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Psycho-oncology Aug 2023Childhood cancer may negatively impact childhood cancer survivors' (CCS) sexuality. However, this is an understudied research area. We aimed to describe the psychosexual...
OBJECTIVES
Childhood cancer may negatively impact childhood cancer survivors' (CCS) sexuality. However, this is an understudied research area. We aimed to describe the psychosexual development, sexual functioning and sexual satisfaction of CCS, and identify determinants for these outcomes. Secondarily, we compared the outcomes of a subsample of emerging adult CCS to the Dutch general population.
METHODS
From the Dutch Childhood Cancer Survivor Study LATER cohort (diagnosed 1963-2001), 1912 CCS (18-71 years, 50.8% male) completed questions on sexuality, psychosocial development, body perception, mental and physical health. Multivariable linear regressions were used to identify determinants. Sexuality of CCS age 18-24 (N = 243) was compared to same-aged references using binomial tests and t-tests.
RESULTS
One third of all CCS reported hindered sexuality due to childhood cancer, with insecure body the most often reported reason (44.8%). Older age at study, lower education, surviving central nervous system cancer, poorer mental health and negative body perception were identified as determinants for later sexual debut, worse sexual functioning and/or sexual satisfaction. CCS age 18-24 showed significantly less experience with kissing (p = 0.014), petting under clothes (p = 0.002), oral (p = 0.016) and anal sex (p = 0.032) when compared to references. No significant differences with references were found for sexual functioning and sexual satisfaction, neither among female CCS nor male CCS age 18-24.
CONCLUSIONS
Emerging adult CCS reported less experience with psychosexual development, but similar sexual functioning and sexual satisfaction compared to references. We identified determinants for sexuality, which could be integrated in clinical interventions for CCS at risk for reduced sexuality.
Topics: Adult; Child; Humans; Male; Female; Cancer Survivors; Neoplasms; Orgasm; Survivors; Sexual Behavior; Sexuality; Psychosexual Development
PubMed: 37365748
DOI: 10.1002/pon.6181 -
Molecular and Cellular Endocrinology May 2018Differences between males and females are widely represented in nature. There are gender differences in phenotypes, personality traits, behaviors and interests,... (Review)
Review
Differences between males and females are widely represented in nature. There are gender differences in phenotypes, personality traits, behaviors and interests, cognitive performance, and proneness to specific diseases. The most marked difference in humans is represented by sexual orientation and core gender identity, the origins of which are still controversial and far from being understood. Debates continue on whether sexual behavior and gender identity are a result of biological (nature) or cultural (nurture) factors, with biology possibly playing a major role. The main goal of this review is to summarize the studies available to date on the biological factors involved in the development of both sexual orientation and gender identity. A systematic search of published evidence was performed using Medline (from January 1948 to June 2017). Review of the relevant literature was based on authors' expertise. Indeed, different studies have documented the possible role and interaction of neuroanatomic, hormonal and genetic factors. The sexual dimorphic brain is considered the anatomical substrate of psychosexual development, on which genes and gonadal hormones may have a shaping effect. In particular, growing evidence shows that prenatal and pubertal sex hormones permanently affect human behavior. In addition, heritability studies have demonstrated a role of genetic components. However, a convincing candidate gene has not been identified. Future studies (e.i. genome wide studies) are needed to better clarify the complex interaction between genes, anatomy and hormonal influences on psychosexual development.
Topics: Animals; Brain; Female; Gender Identity; Genes; Gonadal Steroid Hormones; Humans; Male; Models, Animal; Sexual Behavior
PubMed: 28847741
DOI: 10.1016/j.mce.2017.08.008 -
Annual Review of Clinical Psychology May 2022Defined as congenital conditions in which development of chromosomal, gonadal, or anatomic sex is atypical, differences or disorders of sex development (DSDs) comprise... (Review)
Review
Defined as congenital conditions in which development of chromosomal, gonadal, or anatomic sex is atypical, differences or disorders of sex development (DSDs) comprise many discrete diagnoses ranging from those associated with few phenotypic differences between affected and unaffected individuals to those where questions arise regarding gender of rearing, gonadal tumor risk, genital surgery, and fertility. Controversies exist in numerous areas including how DSDs are conceptualized, how to refer to the set of conditions and those affected by them, and aspects of clinical management that extend from social media to legislative bodies, courts of law, medicine, clinical practice, and scholarly research in psychology and sociology. In addition to these aspects, this review covers biological and social influences on psychosocial development and adjustment, the psychosocial and psychosexual adaptation of people born with DSDs, and roles for clinical psychologists in the clinical management of DSDs.
