Nonbinary people experience marginalization through discrimination, rejection, microaggressions, and stigma as a result of not always conforming to societal gender norms embedded in the gender binary. There is limited research about how nonbinary Black, Indigenous, and People of Color (BIPOC) living in the United States navigate societally enforced binary gender norms, which is especially important to understand given how racism and Euro-colonization have enforced the gender binary. Better understanding the internal strategies nonbinary people use to cope, embody affirmation, and regulate emotions in response to marginalizing experiences could increase understanding of how to best prevent and address the health disparities experienced by nonbinary people. Drawing on the practices of interrogating norms central to queer theory with a sensitization to racism and settler colonialism, this study aimed to identify a framework to understand nonbinary peoples' processes of navigating gender norms internally through their lived experiences with an awareness of how context impacts these processes. This qualitative interview study utilized construcitivist grounded theory methodology, guided by queer theory. Twenty-one nonbinary individuals were interviewed over Zoom with 15 being BIPOC. Participants navigated binary gender norms internally by self-defining affirmative nonbinary ways of being, noticing affirmation in a chosen community that allowed them to experience existing authentically outside of binary gender norms, and internally connecting to an embodied, authentic sense of gender within themselves and in community with other nonbinary people. These internal processes were influenced by two contextual factors: societal and cultural expectations of gender; and the contextual impacts of holding multiple marginalized identities. Understanding the contexts of the gender binary, racism, and cissexism that impact nonbinary people on a daily basis is crucial for mental health professionals, researchers, policy makers, and creators of gender inclusive education and support programs to support and affirm nonbinary people.

Research with transgender and gender-diverse (TGD) young people is essential to understand their experiences and to be able to propose, implement and adapt 'services' in the broadest sense to meet their needs. However, research outside clinical settings on current experiences and needs of youth under the age of 18 is limited which hinders the development of knowledge on TGD, as well as the development of research informed support practices. Acquiring parental consent for participatory research may present ethical and logistical difficulties, as it could jeopardize the safety, well-being, or confidentiality of adolescent participants. This creates a tension between the adolescent's right to autonomy, privacy, freedom, and all aspects related to the consent of the underage on the one hand, and the parents' right to protect their child on the other hand. This review aims to identify the methodological and ethical challenges associated with participatory research with transgender and gender-diverse young people.

Trans students are underrepresented in institutions of higher education, and little is known about their experiences and the stressors they face in this context. This study aims to understand Israeli trans students' experiences in such institutions, with a focus on the unique stressors they face and the elements that reduce these stressors' impact on their mental health. Qualitative interviews were conducted with 20 Israeli trans students who attended various institutions of higher education in Israel. Data were collected through semi-structured, in-depth interviews and was thematically analyzed. Two themes were identified. The first focused on the participants' stressors, including financial difficulties, administrative difficulties, and feelings of loneliness. The second theme focused on the elements that serve to temper the stressors they faced, including social support, hope for future social mobility, and academic skills that served to enhance their ability to cope with the stressors. The participants associated these elements with a sense of competency, higher levels of self-esteem, and a sense of belonging, thus, contributing to their psychological wellbeing. Our findings reveal that the stressors faced by trans students in academia are tempered by inter and intra personal aspects. This provides us with a deeper understanding of the salutogenic character of coping with stress and its relationship to resilience and agency. Our findings call for trans-affirming actions to create a gender-affirming environment in academia.

Nonbinary individuals grapple with societal and individual pressures from a pervasive lack of comprehension, acknowledgment, and affirmative social representation. This dearth of a societal conversation recognizing the validity of nonbinary identities leads to instances of discrimination. Social support is recognized as a buffer to these experiences and is positively related to better physical and psychological health.

Misgendering-using the wrong name, pronoun, or gendered language to refer to someone-is known to have negative impacts on the mental health and well-being of trans individuals generally. However, little is known about the effects of misgendering on nonbinary people specifically. As such, our research asked: 1) Among nonbinary people, what factors are associated with frequency of misgendering?; and 2) Do nonbinary people who experience misgendering less often have better health outcomes? We analyzed data from Trans PULSE Canada, a community-based survey of trans and nonbinary people living in Canada, using a subset ( = 1091) who identified as nonbinary and completed questions on misgendering. Misgendering was a frequent and distressing experience for nonbinary participants, with 59% misgendered daily, 30% weekly or monthly, and only 11% yearly or less. Most (58%) reported being very or quite upset when misgendered. About one in eight (13%) corrected others most or all of the times they were misgendered. Daily misgendering was more common among nonbinary people who were younger than 25 years old (64%, < .0001), visibly disabled (74%, = .003), assigned female at birth (61%, <.0001) or racialized as a person of color and assigned male at birth (65%, < .0001) compared with their counterparts. In multivariable regression analyses, less frequent misgendering (weekly/monthly vs. daily) was associated with a lower OASIS anxiety score (β = -0.555, 95% CI = -1.062, -0.048). Our research highlights the complexity of outness, passing, concealment, and affirmation for nonbinary people living at the intersections of marginalizations. Future research could build stronger causal analyses of the impacts of misgendering, how nonbinary people cope with misgendering, and policy and interventions to decrease misgendering.

