Background: Research shows that transgender people are disproportionally represented in term of physical and mental illness compared to cis people. Stigmatization and discrimination in society results in transgender people having low trust in society's institutions, including health care. A good care relationship and equal care are of great importance for a patient's well-being and health. However, nurses feel that they do not have enough competence or experience in caring for transgender people. Aim: The aim of this literature study was to describe transgender people's experiences of care relationships with health care staff. Method: A qualitative literature study with an inductive approach consisting of twelve articles that were analyzed through a qualitative content analysis. Results: Three categories were identified: Lack of competence in the care meeting, Abusive care meetings and Affirmingcare meetings. Seven subcategories were also identified. These findings highlight that transgender people experience incompetence and violations in care meetings. However, positive experiences in the form of affirmative care meetings have also been described. Conclusions: The healthcare institution needs to implement education on cis-normativity and transgender people's specific care needs. Therefore, more research is needed on how transgender people believe that care can become more inclusive for this group of individuals.

This study was conducted through in-depth interviews to examine potential differences between binary-aligned transgender individuals and non-binary individuals in regards to media usage when learning about, articulating, and explaining their gender identity. Results showed numerous differences between transgender people with binary-aligned and non-binary gender identifications in regards to social media preferences and differences in perceived media importance and effects. Additional information was found in regards to the age at which gender identity is articulated and the importance of individuality in comparison to one's gender identity.

Text in English with abstracts in English and isiZulu / This qualitative study set out to discover the lived experiences of South African transgender individuals within the liminal space of having been confirmed for gender affirming surgery, yet who have not completed their surgery. The aim included seeking out how participants’ wellbeing was affected by being within this liminal space. Six participants were recruited in Johannesburg, Pretoria and Cape Town. Thematic analysis was used to derive themes from the transcripts. Themes included coming out; relationships; wellbeing; misgendering/misnaming; support; public and private medical care; and liminality. Recommendations for future studies are included, and recommendations on interventions and support are discussed. / Lolu cwaningo lohlobo lwekhethelo lenzelwe ukuthola noma ukubheka izinselelo zabantu abafuna ukushintsha ubulili babo baseNingizimu Afrika ababhekana nazo uma basohlelweni lokuyohlinzwa ngoDokotela ukuze bakhone ukushintsha ubulili babo. Inhloso yalolu cwaningo ukubheka ngqo kubantu abayihambile lena ndima ukuthi bahlukumezeka kanjani ngesikhathi basohlelweni lokuthi bashintshe ubulili babo. Abantu abayisithupha abazibandakanye nalolu cwaningo batholakale eGoli, ePitoli kanye naseKapa. Kusetshenziswe ucwaningo olubheka indikimba ukuze kutholwe izihloko ezivele embalweni osuselwe enkulumeni eqoshiweyo. Izihloko ezivelayo yilezi, ubudlelwano; impilo; ukubizwa ngobulili ongasibona/ukubizwa ngegama okungasilona elakho; ukwesekwa; usizo lwezibhedlela zikahulumeni nezibhedlela ezizimele; kanye nokuba sesimeni sokushintsha ubulili. Izincomo zocwaningo oluzayo zifakiwe nazo, kuphindwe kwakhulunywa noma kwabhekwa ukuthi kungangenelelwa kanjani ngosizo. / M.A. (Clinical Psychology) / Psychology

This interdisciplinary research paper explores story and metaphor of "trans/formative identities" as a basis for challenging normative racial and gender categories. Autoethnography is used as a method for weaving the author's own experience as a mixed-race Indigenous person with academic research and theory. The discussion is contextualized by an analysis of institutionalized colonial relationships framing Indigenous knowledge in academia and the role of Indian status in defining Indigenous identity. Six mixed-race and transgender or genderqueer people in Victoria and Vancouver. British Columbia are interviewed and the themes from their shared experiences are used as the basis for further understanding trans/formative identities. These themes are: irony; contradiction and impossibility; stories of home and family; naming and language; embodied negotiations, contextual selves, and; artistic visions.

The aim for this study was to investigate how social workers perceive that they are responding to clients who define themselves as transgender. The study has a qualitative basis with six semistructured interviews based on an elaborated vignette method. The selection of interviewees was social workers, three in the field of public authority and three workers at various excutive agencies. The material have been analyzed based on Queer theory and Honneths Recognition Theory. The findings indicate that social work organizations are lacking in knowlege of transgender people and their experiences. There is also a lack of evidence-based procedures, action plans and policies to respond to transgender people within the organizations. The findings also implies that social workers can respond to transgender people and address them more empathically, with greater acceptance as well as recognition through a professional self-reflection and a humble attitude. / Denna studies syfte har varit att undersöka hur verksamma inom socialt arbete uppfattar att de själva tillika verksamheten i stort bemöter transpersoner. Studien har en kvalitativ grund och baserar sig på sex semistrukturerade intervjuer med vinjettmetod. Urvalet av intervjupersoner är verksamma inom socialt arbete, tre inom myndighetsutövning och tre arbetande på olika utförarinstanser. Materialet har analyserats utifrån Queerteori och Honneths erkännadeteori. Resultatet visar bland annat att verksamheter inom socialt arbete brister i sin kunskap kring transpersoner och deras upplevelser samt saknar evidensbaserade rutiner, handlingsplaner och policys för att bemöta transpersoner inom organisationen. Resultatet visar även att yrkesverksamma inom socialt arbete kan bemöta transpersoner mer inkännande, med större acceptans och med en erkännande karaktär genom en självreflekterande och ödmjuk attityd.

