3 years. Most patients presented late in puberty before a GD-specific psychological evaluation and few were eligible for hormonal treatment at baseline. Over half had psychiatric and/or developmental comorbidities. CONCLUSIONS: A dramatic increase in referrals for GD since 2002 was confirmed. Enhanced provider education and outreach regarding care of patients with GD are needed.
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    Learning to Thrive in a Binary World: Understanding the Gendered Experiences of Nonbinary Individuals and Ways to Bolster Wellbeing
    (2021-08) Kinney, M. Killian; Victor, Bryan G.; Fortenberry, J. Dennis; Thigpen, Jeffry W.; Wahler, Elizabeth A.
    Traditionally, gender has been viewed through an essentialist lens with fixed biology-based traits or polarized gender norms between women and men. As awareness of gender diversity grows, increasingly more people identify as nonbinary – or not exclusively a man or woman. Despite a growing literature on the experiences of binary transgender individuals, little has been explored regarding experiences unique to nonbinary individuals. The research that does include nonbinary individuals focuses primarily on adverse risks and outcomes. As such, a dearth of empirical research exists to understand the unique experiences of nonbinary people and how they relate to wellbeing. A qualitative participatory action study using PhotoVoice was conducted virtually to address the identified gaps in the literature on nonbinary individuals concerning gendered experiences and wellbeing. Prevailing theories of wellbeing informed the study along with minority stress theory and the resilience literature to account for environmental factors of oppression and individual and community resilience. A sample of 17 nonbinary adults in the Midwestern United States was recruited using convenience sampling and participated in online group discussions and individual interviews. The findings were reported in sections corresponding with the three study aims: 1) Explore core dimensions of wellbeing as defined by nonbinary individuals, 2) Identify promotive and corrosive factors of that wellbeing, and 3) Provide recommendations to bolster nonbinary wellbeing. The findings provided a thorough description of how nonbinary individuals perceive their wellbeing concerning their gender and as part of a marginalized population. Thematic analysis identified nine wellbeing themes for how participants conceptualized their wellbeing (e.g., Exploring gender identity and expression, Being connected to community, etc.), seven themes of promotive and corrosive factors of wellbeing (e.g., Positive, accurate, and nuanced representation, Coping skills to manage minority stressors, etc.), and three themes of recommendations (e.g., personal, interpersonal, and professional) with eighteen strategies to bolster wellbeing among nonbinary individuals and communities. The significance of the findings to social work was discussed, including practice application and advocacy. This study contributes to PhotoVoice methodology, wellbeing literature, and trans literature.
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    Nontraditional School Enrollment in Transgender and Gender-Diverse Youth
    (Elsevier, 2021) Gohil, Anisha; Donahue, Kelly L.; Eugster, Erica A.; Pediatrics, School of Medicine
    Purpose: This study aimed to investigate the prevalence of online and homeschool attendance in transgender and gender-diverse (TGD) youth. Methods: Caregivers of 12- to 17-year-olds participated in a phone survey about school attendance. Subjects included TGD youth receiving care in a gender health clinic and youth receiving care in a pediatric endocrinology/diabetes (PED) clinic. Results: Parents of 83 TGD and 83 PED youth participated in the study. Current/past enrollment in a nontraditional school setting was higher among TGD than PED youth (37.3% vs. 19.3%; p = .01). In addition, 14.5% of TGD and 7.2% of PED youth had transferred between traditional school settings (public, private, and charter) for psychosocial reasons. Conclusions: Approximately half of the TGD youth had either attended a nontraditional school setting or changed schools for psychosocial reasons, compared with approximately one fourth of PED youth (51.8% vs. 26.5%, p = .001). This suggests that traditional school environments present significant psychological difficulties for TGD adolescents.
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    Sex-Based Employment Protections for Transgender Individuals: A Study of Title VII Legal Cases in the Sixth Circuit
    (2019-07) Harris, Evan Marshall; Gentle-Genitty, Carolyn; Boys, Stephanie K.; McCabe, Heather; McGregor, Kyle A.; Pfeffer, Carla A.
