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Addressing sexual health concerns in Tanzania: perceived barriers among healthcare professionals and students in the "training for health professionals" study. 解决坦桑尼亚的性健康问题:"卫生专业人员培训 "研究中卫生保健专业人员和学生感知到的障碍。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-01 Epub Date: 2024-01-29 DOI: 10.1080/13691058.2024.2306227
Agnes F Massae, Lucy R Mgopa, Zobeida E Bonilla, Inari Mohammed, B R Simon Rosser, Stella E Mushy, Michael W Ross, Dorkasi L Mwakawanga, Ever Mkonyi, Gift G Lukumay, James Wadley, Dickson A Mkoka, Maria Trent

Little is known about the factors that may prevent healthcare professionals as key stakeholders from exploring sexual health issues in Tanzania. This study examined healthcare professionals' perspectives on the barriers to addressing sexual health concerns in practice. In June 2019, we conducted an exploratory qualitative study involving 18 focus group discussions among healthcare professionals (n = 60) and students (n = 61) in the health professions (midwifery, nursing, medicine) in Dar es Salaam, Tanzania. Study participants and design were purposively selected and stratified. We used a focus group discussion guide in Kiswahili. Data were transcribed in Kiswahili and translated into English. A thematic analysis approach was used for data analysis. Two themes were developed: (1) differences between health care professional and patient socio-demographic characteristics; (2) health care system and patients' backgrounds, such as communication barriers, lack of confidentiality and privacy within health facilities, type of clinical presentation and complaint, patient behaviours, and their clinical background. Several key barriers prevented sexual health communication between healthcare professionals and patients, affecting the quality of sexual health service delivery. Additional sexual health clinical training is warranted for health professions students and professionals to optimise sexual health care delivery in a culturally conservative country like Tanzania.

在坦桑尼亚,医护人员作为主要利益相关者,对可能阻碍他们探讨性健康问题的因素知之甚少。本研究探讨了医护专业人员对在实践中解决性健康问题的障碍的看法。2019 年 6 月,我们在坦桑尼亚达累斯萨拉姆开展了一项探索性定性研究,对医疗保健专业人员(n = 60)和卫生专业(助产、护理、医学)学生(n = 61)进行了 18 次焦点小组讨论。我们有目的性地选择和分层设计了研究参与者。我们使用了斯瓦希里语的焦点小组讨论指南。数据以斯瓦希里语转录并翻译成英语。数据分析采用了主题分析法。形成了两个主题:(1) 医疗专业人员和患者社会人口特征之间的差异;(2) 医疗系统和患者背景,如沟通障碍、医疗机构内缺乏保密性和隐私、临床表现和主诉类型、患者行为及其临床背景。几个主要障碍阻碍了医护人员与患者之间的性健康沟通,影响了性健康服务的质量。在坦桑尼亚这样一个文化保守的国家,有必要对卫生专业的学生和专业人员进行更多的性健康临床培训,以优化性健康保健服务的提供。
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引用次数: 0
'We had that abortion together': abortion networks and access to il/legal abortions in Turkey. 我们一起堕胎":土耳其的堕胎网络和获得非法/合法堕胎的机会。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-01 Epub Date: 2024-01-09 DOI: 10.1080/13691058.2023.2301410
Sinem Esengen

Abortion was legalised in Turkey in 1983 with a 10-week limit, restrictions on who could provide abortions, and spousal or parental consent requirements. Currently, although abortion is legal, because of structural barriers, access is restricted (O'Neil, Altuntaş, and Keskin 2020). This study aimed to investigate how women strategically mobilise their social networks to overcome such restrictions to abortion care. Drawing from 25 in-depth interviews with urban-educated cis-women aged 24-30, I identify three groups within abortion networks: included, excluded and ambiguous. While included groups comprised largely of female family and friends, excluded groups were male family members and organisations, and the ambiguous category included health professionals and partners. Supporting findings in other contexts, individuals initially utilise their abortion networks to access the provider, they then build abortion solidarity networks to act as buffers against groups they wish to exclude during the abortion experience. Additionally, I show that excluded and ambiguous networks also impact abortion access, decision-making, and experience, even pushing individuals to follow through with illegal or semi-legal abortion procedures. Findings draw attention to the structural boundaries surrounding abortion laws, how patriarchal institutions make access to abortion care and abortion networks challenging, and how social networks may be utilised to alleviate such obstacles.

