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Transgender and gender diverse people presumed female at birth experience gynaecological conditions, such as chronic pelvic pain at elevated rates, estimated to impact between 51% and 72% of this population, compared to rates of up to 26.6% in cisgender women. The negative impact of these conditions is likely amplified due to limited access to safe and affirming healthcare. Despite this high prevalence rate, there is limited research investigating the prevalence, presentation or management options for trans and gender diverse people with endometriosis. Cisgender women with endometriosis report barriers to accessing care, with lengthy times to diagnosis and limited treatment options available. However, barriers for trans and gender diverse individuals are enhanced by physician bias and lack of education in gender-affirming care. This is reflected in stories of discrimination and denial of basic healthcare. A healthcare environment built on the presumption that gynaecological patients are women, others trans and gender diverse patients, which can result in avoidance of needed medical care. A lack of knowledge of gender-affirming care alongside healthcare provider bias highlights a need for gender-affirming care and bias reduction training in undergraduate healthcare provider curricula. Research to date assessing current curriculum in Australia and Aotearoa (New Zealand) shows limited inclusion of lesbian, gay, bisexual, trans, queer, intersex, asexual and other related identities content as a whole with gender-affirming care being among the least-frequently addressed topics. This review will detail barriers to accessing gender-affirming healthcare specific to gynaecology, interweaving the experiences of a non-binary individual seeking access to gender-affirming endometriosis care. Plain Language Summary: Transgender and gender diverse people with endometriosis: a perspective on affirming gynaecological care Transgender and gender diverse people have limited access to safe and affirming healthcare. Barriers to accessing care are particularly prominent for those presumed female at birth attempting to access gynaecological care for conditions, such as endometriosis or chronic pelvic pain (CPP). A key barrier to safe and affirming healthcare for this population is a lack of inclusion of trans and gender diverse health in healthcare provider curriculum. The dearth of healthcare providers knowledgeable in gender-affirming care results in healthcare discrimination and poorer health outcomes for trans and gender diverse people. [ABSTRACT FROM AUTHOR]

Introduction: The intersection of sexism with racism and xenophobia disproportionately exposes visible minority women to gender-based violence (GBV) at the community and systemic levels. This study aims to understand the knowledge strengths and gaps on GBV against visible minority women with an intersectional lens, revealing systemic barriers to accessing support and how these barriers intensify GBV and its effects. It will also identify effective and ineffective policies and practices in the literature to develop strategies addressing the root causes of GBV and supporting survivors., Methods and Analysis: We will conduct a mixed-methods systematic review using a convergent integrated approach to examine current literature on community- and systemic-level GBV against visible minority women. We will follow Joanna Briggs Institute's guidelines to converge data from both qualitative and quantitative studies to obtain an integrated qualitative synthesis on GBV in five countries: Canada, the USA, the UK, Australia and New Zealand. This analysis will be conducted following Thomas and Harden's thematic synthesis guidelines. Community members with lived experience of GBV will actively contribute to improving the relevance and interpretation of results, following a community-engaged research approach. Themes are expected to unveil various aspects of community- and systemic-level GBV due to the intersection of racism, xenophobia and sexism, alongside barriers in addressing GBV and research gaps., Ethics and Dissemination: Since this study does not involve primary data collection or the use of identifiable human data, no ethical approval will be needed. Results will be disseminated through integrated knowledge translation, involving collaboration with participants who have lived experience of GBV. The findings will be used to identify specific areas of policy intervention, including adopting culturally sensitive approaches, improving school and workplace policies and promoting rights of visible minority women., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Gender inequity remains an issue in anaesthesia despite increasing numbers of women training and achieving fellowship in the speciality. Women are under-represented in all areas of anaesthetic research, academia and leadership. The Gender Equity Subcommittee of the Australian and New Zealand College of Anaesthetists recently conducted a survey asking "Does gender still matter in the pursuit of a career in anaesthesia in 2022?". The survey was distributed to a randomly selected sample of 1225 anaesthetic consultants and completed by 470 respondents (38% response rate) with 793 free-text comments provided. Three overarching themes were identified: gender effects on the career and family interface; women do not fit the mould; and gender equity changes the status quo. Women respondents described a need to make a choice between career and family, which was not described by men, as well as stigmatisation of part-time work, a lack of access to challenging work and negative impacts of parental leave. Women respondents also described a sense of marginalisation within anaesthesia due to a 'boys' club' mentality, a lack of professional respect and insufficient structural supports for women in leadership. This was compounded for women from ethnically and culturally diverse backgrounds. A need for specific strategies to support anaesthetic careers for women was described as well as normalisation of flexibility in workplaces, combined with a broadening of our definition of success to allow people of all genders to experience fulfilment both at home and at work. This study is the first published qualitative data on factors affecting gender equity for anaesthetists in Australia and Aotearoa New Zealand. It highlights the need for further exploration, as well providing a foundation for changes in attitude and structural changes towards advancing gender equity., (© 2024 Association of Anaesthetists.)

