Gender and sexuality I: Genderqueer geographies?

This review considers gender diversity across a range of spaces and places. I note that while the notion of gender has been troubled, there exists opportunities to trouble it further. I highlight the scholarship that has sought to deconstruct genders, and the binary framing of man/woman and male/female roles and relationships. The queering of sexuality has meant that geographers are now tracing the ways in which lesbian, gay, bisexual, transgender, intersex, queer (LGBTIQ) bodies experience and live their gender beyond normative binaries. Research concerned with relational gendered subjectivities within LGBTIQ communities is discussed, and I flag the trend that this research may conflate gendered experiences while privileging sexual subjectivities. Finally, I turn to the recent interest by geographers who - drawing on queer and trans* theories - argue for new and innovative understandings of gender diversity

“Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients

<p>Abstract</p> <p>Background</p> <p>Members of the transgender community have identified healthcare access barriers, yet a corresponding inquiry into healthcare provider perspectives has lagged. Our aim was to examine physician perceptions of barriers to healthcare provision for transgender patients.</p> <p>Methods</p> <p>This was a qualitative study with physician participants from Ontario, Canada. Semi-structured interviews were used to capture a progression of ideas related to barriers faced by physicians when caring for trans patients. Qualitative data were then transcribed verbatim and analysed with an emergent grounded theory approach.</p> <p>Results</p> <p>A total of thirteen (13) physician participants were interviewed. Analysis revealed healthcare barriers that grouped into five themes: Accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs. pathologising trans patients, and health system determinants. A centralising theme of “not knowing where to go or who to talk to” was also identified.</p> <p>Conclusions</p> <p>The findings of this study show that physicians perceive barriers to the care of trans patients, and that these barriers are multifactorial. Access barriers impede physicians when referring patients to specialists or searching for reliable treatment information. Clinical management of trans patients is complicated by a lack of knowledge, and by ethical considerations regarding treatments—which can be unfamiliar or challenging to physicians. The disciplinary division of responsibilities within medicine further complicates care; few practitioners identify trans healthcare as an interest area, and there is a tendency to overemphasise trans status in mental health evaluations. Failure to recognise and accommodate trans patients within sex-segregated healthcare systems leads to deficient health policy. The findings of this study suggest potential solutions to trans healthcare barriers at the informational level—with increased awareness of clinical guidelines and by including trans health issues in medical education—and at the institutional level, with support for both trans-focused and trans-friendly primary care models.</p