Topics: Disorders of Sex Development; Female; Gender Identity; Humans; Male; Sexual Development
PubMed: 35216524
DOI: 10.1146/annurev-clinpsy-081219-101412 -
Psychoanalytic Review Jun 2018The author uses Lacanian psychoanalysis to conceptualize transgender embodiment, focusing on the Lacanian concept "objet a" to analyze how transpeople may be uniquely... (Review)
Review
The author uses Lacanian psychoanalysis to conceptualize transgender embodiment, focusing on the Lacanian concept "objet a" to analyze how transpeople may be uniquely attuned to a fundamental lack in being endemic to all subjects of language. Objet a is central to the Imaginary register where body images and sex morphology intermingle. The author discusses objet a in relation to the mirror (and the Other's cisgender gaze), anxiety, postsurgical scars, linguistics, and Thing-like feelings of monstrosity (born of transphobia). For those who are transgender, the a may register as an embodied disjunction between gender identity and natal sex assignment.
Topics: Body Image; Female; Gender Identity; Humans; Male; Psychoanalytic Theory; Transgender Persons; Transsexualism
PubMed: 29791263
DOI: 10.1521/prev.2018.105.3.303 -
Clinical Imaging Dec 2021Transgender women are increasingly evaluated in breast imaging centers. Radiologists should be familiar with a range of imaging findings related to feminizing hormone... (Review)
Review
Transgender women are increasingly evaluated in breast imaging centers. Radiologists should be familiar with a range of imaging findings related to feminizing hormone therapy and breast augmentations as well as benign and malignant lesions seen in this population. A growing body of literature has suggested that feminizing hormone therapy may increase the risk of breast cancer, prompting professional organizations to develop screening guidelines. The aim of this paper is to review common breast imaging findings in transgender women, recent data on the association between feminizing hormone therapy and breast cancer, and guidelines for breast cancer screening. Knowing these unique imaging features in transgender women is essential for providing competent care and reducing health care disparities.
Topics: Breast; Breast Neoplasms; Female; Gender Identity; Humans; Transgender Persons; Transsexualism
PubMed: 34455238
DOI: 10.1016/j.clinimag.2021.07.031 -
Obstetrics and Gynecology Jul 2022Transgender individuals face discrimination in several contexts and spaces, which exacerbates dysphoria and disparities in mental and physical well-being....
Transgender individuals face discrimination in several contexts and spaces, which exacerbates dysphoria and disparities in mental and physical well-being. Gender-exclusionary environments in the health care system lead to limitations in access to care and unaddressed health care needs. The full spectrum of gender is often not recognized in the field of medicine, which is predicated on the binary of male and female. Obstetrics and gynecology is societally viewed as a field for cisgender women, but transgender individuals can, and do, benefit from services offered by obstetricians and gynecologists. It is imperative that all specialties consider which aspects of care can be altered to promote the safety and health care of medically marginalized groups, including transgender patients. Alternative vocabulary to gendered language commonly used in medicine is discussed in three contexts: patient counseling, medical records, and institutional language. Understanding and using gender-inclusive language is an important step to create safer, respectful, affirming spaces for transgender people to receive medical care.
Topics: Female; Gender Identity; Gynecology; Humans; Male; Obstetrics; Pregnancy; Transgender Persons; Transsexualism
PubMed: 35849468
DOI: 10.1097/AOG.0000000000004803 -
JAMA Network Open Jun 2022Although LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority) physicians experience bias in the workplace, there is a paucity of...
IMPORTANCE
Although LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority) physicians experience bias in the workplace, there is a paucity of data on the experiences of physicians who identify specifically as transgender and/or gender expansive (TGE; gender expansive is an umbrella term encompassing individuals and gender identities that may exist beyond the binary framework [eg, may include nonbinary, genderqueer, and agender individuals]).
OBJECTIVES
To explore the professional experiences of TGE physicians, identify barriers to inclusion, and highlight stakeholder-derived strategies that promote an inclusive workplace.
DESIGN, SETTING, AND PARTICIPANTS
This qualitative study informed by semistructured interviews was conducted among 24 TGE physicians in the US from April 1 to December 31, 2021. The sample of TGE physicians was recruited using convenience and snowball sampling. Interviews were recorded and transcribed. Using thematic analysis, at least 2 members of the research team performed blinded coding of each transcript, in an iterative process.
MAIN OUTCOMES AND MEASURES
Data collection and thematic analysis examining themes of physicians' experiences.
RESULTS
Among 24 physicians (mean [SD] age, 39 [1.4] years) interviewed, 8 (33%) self-identified as transgender women, 7 (29%) as transgender men, 4 (17%) as nonbinary, 3 (13%) as transgender and nonbinary, and 2 (8%) as genderqueer. Prominent themes of the interviews included emotional distress as a result of transphobia, dominance of a rigid binary gender paradigm, and structural and institutional factors that are associated with psychological and physical safety and feelings of isolation as a TGE physician. Clear steps of affirmation were identified that could mitigate the emotional stressors, including signs of safety, active allyship, and mentorship by other TGE physicians.
