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Trans Pathways: the mental health experiences and care pathways of trans young people. Summary of results.

Technical Report

Trans Pathways: the mental health experiences and care pathways of trans young people. Summary of results.

Abstract

Trans Pathways is the largest study ever conducted of the mental health and care pathways of trans and gender diverse young people in Australia (859 participants). It is also the first Australian study to incorporate the views of parents and guardians of trans young people (194 participants). Trans young people are at very high risk for poor mental health, self-harming and suicide attempts. Around 3 in every 4 trans young people have experienced anxiety or depression. Four out of 5 trans young people have ever engaged in self-harm, and almost 1 in 2 trans young people have ever attempted suicide (48%). Trans young people found it difficult to access health services with 60% feeling isolated from medical and mental health services, and 42% having reached out to a service provider who did not understand or respect their gender identity. Problems with health services included a lack of education about gender diversity, not knowing where to refer trans clients, and transphobia. Many trans young people have experienced negative situations that affect their mental health such as peer rejection, bullying, issues with school, university or TAFE, and a lack of family support. Participants told us they used music and art, peers and friends, activism, social media and pets to make themselves feel better and take care of the mental wellbeing. We have provided a list of recommendations for governments and health providers, as well as guidance for schools, parents, peers and young trans people.
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... Australian research has found a lack of TGD sensitive services, inadequate knowledge on the part of healthcare professionals, problems with access, and a high frequency of bad experiences which result in avoidance of healthcare and poor mental health (Couch et al. 2007;Hyde et al. 2014;McLean 2011;Riggs and Due 2013;Strauss et al. 2017). The characteristics of bad experiences for TGD Australians include; lack of respect; expressions of hostility, surprise, discomfort, contempt, and disgust; prejudicial attitudes; misgendering language; the patient having to educate the healthcare professional; refusal of services; and feeling pathologized (Ho and Mussap 2016;Jones et al. 2015;McLean 2011;Riggs and Due 2013). ...
... In their important role for primary healthcare, General Practitioners (GPs) are often the first point of contact when engaging with health services. GPs provide ongoing support and care, make referrals to more specialized care (and may be seen as 'gatekeepers' for this reason), and coordinate the care of their patients (Strauss et al. 2017). GPs are the most common healthcare professional for people to access in relation to their gender, and an individual's health needs are more likely to be met if they have a good, regular general practitioner (Hyde et al. 2014;Strauss et al. 2017). ...
... GPs provide ongoing support and care, make referrals to more specialized care (and may be seen as 'gatekeepers' for this reason), and coordinate the care of their patients (Strauss et al. 2017). GPs are the most common healthcare professional for people to access in relation to their gender, and an individual's health needs are more likely to be met if they have a good, regular general practitioner (Hyde et al. 2014;Strauss et al. 2017). In 2014, Hyde et. ...
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For many years the landscape has looked very bleak for TGD people in South Africa. Today, there are signs of hope, oases of possibility for improved access to care. Most encouragingly, trans people and organizations are playing an active role in educating trans communities and healthcare workers, and in developing guidelines for the delivery of gender-affirming care.
... Several factors contribute to unemployment and lower income in the TRANS population, such as employer discrimination, mental health conditions, and gender-conflicting name [42]. Therefore, it is necessary to develop public policies that ensure the inclusion of this population in the formal labor market. ...
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Background The term transgender (TRANS) may be used for people whose gender identity differs from the one assigned at birth. A large part of this population segment faces social (lack of social support, discrimination, rejection, transphobia) and psychological (anxiety, depression) challenges. These factors, in turn, may negatively impact the quality of life (QoL) of these individuals. In this context, the aim of this study is to identify the factors associated with QoL of TRANS people.Methods Cross-sectional study with non-probability sample, conducted with TRANS and cisgender (CIS) adults living in a southeastern Brazilian state. The research questionnaire was accessed electronically and comprised sociodemographic, health, and QoL information. QoL was assessed through the Short-Form 6 dimensions (SF-6D) instrument. Multivariable linear regression analysis (forward method) was applied to determine the influence of independent variables on QoL (outcome variable). All variables that presented p < 0.10 in the bivariate analyses were included. The analyses were carried out in the Statistical Package for the Social Sciences (SPSS)® software, version 22.0, with a significance level of 5%.ResultsThe sample included 65 TRANS individuals and 78 CIS individuals. The CIS group showed a predominance of people with higher education (p = 0.002) and higher income (p = 0.000) when compared with the TRANS sample. TRANS participants had worse QoL score (p = 0.014) and the same was observed when QoL was assessed by all dimensions (p ≤ 0.05). In addition, the place of residence and the report of recent prejudice remained associated with QoL even after adjusting for age, gender identity, occupation, and follow-up by a health professional (p < 0.05).Conclusion The TRANS population showed worse QoL when compared with the CIS population. Moreover, living in the state’s capital and having suffered episodes of prejudice were the factors remain statistically associated with the QoL among TRANS individuals.
... Following recommendations to lose weight may increase the risk of altered mood, body dissatisfaction and disordered eating behaviors. In the Trans Pathway Study, researchers found that 1 out of 4 youth reduced their exercise and 2 out of 3 limited their eating because of their gender identity and/or expression [17]. Clinicians may benefit from learning more about the unique perspectives of TGD youth to help provide healthcare that acknowledges their unique experiences and needs. ...
