Background: Healthcare plays a vital role in the health and quality of life of transgender people, particularly those who wish to medically and/or surgically transition. In these cases, healthcare experiences can have a significant impact on the transgender person’s perception of healthcare and future interactions with the healthcare system. Aim: To explore and systematically review the literature related to transgender peoples’ experiences and perspectives of general healthcare. Methods: A systematic search of MEDLINE, CINAHL, Scopus, Web of Science, Informit, and PsycINFO was performed according to established search strategies. Results were screened for eligibility in two parts. Titles and abstracts were screened for relevance, and then full-texts were retrieved and screened using eligibility criteria, resulting in 20 articles of primary research included in the review. Data were extracted from the studies and thematically analyzed to synthesize findings. Results: Four main themes were identified relating to healthcare provider (HCP) knowledge, HCP communication, relationship dynamics, and healthcare systems. These reflected a subtheme of perceived underlying cisnormativity and transphobia which influenced transgender patients’ interactions with the healthcare system. Participants also provided suggestions for improved care experiences. Discussion: Findings from prior studies and reviews about other transgender healthcare related topics describe similar themes and recommendations from participants. This reflects an impetus towards shared dialog and compromise between HCPs, policy makers and transgender patients to listen to each other’s experiences and work collaboratively to improve transgender healthcare. Further research is necessary to explore and target geographic, demographic, and specific healthcare aspects regarding potential implementation of these recommendations.

Objective: To describe the proportion of 16–29‐year‐olds tested for chlamydia by Australian general practitioners in a 12‐month period. Design and setting: Between October 2007 and September 2008, the national chlamydia testing rate in 16–29‐year‐olds was calculated by dividing the number of Medicare‐reimbursed chlamydia tests by two denominators: (i) Medicare‐reimbursed GP consultations; and (ii) estimated resident populations adjusted for the proportion who were sexually active. Main outcome measures: GP chlamydia testing rates in 16–29‐year‐olds per 100 patients attending a GP consultation and per 100 sexually active population, by patient age and sex, state/territory of residence, and remoteness area. Results: Among the estimated Australian population of 16–29‐year‐olds, 85.6% of females and 64.4% of males had at least one GP consultation in the 12‐month period. The national GP chlamydia testing rate per 100 patients was 8.9% (95% CI, 8.88%–8.94%). The national GP chlamydia testing rate per 100 sexually active population was 8.0% (95% CI, 7.92%–7.98%). The rate per 100 sexually active population was higher in females (12.5%) compared with males (3.7%) (P < 0.01); higher in 20–24‐year‐olds (9.0%) compared with 16–19‐year‐olds (8.7%) and 25–29‐year‐olds (6.6%) (P < 0.01); higher in those living in non‐metropolitan areas (11.0%) compared with metropolitan areas (8.4%) (P < 0.01); and highest in those living in the Northern Territory (21.4%) compared with other jurisdictions (P < 0.01). Conclusions: Despite clinical guidelines recommending annual chlamydia testing for sexually active 15–29‐year‐olds, our analysis showed that a high proportion of young people aged 16–29 years attend a GP each year, but few of the sexually active population in this age group were tested for chlamydia in general practice. Strategies are needed to support GPs to enhance chlamydia testing in young people.

Objective To compare standard management of keeping wounds dry and covered with allowing wounds to be uncovered and wet in the first 48 hours after minor skin excision. Design Prospective, randomised controlled, multicentre trial testing for equivalence of infection rates. Setting Primary care in regional centre, Queensland, Australia. Participants 857 patients randomised to either keep their wound dry and covered (n = 442) or remove the dressing and wet the wound (n = 415). Results The incidence of infection in the intervention group (8.4%) was not inferior to the incidence in the control group (8.9%) (P < 0.05). The one sided 95% confidence interval for the difference of infection rates was ∞ to 0.028. Conclusion These results indicate that wounds can be uncovered and allowed to get wet in the first 48 hours after minor skin excision without increasing the incidence of infection.

Objective: To determine the incidence of and risk factors for surgical site infections in general practice. Design: Prospective, observational study of patients presenting for minor excisions. Settin...