The criminal justice system is a primary driver of racial and gender injustice. While research and policy advocacy tends to center the most typical criminalized subjects— black, and more recently Latino, men— unique insights into the dynamics of race, gender, and punishment emerge when we focus on a more unique group: transgender people of color. Nearly half of black transgender people experience incarceration over the course of their lives. The extreme criminalization of transgender people of color highlights the intersectional nature of carceral violence, and the ways state violence operates alongside social exclusion and structural abandonment. The carceral state produces and maintains social divisions. This dissertation investigates how the penal definition and management of racialized gender boundaries produces vulnerability and constrains life chances for transgender and gender-nonconforming people. I also demonstrate how, in the face of state coercion, criminalized gender-nonconforming people navigate and seek to mitigate vulnerability. The empirical context for this work is the California state prison system and the reentry ecosystem of San Francisco. Drawing on extensive archival research, 20 months of ethnographic observation in transgender prisoner advocacy organizations, and 136 interviews with formerly incarcerated transgender people, advocates, policymakers, and former prison staff, this dissertation shows how racialized gender regulation operates, transforms, and is resisted in penal organizations. This study traces racialized gender regulation over time— from 1941 to 2018— and across the carceral continuum, examining the management and navigation of racialized gender boundaries behind prison walls and in reentry organizations upon transgender people’s release. While transgender prisoner discourse foregrounds issues of identity, I find that neither identity nor accounts of race and gender as stable and transportable structures are sufficient to explain the ways racialized gender boundaries operate at the meso-level of penal organizations. Prison administrators and reentry staff articulate and regulate racialized gender boundaries based on historically-specific organizational imperatives (e.g. to distinguish between reformable and incurable prisoners, or to allocate limited reentry resources). Currently and formerly incarcerated transgender people, in turn, engage with classification pragmatically and pursue safety strategies designed to minimize vulnerability to both interpersonal and state violence. I arrive at these findings through three papers that focus on different dimensions of organizational practice and pragmatic survival strategies. In the first paper, I argue that, rather than emphasizing a categorical conflict between an institutionalized gender binary and gender-nonconformity, we should analyze how the nature of prison gender boundaries arises from the historically evolving nature of racialized punishment and the inherently coercive nature of classification in a total institution. Prison gender boundaries reflect an evolving conflict between the prison’s efforts to label, control, and confine bodies, and prisoners’ capacity to resist. Prison administrators make and manage gender boundary violation based on the evolving penal logics and resources at their disposal; from 1941-2018, administrators successively use strategies of segregation, treatment, risk management, and bureaucratic assimilation. Prisoners, in turn, express or repress non-normative gender identifications based on the consequences of classification in changing penal regimes. In the second paper, I extend research that has explained incarcerated transgender women’s high rates of victimization based on the prison’s rigid institutionalization of the gender binary. Employing an intersectional approach, I demonstrate that trans women of color in men's prisons are vulnerable because their restricted mobility, subjection to guard coercion, and material deprivation facilitates sexual assault. In this context, trans women of color use embodied, social, and economic resources to avoid victimization. Lastly, I examine how racialized gender regulation persists in the reentry organizations transgender people encounter upon release. Examining the gender rules and gendered interactions fostered by reentry housing programs, I show how the repudiation and regulation of black trans women’s womanhood leads to their exclusion from reentry resources and heightened reentry hardship. Together, these three papers work to explain how racialized gender regulation in the penal system generates complex, intersectional inequality, while also illuminating the ways criminalized transgender people of color understand, navigate, and resist these conditions.

