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How to begin : an introduction to the book / Michael R. Kauth and Jillian C. Shipherd -- Scientific and cultural perspectives on the gender binary / Major Laura Johnson -- The intersectionality of minority identities and health / John R. Blosnich -- Providing a welcoming clinic environment / Bryan N. Cochran, Oakleigh M. Reed, and Hillary Gleason -- Supporting the transgender individual in deciding their pathway / Ruben A. Hopwood -- Preparing clients for hormone therapy / Anthony Firek and Ranya Sawan-Garcia -- The high-risk client : comorbid conditions that affect care / Collen A. Sloan, and Joshua Safer -- Dialectical behavior therapy as a treatment option for complex cases of gender dysphoria / Colleen A. Sloan and Danielle S. Berke -- Pursuing gender transitioning surgeries / Loren S. Schechter and Rebecca B. Schechter -- Adjunctive interventions : supportive services for gender role transitions / Anne L. Boedecker -- Identity and support letters / Colt Keo-Meier, Kelly Ducheny, and Michael L. Hendricks -- Finding additional resources / Zander Keig and Jamison Green -- Sexual health among transgender people / Ladawn Sheffield and Alex S. Keuroghlian -- Implementing a transgender care policy in a national healthcare system / Jillian C. Shipherd, Michael R. Kauth, and George Brown.

BACKGROUND: Transgender individuals are overrepresented among Veterans. However, little is known regarding their satisfaction with Veterans Administration (VA) care and unmet health needs. OBJECTIVES: This study examined transgender Veterans' satisfaction with VA medical and mental health care, prevalence of delaying care, and correlates of these outcomes. RESEARCH DESIGN: We used data from transgender Veterans collected in 2014 through an online, national survey. SUBJECTS: In total, 298 transgender Veterans living in the United States. MEASURES: We assessed patient satisfaction with VA medical and mental health care and self-reported delays in seeking medical and mental health care in the past year. Potential correlates associated with these 4 outcomes included demographic, health, and health care variables. RESULTS: Over half of the sample used VA (56%) since their military discharge. Among transgender Veterans who had used VA, 79% were satisfied with medical care and 69% with mental health care. Lower income was associated with dissatisfaction with VA medical care, and being a transgender man was associated with dissatisfaction with VA mental health care. A substantial proportion reported delays in seeking medical (46%) or mental (38%) health care in the past year (not specific to VA). Screening positive for depression and/or posttraumatic stress disorder was associated with delays in seeking both types of care. CONCLUSIONS: Although the majority of transgender Veterans are satisfied with VA health care, certain subgroups are less likely to be satisfied with care. Further, many report delaying accessing care, particularly those with depression and/or posttraumatic stress disorder symptoms. Adapting health care settings to better engage these vulnerable Veterans may be necessary.

There has been a call to identify populations who are at-risk for harassment. At our institution, participant-perpetrated harassment led to the development of an institution-wide program called Cultivating Respect in Research Environments (CuRRE). In this article, we describe the proactive and multipronged approach used to promote and implement the CuRRE program. We describe a policy created to set guidelines and expectations for research participants and discuss the educational and skills-based trainings delivered to principal investigators and research staff members. Research staff members completed anonymous surveys before and after the training. Over half of the attendees reported having been harassed by a participant/patient. Attendees responded favorably to the training; they felt more confident and better equipped to address participant-perpetrated harassment at the conclusion of the training. Given the dearth of literature in this area, we offer our experiences to encourage others to address this issue within their own research environment and institution.