ABSTRACT
Recently, there has been an increase in media attention surrounding transgender and gender-diverse (TGD) individuals between discriminatory legislation efforts and changing participation policies within organized sports. These changes and the historical lack of competence and education regarding the transgender patient population have resulted in sub-par patient care, and a misunderstanding of the athletic trainer's (AT) role within the healthcare and compliance systems. This literature review is the second part of a two-paper series and the objective of this paper was to educate ATs on the processes relevant to medical affirmation including compliance considerations regarding medical eligibility and to establish the AT's role. The gender affirmation framework includes social and legal components which are discussed in part one of this literature, and the medical component is thoroughly discussed in part two. AT's and all health care providers involved in the patient care of TGD individuals should work collaboratively on an interprofessional care team and have a general knowledge of the gender affirmation process including GAHT, surgical options, known risks and complications, and the general health needs of TGD patients. By being more knowledgeable, ATs are uniquely positioned to help reduce health and healthcare disparities as they are point-of-care providers as well as members of the interprofessional care team. Furthermore, ATs can use their knowledge to facilitate medical compliance and eligibility within the evolving policies of sporting organizations.
ABSTRACT
Transgender and Gender Diverse (TGD) patients experience discrimination, harassment, marginalization, and minority stress at greater rates than their cisgender counterparts leading to numerous health and healthcare disparities that negatively impact wellbeing and access to quality healthcare.1 While in an opportune position to improve health equity for TGD patients under their care, many athletic trainers (ATs) report having little to no formal education on TGD patient care leading to a reduction in self-reported competence. As such, to fill this knowledge gap, the purpose of the first part of this two-part narrative literature review is to 1) provide readers with foundational information and terminology, 2) explore relevant health and healthcare disparities, and 3) identify the role of the AT within an interprofessional care team treating TGD patients.
ABSTRACT
Objective. In pharmacy education, considerable debate surrounds the decision about whether didactic cases should include social identities, such as race, ethnicity, sexual orientation, gender identity, ability, spirituality, nationality, and socioeconomic status. In considering what and how much of these identities to include, the first step could be to measure their current inclusion. This study aimed to quantify the presence of these social identities in cases presented to student pharmacists in a three-semester course series.Methods. One hundred forty-four cases presented in a three-semester pharmacotherapeutics course series were reviewed. The primary objective was to quantify the inclusion of each social identity. The secondary objective was to assess whether the identities were needed to answer specific questions related to each case. Cases were reviewed by two independent study researchers; a third impartial reviewer settled disagreements.Results. Cases rarely explicitly included social identities. Race was explicitly stated in 15% of cases (n = 21). Gender identity was explicitly named in two cases (1%), but nearly all cases implied gender through pronouns. Gender was necessary to answer case questions in approximately 20% of cases (n=27). Socioeconomic status, ability, sexual orientation, and nationality were infrequently named among all cases, at rates of 6%, 5%, 1%, and 1%, respectively.Conclusion. This study found that didactic cases rarely explicitly state social identities. In determining the next steps for integrating social identities, pharmacy education must first take stock of how it currently acknowledges these identities.