土耳其于1983年将堕胎合法化,但规定了10周的期限,限制了提供堕胎服务的人员,并要求获得配偶或父母的同意。目前,尽管堕胎是合法的,但由于结构性障碍,获得堕胎的机会受到限制(O'Neil、Altuntaş 和 Keskin,2020 年)。本研究旨在探讨妇女如何战略性地动员其社交网络,以克服堕胎护理方面的这些限制。通过对 25 名年龄在 24-30 岁的城市受过教育的顺式女性进行深入访谈,我在堕胎网络中确定了三个群体:纳入群体、排除群体和模糊群体。被纳入的群体主要由女性家人和朋友组成,被排除的群体则是男性家庭成员和组织,而模棱两可的群体则包括医疗专业人员和伴侣。与其他情况下的研究结果相吻合的是,个人最初利用其堕胎网络与提供者取得联系,然后建立堕胎团结网络,在堕胎过程中对他们希望排除在外的群体起到缓冲作用。此外,我还表明,被排斥和模糊的网络也会影响堕胎的获取、决策和经历,甚至会促使个体实施非法或半合法的堕胎程序。研究结果提请人们注意围绕堕胎法的结构性界限,父权体制如何使获得堕胎护理和堕胎网络具有挑战性,以及如何利用社会网络来缓解这些障碍。
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引用次数: 0
'I never see anyone like myself represented in discussions about endometriosis': priorities of LGBTQIA + endometriosis patients in New Zealand. 在有关子宫内膜异位症的讨论中,我从未见过像我这样的人":新西兰 LGBTQIA + 子宫内膜异位症患者的优先考虑事项。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-08-28 DOI: 10.1080/13691058.2024.2394650
Katherine Ellis, Wayne Armour, Rachael Wood

Limited information is available regarding the experiences and perspectives of LGBTQIA + patients internationally, and no literature exists for New Zealand. Twenty-eight LGBTQIA + endometriosis patients took part in asynchronous, online text-based discussions about their experiences navigating endometriosis diagnosis and management in Aotearoa New Zealand. Their qualitative responses were coded in an iterative thematic manner. The mean delay to diagnosis of this cohort was 10.2 ± 5.6 years from symptom onset, longer than previously reported delays in Aotearoa New Zealand. Participants shared a strong discomfort with the predominant focus of endometriosis management strategies on penetrative sex and pregnancy, and the sense they were dismissed if prioritising these functions was not their priority. Several potential improvements to current treatment and care for LGBTQIA + endometriosis patients were generally agreed upon by the cohort, including research to better understand a practice approach for managing the symptoms of transmasculine patients; expanding the management strategies for patients who are not prioritising fertility and penetrative sex; improving awareness of LGBTQIA + people and experiences amongst medical practitioners to reduce homophobia, transphobia, misogyny, misgendering and mistreatment in care; and the development of gender-neutral spaces for the support of patients who feel uncomfortable in cisgender women-centric endometriosis spaces.

国际上有关 LGBTQIA + 患者的经历和观点的资料有限,新西兰也没有相关文献。28 名 LGBTQIA + 子宫内膜异位症患者参加了异步在线文本讨论,讲述了他们在新西兰奥特亚罗瓦地区进行子宫内膜异位症诊断和管理的经历。他们的定性回答以迭代主题方式进行了编码。从症状出现到确诊的平均延迟时间为(10.2 ± 5.6)年,比新西兰奥特亚罗瓦地区之前报道的延迟时间更长。子宫内膜异位症的治疗策略主要集中在插入性生活和怀孕上,这让参与者感到非常不舒服,而且他们感觉到,如果不优先考虑这些功能,他们就会被嫌弃。与会人员普遍认为,目前对 LGBTQIA + 子宫内膜异位症患者的治疗和护理有几项潜在的改进措施,其中包括开展研究,以更好地了解管理跨男性患者症状的实践方法;为不优先考虑生育和插入性生活的患者扩展管理策略;提高医疗从业人员对女同性恋、男同性恋、双性恋、变性人和两性人的认识,减少在护理过程中对同性恋的恐惧、对变性人的恐惧、对女性的厌恶、对性别的误解和虐待;开发性别中立空间,为那些在以顺性女性为中心的子宫内膜异位症空间中感到不适的患者提供支持。
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引用次数: 0
Managing the business of sex: swinger club managers and sexual health promotion. 管理性事业:交换俱乐部经理和性健康推广。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-08-27 DOI: 10.1080/13691058.2024.2394648
Chris Haywood

