Care of transgender patients by diagnostic radiographers: What can be learnt from the literature

Journal article


Hammond, C and Lockwood, P. 2023. Care of transgender patients by diagnostic radiographers: What can be learnt from the literature. Radiography. 30 (1), pp. 145-150. https://doi.org/10.1016/j.radi.2023.10.020
AuthorsHammond, C and Lockwood, P.
Abstract

Introduction: Transgender patients have described negative healthcare experiences, including discrimination and feeling unwelcome. Additionally, these patients are at risk of inadequate or unsafe care due to healthcare providers being unable to obtain and record transgender patients’ correct gender and assigned birth sex. This literature review aims to review radiology and radiographer articles published since 2018 about transgender healthcare issues and make recommendations that can be applied by diagnostic radiographers, their managers and diagnostic radiography programme providers.

Method: A literature search used multiple databases containing peer-reviewed articles. Boolean operators and key words were utilised. Identified articles were searched to identify any articles not found by searching the databases. Themes and sub-themes from each paper were identified and discussed.

Results: Three key themes were identified: education, systems and environment. Education sub-themes were knowledge and awareness. Systems sub-themes were recording gender correctly and discriminating/stigmatising policies. Environment sub-themes were transgender-friendly symbols and environmental dysphoria.

Conclusion: Transgender patients still face barriers to equitable care. Several recommendations were made based on the thematic discussion that could be applied by diagnostic radiographers, student radiographers, radiology managers, University training providers, and professional body organisations. Diagnostic radiography programmes should include training on both clinical topics and cultural competence. Radiology managers should display transgender-positive symbols in their departments and ensure their policies are non-discriminatory and non-stigmatising. Radiology hardware and software providers should provide the ability to record non-binary genders and birth-assigned sex.

Implications for Practice: Transgender patients have the right to receive equitable care from diagnostic radiographers during their imaging examination and radiology attendance, and that any risks relating to their transgender status should be correctly managed with appropriate sensitivity.

KeywordsTransgender; Gender identity; Non-cisgendered; Radiography; Patient care
Year2023
JournalRadiography
Journal citation30 (1), pp. 145-150
PublisherElsevier
ISSN1078-8174
Digital Object Identifier (DOI)https://doi.org/10.1016/j.radi.2023.10.020
Official URLhttps://www.sciencedirect.com/science/article/pii/S1078817423002158
Publication dates
Online29 Nov 2023
PrintJan 2024
Publication process dates
Accepted25 Oct 2023
Deposited04 Dec 2023
Accepted author manuscript
License
All rights reserved
File Access Level
Restricted
Publisher's version
License
File Access Level
Open
Output statusPublished
References

