Non-binary patients in ART: new challenges and considerations
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Aleksandar Ljubić
,
Milan Stanojević
Abstract
Objectives
To discuss the increasing visibility of non-binary individuals and inclusive policies and practices in assisted reproductive technologies (ART).
Methods
Comparison between traditional ART approach designed for binary genders and propose approach in non-binary individuals.
Results
Traditional ART services, designed for binary genders, must adapt to address the unique fertility needs of non-binary patients. This includes using gender-neutral language, providing comprehensive fertility assessments, and offering hormone therapy and fertility preservation options. Children of non-binary parents benefit from open communication about gender diversity, enhancing psychological well-being. Positive societal attitudes and inclusive environments in schools are crucial for preventing discrimination and promoting mental health. A systemic approach is required to make ART inclusive. This involves training staff, adjusting facilities, updating documentation, and advocating for supportive legislation. Addressing the reproductive needs of non-binary individuals ensures equitable access to care and supports their family-building goals.
Conclusions
Ensuring the well-being of children in non-binary families requires psychological support, inclusive healthcare, legal recognition, social support, and comprehensive education.
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Research ethics: Not applicable.
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Informed consent: Not applicable.
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Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: Not applicable.
References
1. Williams Institute. LGBTQ+ nonbinary press release [Internet]; 2022 [cited 2024 Jul 21]; Available from: https://williamsinstitute.law.ucla.edu/press/lgbtq-nonbinary-press-release/.Search in Google Scholar
2. Spizzirri, G, Eufrásio, R, Lima, MCP, Nunes, BP, dos Santos, MA, Carvalho, H, et al.. Proportion of people identified as transgender and non-binary gender in Brazil. Sci Rep 2021;11:2240. https://doi.org/10.1038/s41598-021-81411-4.Search in Google Scholar PubMed PubMed Central
3. Statista. Gender identity worldwide by country [Internet]; 2023 [cited 2024 Jul 21]; Available from: https://www.statista.com/statistics/1269778/gender-identity-worldwide-country/.Search in Google Scholar
4. Badawy, MK, Dadoo, P, Grossmann, K, Lane, R, Colon-Cabrera, D. Gender-inclusive practice in pregnancy determination for transgender, gender diverse and non-binary patients in medical imaging. J Med Imaging Radiat Oncol 2023;67:625–33. https://doi.org/10.1111/1754-9485.13551.Search in Google Scholar PubMed
5. Coffman, KB, Coffman, LC, Ericson, KM. Non-binary gender Economics. NBER Working Paper No. 32222; 2024.10.3386/w32222Search in Google Scholar
6. Mak, J, Shires, DA, Zhang, Q, Prieto, LR, Witten, TM, Shipherd, JC, et al.. Suicide attempts among a cohort of transgender and gender diverse people. Am J Prev Med 2020;59:570–7. https://doi.org/10.1016/j.amepre.2020.03.026.Search in Google Scholar PubMed PubMed Central
7. Kreines, FM, Quinn, GP, Cardamone, S, Vadaparampil, ST, Bower, B, Silva, C, et al.. Training clinicians in culturally relevant care: a curriculum to improve knowledge and comfort with the transgender and gender diverse population. J Assist Reprod Genet 2022;39:2755–66. https://doi.org/10.1007/s10815-022-02655-1.Search in Google Scholar PubMed PubMed Central
8. Lampe, NM, Nowakowski, ACH. New horizons in trans and non-binary health care: bridging identity affirmation with chronicity management in sexual and reproductive services. Int J Transgend Health 2021;22:141–53. https://doi.org/10.1080/26895269.2020.1829244.Search in Google Scholar PubMed PubMed Central