The increased popularity of swinger clubs across the UK in the past two decades has not been met with commensurate public health initiatives or interventions that engage with the relationship between swinger clubs and sexual health. Consequently, the responsibility for sexual health promotion within these establishments largely depends on the discretion of club managers. Drawing on data from semi-structured interviews with 10 managers from across the UK, the study suggests that the managers' perceptions of the club-consumer relationship shape the nature of sexual health promotion. Three distinct approaches were evident in the research: those who perceive sexual health promotion as financially detrimental; those who see it as an individual rather than a collective club concern; and those who consider it as part of a broader social community responsibility. These findings highlighted an implicit beneficence of managers towards their customers; a shared assumption that an ideal consumer was heterosexual, partnered and in their forties; and differing perceptions of manager responsibility towards the sexual health of customers. The paper concludes by suggesting that the swinger community is a blind spot in sexual health discussion in the UK and that by talking to the managers of swinger clubs we can further develop our understanding of the area.

过去二十年间,英国各地的性爱俱乐部越来越受欢迎,但却没有相应的公共卫生倡议或干预措施来处理性爱俱乐部与性健康之间的关系。因此,在这些场所内促进性健康的责任在很大程度上取决于俱乐部经理的自由裁量权。根据对英国各地 10 名经理进行的半结构式访谈数据,研究表明,经理们对俱乐部与消费者之间关系的看法决定了性健康推广的性质。研究中发现了三种截然不同的方法:认为性健康推广在经济上有害的方法;认为性健康推广是个人而非俱乐部集体问题的方法;认为性健康推广是更广泛的社会责任的一部分的方法。这些发现强调了管理者对顾客的隐性恩惠;理想消费者是异性恋、有伴侣、40 多岁的共同假设;以及管理者对顾客性健康责任的不同看法。本文最后指出,在英国,交换俱乐部是性健康讨论中的一个盲点,通过与交换俱乐部的管理者交谈,我们可以进一步加深对这一领域的了解。
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引用次数: 0
Sexual healthcare to meet the needs of sexuality and gender diverse aboriginal young people: imagined possibilities. 满足不同性取向和性别的土著年轻人需求的性保健:想象的可能性。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-08-24 DOI: 10.1080/13691058.2024.2394649
Heather McCormack, Michelle Dickson, Thomas Harrington, Mahlia Garay, Robert Whybrow, Julie Mooney-Somers, Peter Aggleton, Lise Lafferty, Elke Mitchell, Jessica Morris, Bridget Haire

In Australia, Aboriginal young people who are lesbian, gay, bisexual, trans, queer or otherwise sexuality and gender diverse (LGBTQ+) are recognised within several overlapping priority populations in state and federal sexually transmissible infection and HIV strategies. However, limited research has documented their unique sexual health experiences, needs and preferences. In this qualitative study, semi-structured interviews were conducted with 10 LGBTQ+ Aboriginal young people aged 16-24 years in New South Wales. Interviews incorporated questions about service access, positive and negative experiences and self-determined healthcare priorities. We conducted a strengths-based thematic analysis to understand the issues of greatest importance in sexual healthcare for participants. Using the framework of 'imaginaries', we explored how participants imagined sexual healthcare that would meet their individual and cultural needs. The dominant imaginary centred on respect, representation and the as-yet-unrealised possibility of sexual healthcare designed by and for people who shared the intersection of Aboriginal and LGBTQ+ experience. We identified individual-level, service-level and societal-level factors influencing this imaginary, including relationships, accessibility and experiences of racism. Analysing the imaginaries constructed by LGBTQ+ Aboriginal young people of empowering, culturally safe sexual healthcare that is 'for them' provides insight into potential service design to improve sexual health outcomes for this population.

在澳大利亚,男女同性恋、双性恋、变性人、同性恋者或其他性取向和性别多样化(LGBTQ+)的土著年轻人在州和联邦的性传播感染和艾滋病战略中被认为是几个重叠的重点人群。然而,记录他们独特的性健康经历、需求和偏好的研究却很有限。在这项定性研究中,我们对新南威尔士州 10 名 16-24 岁的 LGBTQ+ 原住民年轻人进行了半结构化访谈。访谈内容包括服务获取、正面和负面经历以及自我决定的医疗保健优先事项等问题。我们进行了基于优势的主题分析,以了解参与者在性保健方面最关心的问题。利用 "想象 "框架,我们探讨了参与者如何想象性保健来满足他们的个人和文化需求。主流想象的核心是尊重、代表性以及尚未实现的可能性,即由与原住民和 LGBTQ+ 有共同经历的人设计并为他们服务的性保健。我们确定了影响这种想象的个人层面、服务层面和社会层面的因素,包括人际关系、可及性和种族主义经历。通过分析 LGBTQ+ 原住民年轻人对 "为他们 "提供的赋权、文化上安全的性保健的想象,我们可以深入了解潜在的服务设计,以改善这一人群的性健康结果。
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引用次数: 0
Reconciling moral discourses on choice, risk and pronatalism: the politics of elective egg freezing in Singapore. 协调关于选择、风险和代孕的道德论述:新加坡选择性冷冻卵子的政治。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-08-17 DOI: 10.1080/13691058.2024.2391936
Gracia J Lee

