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Introduction: Transgender and gender diverse (TGD) people are disproportionately negatively impacted by gaps in several social determinants of health (SDH) domains. Methods: Using an SDH lens, this commentary leverages and reflects upon the expertise and experience of practitioners in the largest adult gender identity clinic in Canada providing services to TGD patients by facilitating access to gender-affirming healthcare. Results: Perceived needs across SDH domains, efforts to address these needs, and recommendations for improving services and increasing access for TGD patients are shared. Conclusion: We argue that addressing SDH needs is a necessary and critical component of both comprehensive primary and mental healthcare for TGD individuals in particular, given the inequity many of them face across SDH domains. [ABSTRACT FROM AUTHOR]

Transforming our world the 2030 agenda for sustainable development is working towards a world that reflects equity, with universal respect for human dignity, pledging to leave no one behind. However, transgender and gender-diverse individuals experience significant health inequities, including negative health outcomes and multiple barriers to accessing care. In this article, we first highlight the health inequities that transgender and gender-diverse people face globally. We describe important aspects of transgender and gender-diverse health care, including the design and provision of health services, epidemiological considerations, transition-related care, changes in transition-related goals, cultural considerations, and political and legal issues. We then review the existing global literature on incorporating transgender health into medical curricula. We make a case for prioritizing improved education in medical schools on the specific health needs of transgender and gender-diverse people as part of addressing global health inequities in care. Our recommendations for comprehensive education on transgender health include cultural humility and anti-oppression training; involvement of transgender and gender-diverse community members; integration of transgender and gender-diverse health into curricula; practice-focused and in situ training; staff development in medical schools; and improving access to careers in medicine for transgender and gender- diverse people. Transformer notre monde: le Programme de developpement durable a l'horizon 2030 aspire a un monde oU regne l'equite, le respect universel de la dignite humaine, et s'engage a ce que personne ne soit oublie. Pourtant, les individus transgenres et de genre variant subissent de profondes inegalites sur le plan sanitaire, qui affectent leur etat de sante et compliquent grandement l'acces aux soins. Dans cet article, nous commencons par souligner les inegalites sanitaires auxquelles sont confrontes les individus transgenres et de genre variant a travers le monde. Nous evoquons d'importants aspects a prendre en compte pour les soins de sante aux personnes transgenres et de genre variant, parmi lesquels la conception et la fourniture de services de sante, les considerations d'ordre epidemiologique, les soins lies a la transition, l'evolution des objectifs lies a la transition, les facteurs culturels, ainsi que les enjeux politiques et juridiques. Nous examinons ensuite la litterature internationale consacree a l'integration de la sante transgenre dans les programmes d'enseignement medical. Nous soutenons que, dans le cadre de la lutte contre les inegalites sanitaires au niveau mondial, il faut privilegier une amelioration de l'enseignement dans les ecoles de medecine afin de sensibiliser aux besoins specifiques des individus transgenres et de genre variant en matiere de sante. Nous avons formule plusieurs recommandations en vue d'instaurer un enseignement qui tient compte de la sante des personnes transgenres: apprentissage anti-oppressif integrant la notion d'humilite culturelle; implication de membres de la communaute transgenre et de genre variant; ajout de la sante transgenre et de genre variant dans les programmes de cours; formation centree sur la pratique, dispensee sur le terrain; developpement du personnel des ecoles de medecine; et enfin, amelioration de l'acces aux carrieres medicales pour les individus transgenres et de genre variant. Transforming our world: the 2030 agenda for sustainable development (Transformar de nuestro mundo: la Agenda 2030 para el desarrollo sostenible) trabaja por un mundo que refleje la igualdad, con respeto universal por la dignidad humana, comprometiendose a no dejar a nadie atras. Sin embargo, las personas transgenero y con genero diverso experimentan importantes desigualdades en materia de salud, incluidos resultados sanitarios negativos y multiples obstaculos para acceder a la atencion sanitaria. En este articulo, destacamos, en primer lugar, las desigualdades sanitarias a las que se enfrentan las personas transgenero y de genero diverso en todo el mundo. Describimos aspectos importantes de la atencion sanitaria a las personas transgenero y con genero diverso, como el diseno y la prestacion de servicios sanitarios, las consideraciones epidemiologicas, la atencion relacionada con la transicion, los cambios en los objetivos relacionados con la transicion, las consideraciones culturales y las cuestiones politicas y juridicas. A continuacion, revisamos la documentacion global existente sobre la incorporacion de la salud transgenero en los planes de estudio de medicina. Defendemos la necesidad de dar prioridad a la mejora de la formacion en las facultades de medicina sobre las necesidades sanitarias especificas de las personas transgenero y con genero diverso como parte del tratamiento de las desigualdades sanitarias globales en la atencion sanitaria. Nuestras recomendaciones para una educacion integral sobre la salud de las personas transgenero incluyen la formacion en humildad cultural y lucha contra la opresion; la participacion de los miembros de la comunidad transgenero y con genero diverso; la integracion de la salud de las personas transgenero y con genero diverso en los planes de estudio; la formacion centrada en la practica e in situ; el desarrollo del personal en las facultades de medicina; y la mejora del acceso a las carreras de medicina para las personas transgenero y con genero diverso., Introduction Transgender people are individuals with a gender identity different from the sex assigned to them at birth. The term transgender can be used to encapsulate various gender identities, including [...]