9. Norris, M, Borneskog, C. The cisnormative blindspot explained: healthcare experiences of trans men and non-binary persons and the accessibility to inclusive sexual & reproductive healthcare, an integrative review. Sex Reprod Healthc 2022;32:100733. https://doi.org/10.1016/j.srhc.2022.100733.Search in Google Scholar PubMed
10. Jung, C, Hunter, A, Saleh, M, Quinn, GP, Nippita, S. Breaking the binary: how clinicians can ensure everyone receives high quality reproductive health services. Open Access J Contracept 2023;14:23–39. https://doi.org/10.2147/OAJC.S368621.Search in Google Scholar PubMed PubMed Central
11. Silva Lara, LA, Navarro, PAA, Reis, ETS, Abrão, MS, Rosa-E-Silva, JC, Dias, JAJr, et al.. Reproductive aspects of trans genders. Hum Reprod Arch 2023;38. https://doi.org/10.4322/hra.000223.Search in Google Scholar
12. Choi, JY, Kim, TJ. Fertility preservation and reproductive potential in transgender and gender fluid population. Biomedicines 2022;10:2279. https://doi.org/10.3390/biomedicines10092279.Search in Google Scholar PubMed PubMed Central
13. Faok, F, Dhejne, CMU, Frisén, LMM, Armuand, GM. Subjective experiences of pregnancy, delivery, and nursing in transgender men and non-binary individuals: a qualitative analysis of gender and mental health concerns. Arch Sex Behav 2024. https://doi.org/10.1007/s10508-023-02787-0.Search in Google Scholar PubMed PubMed Central
14. Greenfield, M, Darwin, Z. Trans and non-binary pregnancy, traumatic birth, and perinatal mental health: a scoping review. Int J Transgend Health 2021;22:203–16. https://doi.org/10.1080/26895269.2020.1841057.Search in Google Scholar PubMed PubMed Central
15. Casey, BJ, Jones, RM, Hare, TA. The adolescent brain. Ann N Y Acad Sci 2008;1124:111–26. https://doi.org/10.1196/annals.1440.010.Search in Google Scholar PubMed PubMed Central
16. King, M, Semlyen, J, Tai, SS, Killaspy, H, Osborn, D, Popelyuk, D, et al.. A systematic review of mental disorder, suicide, and self-harm in Lesbian, gay, and bisexual people. BMC Psychiatr 2008;8:70. https://doi.org/10.1186/1471-244x-8-70.Search in Google Scholar PubMed PubMed Central
17. Shilo, G, Savaya, R. Effects of family and friend support on LGB youths’ mental health and sexual orientation milestones. Fam Relat 2011;60:318–30. https://doi.org/10.1111/j.1741-3729.2011.00648.x.Search in Google Scholar
18. Hatzenbuehler, ML. How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychol Bull 2009;135:707–30. https://doi.org/10.1037/a0016441.Search in Google Scholar PubMed PubMed Central
19. Grant, JM, Mottet, LA, Tanis, J, Harrison, J, Herman, JL, Keisling, M, et al.. Injustice at every turn: a report of the national transgender discrimination survey. Washington DC: National Center for Transgender Equality and National Gay and Lesbian Task Force; 2011.Search in Google Scholar
20. James, SE, Herman, JL, Rankin, S, Keisling, M, Mottet, L, Anafi, M, et al.. The Report of the 2015 U.S. Transgender survey. Washington DC: National Center for Transgender Equality; 2016.Search in Google Scholar
21. Meyer, IH. Prejudice, social stress, and mental health in Lesbian, Gay, and Bisexual populations: conceptual issues and research evidence. Psychol Bull 2003;129:674–97. https://doi.org/10.1037/0033-2909.129.5.674.Search in Google Scholar PubMed PubMed Central
22. Gates, GJ. How many people are Lesbian, Gay, Bisexual, and transgender? Los Angeles: UCLA: The Williams Institute; 2011.Search in Google Scholar
23. Craig, SL, Austin, A, Alessi, EJ, McInroy, LB, Keane, G, Eaton, AD, et al.. Minority stress and heroin use: differences between Lesbian, Gay, Bisexual, and transgender and heterosexual young adults. Subst Use Misuse 2017;52:1467–74.Search in Google Scholar
24. Mallory, C, Brown, TN, Russell, ST, Sears, B. The impact of stigma and discrimination against LGBT people in Texas. Los Angeles: UCLA: The Williams Institute; 2017.Search in Google Scholar