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Purpose of Review The relationships between gender identity, body image, and gender expression are complex, requiring a gender affirming approach to address weight management. This purpose of this review is to describe the essentials to caring for gender diverse youth, as well as the differences and intersections among those with obesity. Recent Findings Gender-affirming hormone therapy may lead to abnormal weight gain and increased body mass index, or worsen obesity and exacerbate weight-related complications. Moreover, given the high prevalence of victimization, marginalization, and stigmatization among gender diverse people and youth with obesity, care guidelines and treatment goals should also include reducing the negative impact of social-related complications. Summary Despite the overlap in clinical care and lived experiences that impact the health of gender diverse youth with obesity, there is very little research to help guide clinicians. Careful attention to medical and behavioral comorbidities, barriers to care, and health disparities can inform clinical practice. Future research that specifically addresses nuances to care for gender diverse youth with obesity can help to establish standards of care to address their unmet needs and further support clinicians, patients and their families.
... Autistic characteristics were over-represented in most studies of transgender children and adolescents (e.g., and transgender adults (e.g., Jones et al., 2012). In addition, Strauss et al. (2017) found 22.5% of 1000 transgender adolescents had an existing autism diagnosis. A second set of studies looked at gender diversity or GD diagnoses in autistic people. ...
... Autistic characteristics were over-represented in most studies of transgender children and adolescents (e.g., and transgender adults (e.g., Jones et al., 2012). In addition, Strauss et al. (2017) found 22.5% of 1000 transgender adolescents had an existing autism diagnosis. A second set of studies looked at gender diversity or GD diagnoses in autistic people. ...
... Depression significantly predicted work loss days (β = 0.45, p < .01) and gender diverse adults in the general population (Malkiel & Malkiel, 1973;Strauss et al., 2017) and may place cisgender female and/or gender diverse autistic adults at higher risks for depression and unemployment than their cisgender male peers. However, continued investigations with larger and more gender diverse samples are needed to understand the intersection of depression and employment in the context of autism. ...
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Autistic adults face elevated risks for depression and unemployment, yet a systematic review of studies on the intersection of depression and employment in autism is needed to inform research and clinical efforts. The present review synthesizes findings from studies that (1) measure both depression and employment in autistic adults, and (2) empirically test associations between these constructs. Results support other work indicating elevated prevalence rates of depression and unemployment in autism with new information on the complex associations between constructs. Insights from the present review were used to (1) discuss associations between depression and employment in autism, (2) identify current challenges to understanding the intersection of depression and employment in autism, (3) propose future lines of research, and (4) suggest clinical applications for providers (e.g., mental health clinicians, vocational rehabilitation practitioners) working with autistic adults.
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Ausgehend von einer skizzierenden Darstellung des aktuellen Paradigmenwechsels in der medizinisch-psychologischen Fachwelt hin zu einem nicht pathologisierenden Verständnis von geschlechtsnonkonformen Lebensformen und eingebettet in die sich daraus ergebenden medizinethischen Implikationen wird der aktuelle Wissensstand zur Entwicklung der Geschlechtsidentität und ihrer Varianten dargestellt. Die große phänomenologische Bandbreite und Prävalenz der Geschlechtsinkongruenz im Kindes- und Jugendalter, die sowohl normvariante als auch psychopathologische Auffälligkeiten umfasst, wird im Entwicklungsverlauf dargestellt, ebenso wie die diagnostischen Kriterien einer Geschlechtsdysphorie sowie der Wissensstand zur Ätiologie der persistierenden Transidentität und ihrer Prädiktoren in der Kindheit. Das dezidierte Vorgehen bei der Behandlung geschlechtsdysphorischer Kinder und Jugendlicher nebst Begleitung und Unterstützung ihrer sozialen Transition wird auf der Basis aktueller fachlicher Standards ausgeführt.
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This article is a critical celebration of Title IX. Fifty years of this landmark civil rights legislation has brought tremendous progress for girls and women in all areas of the U.S. educational system—including sport. However, Title IX has yet to achieve its full potential. For this to happen, I propose nine pressing issues that must be addressed: enforcing compliance; roster management and other dubious compliance tactics; more opportunities for women of color; the leadership gap; sex-segregated sport; the inclusion of transgender athletes; name, image, and likeness opportunities; the athletic arms race; and sexual harassment and violence. Based on current, scholarship, published data, and contemporary examples, this “nine for IX” approach is not a critique of the law but rather a critique of those aspects of American interscholastic and intercollegiate sport that continually hamstring Title IX’s power.
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Gender dysphoria (GD) in childhood is a complex phenomenon characterized by clinically significant distress due to the incongruence between assigned gender at birth and experienced gender. The clinical presentation of children who present with gender identity issues can be highly variable; the psychosexual development and future psychosexual outcome can be unclear, and consensus about the best clinical practice is currently under debate. In this paper a clinical picture is provided of children who are referred to gender identity clinics. The clinical criteria are described including what is known about the prevalence of childhood GD. In addition, an overview is presented of the literature on the psychological functioning of children with GD, the current knowledge on the psychosexual development and factors associated with the persistence of GD, and explanatory models for psychopathology in children with GD together with other co-existing problems that are characteristic for children referred for their gender. In light of this, currently used treatment and counselling approaches are summarized and discussed, including the integration of the literature detailed above.