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Article
Publication date: 2 December 2014

Louis Bailey, Sonja J. Ellis and Jay McNeil

The purpose of this paper is to present findings from the Trans Mental Health Study (McNeil et al., 2012) – the largest survey of the UK trans population to date and the…

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Abstract

Purpose

The purpose of this paper is to present findings from the Trans Mental Health Study (McNeil et al., 2012) – the largest survey of the UK trans population to date and the first to explore trans mental health and well-being within a UK context. Findings around suicidal ideation and suicide attempt are presented and the impact of gender dysphoria, minority stress and medical delay, in particular, are highlighted.

Design/methodology/approach

This represents a narrative analysis of qualitative sections of a survey that utilised both open and closed questions. The study drew on a non-random sample (n=889), obtained via a range of UK-based support organisations and services.

Findings

The study revealed high rates of suicidal ideation (84 per cent lifetime prevalence) and attempted suicide (48 per cent lifetime prevalence) within this sample. A supportive environment for social transition and timely access to gender reassignment, for those who required it, emerged as key protective factors. Subsequently, gender dysphoria, confusion/denial about gender, fears around transitioning, gender reassignment treatment delays and refusals, and social stigma increased suicide risk within this sample.

Research limitations/implications

Due to the limitations of undertaking research with this population, the research is not demographically representative.

Practical implications

The study found that trans people are most at risk prior to social and/or medical transition and that, in many cases, trans people who require access to hormones and surgery can be left unsupported for dangerously long periods of time. The paper highlights the devastating impact that delaying or denying gender reassignment treatment can have and urges commissioners and practitioners to prioritise timely intervention and support.

Originality/value

The first exploration of suicidal ideation and suicide attempt within the UK trans population revealing key findings pertaining to social and medical transition, crucial for policy makers, commissioners and practitioners working across gender identity services, mental health services and suicide prevention.

Details

Mental Health Review Journal, vol. 19 no. 4
Type: Research Article
ISSN: 1361-9322

Keywords

Book part
Publication date: 5 December 2022

Richard Pringle and Erik Denison

This chapter critically examines the unprecedented 2020 decision by World Rugby's (WR) primarily male leadership (92% of board members) to ban transgender (trans) women…

Abstract

This chapter critically examines the unprecedented 2020 decision by World Rugby's (WR) primarily male leadership (92% of board members) to ban transgender (trans) women from playing women's rugby union. We examined the process that was followed and found a lack of consultation with those directly impacted: women. To address this critical gap in the policy development process we conducted interviews and focus groups with cisgender female rugby players (junior to elite) of mixed ethnic backgrounds living in England, Canada and Australia. This was done with the support of rugby governing bodies and professional rugby teams. We found no support for WR's blanket ban. Rugby players felt the policy was a contradiction of rugby's claims it is a ‘game for all’. The minority of players with safety concerns supported exclusion on a case-by-case basis, with exclusion justified in a small number of narrowly defined circumstances (e.g. elite male players who transitioned recently). Importantly, the women and girls questioned why rugby's leaders had chosen to focus their energy on ‘protecting’ them from trans athletes but had ignored serious problems which cause them direct harm, such as a lack of funding, pervasive sexist and homophobic behaviour, sexual harassment, and substandard coaching and training facilities (relative to men). Our findings are consistent with and they support the position of women's sports organizations which have called on WR's male leaders to discard their blanket ban and undertake a rigorous, science-driven, collaborative policy development process.

Details

Justice for Trans Athletes
Type: Book
ISBN: 978-1-80262-985-9

Keywords

Article
Publication date: 17 January 2022

Hazel Marzetti, Alexander Oaten, Amy Chandler and Ana Jordan

With encouragement from the World Health Organisation, national suicide prevention policies have come to be regarded as an essential component of the global effort to…

Abstract

Purpose

With encouragement from the World Health Organisation, national suicide prevention policies have come to be regarded as an essential component of the global effort to reduce suicide. However, despite their global significance, the construction, conceptualisation and proposed provisions offered in suicide prevention policies have, to date, been under researched; this study aims to address this gap.

Design/methodology/approach

we critically analysed eight contemporary UK suicide prevention policy documents in use in all four nations of the UK between 2009 and 2019, using Bacchi and Goodwin’s post-structural critical policy analysis.

Findings

The authors argue that across this sample of suicide prevention policies, suicide is constructed as self-inflicted, deliberate and death-intentioned. Consequently, these supposedly neutral definitions of suicide have some significant and problematic effects, often individualising, pathologising and depoliticising suicide in ways that dislocate suicides from the emotional worlds in which they occur. Accordingly, although suicide prevention policies have the potential to think beyond the boundaries of clinical practice, and consider suicide prevention more holistically, the policies in this sample take a relatively narrow focus, often reducing suicide to a single momentary act and centring death prevention at the expense of considering ways to make individual lives more liveable.

Originality/value

UK suicide prevention policies have not been subject to critical analysis; to the best of the authors’ knowledge, this study represents the first attempt to examine the way in which suicide is constructed in UK suicide prevention policy documents.

