Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T03:12:34.477Z Has data issue: false hasContentIssue false

Chapter 7 - Dealing with Health Needs and Physical Complaints of Nonbinary Clients

from Section A - Contextual Transgynecology

Published online by Cambridge University Press:  22 December 2022

By
Cristiano Scandurra ,
Fabrizio Mezza  and
Vincenzo Bochicchio
Edited by
Mick van Trotsenburg ,
Rixt A. C. Luikenaar  and
Maria Cristina Meriggiola
Mick van Trotsenburg
Affiliation:
Sigmund Freud PrivatUniversität, Wien
Rixt A. C. Luikenaar
Affiliation:
Rebirth Health Center, Utah
Maria Cristina Meriggiola
Affiliation:
Università di Bologna
Get access

Summary

Nonbinary people are those who do not self-identify within the gender binary system. Recently, scientific research has increasingly recognized that nonbinary individuals have specific social and health needs, which may be different from those of binary transgender people. Obstetricians and gynecologists (Ob/Gyns) are paying increasing attention to transgender clients, who are in need of care services for either screening purposes, genital complaints, or information on genital health maintenance. However, since the nonbinary population has only recently been acknowledged in legal, medical, and psychological systems, most Ob/Gyns are likely to be unaware of specific nonbinary clients’ particular experiences and challenges. For this reason, in accordance with an affirmative, individualized, and culturally competent approach, this chapter addresses the health needs and physical complaints of nonbinary individuals, by focusing on two main issues: (1) how an affirmative environment for nonbinary clients may foster the therapeutic alliance; and (2) which are the specific physical complaints of nonbinary clients within Ob/Gyn care.