This article examines the framing of choice, risk and pronatalism in Singapore's debate on elective egg freezing, beginning from the government's review of the ban in 2012 and ending in 2023 when the procedure was legalised. It demonstrates the possibility of reconciling liberal discourses on reproductive choice with technocritical discourses on egg freezing as a risky and oppressive pronatalist technology. While medical complications, false hope and commercial abuse were longstanding concerns in Singapore, these risks were perceived as reconcilable with choice through an age limit, mandatory counselling and comparative frames from the national and international regulatory context. Additionally, low fertility rates and efforts to advance gender equality enabled the reconciliation of choice and pronatalism as policy justifications, while the construction of female candidates' heteronormative reproductive desire framed pronatalism in women-centric ways. Such reconciliation was facilitated by Singapore's strong interventionist culture which normalises paternalism and pronatalism. Within this context and through actors' articulation of policy ideas, elective egg freezing was reinterpreted as a technology with manageable risks, and a hope technology for women and nation. A moral Singapore State which permits elective egg freezing while supporting the interests of women and society was thus co-produced by politicians, journalists and doctors.

本文研究了新加坡关于选择性冷冻卵子的辩论中选择、风险和代孕主义的框架,从2012年政府对禁令的审查开始,到2023年冷冻卵子程序合法化为止。它展示了调和有关生育选择的自由主义论述与有关冷冻卵子是一种具有风险和压迫性的代孕技术的技术批判论述的可能性。虽然医疗并发症、虚假希望和商业滥用是新加坡长期关注的问题,但通过年龄限制、强制咨询以及国家和国际监管背景下的比较框架,这些风险被认为是可以与选择相调和的。此外,低生育率和促进性别平等的努力使选择与代孕主义得以调和,成为政策的理由,而女性候选人异性恋生殖欲望的构建则以妇女为中心的方式框定了代孕主义。新加坡浓厚的干预主义文化将家长制和代产主义正常化,为这种调和提供了便利。在此背景下,通过行动者对政策理念的阐述,选择性冷冻卵子被重新诠释为一种风险可控的技术,是妇女和国家的希望技术。因此,政治家、记者和医生共同创造了一个允许选择性冷冻卵子,同时支持妇女和社会利益的道德新加坡国。
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引用次数: 0
First Nations music and social emotional wellbeing and health among LGBTIQA+SB First Nations peoples: a review of the literature. 原住民音乐与 LGBTIQA+SB 原住民的社会情感福祉和健康:文献综述。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-08-15 DOI: 10.1080/13691058.2024.2387674
Kristy Apps, Naomi Sunderland, Te Oti Rakena

Music has been linked to improved social and emotional wellbeing for First Nations Peoples, yet little research directly explores the link between music and social emotional wellbeing of Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, Asexual, Sistergirl, and Brotherboy (LGBTIQA+SB) First Nation Peoples in Australia. This article reports on a hybrid scoping narrative review of existing literature that explores LGBTIQA+SB social emotional wellbeing and potential links to music practices, such as music listening, performance, and composing. Findings suggest that music and creative practices can be linked to feelings of elation, positive self-regard, and safety. Music and performance can promote and celebrate the diversity and complexities of Queer First Nations people and identities through art and performance, enhancing a sense of belonging and links to community, generating feelings of pride, and contributing to knowledge sharing. Community connections built through creative arts and digital platforms are seen as enhancing social emotional wellbeing for First Nations Lesbian, Gay, Bisexual, Transgender, Intersex, Queer/Questioning, Brotherboy, Sistergirl people.