25. Institute of Medicine. The health of Lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Washington DC: National Academies Press; 2011.Search in Google Scholar
26. Whitehead, J, Shaver, J, Stephenson, R. Outness, stigma, and primary health care utilization among rural LGBT populations. PLoS One 2016;11. https://doi.org/10.1371/journal.pone.0146139.Search in Google Scholar PubMed PubMed Central
27. White Hughto, JM, Reisner, SL, Pachankis, JE. Transgender stigma and health: a critical review of stigma determinants, mechanisms, and interventions. Soc Sci Med 2015;147:222–31. https://doi.org/10.1016/j.socscimed.2015.11.010.Search in Google Scholar PubMed PubMed Central
28. Austin, A, Craig, SL. Transgender affirmative cognitive behavioral therapy: clinical considerations and applications. Prof Psychol Res Pract 2015;46:21–9. https://doi.org/10.1037/a0038642.Search in Google Scholar
© 2024 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Chorioamnionitis and respiratory outcomes in prematurely born children: a systematic review and meta analysis
- Opinion Paper
- Non-binary patients in ART: new challenges and considerations
- Corner of Academy
- KANET evaluation in patients with SARS-CoV-2
- Original Articles – Obstetrics
- Socioeconomic status as a risk factor for SARS-CoV-2 infection in pregnant women
- Social vulnerability and prenatal diagnosis
- Perinatal outcomes in pregnant women with ITP: a single tertiary center experience
- Ability of an obstetric hemorrhage risk assessment tool to predict quantitative peripartum blood loss
- Sensitive detection of hemodynamic changes after fetoscopic laser photocoagulation by assessing intraventricular pressure difference in fetuses with twin-to-twin transfusion syndrome
- Prevalence of restless legs syndrome during pregnancy and postpartum period
- Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis
- Uterine isthmic tourniquet left in situ as a new approach for placenta previa-accreta surgery: a comparative study
- Maternal and newborn outcomes in pregnancies complicated by Guillain-Barré syndrome
- Original Articles – Fetus
- A customised fetal growth and birthweight standard for Qatar: a population-based cohort study
- Molecular analysis of 31 cases with fetal skeletal dysplasia
- Short Communication
- Current practice of ultrasound in the management of postpartum hemorrhage: a secondary analysis of a national survey
Articles in the same Issue
- Frontmatter
- Review
- Chorioamnionitis and respiratory outcomes in prematurely born children: a systematic review and meta analysis
- Opinion Paper
- Non-binary patients in ART: new challenges and considerations
- Corner of Academy
- KANET evaluation in patients with SARS-CoV-2
- Original Articles – Obstetrics
- Socioeconomic status as a risk factor for SARS-CoV-2 infection in pregnant women
- Social vulnerability and prenatal diagnosis
- Perinatal outcomes in pregnant women with ITP: a single tertiary center experience
- Ability of an obstetric hemorrhage risk assessment tool to predict quantitative peripartum blood loss
- Sensitive detection of hemodynamic changes after fetoscopic laser photocoagulation by assessing intraventricular pressure difference in fetuses with twin-to-twin transfusion syndrome
- Prevalence of restless legs syndrome during pregnancy and postpartum period
- Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis
- Uterine isthmic tourniquet left in situ as a new approach for placenta previa-accreta surgery: a comparative study
- Maternal and newborn outcomes in pregnancies complicated by Guillain-Barré syndrome
- Original Articles – Fetus
- A customised fetal growth and birthweight standard for Qatar: a population-based cohort study
- Molecular analysis of 31 cases with fetal skeletal dysplasia
- Short Communication
- Current practice of ultrasound in the management of postpartum hemorrhage: a secondary analysis of a national survey
