While recognition of transgender people has increased in Vietnam, this population continues to face significant stigma and discrimination within their families and in public, including in medical settings. Understanding of transgender health is limited, especially regarding the provision of care to transgender people. This paper explores providers’ preparedness for delivering transgender care using data from qualitative interviews with twelve healthcare professionals in Hanoi and Ho Chi Minh City. Drawing on the socio-ecological model, we illustrated multi-level factors that influenced the provision of medical services to transgender people, including restrictive legislation (policy level); shortage of transgender-specific services, and lack of training and guidelines (organisational level); and ambiguous perceptions, inappropriate provider-patient communication, and medical knowledge gaps (individual level). Overall, our study has identified a healthcare environment that is under-prepared to meet the complex health needs of transgender individuals. With this study, we call for intervention strategies beyond individual-level support and emphasise the urgency of allowing medical institutions to provide transgender-specific health services including gender-affirming surgery and hormonal treatments.

In Vietnam, it is commonly believed that gender norms, sex labour segregation, and structural organization of social institutions often favour male dominance while restricting women’s roles in domestic spheres. However, there is a scant literature of Vietnamese scholarship on the determinants of gender role attitudes, especially geographical disparities. This paper aims to fill this void by using a nationally representative survey with 8288 respondents. Our findings suggested that age, marital status, religion, education, living area, region, ethnicity, and personal monthly income are the factors that predicted gender attitudes. In terms of regional disparities, we found that Northerners were more permissive in their gender attitudes than Southerners, which may be explained by distinct historical and political trajectories in Northern and Southern Vietnam during the last century. There were, however, inconsistent patterns among different age cohorts whereby region significantly impacted the attitudes of women born before the end of the French War in 1954, men born after the Reunification in 1975, as well as both men and women born between 1954 and 1975.

Genetic counsellors (GCs) across the world are increasingly transitioning beyond clinical genetics services to meet the growing demands for genomic healthcare. This presents a unique opportunity for GCs to be ‘genomic change agents’ as they work in alternative models of care. Through various innovative models of mainstream care funded through a change program, we explored the views of GCs regarding their position as ‘genomic change agents’ and what may hinder or drive the success of their evolving roles. Guided by the Diffusion of Innovation Theory, we conducted qualitative interviews with all twelve GCs employed by the change program in different models of providing genomics across five specialties in Australia. Audio-recordings of all interviews were transcribed verbatim and analysed using inductive content analysis. Findings show that early in these new roles, participants held varied descriptions of ‘genomics mainstreaming’: some envisioned it as an end state exclusive to medical specialists practicing genomics while others saw the involvement of GCs as crucial. Participants believed they were uniquely positioned to expedite patient access to genomic testing and counselling and enhance medical specialists’ capability to use genomics. Challenges included hesitancy of some medical specialists regarding the value of genomics in healthcare and potential tension arising from distinct perspectives and practice between genetic and non-genetic professionals. Participants anticipated a decline in the standard of care when non-genetic colleagues managed consent discussion and result disclosure. Our study underscores leadership support and peer connection with those in similar roles as essential elements for GCs’ success in mainstream settings.

Protecting the rights of the lesbians, gays, bisexuals, transgender, intersex, and queers (LGBTIQ) population requires, first and foremost, a proper understanding of their sexual orientation and gender identity. This study highlights a severe misunderstanding and lack of knowledge among health professionals in Vietnam with regard to the men who have sex with men (MSM) and transgenders. This study uses (i) a survey based on the convenience sampling method among 150 health workers that covered 61 questions and (ii) 12 in-depth interviews in two metropolitan centres in Vietnam, Hanoi and Ho Chi Minh city. Three main topics are explored: (i) the general knowledge of healthcare workers about MSM and transgenders; (ii) their knowledge about the sexual reproductive health and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) risks of MSM and transgenders; and (iii) their attitudes and behaviors towards MSM and transgenders. One of the notable findings is how prevalent the misperceptions are across the board, namely, in staff of both sexes, in both cities, at various kinds of medical facilities, at different work positions and educational levels. Half of the respondents consider transgenders to have a curable mental problem while 45% say MSM only have sex with males. Most remarkably, 12.7% state if they have any choice, they want nothing to do with MSM and transgenders. The study finds there is a considerable percentage of health professionals who lack knowledge about the diversity of sexual orientation, gender identity, and health issues related to the sexual minorities and gender non-conforming population. To improve the clinical process for serving these at-risk groups, the study suggests the continual education for the health workers needs to be added to their formal as well as in-job training.