Mapping gender and sexual minority representation in cancer research: a scoping review protocol.

BACKGROUND: Addressing the risk of people from gender and sexual minority (GSM) groups experiencing inequities throughout the cancer continuum requires a robust evidence base. In this scoping review, we aim to map the literature on cancer outcomes among adults from GSM groups and the factors that influence them along the cancer continuum. METHODS: This mixed-methods scoping review will follow the approach outlined by JBI. We will systematically search electronic databases for literature in collaboration with a health sciences librarian. Two reviewers will screen titles and abstracts to determine eligibility based on inclusion criteria, and then retrieve full text articles for data extraction. Results will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Quantitative data will be qualitized through a narrative interpretation and pooled with qualitative data. We will use meta-aggregation to synthesize findings. This protocol was developed in collaboration with GSM patient and public advisors. We will engage people from GSM groups, community organizations and knowledge users in disseminating results. INTERPRETATION: This review will direct future research efforts by expanding the wider body of research examining cancer disparities across the cancer continuum that GSM groups experience, identifying literature gaps and limitations, and highlighting relevant social determinants of health that influence cancer outcomes for adults from GSM groups.

Gender-affirming care in undergraduate nursing education: a scoping review protocol.

INTRODUCTION: Transgender and gender-diverse (TGD) people face a multitude of barriers to safe, accessible healthcare. One way to overcome access inequities is through the provision of gender-affirming care. Gender-affirming care is culturally safe and engaged care that values TGD identities and is focused on depathologising TGD people. Additionally, gender-affirming care encompasses awareness and support of TGD individuals as unique beings, including supporting gender-affirming medical goals for those who are interested. The discipline of nursing is well situated to advocate for gender-affirming care, however, receives little undergraduate education in the subject. Undergraduate schools of nursing (including faculty and curriculum) are in a crucial position to implement gender-affirming care, though how they have done this is not widely known. Our scoping review aims to understand how Canadian and US undergraduate schools of nursing teach and integrate gender-affirming education. METHODS AND ANALYSIS: Our scoping review will follow the six stages by Arksey and O'Malley and the advancements by Levac et al, reported on as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. The review will be completed in 2023, with the database searches carried out in spring 2023, followed by screening and analysis. ETHICS AND DISSEMINATION: Ethics approval is not required for this protocol. To aid in knowledge translation, a visual representation of the findings will be created. Results from the final scoping review will be published in a peer-reviewed journal, promoted on social media to schools of nursing, and presented at conferences and seminars. PROTOCOL REGISTRATION NUMBER: Open Science Framework (https://doi.org/10.17605/OSF.IO/Q68BD).

Awkward Choreographies from Cancer's Margins: Incommensurabilities of Biographical and Biomedical Knowledge in Sexual and/or Gender Minority Cancer Patients' Treatment.

Canadian and American population-based research concerning sexual and/or gender minority populations provides evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides. The Cancer's Margins research investigates the complex intersections of sexual and/or gender marginality and incommensurabilities and improvisation in engagements with biographical and biomedical cancer knowledge. The study examines how sexuality and gender are intersectionally constitutive of complex biopolitical mappings of cancer health knowledge that shape knowledge access and its mobilization in health and treatment decision-making. Interviews were conducted with a diverse group (n=81) of sexual and/or gender minority breast or gynecologic cancer patients. The LGBQ//T2 cancer patient narratives we have analyzed document in fine grain detail how it is that sexual and/or gender minority cancer patients punctuate the otherwise lockstep assemblage of their cancer treatment decision-making with a persistent engagement in creative attempts to resist, thwart and otherwise manage the possibility of discrimination and likewise, the probability of institutional erasure in care settings. Our findings illustrate the demands that cancer places on LGBQ//T2 patients to choreograph access to, and mobilization of knowledge and care, across significantly distinct and sometimes incommensurable systems of knowledge.

Pride and prejudice: factors affecting school attachment among lesbian, bisexual, and heterosexual girls.

School attachment is often regarded as a key measure in gauging the integration and wellbeing of students. Previous research suggests that levels of school attachment are generally lower among sexual minority students, but most studies focus on between-gender comparisons and do not conduct within-gender analyses. Using data from the First National Climate Survey on Homophobia and Transphobia in Canadian schools, this study set out to empirically analyze what, if any, differences exist among lesbian, bisexual, and heterosexual female students when assessing the relationship between homophobic and gender-negative language, feelings of safety, harassment/direct victimization, and school climate on school attachment. Bivariate and multivariate findings suggest that there are key differences among female students in terms of school attachment.

