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Archives of Sexual Behavior Jul 2023Gender transition is undertaken to improve the well-being of people suffering from gender dysphoria. However, some have argued that the evidence supporting medical...
Gender transition is undertaken to improve the well-being of people suffering from gender dysphoria. However, some have argued that the evidence supporting medical interventions for gender transition (e.g., hormonal therapies and surgery) is weak and inconclusive, and an increasing number of people have come forward recently to share their experiences of transition regret and detransition. In this essay, I discuss emerging clinical and research issues related to transition regret and detransition with the aim of arming clinicians with the latest information so they can support patients navigating the challenges of regret and detransition. I begin by describing recent changes in the epidemiology of gender dysphoria, conceptualization of transgender identification, and models of care. I then discuss the potential impact of these changes on regret and detransition; the prevalence of desistance, regret, and detransition; reasons for detransition; and medical and mental healthcare needs of detransitioners. Although recent data have shed light on a complex range of experiences that lead people to detransition, research remains very much in its infancy. Little is known about the medical and mental healthcare needs of these patients, and there is currently no guidance on best practices for clinicians involved in their care. Moreover, the term detransition can hold a wide array of possible meanings for transgender-identifying people, detransitioners, and researchers, leading to inconsistences in its usage. Moving forward, minimizing harm will require conducting robust research, challenging fundamental assumptions, scrutinizing of practice patterns, and embracing debate.
Topics: Humans; Transgender Persons; Transsexualism; Gender Identity; Uncertainty; Gender Dysphoria; Emotions
PubMed: 37266795
DOI: 10.1007/s10508-023-02626-2 -
Zeitschrift Fur Kinder- Und... Sep 2023
Topics: Adolescent; Child; Humans; Transgender Persons; Adolescent Psychiatry; Transsexualism
PubMed: 37681654
DOI: 10.1024/1422-4917/a000943 -
Plastic and Reconstructive Surgery Jul 2023Lasting regret after gender-affirming surgery (GAS) is a difficult multifaceted clinical scenario with profound effects on individual well-being as well as being a...
BACKGROUND
Lasting regret after gender-affirming surgery (GAS) is a difficult multifaceted clinical scenario with profound effects on individual well-being as well as being a politically charged topic. Currently, there are no professional guidelines or standards of care to help providers and patients navigate this entity. This article summarizes the authors' Transgender Health Program's cohesive multidisciplinary lifespan approach to mitigate, evaluate, and treat any form of temporary or permanent regret after GAS.
METHODS
A multidisciplinary (primary care, pediatric endocrinology, psychology, social work, plastic surgery, urology, gynecology, and bioethics) workgroup including cisgender, transgender, and gender-diverse professionals met for a duration of 14 months. The incidence of individuals who underwent GAS at the authors' program between 2016 and 2021 and subsequently expressed desire to reverse their gender transition was reported.
RESULTS
Among 1989 individuals who underwent GAS, six (0.3%) either requested reversal surgery or transitioned back to their sex assigned at birth. A multidisciplinary assessment and care pathway for patients who request reversal surgery is presented in the article.
CONCLUSIONS
A care environment that welcomes and normalizes authentic expression of gender identity, affirms surgical goals without judgment, and destigmatizes the role of mental health in the surgical process are foundational to mitigating the occurrence of any form of regret. The authors hope this can provide a framework to distinguish normal postoperative distress from temporary forms of grief and regret and regret attributable to societal repercussions, surgical outcomes, or gender identity.
Topics: Child; Infant, Newborn; Humans; Male; Female; Sex Reassignment Surgery; Gender Identity; Transsexualism; Transgender Persons; Emotions; Patient Outcome Assessment
PubMed: 36727823
DOI: 10.1097/PRS.0000000000010243 -
Psychiatria Danubina Oct 2023Gender dysphoria (GD) describes individuals for whom the native sex and expressed gender are not coincident and most of them self-identify as transgender women or men.... (Review)
Review
Gender dysphoria (GD) describes individuals for whom the native sex and expressed gender are not coincident and most of them self-identify as transgender women or men. It has been shown that genetic factors play an important role in GD and the presence of specific genetic variants in candidate genes could be correlated. On the other hand, twins studies have estimated its heritability. In this review, we collect and report the available data obtained by different molecular genetic studies.
Topics: Male; Humans; Female; Gender Dysphoria; Gender Identity; Transsexualism; DNA
PubMed: 37800223
DOI: No ID Found -
Cell Mar 2024Dr. Shirin Heidari is the lead author of the Sex and Gender Equity in Research (SAGER) guidelines. In this interview with Dr. Isabel Goldman at Cell, she discusses her...
Dr. Shirin Heidari is the lead author of the Sex and Gender Equity in Research (SAGER) guidelines. In this interview with Dr. Isabel Goldman at Cell, she discusses her research, GENDRO, the SAGER guidelines and importance of considering sex- and gender-related variables in research, and her work on sexual and reproductive health in forced displacement.
