Policy Framing and Comparative Discourse Analysis

BackgroundHate crimes have raised in Spain and the gender and sexuality-based conflicts persist worldwide which leads to this problem having an effect on health and wellbeing. Following a focus of transforming Higher Education Institutions, this research analysed the problem that affects undergraduate students in six Spanish universities. The research goal is to improve the life quality of lesbian, gay, bisexual, transgender, queer and intersex university students, breaking the silence that exists around the violence that this group suffer in Catalonia, Spain.MethodsFollowing the Communicative Methodology, this study has identified violence based on sexual orientation, gender identity or gender expression in the target universities and provided guidelines to improve anti-discrimination protocols. A qualitative method has reached experiences of university students, heads of equality commissions, professors and administrative staff regarding this conflict. Focussing on the qualitative research tools, 30 semi-structured interviews were conducted with university students and staff around issues related to the violence against lesbian, gay, bisexual transgender, queer and intersex students: 1) perception of violence and discrimination, 2) institutional measures, 3) actions against violence. An analysis of exclusionary and transformative dimensions was used to identify emergent themes.ResultsWe have identified two dimensions for the analysis given their impact in contributing or overcoming violence: exclusionary and transformative. A wide range of forms of violence on the grounds of sexual orientation, gender identity and gender expression perpetrated at universities have been identified as exclusionary facts and described by participants in the study. Equality commissions have not received reports of violence based on sexual orientation, gender identity or gender expression, and university staff shows certain unfamiliarity regarding the measures and politics to prevent and intervene in cases of violence against the lesbian, gay, bisexual, transgender, queer and intersex community. Among the results identified as transformative are the ways through which actions of lesbian, gay, bisexual, transgender, queer and intersex groups against violence and the professors’ commitment to intervene have a relevant impact on student’s wellbeing. An improvement and implementation of anti-discrimination protocols with mandatory applicability has also been documented.ConclusionsFindings highlight the need of collecting more evidence that contributes to the improvement of protocols, measures and politics to protect all the members of the university community. A better understanding of violence based on sexual orientation, gender identity and gender expression in HEI’s may guide national and international governments to improve the health and well-being of lesbian, gay, bisexual, transgender, queer and intersex persons.

Discriminalization: Reevaluating Sexuality, Punishment, and Human Rights

Chief complaint: “I feel like I have the brain of a man. Am I crazy?” On her first visit to a psychiatrist ( J.M.B.), “Ms. C,” a 48year-old woman, asked this question about her confused gender identity. Having also discovered a primary sexual attraction to women, Ms. C was having difficulty reconciling her church’s injunctions against sinful homosexual activities with her sense of herself as fundamentally male. She was dressed in a subtly frilly blouse and leather jacket she called “my leather-and-lace look.” Encircling each wrist were tattooed bracelets, traceries of curlicues and rosebuds that gently contradicted pearl earrings and a delicate gold locket. Born in the early 1950s and raised resolutely as a girl, Ms. C did not learn until she was 23 and married the unusual circumstances of her birth. Her mother finally divulged that she had entered the world with strange-looking genitals—neither male nor female. Doctors told her parents it was best to remove the odd tissue, fashion what remained to look female, and raise her as if nothing unusual had happened. At 6 months, surgeons removed both external tissue and presumed intra-abdominal testicular tissue and fashioned labia around the vaginal entrance she had always had. In grade school, she was told her large abdominal scar resulted from herniorrhaphy. At 12, after starting daily estrogen pills to induce puberty, she developed breasts and feminine curves, although without menarche or an increase in height beyond 5 feet. Her mother said she could not have children but did not explain why. She recalls being a tomboy who preferred boys for playmates. Because of her small stature and feminine appearance, however, boys were not particularly comfortable hanging out with her. Then, as now, she identified with the way males think rather than a sense of being physically male. She dated boys in high school, had a sexual experience with a woman during college, and married a man with whom she enjoyed satisfying marital relations for nearly two decades until they experienced a menage a trois. Her husband fell in love with the other woman, and she kindled awareness of her greater attraction to women than men. The marriage ended, and she embarked upon two long-term lesbian relationships and a struggle with alcoholism. Ms. C found sobriety and her church while that second relationship was unraveling. Welcomed and spiritually nurtured by church members, she felt happy except for increasing discontent with her pastor’s insistence that homosexual desires were her “cross to bear” and her options were either heterosexual marriage or celibacy. On one hand, her personal theology concurred that homosexuality was against God’s plan. On the other, she struggled with identifying herself as either man or woman, a dilemma her pastor could not solve. Ms. C’s childhood medical records had been lost. The psychiatrist asked if she had been karyotyped, given her unusual birth. She did not know. When she was born, chromosome testing was not routinely available. Given medical advice to raise her unquestioningly as a girl, the issue had not resurfaced. The psychiatrist suggested the test, and when results revealed 45,X/ 46,XY chromosomes, 75% the latter, the fragments—the childhood operation, hormones, her short stature, “brain of a man”—fell into place. She immediately reported feeling “less of a freak” now that she had a name—“intersexual”—for her condition.