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Background: The perinatal period may uniquely impact the mental health and wellbeing of lesbian, gay, bisexual, transgender, queer, and Two‐Spirit (LGBTQ2S+) childbearing individuals. Objectives: To characterise and synthesise the experiences of LGBTQ2S+ childbearing individuals regarding perinatal mental health, including symptomatology, access to care and care‐seeking. Search strategy: We conducted and reported a systematic review following PRISMA guidelines of eight databases (EMBASE, MEDLINE‐OVID, CINAHL, Scopus, Web of Science: Core Collection, Sociological Abstracts, Social Work Abstract, and PsycINFO) from inception to 1 March 2021. Selection criteria: Original, peer‐reviewed research related to LGBTQ2S+ mental health was eligible for inclusion if the study was specific to the perinatal period (defined as pregnancy planning, conception, pregnancy, childbirth, and first year postpartum; includes miscarriages, fertility treatments and surrogacy). Data collection and analysis: Findings were synthesised qualitatively via meta‐aggregation using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI), and the ConQual approach. Main results Our systematic search included 26 eligible studies encompassing 1199 LGBTQ2S+ childbearing participants. Using the JBI SUMARI approach, we reported 65 results, which we synthesised as six key findings. The studies described unique considerations for LGBTQ2S+ individuals' perinatal mental health, including heteronormativity, cisnormativity, isolation, exclusion from traditional pregnancy care, stigma, and distressing situations from the gendered nature of pregnancy. Many participants described a lack of knowledge from healthcare providers related to care for LGBTQ2S+ individuals. In addition, LGBTQ2S+ individuals described barriers to accessing mental healthcare and gaps in health systems. Strategies to improve care include provider education, avoidance of gendered language, documentation of correct pronouns, trauma‐informed practices, cultural humility training and tailored care for LGBTQ2S+ people. Conclusions: Pregnancy, postpartum, and the perinatal period uniquely impacts the mental health and wellbeing of LGBTQ2S+individuals, largely due to systems‐level inequities and exclusion from perinatal care. Healthcare providers should implement the identified strategies to improve perinatal care and address inequities. [ABSTRACT FROM AUTHOR]

Filial piety involves the Confucian view that children always have a duty to be obedient and to provide care for their parents. Filial piety has been described as both a risk and a protective factor in depression and suicide. This qualitative study aimed to explore the role of filial piety in the suicidal behavior of Chinese women. Qualitative interviews were conducted with Chinese women with a history of suicidal behavior living in the Beijing area (n = 29). Filial piety data were extracted and analyzed in accordance with constructivist grounded theory. The women described five specific family and filial piety factors and how they influenced their ability to fulfill family role obligations, which was described as a nexus connecting these factors to depression, suicidal behavior, and recovery. The five factors were: 1) rigidity of parental filial expectations, 2) perception of family relationships as positive/supportive or negative/harsh, 3) whether filial piety is of high or low personal value in the woman's life, 4) any experiences of rebellion leading to punitive consequences, and 5) how much filial piety she receives from her children. These factors could inform suicide risk assessments in this population. They can be harnessed as part of recovery and protect against future suicidal behavior. [ABSTRACT FROM AUTHOR]

Background: The perinatal period may uniquely impact the mental health and wellbeing of lesbian, gay, bisexual, transgender, queer, and Two-Spirit (LGBTQ2S+) childbearing individuals., Objectives: To characterise and synthesise the experiences of LGBTQ2S+ childbearing individuals regarding perinatal mental health, including symptomatology, access to care and care-seeking., Search Strategy: We conducted and reported a systematic review following PRISMA guidelines of eight databases (EMBASE, MEDLINE-OVID, CINAHL, Scopus, Web of Science: Core Collection, Sociological Abstracts, Social Work Abstract, and PsycINFO) from inception to 1 March 2021., Selection Criteria: Original, peer-reviewed research related to LGBTQ2S+ mental health was eligible for inclusion if the study was specific to the perinatal period (defined as pregnancy planning, conception, pregnancy, childbirth, and first year postpartum; includes miscarriages, fertility treatments and surrogacy)., Data Collection and Analysis: Findings were synthesised qualitatively via meta-aggregation using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI), and the ConQual approach., Main Results: Our systematic search included 26 eligible studies encompassing 1199 LGBTQ2S+ childbearing participants. Using the JBI SUMARI approach, we reported 65 results, which we synthesised as six key findings. The studies described unique considerations for LGBTQ2S+ individuals' perinatal mental health, including heteronormativity, cisnormativity, isolation, exclusion from traditional pregnancy care, stigma, and distressing situations from the gendered nature of pregnancy. Many participants described a lack of knowledge from healthcare providers related to care for LGBTQ2S+ individuals. In addition, LGBTQ2S+ individuals described barriers to accessing mental healthcare and gaps in health systems. Strategies to improve care include provider education, avoidance of gendered language, documentation of correct pronouns, trauma-informed practices, cultural humility training and tailored care for LGBTQ2S+ people., Conclusions: Pregnancy, postpartum, and the perinatal period uniquely impacts the mental health and wellbeing of LGBTQ2S+individuals, largely due to systems-level inequities and exclusion from perinatal care. Healthcare providers should implement the identified strategies to improve perinatal care and address inequities., (© 2022 John Wiley & Sons Ltd.)

Competing Interests: Competing interests: None declared.