Caregiver and student perspectives on school services for students with traumatic brain injury during the COVID-19 pandemic.
Authors: Palusak C, Dart L, Ciccia A, Nagele D, Lundine JP
Journal: Journal of pediatric rehabilitation medicine
mental health
psychology
open access
Abstract
The global prevalence of self-identified transgender individuals is estimated at
approximately 0.6%, though estimates vary by region, age, and study method
(). In Brazil, recent
estimates suggest a prevalence of 0.69% among adults, with relatively uniform
distribution across regions ().
The transgender population faces significant barriers to accessing public health
services, including stigma, discrimination, and geographic inequities (). These barriers underscore the
urgent need for inclusive and equitable public health policies. The demand for comprehensive gender-affirming care for transgender individuals has
increased significantly, while the average age at treatment initiation has decreased
by approximately four years ().
Moreover, care-seeking among individuals assigned female at birth (AFAB) has
increased substantially, now equaling or surpassing that of those assigned male at
birth (AMAB), including transgender, non-binary, and other gender-diverse
individuals (-). Although these trends are
encouraging and may reflect greater societal acceptance (), they also present new challenges for healthcare
systems that are often unprepared to meet this rising demand. Despite being limited, existing literature indicates that specialized healthcare
services and hospital-based procedures are concentrated in large urban centers and
more socioeconomically developed regions (,-). Limited
access to care is frequently associated with nonprescribed hormone use and high
rates of suicidal ideation prior to gender transition (,,). As
primary health care (PHC) often serves as the main entry point into the health
system, transgender individuals frequently rely on these services (). However, insufficient training
in gender-affirming care, uncomfortable patient-provider interactions, and systemic
discrimination within healthcare settings limit the effectiveness of care
(,,).
approximately 0.6%, though estimates vary by region, age, and study method
(). In Brazil, recent
estimates suggest a prevalence of 0.69% among adults, with relatively uniform
distribution across regions ().
The transgender population faces significant barriers to accessing public health
services, including stigma, discrimination, and geographic inequities (). These barriers underscore the
urgent need for inclusive and equitable public health policies. The demand for comprehensive gender-affirming care for transgender individuals has
increased significantly, while the average age at treatment initiation has decreased
by approximately four years ().
Moreover, care-seeking among individuals assigned female at birth (AFAB) has
increased substantially, now equaling or surpassing that of those assigned male at
birth (AMAB), including transgender, non-binary, and other gender-diverse
individuals (-). Although these trends are
encouraging and may reflect greater societal acceptance (), they also present new challenges for healthcare
systems that are often unprepared to meet this rising demand. Despite being limited, existing literature indicates that specialized healthcare
services and hospital-based procedures are concentrated in large urban centers and
more socioeconomically developed regions (,-). Limited
access to care is frequently associated with nonprescribed hormone use and high
rates of suicidal ideation prior to gender transition (,,). As
primary health care (PHC) often serves as the main entry point into the health
system, transgender individuals frequently rely on these services (). However, insufficient training
in gender-affirming care, uncomfortable patient-provider interactions, and systemic
discrimination within healthcare settings limit the effectiveness of care
(,,).