Gender affirmation through hormone replacement therapies and surgery can significantly improve the health and wellbeing of some transgender, nonbinary, and gender diverse people. Despite the well-documented benefits of gender affirming care, barriers persist for many trans and gender diverse people, particularly those in rural areas. This exploratory study aimed to identify the barriers trans and gender diverse people faced when seeking to medically affirm their gender in the rural state of Tasmania, Australia. This article draws on qualitative data from a mixed-methods online survey of 84 trans and gender diverse Tasmanians aged 18-70. Participants identified financial and geographical barriers, discrimination, and medical gatekeeping as the three key factors that prevented or delayed their gender affirmation. Costly services that require multiple referrals to access limit trans and gender diverse patients' options, impacting their mental health and wellbeing. Gender affirmation on the basis of informed consent would reduce unnecessary medical gatekeeping and improve trans and gender diverse health and wellbeing.

Endometriosis is described as a gynecological disease that can severely impact on people's quality of life. Much of endometriosis research and literature is focused on cis women, although gender diverse people and cis men have been diagnosed with this disease. Cis women have reported problems in their healthcare for endometriosis due to delays in diagnosis and a lack of support in their treatment. Gender diverse people have reported to experience discrimination in healthcare settings. There is a lack of research on gender diverse people's experience of living with endometriosis and little is known about their experience of healthcare for endometriosis.

A growing body of research has explored the benefits of animal companionship to trans people, yet too often this research reinforces human exceptionalism, and fails to explore what it means for trans people to engage in more-than-human relationships. Conversely, trans theorists have increasingly turned to consider what it means for trans people to lay claim to the category 'human', wrapped up as it is in normative claims to gender and sociality.

Gynecological primary care is a public health issue, however, there is no French data on the transmasculine population, despite identified needs and a low coverage rate described in the international literature. The objective was to analyze the access of the French transmasculine population to gynecological primary care.

Barriers to healthcare and negative healthcare experiences are frequently reported by transgender people, which is known to be compounded by intersectional issues including racism. The present study aimed to explore the experiences of trans people of color accessing a national Gender Service in the United Kingdom, to better understand the facilitators and barriers to positive healthcare experiences. Six transgender people of color attended two separate focus groups. Thematic analysis was used to identify themes in the data. Three themes were identified: and Participants talked of various ways in which their ethnicity and cultural backgrounds raised apprehensions and negative experiences within their gender-related care, such as assumptions being made about their transition process, and a general lack of visibility such as not seeing examples of the outcomes of surgeries and in community spaces. The findings are discussed in relation to previous research, noting that culturally-inclusive models of transition, increased access to diverse, inclusive community spaces and further research in this field is needed to improve healthcare experiences.

Worldwide, trans people are known to take hormones without prescription or take higher or lower doses than prescribed. The study's goal was examination of the social context behind provision and receiving of gender-affirming hormonal therapy (GAHT) in Russia, as well as collection of opinions on the organization of healthcare.

Transgender and non-binary individuals face unique challenges when it comes to fertility preservation (FP). Despite the growing prevalence of gender dysphoria (GD) and gender transitioning, there is a lack of clear guidelines and consensus on the management of these patients in the FP setting. Clinicians and institutions providing FP services should ensure that they are aware of the needs and circumstances of this underrepresented group of patients and offer them accurate and evidence-based information when counseling and tailoring their FP treatment. For this scoping review, three major search engines were used. Including Embase, Epistemonikos, Google Scholar, MEDLINE and PubMed. Sources of grey literature were also explored (ResearchGate and Web of Science). The combination of only two keywords [transgender] AND [fertility preservation] was used up to May 2023. The available evidence on clinical management and FP outcomes in transgender patients is limited and mainly originates from case reports or small case series. The main limitation of current FP services for transgender and non-binary individuals is the lack of scientific evidence regarding their care. Overall, FP in transgender patients requires individualized and realistic plans, and psychological counseling should be offered. This review aims to provide the latest evidence coming from original studies to facilitate proper counseling and fertility management for these individuals. Inclusive health systems that provide comprehensive reproductive health care to transgender individuals can help them make informed decisions about FP and improve their quality of life. Future research is needed to establish more robust evidence-based guidelines for the management of transgender and non-binary individuals in the FP setting.

