A transgender individual's lived experiences: Navigating discrimination and stigma in healthcare

This paper explores the various types of marginalization transgender individuals experience on a daily basis and its direct impact on the aggregation of health disparities for this population. In addition, responses from the healthcare community to the documented injustices of transgender people are analyzed at a federal, systems, and academic level. Conceptual frameworks are also evaluated to further understand and care for transgender clients. Using a phenomenological approach, this research describes the lived experiences of a transgender individual with healthcare, specifically how they navigate discrimination and stigma with providers, nurses, administrative staff, and facilities. Analysis revealed four themes, both with navigating healthcare and social interactions that have influenced his sense of self and state of health. These themes are (a) calculating the disclosure of a transgender identity, (b) managing discomfort of self and others, (c) respect and validation from others, and (d) lack of healthcare access. Practical implications for healthcare providers are also investigated, including opportunities for furthering the advancement of the healthcare profession as it relates to caring for the transgender community.Bachelor of Scienc

Subjective Cognitive Decline Higher Among Sexual and Gender Minorities in the United States, 2015–2018

Introduction: Subjective cognitive decline (SCD) represents self-reported problems with memory, a possible early sign of dementia. Little is known about SCD among sexual and gender minority (SGM) adults who identify as lesbian, gay, bisexual, and/or transgender or gender non-binary. Methods: Data were weighted to represent population estimates from 25 states’ 2015–2018 Behavioral Risk Factor Surveillance System to describe SCD in adults ≥ 45 years by SGM status. Logistic regression tested associations between demographic and health conditions. Results: SCD prevalence was higher in SGM (15.7%; 95% confidence interval [CI]:13.1–18.2) than in non-SGM adults (10.5%; 95% CI:10.1–10.9; P \u3c .0001). SGM adults with SCD were also more likely to report functional limitations due to SCD than non-SGM adults with SCD, 60.8% versus 47.8%, P =.0048. Differences in SCD by SGM status were attenuated after accounting for depression. Discussion: Higher prevalence of SCD in SGM adults highlights the importance of ensuring inclusive screenings, interventions, care services, and resources for SGM adults

Minority Stress, Structural Stigma, and Physical Health among Sexual and Gender Minority Individuals: Examining the Relative Strength of the Relationships

Background: Sexual and gender minority (SGM; i.e., non-heterosexual and transgender or gender-expansive, respectively) people experience physical health disparities attributed to greater exposure to minority stress (experiences of discrimination or victimization, anticipation of discrimination or victimization, concealment of SGM status, and internalization of stigma) and structural stigma. Purpose: To examine which components of minority stress and structural stigma have the strongest relationships with physical health among SGM people. Methods: Participants (5,299 SGM people, 1,902 gender minority individuals) were from The Population Research in Identity and Disparities for Equality (PRIDE) Study. Dominance analyses estimated effect sizes showing how important each component of minority stress and structural stigma was to physical health outcomes. Results: Among cisgender sexual minority women, transmasculine individuals, American Indian or Alaskan Native SGM individuals, Asian SGM individuals, and White SGM individuals a safe current environment for SGM people had the strongest relationship with physical health. For gender-expansive individuals and Black, African American, or African SGM individuals, the safety of the environment for SGM people in which they were raised had the strongest relationship with physical health. Among transfeminine individuals, victimization experiences had the strongest relationship with physical health. Among Hispanic, Latino, or Spanish individuals, accepting current environments had the strongest relationship with physical health. Among cisgender sexual minority men prejudice/discrimination experiences had the strongest relationship with physical health. Conclusion: Safe community environments had the strongest relationships with physical health among most groups of SGM people. Increasing safety and buffering the effects of unsafe communities are important for SGM health

The health status of transgender and gender nonbinary adults in the United States.

