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Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review

OBJECTIVES: Conversion is a term for treatments that seek to suppress or change a person’s sexual orientation or gender. Our review focuses on transgender and gender-diverse (TGD) people. Our aims were to (1) describe the frequency, nature and structure of conversion practices; (2) document difficul...

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Autores principales: Wright, Talen, Candy, Bridget, King, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318517/
https://www.ncbi.nlm.nih.gov/pubmed/30580262
http://dx.doi.org/10.1136/bmjopen-2018-022425
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author Wright, Talen
Candy, Bridget
King, Michael
author_facet Wright, Talen
Candy, Bridget
King, Michael
author_sort Wright, Talen
collection PubMed
description OBJECTIVES: Conversion is a term for treatments that seek to suppress or change a person’s sexual orientation or gender. Our review focuses on transgender and gender-diverse (TGD) people. Our aims were to (1) describe the frequency, nature and structure of conversion practices; (2) document difficulties in accessing transition-related healthcare and (3) evaluate the mental health consequences of such practices and access barriers. METHOD: Systematic review and narrative synthesis using the Critical Appraisals Skills Programme and Joanne Briggs Institute critical appraisal tools. Data sources include Embase, MEDLINE, PsychINFO, PsychARTICLES and Web of Science between 1990 and June 2017. PARTICIPANTS: Studies were included that (1) document use of conversion therapies or access barriers to transition-related healthcare; and/or (2) describe how such therapeutic practices and access barriers have been applied and/or (3) evaluate the mental health impacts of such therapies and difficulties accessing transition-related healthcare. Two reviewers screened papers for eligibility. Data were then grouped according to the objectives. Narratives and themes were presented per study. RESULTS: Seven studies met inclusion criteria. Four reports were on ‘realignment’, involving case studies or case series. Two involved psychoanalysis, one self-exposure therapy and one open-ended play psychotherapy. All four studies concerning ‘realignment’ were of poor methodological quality. The other three studies explored access barriers from the view point of TGD youth, their parents and healthcare providers. All papers reported access barriers, such as inability to access puberty-delaying medications. The papers concerning barriers to access were of good methodological quality. CONCLUSION: We found limited published evidence on use, nature, structure and/or health consequences of conversion therapies and access barriers to transition in TGD people. However, reports of restriction to access may indicate a more widespread problem. Research is needed into TGD people’s experiences of conversion therapy and access barriers to transition-related healthcare TRIAL REGISTRATION NUMBER: CRD42017062149.
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spelling pubmed-63185172019-01-14 Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review Wright, Talen Candy, Bridget King, Michael BMJ Open Mental Health OBJECTIVES: Conversion is a term for treatments that seek to suppress or change a person’s sexual orientation or gender. Our review focuses on transgender and gender-diverse (TGD) people. Our aims were to (1) describe the frequency, nature and structure of conversion practices; (2) document difficulties in accessing transition-related healthcare and (3) evaluate the mental health consequences of such practices and access barriers. METHOD: Systematic review and narrative synthesis using the Critical Appraisals Skills Programme and Joanne Briggs Institute critical appraisal tools. Data sources include Embase, MEDLINE, PsychINFO, PsychARTICLES and Web of Science between 1990 and June 2017. PARTICIPANTS: Studies were included that (1) document use of conversion therapies or access barriers to transition-related healthcare; and/or (2) describe how such therapeutic practices and access barriers have been applied and/or (3) evaluate the mental health impacts of such therapies and difficulties accessing transition-related healthcare. Two reviewers screened papers for eligibility. Data were then grouped according to the objectives. Narratives and themes were presented per study. RESULTS: Seven studies met inclusion criteria. Four reports were on ‘realignment’, involving case studies or case series. Two involved psychoanalysis, one self-exposure therapy and one open-ended play psychotherapy. All four studies concerning ‘realignment’ were of poor methodological quality. The other three studies explored access barriers from the view point of TGD youth, their parents and healthcare providers. All papers reported access barriers, such as inability to access puberty-delaying medications. The papers concerning barriers to access were of good methodological quality. CONCLUSION: We found limited published evidence on use, nature, structure and/or health consequences of conversion therapies and access barriers to transition in TGD people. However, reports of restriction to access may indicate a more widespread problem. Research is needed into TGD people’s experiences of conversion therapy and access barriers to transition-related healthcare TRIAL REGISTRATION NUMBER: CRD42017062149. BMJ Publishing Group 2018-12-22 /pmc/articles/PMC6318517/ /pubmed/30580262 http://dx.doi.org/10.1136/bmjopen-2018-022425 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Mental Health
Wright, Talen
Candy, Bridget
King, Michael
Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review
title Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review
title_full Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review
title_fullStr Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review
title_full_unstemmed Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review
title_short Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review
title_sort conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review
topic Mental Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318517/
https://www.ncbi.nlm.nih.gov/pubmed/30580262
http://dx.doi.org/10.1136/bmjopen-2018-022425
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