Reproductive Considerations for the LGBTQ+ Community

Montoya, Melissa N.; Peipert, Benjamin J.; Whicker, Dane R.; Gray, Beverly

doi:10.1016/j.pop.2021.02.010

Cited by 7 publications

(14 citation statements)

References 53 publications

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“…health care for personal care and family planning, and many clinicians utilize assisted reproductive technology (ART) to build their families for a wide variety of reasons (e.g., infertility, lesbians or gay men). 50 These reproductive technology resources may be threatened by legislative changes with the overturning of Roe v Wade. 51 Physicians who can become pregnant have higher rates of pregnancy-related complications than nonphysicians.…”

Section: All Clinicians Who Can Become Pregnant Access Reproductivementioning

confidence: 99%

“…All clinicians who can become pregnant access reproductive health care for personal care and family planning, and many clinicians utilize assisted reproductive technology (ART) to build their families for a wide variety of reasons (e.g., infertility, lesbians or gay men) 50 . These reproductive technology resources may be threatened by legislative changes with the overturning of Roe v Wade 51 …”

Section: Introductionmentioning

confidence: 99%

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Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians

Samuels‐Kalow

Agrawal

Rodriguez

et al. 2022

Academic Emergency Medicine

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On June 24, 2022, the United States Supreme Court ruled on Dobbs v. Jackson Women's Health Organization and overturned Roe v. Wade, removing almost 50 years of precedent and allowed individual states to determine restrictions on abortion. While the state-level policy landscape remains fluid, the Guttmacher Institute reports that 26 states (half of the United States) are likely to ban access to abortion, if their trigger laws have not already done so, 1 with critical implications for pregnant patients, those with reproductive potential, and the clinicians who care for them.The emergency department (ED) is an important access point for reproductive healthcare. More than 900,000 ED visits each year are for early pregnancy loss, which does not include those presenting for

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Section: All Clinicians Who Can Become Pregnant Access Reproductivementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians

Samuels‐Kalow

Agrawal

Rodriguez

et al. 2022

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…The choice of contraceptive method should also consider conditions associated with possible discomfort related to the use or insertion/withdrawal of the chosen method. [31][32][33][34][35][36][37] The genital exposure and pelvic manipulation can generate physical, psychological, and emotional discomfort. 6,38 In some protocols, the association of testosterone with an isolated progestogen method at the beginning of therapy is recommended to reduce possible unfavorable bleeding patterns.…”

Section: Side Effects and Possible Discomfort Associated With Contrac...mentioning

confidence: 99%

“…26,34 In cisgender women, the use of ethinyl estradiol or estradiol valerate increases the production of sex hormone-binding globulin (SHBG), leading to the reduced bioavailability of testosterone; however, there are no studies that evaluate this effect in transgender people, neither other possible deleterious effects during hormonal transition. 9,31 Some surveys report that the use of exogenous estrogen by this population may occasionally cause the enlargement and development of the mammary glands. 27 Since there are no studies that contraindicate the use of estrogens associated with testosterone in TM, and the risk of developing thrombosis is unknown in this situation, it is prudent to initially offer the prescription of progestogens alone to testosterone users.…”

Section: Side Effects and Possible Discomfort Associated With Contrac...mentioning

confidence: 99%

Contraceptive Counseling for the Transgender Patient Assigned Female at Birth

Okano

Pellicciotta

Braga

2022

Rev Bras Ginecol Obstet

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Although almost 0.7% of the Brazilian population identifies as transgender, there is currently no training for healthcare professionals to provide comprehensive care to these patients, including the discussion of reproductive planning. The use of testosterone promotes amenorrhea in the first months of use; however, this effect does not guarantee contraceptive efficacy, and, consequently, increases the risks of unplanned pregnancy. The present article is an integrative review with the objective of evaluating and organizing the approach of contraceptive counseling for the transgender population who were assigned female at birth. We used the PubMed and Embase databases for our search, as well as international guidelines on care for the transgender population. Of 88 articles, 7 were used to develop the contraceptive counseling model. The model follows the following steps: 1. Addressing the information related to the need for contraception; 2. Evaluation of contraindications to the use of contraceptive methods (hormonal and nonhormonal); and 3. Side effects and possible discomfort associated with the use of contraception. The contraceptive counseling model is composed of 18 questions that address the indications and contraindications to the use of these methods, and a flowchart to assist patients in choosing a method that suits their needs.

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“…Gender identity has been cited as a likely source of mental health difficulty and dysphoria during pregnancy, especially in transgender and nonbinary individuals, and poor access to gender-affirming care further raises this risk [ 24 , 26 , 27 ]. Physicians and other providers frequently lack knowledge about LGBTQ+ reproductive care, including mental health care, adding to risks of isolation [ 24 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

Postpartum Depression—Identifying Risk and Access to Intervention

Gopalan

Spada

Shenai

et al. 2022

Curr Psychiatry Rep

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Purpose of Review As maternal mortality climbs in the USA with mental health conditions driving these preventable deaths, the field of reproductive psychiatry must shift towards identification of women and other birthing individuals at risk and facilitating access. This review brings together recent studies regarding risk of perinatal depression and highlights important comorbidities that place individuals at higher vulnerability to poor perinatal outcomes. Recent Findings Recent research suggests that identifying risk for perinatal depression including historical diagnoses of depression, anxiety, trauma, and comorbid substance use and intimate partner violence may move the field to focus on preventive care in peripartum populations. Emerging data shows stark health inequities in racial and ethnic minority populations historically marginalized by the health system and in other vulnerable groups such as LGBTQ+ individuals and those with severe mental illness. Summary Innovative models of care using systems-level approaches can provide opportunities for identification and risk analyses of vulnerable peripartum patients and facilitate access to therapeutic or preventive interventions. Utilizing intergenerational approaches and leveraging multidisciplinary teams that thoughtfully target high-risk women and other birthing individuals could promote significant changes to population-level care in maternal health.

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Reproductive Considerations for the LGBTQ+ Community

Cited by 7 publications

References 53 publications

Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians

Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians

Contraceptive Counseling for the Transgender Patient Assigned Female at Birth

Postpartum Depression—Identifying Risk and Access to Intervention

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