Examined in this study are factors that might account for social workers' negative affective responses to gay, lesbian and bisexual persons through analysis of individual predictors of homophobia: residence (urban/rural), gender, age, social interaction with gay persons, political opinions, and religiosity. The Hudson-Ricketts Index of Homophobia was administered to nonstudent adults and students from two social work schools (n = 177). Amount of homophobia was related to social interaction, residence, and religiosity. The authors discuss the need to individualize educational strategies for student subgroups and prepare social workers for practice with gay, lesbian, and bisexual persons in all settings, especially community practice.

A Systematic Review of Inflammatory Bowel Disease Epidemiology and Health Outcomes in Sexual and Gender Minority Individuals

STUART BIEGEL. THE RIGHT TO BE OUT: SEXUAL ORIENTATION AND GENDER IDENTITY IN AMERICA'S PUBLIC SCHOOLS. MINNEAPOLIS: UNIVERSITY OF MINNESOTA PRESS, 2010, 320 PAGES. acceptance and participation of gay and lesbian people in our society has been and remains contentious and divisive issue. Some argue that best they should remain closeted, while others argue that minimum they should openly take their place in society alongside all other members of the community.1 There may be few places in society where this issue has generated more passion than in the public schools. Should teachers be allowed to teach who gay2 Should students be allowed to organize gay-straight alliance clubs for speech school thus gaining the school's recognition?3 Should schools foster climate and develop curriculum,4 that contemplates learning more about the challenges that members of marginalized and disenfranchised subgroups face?5 This discussion important because as Tyack and Cuban note the over potent means of defining the present and shaping the future.6 Consequently, questions about who shall teach our children, how accepting the school of all children, and what lessons most important part of this debate of who we and who we will become as society and as individuals. These just few of the questions that addressed in Stuart Biegel's latest book,7 Right to be Out: Sexual Orientation and Gender Identity in America's Schools.* He writes that major reason for writing his book is to help shine light on issues relating to sexual orientation and gender identity in American public education.9 Biegel focuses on the public schools because they at the eye of the proverbial storm of the tension regarding the right of gay and transgender persons to live their lives openly . . . .10 But most revealing his inclusive approach to the book acknowledging that individuals who not gay, lesbian, bisexual, or transgendered are also impacted by what transpires school around these issues. He asserts that the education of all students predicated on establishing a safe and supportive educational environment, built on shared values and geared towards greater appreciation of our pluralistic society, [that] can lead to better world for everyone.12 Right to Be provocative title. lays down marker that the discussion will not center on whether person should be open about his or her sexuality, but rather it states that there legal protections for those who decide to live an open life. book divided into two sections with total of eight chapters and conclusion. chapters designed to stand alone for individuals seeking discussion on specific topic. first part, The Law: Emergence of the Right to be Out builds the argument that the right to be out not just rhetorical device, it legal right supported by the First and Fourteenth Amendments.13 second part, Public Policy: Implementing the Right to Be Out, examines the educational policy applications that flow from the legal analysis. Both parts and their chapters composed of rich discussions that explore the fact patterns and, most importantly, provide human face for the legal policy issues. Part I has four chapters. first chapter, The Legal Foundations of the Right to Be Out, develops the argument that person's right to come out of the closet and live his or her life openly supported by the First and Fourteenth Amendments. Biegel grounds the connection of these two pillars of legal rights through the work of Ronald Dworkin characterizing these clauses as the textual embodiments of moral principles.14 intersection of freedom of speech and equality provide the locus and foundation for gay identity to emerge. It both right to express an identity and right to be treated equally as result of expressing this identity. …