The goal of this exploratory study was to delineate health differences among transgender subpopulations (transgender women/TW, transgender men/TM, gender nonbinary/GNB adults). 2015 Behavioral Risk Factor Surveillance System data were analyzed to compare the health of three groups (TW:N = 369; TM:N = 239; GNB:N = 156). Logistic regression and adjusted odds ratios were used to determine whether health outcomes (fair/poor health, frequent physical and mental unhealthy days, chronic health conditions, and health problems/impairments) are related to group and its interaction with personal characteristics and socioeconomic position. Group was a significant predictor of fair/poor health and frequent mental unhealthy days, revealing significant health differences between the transgender groups. The odds of poor/fair health were approximately 2.5 times higher in TM and GNB adults relative to TW. The odds of frequent mental unhealthy days for TM were approximately 1.5-2 times greater than TW and GNB adults. Among those with health insurance, the odds of fair/poor health for GNB adults was more than 1.5-2 times higher that of TM and TW. Among those without health insurance, TM had over 7 times greater odds of fair/poor health than TW. This study underscores the importance of classifying and examining the health of the transgender population as unique subpopulations, as notable health differences were discovered. TM and GNB adults have significant health concerns, requiring the attention of clinical interventions aimed at promoting health and preventing illness

Transgender women's satisfaction with healthcare services: A mixed-methods pilot study

Many transgender women are dissatisfied with healthcare services PURPOSE: (a) To describe satisfaction/dissatisfaction with healthcare services; and (b) to describe barriers/facilitators of satisfaction with healthcare services among a sample of transgender women. A mixed methods design collected quantitative data (n = 50) and qualitative data (n = 25) from transgender women. Quantitatively, satisfaction with healthcare services was high among the participants, with lower areas related to healthcare systems issues. Qualitatively, participants identified barriers and facilitators of healthcare satisfaction. This study provides clinical, research, educational, and policy implications for improving healthcare satisfaction among transgender women

Promoting diverse perspectives: Addressing health disparities related to Alzheimer's and all dementias

Dementia research lacks appropriate representation of diverse groups who often face substantial adversity and greater risk of dementia. Current research participants are primarily well-resourced, non-Hispanic White, cisgender adults who live close to academic medical centers where much of the research is based. Consequently, the field faces a knowledge gap about Alzheimer's-related risk factors in those other groups. The Alzheimer's Association hosted a virtual conference on June 14-16, 2021, supported in part by the National Institute on Aging (R13 AG072859-01), focused on health disparities. The conference was held entirely online and consisted of 2 days of core programming and a day of focused meetings centered on American Indian and Alaska Natives and on LGBTQIA+ populations. Over 1300 registrants attended discussions focused on the structural and systemic inequities experienced across diverse groups, as well as ways to investigate and address these inequities

The structural and social determinants of Alzheimer\u27s disease related dementias

INTRODUCTION: The projected growth of Alzheimer\u27s disease (AD) and AD-related dementia (ADRD) cases by midcentury has expanded the research field and impelled new lines of inquiry into structural and social determinants of health (S/SDOH) as fundamental drivers of disparities in AD/ADRD. METHODS: In this review, we employ Bronfenbrenner\u27s ecological systems theory as a framework to posit how S/SDOH impact AD/ADRD risk and outcomes. RESULTS: Bronfenbrenner defined the macrosystem as the realm of power (structural) systems that drive S/SDOH and that are the root cause of health disparities. These root causes have been discussed little to date in relation to AD/ADRD, and thus, macrosystem influences, such as racism, classism, sexism, and homophobia, are the emphasis in this paper. DISCUSSION: Under Bronfenbrenner\u27s macrosystem framework, we highlight key quantitative and qualitative studies linking S/SDOH with AD/ADRD, identify scientific gaps in the literature, and propose guidance for future research. HIGHLIGHTS: Ecological systems theory links structural/social determinants to AD/ADRD. Structural/social determinants accrue and interact over the life course to impact AD/ADRD. Macrosystem is made up of societal norms, beliefs, values, and practices (e.g., laws). Most macro-level determinants have been understudied in the AD/ADRD literature