Colpectomy entails the surgical removal of the vaginal epithelium. It may be performed in trans-masculine individuals as gender-affirming surgery. Vaginal colpectomy is a complex procedure with potentially severe complications. As alternative, robotic-assisted laparoscopic colpectomy combined with robotic-assisted laparoscopic hysterectomy and possible bilateral salpingo-oophorectomy (RAC+) can be performed. To compare surgical outcomes of robotic-assisted colpectomy combined with a hysterectomy and bilateral salpingo-oophorectomy with a vaginal colpectomy after previous hysterectomy in trans masculine patients. A single-center retrospective cohort study included 310 transgender men who underwent either robotic-assisted colpectomy combined with a hysterectomy and bilateral salpingo-oophorectomy (RAC+) ( = 140) or vaginal colpectomy ( = 170) between January 2006 and December 2019. Surgical details and clinical outcomes were collected from all patients. The median intra-operative blood loss was 100 mL (50-200) in RAC + and 300 mL (200-450) in vaginal colpectomy ( < 0.01). The median duration of hospital stay was 2 days (1-2) in the RAC + group and 3 days (2-4) in the vaginal group ( < 0.01). In the RAC + group 63 (45%) peri-operative complications were reported, compared to 93 (54.7%) in the vaginal group [OR 0.7 (0.4-1.1)]. The main difference was found in intra-operative complications (RAC+ 0.7% vaginal 10.6%). Furthermore, the total number of complications graded 3a and higher was significantly lower in the RAC + group [OR 0.3 (0.2-0.7)]. Although RAC + entailed a more extensive procedure, compared to vaginal colpectomy, RAC + had a lower risk of severe peri-operative complications, requiring re-intervention; intra-operative blood loss was lower and hospital stay shorter. Both routes of colpectomy are complex procedures with potentially severe complications. Future studies are needed to study whether robot-colpectomy could be a safe alternative to vaginal colpectomy in patients with a previous hysterectomy.

Accurate data on the number of transgender and non-binary people are essential for the effectiveness of planning and implementation of transgender services, as well as for advocacy, but these data are insufficient. Our goal in this study was to estimate the number of transgender people in Georgia and compare it with estimations in other Eastern European and Central Asian (EECA) countries.

Trans and/or non-binary parents experience structural exclusion in family healthcare and there is a need for specialist training for healthcare professionals so that they are able to create a gender inclusive environment. As part of a continued effort to address health inequity this study explores the body experiences of infant feeding within trans and non binary communities. Semi structured interviews were conducted with seven trans or non-binary parents, based in the United Kingdom, who have experienced chestfeeding or breastfeeding. A reflexive thematic analysis was utlitised to identify three main themes which centered around baby, body and support in health care settings. Parents were informed of the benefits of their milk and were strongly motivated by their child's needs. However, body feeding was emotionally and physically challenging. Person-centered care with consistent attention to language is required when supporting lactation.

There is growing interest in investigating genetic explanations for transgender identity. In the spirit of a Community-Engaged Research Framework, which highlights the importance of involving community members who would be impacted by research throughout the entire research process, it is important for researchers to understand transgender and gender expansive individuals' views and concerns regarding the potential harms and benefits of transgender identity genetic research (TIGR). To evaluate the thoughts, opinions, and beliefs in the transgender and gender diverse communities toward TIGR We conducted an online survey study, asking 409 transgender and gender diverse individuals about their views regarding potential benefits and risks of TIGR. Participants demonstrated a mixture of positive and negative opinions on the search for a genetic contribution to gender identity. Overall, there was a slight trend toward more positive views, with 71% agreeing or strongly agreeing that TIGR made them feel hopeful. Given the varied and nuanced views held within the transgender and gender diverse communities toward transgender genetic research, we hope that this study can be one of many evaluating this topic, and that our findings, and those of future studies, can serve as a foundation for conducting transgender genetic research in a way that is in alignment with the ethos and priorities of the transgender and gender diverse communities.