1. Vincent B. Transgender health: A Practitioner’s Guide to Binary and Non-Binary Trans Patient Care, London: Jessica Kingsley Publishers; 2018.
2. Stonewall. List of LGBTQ+ terms, London; 2022.
3. Mack K. BIPOC, LGBTQ+, and the Power and Limitations of Umbrella Terms. MacArthur Foundation. Available from: https://www.macfound.org/press/perspectives/bipoc-lgbtq-power-limita... [accessed May 30, 2023].
4. Winter S., Diamond M., Green J., Karasic D., Reed T., Whittle S., et al. Transgender people: health at the margins of society. The Lancet 2016;388(10042):390–400. Doi: 10.1016/S0140-6736(16)00683-8.
5. Stowell JT., Grimstad FW., Kirkpatrick DL., Brown LR., Flores EJ. Serving the Needs of Transgender and Gender-Diverse Persons in Radiology. Journal of the American College of Radiology 2019;16(4):533–5. Doi: 10.1016/j.jacr.2018.12.050.
6. Reisner SL., Poteat T., Keatley J., Cabral M., Mothopeng T., Dunham E., et al. Global health burden and needs of transgender populations: a review. The Lancet 2016;388(10042):412–36. Doi: 10.1016/S0140-6736(16)00684-X.
7. NHS England. Equality objectives and information , London; 2021.
8. NHS England. The NHS Constitution for England, London; 2023.
9. Hudson-Sharp N., Metcalf H. Inequality among lesbian, gay bisexual and transgender groups in the UK: a review of evidence, 2016.
10. Bolderston A., Ralph S. Improving the health care experiences of lesbian, gay, bisexual and transgender patients. Radiography 2016;22(3):e207–11. Doi: 10.1016/j.radi.2016.04.011.
11. Watts S., Hirsch B. Connecting Radiography Students to Transgender Patient Care. Radiol Technol 2020;91(4):401–3.
12. Cates BA. Caring for Transgender Patients in the Radiology Department. Radiol Technol 2022;93(6):573–6.
13. Custer T., Sayles H., Michael K. Assessing the Educational Climate: Transgender Content in Medical Imaging Curricula. Journal of Diagnostic Medical Sonography 2020;36(6):536–43. Doi: 10.1177/8756479320944930.
14. UK Government. Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2017 (SI 2017/1322), London: HMSO; 2017.
15. Clark K., Vealé B., Zaleski F. Caring for the transgender patient. Radiol Technol 2018;90(1):7–19.
16. Floyd MJ., Martin O., Eckloff KJ. A qualitative study of transgender individuals’ experiences of healthcare including radiology. Radiography 2020;26(2):e38–44. Doi: 10.1016/j.radi.2019.10.008.
17. Health Protection Agency. Protection of Pregnant Patients during Diagnostic Medical Exposures to Ionising Radiation., London; 2009.
18. Aarne Grossman VG. Providing Quality Care to the Transgender Patient in the Radiology Setting. J Radiol Nurs 2016;35(3):218–26. Doi: 10.1016/j.jradnu.2016.06.002.
19. Hammond I., Lentle B., van den Berg L., Vitols-McKay M. Gender Identity and Bone Densitometry. Canadian Association of Radiologists Journal 2017;68(3):267–9. Doi: 10.1016/j.carj.2016.10.006.
20. Neira PM. Caring for the Transgender Patient. J Radiol Nurs 2017;36(2):88–9. Doi: 10.1016/j.jradnu.2017.03.002.
21. Wanta JW., Unger CA. Review of the Transgender Literature: Where Do We Go from Here? Transgend Health 2017;2(1):119–28. Doi: 10.1089/trgh.2017.0004.
22. Canterbury Christ Church University. Research Ethics Policy , Canterbury; 2023.
23. Cooper C., Booth A., Varley-Campbell J., Britten N., Garside R. Defining the process to literature searching in systematic reviews: a literature review of guidance and supporting studies. BMC Med Res Methodol 2018;18(1):85. Doi: 10.1186/s12874-018-0545-3.