音乐与改善原住民的社会和情感福祉息息相关,但很少有研究直接探讨音乐与澳大利亚女同性恋、男同性恋、双性恋、变性人、双性人、同性恋者、无性恋者、女姊妹和男兄弟(LGBTIQA+SB)原住民的社会情感福祉之间的联系。本文对现有文献进行了混合范围叙述性回顾,探讨了 LGBTIQA+SB 的社会情感福祉以及与音乐实践(如音乐聆听、表演和作曲)之间的潜在联系。研究结果表明,音乐和创作实践可与愉悦感、积极的自我评价和安全感联系在一起。音乐和表演可以通过艺术和表演促进和颂扬第一民族同性恋者和身份的多样性和复杂性,增强归属感和与社区的联系,产生自豪感,促进知识共享。通过创造性艺术和数字平台建立的社区联系被视为能提高原住民女同性恋、男同性恋、 双性恋、变性人、双性人、同性恋者/质疑者、兄弟男孩、姐妹女孩的社会情感福祉。
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引用次数: 0
What counts as mutilation-and who should decide? Disrupting dominant discourses on genital cutting and modification. 什么算切割--谁来决定?打破关于切割和改造生殖器的主流论调。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-08-12 DOI: 10.1080/13691058.2024.2388438
Brian D Earp, Jasmine Abdulcadir, Arianne Shahvisi
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引用次数: 0
Cripping and queering gender-based violence prevention: bridging disability justice, queer joy, and consent education. 预防性别暴力的 "瘸腿 "和 "同性恋":将残疾公正、同性恋快乐和同意教育结合起来。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-08-10 DOI: 10.1080/13691058.2024.2380768
J J Wright, Caitlin A Manuel

Although frequently relegated to the periphery in conversations about gender-based violence prevention, the disabling impacts of traumatised subjectivity both affect survivors' abilities to fully participate in sex and contribute to survivors being more than twice as likely to be sexually (re)victimised compared to peers without trauma histories. In this paper, we seek to crip and queer approaches to gender-based violence prevention, particularly consent education, by learning from 2SLGBTQ+ and disabled trauma survivors' affective experiences of queer, crip sexual joy and the radically messy ways in which they establish their own care networks for deeply pleasurable sex through the principles of disability justice. Refusing pathologising understandings of survivors as those who need to be cured, we highlight traumatised subjectivity as emblematic of the ambiguity and ambivalence inherent in sex as well as the possibilities for caring, consensual sex that moves beyond the concept of consent employed in colonial, neoliberal capitalist societies' binary (Yes/No) consent laws. Drawing on the work of crip and queer theorists such as Mia Mingus, Alison Kafer, Leah Piepzna-Samarasinha, and J. Logan Smilges, we reveal how disability justice principles, such as interdependence, collective access, and access intimacy, offer transformative understandings for anti-violence efforts.

尽管在有关预防性别暴力的对话中,创伤性主体性的影响常常被边缘化,但它既影响了幸存者充分参与性活动的能力,也导致幸存者与没有创伤史的同龄人相比,遭受性(再)伤害的可能性高出两倍多。在本文中,我们试图通过学习 2SLGBTQ+ 和残障创伤幸存者对同性恋、瘸子性快乐的情感体验,以及他们通过残障正义原则建立自己的关爱网络以获得深度愉悦性爱的极端混乱的方式,来采用瘸子和同性恋方法来预防性别暴力,尤其是同意教育。我们拒绝将幸存者病理化,将其理解为需要治愈的人,而是强调创伤主体性象征着性爱中固有的模糊性和矛盾性,以及超越殖民主义、新自由主义资本主义社会二元(是/否)同意法中使用的同意概念的关爱、同意性爱的可能性。我们借鉴了米娅-明戈斯(Mia Mingus)、艾莉森-卡弗(Alison Kafer)、莉娅-皮耶普兹娜-萨马拉辛哈(Leah Piepzna-Samarasinha)和 J. 洛根-斯米尔兹(J. Logan Smilges)等瘸子和同性恋理论家的研究成果,揭示了残疾公正原则,如相互依存、集体获取和亲密获取,如何为反暴力工作提供变革性的理解。
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引用次数: 0
Women’s experiences of needing abortion care whilst incarcerated: a systematic review of the international literature 妇女在被监禁期间需要堕胎护理的经历:对国际文献的系统性审查
IF 2.2 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-08-06 DOI: 10.1080/13691058.2024.2386050
Conor Murray, Emma Campbell, Dean Burns, Rachel Roth, Dorothy Newbury-Birch, Fiona Bloomer
Incarcerated women are confined in institutions designed to punish. These sites often ignore the complex mental and physical health needs of people who are incarcerated. Despite the World Health Or...
被监禁的妇女被关押在旨在惩罚的机构中。这些场所往往忽视了被监禁者复杂的身心健康需求。尽管世界卫生组织(WHO)和联合国儿童基金会(UNICEF)都对被监禁妇女的身心健康问题做出了规定,但这些规定并没有得到有效执行。
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引用次数: 0
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Culture, Health & Sexuality
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