Improving the Gender-Affirmation Process for Transgender and Gender-Nonconforming Individuals: Associations Among Time Since Transition Began, Body Satisfaction, and Sexual Distress

Staples, Jennifer; Bird, Elizabeth R.; Gregg, Jeffrey J.; George, William H.

doi:10.1080/00224499.2019.1617829

Cited by 27 publications

(20 citation statements)

References 32 publications

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“…Attempts to describe the transitioning process in ways other than types strive to simplify the process. Staples et al, (2019) list “steps” to the process of transitioning as “coming out”, “nonsurgical cosmetic procedures”, “hormone therapy” and “gender‐affirming surgery” and infer part social or medical transitioning. Budge et al, (2013) identify coping needs for the transgender population and categorize transitioning into three phases: pre‐transition, during transition and post‐transition.…”

Section: Resultsmentioning

confidence: 99%

“…Most participants were out individuals with higher education and social support and with minimal findings describing individuals questioning their gender status or living stealth (Huttunen et al, 2020; Trujilo et al, 2017). Participant samples lacked diversity in race, culture, ethnicity and age, and most participants identified as White (Kozee et al, 2012; Puckett et al, 2018; Roller et al, 2015; Schimmel‐Bristow et al, 2018; Staples et al, 2019). The above‐mentioned studies had more transmen—or transmasculine participants—and those identifying as transwomen/transfeminine were underrepresented.…”

Section: Discussionmentioning

confidence: 99%

“…Attempts to breakdown transitioning in steps suggest a linear progress (Staples et al, 2019), yet others describe transitioning as fluid and recursive (Kozee et al, 2012) and transgender individuals may or may not take certain steps in transitioning. Theorists, Piper and Mannino (2008), have explored transitioning, through building on concepts such as Marcia's 1990 ego identity paradigm of "identity formation" (Bergh & Erling, 2005) to emphasize the non-linear path and saliency of gender identity.…”

Section: Identification Of the Processmentioning

confidence: 99%

“…Participant samples lacked diversity in race, culture, ethnicity and age, and most participants identified as White (Kozee et al, 2012;Puckett et al, 2018;Roller et al, 2015;Schimmel-Bristow et al, 2018;Staples et al, 2019). The above-mentioned studies had more transmen-or transmasculine participants-and those identifying as transwomen/transfeminine were underrepresented.…”

Section: Limitationsmentioning

confidence: 99%

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The process of transitioning for the transgender individual and the nursing imperative: A narrative review

Evans

Crawley

Kane

et al. 2021

Journal of Advanced Nursing

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Aims The objectives of this study were to bring the experience of the transitioning process for the transgender population to the nursing profession and address the lack of knowledge to promote improved patient outcomes. Design This study used a narrative review using the literature matrix method. Because of the dearth of trans specific literature, editorials and monologues were included. Data source A broad search was undertaken across all databases including CINAHL, PubMed, PsycINFO, Ovid MEDLINE, ProQuest Nursing & Allied Health and Google Scholar. Literature from June 1994 to May 2020 was appraised. Non‐peer reviewed literature and published texts were procured via Google Alerts. Review methods Selection for inclusion was based on credibility and relevance from a variety of social science disciplines. A narrative analysis was used to identify common themes, incongruencies in schools of thought and perspectives that require consideration. Results Analysis of the literature revealed the following themes: (a) literature and terminology evolution, (b) transitioning as a process, (c) medicalization of transitioning, (d) generational views on transitioning and (e) needs during transition. Conclusion This review highlights key issues about the transitioning process imperative to nursing when meeting the needs of the transgender population. Impact This review addresses the lack of trans specific literature and lack of consistency in the literature about the understanding of the transitioning process for the transgender population. Main findings? Terminology to explain the transitioning process is ever evolving. Future studies about transitioning need to go beyond the medical lens. Generational views differ in the approach to transitioning, and there are needs unique to this population required during the process. Where and whom will the research impact? The review has significant implications for change in health delivery, nursing policy and formulating nursing practice and education to improve trans competent care.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Identification Of the Processmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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The process of transitioning for the transgender individual and the nursing imperative: A narrative review

