Best Nursing Practice: Safe and Inclusive Healthcare Environments for Transgender People: A Systematic Review.

(1) Background: The aim of this study was to review the scope of the existing scientific literature on creating safe and inclusive healthcare environments for transgender people and provide an overview of the resources and nursing skills required to do so. (2) Methods: With the research question in mind, an exploratory search of six databases was conducted to identify all relevant primary studies. After screening and selection of articles based on the inclusion and exclusion criteria, a total of 41 articles were included and reviewed. (3) Results: The results were classified under four headings: the training of health professionals, the creation of safe spaces, the nurse as facilitator, and best care practice. Most of the evidence indicates that it is essential for nurses and other healthcare staff to be trained in specific skills to provide comprehensive, high-quality care to transgender people; however, there is a lack of material and human resources to do so. (4) Conclusions: The trans-inclusive care competent nurse should use neutral language that respects the person's preferred name and pronouns in a safe healthcare environment that offers and ensures warmth, respect, and inclusivity in the care provided. This study was registered with the Open Science Framework (OSF) on 9 January 2024 (osf.io/rpj6a).

Virtual Reality and Simulation Videos as Effective Training Tools for Creating Safe and Inclusive Environments for Transgender People.

BACKGROUND: University education is undergoing a paradigm shift towards active methodologies, such as virtual reality and training videos, which have proven to be valuable resources, especially in the health sciences. The scarcity of existing research on the topic prompted us to conduct this study, which seeks to measure the knowledge gained from the aforementioned tools by users, their level of satisfaction with them, and their perceived utility. METHODS: This is a quasi-experimental intervention study analysing the impact of virtual objects as learning resources for undergraduate nursing students. RESULTS: Fifty-four participants completed the training, yielding highly significant differences between their mean scores, with a high statistical power and a large effect size. A total of 85.46% of participants confirmed that the virtual resources helped them considerably to empathise with the experiences of trans people in healthcare settings. Students were comfortable using the virtual resources, very satisfied with the methodology employed, and would recommend the training received. CONCLUSIONS: University teaching must adapt to meet the current legislations and changing health needs of society, and teaching staff must be prepared to implement new active teaching methodologies that make learning a more dynamic process. Considering these results, our study serves as a guide for other nursing educators who seek to promote inclusive healthcare regarding gender diversity. This study is not registered.

Measuring Explicit Prejudice and Transphobia in Nursing Students and Professionals.

Trans* people frequently report attitudes of prejudice/transphobia in health professionals. Conversely, health professionals indicate the lack of adequate training to care for these people and its impact on the quality of care provided. OBJECTIVE: Our objective was to evaluate the explicit prejudices/transphobia of health students and professionals and compare them with the general population in Tenerife. METHODS: A descriptive cross-sectional study was carried out with the Genderism and Transphobia Scale (GTS) and the Negative Attitude towards Trans* people Scale (EANT) with a total of 602 participants. RESULTS: We found a low mean level of explicit prejudice/transphobia, with little/no differences between occupation groups. Explicit transphobia was correlated with being a man, less educated, and heterosexual, and not personally knowing a trans* person. Men and women were less transphobic about trans* people whose identities coincided with their own. CONCLUSION: All participants showed a low mean level of explicit transphobia. This result is not incompatible with unconscious prejudice, which may translate to discriminatory behaviors. Interventions to change negative attitudes are still needed, since even a small percentage of transphobic health professionals could exert a considerable negative impact on health care. In professionals without transphobic attitudes, the barriers identified by trans* people might be a problem due to the lack of specific training.

Trans* Pregnancy and Lactation: A Literature Review from a Nursing Perspective.

Pregnancy and lactation involve two aspects that are socially and culturally associated with women. However, there are a few biological differences between male and female breast tissue. Lactation and pregnancy are viable processes that do not depend on sex. Even for the latter, it is only necessary to have an organ capable of gestation. Ways to favor mammogenesis and lactogenesis in trans* women have been established. There are protocols to promote lactation in trans* women, usually used for adoptive mothers or those whose children have been born through gestational surrogacy. Chestfeeding a baby could be the cause of feelings as diverse as gender dysphoria in the case of trans* men, and euphoria and affirmation of femininity in trans* women. This study involves a review of the available scientific literature addressing medical aspects related to pregnancy and lactation in trans* individuals, giving special attention to nursing care during perinatal care. There are scarce studies addressing care and specifically nursing care in trans* pregnancy and lactation. Our study indicates the factors that can be modified and the recommendations for optimizing the care provided to these individuals in order to promote and maintain the lactation period in search of improvement and satisfaction with the whole process.