The transgender population is one of the most marginalized and misunderstood population groups in South Africa. Despite a progressive and inclusive human rights-based legal framework, transgender people in South Africa are vulnerable to multiple human rights violations, including inequality and grave healthcare disparities. This study aims to assess the healthcare disparities experienced by transgender persons in South Africa. In South Africa, transgender people are legally entitled to equality and the right to access healthcare services. The article examines sparsely explored discrepancies and recommends how a transgender person's right to access healthcare can be strengthened through a comprehensive human rights approach. The methodology involved semi-structured interviews with transgender respondents and healthcare experts. The sample comprised 43 transgender respondents aged between 23 and 45 residing in Gauteng, Mpumalanga, North West and the Western Cape and a multi-disciplinary group of nine healthcare professionals working in South African health institutions. The data was analyzed through relevant thematic analysis. The majority of transgender participants and healthcare experts reported that there are transgender-related inequalities in the healthcare system, including stigma and discrimination, exclusionary and culturally incompetent health services and limited availability of competent healthcare services. There is a need for South Africa to intensify its application of transgender human rights to bridge the gap between lived experiences and the law. Comprehensive and explicit transgender-inclusive laws must be developed. Diverse transgender people must participate in the law and policy-making process. Activism, advocacy, and strategic litigation should be used effectively by relevant parties to create awareness and impact change.

Transgender individuals frequently undergo gender-affirming hormone therapy (GAHT) during their gender transition which plays a vital role in gender identity affirmation. Cholelithiasis, a common condition affecting 10-15% of the US population, has been linked to estrogen therapy in cisgender women. Despite the fact that hormonal profiles achieved after GAHT are not always identical to cisgender individuals, the effects of GAHT on gallbladder disease (GBD) risk have not been evaluated in transgender populations. This research aims to address this gap utilizing a large nationwide database.

The phenomenon of the and of French Polynesia represents a long-standing historical recognition of a third gender status that makes space for a level of respect and integration within a broader society. is a more recent type of who more overtly express themselves as women in society. This article describes the gender identity, gender expression, sexual behavior, and sexual orientation of gender diverse individuals in French Polynesia, including the Society, Tuamotus, and the Marquesas Islands. By studying cultures with protective factors, this research seeks to contribute to the development of effective approaches to sexual and gender health promotion, including HIV/STI prevention. Our analysis is based on ethnographic work, field observation, in depth interviews, and survey data. The focus of this study was specifically on the and (gender diverse individuals). We collected data from ten islands in French Polynesia and included 47 participants. The results include demographics, information about self-identification, gender identity development and family and social acceptance, current gender identity, expression, early and current sexual experiences, relationships, involvement in sex work, and health status, including HIV risk and status. While not a utopia for gender variant individuals living in French Polynesia, this cultural recognition serves as a protective factor as compared to other cultures that greatly stigmatize transgender and gender diverse individuals or those who transgress socially defined roles for men.

Rejection from parents can lead transgender (trans) youth and young adults to experience poor health outcomes, while parental and sibling acceptance and support can be protective against poor health outcomes. The role of family in adult trans women's lives has been minimally investigated.

The health and well-being of transgender, non-binary, and gender-diverse people is receiving increasing attention from epidemiologists and public health researchers, including those utilizing longitudinal observational cohort studies. These longitudinal studies are advantageous over cross-sectional observational study designs given their scope over several timepoints rather than one, and when exposures and outcomes are prospectively measured this improves validity of causal claims. However, within these longitudinal studies, gender is often collected inconsistently (e.g. only asked at a single timepoint), or inadequately (e.g. questions that use limiting notions of gender). Due to the temporal nature of gender, this introduces potential including misclassification error and may provide an incomplete picture of gender diversity in a sample. This article considers these methodological issues and offers evidence-based recommendations to ensure longitudinal data on trans, non-binary, and gender-diverse people is treated with epidemiological rigor, while maintaining inclusivity.

For many trans folks, gender-affirming hormone therapy (GAHT) is a desired affirming procedure that has been linked with positive health outcomes, however literature has had little focus on the journeys of trans people as they access GAHT.

