Exploring the Experiences of Transgender and Gender Diverse Adults in Accessing a Trans Knowledgeable Primary Care Physician

Transgender and gender diverse individuals face a variety of barriers when attempting to access healthcare, from discrimination to lack of access to lack of knowledgeable providers. Using data from the 2015 United States Trans Survey (N = 27,715), this study looks at the differences within the TGD population regarding having seen a doctor in the past year, having a primary care provider, and having a primary care provider who is knowledgeable about trans health. Logistic regressions indicate that even within an all transgender and gender diverse sample, a variety of identities and experiences are related to increased or decreased likelihood of each of these outcomes, with significant differences across gender, race/ethnicity, age, sexual orientation, disability status, educational attainment, annual income, disability status, religiosity, military status, overall health, housing status, and insurance coverage. Not only should there be an effort to support transgender and gender diverse individuals in accessing care, but there is a clearly indicated need for additional education for healthcare providers, especially those doing primary care, on how to offer knowledgeable, affirming, and intersectional care to their patients

Trans Men’s Access to Knowledgeable Providers and Their Experiences in Health Care Settings: Differences by Demographics, Mental Health, and Degree of Being “Out” to Providers

Transgender adults face a health care system rife with stigma, including a lack of culturally responsive providers and high likelihood of discrimination and mistreatment. However, there is a gap in knowledge about trans men—those assigned a female sex at birth who identify as men or as transmasculine—including subgroups, such as trans men of color. Using data from the U.S. Transgender Survey, the largest transgender survey conducted in the United States, this study analyzes whether trans men’s access to knowledgeable providers and their experiences of mistreatment in health care were related to demographic and mental health characteristics and degree of being “out” to providers. Among 7,950 trans men, respondent race and ethnicity, education level, disability status, psychological distress, suicidality, and being less “out” were associated with assessing one’s health care provider as not knowledgeable about trans-related care. Mistreatment in health care was more common among Alaska Native/American Indian trans men; those who lived in or near poverty; those who were queer, pansexual, bisexual, or an orientation not listed; those with a disability; those experiencing distress or suicidality; and those who were more “out.” This article discusses how findings can inform culturally responsive health care interventions with trans men

Does it get better? LGBTQ social work students and experiences with harmful discourse

Although the field of social work is grounded in social justice, the social work educational experience, including classrooms, may not live up to this value, especially for lesbian, gay, bisexual, transgender, and queer (LGBTQ) students. Using a qualitative phenomenological approach, this study examined the experiences of harmful discourse in social work classrooms for LGBTQ students. Findings indicate that students experienced being misgendered, tokenized, and erased through cis-/heteronormative language and classroom teachings. Although social work is guided by frameworks of social justice, microaggressions and discrimination may be vaguely glossed over, if addressed at all. This study highlights the gap between the values social work teaches and how social work education is delivered

Predictors of Healthcare Mistreatment Among Transgender and Gender Diverse Individuals: Are There Different Patterns by Patient Race and Ethnicity?

Using data from the 2015 United States Transgender Survey, this study investigates which patient sociodemographic characteristics and psychosocial risks are associated with likelihood of transgender mistreatment in healthcare and how patterns vary for patients of color. Numerous predictors, including alignment of identity documents, were associated with healthcare mistreatment. Among subgroups of transgender patients of color, psychosocial risks were more consistently significant than sociodemographic characteristics in predicting mistreatment. National and international health organizations are called to enact clear policies that affirm transgender patients and patients of color and establish a commitment to effectively serving these populations within their ethical codes

Defund the Police: Moving Towards an Anti-Carceral Social Work

This paper addresses social work’s place in the movement to “defund the police.” We argue that social work’s collaboration with police and use of policing constitutes carceral social work. In defining carceral social work, we specify the ways in which coercive and punitive practices are used to manage Black, Indigenous, other people of color and poor communities across four social work arenas – gender-based violence, child welfare, schools, and health and mental health. To inform anti-carceral social work, we provide examples of interventions in these arenas that dismantle police collaborations and point to life-affirming, community-centered, and mutual aid alternatives

Review of Trauma and Disability in Mad Max: Beyond the Road Warrior's Fury by Mick Broderick and Katie Ellis