CONCLUSIONS AND RELEVANCE
In this qualitative study, TGE physicians reported facing both overt and subtle biases associated with their identity and gender presentation. Participants also noted several interpersonal and structural factors that mitigate the effect of these biases.
Topics: Adult; Female; Gender Identity; Humans; Male; Physicians; Sexual and Gender Minorities; Transgender Persons; Transsexualism
PubMed: 35767255
DOI: 10.1001/jamanetworkopen.2022.19791 -
Endocrine Practice : Official Journal... Dec 2019The objective of this article is to describe the hormonal pathways required for breast development in cisgender women and to review the current available literature... (Review)
Review
The objective of this article is to describe the hormonal pathways required for breast development in cisgender women and to review the current available literature describing breast growth and breast cancer risk in transgender women. Literature review and discussion. Early mammary tissue development occurs prenatally. This process is hormone-independent and occurs similarly in males and females. Breast tissue is quiescent until puberty, at which time surging estrogen levels in cisgender girls mediate breast development and growth. Adult breast tissue composition further evolves in cisgender women during pregnancy, lactation, and menopause, revealing the ever-changing interplay between breast structure and hormonal environment. Breast growth is a significant physical endpoint in the hormonal treatment of transgender women. Transgender hormone regimens, which typically pair an estrogen with an anti-androgen, can help achieve this goal.
Topics: Adult; Breast; Estrogens; Female; Gender Identity; Humans; Male; Sexual Maturation; Transgender Persons; Transsexualism
PubMed: 31412232
DOI: 10.4158/EP-2019-0183 -
Journal of Forensic Sciences Mar 2020Researchers have examined a number of typologies of juvenile sex offenders, including victim age. Using data from psychological evaluations and the Multiphasic Sex...
Researchers have examined a number of typologies of juvenile sex offenders, including victim age. Using data from psychological evaluations and the Multiphasic Sex Inventory-II (MSI-II; [Psychological assessment of sex offenders, 2010]), this study compared child offenders (i.e., victims were more than 4 years younger), peer offenders (i.e., victims were 4 years younger or less), and mixed offenders (i.e., both child and peer victims) on variables including victim, offender, and offense characteristics, and psychosexual development. Peer offenders had more severe sexual offenses, prior status/nonviolent charges, and issues with sexual functioning. Mixed offenders began offending at a younger age and were indiscriminate in gender and relationship of the victim. Mixed offenders were also more likely than child and peer offenders to have prior sex offender treatment, meaning they had previously failed treatment. As juvenile sex offenders are a heterogeneous group, these research findings suggest that child offenders, peer offenders, and mixed offenders' treatment needs differ from each other.
Topics: Adolescent; Child; Crime Victims; Criminals; Female; Forensic Psychiatry; Humans; Juvenile Delinquency; Male; Psychosexual Development; Sex Offenses; Young Adult
PubMed: 31532844
DOI: 10.1111/1556-4029.14194 -
Psychiatria Danubina Sep 2015Teen suicide is a major public health problem. In the United States, it is the third cause of death among the 10-24 year olds. Adolescence involves numerous changes,... (Review)
Review
BACKGROUND
Teen suicide is a major public health problem. In the United States, it is the third cause of death among the 10-24 year olds. Adolescence involves numerous changes, whether physical, social, emotional or hormonal. At a neurobiological level, a teenager's nervous system is also affected and undergoes significant modifications.
SUBJECTS AND METHODS
We conducted a systematic review of electronic literature published between January 1990 and August 2014 via MEDLINE, PubMED and PsychINFO to list articles concerning the risk of teen depression and suicide risks in adolescents as well as those relating to the adolescent's neuro-anatomical brain and the effect that puberty has on it.
RESULTS AND DISCUSSION
When analyzing the various studies, it is clear that all support the idea that adolescence is a special period, both at neuroanatomical and biological levels. The risk of impulsiveness and depression is explained, anatomically, by a faster maturation of the limbic system, and biologically, by a higher sensitivity of the serotoninergic system and to glucocorticoids, which themselves are influenced by the specific hormonal environment during this period. Moreover and above all, adolescence is a vulnerable time for many reasons: physical, hormonal, social, cognitive, and emotional changes, self-development, etc. We should not restrict it to structural neurological changes without taking into account the other factors or compartmentalize young people into a reductive model based on determinism.
CONCLUSIONS
Adolescence is a time of change, transformation, and adaptation. The hormonal events that occur during this period have significant effects on brain development, neuro-cerebral chemistry, adolescent behavior and risks of depression. It is important to try to prevent suicide and depression in adolescents considering its entirety and complexity but also by paying attention to neuro-biological factors even if, at present, many research projects are currently underway to develop an appropriate drug therapy strategy.
Topics: Adolescent; Brain; Depressive Disorder; Female; Gonadal Steroid Hormones; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Male; Pituitary-Adrenal System; Psychosexual Development; Puberty; Suicide; Suicide Prevention
PubMed: 26417784
DOI: No ID Found