Actualización del uso como terapia del Ácido Hialurónico en el síndrome genitourinario para enfermería / Updating the use as therapy of hyaluronic Acid in Genitourinary syndrome for nursing

La menopausia supone una etapa de grandes cambios para la mujer. De entre las principales complicaciones que podemos encontrar, una de ellas corresponde al Síndrome Genitourinario de la Menopausia (SGM) de alta prevalencia en la salud de la mujer climatérica y que se manifiesta mediante la atrofia vulvovaginal, sequedad, dispareunia e irritación, principalmente. Pese a su gran prevalencia, es poco consultado en las valoraciones de salud por parte de los profesionales sanitarios, y se desconocen las terapias alternativas al tratamiento estrogénico tópico como la aplicación de fórmulas con Ácido Hialurónico (AH), un polisacárido natural de la matriz extracelular de la piel que ha mostrado una mejora significativa en el alivio de los síntomas, por su alta capacidad en la retención de agua y en la regeneración de los tejidos. Este estudio supone una actualización de las terapias disponibles con AH y sus principales resultados en el control de las manifestaciones del síndrome

Menopause is a stage of great change for women. Among the main complications that we can find, one of them corresponds to the Genitourinary Syndrome of Menopause (GSM) of high prevalence in the health of the woman climacteric and that is manifested by the vulvovaginal atrophy, dryness, dyspareunia and irritation, mainly. Despite its great prevalence, it is rarely consulted in health assessments by healthcare professionals, and alternative therapies to topical estrogenic treatment such as the application of formulas with Hyaluronic Acid (HA), a natural polysaccharide of the extracellular matrix of the skin that has shown a significant improvement in symptom relief, due to its high capacity in water retention and tissue regeneration, are unknown. This study implies an update of the therapies available with HA and its main results in the control of the manifestations of the syndrome

Atención sanitaria trans competente, situación actual y retos futuros. Revisión de la literatura / Competent trans health care, current situation and future challenges. A review

Introducción: Conocemos como una persona trans a aquella que no se identifica con el sexo de nacimiento, este hecho aún recogido como patología por el actual manual diagnóstico y estadístico de enfermedades mentales (DSM-V) va a provocar que existan desigualdades y barreras significativas a la hora de la atención sanitaria. Objetivo: Explorar las dificultades para la asistencia sanitaria percibidas por las personas trans y por los profesionales que los atienden en centros sanitarios. Material y método: Revisión de la literatura. Resultados: Tanto los profesionales como las personas trans perciben barreras significativas. Se podrían agrupar en diversos temas: desigualdades en la atención sanitaria percibidas por los pacientes trans, prejuicios y discriminación sentida, riesgos específicos de salud, déficit de conocimientos de los profesionales y déficit de formación en los planes de estudio actuales. Por otro lado, enfermería ante los pacientes trans puede resultar un facilitador. Conclusiones: Existen numerosos factores que pueden ser modificables y que provocan que las personas trans no perciban una asistencia adecuada. La adecuada formación de los profesionales sanitarios es uno de los que adquiere mayor relevancia Los resultados encontrados aportan una información clave para el futuro diseño de intervenciones dirigidas a mejorar la calidad de la asistencia en este colectivo

Introduction: We know as a transgender person who is not identified with the sex of birth, this fact still collected as pathology by the current Diagnostic and Statistical Manual of Mental Illness (DSM-V) will cause inequalities and barriers At the time of health care. Objective: To explore the difficulties for health care perceived by trans people and by the professionals who assist them in health centres. Material and method: Literature review. Results: Both professionals and trans people perceive significant barriers. They could be grouped by diverse topics: healthcare inequalities noticed by trans patients, prejudices and felt discrimination, specific health risks, lack of professional knowledge and deficit of training in current curricula. On the other hand, nursing with trans patients may result in a facilitator. Conclusions: There are multiple factors which can be modified and which produce that trans people do not notice appropriate care. Appropriate training of health professionals is the one which acquires more relevance. The results found provide key information for the future design of interventions aimed at improving the quality of the assistance in this group

Impact of a Formative Program on Transgender Healthcare for Nursing Students and Health Professionals. Quasi-Experimental Intervention Study.