Keywords

nonbinarygenderfluidgender nonconformityhealthphysical complaintsaffirmative approachgender dysphoriahealth disparitiesmicroaggressions
Type
Chapter
Information
Context, Principles and Practice of TransGynecology
Managing Transgender Patients in ObGyn Practice
 , pp. 49 - 55
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Moradi, B, Tebbe, EA, Brewster, ME, et al. A content analysis of literature on trans people and issues: 2002–2012. Couns Psychol 2016;44:960–995. https://doi.org/10.1177/0011000015609044Google Scholar
Fiani, CN, Han, HJ. Navigating identity: experiences of binary and nonbinary transgender and gender non-conforming (TGNC) adults. Int J Transgend 2018;20(2–3):181–194. https://doi.org/10.1080/15532739.2018.1426074CrossRefGoogle ScholarPubMed
Johnson, KC, LeBlanc, AJ, Deardorff, J, Bockting, WO. Invalidation experiences among nonbinary adolescents. J Sex Res 2020;57(2):222–233. https://doi.org/10.1080/00224499.2019.1608422Google Scholar
Clark, BA, Veale, JF, Townsend, M, Frohard-Dourlent, H, Saewyc, E. Nonbinary youth: access to gender-affirming primary health care. Int J Transgend 2018;19(2):158–169. https://doi.org/10.1080/15532739.2017.1394954CrossRefGoogle Scholar
Goldberg, AE, Kuvalanka, KA, Budge, SL, Benz, MB, Smith, JZ. Health care experiences of transgender binary and nonbinary university students. Couns Psychol 2019;47(1):59–97. https://doi.org/10.1177/0011000019827568Google Scholar
Lykens, JE, LeBlanc, AJ, Bockting, WO. Healthcare experiences among young adults who identify as genderqueer or nonbinary. LGBT Health 2018;5(3):191–196. https://doi.org/10.1089/lgbt.2017.0215CrossRefGoogle ScholarPubMed
Bradford, NJ, Catalpa, JM. Social and psychological heterogeneity among binary transgender, nonbinary transgender and cisgender individuals. Psychol Sex 2019;10(1):69–82. https://doi.org/10.1080/19419899.2018.1552185Google Scholar
Scandurra, C, Mezza, F, Maldonato, NM, et al. Health of nonbinary and genderqueer people: a systematic review. Front Psychol 2019;10:1453. https://doi.org/10.3389/fpsyg.2019.01453Google Scholar
American Psychological Association. Guidelines for psychological practice with transgender and gender nonconforming people. Am Psychol 2015;70(9):832–864. https://doi.org/10.1037/a0039906CrossRefGoogle Scholar
Darwin, H. Doing gender beyond the binary: a virtual ethnography. Symb Interact 2017;40(3):317–334. https://doi.org/10.1002/symb.316CrossRefGoogle Scholar
Richards, C, Bouman, WP, Seal, L, et al. Nonbinary or genderqueer genders. Int Rev Psychiatry 2016;28(1):95–102. https://doi.org/10.3109/09540261.2015.1106446CrossRefGoogle ScholarPubMed
Government Equalities Office. National LGBT Survey: Research Report. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/721704/LGBT-survey-research-report.pdfGoogle Scholar
James, SE, Herman, JL, Rankin, S, et al. The report of the 2015 U.S. transgender survey. National Center for Transgender Equality. Published 2016.Google Scholar
Chew, D, Tollit, MA, Poulakis, Z, et al. Youths with a nonbinary gender identity: a review of their sociodemographic and clinical profile. Lancet Child Adolesc Health 2020;4(4):322–330. https://doi.org/10.1016/S2352-4642(19)30403-1CrossRefGoogle ScholarPubMed
Motmans, J, Nieder, TO, Bouman, WP. Transforming the paradigm of nonbinary transgender health: a field in transition. Int J Transgend 2019;20(2–3):119–125. https://doi.org/10.1080/15532739.2019.1640514CrossRefGoogle ScholarPubMed
Lang, C, Kuhnle, U. Intersexuality and alternative gender categories in non-Western cultures. Horm Res 2008;69(4):240–250. https://doi.org/10.1159/000113025Google Scholar
Reisner, SL, Hughto, JMW. Comparing the health of nonbinary and binary transgender adults in a state-wide non-probability sample. PLOS ONE 2019;14(8):e0221583. https://doi.org/10.1371/journal.pone.0221583Google Scholar
Koehler, A, Eyssel, J, Nieder, TO. Genders and individual treatment progress in (non-)binary trans individuals. J Sex Med 2018;15(1):102–113. https://doi.org/10.1016/j.jsxm.2017.11.007CrossRefGoogle ScholarPubMed
Scandurra, C, Carbone, A, Baiocco, R, et al. Gender identity milestones, minority stress and mental health in three generational cohorts of Italian binary and nonbinary transgender people. Int J Environ Res Public Health 2021;18(17):9057. https://doi.org/10.3390/ijerph18179057CrossRefGoogle ScholarPubMed
Bradford, NJ, Rider, GN, Catalpa, JM, et al. Creating gender: a thematic analysis of genderqueer narratives. Int J Transgend 2019;20(2–3):155–168. https://doi.org/10.1080/15532739.2018.1474516Google Scholar
Matsuno, E. Nonbinary-affirming psychological interventions. Cogn Behav Pract 2019;26(4):617–628. https://doi.org/10.1016/j.cbpra.2018.09.003CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Association, 2013.Google Scholar
Nieder, TO, Eyssel, J, Köhler, A. Being trans without medical transition: exploring characteristics of trans individuals from Germany not seeking gender-affirmative medical interventions. Arch Sex Behav 2020;49(7):2661–2672. https://doi.org/10.1007/s10508-019-01559-zGoogle Scholar
Galupo, MP, Pulice-Farrow, L, Pehl, E. “There is nothing to do about it”: nonbinary individuals’ experience of gender dysphoria. Transgend Health 2021;6(2):101–110. https://doi.org/10.1089/trgh.2020.0041Google Scholar
Vincent, B. Transgender Health: A Practitioner’s Guide to Binary and Nonbinary Trans Patient Care. London: Jessica Kingsley, 2018.Google Scholar
Meyer, IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull 2003;129(5):674–697. https://doi.org/10.1037/0033-2909.129.5.674Google Scholar
