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This paper is divided into three parts, each separated by centrally spaced asterisks. The first part, co-written on the basis of the standpoint interests of both authors, outlines the historical, philosophical, theoretical and methodological contexts for the use of autoethnographic short stories in the social and human sciences. The functions and representational practices of this genre are reviewed and discussed, and the main criticisms leveled by its detractors responded to. This sets the scene for the second part of the paper, an autoethnographic short story. Effectively a story of stories, it was constructed directly from the first author's memories of his early life in relation to textual material and was written exclusively by him. In part three, some of the significant issues raised in the story are discussed in relation to larger co-evolving social, cultural and therapeutic frameworks from a reflexive and narrative identity perspective. It is written as, and represents, an extended, unfinished dialogue between the first and second author.

Policy promotes the active participation of those with lived experience of mental health difficulties in UK NHS mental health services, from the level of collaborative care-planning to service delivery, leadership and development. However, research indicates different forms of resistance to the implementation of such service user involvement. This article reports the findings of a qualitative, interview-based study which used Foucauldian discourse analysis and psychoanalytic theory to understand how resistances are produced through the interplay of clinical mental health professionals' subjectivity and their organisational context. Service user involvement was found to highlight conflicts within clinicians' roles. Central to this conflict was an ambivalent relationship to the power associated with these roles. Power could protect professionals from work related stresses, but could also be used to dominate, silence and coerce service users in ways that conflicted with the core function of providing care. Whilst important, raising awareness of such conflict will arouse discomfort and resistance where psychological defences are challenged. A parallel is drawn with psychotherapeutic change, in which resistance must be understood and worked with as part of meaningful change. [ABSTRACT FROM AUTHOR]

Health inequalities impact sex‐variant people in highly differentiated ways. This is evidenced in much academic and activist intersex research documenting the highly specific forms of inequalities arising from misrecognition, discrimination and human rights abuses inherent to pathologised accounts of non‐normative bodies. Important theoretical work further interrogates the implications of sex variant subjectivities, identities and bodies for static or binary notions of both sex and gender. In this paper, we aim to contribute further to this scholarship. We draw upon feminist materialist and Deleuzean‐informed understandings of materials or matter to rethink debates over sex‐variant subjectivities, identities and bodies in relation to inequalities in health. We argue 'the turn to matter' and associated new materialist theories draw attention to the complex, dynamic relational assemblages and entanglements mutually constituting the affective, embodied and socio‐material worlds of intersex people. Informed by these theories, we propose that inequalities can be more fully addressed through a new health equity research agenda that is co‐produced with sex‐variant people. This agenda will enable a fuller exploration of the unsettling but transformative capacities of intersex matters and meanings with the contextually specific understandings of equity in relation to health and health care. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender, intersex, queer people and minority gender identities and sexualities (LGBTIQ+) are often stigmatized and experience discrimination in health care settings, leading to poorer mental health outcomes and unmet needs compared to heterosexual and cisgendered peers. It is thus imperative that mental health providers consider and address structural challenges in order to reduce mental health inequalities of this population. This narrative review assessed the barriers that may prevent access to care and the pathways for care in LGBTIQ + communities. PubMed, PsycInfo, Embase, and Scopus were searched for papers published between December 2021 and February 2022. A total of 107 papers were included with studies reflecting five themes: (1) Unmet mental health needs; (2) Young people; (3) Substance abuse and addiction; (4) Barriers and pathways to care; and (5) Interventions. Findings demonstrate that LGBTIQ + people experience stigmatization and higher rates of substance misuse and mental ill health, which may lead to barriers in accessing health care services, and fewer tailored interventions being provided. These findings have implications for policy, health care screening, and how specialist services are structured. Substantial gaps in the evidence-base exist, and future research should examine how mental health care providers can challenge social issues that maintain discriminatory and stigmatizing practices, and support LGBTIQ + individuals to sustain their resilience. [ABSTRACT FROM AUTHOR]

This article serves as an introduction to discourse analysis. Due to logistical reasons, because this is a relatively new and multifaceted approach in research, this article involves only introductory remarks about discourse analysis as approach to qualitative, reflexive educational research. Different postmodern 'approaches' to qualitative nursing research derived from other disciplines are being rooted in nursing as epistemology. Discourse analysis is introduced as a Poststructuralist and Social Constructionist 'approach' to educational research developing within the postmodern line of thought. The ideas on discourse analysis as a research `approach' of Parker (1992: 6-20) and Terre Blanche & Durrheim (1999: 154-167) are discussed. Discourse analysis could serve as a valuable 'approach' in educational research as it challenges current dominant ways of understanding or viewing the objects of study. This process opens up space for alternative reflections that could lead to change., Postmodernism is not a school of thought. It is not a unified intellectual movement with a definite goal or perspective. 'Postmodernism can be the set of ideas which try to [...]