Homosexual acts were illegal in Ireland until 1993. Between 1962 and 1972 there were 455 convictions of men for crimes such as ‘indecency with males’ and ‘gross indecency’. Homosexuality was regarded as a mental illness by the American Psychiatric Association until 1973 and by the World Health Organisation until 1990. ‘Treatment’ provided in various countries, including England and Northern Ireland, included psychotherapies (such as psychoanalysis) and ‘aversion therapies’ involving delivering emetic medication or electric shocks to homosexual men as they viewed images of undressed males; administration of testosterone followed by showing films of nude or semi-nude women; and playing tape recordings outlining the alleged adverse effects of homosexuality and alleged benefits of heterosexuality. In Ireland, homosexuality was regarded as a sexual deviation throughout the 1960s and some psychiatrists were involved in court proceedings and ‘treating’ homosexual persons with psychotherapy. Although there are some suggestions that ‘aversive therapies’ were used for homosexuality in Ireland, there is currently insufficient primary evidence to clarify this further. The history of psychiatry’s attitude to homosexuality is revealing for what it shows of the changeability of psychiatric diagnostic practices over time, and the extent to which certain psychiatric diagnoses are subject to social, political and various other influences. There is a strong need to enhance mental health services for lesbian, gay, bisexual and transgender persons who experience mental health problems.

LGBT people in the United States continue to experience discrimination because of their sexual orientation and gender identity, despite increasing acceptance of LGBT people and legal recognition of marriage for same-sex couples nationwide. This ongoing discrimination can lead to under- and unemployment, resulting in socioeconomic disparities for LGBT people. In addition, empirical research has linked LGBT health disparities, including disparities in health-related risk factors, to experiences of stigma and discrimination. Currently, federal statutes in the United States do not prohibit discrimination based on sexual orientation or gender identity in employment, housing, or public accommodations, leaving regulation in this area primarily to state and local governments. This creates a limited and uneven patchwork of protections from discrimination against LGBT people across the country. Despite public support for LGBT-inclusive non-discrimination laws across the country, in 28 states there are no statewide statutory protections for LGBT people in employment, housing, or public accommodations. To date, only 20 states and the District of Columbia have enacted comprehensive non-discrimination statutes that expressly prohibit discrimination based on both sexual orientation and gender identity in all three of these areas. One additional state has statutes that prohibit sexual orientation discrimination, but not gender identity discrimination, in these areas. One other state prohibits discrimination based on sexual orientation and gender identity in employment and housing, but not in public accommodations. In states without statutes that prohibit discrimination based on sexual orientation and/or gender identity, there are other policies that afford LGBT people at least some limited protections from discrimination. In some of these states, state executive branch officials have expanded non-discrimination protections for LGBT people under their executive or agency powers. For example, in three states, state government agencies have expanded broad protections from sexual orientation or gender identity discrimination through administrative regulations. And, in 12 states without statutes prohibiting discrimination against LGBT people, governors have issued executive orders that protect state government employees (and sometimes employees of state government contractors) from discrimination based on sexual orientation and gender identity. In addition, local government ordinances provide another source of protection from discrimination; however, these laws are generally unenforceable in court and provide much more limited remedies than statewide non-discrimination statutes. In recent years, lawmakers have increasingly attempted to limit the reach of state and local non-discrimination laws, which can leave LGBT people vulnerable to discrimination. For example, some states have passed laws allowing religiously motivated discrimination and others have passed laws prohibiting local governments from enacting their own non-discrimination ordinances that are broader than state non-discrimination laws. While most of these bills have not passed, the recent increase in the introduction of these measures suggests that state legislatures will continue to consider rolling back non-discrimination protections for LGBT people in the coming years. Continued efforts are required at both the state and federal levels to ensure that LGBT people are fully protected from discrimination based on their sexual orientation and gender identity throughout the United States, including federal legislation and statewide bills in over half the states.