24. Page MJ., McKenzie JE., Bossuyt PM., Boutron I., Hoffmann TC., Mulrow CD., et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev 2021;10(1):89. Doi: 10.1186/s13643-021-01626-4.
25. Benton DC., Cormack DFS. ’Reviewing and evaluating the literature. In: Cormack DFS, editor. The research process in nursing . Fourth, Oxford: Blackwell Sciences Ltd; 2000, p. 53–63.
26. Aveyard H. Doing a Literature Review in Health and Social Care: A Practical Guide, Third, Maidenhead: Open University Press; 2014.
27. Clark KR., Vealé BL. Assessing Transgender-Related Content in Radiography Programs in the United States: A Survey of Educators. J Med Imaging Radiat Sci 2018;49(4):414–9. Doi: 10.1016/j.jmir.2018.06.050.
28. Ussher JM., Perz J., Allison K., Power R., Hawkey A., Dowsett GW., et al. Attitudes, knowledge and practice behaviours of oncology health care professionals towards lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) patients and their carers: A mixed-methods study. Patient Educ Couns 2022;105(7):2512–23. Doi: 10.1016/j.pec.2021.12.008.
29. White Hughto JM., Clark KA., Altice FL., Reisner SL., Kershaw TS., Pachankis JE. Creating, reinforcing, and resisting the gender binary: a qualitative study of transgender women’s healthcare experiences in sex-segregated jails and prisons. Int J Prison Health 2018;14(2):69–88. Doi: 10.1108/IJPH-02-2017-0011.
30. Hendrickson SG., Contreras C V., Schiller E., Walsh D. Exploring health care experiences of transgender people living in Texas. Nurs Outlook 2020;68(4):476–83. Doi: 10.1016/j.outlook.2020.02.002.
31. Tabaac AR., Sutter ME., Wall CSJ., Baker KE. Gender Identity Disparities in Cancer Screening Behaviors. Am J Prev Med 2018;54(3):385–93. Doi: 10.1016/j.amepre.2017.11.009.
32. Perry H., Fang AJ., Tsai EM., Slanetz PJ. Imaging Health and Radiology Care of Transgender Patients: A Call to Build Evidence-Based Best Practices. Journal of the American College of Radiology 2021;18(3):475–80. Doi: 10.1016/j.jacr.2020.10.008.
33. Matoori S., Donners R., Garcia Nuñez D., Nguyen-Duong S., Riopel C., Baumgartner M., et al. Transgender health and medicine – Are radiological devices prepared? Eur J Radiol 2022;151:110320. Doi: 10.1016/j.ejrad.2022.110320.
34. Society and College of Radiographers. Inclusive pregnancy status guidelines for ionising radiation: Diagnostic and therapeutic exposures, London; 2021.
35. Society and College of Radiographers. New version of popular SCoR pregnancy poster. , London; 2020.
36. Society and College of Radiographers. Society defends inclusive pregnancy guidance after media criticism. Society Defends Inclusive Pregnancy Guidance after Media Criticism. Available from: https://www.sor.org/news/obstetrics-and-gynaecology/inclusive-pregna... [accessed May 24, 2023].
37. Macdonald DW., Grossoehme DH., Mazzola A., Pestian T., Schwartz SB. “I just want to be treated like a normal person.” The Journal of the American Dental Association 2019;150(9):748–54. Doi: 10.1016/j.adaj.2019.03.025.
38. Yan TD., Mak LE., Carroll EF., Khosa F., Yong-Hing CJ. Gender-Inclusive Fellowship Naming and Equity, Diversity, and Inclusion in Radiology: An Analysis of Radiology Department Websites in Canada and the United States. Canadian Association of Radiologists Journal 2022;73(3):473–7. Doi: 10.1177/08465371211066104.