Topics: Female; Humans; Male; Gender Identity; Guidelines as Topic; Sex; Health Equity
PubMed: 38490177
DOI: 10.1016/j.cell.2024.01.046 -
Expert Review of Anti-infective Therapy 2023Candida auris is a pathogen of growing public health concern given its rapid spread across the globe, its propensity for long-term skin colonization and... (Review)
Review
INTRODUCTION
Candida auris is a pathogen of growing public health concern given its rapid spread across the globe, its propensity for long-term skin colonization and healthcare-related outbreaks, its resistance to a variety of antifungal medications, and the high morbidity and mortality associated with invasive disease. Despite that, the host immune response mechanisms that operate during C. auris skin colonization and invasive infection remains poorly understood.
AREAS COVERED
In this manuscript, we review the available literature in the growing research field pertaining to C. auris host defenses and we discuss what is known about the ability of C. auris to thrive on mammalian skin, the role of lymphoid cell-mediated, IL-17-dependent defenses in controlling cutaneous colonization, and the contribution of myeloid phagocytes in curtailing systemic infection.
EXPERT OPINION
Understanding the mechanisms by which the host immune system responds to and controls colonization and infection with C. auris and developing a deeper knowledge of tissue-specific host-C. auris interactions and of C. auris immune-evading mechanisms may help devise improved strategies for decolonization, prognostication, prevention, vaccination, and/or directed antifungal treatment in vulnerable patient populations.
Topics: Animals; Humans; Candida; Candidiasis; Candida auris; Antifungal Agents; Defense Mechanisms; Mammals
PubMed: 37753840
DOI: 10.1080/14787210.2023.2264500 -
Neuroscience and Biobehavioral Reviews Sep 2023Sex/gender differences in cognitive sciences are riddled by conflicting perspectives. At the center of debates are clinical, social, and political perspectives. Front... (Review)
Review
Sex/gender differences in cognitive sciences are riddled by conflicting perspectives. At the center of debates are clinical, social, and political perspectives. Front and center, evolutionary and biological perspectives have often focused on 'nature' arguments, while feminist and constructivist views have often focused on 'nurture arguments regarding cognitive sex differences. In the current narrative review, we provide a comprehensive overview regarding the origins and historical advancement of these debates while providing a summary of the results in the field of sexually polymorphic cognition. In so doing, we attempt to highlight the importance of using transdisciplinary perspectives which help bridge disciplines together to provide a refined understanding the specific factors that drive sex differences a gender diversity in cognitive abilities. To summarize, biological sex (e.g., birth-assigned sex, sex hormones), socio-cultural gender (gender identity, gender roles), and sexual orientation each uniquely shape the cognitive abilities reviewed. To date, however, few studies integrate these sex and gender factors together to better understand individual differences in cognitive functioning. This has potential benefits if a broader understanding of sex and gender factors are systematically measured when researching and treating numerous conditions where cognition is altered.
Topics: Female; Humans; Male; Gender Identity; Sex Factors; Sexual Behavior; Cognition; Gonadal Steroid Hormones; Sex Characteristics
PubMed: 37517542
DOI: 10.1016/j.neubiorev.2023.105333 -
Current Opinion in Psychology Dec 2023The U.S. is plagued by a variety of societal divides across political orientation, race, and gender, among others. Listening has the potential to be a key element in... (Review)
Review
The U.S. is plagued by a variety of societal divides across political orientation, race, and gender, among others. Listening has the potential to be a key element in spanning these divides. Moreover, the benefits of listening for mitigating social division has become a culturally popular idea and practice. Recent evidence suggests that listening can bridge divides in at least two ways: by improving outgroup sentiment and by granting outgroup members greater status and respect. When reviewing this literature, we pay particular attention to mechanisms and to boundary conditions, as well as to the possibility that listening can backfire. We also review a variety of current interventions designed to encourage and improve listening at all levels of the culture cycle. The combination of recent evidence and the growing popular belief in the significance of listening heralds a bright future for research on the many ways that listening can diffuse stereotypes and improve attitudes underlying intergroup division.
Topics: Humans; Attitude; Cognition; Gender Identity
PubMed: 37897952
DOI: 10.1016/j.copsyc.2023.101696 -
The International Journal of... Feb 2024This paper describes the anxiety evoked in a patient threatened by invasion or engulfment by his object on the one hand, and the fears of isolation and abandonment on...
This paper describes the anxiety evoked in a patient threatened by invasion or engulfment by his object on the one hand, and the fears of isolation and abandonment on the other. The author illustrates the patient's strugles to find a distance between himself and his object he can tolerate. The analyst has also to cope with the anxieties evoked by the patient's projections, and find a distance between himself and his patient that enables him to think and work.
Topics: Male; Humans; Anxiety; Fear; Projection
PubMed: 38470288
DOI: 10.1080/00207578.2023.2286753 -
AMA Journal of Ethics Nov 2023This essay connects loneliness with health problems and argues that both are comorbid with authoritarian politics. Although an old idea from Plato and Aristotle, this...
This essay connects loneliness with health problems and argues that both are comorbid with authoritarian politics. Although an old idea from Plato and Aristotle, this problem takes an acute shape in the contemporary world, as argued by Hegel, Hannah Arendt, and Kate Manne, and has a gendered dimension, as men are lonelier than women. This article also attends, briefly, to empirical material about loneliness in the contemporary world.
Topics: Male; Humans; Female; Loneliness; Gender Identity; Politics
PubMed: 38085591
DOI: 10.1001/amajethics.2023.850