Evans

Crawley

Kane

et al. 2021

Journal of Advanced Nursing

View full text Add to dashboard Cite

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“…TGD adolescents have lower self-esteem and poorer body image, and are less romantically and sexually experienced than their cisgender peers ( 98 ). Because body image, self-esteem, psychological wellbeing, and sexual anxiety are all critical aspects of sexual health and satisfaction ( 99 , 100 ), hormonal interventions have the potential to positively influence sexual wellbeing by improving GD ( 101 , 102 ).…”

Section: Potential Side Effects Of Hormonal Interventionmentioning

confidence: 99%

Approach to the Patient: Pharmacological Management of Trans and Gender-Diverse Adolescents

O’Connell

Nguyen

Ahler

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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Internationally, increasing numbers of children and adolescents with gender dysphoria are presenting for care. In response, gender affirming therapeutic interventions that seek to align bodily characteristics with an individual’s gender identity are more commonly being employed. Depending on a young person’s circumstances and goals, hormonal interventions may aim to achieve full pubertal suppression, modulation of endogenous pubertal sex hormone effects and/or development of secondary sex characteristics congruent with their affirmed gender. This is a relatively novel therapeutic area and, while short-term outcomes are encouraging, longer-term data from prospective longitudinal adolescent cohorts are still lacking, which may create clinical and ethical decision-making challenges. Here we review current treatment options, reported outcomes, and clinical challenges in the pharmacological management of trans and gender diverse adolescents.

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Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

et al. 2023

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ImportanceGender-affirming care is a key clinical area that can benefit from implementation of patient-reported outcome measures (PROMs). Identifying barriers to and enablers of PROM implementation is needed to develop an evidence-based implementation strategy.ObjectiveTo identify (1) PROMs previously implemented for gender-affirming care and constructs measured, (2) how patients completed PROMs and how results were reported and used, and (3) barriers to and enablers of PROM implementation.Evidence ReviewIn this systematic review, PubMed, Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science were searched from inception to October 25, 2021, and updated on December 16, 2022. Gray literature was searched through gray literature database, online search engine, and targeted website searching. Inclusion criteria were (1) original articles of (2) a formally developed PROM or ad hoc instrument administered for gender-affirming care to (3) patients accessing gender-affirming care. The Critical Appraisal Skills Programme tool was used to evaluate quality of included studies. This review was registered on PROSPERO (CRD42021233080).FindingsIn total, 286 studies were included, representing 85 395 transgender and nonbinary patients from more than 30 countries. A total of 205 different PROMs were used in gender-affirming care. No studies described using an implementation science theory, model, or framework to support PROM deployment. Key barriers to PROM implementation included issues with evidence strength and quality of the PROM, engaging participants, and PROM complexity. Key enablers of PROM implementation included using PROMs validated for gender-affirming care, implementing PROMs able to be deployed online or in person, implementing PROMs that are shorter and reduce patient burden, engaging key stakeholders and participants as part of developing an implementation plan, and organizational climate.Conclusions and RelevanceIn this systematic review of barriers to and enablers of PROM implementation in gender-affirming care, PROM implementation was inconsistent and did not follow evidence-based approaches in implementation science. There was also a lack of patient input in creating implementation strategies, suggesting a need for patient-centered approaches to PROM implementation. Frameworks created from these results can be used to develop evidence-based PROM implementation initiatives for gender-affirming care and have potential generalizability for other clinical areas interested in implementing PROMs.

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Improving the Gender-Affirmation Process for Transgender and Gender-Nonconforming Individuals: Associations Among Time Since Transition Began, Body Satisfaction, and Sexual Distress

Cited by 27 publications

References 32 publications

The process of transitioning for the transgender individual and the nursing imperative: A narrative review

The process of transitioning for the transgender individual and the nursing imperative: A narrative review

Approach to the Patient: Pharmacological Management of Trans and Gender-Diverse Adolescents

Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

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