Diskriminering mot transpersoner är ett omfattande problem på arbetsmarknaden. Samtliga forskningsresultat påvisar att transpersoner utsätts för olika diskriminerande handlingar på deras arbetsplatser. Den brist som framträder i den svenska forskningen om arbetsmarknadsdiskriminering är att den inte utforskar hur arbetsplatsens kontext formar diskrimineringen. Studiens syfte blir därför att generera kunskap om hur arbetsplatsen påverkar transpersonernas erfarenheter av diskriminering, samt vilka konsekvenser som genereras kopplat till formen av diskriminering. Den teori som används i studien för att förklara arbetsplatsens betydelse för hur diskrimineringen utformas är Anthony Giddens struktureringsteori. Giddens struktureringsteori är en teori som används för att förklara hur kontexten påverkar utformningen av dess sociala system. Den datainsamlingsmetod som tillämpas för att undersöka studiens syfte är nio semistrukturerade intervjuer och dataanalysmetoden utgår ifrån en modell inspirerad av Grounded Theory. Studiens empiri påvisar att intervjupersonerna har erfarenheter av direkt diskriminering, indirekt diskriminering och trakasserier på sina arbetsplatser. De konsekvenser diskrimineringen medför är framförallt psykiskt lidande, emotionella svårigheter, bristande tillgång till arbetsmarknaden och sämre ekonomi. Slutsatsen härleder diskrimineringen till arbetsplatskontexter karaktäriserade av (1) manligt kodade normer, (2) mindre storlek, (3) mer homogen arbetsgrupp och (4) låg utbildningsnivå hos personalen. En arbetsplatskontext karaktäriserade av dessa fyra koder är således mindre transvänliga. / Discrimination against transgender people is a widespread problem in the labour market. All research results shows that transgender people are exposed to various discriminatory acts in their workplaces. The shortcoming that emerges in Swedish research regarding discrimination in the labour is that it does not explore how the context of the workplace shapes the acts of discrimination. The purpose of this study is therefore to generate knowledge about how the context of the workplace affects the trans people's experiences of discrimination, and what consequences that are generated because of the discrimination. The theory used in this study are Anthony Giddens Theory of structures. Gidden's structuring theory is a theory used to explain the context's influence on the constructions of social systems. The method used to investigate the purpose of this study is nine individual semi-structured interviews and the method for analysis is based on a model inspired by Grounded Theory. The study's empirical evidence shows that transgender people have experiences of direct discrimination, indirect discrimination, and harassment in the workplace. The consequences of being exposed to discrimination are mental and emotional fatigue, as well as financial vulnerability. The conclusion derives the discrimination is constructed the context of the workplace characterized by (1) male-coded norms, (2) smaller size, (3) small diversity and (4) low level of education. A workplace context characterized by these four codes is thus less trans-friendly.

Indiana University-Purdue University Indianapolis (IUPUI) / Transgender women have the highest HIV prevalence rates of all gender and sexual minorities, yet are less likely to enter and be retained in HIV care. As a result, they are at high risk for HIV-related morbidity and mortality. This study aimed to describe the illness career of transgender women living with HIV and to describe how interactions with health care providers and important others influenced their illness trajectory. The findings are a theoretical model that includes four stages: Having the world come crashing down, shutting out the world, living in a dark world, and reconstructing the world. Relationships within the social network (family, friends, and romantic partners) and the network of health care providers provided the context of the women's illness careers. Pivotal moments marked movement from one phase to the next. Having the World Crashing Down was the first stage that occurred when the participants were diagnosed with HIV. They felt that their lives as they knew them had been destroyed. They indicated that the "whole world just shattered" the moment they found out they had HIV. Shutting Out the World occurred next. During this stage, many participants experienced withdrawal, denial, social isolation and loneliness. As they struggled with their diagnosis, they often avoided HIV care and avoided contact with important others. During the third stage, Living in a Dark World, participants descended into a dark phase of self-destructive life and health-threatening behaviors following their diagnosis. During the fourth stage, Reconstructing the World, participants began to reestablish themselves in the world and found new ways to reengage with important others and resume meaningful life activities. Findings confirm that the illness careers of HIV-positive transgender women are influenced by the social context of the health care setting and interactions with health care providers and important others.

Renewed efforts are needed to address rapidly rising HIV incidence among sexual and gender diverse (SGD) individuals—particularly cisgender gay, bisexual, and other men (MSM) and transgender and nonbinary individuals (TSM) who have sex with men—in Kazakhstan. Intervention research is uniquely positioned to advance HIV prevention through surveying factors shaping the HIV epidemic among MSM and TSM in Kazakhstan, developing and testing the effects of an HIV prevention intervention, and assessing overall social impacts of conducting research. This research proceeded to describe strategies and lessons learned during implementation of a stepped wedge clinical trial of an intervention designed to increase the number of MSM and TSM in the HIV care continuum in Kazakhstan cities of Almaty, Shymkent, and Nur-Sultan. Thus, this three-paper dissertation aimed to: (1) identify psychosocial factors associated with lifetime, past-12-month, and past-6-month HIV testing among a sample of MSM and TSM enrolled in the clinical trial; (2) describe the process of implementing remote training of facilitators for remotely delivering the HIV preventive intervention; and (3) assess social impacts of participating in the clinical trial. MSM and TSM from the study cities were recruited into the clinical trial and administered a structured behavioral survey at their primary visit and at follow-up visits every six months thereafter. After a period of no intervention implementation (‘pre-implementation period’), the intervention was implemented sequentially every six months in the study cities. Among 304 MSM and TSM enrolled in the clinical trial during the pre-implementation period, lifetime and past-12-month HIV testing were positively associated with polydrug use and negatively with sexual transmission HIV risk, and past-6-month HIV testing was negatively associated with sexual risk. The process of developing and implementing remote training of facilitators was guided by a protocol outlining phases involving formative assessment and planning, fundamentals training, and feedback loop and technical assistance. Out of 627 MSM and TSM who completed their primary assessment during the clinical trial, 579 (92%) returned for at least one follow-up visit; of these individuals, 88% reported at least one positive social impact, while 2% reported at least one negative social impact. Findings underscore the value of expanding access to substance use treatment for HIV prevention among MSM and TSM in Kazakhstan, the viability of remote training of facilitators for remote intervention delivery, and the feasibility of conducting HIV prevention research involving MSM and TSM with many benefits and few risks.

