Moving Forward: Transgender Persons as Change Agents in Health Care Access and Human Rights

Cobos, Daniel; Jones, Jonathan

doi:10.1016/j.jana.2009.06.004

Cited by 29 publications

(24 citation statements)

References 5 publications

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“…Community outreach programs need to be developed in support of members of the community, including programs that promote intergenerational and multicultural interaction. 66,73 Legal support for later-life and end-of-life preparations needs to be rapidly increased, as many elders of the community have no end-of-life documents in place.…”

Section: Research Challenges and Conclusionmentioning

confidence: 99%

It's Not All Darkness: Robustness, Resilience, and Successful Transgender Aging

Witten

2014

LGBT Health

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We review the recent psychosocial literature on transgender aging. We also report relevant in-press results from the Trans MetLife Survey on Later-Life Preparedness and Perceptions in Transgender-Identified Individuals (TMLS) on end-of-life and later-life trans-aging. To obtain relevant literature, we employed the search engines Google Scholar, Stanford Highwire, and PubMed/Medline. Databases searched included Web of Science, Cinhal, PsyINFO, Gender Studies Database, Sociological Abstracts, and Social Services Abstracts. Keyword searches included "transgender" and "transsexual." Key phrases included "transgender aging," "transsexual aging," and "LGBT aging." Years searched were from January 1, 2011, through April 26, 2013. We found two types of articles: LGBT aging-related (or lumped aging) articles and articles that focused specifically on transgender aging, or trans-aging. We found that the articles spoke of concerns and fears regarding discrimination, potential abuse at the hands of caregivers, inability to live out their lives in their true identities, risk of becoming homeless, loss of independence, and dementia, among other concerns. We note that the elder trans-identified population is significantly ill-prepared for the major legal issues that arise and events that occur in the later-life to end-of-life time periods. Despite these difficulties, a few articles spoke of resilience and successful aging in the population. Some TMLS respondents indicated that they were considering either "detransitioning," that is, changing social presentation to the pretransition gender identity, or suicide (which some referred to as euthanasia) as means of managing the severe problems they expected to encounter later in the aging process. A number of potentially modifiable risk factors exist within this population. Modification strategies include increasing the population awareness of the need for end-of-life legal preparations for members of the trans-identified community as well as those who serve it. There is a continued need to reduce stigma and to include gender identity/gender presentation in nondiscrimination and hate crime statutes. Despite these difficulties, there is a resilience and robustness that can be found in many individuals within the community of transgender older adults. There is a need to investigate this further.

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Section: Research Challenges and Conclusionmentioning

confidence: 99%

It's Not All Darkness: Robustness, Resilience, and Successful Transgender Aging

Witten

2014

LGBT Health

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“…Real or perceived stigma and discrimination within biomedicine and the health care provision in general may impact transgender people’s desire and ability to access appropriate care (3, 4). Transgender women (Male to Female, MTF) are internationally recognized as a population group that carries a disproportionate burden of HIV infection, with a worldwide HIV prevalence of 20% (5).…”

Section: Introductionmentioning

confidence: 99%

Barriers to healthcare for transgender individuals

Safer

Coleman

Feldman

et al. 2016

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

663

379

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Purpose of Review-Transgender persons suffer significant health disparities and may require medical intervention as part of their care. The purpose of this manuscript is to briefly review the literature characterizing barriers to health care for transgender individuals and to propose research priorities to understand mechanisms of those barriers and interventions to overcome them.Recent Findings-Current research emphasizes sexual minorities' self report of barriers, rather than using direct methods. The biggest barrier to health care reported by transgender individuals is lack of access due to lack of providers who are sufficiently knowledgeable on the topic. Other barriers include: financial barriers, discrimination, lack of cultural competence by providers, health systems barriers and socioeconomic barriers.Summary-National research priorities should include rigorous determination of the capacity of the United States health care system to provide adequate care for transgender individuals. Studies should determine knowledge and biases of the medical work force across the spectrum of medical training with regard to transgender medical care; adequacy of sufficient providers for the care

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“…If gender is required, question should read, "How do you define your gender? Male, Female, Trans" When calling in waiting area, on the phone, and booking patients, preferred name and not Ms. or Mr. (even if that name is not on their photo ID or insurance) should be used [7,33] In EMR, system's coding to designate nickname/preferred name and preferred gender and flag to ensure that all users of the program are made aware of preferences should be used [4,31,32,34]. If no fields available, follow a standard protocol of where information about pronouns/preferred name is stored (in space easily visible to all program users) [31] Ask which pronouns the patient prefers: "What are your preferred pronouns?…”

Section: Tablementioning

confidence: 99%

“…he, she, they, none, or another pronoun?" [26,33] Ask which pronouns the patient prefers: "What are your preferred pronouns? he, she, they, none, or another pronoun?"…”

Section: Tablementioning

confidence: 99%

“…he, she, they, none, or another pronoun?" [26,33] Use gender-neutral terms when asking about sexual experiences, "partners" for example, unless the patient uses other language (mirror their terms) [7] Leave room for open-ended answers to avoid making patients feel judged and to avoid excluding any of their experiences Ask questions about past sexual assault or coercion; MTF individuals especially have a higher incidence of violence against them [9] more inclusive. For specific care issues, especially those dealing with endocrinology, a specialist may be required for treatment, but general effects (Table 3) can impact care in any type of practice.…”

Section: Tablementioning

confidence: 99%

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