Search

Background: A surgical readiness assessment is a major step in the medical journey of trans people seeking gender-affirming surgery. Much of the peer-reviewed literature surrounding surgical readiness assessments emphasizes the perspectives of academics and clinicians, leaving the voices of trans and gender diverse patients largely unheard. Aims: This paper foregrounds patient experiences with surgery readiness assessments to discuss the tensions, challenges and opportunities they generate. Methods: We conducted a thematic analysis of 35 in-depth interviews with trans people who accessed or were seeking to access gender-affirming surgery in British Columbia. Results: We developed three main themes to capture participants' narratives of their surgical assessment experiences. The first, assessments as gatekeeping, explores the stories of people who described their assessments as outdated and even discriminatory processes. The second, assessments as a barrier to care, discusses the informational missteps, bureaucratic regulations, economic issues, and geographic concerns that made assessments difficult to access. The third, assessments as useful, includes positive stories about assessments that often involved feeling supported by an assessor and feeling prepared for the next steps. Discussion: These narratives demonstrate how much variation exists among people's experiences of readiness assessments for gender-affirming surgery. No matter how their actual assessment turned out, many participants approached their appointments with a great deal of anxiety and trepidation. We attributed this stress was to challenges ranging from lengthy wait times, arbitrary medical gatekeeping, a lack of access to knowledgeable and supportive providers, unclear or changing administrative processes, and insufficient communication. To address these challenges, it is crucial for the medical system to create more accessible pathways with centralized, up-to-date information for people trying to access assessments. Patients are best served by multi-disciplinary gender-affirming teams that provide individualized care. [ABSTRACT FROM AUTHOR]

The higher religiosity of women in the Western Christian societies is one of the best documented findings in the religious scholarship. In spite of the recent vibrancy of secular movements in North America, the higher religiosity of women appears persistent. As a result, the gender ratio is greatly skewed in the secular groups in favour of males. For instance, for every atheist female in North America, there are at least three males. Using the Canadian General Social Surveys of 1985–2014, this paper examines how the gender religiosity gap has evolved among the Canadian-born. Throughout the period, Canadian-born women are found less likely to be unaffiliated and show a greater frequency of religious attendance. The religious attendance gap is found to be closing. The unaffiliation gap, on the other hand, seems to have widened in the 21st century. Limiting the analyses to the gainfully employed respondents only reduces the religious attendance gap. For the high earners, the attendance gap effectively disappears, while a large unaffiliation gap persists into the 2010s. This pattern is best explained by the recent literature asserting that men and women are differentially socially sanctioned for the adoption of a secularized identity. The alleged sexism of the new secular movements is also noted as a potential explanation. The examination of the recent Canadian data on perceived religious and gender discrimination produces evidence congruent with both of these potential explanations. [ABSTRACT FROM AUTHOR]