No abstract available

Review: Prevalence of Addictions among Transgender and Gender Diverse Subgroups

We conducted an analysis of the prevalence of substance and behavioral addictions across different transgender and gender diverse (TGD) subgroups. We performed a scoping review using MEDLINE and Google Scholar databases and examined 12 addictions, including alcohol, nicotine, cannabis, illicit drugs, gambling, eating/food, internet, sex, love, exercise, work, and shopping. We presented prevalence rates for each addiction as a function of an individual’s gender identity (stratified into transgender females, transgender males, and gender nonconforming), and used cisgender women and men as reference groups. We included 55 studies in our final analysis, the majority of which investigated substance use disorders among TGD subgroups. Overall findings indicated that substantial differences in substance use exist among US TGD subgroups. There were far fewer publications that examined the prevalence of behavioral addictions across TGD subgroups. However, despite limited research in this area, findings still suggest that notable differences in behavioral addictions may exist between individual TGD subgroups. The conclusions of our review may provide clinicians with a better ability to screen for and treat at-risk individuals within the TGD community

Examining more inclusive approaches to social work, physical disability, and sexuality

People with disabilities often experience the idea that those with disabilities are not, or should not be, sexual beings. This article examines how people with physical disabilities define sexual activity, their levels of sexual satisfaction, group differences in how people define different acts as sexual activities, and the differences in levels of sexual satisfaction. Additionally, this study (N = 450) looks at the correlations between levels of independence in multiple contexts. Levels of independence are also assessed in relationship to severity of disability and sexual satisfaction. Implications for social work and social service practice, education, and policy are discussed

Increased Prevalence, Predictors, and In-Group Differences of Forced Sex and Physical Dating Violence among Trans/Gender Diverse Youth

Forced sex and dating violence are too common among young people and rates are higher for young transgender and gender diverse (TGD) individuals. However, the TGD youth population has differential experiences across gender, race, age, sexual orientation, and other identity factors. This study, using data from the 2015 Healthy Kids Colorado Survey, explores these differential within-group experiences of forced sex and dating violence. Findings indicate that sexual minorities who are also TGD are 2.45–3.73 times more likely to experience forced sex and physical dating violence than their TGD heterosexual peers. Individuals who are transfeminine (4.49 times), transmasculine (2.52 times), and nonbinary (3.86 times) are more likely to experience forced sex, as well as physical dating violence (transfeminine (4.01 times), transmasculine (2.91 times), and nonbinary (4.77 times)), as compared to those individuals questioning their gender. Black individuals (3.93 times) and Multiracial individuals (2.39 times) are more likely to experience dating violence than their White counterparts. Age was related to increased experience of forced sex, with individuals being 1.34 times more likely to have experienced this per year increase of age. These findings indicate the need for more trans-inclusive youth programing around sexual violence and dating violence, as well as taking a more intersectional and personalized approach to prevention work

Differential Experiences of Mental Health among Trans/Gender Diverse Adults in Michigan

Transgender and gender diverse individuals experience high rates of health disparities, as compared with their cisgender (non-transgender) counterparts. One area in which these disparities is most grave is that of mental health, with some studies indicating transgender and gender diverse individuals as having a 40% rate of lifetime suicide attempts and similarly high rates of depression, anxiety, and suicidal ideation. These rates vary further within this population, with differential rates seen across sociodemographic factors, including race/ethnicity, gender, sexual orientation, disability status, education level, and income. This study explores mental health experiences across different social identities, using data from the 2018 Michigan Trans Health Survey (N = 659), a community-based participatory action research project collected in Michigan, United States, analyzed using chi-square tests of independence and logistic regressions. Findings indicate incredibly high rates of mental health concerns; 72.2% had been diagnosed with depression in their lifetime and 73.0% had been diagnosed with anxiety in their lifetime. In the past year, 49.9% had had non-suicidal self-injury (NSSI) thoughts, 45.4% had suicidal thoughts, 26.3% engaged in NSSI, and 7.7% had attempted suicide. Bivariate regressions showed some nuanced experiences of rates of mental health diagnoses and experiences, such as greater odds of experiencing all mental health disparities among those with disabilities, and differential odds across gender in regard to ever having a depression diagnosis, non-suicidal self-injury thoughts and engaging in non-suicidal self-injury behavior. This indicates a need for social workers, counselors, therapists, and other human services professionals to act more intentionally and with an intersectional lens when it comes to exploring the mental health of transgender and gender diverse persons