Mental health practitioners' attitudes towards transgender people: A systematic review of the literature

Background: A systematic review was conducted to critically evaluate and synthesize literature investigating mental health practitioners' attitudes towards transgender people.

Objective: Three primary objectives were outlined; first, establish whether overall attitudes are positive or negative. Second, explore whether training, education or experience influences attitudes and finally, examine participant demographics in relation to attitude trends.

Method: A systematic electronic search was carried out in March 2017 using Medline, PsycINFO, PsycArticles, CINAHL, ASSIA, and Web of Science electronic databases. Manual citation and ancestral searches were conducted on identified papers. Qualitative, quantitative and mixed method studies were eligible for inclusion. A total of 13 papers of mixed quality were identified.

Results: Existing literature is limited to cross-sectional, quantitative data and fails to investigate differences between implicit and explicit attitudes. Small to moderate convenience samples reduce the generalizability of data. Overall attitudes were positive although negative attitudes were more frequent in male, Caucasian, heterosexual, religious, conservative mental health professionals.

Conclusions: Refined scales are needed to address the unique heterogeneity within transgender populations. Future research should focus on how attitudes impact care provided and employ longitudinal designs to explore the sustainability of targeted attitudinal training.     

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.     

自适应分组认知诊断测验设计及其选题策略

应用OMST在线装配模式,提出自适应分组认知诊断测验（CD-AMGT）。由于知识状态的先决关系是偏序关系,而且构成格（lattice),利用知识状态当前估计值在格中的上下确界对被试真实知识状态的可能范围进行界定,由此装配下一分组,分组中结合PWKL策略或SHE策略进行选题以兼顾诊断精度、效率和安全性。模拟实验表明,CD-AMGT与PWKL、SHE对比,当题目类型丰富时,以分类准确率略微降低为代价,其题库使用均匀性和计算用时均表现出较大优势。     

The universe of our concerns: the human as person in the praxis of analysis

Since its inception, psychoanalysts and analytical psychologists have used the reductionistic methods of science to explain both human development and analytic practice. The most recent iteration of this tendency uses attachment as the explanatory principle. This disposition has created theories that understand the human solely as an organism. While this is a satisfactory way to view human development, it is not appropriate for the practice of analysis. In this context, the human must be viewed as a person that is explicable in his/her own terms. Interpretation based on reductionism eliminates personhood. Humans appear as persons in 'the feeling of what happens' or of 'being there', and, on the basis of this experience, develop stories in which their personhood evolves. The psychoanalytic, philosophical and neuro-scientific basis for this view of the human as person is discussed, and its relevance for analytic practice is considered.     

画人智力测验评分项目的再确定

该研究参照国内外已有的画人测验材料 ,并在以往使用绘人智能测验的基础上 ,重新设计 ,提出了一份包含 80个评分项目的画人评分标准。新标准首先在课题组内试用修改 ,然后又用于 9名标准评分员的培训 ,最后运用总计 2 5 8名 ,年龄为 6～ 1 2岁的小学儿童作预试 ,进行系统的项目分析。在上述过程中 ,对项目进行反复推敲删改 ,最终形成了一份供制订画人智力测验常模用的画人评分标准。该标准分有无、细节、比例、奖励四个维度 ,按身体部位分成头、头发、眼、耳、鼻、口、颈、躯干、上肢、手、下肢、脚以及连接和服饰共十四个大类 ,每大类包含 4～ 8个评分点 ,总计 75个评分点。     

An exact and optimal standardized person test for assessing consistency with the rasch model

The Rasch model predicts that an individual's ability level is invariant over subtests of the total test, and thus, all subtests measure the same latent trait. A person test of this invariance hypothesis is discussed that is uniformly most powerful and standardized in the sense that the conditional distribution of the test statistic, given a particular level of ability, does not depend on the absolute value of the examinee's ability parameter. The test can be routinely performed by applying a computer program designed by and obtainable from the author. Finally, a suboptimal test is derived that is extremely easy to use, and an overall group test of the invariance hypothesis discussed. All tests considered do not rely on asymptotic approximations; hence, they may be applied when the test is of only moderate length and the group of examinees is small.     

What are the relationship experiences of in which one member identifies as transgender? A systematic review and meta-ethnography

Transgender individuals and their partners may face unique challenges that other couples do not. These unique challenges merit investigation, understanding and consideration by systemic practitioners in order to provide a culturally attuned service for transgender clients. A systematic review of the literature into the experiences of couples in which one member is transgender identified 22 qualitative papers. A translation and synthesis of constructs from these papers utilising a meta-ethnographic approach generated a number of third order constructs organised into nine overarching themes. These themes included experiences of stigma and discrimination, issues of power, privilege, visibility and identity, and experiences of dissonance and dysphoria that required adjustments and negotiations on the personal and relationship levels. Implications for practice and avenues for future research are discussed.     

Selecting entrepreneurial employees using a person-group fit perspective

As jobs become unstructured and collective endeavor oriented, it is increasingly being realized that work groups must become more autonomous and entrepreneurial. The selection literature is however silent on the predictive mechanisms that may be leveraged to select group members with the desired competencies. The person-group fit perspective enables us to hypothesize and demonstrate that selection instruments geared toward gauging an individual's fit within a group are likely to manifest entrepreneurial competencies and behaviors in the individual. Further, the nature of the job, in terms of the structuredness of work (task formalization) and the repetitiveness of work activities (task routinization), has a moderating impact on the relationship between overall entrepreneurial competence and selection practices. The study has implications for incorporating the principles of person-group fit into the design of job profiles.     

A Developmental Approach to Social Science: A Model for Analyzing Charles Alexander's Scientific Contributions

A seven-paradigm developmental model of social science is presented (behaviorism, gestalt sociologism, empirical positivism, multi-method eclecticism, postmodern interpretivism, cooperative ecological inquiry, and developmental action inquiry). Charles Alexander's research is interpreted as bridging aspects of several paradigms, using third-person empirical positivist experiments to demonstrate the effects of a first-person research/practice called Transcendental Meditiation. The author suggests the possibility of complementing current research on TM with explicit double- and triple-loop research on the second- and third-person practices within the TM movement.     

Exact person fit indexes for the rasch model for arbitrary alternatives

A new algorithm for obtaining exact person fit indexes for the Rasch model is introduced which realizes most powerful tests for a very general family of alternative hypotheses, including tests concerning DIF as well as model-deviating item correlations. The method is also used as a goodness-of-fit test for whole data sets where the item parameters are assumed to be known. For tests with 30 items at most, exact values are obtained, for longer tests a Monte Carlo-algorithm is proposed. Simulated examples and an empirical investigation demonstrate test power and applicability to item elimination.The author wishes to thank Elisabeth Ponocny-Seliger and the reviewers for many helpful comments. All exact goodness-of-fit tests proposed in this article are implemented in the menu-driven program T-Rasch 1.0 by Ponocny and Ponocny-Seliger (1999) which can be obtained from ProGAMMA (WWW: http://www.gamma.rug.nl) and also performs nonparametric tests.