Trans intracommunity support &amp; knowledge sharing in the United States &amp; Canada: A scoping literature review

Harner, Vern

doi:10.1111/hsc.13276

Cited by 20 publications

(11 citation statements)

References 54 publications

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“…Relatedly, participants sourced peer-based medical advice and support from online detransition networks to address unmet clinical care. This is consistent with existing research showing transgender people seek and provide peer-based mental health support and engage in peer-to-peer health information sharing …”

Section: Discussionsupporting

confidence: 90%

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Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments

et al. 2022

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IMPORTANCEMedical education, research, and clinical guidelines are available to support the initiation of gender-affirming care for transgender and nonbinary people. By contrast, little is known about the clinical experiences of those who discontinue or seek to reverse gender-affirming medical or surgical interventions due to a change in gender identity, often referred to as detransition. OBJECTIVE To examine the physical and mental health experiences of people who initiated medical or surgical detransition to inform clinical practice.DESIGN, SETTING, AND PARTICIPANTS Using constructivist grounded theory as a qualitative approach, data were collected in the form of in-depth interviews. Data were analyzed using an inductive 2-stage coding process to categorize and interpret detransition-related health care experiences to inform clinical practice. Between October 2021 and January 2022, individuals living in Canada who were aged 18 years and older with experience of stopping, shifting, or reversing a gender transition were invited to partake in semistructured virtual interviews. Study advertisements were circulated over social media, to clinicians, and within participants' social networks. A purposive sample of 28 participants who discontinued, shifted, or reversed a gender transition were interviewed. MAIN OUTCOMES AND MEASURESIn-depth, narrative descriptions of the physical and mental health experiences of people who discontinued or sought to reverse prior gender-affirming medical and/or surgical interventions. RESULTS Among the 28 participants, 18 (64%) were assigned female at birth and 10 (36%) were assigned male at birth; 2 (7%) identified as Jewish and White, 5 (18%) identified as having mixed race and ethnicity (which included Arab, Black, Indigenous, Latinx, and South Asian), and 21 (75%) identified as White. Participants initially sought gender-affirmation at a wide range of ages (15 [56%] were between ages 18 and 24 years). Detransition occurred for various reasons, such as an evolving understanding of gender identity or health concerns. Participants reported divergent perspectives about their past gender-affirming medical or surgical treatments. Some participants felt regrets, but a majority were pleased with the results of gender-affirming medical or surgical treatments. Medical detransition was often experienced as physically and psychologically challenging, yet health care avoidance was common. Participants described experiencing stigma and interacting with clinicians who were unprepared to meet their detransition-related medical needs.CONCLUSIONS AND RELEVANCE This study's results suggest that further research and clinical guidance is required to address the unmet needs of this population who discontinue or seek to reverse prior gender-affirming interventions.

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Section: Discussionsupporting

confidence: 90%

“…This is consistent with existing research showing transgender people seek and provide peer-based mental health support 37 and engage in peer-to-peer health information sharing. 38 …”

Section: Discussionmentioning

confidence: 99%

Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments

et al. 2022

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“…TikTok also provides a platform for health care providers and researchers who specialize in gender-affirming medicine to educate other clinicians and policy makers. Reflecting contemporary collaborative knowledge coproduction [ 42 ], trans communities are digitally well-connected and are active in peer-to-peer information sharing, support, and intracommunity education on the web [ 22 , 49 , 50 ]. This creates optimal conditions for community-engaged research and digital knowledge exchange between researchers, health care providers, and trans health care users.…”

Section: Community-engaged Knowledge Mobilization and Trans Peer-to-peer Information Sharingmentioning

confidence: 99%

“…A 2021 scoping review found that social media and web-based communities were sources of both peer-based support and resilience for trans people, which in turn could buffer poor mental health outcomes experienced by this population [ 49 ]. Another 2021 scoping review identified advocacy and education as prominent themes of trans peer-to-peer information sharing and support [ 22 ]. Lupton [ 31 ] specifically recommends examining how TikTok and other social media platforms are used for health-related content creation and peer-to-peer sharing among young people.…”

Section: Community-engaged Knowledge Mobilization and Trans Peer-to-peer Information Sharingmentioning

confidence: 99%

“…The fear of nonaffirming or discriminatory and/or incompetent health care can contribute to delayed health care among trans persons and teaching their own health care providers, which has been shown to increase the odds of delaying needed medical care [ 20 , 21 ]. At the same time, this may explain much of the intracommunity, peer-to-peer sharing of health-related content via web-based platforms [ 22 ]. In this paper, we discuss why and how trans people’s health care inequities can be addressed by bolstering digital knowledge mobilization and community-engaged knowledge exchange.…”