The high risk of IPV against Canadian women with disabilities.

BACKGROUND: Mounting evidence suggests that women with disabilities have a particularly high risk of experiencing violence by an intimate partner. This study examined the elevated risk for male-female intimate partner violence (IPV) against women with disabilities compared to women without disabilities across three large-scale Canadian surveys. An explanatory framework was tested that organized risk markers based on whether they referred to the context of the relationship between the couple (relationship factors), the victim (victim-related characteristics), or the perpetrator (perpetrator-related characteristics). MATERIAL/METHODS: The data employed in this study were from three surveys collected by Statistics Canada: the 1993 Violence Against Women Survey, and the 1999 and 2004 iterations of the General Social Survey. Descriptive analyses consisted of cross-tabulations with Chi-square tests of significance. Logistic regression was used to calculate zero-order odds ratios and to perform multivariate analyses. RESULTS: A pattern was found in which women with disabilities reported a significantly higher prevalence of violence than those without disabilities. The perpetrator-related characteristics were the only variables that reduced the elevated odds of violence against women with disabilities. Partners of women with disabilities were more likely to engage in patriarchal domination as well as possessive and jealous behaviors. CONCLUSIONS: The apparent importance of perpetrator-related characteristics (e.g., jealousy) suggests that future research should include a focus on what it is about the context of disability that makes these men more likely to engage in behaviors that are associated with IPV perpetration. Population-based efforts, professionals working with women who are victims, and professionals working with male perpetrators need to pay attention to the role of disability in IPV.

The elevated risk for non-lethal post-separation violence in Canada: a comparison of separated, divorced, and married women.

The purpose of the study was to shed light on the potentially differing dynamics of violence against separated and divorced women by their ex-husbands and violence against married women by their current husbands. Using a nationally representative sample of 7,369 heterosexual women from Cycle 13 of Statistics Canada's General Social Survey, available risk markers were examined in the context of a nested ecological framework. Separated women reported nine times the prevalence of violence and divorced women reported about four times the prevalence of violence compared with married women. The strongest predictors of violence against married women, namely, patriarchal domination, sexual jealousy, and possessiveness, were not significant predictors of violence against separated and divorced women. This suggested that post-separation violence is a complex phenomenon the dynamics of which can be affected by much more than domination and ownership.

The nature of stress experienced by lesbians and gay men.

This study examined both the meanings and sources/causes of stress from the perspectives of lesbians and gay men (n=30), using a series of focus groups. The findings suggest that stress is considered a part of life itself, and is perceived to contain both negative (e.g. detrimental effects on health and overall functioning, unfairness, out-of-control), and positive (e.g. a motivator, growth-facilitator) elements. The sources/causes of stress (i.e. stressors) identified include stress experienced from the "coming out" process, stress in family relations and intimate relationships, conflict over one's sexuality given society's homophobic and heterosexist attitudes toward lesbians and gay men, as well as stress from financial and work-related issues. More importantly, this study suggests that culture/ethnicity, gender, and aging, which are interconnected with one's sexual identity, play an important role in shaping the experiences of stress among lesbians and gay men.

Exploring dynamics of abusive lesbian relationships: preliminary analysis of a multisite, qualitative study.

This paper presents preliminary results from a multisite, qualitative study on violence in lesbian relationships. A framework for conducting community-based, empowerment research that draws on theories of community psychology, feminism, and postmodernism is presented. The study was designed to understand the dynamics of abusive lesbian relationships and social service providers' responses to the abuse. Results from 80 in-depth interviews with lesbians who have experienced relationship violence are examined with a particular focus on a pattern of first relationships being abusive and a theme of shifting power dynamics. Analysis of focus group discussions with 45 feminist service providers (e.g., counselors, shelter workers, social workers, healthcare providers) reveals the difficulties in assessing the power dynamics of abusive same-sex relationships and in developing appropriate responses when relying on heterosexually gendered models developed to address men's violence against women. The preliminary results present implications both for how we theorize and research this form of violence, and for improving the practices and policies of social services that work with lesbian, gay, bisexual, and transgendered communities.