Facial gender-affirming surgery (FGAS), one of many transition-related surgeries (TRSs), "feminizes" the faces of transgender and gender diverse (TGD) patients undergoing transition. However, it is difficult to demonstrate the medical necessity of FGAS in terms of postoperative quality of life (QoL) outcomes due to a lack of standardized assessment tools. Thus, FGAS remains largely unsubsidized in North America. A systematic review of online databases was conducted according to PRISMA guidelines. Screening and quality assessment was conducted by two independent blinded reviewers (KJ and GR). For statistical analysis, data from different Likert-scale-like questionnaires were extracted and coalesced into three-point scales on a data table of seven QoL domains; "Pre-" and "Postoperative femininity," "Psychological satisfaction," "Social Integration and Functioning," "Aesthetic Satisfaction," "Physical Health," and "Satisfaction with Surgical Results." From 2000 to 2022, 1837 patients and 3886 procedures from 19 studies were included. Weighted averages across all QoL domains reflected statistically significant improvement compared to neutral following FGAS ( < 0.001). Three studies used the same questionnaire, which showed that out of all eight questions regarding facial appearance, FGAS patients most strongly agreed the surgery was important to their ability to live as a woman (mean = 4.56/5,  = 137). Secondary outcomes showed the most common complications were hardware palpability (3.45%,  = 145) and aberrant scarring (2.17%,  = 423) with an overall revision rate of 2.17% ( = 423). The most common procedure was fronto-orbital remodeling. FGAS significantly improves QoL with minimal risk to life and supports the literature in defining FGAS as a medically necessary procedure comparable to other TRSs.

Transgender, non-binary, gender non-conforming, and other gender diverse individuals (TGN) may be at higher risk of sexually transmitted infections (STIs). Transgender women specifically bear a disproportionate burden of HIV and other STIs worldwide. This study describes STI knowledge, risks, and prevention practices among TGN to better characterize barriers to sexual health care and identify potential platforms for sexual health education focusing on STI prevention. Qualitative interviews were conducted with  = 14 TGN individuals until thematic saturation was reached. Transcripts were coded and analyzed using thematic analysis. Four major themes emerged: (1) Sexual risk behaviors and STI prevention practices varied across participants; (2) individuals who demonstrated more knowledge about STIs either had a significant identifiable sexual educational experience or had a past personal experience with an STI; (3) individuals were interested in receiving information about STIs and sexual health from health care providers, school sexual education programs, and online resources based on a desire for accessible, private, factual, and inclusive content; and (4) public messaging around sexual health and STIs was seen both as potentially stigmatizing, but also important for increasing awareness of available services. We found that while important, considering gender alone may not adequately characterize risk of STI infection for TGN populations, and more research is needed to better characterize risk profiles. Individuals were interested in learning about sexual health and STI prevention from school curricula, health care settings, online resources, and public messaging advertisements, and had recommendations to ensure that these forms of information sharing were relevant, inclusive, and non-stigmatizing.

The present study explores how coming out to parents - in terms of both status (being out vs. not) and, if out, experience (continuum from rejection to acceptance) - affects trans people's mental health.

Traditionally, gender has been viewed through an essentialist lens with fixed biology-based traits or polarized gender norms between women and men. As awareness of gender diversity grows, increasingly more people are coming out as nonbinary - or not exclusively a man or woman. Little has been explored regarding experiences unique to nonbinary individuals, particularly beyond a focus on adverse risks and outcomes to understand their wellbeing. This article discusses gendered experiences and the construction of wellbeing among nonbinary individuals. The purpose of this study was to conceptualize wellbeing as a complex multidimensional phenomenon through nonbinary individuals' perspectives. A virtual PhotoVoice study was conducted with 17 nonbinary adults in the Midwestern United States who participated in online group discussions and in-depth semi-structured interviews, which were analyzed with thematic analysis. The analysis identified five core dimensions of nonbinary wellbeing: 1) Security, 2) Mental and physical health, 3) Autonomy, 4) Belonging, and 5) Gender positivity. Exemplary definitions of wellbeing are also presented. Understanding how nonbinary individuals thrive challenges the framing of gender diverse experiences in adversity and presents a more holistic portrayal that community members and allies can strive toward. This study contributes an intersectional understanding of wellbeing in relation to identities of race, culture, age, disability, neurodiversity, and sociopolitical geographical context. The findings of this study can aid in practice, advocacy, and research to bolster the wellbeing of nonbinary people.

Prescribing testosterone for gender affirming hormone therapy (GAHT) has been increasing in Australia with much of this practice done by general practitioners (GPs) and there are current AusPATH guidelines on how this can be done appropriately. There has been limited data collected from GPs about how well these patients are monitored and the adverse effects (AEs) that are experienced by this population of patients.

Ensuring proper early feeding for young children is crucial, as encountering feeding difficulties (FD) during this stage can give rise to a cascade of health problems, the repercussions of which may endure into late childhood and adolescence. Children raised by transgender parents may be at risk of encountering FD, however, there is no research conducted on Chinese transgender families.

Current cancer screening guidelines for transgender individuals are guided primarily by expert opinion, and are extrapolated from guidelines for cisgender populations, despite the additional unique risks that transgender populations face in cancer risk and cancer care.