Gender inequity persists within the anaesthetic workforce, despite approaching numerical parity in Australia and New Zealand. There is evidence, from anaesthesia and the wider health workforce, that domestic gender norms regarding parental responsibilities contribute to this. The creation of 'family-friendly' workplaces may be useful in driving change, a concept reflected in the gender equity action plan developed by the Australian and New Zealand College of Anaesthetists. This study aimed to explore the extent to which a family-friendly culture exists within anaesthesia training in New Zealand, from the perspective of leaders in anaesthesia departments. An electronic survey composed of quantitative and qualitative questions was emailed to all supervisors of training, rotational supervisors and departmental directors at Australian and New Zealand College of Anaesthetists accredited training hospitals in New Zealand. Twenty-eight of the 71 eligible participants responded (response rate 39%). The majority (61%) agreed with the statement 'our department has a "family friendly" approach to anaesthesia trainees'; however, there was a discrepancy between views about how departments should be and how they actually are. Several barriers contributing to this discrepancy were identified, including workforce logistics, governance, departmental structures and attitudes. Uncertainty in responses regarding aspects of working hours, parental leave and the use of domestic sick leave reflect gaps in understanding, with scope for further enquiry and education. To redress gender bias seriously through the development of family-friendly policies and practices requires supportive governance and logistics, along with some cultural change. [ABSTRACT FROM AUTHOR]

Objectives: This article explores the increasing number of medical women speaking out about gender inequity and sexual harassment, using the Royal Australian and New Zealand College of Psychiatry Congress 2022 as a reference. It explores the barriers for women in medical leadership known under the themes of capacity, perceived capability, and credibility and how this relates to experiences for women at work., Conclusions: Sexual harms occur in the context of ongoing gender bias in our profession, even at college events. The author calls on the college to investigate and take action on sexual harms in the workplace and gender equity.

This study was designed to investigate levels of stress, anxiety or depression and to identify factors compounding or relieving stress in anaesthesia trainees within the Australian and New Zealand College of Anaesthetists (ANZCA) training scheme. An electronic survey was sent to 999 randomly selected trainees and 428 responses were received. In addition to demographics, psychological wellbeing was assessed using the Kessler Psychological Distress Scale (K10) and questions were asked about depression and anxiety, exacerbating factors, personal healthcare and strategies used to manage stress. The majority of respondents (73%) reported being satisfied or very satisfied with their job and training. However, 28% of respondents had K10 scores indicating high or very high distress levels. Eleven percent reported being currently on treatment for anxiety and/or depression. Twenty-two percent reported having experienced bullying and 14% sexism. Twenty-eight percent reported that they did not have a regular general practitioner (GP), and 41% reported having not visited their GP in the previous year. Forty-seven percent of trainees reported that they self-prescribe medications. Major stressors reported were exams, critical clinical events and fear of making errors. Two stressors previously not identified in similar studies were concern about job prospects in 71% of respondents and workplace-based assessments in 51%. This survey demonstrates significant psychological impairment and poor personal healthcare amongst many trainees. Education, careful continuing assessment of trainees' welfare and a review of current support and remedial measures may be required. [ABSTRACT FROM AUTHOR]

