Search

Background: Transgender and gender nonbinary (trans/NB) individuals face many barriers to accessing health care in the United States due to systemic and clinician discrimination. Such experiences can lead to avoidance or delays in seeking care. These issues are relevant for emergency department (ED) clinicians and staff because trans/NB patients may use the ED in times of crisis.Objectives: The purpose of this study was to qualitatively explore experiences of trans/NB individuals accessing health care in the ED and provide recommendations for improvements.Methods: This study involved semi-structured qualitative interviews with nine trans/NB individuals living in Arkansas about their experiences when visiting local EDs.Results: Interviews revealed four main themes: 1) system and structural issues; 2) interactions with clinicians/staff influence care received; 3) perceptions of clinician knowledge and education about trans/NB health; and 4) impact on future health and health care access. Participants recommended education for current and future ED clinicians and staff to improve knowledge of best practices for trans/NB health care. Recommendations were also made to improve ED policy for inclusive and affirming intake processes, intake forms, and electronic health record (EHR) documentation, including documentation and use of patients' chosen name and pronouns.Conclusion: The negative experiences and discrimination reported by trans/NB patients in ED visits underscores the importance of improving ED clinician knowledge of gender-affirming care practices, ED intake policies and practices, and EHR documentation in EDs. [ABSTRACT FROM AUTHOR]

Despite a national decline in teenage pregnancy rates, Arkansas continues to have one of the highest rates in the USA. More teenagers in the state reported not using any method of contraception (20%) compared to the USA (13.8%). National-level research suggests that misinformation and lack of awareness about contraception is prevalent. This study examines awareness, knowledge and attitudes towards contraception among Arkansas teenagers and parents. Between July-November 2018, twelve focus groups – 6 with teenagers (n = 40) and 6 with parents (n = 28) – were conducted around the state. Parent participants were uncertain about their teenagers' access to and knowledge of contraception, had many concerns about their teenagers using contraception and spoke about teaching their kids about contraception in a future sense ('would' and 'should'). Although parents preferred abstinence for their teenagers, they preferred contraception use to teenage pregnancy. Teenage participants had limited knowledge/awareness of methods of contraception beyond condoms and birth control pills. They saw contraception as ineffective, were concerned about side effects and experienced difficulty accessing contraception. This study provides insight into current knowledge and attitudes towards contraception among teenagers and parents in Arkansas, as well as recommendations for designing educational campaigns centred around awareness, empowerment and inclusion. [ABSTRACT FROM AUTHOR]