Posts tagged as Health Care Access

(Dis) integrated Care

Barriers to Health Care Utilization for Trans Women Living With HIV

Transgender (trans) women have been particularly impacted by HIV. To seek insights into the dynamics of health service utilization, interviews were conducted with trans women living with HIV (n = 14) as part of the Trans PULSE community-based research project in Ontario, Canada.

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Factors Impacting Transgender Patients’ Discomfort with Their Family Physicians

A Respondent-Driven Sampling Survey

Representing approximately 0.5% of the population, transgender (trans) persons in Canada depend on family physicians for both general and transition-related care. However, physicians receive little to no training on this patient population, and trans patients are often profoundly uncomfortable and may avoid health care. This study examined factors associated with patient discomfort discussing trans health issues with a family physician in Ontario, Canada.
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Barriers to Well-being for Aboriginal Gender-diverse People

Results from the Trans PULSE Project in Ontario, Canada

Despite health inequities experienced by Aboriginal and transgender (trans) communities, little research has explored the well-being of Aboriginal trans (gender-diverse) people. This paper aims to describe barriers to well-being in a sample of Aboriginal gender-diverse people in Ontario, Canada.

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Reported Emergency Department Avoidance, Use, and Experiences of Transgender Persons in Ontario, Canada

Results From a Respondent-Driven Sampling Survey

Transgender, transsexual, or transitioned (trans) people have reported avoiding medical care because of negative experiences or fear of such experiences. The extent of trans-specific negative emergency department (ED) experiences, and of ED avoidance, has not been documented.

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Breast and Cervical Cancer Screening Among Trans Ontarians

A report prepared for the Screening Saves Lives Program of the Canadian Cancer Society

The objective of this report is to provide requested information on perceived need for, and access to, Pap tests and mammograms for trans (transgender, transsexual and transitioned) people in Ontario, using data from the Trans PULSE Project.

Among FTM trans people who had not had hysterectomies, 56.2% reported perceived need for a Pap test in the past year, of whom 83.1% were able to access one. In other words, an estimated 46.7% of FTMs who had not undergone hysterectomies had accessed a Pap test in the past year. Ten FTMs who had not had chest surgery (mastectomy) reported perceived need for a mammogram in the past year, of whom 7 were able to access one. Among MTF trans people who were on estrogen, 12 of 16 participants who perceived need for a mammogram were able to access one.  Read more

Nonprescribed Hormone Use and Self-Performed Surgeries

“Do-It-Yourself” Transitions in Transgender Communities in Ontario, Canada

Objectives. We examined the extent of nonprescribed hormone use and self-performed surgeries among transgender or transsexual (trans) people in Ontario, Canada.

Methods. We present original survey research from the Trans PULSE Project. A total of 433 participants were recruited from 2009 to 2010 through respondent-driven sampling. We used a case series design to characterize those currently taking nonprescribed hormones and participants who had ever self-performed sex-reassignment surgeries.

Results. An estimated 43.0% (95% confidence interval = 34.9, 51.5) of trans Ontarians were currently using hormones; of these, a quarter had ever obtained hormones from nonmedical sources (e.g., friend or relative, street or strangers, Internet pharmacy, herbals or supplements). Fourteen participants (6.4%; 95% confidence interval = 0.8, 9.0) reported currently taking nonprescribed hormones. Five indicated having performed or attempted surgical procedures on themselves (orchiectomy or mastectomy). Read more

Estimating Unmet Need for OHIP-funded Sex Reassignment Surgeries

A Report Prepared for the Ministry of Health and Long-term Care of Ontario

The objective of this report is to provide information from Trans PULSE Project data to inform health systems planning with regard to sex reassignment surgeries covered under the Ontario Health Insurance Program (OHIP). Hormonal care and non-listed medical procedures are thus not included, though they represent important additional components of transition-related care.

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“I Don’t Think This Is Theoretical; This Is Our Lives”

How Erasure Impacts Health Care for Transgender People

For people who are transgender, transsexual, or transitioned (trans), access to primary, emergency, and transition-related health care is often problematic. Results from Phase I of the Trans PULSE Project, a community-based research project in Ontario, Canada, are presented. Based on qualitative data from focus groups with 85 trans community members, a theoretical framework describing how erasure functions to impact experiences interacting with the health care system was developed. Two key sites of erasure were identified: informational erasure and institutional erasure. How these processes work in a mutually reinforcing manner to erase trans individuals and communities and produce a system in which a trans patient or client is seen as an anomaly is shown. Thus, the impetus often falls on trans individuals to attempt to remedy systematic deficiencies. The concept of cisnormativity is introduced to aid in explaining the pervasiveness of trans erasure. Strategies for change are identified.

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