Purpose – In light of the fact that the “baby boomer” generation is moving into early old age, the purpose of this paper is to examine what aspects of ageing and old age concerned an age cohort of 25 gay men aged 60 plus. Design/methodology/approach – The primary data for this paper came from interviews with 25 men aged 60 and older who were recruited in Auckland, London, Manchester, Melbourne, and New York. Interviewees were contacted by a variety of means, such as by e-mail introductions, advertisements placed on social media, and recommendations of mutual friends or acquaintances. Once contacted, the men were sent a plain-language statement outlining the purpose of the study and the intention to publish the results and were asked to sign and return a consent form. Narrative identity was central to understandings of the men’s lives got from analysing their interview transcripts. Findings – Analysis of extracts from their life stories showed the men interviewed for this paper drew on two principal narratives when discussing their apprehensions about growing old. The first related to general fears or concerns about old age that would be fairly common among members of the general population. The second narrative related to gay-specific fears or concerns. Significant claims: that class affects gay men’s experience of old age just as it does for everyone else; and that fears of being ostracised because of their sexuality were strongest when the men spoke about aged-accommodation settings. Research limitations/implications – More research is needed on gay men’s experience of in-home supported care and residential care to see if the reality of the heterosexism and/or homophobia matches the fears of some in this sample. Originality/value – This is a relatively new field and there is a growing number of researchers examining the ageing concerns and experiences of the GLBT population. The originality of this paper lies in the international sample on which it is based, its use of narrative analysis, and its relevance to policy makers as well as to members of the GLBT population, carers, and owners/managers of aged-care accommodation facilities. [ABSTRACT FROM AUTHOR]

Background: Discrimination, bullying and sexual harassment (DBSH) impact the psychological well-being of doctors and contribute to poor health outcomes. The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) commissioned independent surveys to evaluate DBSH among members/trainees., Methods: Anonymous online surveys by Best Practice Australia were undertaken in 2015 and 2018. Cross-sectional analysis was prevalence of perceived DBSH, rates of reporting, intervention and resolution undertaken. Response rate was 50% (658/1319) in 2015 and 40% (557/1401) in 2018. In both surveys, 29% were female. This is representative of the distribution of the RANZCO members., Results: In a 2015 survey, 37.6% of respondents experienced DBSH, with prevalence being the highest for females (62.3%; N = 104 cf males 27.7%; N = 167) and trainees (49.2%; N = 61). In 2018, 49.2% of respondents reported DBSH with rates low for all forms of DBSH (22%-29%). Sexual harassment was reported by 12% and the least discussed or reported. Respondents strategy for taking action included draw on personal support network (25-43%), official complaints to supervisors (16-22%), human resources (2%-10%) and RANZCO (0%-6%). Reasons for not taking action included fear of impact of future career options (54.1%-60.7%), fear of victimization (35.7%-50.4%) and afraid of not being believed (31.9%-52.4%). Satisfactory resolution rates were 6% to 25%. A majority of respondents (77%) were positive about RANZCO initiatives., Conclusions: DBSH is commonly reported by RANZCO members with female ophthalmologists more than two times more likely to experience any one of the four behaviours, three times more likely to experience discrimination and six times for sexual harassment. Fear of compromising personal and career progression contribute to low levels of reporting., (© 2021 Royal Australian and New Zealand College of Ophthalmologists.)

Background: Women face gender-based challenges in their medical education and career. Inequitable access to procedural training, a confidence gap, and professional identity deficit have been shown. We made a gender comparison of procedural case volume, confidence for independent practice, perceived gender and ethnic bias, and professional identity in Australasian anaesthesia trainees., Methods: An online, voluntary, anonymous survey using SurveyMonkey® was delivered to Australasian anaesthesia trainees. Information collected included demographics, experience and confidence in 12 anaesthetic procedures, assessments relating to confidence and professional identity, and perceived gender and ethnic bias. Gender differences were evaluated., Results: Three hundred and fifty-six trainees (22.2%) of the Australian and New Zealand College of Anaesthetists (ANZCA) responded. Male trainees reported a higher number (standard deviation) of procedures performed greater than 10 times (men 4.45 [2.55], women 3.78 [1.95]; P<0.001 adjusted for training level). Men were more likely to rate themselves at a training competency above their actual training level (men 18.6%, women 7.8%; P=0.004) and exaggerate procedural experience to supervisors (men 30.8%, women 11.8%; P<0.001). Final-year male trainees felt significantly more prepared for independent practice (P=0.021, trend across ordered responses). Women reported significantly higher levels of gender bias exhibited by patients (men 1.1%, women 84.5%; P<0.001) and in training overall (men 10.3%, women 55.3%; P<0.001), which was compounded in women with an ethnic minority background., Conclusions: A discrepancy exists between the number of procedures performed by male and female anaesthesia trainees in Australia and New Zealand. Relative male overconfidence may be a major contributing factor to the gender confidence gap., (Copyright © 2020 British Journal of Anaesthesia. All rights reserved.)