Background: Though growing numbers of peer support workers are employed in the UK National Health Service (NHS), conflicts persist between core values of peer support and values which exert power within these services. Objectives: To explore what NHS mental health professionals value about the peer support worker role. Design: Five professionals from different professions and mental health settings were interviewed twice. The first interviews explored their experiences of working with peers. Transcripts were analysed using discourse analysis and psychosocial theory. Second interviews allowed participants to respond to the analysis and influence subsequent analysis. Results: Mental health professionals valued peers for the deeply empathic, relational approach they brought, based in their subjective experience. Peer work was also valued for the affect‐focused quality of this work, and the challenge peers pose to existing values in mental health services. The values of peer support troubled dominant ways of working based in forms of knowledge that favour objectivity and hence encountered challenges. Conclusions: Peers fulfil the role of amplifying the status of diverse forms of knowledge, values and related ways of working that have become marginalized in NHS mental health services. It is important that peers are not seen as an isolated solution to the marginalization of these forms of knowledge and values, but that their way of working becomes reflected in other roles whilst evoking change throughout these services. Patient or Public Contribution: Patient and Public Involvement groups were consulted both in the design and analysis stages of the study. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience significant healthcare inequalities and barriers to healthcare services. Contextualised within six Member States of the European Union (EU), this paper discusses efforts to identify and explore the nature of barriers to healthcare as part of Health4LGBTI, a 2-year pilot project funded by the EU. Data were generated through focus groups and interviews with LGBTI people and healthcare professionals and analysed using thematic analysis. Findings reveal that barriers to healthcare are underpinned by two related assumptions held by healthcare professionals: first, the assumption that patients are heterosexual, cisgender and non-intersex by default; second, the assumption that LGBTI people do not experience significant problems (and therefore that their experience is mostly irrelevant to healthcare). On the other hand, it is notable that responding healthcare professionals were broadly 'LGBTI-friendly'. Thus, we argue that efforts to improve LGBTI healthcare should not be limited to engaging with healthcare professionals with negative views of LGBTI people. Rather, such efforts should also tackle these assumptions amongst LGBTI-friendly healthcare professionals. [ABSTRACT FROM AUTHOR]

Background Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience significant health inequalities. Located within a European Commission funded pilot project, this paper presents a review of the health inequalities faced by LGBTI people and the barriers health professionals encounter when providing care. Methods A narrative synthesis of 57 papers including systematic reviews, narrative reviews, meta-analyses and primary research. Literature was searched in Cochrane, Campbell Collaboration, Web of Science, CINAHL, PsychINFO and Medline. The review was undertaken to promote understanding of the causes and range of inequalities, as well as how to reduce inequalities. Results LGBTI people are more likely to experience health inequalities due to heteronormativity or heterosexism, minority stress, experiences of victimization and discrimination, compounded by stigma. Inequalities pertaining to LGBTI health(care) vary depending on gender, age, income and disability as well as between LGBTI groupings. Gaps in the literature remain around how these factors intersect to influence health, with further large-scale research needed particularly regarding trans and intersex people. Conclusion Health inequalities can be addressed via changes in policy, research and in practice through health services that accommodate the needs of LGBTI people. With improved training to address gaps in their knowledge of LGBTI health and healthcare, health professionals should work in collaboration with LGBTI people to address a range of barriers that prevent access to care. Through structural change combined with increased knowledge and understanding, services can potentially become more inclusive and equally accessible to all. [ABSTRACT FROM AUTHOR]

Background: The health inequalities experienced by lesbian, gay, bisexual, trans and intersex (LGBTI) people are well documented with several reviews of global research summarizing key inequalities. These reviews also show how the health‐care needs of LGBTI people are often poorly understood whilst suggesting that targeted initiatives to reduce inequalities should involve LGBTI people. Objectives: To determine what is known about the health‐care inequalities faced by LGBTI people? What are the barriers faced by LGBTI people whilst accessing health care, and health professionals when providing care? What examples of promising practice exist? Design: Rapid reviews of grey literature were co‐produced with LGBTI people in 27 countries followed by a thematic analysis and synthesis across all data sets. The review included grey literature from each country that might not otherwise be accessible due to language barriers. Main results: Rapid reviews showed that LGBTI people faced various inequalities and barriers whilst accessing health care. Where heterosexuality, binary gender and assumed male/female sex characteristics were upheld as the norm, and where LGBTI people differed from these norms, discrimination could result. In consultations where LGBTI people feared discrimination and did not disclose their LGBTI status, health professionals lacked the information required for appropriate assessments. Conclusion: With greater understanding of sexual orientation (LGB people), gender identity (trans people) and sex characteristics (intersex people), combined with access to contemporary knowledge and training, health professionals can work in collaboration with researchers, policymakers and LGBTI people to develop systems that are better attuned to the needs of all service users. [ABSTRACT FROM AUTHOR]

Within lesbian, gay, bisexual and transgender (LGBT) research there is increasing health-related scholarship on trans lives, with a growing awareness of the impact of health inequalities on trans well-being. The aim of the paper is to provide greater understanding of transgender young people’s views of what is needed to promote their emotional well-being and resilience by undertaking specific analysis of data collected as part of wider research with young people (n = 97). The study utilised participatory qualitative methods with a cross sectional design generating data via a focus group with trans youth (n = 5), followed by thematic analysis. Findings suggest that both individual and collective capacities or resources enable and sustain resilience and well-being for trans young people. The adversity trans youth face is present in school, the community and in healthcare, but they are able to find places where they feel safe and connected to others. Practitioners, teachers and school nurses are well positioned to facilitate structural change in alliance with trans youth to promote resilience. Research results were utilised to inform health improvement, commissioning and service delivery. [ABSTRACT FROM PUBLISHER]