Details

Journal of Public Mental Health, vol. 21 no. 1
Type: Research Article
ISSN: 1746-5729

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Article
Publication date: 16 March 2020

Ivy Hammond, Sarah Godoy, Mikaela Kelly and Eraka Bath

The available research on specialized interventions for youth experiencing commercial sexual exploitation almost exclusively focuses on the impact and efficacy related to…

Abstract

Purpose

The available research on specialized interventions for youth experiencing commercial sexual exploitation almost exclusively focuses on the impact and efficacy related to cisgender girls, despite the inclusion of youth who identify as transgender in these programs. This paper aims to present a case study on the experience of a transgender adolescent girl who experienced commercial sexual exploitation and provides a narrative of the multifarious challenges she faced while involved in institutional systems of care.

Design/methodology/approach

This paper conducted an in-depth case review of all records on “Jade,” a white adolescent transgender girl who experienced commercial sexual exploitation, from a specialty court program in the juvenile justice system between 2012 and 2016. Her experiences throughout childhood exemplify many of the unique challenges that transgender girls and young women with histories of exploitation or trafficking may encounter within service delivery and socioecological systems. This paper applied concepts adapted from the gender minority stress theoretical model to understand how minority gender identity can shape the experiences and outcomes of the youth impacted by commercial sexual exploitation.

Findings

Jade’s narrative underscores the interplay of gender-based sexual violence, heteronormative structural barriers, transphobia and their intersectional impact on her experience while receiving specialized care. The intersectional hardships she experienced likely contributed to adverse biopsychosocial outcomes, including high rates of medical and behavioral health diagnoses and expectations of further rejection.

Originality/value

This paper highlights the extraordinary challenges and barriers faced by an often under-recognized and overlooked subset of the youth impacted by commercial sexual exploitation, who may receive services that do not account for their unique needs related to gender expression and identity. This paper exemplifies how internalized stigma along with expectations of further rejection and victimization have implications for clinical and multidisciplinary intervention settings. Jade’s case underscores the need for improved access to supportive services for youth with minority gender identities, including peer community-building opportunities. Finally, this paper identifies a critical gap in US legislation and social policy. This gap contributes to the structural harms faced by transgender and gender-nonconforming youth receiving services during or following experiences of commercial sexual exploitation.

Details

International Journal of Human Rights in Healthcare, vol. 13 no. 2
Type: Research Article
ISSN: 2056-4902

Keywords

Book part
Publication date: 19 November 2021

Sameera V. Akella

This study explores the health-seeking process for queer and/or trans people, and factors involved in their healthcare negotiations and decisions to seek care. The data…

Abstract

This study explores the health-seeking process for queer and/or trans people, and factors involved in their healthcare negotiations and decisions to seek care. The data included 20 semi-structured interviews of people who identify as queer and/or trans in the southeastern United States. Qualitative analysis was conducted using constructivist grounded theory to inductively analyze accounts of healthcare events, behaviors, and experiences of queer and/or trans people. Participants’ ages ranged from 18 to 57, with a majority identifying as trans/gender nonconforming (65%) and those remaining identifying as queer, cisgender individuals (35%). Both queer and trans identities can overlap, therefore, I use the term “queer and/or trans.” Categories generated through the coding process were as follows: (1) mental health concerns, (2) negotiating gendered and heteronormative assumptions, and (3) significance of participants creating a bed of knowledge. My analysis asserts that these data indicate that queer and/or trans participants manage not just healthcare decisions, but the hopelessness attached to seeking this type of help.

Details

Advances in Trans Studies: Moving Toward Gender Expansion and Trans Hope
Type: Book
ISBN: 978-1-80262-030-6

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Book part
Publication date: 15 January 2021

Brea L. Perry and Allen J. LeBlanc

Purpose: The goal of Volume 21 of Advances in Medical Sociology, entitled Sexual and Gender Minority Health, is to showcase recent developments and areas for future…

Abstract

Purpose: The goal of Volume 21 of Advances in Medical Sociology, entitled Sexual and Gender Minority Health, is to showcase recent developments and areas for future research related to the health, well-being, and healthcare experiences of LGBTQA+ (Lesbian, Gay, Transgender, Queer, Asexual, and related communities that do not identify as heterosexual) persons and communities.

Approach: In this introduction to the volume, we trace the historical development of research on sexual and gender minority (SGM) health, discussing how priorities, theories, and evidence have evolved over time. We conclude with brief suggestions for future research and an overview of the articles presented in this volume.

Findings: Research on SGM health has flourished in the past two decades. This trend has occurred in conjunction with a period of intense social, political, and legal discourse about the civil rights of SGM persons, which has increased understanding and recognition of SGM experiences. However, recent advances have often been met with resistance and backlash rooted in enduring social stigma and long histories of discrimination and prejudice that reinforce and maintain health disparities faced by SGM populations.

Value: Our review highlights the need for additional research to understand minority stress processes, risk factors, and resiliency, particularly for those at the intersection of SGM and racial/ethnic or socioeconomic marginality.

