Transgender People's Perceptions of Medical Treatment: Implications for Providers and Loved Ones

In this study, we examine qualitative data from 73 transgender adults. We present the information our participants shared about their experiences navigating health care systems (i.e., medical health, mental health, other providers). Four themes emerged. First, participants indicated that they wanted health care providers to be more aware of transgender-specific terminology, identities, and experiences. Second, participants were concerned that health care providers blame their medical transition for unrelated health concerns. Third, participants said they did not want health care providers to probe transgender patients about their transitions. Fourth, they reported that they wanted health care providers to treat transgender patients as individuals rather than a monolith. Our research has implications for mental health providers because they benefit from understanding the health care barriers experienced by their transgender patients, in mental health and other health realms. This will allow mental health providers to better support their patients as well as bolster support from loved ones.

Remediating AIDS Archives

In response to mainstream narratives of AIDS history, which too often highlight only experiences of white, cisgender gay men, this article argues that an analysis of recent AIDS activist media is crucial to complicate mainstream representations. It looks to recent video work as an important site of a diversified AIDS history and analyzes three videos made by Thomas Allen Harris, Shanti Avirgan, and Nguyen Tan Hoang for the Visual AIDS Alternate Endings series. Instead of presenting AIDS history as firmly embedded in the past, much of this newer work intertwines past and present to show the ongoing nature of the crisis. Many videos use archival footage to highlight the persistent nature of racism, poverty, drug use stigma, and health care barriers in the epidemic. Through temporal contrast, the videos powerfully show that progress is not always linear, and the past has much to teach us about the present.

Assessing the Effect of Demographic Background on Barriers to Seek Medical Attention for Psoriasis

Background: Lack of treatment or undertreatment of psoriasis is a major issue. Demographics might be related to specific barriers to health care. Objective: To assess the association between demographic background and barriers to seek medical attention for individuals with psoriasis. Methods: A total of 152 subjects with self-reported psoriasis were recruited through Amazon Mechanical Turk and surveyed via Qualtrics to assess the impact of demographics on health care barriers. Subjects were presented with an image of a psoriatic plaque on an elbow and asked to rate how large of a barrier they would face to seek care on a 1 to 10 scale. Outcome measures were compared using multiple linear regression. Results: Demographics were correlated with high cost of care (F(6,107) = 3.38, P < .01, R 2 = 0.16), lack of availability of services (F(6,60) = 2.84, P = .01, R 2 = 0.22), and lack of understanding treatment options (F(6,61) = 2.18, P = .05, R 2 = 0.18). Conclusion: Some demographic groups face higher rates of barriers to seek medical attention. These barriers may contribute to undertreatment of psoriasis.

Characterization of Chronic Sinonasal Disease Symptoms in an Urban Homeless Population

Background The urban homeless population has increased exposure to risk factors associated with chronic rhinosinusitis (CRS). However, a gap in knowledge of the prevalence of sinonasal symptoms in these demographic limits complete understanding of CRS epidemiology. There is a need to elucidate sinonasal disease burden in this vulnerable patient population to bring awareness to any existing disparities. Objective To assess the prevalence, severity, and associated factors of CRS clinical symptoms and health-care barriers in an urban homeless population. Methods Homeless adults completed a sociodemographic questionnaire and the 22-item Sinonasal Outcome Test (SNOT-22) and EuroQol-5 Dimension-3 Level-Visual Analog Scale surveys. Responses were categorized by potential CRS symptoms defined as reporting at least 2 CRS cardinal symptoms. Risk factors associated with potential CRS symptoms were analyzed with multivariate regression models. Results Fifty-six (16%) out of 341 total subjects reported potential CRS symptoms. Those with potential CRS symptoms had a higher median SNOT-22 score (53 vs 22, P < .001) than those without. Logistic regression models identified history of smoking (odds ratio [OR], 6.54; 95% confidence interval [CI], 2.04–21.04) and duration of homelessness over 3 months (OR, 3.46; CI, 1.51–7.94) as factors associated with potential CRS symptoms. Duration of homelessness over 3 months was associated with higher SNOT-22 scores (standardized beta coefficient [β], 0.48; CI, 0.39–0.57). Among those reporting 2 or more CRS cardinal symptoms, 18% had ever been seen by any physician for their symptoms. Conclusions Our study estimates a high prevalence of potential CRS symptoms in the urban homeless population. Longer duration of homelessness was associated with potential CRS symptoms and poor CRS-specific quality of life scores. Disparities in access to care emphasize the need for increased preventive efforts designed for this unique patient group.