Matsuno, E, Budge, SL. Nonbinary/genderqueer identities: a critical review of the literature. Curr Sex Health Rep 2017;9:116–120. https://doi.org/10.1007/s11930–017-0111-8CrossRefGoogle Scholar
Aparicio-García, ME, Díaz-Ramiro, EM, Rubio-Valdehita, S, López-Núñez, MI, García-Nieto, I. Health and well-being of cisgender, transgender and nonbinary young people. Int J Environ Res Public Health 2018;15(10):2133. https://doi.org/10.3390/ijerph15102133CrossRefGoogle Scholar
Burgwal, A, Gvianishvili, N, Hård, V, et al. Health disparities between binary and nonbinary trans people: a community-driven survey. Int J Transgend 2019;20(2–3):218–229. https://doi.org/10.1080/15532739.2019.1629370Google Scholar
White-Hughto, JM, Reisner, SL, Pachankis, JE. Transgender stigma and health: a critical review of stigma determinants, mechanisms, and interventions. Soc Sci Med 2015;147:222–231. https://doi.org/10.1016/j.socscimed.2015.11.010Google Scholar
Nieder, TO, Richter-Appelt, H. Tertium non datur—either/or reactions to transsexualism amongst health care professionals: the situation past and present, and its relevance to the future. Psychol Sex 2011;2(3):224–243. https://doi.org/10.1080/19419899.2010.545955Google Scholar
Markovic, L, McDermott, DT, Stefanac, S, et al. Experiences and interactions with the healthcare system in transgender and nonbinary patients in Austria: an exploratory cross-sectional study. Int J Environ Res Public Health 2021;18(13):6895. https://doi.org/10.3390/ijerph18136895CrossRefGoogle ScholarPubMed
Kattari, SK, Bakko, M, Hecht, HK, Kattari, L. Correlations between healthcare provider interactions and mental health among transgender and nonbinary adults. SSM Popul Health 2020;10:100525. https://doi.org10.1016/j.ssmph.2019.100525Google Scholar
Agénor, M, White Hughto, JM, Peitzmeier, SM, et al. Gender identity disparities in Pap test use in a sample of binary and nonbinary transmasculine adults. J Gen Intern Med 2018;33(7):1015–1017. https://doi.org/10.1007/s11606-018-4400-3CrossRefGoogle Scholar
Committee on Health Care for Underserved Women. Committee Opinion no. 512: health care for transgender individuals. Obstet Gynecol 2011;118(6):1454–1458. https://doi.org/10.1097/AOG.0b013e31823ed1c1Google Scholar
Mayhew, AC, Cohen, A, Gomez-Lobo, V. Transgender men and the gynecologist. Clin Obstet Gynecol 2020;63(3):588–598. https://doi.org/10.1097/GRF.0000000000000549Google Scholar
Unger, CA. Care of the transgender patient: a survey of gynecologists’ current knowledge and practice. J Womens Health 2015;24(2):114–118. https://doi.org/10.1089/jwh.2014.4918Google Scholar
Snelgrove, JW, Jasudavisius, AM, Rowe, BW, Head, EM, Bauer, GR. “Completely out-at-sea” with “two-gender medicine”: a qualitative analysis of physician-side barriers to providing healthcare for transgender patients. BMC Health Serv Res 2012;12:110. https://doi.org/10.1186/1472-6963-12-110CrossRefGoogle ScholarPubMed
Shires, DA, Prieto, L, Woodford, MR, Jaffee, KD, Stroumsa, D. Gynecologic health care providers’ willingness to provide routine care and Papanicolaou tests for transmasculine individuals. J Womens Health 2019;28(11):1487–1492. https://doi.org/10.1089/jwh.2018.7384CrossRefGoogle ScholarPubMed
Stroumsa, D, Wu, JP. Welcoming transgender and nonbinary patients: expanding the language of “women’s health”. Am J Obstet Gynecol 2018;219(6):585.e1–585.e5. https://doi.org/10.1016/j.ajog.2018.09.018CrossRefGoogle ScholarPubMed
Moseson, H, Zazanis, N, Goldberg, E, et al. The imperative for transgender and gender nonbinary inclusion: beyond women’s health. Obstet Gynecol 2020;135(5):1059–1068. https://doi.org/10.1097/AOG.0000000000003816Google Scholar
Vincent, B. Breaking down barriers and binaries in trans healthcare: the validation of nonbinary people. Int J Transgend 2019;20(2–3):132–137. https://doi.org/10.1080/15532739.2018.1534075Google Scholar
Nisly, NL, Imborek, KL, Miller, ML, et al. Unique primary care needs of transgender and gender nonbinary people. Clin Obstet Gynecol 2018;61(4):674–686. https://doi.org/10.1097/GRF.0000000000000404Google Scholar
Webb, A, Matsuno, E, Budge, S, Krishnan, M, Balsam, K. Nonbinary Gender Identities Fact Sheet. The Society for the Psychological Study of Lesbian, Gay, Bisexual and Transgender Issues APA Division 44. Washington, DC: The American Psychological Association, 2016.Google Scholar
Elias, NM. Transgender and Nonbinary Gender Policy in the Public Sector. New York: Oxford Research Encyclopedia Politics, 2019.Google Scholar
Nadal, KL, Whitman, CN, Davis, LS, Erazo, T, Davidoff, KC. Microaggressions toward lesbian, gay, bisexual, transgender, queer, and genderqueer people: a review of the literature. J Sex Res 2016;53(4–5):488–508. https://doi.org/10.1080/00224499.2016.1142495CrossRefGoogle ScholarPubMed
Morris, ER, Lindley, L, Galupo, MP. “Better issues to focus on”: transgender microaggressions as ethical violations in therapy. Couns Psychol 2020;48(6):883–915. https://doi.org/10.1177/0011000020924391Google Scholar
Cruz, D, Rodriguez, Y, Mastropaolo, C. Perceived microaggressions in health care: a measurement study. PLOS ONE 2019;14(2):e0211620. https://doi.org/10.1371/journal.pone.0211620CrossRefGoogle Scholar
Anzani, A, Morris, ER, Galupo, MP. From absence of microaggressions to seeing authentic gender: transgender clients’ experiences with microaffirmations in therapy. J LGBT Issues Couns 2019;13(4):258–275. https://doi.org/10.1080/15538605.2019.1662359Google Scholar
Seal, L. Adult endocrinology. In: Richards, C, Bouman, WP, Barker, MJ, Eds. Genderqueer and Nnonbinary Genders. Basingstoke: Palgrave Macmillan, 2017, pp. 183–223.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×