Article
Publication date: 1 February 2008

Ian Cummins

The custody environment is not designed nor can it hope to meet the needs of individuals who are experiencing acute mental distress. The article reports the findings of…

Abstract

The custody environment is not designed nor can it hope to meet the needs of individuals who are experiencing acute mental distress. The article reports the findings of analysis of the recorded incidents of self‐harm that occurred in the custody of one English police force during an eight‐month period in 2006. There were 168 such incidents in this period. The ratio of male/female detained persons, who harmed themselves was 3:1. The most common method used was a ligature either from the detained person's own clothes or the paper suits that are used in custody. Alcohol or substance misuse was identified as a clear risk factor. The police response is analysed and recommendations made for improved access to health care for those in custody.

Details

The Journal of Adult Protection, vol. 10 no. 1
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 29 November 2013

Ayden I. Scheim, Randy Jackson, Liz James, T. Sharp Dopler, Jake Pyne and Greta R. Bauer

Despite health inequities experienced by Aboriginal and transgender (trans) communities, little research has explored the well-being of Aboriginal trans (gender-diverse…

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Abstract

Purpose

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.

Design/methodology/approach

In 2009-2010, 433 trans people in Canada's most populous province participated in a multi-mode health survey. In all, 32 participants identified as First Nations, Métis, or Inuit (Aboriginal); unweighted frequencies were calculated to describe their characteristics.

Findings

Participants expressed diverse gender identities; 44 per cent identified with the pan-Aboriginal term two-spirit. High levels of poverty (47 per cent), homelessness or underhousing (34 per cent), and ever having to move due to being trans (67 per cent) were reported. In all, 61 per cent reported at least one past-year unmet health care need. Most participants had experienced violence due to being trans (73 per cent) and had ever seriously considered suicide (76 per cent). One-fifth had been incarcerated while presenting in their felt gender. Aboriginal spirituality was practiced by 44 per cent, and 19 per cent had seen an Aboriginal Elder for mental health support.

Research limitations/implications

Action is needed to address the social determinants of health among Aboriginal gender-diverse people. Using principles of self-determination, there is a need to increase access to health and community supports, including integration of traditional culture and healing practices. Larger study samples and qualitative research are required.

Originality/value

These first published data regarding the health of Aboriginal gender-diverse Ontarians illustrate both their heterogeneity and all-too-common experiences of individual and systemic discrimination, and barriers to care. Results highlight potential impacts of colonialism and social exclusion, and suggest priorities for ameliorative action.

Details

Ethnicity and Inequalities in Health and Social Care, vol. 6 no. 4
Type: Research Article
ISSN: 1757-0980

Keywords

Book part
Publication date: 16 June 2022

Kathryn McGrath

Purpose: The author seeks to identify how suicide-bereaved individuals conceptualize their relationships with deceased loved ones. The author engages Durkheim’s theory of

Abstract

Purpose: The author seeks to identify how suicide-bereaved individuals conceptualize their relationships with deceased loved ones. The author engages Durkheim’s theory of suicide to provide a new framework to analyze this population.

Methodology: The author uses qualitative research and coding methods to produce a secondary analysis of previously collected interview transcripts.

Findings: The author concludes that participants experience the suicide of a loved one as a social event, conceptualizing it similarly to how Durkheim defined his four suicide types – characterized by too much or too little regulation and/or integration.

Research Limitations: As a result of the secondary analysis, a lack of demographic information remains the largest limitation, and the available demographic information indicates the participant population is not a diverse one. Therefore, the larger analysis is limited.

Practical and Social Implications: This work provides potential ways to improve current prevention and postvention practices for both the suicide-bereaved and those struggling with suicidality. Subsequently, it may help to improve the health outcomes of these groups.

Originality: To the author’s current knowledge, this is the first published use of Durkheim’s Suicide (1897/1966) as a framework to directly examine the suicide-bereaved population in this way. Thus, this work contributes to suicidology and sociology more broadly in two ways: by providing a new way to understand and ultimately help a vulnerable population and by providing a new use of a classic theory.

Details

Facing Death: Familial Responses to Illness and Death
Type: Book
ISBN: 978-1-80382-264-8

Keywords

Book part
Publication date: 27 August 2014

Damian Tago, Henrik Andersson and Nicolas Treich

This study contributes to the understanding of the health effects of pesticides exposure and of how pesticides have been and should be regulated.

Abstract

Purpose

This study contributes to the understanding of the health effects of pesticides exposure and of how pesticides have been and should be regulated.

Design/methodology/approach

This study presents literature reviews for the period 2000–2013 on (i) the health effects of pesticides and on (ii) preference valuation of health risks related to pesticides, as well as a discussion of the role of benefit-cost analysis applied to pesticide regulatory measures.

Findings

This study indicates that the health literature has focused on individuals with direct exposure to pesticides, i.e. farmers, while the literature on preference valuation has focused on those with indirect exposure, i.e. consumers. The discussion highlights the need to clarify the rationale for regulating pesticides, the role of risk perceptions in benefit-cost analysis, and the importance of inter-disciplinary research in this area.

Originality/value

This study relates findings of different disciplines (health, economics, public policy) regarding pesticides, and identifies gaps for future research.

Details

Preference Measurement in Health
Type: Book
ISBN: 978-1-78441-029-2

Keywords

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