Publications

Dietitians supporting gender-diverse clients may need knowledge that training aimed at cisgender patients never covers. This qualitative mini review systematically searched for and synthesised studies on gender-diverse people's own experiences with nutrition, eating disorders, and eating-related health services, ultimately including 14 papers, 11 about disordered eating and three about nutritional needs, knowledge, and food insecurity. Themes included restricting food to suppress secondary sex characteristics or meet social expectations, the effect of gender-affirming care on disordered eating, and negative encounters with nutrition and eating disorder services. Recommendations centre trans literacy among clinicians, safer treatment spaces, and dual competence in eating disorders and gender-affirming care.

People living with HIV who use drugs are hospitalized more often than the general population and frequently describe poor treatment on the ward. To understand why, researchers interviewed 26 hospital-based providers in Toronto and Ottawa, including physicians, registered nurses, social workers, pharmacists, a dietitian and a nurse practitioner, analysing the transcripts through structuration theory. Most providers said their hospitals offer no explicit rules guiding care for patients who use drugs, and many considered this work beyond their scope of practice. In that vacuum, implicit rules and improvised actions take over, which the authors argue can undermine equitable care for this group.

Barriers dominate discussion of trans healthcare, so this Canadian study asks instead what goes right. Researchers conducted 33 longform interviews with trans people, using 29 in the final sample, and analyzed them in NVivo with a thematic approach combining inductive and deductive coding. Four provider characteristics stood out: being a member of the LGBTQ community, being knowledgeable and willing to learn about trans health, being transparent and empowering patients in medical decisions, and being sensitive and validating of gender identity. Two patient attributes also mattered: self-advocacy and connection to supportive trans communities, online and in person.

Sex recorded at birth tells only part of the story in mental health research, so this work builds a way to measure gender alongside it. Using sociodemographic and psychosocial variables that differed by sex among 1,708 psychiatric emergency patients, researchers derived a composite gender score through confirmatory factor analysis; it predicted birth-assigned sex with 67% accuracy. The score revealed differences in impulsivity that birth-assigned sex alone missed. Feminine scores were linked with anxiety and mood diagnoses, masculine scores with psychotic and substance use diagnoses, and undifferentiated scores appeared more often in the psychotic disorder group. Gender can be indexed even using secondary data.

Oral health is central to overall wellbeing, and two-spirit, lesbian, gay, bisexual, transgender, and queer (2SLGBTQ+) communities have reported poorer outcomes. This scoping review searched six databases worldwide for evidence on 2SLGBTQ+ oral health, unmet dental needs, service use, and the risk factors behind them. Only ten studies met the criteria, five from India, four from the United States, and one from Brazil. Two reported worse oral health among transgender than cisgender people, while two found similar rates of dental service use. Reported risks included affordability, income, discrimination, and misgendering in clinical settings. The authors stress that the literature remains strikingly sparse.