Overcoming the barriers in transgender healthcare in rural Ontario: discourses of personal agency, resilience, and empowerment

Blodgett, Nolan; Coughlan, Rory; Khullar, Neha

doi:10.1111/issj.12162

Cited by 13 publications

(20 citation statements)

References 31 publications

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“…Specifically, trans women and service providers were recruited from urban centres with historically better access to both LGBTQ + and HIV-specific services. Trans women living rurally may have different -and likely more negative -experiences accessing HIV care (Blodgett et al, 2018). Nevertheless, we recruited a racial/ethnically diverse group of trans women, with a range of education, employment, immigration experiences and sexual orientations, allowing for a rich exploration of intersectional considerations.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

A qualitative exploration of barriers to HIV prevention, treatment and support: Perspectives of transgender women and service providers

Lacombe‐Duncan

Kia

Logie

et al. 2020

Health Soc Care Community

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Transgender (trans) women experience barriers to access to HIV care, which result in their lower engagement in HIV prevention, treatment and support relative to cisgender people living with HIV. Studies of trans women's barriers to HIV care have predominantly focused on perspectives of trans women, while barriers are most often described at provider, organisation and/or systems levels. Comparing perspectives of trans women and service providers may promote a shared vision for achieving health equity. Thus, this qualitative study utilised focus groups and semi-structured interviews conducted 2018-2019 to understand barriers and facilitators to HIV care from the perspectives of trans women (n = 26) and service providers (n = 10). Barriers endorsed by both groups included: (a) anticipated and enacted stigma and discrimination in the provision of direct care, (b) lack of provider knowledge of HIV care needs for trans women, (c) absence of trans-specific services/organisations and (d) cisnormativity in sexual healthcare. Facilitators included: (a) provision of transpositive trauma-informed care, (b) autonomy and choice for trans women in selecting sexual health services and (c) models for trans-affirming systems change. Each theme had significant overlap, yet nuanced perspective, between trans women and service providers. Specific recommendations to improve HIV care access for trans women e34 | LACOMBE-DUNCAN Et AL.

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Section: Strengths and Limitationsmentioning

confidence: 99%

A qualitative exploration of barriers to HIV prevention, treatment and support: Perspectives of transgender women and service providers

Lacombe‐Duncan

Kia

Logie

et al. 2020

Health Soc Care Community

View full text Add to dashboard Cite

show abstract

“…Transgender and gender diverse people (henceforth 'trans') often encounter a range of barriers to health care, which can significantly undermine access to and quality of care [1][2][3][4][5][6][7]. Studies of trans experiences of health care indicate that clinical services and providers are often uninformed of the needs of, or are directly discriminatory towards, trans patients [8,9].…”

Section: Introductionmentioning

confidence: 99%

Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey

et al. 2021

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Transgender and gender diverse people have unique risks and needs in the context of sexual health, but little is known about sexual health care for this population. In 2018, a national, online survey of sexual health and well-being was conducted with trans and gender diverse people in Australia (n = 1,613). Data from this survey were analysed to describe uptake of sexual health care and experiences of interpersonal and structural cisgenderism and transphobia. Experiences of cisgenderism and transphobia in sexual health care were assessed using a new, four-item scale of ‘gender insensitivity’, which produced scores ranging from 0 (highly gender sensitive) to 4 (highly gender insensitive). Logistic and linear regression analyses were conducted to determine if experiences of gender insensitivity in sexual health care were associated with uptake and frequency of HIV/STI testing in the 12 months prior to participation. Trans and gender diverse participants primarily accessed sexual health care from general practice clinics (86.8%), followed by publicly funded sexual health clinics (45.6%), community-based services (22.3%), and general hospitals (14.9%). Experiences of gender insensitivity were common overall (73.2% of participants reported ≥2 negative experiences) but most common in hospitals (M = 2.9, SD = 1.3) and least common in community-based services (M = 1.3, SD = 1.4; p<0.001). When controlling for sociodemographic factors, social networks, general access to health care, and sexual practices, higher levels of gender insensitivity in previous sexual health care encounters were associated with a lower likelihood of recent HIV/STI testing (adjusted prevalence ratio = 0.92, 95% confidence interval [CI]:091,0.96, p<0.001) and less-frequent HIV/STI testing (B = -0.07, 95%CI:-0.10,-0.03, p = 0.007). Given the high rates of HIV and other STIs among trans and gender diverse people in Australia and overseas, eliminating cisgenderism and transphobia in sexual health care may help improve access to diagnostic testing to reduce infection rates and support the overall sexual health and well-being of these populations.

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“…the assumption that what gender means is understood in the same way by everyone. Research about medical transition has tended to focus on barriers to access, negative interpersonal experiences, and a lack of knowledge of the existence of trans people in healthcare settings (Blodgett et al, 2017). This chapter contributes to scholarship about gender, transition, and how trans people come to know themselves as trans.…”

Section: Setting the Stage: What Stories Are Being Told?mentioning

confidence: 96%

“…Although medical systems in both Canada and the US are shifting toward a model of trans healthcare that operates on the premise of informed consent, trans individuals maintain a tumultuous relationship to medical discourses. We must convince mental health practitioners that we are well enough, secure enough, and stable enough to access the tools needed to medically transition (Blodgett et al, 2017). The ways that trans people feel safe using health services are shaped by our continuing positionality as sites of discriminatory possibility and the fear of a revocation of primary care.…”

Section: Setting the Stage: What Stories Are Being Told?mentioning

confidence: 99%

“…As Eyssel et al (2017) emphasize, "this system [is] characterised by gate-keeping [and] is likely to foster hierarchical patient-[Trans Health Care] professional relationships with little room for trust and individuality" (p. 85). This is even more true for those who do not fit within the predetermined authentic trans narrative, such as those who question gender and transition as adults (Blodgett et al, 2017;Eyssel et al, 2017;Miller and Grollman, 2015). While important and necessary inquiries, these studies primarily focus on how people who are not trans make sense of trans embodiments and how trans people felt in response.…”

Section: Setting the Stage: What Stories Are Being Told?mentioning

confidence: 99%

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The Stories We Tell: Making Sense of Gender, Transition, and the Centrality of Relationships

Debney¹

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What does it mean to be trans? What brings some of us to medically transition? This thesis contributes to a better understanding of trans lives. More specifically, my work attends to how we situate ourselves within others' stories to determine validity and humanity.Motivated by my own experiences of making sense of gender and medically transitioning in my youth, my research considers how the dominant stories of gender inform how trans adults in North America make sense of their own genders and transition.These stories and orientations are enmeshed with relationships and relationships vary. This variation is not because of any one identifiable thing. These variations tell us things about the way we see and think about gender, as well as our orientations to it. This thesis is a call for research on transition to return to considering what gender means, starting from the perspective of trans lives and voices.

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Overcoming the barriers in transgender healthcare in rural Ontario: discourses of personal agency, resilience, and empowerment

Cited by 13 publications

References 31 publications

A qualitative exploration of barriers to HIV prevention, treatment and support: Perspectives of transgender women and service providers

A qualitative exploration of barriers to HIV prevention, treatment and support: Perspectives of transgender women and service providers

Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey

The Stories We Tell: Making Sense of Gender, Transition, and the Centrality of Relationships

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