Non-binary youth: Access to gender-affirming primary health care

ABSTRACT

Background: Transgender (trans) youth who identify outside the gender binary are a growing subpopulation. In this article, we document differences in access to gender-affirming health care between binary and non-binary identified trans youth and explore ways of meeting the health needs of non-binary youth within primary care settings.

Methods: The Canadian Trans Youth Health Survey is a national online survey of trans youth, 14–25 years, conducted in 2013–2014. Among the 839 participants who responded to gender identity items in the survey, 41% identified as non-binary. We compared demographic, health outcome, and health care access responses between non-binary and binary (trans girls/women and trans boys/men) youth.

Results: Non-binary and binary youth were similar in most demographics, including age, geographic distribution, and ethnocultural backgrounds, however a larger proportion (82%) of non-binary youth were assigned female at birth. Older non-binary youth (aged 19–25) were significantly more likely to forego needed healthcare than older binary youth; no significant differences were found between younger (14–18) non-binary and binary youth in foregoing healthcare. Overall, non-binary youth (13%) were significantly less likely than binary youth (52%) to access hormone therapy, but they were more likely than binary youth to report experiencing barriers to accessing hormone therapy when needed.

Conclusions: Non-binary trans youth in Canada report challenges in accessing needed gender-affirming healthcare. Primary care providers are well-situated to integrate a broad range of gender-affirming care services into practice in order to address the unique needs of non-binary youth. Future research is warranted to explore experiences of non-binary youth related to barriers to care and to explore how services can be designed and delivered to better meet the needs of non-binary youth seeking gender-affirming primary care.     

Skills of Cognitive Therapy (SoCT): a new measure of patients' comprehension and use

The authors describe the development and psychometric properties of a new measure called the Skills of Cognitive Therapy (SoCT) in depressed adults and their cognitive therapists. The 8-item SoCT assesses patients' understanding and use of basic cognitive therapy (CT) skills rated from the perspectives of both observers (SoCT-O; therapists in this report) and patients (SoCT-P). Ratings of patients' skill usage are made on 5-point Likert-type scales ranging from 1 (never) to 5 (always or when needed). Higher scores reflect greater patient skill in applying cognitive therapy principles and coping strategies. To develop this scale, a 33-item pool was used, rated by both patients and their therapists at the middle and end of CT (Ns = 359-416), and evaluated the reliability and concurrent and predictive validity of both versions of the scale. The SoCT has excellent internal consistency reliability and moderate correlations between the observer and patient versions. It is important to note that the SoCT showed good predictive validity for response when collected at the midpoint of acute phase CT. Considering both patients' self-ratings and clinicians' SoCT ratings, the odds ratio for responding to CT was 2.6. The practical utility of the SoCT is discussed, as well as its theoretical importance in research of patient CT skills (e.g., acquisition, comprehension, and generalization) as putative moderators or mechanisms of symptom change in the therapy.     

Spiritual well-being and spiritual practices in elderly depressed psychiatric inpatients

This study's aims were to describe the spirituality of depressed elderly psychiatric inpatients and to examine associations among spirituality, depression, and quality of life (QOL). Forty-five persons participated. Most reported frequent, stable spiritual practices and experiencing spiritual comfort and guidance. Some reported spiritual distress and changes in spirituality. During hospitalization, participants demonstrated increased spiritual well-being (SWB) and peacefulness, and reduced hopelessness, worthlessness, and guilt. Positive associations were found between SWB and QOL and negative associations between SWB and depression.     

Adultspan Publication Patterns: Author and Article Characteristics From 1999 to 2009

Publication patterns of articles in Adultspan from 1999 to 2009 were reviewed. Author characteristics and article content were analyzed to determine trends over time. Research articles were analyzed specifically for type of research design, classification, sampling method, types of participants, sample size, types of statistics used, and statistical sophistication.     

Mothers' personality and its interaction with child temperament as predictors of parenting behavior

In this longitudinal, multimethod investigation, the authors examined mothers' personality and its interaction with infants' negative emotionality as predictors of parenting behavior. When infants were 8-10 months old (N = 112), mothers completed personality self-reports, and the authors observed infants' negative emotionality in both standard procedures and naturalistic daily contexts. When infants were 13-15 months old (N = 108), the authors observed two aspects of parenting, power assertion and maternal responsiveness, in mother-child interactive contexts. Maternal personality alone and also in interaction with child emotionality predicted future parenting behaviors. The longitudinal links established between personality and parenting behaviors indicate the predictive utility of personality. Findings also highlight the bidirectionality of the early parent-child relationship.     

Does the Conners' Continuous Performance Test Aid in ADHD Diagnosis?

The performance of clinic-referred children aged 6–11 (N = 100) was examined using the Conners' Continuous Performance Test (CPT) and measures of auditory attention (Auditory Continuous Performance Test; ACPT), phonological awareness, visual processing speed, and visual-motor competence. The Conners' CPT overall index was unrelated to measures of visual processing speed or visual-motor competence. Although the Conners' CPT converged with the ACPT, the latter demonstrated age and order effects. Significant variance in Conners' CPT parameters was predicted by phonological awareness measures, suggesting that Reading Disordered (RD) children could be false positives on the Conners' CPT. The Conners' CPT overall index, phonological awareness, and visual-motor measures were submitted to a 2×2 MANCOVA (ADHD vs. RD, covarying for age and socieoeconomic status): a main effect for RD status was found. Children with ADHD did not have higher Conners' CPT scores than did clinical controls; however, children with Reading Disorders did. Phonological measures distinguished RD children from ADHD children and other clinical controls. ADHD children who failed the Conners' CPT were rated by teachers as more hyperactive. Despite the strengths of the Conners' CPT, its utility for differential diagnosis of ADHD is questioned.     

Reversible hippocampal lesions disrupt water maze performance during both recent and remote memory tests

Conventional lesion methods have shown that damage to the rodent hippocampus can impair previously acquired spatial memory in tasks such as the water maze. In contrast, work with reversible lesion methods using a different spatial task has found remote memory to be spared. To determine whether the finding of spared remote spatial memory depends on the lesion method, we reversibly inactivated the hippocampus with lidocaine either immediately (0-DAY) or 1 mo (30-DAY) after training in a water maze. For both the 0-DAY and 30-DAY retention tests, rats that received lidocaine infusions exhibited impaired performance. In addition, when the 0-DAY group was retested 2 d later, (when the drug was no longer active), the effect was reversed. That is, rats that had previously received lidocaine performed as well as control rats did. These findings indicate that the rodent hippocampus is important for both recent and remote spatial memory, as assessed in the water maze. What determines whether remote spatial memory is preserved or impaired following disruption of hippocampal function appears to be the type of task used to assess spatial memory, not the method used to disrupt the hippocampus.     

Extending the psychological profile of market mavenism

• This paper describes a study in the psychology of market mavenism, the consumer tendency to become especially involved in the marketplace. The purpose was to investigate empirically associations with the important consumer characteristics of innovativeness, status consumption, and need for uniqueness. The findings support the notion that market mavenism is due less to the demographic characteristics of consumers as it is more a socially constructed phenomenon. Global innovativeness, status consumption, and creative choice counterconformity explained more variance in market mavenism than did demographics. Theoretically, these findings enrich our knowledge of the psychology of market mavens by suggesting some motivations for their behavior. Practically, marketing strategies can be fine‐tuned to appeal more effectively to this important segment of consumers by appealing to mavens' willingness to try new things, to their need for uniqueness, and to their willingness to seek social status through consumption.

Copyright © 2006 John Wiley & Sons, Ltd.