Permalink -

https://repository.canterbury.ac.uk/item/967vw/care-of-transgender-patients-by-diagnostic-radiographers-what-can-be-learnt-from-the-literature

Download files


Publisher's version
1-s2.0-S1078817423002158-main.pdf
License: CC BY 4.0
File access level: Open

  • 109
    total views
  • 43
    total downloads
  • 4
    views this month
  • 1
    downloads this month

Export as

Related outputs

Systematic screening for active tuberculosis amongst refugees and asylum seekers in Western Europe: Is universal chest radiography justified? A literature review.
Dooley, N and Lockwood, P. 2024. Systematic screening for active tuberculosis amongst refugees and asylum seekers in Western Europe: Is universal chest radiography justified? A literature review. Radiography. 31 (1), pp. 194-200. https://doi.org/10.1016/j.radi.2024.11.011
Student radiographers’ knowledge and experience of lateral hip X-ray positioning: A survey
Clarke, L. and Lockwood, P. 2024. Student radiographers’ knowledge and experience of lateral hip X-ray positioning: A survey. Radiography. 30 (6). https://doi.org/10.1016/j.radi.2024.08.011
The role of imaging in the diagnosis of potential air pollution related illness: a narrative review
Abigail Taylor and Paul Lockwood 2024. The role of imaging in the diagnosis of potential air pollution related illness: a narrative review. Radiography. 30 (5), pp. 1326-1331. https://doi.org/10.1016/j.radi.2024.07.014
A survey of the NHS reporting radiographer workforce in England
Lockwood, P., Burton, C., Shaw, T. and Woznitza, N. 2024. A survey of the NHS reporting radiographer workforce in England. Radiography Open. 10 (1), pp. 1-18. https://doi.org/10.7577/radopen.5635
Comparing the standard knee X-ray exposure factor, 10 kV rule, and modified 10 kV rule techniques in digital radiography to reduce patient radiation dose without loss of image quality
Lockwood, P. and Wenman, A. 2024. Comparing the standard knee X-ray exposure factor, 10 kV rule, and modified 10 kV rule techniques in digital radiography to reduce patient radiation dose without loss of image quality. Radiography. 30 (2), pp. 574-581. https://doi.org/10.1016/j.radi.2024.01.013
Obesity bias in diagnostic radiography students: A survey of attitudes, perceptions and technical confidence
Tamburrini, N. and Lockwood, P. 2023. Obesity bias in diagnostic radiography students: A survey of attitudes, perceptions and technical confidence. Radiography. 30 (1), pp. 202-208. https://doi.org/10.1016/j.radi.2023.11.006
Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X‑ray reporting service within the NHS in England: a systematic literature review
Lockwood, P., Burton, C., Woznitza, N. and Shaw, T. 2023. Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X‑ray reporting service within the NHS in England: a systematic literature review. BMC Health Services Research. 23 (1270), pp. 1-41. https://doi.org/10.1186/s12913-023-10161-y
Impostor phenomenon traits in radiography students: findings from a UK pilot survey
Gibson, C. and Lockwood, P. 2023. Impostor phenomenon traits in radiography students: findings from a UK pilot survey . Radiography. 30 (1), pp. 61-65. https://doi.org/10.1016/j.radi.2023.10.005
Investigating the adjacent patient radiation dose received during a simulated ward chest X-ray examination
Langfield, H and Lockwood, P. 2023. Investigating the adjacent patient radiation dose received during a simulated ward chest X-ray examination. Radiography Open. 9 (1), pp. 1-14. https://doi.org/10.7577/radopen.5354
Research ethics applications: Back to basics: What you ought to know about research ethics applications
Lockwood, P. 2023. Research ethics applications: Back to basics: What you ought to know about research ethics applications. Insights into Imaging. Spring (7), pp. 39-45.
An investigation into the clinical scope of practice of MRI reporting radiographers within the United Kingdom
Mitchell, M. and Lockwood, P. 2023. An investigation into the clinical scope of practice of MRI reporting radiographers within the United Kingdom. Radiography. 29 (3), pp. 489-495. https://doi.org/10.1016/j.radi.2023.02.015
Assessing the barriers and enablers to the diagnostic radiographer X-ray reporting service within the NHS in England: A systematic literature review
Lockwood, P. 2022. Assessing the barriers and enablers to the diagnostic radiographer X-ray reporting service within the NHS in England: A systematic literature review. York University.
Lead-rubber shielding effect on radiation dose to the gonads from a bilateral hand X-ray examination
Welborn, D. and Lockwood, P. 2022. Lead-rubber shielding effect on radiation dose to the gonads from a bilateral hand X-ray examination. Radiography. 28 (2), pp. 360-365. https://doi.org/10.1016/j.radi.2021.12.013
Could posterior-anterior projection cervical spine radiographs improve image quality and dose reduction
Faulkner, R. and Lockwood, P. 2022. Could posterior-anterior projection cervical spine radiographs improve image quality and dose reduction . Radiography Open. 8 (1). https://doi.org/10.7577/radopen.5004
Diagnostic radiography students' perceptions towards communication with service users who are deaf or hearing impaired.
Nolan-Bryant, A. and Lockwood, P. 2022. Diagnostic radiography students' perceptions towards communication with service users who are deaf or hearing impaired. Radiography. 29 (1), pp. 207-214. https://doi.org/10.1016/j.radi.2022.11.008
A cross-sectional student survey of the impact of the Covid-19 lockdowns on clinical placement in England
Hinds, Z. and Lockwood, P. 2022. A cross-sectional student survey of the impact of the Covid-19 lockdowns on clinical placement in England. Radiography. 29 (1), pp. 190-199. https://doi.org/10.1016/j.radi.2022.11.006
Pre-registration UK diagnostic radiography student ability and confidence in interpretation of chest X-rays
Lockwood, P. and Khan, A. 2021. Pre-registration UK diagnostic radiography student ability and confidence in interpretation of chest X-rays. Radiography Open. 7 (1), pp. 1-13. https://doi.org/10.7577/radopen.4529