BACKGROUND: The field of specific healthcare for transgender people has not been included in the official curriculum of professionals. This causes a lack of knowledge that can be presumed to become a barrier to healthcare. Currently, different methodologies are emerging to achieve meaningful learning for students and professionals. The objective of this study was to evaluate the increase in the level of knowledge of final-year nursing students, applying methodological strategies such as problem-based learning (PBL) and film-forum. METHODS: 59 nursing students were randomly assigned to two intervention groups (G1 = 31 and G2 = 28), and another 57 were assigned to the control group (without specific classes or workshops on the subject of the study). The intervention consisted of a specific training course on transgender issues (TGSC&W, TransGender Specific Course and Workshop), where the type of meaningful learning strategy used depended on the group (G1 = film-forum and G2 = PBL). The study was carried out at the Faculty of Nursing Nuestra Señora de Candelaria of the Canary Islands Health Service. The randomization was done by blindly choosing a computer-generated code. RESULTS: The main outcome was based on 116 participants, comparing their level of knowledge before and after the workshop. The comparison by pairs shows that there were statistically significant differences (p = 0.000) between those undergoing the methodological interventions and the control group. Statistical significance between film-forum and PBL was not obtained (p = 1.000): Both methodologies increased the level of knowledge, but there was no significant difference between them. The means for satisfaction with the learning methodology used did not show statistically significant differences. CONCLUSION: The workshop carried out was highly effective and significant in terms of increasing knowledge. No significant differences were observed in the level of knowledge, or in the degree of satisfaction, between the two methodologies used (PBL and film-forum).

Biological, Psychological, Social, and Legal Aspects of Trans Parenthood Based on a Real Case-A Literature Review.

Trans men are people who, based on their genitals, were assigned the status of female at birth. However, their identity and their way of living gender do not correspond to the socially established norms. In this paper, we discuss the different perspectives in relation to transgender people and their desire for parenthood. This review, and the basis of this paper, is inspired by the case of a trans man who desired gestation with his own genetic material. He began the cycle of assisted reproduction when he was a legally recognized woman, but that attempt ended with a miscarriage. From that assisted reproduction cycle, four embryos remained frozen. After the failed experience of gestation, the person completed his transition. Now legally a man, he attempted to gestate using his reproductive organs. This literature review aimed to identify relevant studies describing the relationship between transgender person and biological parenthood. This study comprehensively addresses important aspects one should know when considering a transgender pregnancy. These factors include biological, psychological, social, and legal issues. After reviewing the state-of-the-art information on trans parenthood, the main conclusion is that 'the desire to have a child is not a male or female desire but a human desire'.

Gender Identity: The Human Right of Depathologization.

Background: Transgender people have a gender identity different from the one allocated to them at birth. In many countries, transsexualism and transgenderism are considered mental illnesses under the diagnosis of gender dysphoria. This pathologization impacts on human rights. Maincontent: The United Nations (UN) has denounced violations against trans-people, including attacks, forced medical treatments, lack of legal gender recognition, and discrimination in the areas of education, employment, access to healthcare, and justice. The UN has linked these violations directly with discriminatory diagnostic classifications that pathologize gender diversity. Trans-people have been pathologized by psycho-medical classification and laws all around the world, with a different impact depending on countries. This paper argues that pathologization infringes infringes upon a wide range of human rights such as; civil, economic, social cultural and also the access to medical care. Conclusions: The current situation for trans-people with respect to legal healthcare matters, depends on the country. Human rights are universal, not a question for cultural interpretation. They are the minimum that every human being must have assured only by the fact of being human. Countries must protect these rights by regulating trans-pathologization with special attention dedicated to intersex people and their specific needs.

Síndrome de aspiración meconial: Avances científicos de los últimos veinticinco años / Meconium aspiration syndrome: twenty-five years of scientific developments

El síndrome de aspiración meconial (SAM) se refiere a los problemas respiratorios que sufre un recién nacido cuando inhala meconio, su primera excreción intestinal, durante o después del parto, y este llega hasta los pulmones. La presencia de meconio en el líquido amniótico es un signo de sufrimiento fetal que precisa una cuidadosa supervisión tanto del parto como de la salud fetal. Con el objetivo de resaltar la importancia de una minuciosa supervisión durante el parto y de una adecuada evaluación de la salud del bebé, se prevé realizar una revisión bibliográfica que permita resumir los principales avances médicos de los últimos veinticinco años, partiendo de una conceptualización teórica, con el fin de subrayar que aquellos recién nacidos que lo padecen presentan una serie de signos y síntomas sobre los cuales será necesario incidir en caso de producirse

Meconium aspiration syndrome (MAS) refers to respiratory problems experienced by newborns after inhaling meconium, their first intestinal excretion, reaching the lungs during or after childbirth. The presence of meconium in the amniotic fluid is a sign of fetal distress that requires close monitoring of labor and fetal health. In order to emphasize the importance of careful supervision during childbirth, together with an adequate evaluation of the newborn's health, a bibliographic review has been carried out to present the main medical advances achieved over the last twenty-five years on the matter. The aim is to establish a theoretical framework based on a series of signs and symptoms, which must be monitored in order to identify and tackle the syndrome in its early stages