Studier visar på att transpersoner i Sverige upplever sämre villkor för sexuell hälsa jämfört med övriga befolkningen. Den forskning som finns att tillgå pekar på att normer kring kön och sexualitet är en av de faktorer som influerar transpersoners upplevda sexuella hälsa. Mot denna bakgrund konstateras på flera håll att människobehandlande professioner behöver satsa på kunskapshöjning och kompetensutveckling för att förbättra transpersoners möjligheter till god hälsa. En förutsättning för detta är att det finns kunskap som representerar transpersoners egna erfarenheter av hur normer och förväntningar samspelar med sexuell hälsa. Det är något som saknas i nuläget. Studiens syfte är därför att fylla denna kunskapslucka genom att undersöka transpersoners subjektiva upplevelser av hur köns- och sexualitetsnormer påverkar förutsättningarna för sexuell hälsa. Uppsatsens empiri bygger på kvalitativa intervjuer med 8 personer som identifierar sig själva som transpersoner. Materialet har analyserats och tematiserats med hjälp av Sara Ahmeds (2006) queera fenomenologi och Gagnon och Simons (2005) teori om sexuella script. Resultatet visar att normer kring kön och sexualitet upplevs influera sexuella livsvillkor på komplexa och mångfacetterade sätt. Denna påverkan tycks ske genom att normer influerar såväl samhällsstrukturer, interpersonella möten som intrapsykiska attityder. Normer upplevs på så vis som ett yttre och inre tryck på samma gång. Studiens slutsats är att personer med normöverskridande könsidentiteter bemöts av omvärlden på ett sätt som begränsar förutsättningarna för sexuell hälsa. Samtidigt pekar resultatet på att normöverskridandet kan främja vissa aspekter av sexuell hälsa genom att det medför en vidgad horisont från vilken det blir möjligt att utforska sex och sexualitet bortom rigida genusnormer. Att existera helt bortom samhällets normativa strukturer upplevs dock som en omöjlighet. Det är därför tydligt att ett mindre cisnormativt samhälle krävs för att transpersoner ska kunna åtnjuta samma sexuella livsvillkor som den övriga befolkningen. Denna slutsats trycker på att det finns ett behov av att utveckla det sociala arbetets praktik för att säkra transpersoners rätt till jämlika levnadsvillkor. / Studies show that the transgender population in Sweden experience poorer conditions for sexual health compared with the rest of the population. The available research indicates that gender norms are one of the factors that influence transgender people's perceived sexual health. Against this background it has been argued that human service organizations need to invest in knowledge and skill development in order for transgender people’s sexual health to be improved. Knowledge that represents transgender people's own experiences of how norms and expectations interact with sexual health is needed for this to be possible. This knowledge is currently lacking. The purpose of this study is therefore to fill this gap by examining transgender people’s subjective experiences of how social norms affect the conditions for sexual health. The study is bases on qualitative interviews with 8 people who self-identify as transgender. The material has been analyzed and thematized based on Sara Ahmed’s (2006) queer phenomenology and Gagnon and Simon's (2005) sexual script theory. The results show that norms are perceived to influence sexual living conditions in complex and multifaceted ways. This influence seems to occur as societal structures, interpersonal encounters as well as intrapsychic attitudes are shaped by social norms. In this way, norms are experienced as an external and internal pressure simultaneously. The study concludes that transgender people are treated in a way that creates poor conditions for sexual health. At the same time, the results indicate that gender nonconformity can promote sexual health by creating space for sexual exploration beyond rigid gender norms. To exist completely beyond society's normative structures, is however perceived as an impossibility. It is therefore clear that a less cisnormative society is required for transgender people to be able to enjoy the same sexual living conditions as the rest of the population. This conclusion emphasizes the need to develop the social work practice to secure transgender people’s rights to equal living conditions.