Universal gender screening: a simple strategy to enhance primary care for transgender and gender diverse people

Townsend, Marria; Clark, Beth A.

doi:10.1093/fampra/cmab176

Cited by 8 publications

(4 citation statements)

References 19 publications

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“…Be sensitive to cultural, religious, and gender considerations in patient dialog to optimize reaching an appropriate diagnosis, designing an effective and safe treatment plan and gaining consent for the mutually agreed plan. 63 …”

Section: Resultsmentioning

confidence: 99%

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Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors: Results of a Delphi Consensus Process

Keating,

Hawk,

Amorin-Woods

et al. 2024

Journal of Integrative and Complementary Medicine

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Objective: To build upon existing recommendations on best practices for chiropractic management of children by conducting a formal consensus process and best evidence synthesis. Design: Best practice guide based on recommendations from current best available evidence and formal consensus of a panel of experienced practitioners, consumers, and experts for chiropractic management of pediatric patients. Methods: Synthesis of results of a literature search to inform the development of recommendations from a multidisciplinary steering committee, including experts in pediatrics, followed by a formal Delphi panel consensus process. Results: The consensus process was conducted June to August 2022. All 60 panelists completed the process and reached at least 80% consensus on all recommendations after three Delphi rounds. Recommendations for best practices for chiropractic care for children addressed these aspects of the clinical encounter: patient communication, including informed consent; appropriate clinical history, including health habits; appropriate physical examination procedures; red flags/contraindications to chiropractic care and/or spinal manipulation; aspects of chiropractic management of pediatric patients, including infants; modifications of spinal manipulation and other manual procedures for pediatric patients; appropriate referral and comanagement; and appropriate health promotion and disease prevention practices. Conclusion: This set of recommendations represents a general framework for an evidence-informed and reasonable approach to the management of pediatric patients by chiropractors.

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Section: Resultsmentioning

confidence: 99%

“…Social/behavioral health history (such as activities, social/emotional stress, conflicts or abuse; depression, including suicidal ideation; gender identity) 63 …”

Section: Resultsmentioning

confidence: 99%

Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors: Results of a Delphi Consensus Process

Keating,

Hawk,

Amorin-Woods

et al. 2024

Journal of Integrative and Complementary Medicine

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“…For instance, our results could be used to develop inclusive language recommendations for physicians, which could be integrated into training programmes or clinical communication strategies. Similarly, Townsend and Clark [ 78 ] gave first recommendations for a gender inclusive primary care screening with, inter alia, physicians asking openly about questions and concerns patients might have due to their gender. Thus, based on these results a new questionnaire assessing trans individuals’ communication preferences systematically will be developed.…”

Section: Discussionmentioning

confidence: 99%

Exploring communication preferences of trans and gender diverse individuals—A qualitative study

von der Warth,

Metzner,

Körner

et al. 2023

PLoS ONE

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Background Trans and gender-diverse individuals experience adverse health outcomes that might be due, in addition to other factors, to stigma and discrimination in the health care sector. At the same time, the concept of person-centred care acknowledges the role of patient-physician communication in health care outcomes. This study aims to explore patient-physician communication preferences in trans and gender-diverse individuals. Method A qualitative interview study was conducted, including N = 10 participants between February and March 2022. Participants were interviewed using a semi-structured interview guideline, based on previous knowledge in person-centred care and sample specific communication. Participants were asked about their experiences and wishes in patient-physician centeredness. Analyses were conducting using a qualitative content analysis strategy. Results Mean age was 29.3 years; n = 6 participants identified themselves within the binary gender concept, while n = 4 identified themselves with a non-binary gender. Communication preferences for patient-physician communication were categorised into four themes: general communication aspects (e.g. active listening); the role of gender during appointments (e.g. appropriate/inappropriate addressing); gender-neutral language (e.g. experiences use of gender neutral language by physicians); own communication style (e.g. early outing and justification). Furthermore, possible contextual factors of patient-physician communication where found (e.g. trusting relationship). Conclusion Adding knowledge to communication preferences of trans and gender-diverse individuals, this study was able to identify preferences that are specific to the sample as well as preferences that differ from the cis-gendered population. However, it remains unclear how the patient-physician communication preferences affects health care utilization and outcomes. Trial registration German Clinical Trial Register (DRKS00026249).

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“…Gender inclusive practices may include assessing for potential barriers to care, such as previous/current experiences of discrimination or victimization, and integrating social service screening and resources that may offset such barriers ( Lerner & Robles, 2017 ). Additional inclusive practices include: reducing the use of binary gender terms; integrating pronouns, preferred name, sex assigned at birth, and current gender identity into intake forms; displaying inclusive images of people with varying gender presentation in educational materials, waiting rooms, and patient rooms; among others ( Lerner & Robles, 2017 ; Soled et al, 2022 ; Townsend & Clark, 2022 ). Lastly, practicing nurses and other clinicians should consider the use of tele-health to potentially alleviate some of the barriers to care by allowing TW the capacity to access high quality care from skilled and qualified providers no matter where they reside.…”

Section: Discussionmentioning

confidence: 99%

Stigma, social and structural vulnerability, and mental health among transgender women: A partial least square path modeling analysis

Sherman,

Higgins,

Balthazar

et al. 2023

J of Nursing Scholarship

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IntroductionExisting literature suggests that transgender women (TW) may be at high risk for adverse mental health due to stress attributed to combined experiences of stigma and complex social and structural vulnerabilities. Little research has examined how these co‐occurring experiences relate to mental health. We aimed to test a theoretically driven conceptual model of relationships between stigma, social and structural vulnerabilities, and mental health to inform future intervention tailoring.Design/MethodsPartial least square path modeling followed by response‐based unit segmentation was used to identify homogenous clusters in a diverse community sample of United States (US)‐based TW (N = 1418; 46.2% White non‐Hispanic). This approach examined associations between latent constructs of stigma (polyvictimization and discrimination), social and structural vulnerabilities (housing and food insecurity, unemployment, sex work, social support, and substance use), and mental health (post‐traumatic stress and psychological distress).ResultsThe final conceptual model defined the structural relationship between the variables of interest within stigma, vulnerability, and mental health. Six clusters were identified within this structural framework which suggests that racism, ethnicism, and geography may be related to mental health inequities among TW.ConclusionOur findings around the impact of racism, ethnicism, and geography reflect the existing literature, which unfortunately shows us that little change has occurred in the last decade for TW of color in the Southern US; however, the strength of our evidence (related to sampling structure and sample size) and type of analyses (accounting for co‐occurring predictors of health, i.e., stigma and complex vulnerabilities, reflecting that of real‐world patients) is a novel and necessary addition to the literature. Findings suggest that health interventions designed to offset the negative effects of stigma must include anti‐racist approaches with components to reduce or eliminate barriers to resources that contribute to social and structural vulnerabilities among TW. Herein we provide detailed recommendations to guide primary, secondary, and tertiary prevention efforts.Clinical RelevanceThis study demonstrated the importance of considering stigma and complex social and structural vulnerabilities during clinical care and design of mental health interventions for transgender women who are experiencing post‐traumatic stress disorder and psychological distress. Specifically, interventions should take an anti‐racist approach and would benefit from incorporating social support‐building activities.

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Universal gender screening: a simple strategy to enhance primary care for transgender and gender diverse people

Cited by 8 publications

References 19 publications

Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors: Results of a Delphi Consensus Process

Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors: Results of a Delphi Consensus Process

Exploring communication preferences of trans and gender diverse individuals—A qualitative study

Stigma, social and structural vulnerability, and mental health among transgender women: A partial least square path modeling analysis

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