Health and Access to Gender-Affirming Care During COVID-19: Experiences of transmasculine individuals and men assigned female sex at birth

D’Angelo, Alexa B; Argenio, Kira; Westmoreland, Drew; Appenroth, Max Nicolai; Grov, Christian

doi:10.1177/15579883211062681

Cited by 13 publications

(7 citation statements)

References 40 publications

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“…Communities of transgender people in other parts of the world found alternative sources of commodity supplies and service access through telehealth [ 78 ]. Telehealth also facilitated access to providers with the competency to address the physical and mental health needs of transgender populations [ 79 ]. Future studies could explore how community members negotiated these community-specific health care need challenges; and the implication of instituting practices that can enhance access to transgender community-specific services during crisis periods.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic inequality, health inequity and well-being of transgender people during the COVID-19 pandemic in Nigeria

Folayan,

Yakusik,

Enemo

et al. 2023

BMC Public Health

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Background We aimed to explore socioeconomic inequality, health inequity, and the well-being of transgender people during the COVID-19 crisis in Nigeria. Methods Between June and December 2021, a cross-sectional survey was conducted collaboratively with community-based organisations in Nigeria. Participants living with or at risk of HIV were recruited voluntarily, online and face-to-face, using a combination of venue-based and snowball sampling. We assessed the association between gender identity (transgender and vulnerable cisgender women), and (i) socioeconomic inequality measured with socioeconomic status, social status, economic vulnerability, macrosocial vulnerability; (ii) health inequity measured with self-assessment of health, recency of HIV test, access to HIV and sexual and reproductive health services, gender-affirming care, financial and non-financial barriers to accessing health services; and (iii) well-being, measured with gender-based violence, mental health, psychoeconomic preferences. We used multivariable logistic regressions and controlled for interactions and confounders. Results There were 4072 participants; 62% were under 30, and 47% reported living with HIV. One in ten (11.9%; n = 485) was transgender, and 56.5% reported living with HIV. Compared to vulnerable cisgender women, the results showed significantly higher odds (aOR:3.80) of disruption in accessing HIV services in transgender participants; gender-based violence (aOR:2.63); severe (aOR:2.28) symptoms of anxiety and depression. Among the barriers to accessing health and HIV services, transgender had three-time higher odds of reporting additional non-official fees compared to vulnerable cisgender women. The disclosure of their gender identity or sexual orientation was the most important non-financial barrier to accessing health services (aOR:3.16). Transgender participants faced higher housing insecurity (aOR: 1.35) and lower odds of using drugs (aOR:0.48). Importantly, they are more likely to have performed a recent HIV test and less likely to not know their HIV status (aOR:0.38) compared to vulnerable cisgender women. Conclusions Socioeconomic inequality, health and well-being inequity in transgender people appear to be exacerbated by the COVID-19 pandemic in Nigeria. Interventions are necessary to mitigate socioeconomic challenges, address structural inequality, and ensure equitable access to health services to meet the Sustainable Development Goals for transgender people.

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Section: Discussionmentioning

confidence: 99%

Socioeconomic inequality, health inequity and well-being of transgender people during the COVID-19 pandemic in Nigeria

Folayan,

Yakusik,

Enemo

et al. 2023

BMC Public Health

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“…No divergent results in the other Central Ideas were evidenced in the discourses from this identity group of cisgender and heterosexual, trans and homosexual men, mainly in relation to establishing affective and marital relationships. In addition to that, it is important to note the fact that gay and trans men might have already been experiencing greater vulnerability before the emergence of the COVID-19 pandemic for reasons related to homophobia and transphobia, due to other experiences of intrafamily violence and to social spaces, which even favor difficulties seeking help and access to health services by LGBTQIA+ men ( Camargo et al, 2021 ; D’Angelo et al, 2021 ; Pan et al, 2021 ), requiring careful analysis to promote strategies that ensure survival, safety, and minimization of the psychosocial impacts in this population segment.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 in Brazil and Psychosocial Repercussions on Men’s Health: Health Literacy Is Important

et al. 2022

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This study aimed at analyzing the psychosocial repercussions of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic on the health of men living in Brazil. For this, we carried out a socio-historical and qualitative study, with the participation of 200 men who answered an online questionnaire. The data collected were processed in the NVIVO12® software, structured by the Collective Subject Discourse method, and analyzed from the epidemic disease theoretical framework proposed by Charles Rosenberg. Our results showed that the SARS-CoV-2 pandemic brought about repercussions of different dimensions that compromised the health of men living in Brazil. The repercussions evidenced were behavioral changes and emergence of new habits due to the pandemic; uncomfortable family situations; impaired affective and sexual relationships; harms in marital relationships; and insecurity and psychological distress. It is important to implement strategies that maximize men’s health literacy, promoting better communication in terms of health, and search for help and suitable information about health/mental health.

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“…There is little research on the impact of the pandemic among trans men, but the unmet healthcare needs affected reproductive health, access to HIV PrEP (pre-exposure) care and gender-affirming procedures. 23 A systematic review concluded that mental health, health behaviours, safety and access to routine healthcare showed worse outcomes in LGBT community compared with before the pandemic or compared with heterosexual/cisgender populations. 24 The low rates of less that 20% of routine screeners in this research may be related, besides other factors described above, to the gaps in healthcare access that already existed and were intensified by Covid-19.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Cervical Cancer Screening among transgender men / Barreiras ao exame do Câncer do Colo do Útero entre homens transgêneros

Scarioti¹,

Bittencourt²,

Zanine³

2022

Braz. J. Hea. Rev.

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Purpose: to evaluate the barriers to cervical cancer screening among transgender men, and also to understand their experiences and preferences for cervical cancer screening. Methods: 19-item online survey structured based on the Health Belief Model, a conceptual formulation for understanding why individuals do or do not engage in health-related actions. It consists of the following dimensions: perceived susceptibility, perceived severity, perceived benefits, perceived barriers and general health motivation. Familiarity with cervical cancer, with Human Papillomavirus (HPV) and with Pap Test, being up-to-date on Pap Tests and preference for HPV self-sampling were additionally assessed. Results: 27 transgender men aged 18-51 years completed the survey. Most of them have a formal job, income up to 1 minimum wage per month, and are health-insured. The majority is single, heterossexual, and completed high school. Despite the fact that most are familiar with HPV and cervical cancer and are aware of the importance of regular Pap Tests, less than 20% are up-to-date. The barriers to cervical cancer screening may be related to discrimination, fear of invasive procedures and also the gaps in preventive health care associated with Covid-19. Only 25.9% of participants preferred HPV self-sampling over provider-collected Pap Test screening. Conclusion: most participants were not up-to-date on Pap Test screening, and refer unpleasant experiences in the past, discrimination and fear of invasive procedures. Healthcare professionals should be aware of the needs of this specific population, in order to provide better care and to affirm the gender identity.

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Health and Access to Gender-Affirming Care During COVID-19: Experiences of transmasculine individuals and men assigned female sex at birth

Cited by 13 publications

References 40 publications

Socioeconomic inequality, health inequity and well-being of transgender people during the COVID-19 pandemic in Nigeria

Socioeconomic inequality, health inequity and well-being of transgender people during the COVID-19 pandemic in Nigeria

SARS-CoV-2 in Brazil and Psychosocial Repercussions on Men’s Health: Health Literacy Is Important

Barriers to Cervical Cancer Screening among transgender men / Barreiras ao exame do Câncer do Colo do Útero entre homens transgêneros

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