Section: Introductionmentioning

confidence: 99%

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Examining TikTok’s Potential for Community-Engaged Digital Knowledge Mobilization With Equity-Seeking Groups

MacKinnon¹,

Kia²,

Lacombe‐Duncan³

2021

J Med Internet Res

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Social media is increasingly being leveraged by researchers to engage in public debates and rapidly disseminate research results to health care providers, health care users, policy makers, educators, and the general public. This paper contributes to the growing literature on the use of social media for digital knowledge mobilization, drawing particular attention to TikTok and its unique potential for collaborative knowledge mobilization with underserved communities who experience barriers to health care and health inequities (eg, equity-seeking groups). Setting the TikTok platform apart from other social media are the unique audiovisual video editing tools, together with an impactful algorithm, that make knowledge dissemination and exchange with large global audiences possible. As an example, we will discuss digital knowledge mobilization with trans and nonbinary (trans) communities, a population that experiences barriers to health care and is engaged in significant peer-to-peer health information sharing on the web. To demonstrate, analytics data from 13 selected TikTok videos on the topic of research on gender-affirming medicine (eg, hormonal therapy and surgeries) are presented to illustrate how knowledge is disseminated within the trans community via TikTok. Considerations for researchers planning to use TikTok for digital knowledge mobilization and other related community engagement with equity-seeking groups are also discussed. These include the limitations of TikTok analytics data for measuring knowledge mobilization, population-specific concerns related to community safety on social media, the spread of disinformation, barriers to internet access, and commercialization and intellectual property issues. This paper concludes that TikTok is an innovative social media platform that presents possibilities for achieving transformative, community-engaged knowledge mobilization among researchers, underserved health care users, and their health care providers, all of whom are necessary to achieve better health care and population health outcomes.

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Transgender Patient Preferences When Discussing Gender in Health Care Settings

Harner,

Moore,

Casillas

et al. 2024

JAMA Netw Open

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ImportanceTransgender (trans) patients report frequent discriminatory and harmful experiences in health care settings; gender-affirming, competent health care improves trans individuals’ health and well-being.ObjectiveTo identify factors influencing trans patients’ decision-making regarding sharing gender-related information with providers (clinicians, health care organizations, health care systems) and trans patient preferences for gender-related questions, as well as the subsequent impact on health care experiences.Design, Setting, and ParticipantsA qualitative, interpretivist phenomenological study was conducted via telephone or video (using Zoom) in English and Spanish from August 10 to September 11, 2020. Participants were recruited via trans-specific social media groups and email listservs. Interviews were transcribed verbatim and analyzed from October 2020 to January 2022 using thematic analysis by a majority trans research team.Main Outcomes and MeasuresSemistructured interviews explored patient health care experiences and preferences.ResultsParticipants included 27 trans and/or nonbinary adults (mean [SD] age, 30.9 [10.4] years; range, 21-69 years) from 13 US states. Four themes were identified: (1) impact of provider behaviors, (2) engaging in relational risk assessment, (3) receiving affirming vs medically competent care, and (4) “how are you going to fit [me] into your system?” The first theme reflected the impact of provider actions, including level of flexibility in care and interpersonal interactions, ability to explain medical relevance of gender-related questions, and preparedness to work with trans patients. Second, respondents weighed a variety of implicit or explicit safety cues when deciding whether and how to share information with providers. Third, participants spoke at length about affirming and medically competent care, noting that they have had to prioritize one over the other. Last, participants reported their needs often being at odds with health care system norms and standards of care.Conclusion and RelevanceIn this qualitative study of trans patient preferences when discussing gender-related information with providers, it was found that equitable, gender-affirming, and competent health care requires flexibility and responsiveness to patient preferences. It requires provider humility and engagement, as well as institutional policies that support competent and gender-affirming spaces. Future research could identify additional roles that providers, administrators, and systems can play in ensuring competent care for trans patients.

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Trans intracommunity support & knowledge sharing in the United States & Canada: A scoping literature review

Cited by 20 publications

References 54 publications

Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments

Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments

Examining TikTok’s Potential for Community-Engaged Digital Knowledge Mobilization With Equity-Seeking Groups

Transgender Patient Preferences When Discussing Gender in Health Care Settings

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