Barriers and facilitators influencing access to primary eye care among transmasculine individuals in Canada: A qualitative analysis
Bibliographic record
Abstract
Background In Canada, transmasculine individuals may face unique barriers when accessing eye care which can lead to a delayed diagnosis and treatment of potentially serious conditions such as idiopathic intracranial hypertension (IIH).Purpose The purpose of this study was to identify barriers and facilitators to accessing eye care among transmasculine individuals in Canada. The findings aim to inform eye care providers regarding the provision of safe and affirming eye care for transgender patients.Methods An 8-item anonymous online survey was distributed through LGBTQIA+ community organizations in Canada. Inclusion criteria included individuals who identified as transmasculine and who were currently taking or had previously taken testosterone as part of gender-affirming care. Content themes were identified and independently confirmed.Results 49 participants were included in the analysis. The most common barrier to accessing eye care was lack of government financial assistance and/or lack of private insurance coverage. The most common facilitator to accessing care was an overtly gender affirming space.Conclusion While many case reports have suggested a link between testosterone gender-affirming therapy and IIH, further research is needed to determine the prevalence, incidence, and risk on an individual and population level. Optometry is well-poised to lead this research, but further action is needed within the profession to ensure transmasculine individuals can access eye care without barriers.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.015 | 0.005 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".