    In the U.S., the transgender community disproportionately experiences a rate of unemployment three times that of the national average. These nearly 1.4 million individuals receive no explicit federal employment protections. Though judges have historically concluded that Title VII of the Civil Rights Act of 1964 does not offer such protections, the Sixth Circuit recently concluded that transgender discrimination is prohibited under Title VII. A study was conducted to discern what lead to the Sixth Circuit explicitly extending Title VII’s sex-based protections to transgender individuals. Analysis consisted of data from historical Title VII legal cases—citing sex-based discrimination— brought by, or on behalf of, transgender individuals in the Sixth Circuit. The sample included 20 court records from 11 legal cases identified through the Nexis Uni database. Both a thematic analysis and a Critical Discourse Analysis (CDA) were conducted. The thematic analysis illustrated four distinct steps taken by the Sixth Circuit—in addition to the two steps previously taken by other Circuits and the Supreme Court. Each stage revealed small deviations in statutory interpretation and application, which lead to a marked change in the legal discourse on Title VII’s sex-based discrimination prohibition. The CDA compared the Circuit’s starting discourse to its more recent discourse and found judges’ moved from a passive to an active role in constructing the legal discourse. Overall, the study illustrates the judicial branch of government’s influential impact on employment rights, and more broadly, social justice. Further, the study presents legal engagement as essential to the pursuit of social change. Given social work’s value of social justice, forensic participation is a suitable addition to the social work toolkit.
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    The Utility of Monitoring Potassium in Transgender, Gender Diverse, and Nonbinary Individuals on Spironolactone
    (Oxford University Press, 2022-09-12) Hayes, Hailey; Russell, Rachel; Haugen, Amber; Nagavally, Sneha; Sarvaideo, Jenna; Pediatrics, School of Medicine
    Context: Current Endocrine Society guidelines recommend that transgender women taking spironolactone have their potassium levels checked every 3 months for the first year after initiating therapy and annually thereafter to monitor for hyperkalemia. Objective: The goal of this study was to assess the need for such frequent potassium monitoring and to investigate whether age plays a role in potassium abnormalities in transgender, gender diverse, and nonbinary (TGDNB) individuals taking spironolactone. Methods: Using EPIC-Clarity, a retrospective study of healthy, adult individuals with gender-identity disorder listed in their problem list and taking spironolactone was performed. We analyzed the incidence of hyperkalemia in this population. Data from June 2006 through November 2021 were obtained. Exclusion criteria included hypertension, renal failure, diabetes mellitus, heart failure, and medications that affect the renin-angiotensin-aldosterone system. Results: 318 healthy TGDNB individuals met our inclusion criteria. We identified 8/318 (2.5%) individuals with hyperkalemia on spironolactone. There was a significant difference in incidence of hyperkalemia events in those >45 years old and those ≤45 years old (8.9% vs 1.5%, P = .016). Conclusion: Our data suggest the incidence of hyperkalemia in our TGDNB population is low, particularly in those ≤45 years old; however, this risk increases with age. These findings suggest practice guidelines may need to be adjusted to minimize unnecessary testing in the population ≤45 years old who are not plagued by comorbidities that affect potassium handling.
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    Transgender and Genderqueer Individuals’ Experiences with Health Care Providers: What’s Working, What’s Not, and Where Do We Go from Here?
    (Johns Hopkins University Press, 2018) Baldwin, Aleta; Dodge, Brian; Schick, Vanessa R.; Light, Brenda; Schnarrs, Phillip W.; Herbenick, Debby; Fortenberry, J. Dennis; Pediatrics, School of Medicine
    Research demonstrates health disparities between gender-minority individuals and cisgender individuals. These disparities arise from multiple sources, including negative health care experiences. This study examines interactions between transgender and gender non-binary (TGGNB) individuals and their health care providers. We analyzed 119 participants’ descriptions of positive and negative health care experiences, and what they wish providers knew about caring for TGGNB patients. Health care experiences went well when providers and staff used inclusive language, demonstrated their experience and education, and treated identity disclosure as routine. Negative interactions were characterized by misgendering, unfamiliarity with TGGNB people and health issues, and transphobic practices. Participants wished providers understood their health concerns, did not expect their patients to educate them, and created a welcoming clinical environment. Medical educators, administrators, and providers share responsibility for improving TGGNB patient experiences. Through a framework of cultural safety, we recommend several changes to ensure more equitable treatment in health care.