Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey
Transgender and gender diverse people have unique risks and needs in the context of sexual health, but little is known about sexual health care for this population. In 2018, a national, online survey of sexual health and well-being was conducted with trans and gender diverse people in Australia (n =...
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| Veröffentlicht in: | PloS one 2021-07, Vol.16 (7), p.e0253589-e0253589 |
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| creator | Rosenberg, Shoshana Callander, Denton Holt, Martin Duck-Chong, Liz Pony, Mish Cornelisse, Vincent Baradaran, Amir Duncan, Dustin T Cook, Teddy |
| description | Transgender and gender diverse people have unique risks and needs in the context of sexual health, but little is known about sexual health care for this population. In 2018, a national, online survey of sexual health and well-being was conducted with trans and gender diverse people in Australia (n = 1,613). Data from this survey were analysed to describe uptake of sexual health care and experiences of interpersonal and structural cisgenderism and transphobia. Experiences of cisgenderism and transphobia in sexual health care were assessed using a new, four-item scale of 'gender insensitivity', which produced scores ranging from 0 (highly gender sensitive) to 4 (highly gender insensitive). Logistic and linear regression analyses were conducted to determine if experiences of gender insensitivity in sexual health care were associated with uptake and frequency of HIV/STI testing in the 12 months prior to participation. Trans and gender diverse participants primarily accessed sexual health care from general practice clinics (86.8%), followed by publicly funded sexual health clinics (45.6%), community-based services (22.3%), and general hospitals (14.9%). Experiences of gender insensitivity were common overall (73.2% of participants reported ≥2 negative experiences) but most common in hospitals (M = 2.9, SD = 1.3) and least common in community-based services (M = 1.3, SD = 1.4; p |
| doi_str_mv | 10.1371/journal.pone.0253589 |
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In 2018, a national, online survey of sexual health and well-being was conducted with trans and gender diverse people in Australia (n = 1,613). Data from this survey were analysed to describe uptake of sexual health care and experiences of interpersonal and structural cisgenderism and transphobia. Experiences of cisgenderism and transphobia in sexual health care were assessed using a new, four-item scale of 'gender insensitivity', which produced scores ranging from 0 (highly gender sensitive) to 4 (highly gender insensitive). Logistic and linear regression analyses were conducted to determine if experiences of gender insensitivity in sexual health care were associated with uptake and frequency of HIV/STI testing in the 12 months prior to participation. Trans and gender diverse participants primarily accessed sexual health care from general practice clinics (86.8%), followed by publicly funded sexual health clinics (45.6%), community-based services (22.3%), and general hospitals (14.9%). Experiences of gender insensitivity were common overall (73.2% of participants reported ≥2 negative experiences) but most common in hospitals (M = 2.9, SD = 1.3) and least common in community-based services (M = 1.3, SD = 1.4; p<0.001). When controlling for sociodemographic factors, social networks, general access to health care, and sexual practices, higher levels of gender insensitivity in previous sexual health care encounters were associated with a lower likelihood of recent HIV/STI testing (adjusted prevalence ratio = 0.92, 95% confidence interval [CI]:091,0.96, p<0.001) and less-frequent HIV/STI testing (B = -0.07, 95%CI:-0.10,-0.03, p = 0.007). Given the high rates of HIV and other STIs among trans and gender diverse people in Australia and overseas, eliminating cisgenderism and transphobia in sexual health care may help improve access to diagnostic testing to reduce infection rates and support the overall sexual health and well-being of these populations.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0253589</identifier><identifier>PMID: 34288911</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; AIDS ; Attitude of Health Personnel ; Australia - epidemiology ; Biology and Life Sciences ; Confidence intervals ; Cross-Sectional Studies ; Delivery of Health Care ; Disease transmission ; Evaluation ; Female ; Gender ; Health aspects ; Health care ; Health care access ; Health care policy ; Health Care Surveys ; Health risks ; Health Services Accessibility ; Health surveys ; HIV ; HIV infection ; HIV Infections - diagnosis ; HIV Infections - epidemiology ; Homophobia ; Hospitals ; Human immunodeficiency virus ; Humans ; Infections ; Male ; Medical diagnosis ; Medicine and Health Sciences ; Middle Aged ; Patients ; People and Places ; Polls & surveys ; Prejudice ; Public health ; Research and Analysis Methods ; Risk factors ; Sex industry ; Sexism ; Sexual and Gender Minorities - psychology ; Sexual Behavior - psychology ; Sexual health ; Sexually transmitted diseases ; Sexually Transmitted Diseases - diagnosis ; Sexually Transmitted Diseases - epidemiology ; Social networks ; Social organization ; Social Sciences ; Statistical analysis ; STD ; Stigma ; Transgender people ; Transgender Persons - psychology ; Transsexualism - psychology ; Well being ; Young Adult</subject><ispartof>PloS one, 2021-07, Vol.16 (7), p.e0253589-e0253589</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Rosenberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Rosenberg et al 2021 Rosenberg et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-11c0461953b98f64188e4a4d48c25523b1bfb6620086f82fe708aca99db956f43</citedby><cites>FETCH-LOGICAL-c692t-11c0461953b98f64188e4a4d48c25523b1bfb6620086f82fe708aca99db956f43</cites><orcidid>0000-0002-2586-8274 ; 0000-0001-7265-508X ; 0000-0001-5741-6013 ; 0000-0003-0657-9677</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8294496/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8294496/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34288911$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Brandelli Costa, Angelo</contributor><creatorcontrib>Rosenberg, Shoshana</creatorcontrib><creatorcontrib>Callander, Denton</creatorcontrib><creatorcontrib>Holt, Martin</creatorcontrib><creatorcontrib>Duck-Chong, Liz</creatorcontrib><creatorcontrib>Pony, Mish</creatorcontrib><creatorcontrib>Cornelisse, Vincent</creatorcontrib><creatorcontrib>Baradaran, Amir</creatorcontrib><creatorcontrib>Duncan, Dustin T</creatorcontrib><creatorcontrib>Cook, Teddy</creatorcontrib><title>Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Transgender and gender diverse people have unique risks and needs in the context of sexual health, but little is known about sexual health care for this population. In 2018, a national, online survey of sexual health and well-being was conducted with trans and gender diverse people in Australia (n = 1,613). Data from this survey were analysed to describe uptake of sexual health care and experiences of interpersonal and structural cisgenderism and transphobia. Experiences of cisgenderism and transphobia in sexual health care were assessed using a new, four-item scale of 'gender insensitivity', which produced scores ranging from 0 (highly gender sensitive) to 4 (highly gender insensitive). Logistic and linear regression analyses were conducted to determine if experiences of gender insensitivity in sexual health care were associated with uptake and frequency of HIV/STI testing in the 12 months prior to participation. Trans and gender diverse participants primarily accessed sexual health care from general practice clinics (86.8%), followed by publicly funded sexual health clinics (45.6%), community-based services (22.3%), and general hospitals (14.9%). Experiences of gender insensitivity were common overall (73.2% of participants reported ≥2 negative experiences) but most common in hospitals (M = 2.9, SD = 1.3) and least common in community-based services (M = 1.3, SD = 1.4; p<0.001). When controlling for sociodemographic factors, social networks, general access to health care, and sexual practices, higher levels of gender insensitivity in previous sexual health care encounters were associated with a lower likelihood of recent HIV/STI testing (adjusted prevalence ratio = 0.92, 95% confidence interval [CI]:091,0.96, p<0.001) and less-frequent HIV/STI testing (B = -0.07, 95%CI:-0.10,-0.03, p = 0.007). Given the high rates of HIV and other STIs among trans and gender diverse people in Australia and overseas, eliminating cisgenderism and transphobia in sexual health care may help improve access to diagnostic testing to reduce infection rates and support the overall sexual health and well-being of these populations.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>AIDS</subject><subject>Attitude of Health Personnel</subject><subject>Australia - epidemiology</subject><subject>Biology and Life Sciences</subject><subject>Confidence intervals</subject><subject>Cross-Sectional Studies</subject><subject>Delivery of Health Care</subject><subject>Disease transmission</subject><subject>Evaluation</subject><subject>Female</subject><subject>Gender</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health care access</subject><subject>Health care policy</subject><subject>Health Care Surveys</subject><subject>Health risks</subject><subject>Health Services Accessibility</subject><subject>Health surveys</subject><subject>HIV</subject><subject>HIV infection</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - epidemiology</subject><subject>Homophobia</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infections</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>People and Places</subject><subject>Polls & surveys</subject><subject>Prejudice</subject><subject>Public health</subject><subject>Research and Analysis Methods</subject><subject>Risk factors</subject><subject>Sex industry</subject><subject>Sexism</subject><subject>Sexual