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Background: Informed by the Gelberg-Andersen behavioral model for vulnerable populations, this study examined the prevalence of and factors associated with not having a family physician among transgender (trans) people in Ontario, Canada.Methods: Data were drawn from a respondent-driven sampling (RDS) survey of trans Ontarians age 16 and above (n = 433) conducted between 2009 and 2010. All analyses were weighted using RDS II methods. Prevalence ratios were estimated using average marginal predictions from logistic regression models.Results: An estimated 17.2% (95% CI, 11.0 to 22.9) of trans Ontarians (median age = 28.7, 77.3% White) did not have a regular family physician. In multivariable analyses accounting for other predisposing and need-related factors, transfeminine persons (trans women and non-binary persons assigned a male sex at birth) who were Indigenous and/or persons of color were less likely than other transfeminine persons to have a family doctor. In addition, trans persons who were h...

Bisexuals are at greater risk for poor mental health compared with heterosexual, gay, and lesbian people. This increased risk has been attributed to biphobia yet the relationship between biphobia and mental health has been understudied. Data were collected from an Ontario-wide survey of bisexuals, broadly defined, using respondent-driven sampling (N = 405), and minority stress theory was applied to examine the relationship between biphobia (from the straight community and gay/lesbian community separately) and anxiety using structural equation modelling. In contrast to our hypothesis, biphobia had little impact on anxiety. Results suggest that we need to enhance our capacity to measure discrimination.

Changes in gay and bisexual men's connectedness to the gay community are related to the declining public visibility of HIV/AIDS and greater acceptance for homosexuality and bisexuality in mainstream society. Little work, however, has focused on perceived acceptance for subgroups within the gay community or broader society. Using interviews (n = 20) and a survey (n = 202) of gay and bisexual men in a mid-sized Canadian city, we find perceived hierarchies of acceptance for the various subgroups as well as an age effect wherein middle-aged men perceive the least acceptance for all groups. These differences are linked with the uneven impact of social, political, and institutional changes relevant to gay and bisexual men in Canada.

Limited research regarding transsexual or transgender (trans) parents has often focused on their children. This analysis represents the first published profile of trans parents (N = 110) from a large probability-based sample of trans people (N = 433). The Trans PULSE Project used respondent-driven sampling to collect survey data from trans people in Ontario, Canada. Trans parents differed from nonparents in that they were older, more educated, and had higher personal incomes. Trans parents did not differ significantly from nonparents in the level of transphobia they experienced and many reported being impacted by multiple stressors. A majority felt that being trans had hurt or embarrassed their family, worried about growing old alone because they are trans, or had been made fun of for being trans. A substantial minority had been turned down for a job, had to move away, been hit or beat up, been harassed by police, or been fired from a job because they were trans. Some reported no legal access to their chi...

Researchers often use survey items on sexual behavior to classify respondents' sexual orientation. Such measures require two sex partners (one male, one female) within a specified period for classification as bisexual, but only one for classification as homosexual or heterosexual. Using 2002 U.S. National Survey of Family Growth data, this proof-of-concept analysis demonstrates that observed effects of ‘behavioral bisexuality’on substance use and sexual health outcomes may thus be tautologically due to encoded differentials in sex partner number, rather than a function of bisexuality as typically defined or practiced. Effects were largely and consistently attenuated when a floor value of two sex partners was consistently applied to all orientation groups. Past-year behavioral bisexuality performed poorly as a proxy measure for either bisexual identity or lifetime bisexual behavioral history. Research using such measures must be interpreted with caution, and researchers are urged to consider alternate codi...

This article explains the report from the work group of WPATH charged to consider whether a diagnosis for gender identity disorder should be included in the revised DSM; whether distress is inherent, a result of social stigma, or both; and what the implications of this are for the diagnosis in the revised DSM. Suggestions are made to remove gender identity disorder from the next revision of DSM and to find a place in the nonmental disorder section of the ICD, using the more broadly defined and less stigmatizing term gender dysphoria. Alternative suggestions are also put forward to incorporate distress within Criterion A of a diagnosis of Gender Dysphoria (formerly Gender Identity Disorder) in the revised DSM, which will make the condition correspond more closely to its description in the ICD.