6520 Background: Most oncology practices do not collect patients’ sexual orientation (SO) or gender identity (GI) (SOGI), prohibiting assessment of sexual and gender minority (SGM) patients’ cancer disparities and identification of such patients in cancer care or research. Studies report that 90% of SGM patients would disclose their SOGI, while 78% of clinicians believe that patients would not. Preliminary evidence indicates that SOGI disclosure improves health outcomes. Organizations, including ASCO and NIH, have called for routine SOGI data collection, but institutional barriers, e.g. lack of SOGI fields in EMRs, hinder progress. This study aimed to delineate institutional and individual-level factors related to SOGI data collection in oncology. Methods: From Oct to Nov 2020, an anonymous 54 item online survey was distributed to ASCO members via direct outreach, listservs and social media. The survey assessed whether respondents’ institutions collect SOGI data, factors related to SOGI data collection, respondents’ attitudes about SOGI data and SGM patients, and demographics. Simple and multiple logistic regression modeling determined factors associated with respondents’ reports of SOGI data collection at their institutions. Results: Nearly half of 257 respondents reported their institutions collect SO and GI data (42%, 48%, respectively); over a third reported their institutions did not collect SO or GI data (36%, 34%, respectively); and a fifth were unsure (22%, 18%, respectively). Collection of both SO and GI was associated in unadjusted models with leadership support and having resources for SOGI data collection. SO collection was also associated with type of institution, having an SGM family member, and belief that knowing SO is important for providing quality care. GI collection was associated with the respondent’s role, SO, political leaning, past SGM training, and belief that knowing GI is important for providing care. Odds ratios (OR) from adjusted models with 95% confidence intervals (CI) comparing respondents who reported SO or GI collection as “Yes” vs. “No” are reported (comparisons to “Unsure” not presented). Most respondents (79%) felt it was important to know both SO and GI to provide quality care, while 14% felt neither was important. Conclusions: Whether or not institutions collect SOGI data is related to many factors. Despite limited statistical power, the same three factors emerged as drivers of data collection: leadership support, resources and individuals’ attitudes. These are critical and possibly self-reinforcing elements for collecting SOGI data.[Table: see text]

As increasing numbers of transgender, gender diverse, and queer youths come out to their friends, families and communities, their rights to express their identities in public life have become the subject of intense media scrutiny and political debate. But for all the attention transgender, gender diverse, and queer youth have received from politicians, journalists, and public intellectuals, basic science research on how these youth actually experience their identities over time remains scarce. In this monograph, we contribute to the emerging knowledge base on this topic by presenting a detailed quantitative description of gender identity and sexual orientation in a sample of over 900 North American transgender, gender diverse, and cisgender youths in the Trans Youth Project (Mage = 8.1 years at first visit; Mage = 14.3 at latest visit; 99% living in the United States, 1% in Canada; 69% non-Hispanic white; 73% household income >$75,000). Youths are in one of three groups: (1) a group of early identifying transgender youths, who were supported by their parents in a social gender transition (changing their name, pronouns, hairstyle, and clothing) by age 12 (Mage at transition = 6.5; N = 317); (2) a group of their siblings, who were cisgender at the beginning of their participation in the study (N = 218); and (3) a group of cisgender youths who were age- and gender-matched to, but not family members of, the early identifying transgender youths (N = 377). Data on the youths' identities have been collected from the youths themselves and their parents between 2013 and 2024. We had two primary research goals. First, we described stability or change in youths' gender identity (Chapter 4) and sexual orientation (Chapter 6). We asked whether transgender youths' rates of change were or were not different from those of cisgender youths. Second, we examined whether measures of gender development earlier in development were related to youths' later gender identity (Chapter 5) or sexual orientation (Chapter 6) trajectories into adolescence. Stability in gender identity was by far the most common pathway for youths in all three groups, with over 80% of youths showing stability throughout their participation in the study. We saw similarity between the three groups of youths, such that the early identifying transgender youths were no more or less likely to show gender change than their siblings or youths in the unrelated comparison sample. Nevertheless, 11.9% of youths who started as cisgender were not so at their most recent report-a much higher proportion than would be predicted based on assumptions held in classic developmental psychology research about gender since the 1950s. When gender change did occur in all three groups, it overwhelmingly involved change to (and, to a lesser extent, from) a nonbinary gender identity. Results were similar regardless of whether youth- or parent-report data were considered, and we found no evidence that youths were more or less likely to change at particular ages. We observed some evidence that more gender nonconformity in childhood (e.g., more femininity in childhood among children living as boys) was related to later gender change, but results were somewhat inconsistent across measures and gender identities. Youths showed diverse sexual orientations, with 60% of binary transgender and 33% of cisgender adolescents expressing queer (i.e., not straight) romantic or sexual interest. A high percentage of youths overall (37%) indicated interest in both boys and girls-a pattern particularly common among nonbinary youths. Finally, more than a third of youths have shown change in their sexual orientation, and childhood gender nonconformity was associated with whether currently binary transgender or cisgender teenagers most recently reported a queer identity. Our results accord with recent evidence indicating that today's youth are defying assumptions about gender and sexual orientationfrom decades of developmental research, considering gender and sexual orientation to be relatively flexible social identitiesrather than ones that are fixed, and view gender as having more than two categories. Early identifying transgender children's sense of their own gender was no more or less stable than cisgender children's, suggesting that children who are supported in their transgender identities tend to show developmental patterns that mirror their cisgender peers. Finally, in Chapter 7, we discuss how our findings exemplify and respond to this unique historical moment, the ways in which our findings do and do not align with past work about gender- nonconforming children, and how future research can continue to make strides toward better understanding a wider swath of gender development trajectories.

