title: Non-binary youth: Access to gender-affirming primary health care

authors: Clark, Drew B. A.

subjects: Social Sciences

abstract: Background: Transgender (trans) youth who identify outside the gender binary are a growing subpopulation. In this article, we document differences in access to gender-affirming health care between binary and non-binary identified trans youth and explore ways of meeting the health needs of non-binary youth within primary care settings.

Methods: The Canadian Trans Youth Health Survey is a national online survey of trans youth, 14–25 years, conducted in 2013–2014. Among the 839 participants who responded to gender identity items in the survey, 41% identified as non-binary. We compared demographic, health outcome, and health care access responses between non-binary and binary (trans girls/women and trans boys/men) youth.

Results: Non-binary and binary youth were similar in most demographics, including age, geographic distribution, and ethnocultural backgrounds, however a larger proportion (82%) of non-binary youth were assigned female at birth. Older non-binary youth (aged 19–25) were significantly more likely to forego needed healthcare than older binary youth; no significant differences were found between younger (14–18) non-binary and binary youth in foregoing healthcare. Overall, non-binary youth (13%) were significantly less likely than binary youth (52%) to access hormone therapy, but they were more likely than binary youth to report experiencing barriers to accessing hormone therapy when needed.

Conclusions: Non-binary trans youth in Canada report challenges in accessing needed gender-affirming healthcare. Primary care providers are well-situated to integrate a broad range of gender-affirming care services into practice in order to address the unique needs of non-binary youth. Future research is warranted to explore experiences of non-binary youth related to barriers to care and to explore how services can be designed and delivered to better meet the needs of non-binary youth seeking gender-affirming primary care.

text: Non-binary youth: Access to gender-affirming primary health care Background: Transgender (trans) youth who identify outside the gender binary are a growing subpopulation. In this article, we document differences in access to gender-affirming health care between binary and non-binary identified trans youth and explore ways of meeting the health needs of non-binary youth within primary care settings.

Methods: The Canadian Trans Youth Health Survey is a national online survey of trans youth, 14–25 years, conducted in 2013–2014. Among the 839 participants who responded to gender identity items in the survey, 41% identified as non-binary. We compared demographic, health outcome, and health care access responses between non-binary and binary (trans girls/women and trans boys/men) youth.

Results: Non-binary and binary youth were similar in most demographics, including age, geographic distribution, and ethnocultural backgrounds, however a larger proportion (82%) of non-binary youth were assigned female at birth. Older non-binary youth (aged 19–25) were significantly more likely to forego needed healthcare than older binary youth; no significant differences were found between younger (14–18) non-binary and binary youth in foregoing healthcare. Overall, non-binary youth (13%) were significantly less likely than binary youth (52%) to access hormone therapy, but they were more likely than binary youth to report experiencing barriers to accessing hormone therapy when needed.

Conclusions: Non-binary trans youth in Canada report challenges in accessing needed gender-affirming healthcare. Primary care providers are well-situated to integrate a broad range of gender-affirming care services into practice in order to address the unique needs of non-binary youth. Future research is warranted to explore experiences of non-binary youth related to barriers to care and to explore how services can be designed and delivered to better meet the needs of non-binary youth seeking gender-affirming primary care.

year: 2018

title: Total site heat and mass integration and optimisation using P-graph: A biorefinery case study

authors: Ong, Benjamin H.Y.

abstract: The aim of this paper is to solve total site heat and mass integration and optimisation using P-graph framework, with a biorefinery case study. Total site heat and mass integration is important for the selection of biorefinery processes because it must achieve high material and energy efficiency to be economically competitive. This paper considers co-location of simultaneous scarification and co-fermentation of wood, hydrothermal liquefaction of forest residues and gasification of black liquor with an existing Kraft pulp mill in Central North Island of New Zealand. Result shows that the Kraft pulp mill is the most profitable biorefinery option, followed by hydrothermal liquefaction. However, an increment in the price of bio-oil by 5 % puts hydrothermal liquefaction in the optimal network with Kraft pulp mill.

text: Total site heat and mass integration and optimisation using P-graph: A biorefinery case study The aim of this paper is to solve total site heat and mass integration and optimisation using P-graph framework, with a biorefinery case study. Total site heat and mass integration is important for the selection of biorefinery processes because it must achieve high material and energy efficiency to be economically competitive. This paper considers co-location of simultaneous scarification and co-fermentation of wood, hydrothermal liquefaction of forest residues and gasification of black liquor with an existing Kraft pulp mill in Central North Island of New Zealand. Result shows that the Kraft pulp mill is the most profitable biorefinery option, followed by hydrothermal liquefaction. However, an increment in the price of bio-oil by 5 % puts hydrothermal liquefaction in the optimal network with Kraft pulp mill.

year: 2017

title: Imagining our own approaches

authors: Smith, Linda Tuhiwai

abstract: I spent some formative years of my life either in the back of museums or their basements helping my father, a scholar of Māori Studies, and keeping myself out of trouble. In the late 1960s I had one small job in the library basement of the Peabody Museum in Salem, Massachusetts, typing new labels for the captains’ log books of ships that were sailing during the American Revolution. I read most of those journals that consisted of pages and pages of wind directions with the rare glimpse of an encounter with another ship or a list of supplies. Why were we there in Salem when we came from Aotearoa, New Zealand? We were there because Salem was the home base for ships that sailed into the Pacific and returned home with collections of materials from the various Pacific Islands countries they visited. My father was studying elaborately carved items from the Marquesa Islands that looked very much like Māori designs.

text: Imagining our own approaches I spent some formative years of my life either in the back of museums or their basements helping my father, a scholar of Māori Studies, and keeping myself out of trouble. In the late 1960s I had one small job in the library basement of the Peabody Museum in Salem, Massachusetts, typing new labels for the captains’ log books of ships that were sailing during the American Revolution. I read most of those journals that consisted of pages and pages of wind directions with the rare glimpse of an encounter with another ship or a list of supplies. Why were we there in Salem when we came from Aotearoa, New Zealand? We were there because Salem was the home base for ships that sailed into the Pacific and returned home with collections of materials from the various Pacific Islands countries they visited. My father was studying elaborately carved items from the Marquesa Islands that looked very much like Māori designs.

year: 2015