Efficacy, utility, and validity in Computed Tomography head reporting by radiographers
Lockwood, P. 2021. Efficacy, utility, and validity in Computed Tomography head reporting by radiographers. PhD Thesis Canterbury Christ Church University School of Allied and Public Health Professions
COVID-19: A literature review of the impact on diagnostic radiography students
Astirbadi, D. and Lockwood, P. 2021. COVID-19: A literature review of the impact on diagnostic radiography students. Radiography. https://doi.org/10.1016/j.radi.2021.09.009
Multi-professional image interpretation: performance in preliminary clinical evaluation of appendicular radiographs
Lockwood, P. and Pittock, L. 2019. Multi-professional image interpretation: performance in preliminary clinical evaluation of appendicular radiographs. Radiography. https://doi.org/10.1016/j.radi.2019.04.013
Computed tomography head and facial bones review of a 2,700 year old Egyptian mummy
Lockwood, P., Elliott, J., Nelson, A. and Harris, S. 2019. Computed tomography head and facial bones review of a 2,700 year old Egyptian mummy . BJR Case Reports. https://doi.org/10.1259/bjrcr.20190076
Visual function assessment of diagnostic radiography students
Lockwood, P. and Blackman, A. 2019. Visual function assessment of diagnostic radiography students. Radiography. https://doi.org/10.1016/j.radi.2019.10.012
An evaluation of CT head reporting radiographers' scope of practice within the United Kingdom
Lockwood, P. 2019. An evaluation of CT head reporting radiographers' scope of practice within the United Kingdom. Radiography. 26 (2), pp. 102-109. https://doi.org/10.1016/j.radi.2019.09.001
Image Interpretation by radiographers in brain, spine and knee MRI examinations: Findings from an accredited postgraduate module
Lockwood, P. and Dolbear, G. 2018. Image Interpretation by radiographers in brain, spine and knee MRI examinations: Findings from an accredited postgraduate module. Radiography. https://doi.org/10.1016/j.radi.2018.05.009
Evaluation of an equilibrium phase free-breathing dynamic contrast-enhanced MRI prototype sequence compared to traditional breath-held MRI acquisition in liver oncology patients
Hopkinson, G., Lockwood, P. and Dolbear, G. 2018. Evaluation of an equilibrium phase free-breathing dynamic contrast-enhanced MRI prototype sequence compared to traditional breath-held MRI acquisition in liver oncology patients. Radiography. https://doi.org/10.1016/j.radi.2018.01.001
Nuclear medicine image interpretation by radiographers: findings of an accredited postgraduate module
Lockwood, P. and Dolbear, G. 2018. Nuclear medicine image interpretation by radiographers: findings of an accredited postgraduate module. Radiography. https://doi.org/10.1016/j.radi.2018.11.007
CT Sinus and facial bones reporting by radiographers: findings of an accredited postgraduate programme
Lockwood, P. 2017. CT Sinus and facial bones reporting by radiographers: findings of an accredited postgraduate programme. Dentomaxillofacial Radiology. 46 (4). https://doi.org/10.1259/dmfr.20160440
Exploring variation and trends in adherence to national occupational standards for reporting radiographers
Lockwood, P. 2017. Exploring variation and trends in adherence to national occupational standards for reporting radiographers. Journal of Social Science & Allied Health Professions. 1 (1), pp. 20-27.
Observer performance in Computed Tomography head reporting
Lockwood, P. 2017. Observer performance in Computed Tomography head reporting. Journal of Medical Imaging and Radiation Sciences. 48 (1), pp. 22-29. https://doi.org/10.1016/j.jmir.2016.08.001
Exploring the benefits of magnetic resonance imaging reporting by radiographers: A UK perspective
Lockwood, P. 2016. Exploring the benefits of magnetic resonance imaging reporting by radiographers: A UK perspective. Journal of Medical Imaging and Radiation Sciences. 47 (2). https://doi.org/10.1016/j.jmir.2015.12.083
An economic evaluation of introducing a skills mix approach to CT head reporting in clinical practice.
Lockwood, P. 2016. An economic evaluation of introducing a skills mix approach to CT head reporting in clinical practice. Radiography. https://doi.org/10.1016/j.radi.2015.09.004
Intraorbital foreign body detection and localisation by radiographers: a preliminary JAFROC observer performance study
Lockwood, P., Pittock, L., Lockwood, C., Jeffery, C. and Piper, K. 2015. Intraorbital foreign body detection and localisation by radiographers: a preliminary JAFROC observer performance study. Radiography. 2015, pp. 1-5. https://doi.org/10.1016/j.radi.2015.06.005
Out of the comfort zone (Part 2)
Lockwood, P. 2013. Out of the comfort zone (Part 2).
AFROC analysis of reporting radiographer’s performance in CT head interpretation
Lockwood, P. and Piper, K. 2015. AFROC analysis of reporting radiographer’s performance in CT head interpretation. Radiography. 21 (3), pp. e90-e95. https://doi.org/10.1016/j.radi.2015.04.001
Out of the comfort zone (Part 1)
Lockwood, P. 2013. Out of the comfort zone (Part 1).
Origins of the Reporting Radiographer
Lockwood, P. 2013. Origins of the Reporting Radiographer.
Patient safety and quality improvement: Iatrogenic venous air embolism in diagnostic imaging
Lockwood, P. and Breen, W. 2013. Patient safety and quality improvement: Iatrogenic venous air embolism in diagnostic imaging.
CT head reporting by radiographers: Findings of an accredited postgraduate programme
Lockwood, P. and Piper, K. 2013. CT head reporting by radiographers: Findings of an accredited postgraduate programme.
CT skull base & calvarium normal variant pitfalls
Lockwood, P. 2013. CT skull base & calvarium normal variant pitfalls.
CT head reporting by radiographers: results of an accredited postgraduate programme
Lockwood, P., Piper, K. and Pittock, L. 2015. CT head reporting by radiographers: results of an accredited postgraduate programme. Radiography. 21 (3), pp. e85-e89. https://doi.org/10.1016/j.radi.2014.12.001