The purpose of the current study was threefold: (a) compare rates of self-reported anorexia nervosa (AN), self-reported bulimia nervosa (BN), and eating pathology-specific academic impairment (EAI) by gender identity (cisgender men, cisgender women, transgender or genderqueer) and sexual orientation (gay or lesbian, bisexual, unsure, other), (b) examine associations between gender identity, sexual orientation, and eating outcomes, and (c) identify for whom rates of eating disorder diagnosis and impairment is greatest. The study includes a sample of Minnesota students (n = 13,906) who participated in the College Student Health Survey from 2015 to 2018. Chi-square tests with bootstrapping examined differences in eating pathology rates between groups. Adjusted logistic regressions tested the association between gender identity, sexual orientation, and self-reported eating outcomes. Chi-square results revealed heightened rates of self-reported AN, self-reported BN, and EAI in cisgender women, transgender or genderqueer, and sexual minority (e.g., lesbian or bisexual) students. Logistic regression analyses in cisgender men and cisgender women revealed higher odds of self-reported AN, self-reported BN, and EAI in sexual minority students relative their heterosexual peers. Chi-square analyses indicated that bisexual cisgender women reported heightened rates of all three eating pathology measures relative to other sexual and/or gender (e.g., transgender) minority students. Individuals with marginalized gender and/or sexual orientation identities report heightened rates of eating pathology, with cisgender bisexual women reporting the poorest outcomes relative to individuals from other marginalized identities. Preventive efforts and more research are needed to understand the mechanisms driving this disparity and to reduce prevalence among marginalized groups.

ABSTRACTLittle is understood about how sexual orientation and gender identity actually interconnect with transgender men. Eight transgender men were interviewed in depth, multiple times, and their perspectives gave insight into how sexual and gender identities are related, and how one informs the other. The present study found fluidity in gender and sexual identities among transgender men, but some trans men were more binary than others with regard to gender. These binary-leaning trans men also tended to be more binary in their sexual orientation. Fluidity in gender in pre-transition often reflected fluidity in sexual orientation. Mental health professionals may gain a better understanding of how the intersectionality of sexual and gender identities manifests in trans men. Implications for practitioners are included.

Lesbian, gay, bisexual, transgender and queer (LGBTQ) persons may be defined under the umbrella term sexual and gender minorities (SGM). SGM often experience disparities in access to care negatively impacting their health outcomes. Aim of the study was to assess knowledge, attitude and practical experience of neurologists associated with European Academy of Neurology (EAN) in caring for SGM patients. The study has been conducted amongst EAN neurologists using a 29 Likert-type questions survey (from "strongly disagree" to "strongly agree") exploring the knowledge, attitudes and practices towards SGM patients. The survey was distributed via mail to all 3410 EAN members, from June to October 2024. Overall, 171 respondents gave the consent to participate, with almost 73% responding to each question. 133 out of 171 respondents declared their sex assigned at birth (76 women, 57.1%; mean age 43.2 ± 13.0 years). Considering knowledge, almost 75% felt comfortable explaining differences between sexual orientation and gender identity. A low percentage (2.9% and 6.4%, respectively), was aware that LGBTQ individuals could experience disproportionate levels of physical and mental health problems compared to heterosexual and cisgender individuals. A large majority of participants reported insufficient training to work with LGBTQ and almost 70% declared interest in receiving further training on providing appropriate care to SGM persons. Most of the European neurologists were aware of the limits in providing healthcare to SGM recognizing the importance of training and education in approach and treat SGM patients in order to provide high-quality neurological care.

Health Communication and Sexual Orientation, Gender Identity, and Expression

Latinx sexual and gender minority (SGM) persons, specifically lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) persons, experience profound health disparities based on multiple factors, including their ethnicity/race, sexual orientation, gender identity, and immigration status. Although the terms SGM and LGBTQI are often used as umbrella terms, the communities and populations described by these terms are deeply varied. Currently, SGM persons are increasingly open and visible in the USA and many other parts of the world, and a modest body of knowledge on the health and well-being of some SGM subgroups currently exists. However, there are profound gaps in this emerging knowledge base. Specifically, we know very little about the health and well-being of Latinx SGM persons in the USA. In this chapter, we define some of the key terms often used to describe communities and populations of SGM, highlight some of the health disparities experienced by Latinx SGM populations, and outline critical research needs and priorities to improve the health and well-being of Latinx SGM populations.