and Gender Minorities - psychology</subject><subject>Sexual Behavior - psychology</subject><subject>Sexual health</subject><subject>Sexually transmitted diseases</subject><subject>Sexually Transmitted Diseases - diagnosis</subject><subject>Sexually Transmitted Diseases - epidemiology</subject><subject>Social networks</subject><subject>Social organization</subject><subject>Social Sciences</subject><subject>Statistical analysis</subject><subject>STD</subject><subject>Stigma</subject><subject>Transgender people</subject><subject>Transgender Persons - 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Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rosenberg, Shoshana</au><au>Callander, Denton</au><au>Holt, Martin</au><au>Duck-Chong, Liz</au><au>Pony, Mish</au><au>Cornelisse, Vincent</au><au>Baradaran, Amir</au><au>Duncan, Dustin T</au><au>Cook, Teddy</au><au>Brandelli Costa, Angelo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-07-21</date><risdate>2021</risdate><volume>16</volume><issue>7</issue><spage>e0253589</spage><epage>e0253589</epage><pages>e0253589-e0253589</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Transgender and gender diverse people have unique risks and needs in the context of sexual health, but little is known about sexual health care for this population. In 2018, a national, online survey of sexual health and well-being was conducted with trans and gender diverse people in Australia (n = 1,613). Data from this survey were analysed to describe uptake of sexual health care and experiences of interpersonal and structural cisgenderism and transphobia. Experiences of cisgenderism and transphobia in sexual health care were assessed using a new, four-item scale of 'gender insensitivity', which produced scores ranging from 0 (highly gender sensitive) to 4 (highly gender insensitive). Logistic and linear regression analyses were conducted to determine if experiences of gender insensitivity in sexual health care were associated with uptake and frequency of HIV/STI testing in the 12 months prior to participation. Trans and gender diverse participants primarily accessed sexual health care from general practice clinics (86.8%), followed by publicly funded sexual health clinics (45.6%), community-based services (22.3%), and general hospitals (14.9%). Experiences of gender insensitivity were common overall (73.2% of participants reported ≥2 negative experiences) but most common in hospitals (M = 2.9, SD = 1.3) and least common in community-based services (M = 1.3, SD = 1.4; p<0.001). When controlling for sociodemographic factors, social networks, general access to health care, and sexual practices, higher levels of gender insensitivity in previous sexual health care encounters were associated with a lower likelihood of recent HIV/STI testing (adjusted prevalence ratio = 0.92, 95% confidence interval [CI]:091,0.96, p<0.001) and less-frequent HIV/STI testing (B = -0.07, 95%CI:-0.10,-0.03, p = 0.007). Given the high rates of HIV and other STIs among trans and gender diverse people in Australia and overseas, eliminating cisgenderism and transphobia in sexual health care may help improve access to diagnostic testing to reduce infection rates and support the overall sexual health and well-being of these populations.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34288911</pmid><doi>10.1371/journal.pone.0253589</doi><tpages>e0253589</tpages><orcidid>https://orcid.org/0000-0002-2586-8274</orcidid><orcidid>https://orcid.org/0000-0001-7265-508X</orcidid><orcidid>https://orcid.org/0000-0001-5741-6013</orcidid><orcidid>https://orcid.org/0000-0003-0657-9677</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-07, Vol.16 (7), p.e0253589-e0253589 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2553788236 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Adolescent Adult Aged Aged, 80 and over AIDS Attitude of Health Personnel Australia - epidemiology Biology and Life Sciences Confidence intervals Cross-Sectional Studies Delivery of Health Care Disease transmission Evaluation Female Gender Health aspects Health care Health care access Health care policy Health Care Surveys Health risks Health Services Accessibility Health surveys HIV HIV infection HIV Infections - diagnosis HIV Infections - epidemiology Homophobia Hospitals Human immunodeficiency virus Humans Infections Male Medical diagnosis Medicine and Health Sciences Middle Aged Patients People and Places Polls & surveys Prejudice Public health Research and Analysis Methods Risk factors Sex industry Sexism Sexual and Gender Minorities - psychology Sexual Behavior - psychology Sexual health Sexually transmitted diseases Sexually Transmitted Diseases - diagnosis Sexually Transmitted Diseases - epidemiology Social networks Social organization Social Sciences Statistical analysis STD Stigma Transgender people Transgender Persons - psychology Transsexualism - psychology Well being Young Adult |
| title | Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey |
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