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Clinics in Chest Medicine Sep 2023Sex and gender impact risk factors, presentations of, and response to therapy in lung diseases such as chronic obstructive pulmonary disease, asthma, lung cancer,... (Review)
Review
Sex and gender impact risk factors, presentations of, and response to therapy in lung diseases such as chronic obstructive pulmonary disease, asthma, lung cancer, interstitial lung disease, and obstructive sleep apnea. Many physicians lack training in the impact of sex and gender on lung disease, resulting in diagnostic delays. Scales and indices taught in the health care system are largely validated in male populations, thereby limiting their application to females. For transgender and lesbian, gay, bisexual, transgender, and questioning + patients, high rates of bias in health care may limit patients' willingness to seek health care.
Topics: Female; Humans; Male; Gender Identity; Sexual and Gender Minorities; Delivery of Health Care; Lung Neoplasms; Lung
PubMed: 37517839
DOI: 10.1016/j.ccm.2023.03.014 -
BMC Public Health Sep 2023Sexual orientation refers to a person's enduring emotional, romantic, or sexual attractions to other people. Sexual orientation measures do not typically consider...
BACKGROUND
Sexual orientation refers to a person's enduring emotional, romantic, or sexual attractions to other people. Sexual orientation measures do not typically consider desires for, or sexual behavior with, transgender people. We describe measures inclusive of transgender people and characterize sexual orientation identity, behavior, and attraction in a representative sample of the U.S. transgender population.
METHODS
Between April 2016-December 2018, a U.S. national probability sample of transgender (n = 274) and cisgender (n = 1,162) adults were invited to complete a self-administered web or mailed paper survey. We assessed sexual identity with updated response options inclusive of recent identity terms (e.g., queer), and revised sexual behavior and attraction measures that included transgender people. Multiple response options were allowed for sexual behavior and attraction. Weighted descriptive statistics and sexual orientation differences by gender identity groups were estimated using age-adjusted comparisons.
RESULTS
Compared to the cisgender population, the transgender population was more likely to identify as a sexual minority and have heterogeneity in sexual orientation, behavior, and attraction. In the transgender population, the most frequently endorsed sexual orientation identities were "bisexual" (18.9%), "queer" (18.1%), and "straight" (17.6%). Sexually active transgender respondents reported diverse partners in the prior 5 years: 52.6% cisgender women (CW), 42.7% cisgender men (CM), 16.9% transgender women (TW), and 19.5% transgender men (TM); 27.7% did not have sex in the past 5 years. Overall, 73.6% were "somewhat"/ "very" attracted to CW, 58.3% CM, 56.8% TW, 52.4% TM, 59.9% genderqueer/nonbinary-females-at-birth, 51.9% genderqueer/nonbinary-males-at-birth. Sexual orientation identity, behavior, and attraction significantly differed by gender identity for TW, TM, and nonbinary participants (all p < 0.05).
CONCLUSIONS
Inclusive measures of sexual orientation captured diverse sexual identities, partner genders, and desires. Future research is needed to cognitively test and validate these measures, especially with cisgender respondents, and to assess the relation of sexual orientation and health for transgender people.
Topics: Female; Adult; Humans; Male; Transgender Persons; Gender Identity; Sexual Behavior; Sexual and Gender Minorities; Bisexuality
PubMed: 37715161
DOI: 10.1186/s12889-023-16654-z -
Child and Adolescent Psychiatric... Oct 2023Transgender and gender diverse (TGD) individuals face higher rates of stressors driving disproportionate health risks. Although psychiatric conditions are important to... (Review)
Review
Transgender and gender diverse (TGD) individuals face higher rates of stressors driving disproportionate health risks. Although psychiatric conditions are important to consider in the context of greater health-promoting efforts for TGD youth, any mental health concerns may or may not be related to gender identity or associated dysphoria. Nevertheless, it is essential to consider the impact of complex mental health factors on decisional capacity and gender care discussions. Psychiatric care of TGD youth includes stratifying risk factors through a minority stress lens, balancing acute needs with patient and caregiver priorities, and bolstering resilience using affirming care principles.
Topics: Male; Adolescent; Female; Humans; Transgender Persons; Gender Identity; Depressive Disorder, Major; Mental Health; Minority Groups
PubMed: 37739631
DOI: 10.1016/j.chc.2023.05.011 -
Psychoneuroendocrinology Sep 2023Sex-specific differences in brain connectivity were found in various neuroimaging studies, though little is known about sex steroid effects on insular functioning. Based...
BACKGROUND
Sex-specific differences in brain connectivity were found in various neuroimaging studies, though little is known about sex steroid effects on insular functioning. Based on well-characterized sex differences in emotion regulation, interoception and higher-level cognition, gender-dysphoric individuals receiving gender-affirming hormone therapy represent an interesting cohort to investigate how sex hormones might influence insular connectivity and related brain functions.
METHODS
To analyze the potential effect of sex steroids on insular connectivity at rest, 11 transgender women, 14 transgender men, 20 cisgender women, and 11 cisgender men were recruited. All participants underwent two magnetic resonance imaging sessions involving resting-state acquisitions separated by a median time period of 4.5 months and also completed the Bermond-Vorst alexithymia questionnaire at the initial and final examination. Between scans, transgender subjects received gender-affirming hormone therapy.
RESULTS
A seed based functional connectivity analysis revealed a significant 2-way interaction effect of group-by-time between right insula, cingulum, left middle frontal gyrus and left angular gyrus. Post-hoc tests demonstrated an increase in connectivity for transgender women when compared to cisgender men. Furthermore, spectral dynamic causal modelling showed reduced effective connectivity from the posterior cingulum and left angular gyrus to the left middle frontal gyrus as well as from the right insula to the left middle frontal gyrus. Alexithymia changes were found after gender-affirming hormone therapy for transgender women in both fantasizing and identifying.
CONCLUSION
These findings suggest a considerable influence of estrogen administration and androgen suppression on brain networks implicated in interoception, own-body perception and higher-level cognition.
Topics: Humans; Male; Female; Gender Dysphoria; Gender Identity; Transsexualism; Brain; Magnetic Resonance Imaging; Gonadal Steroid Hormones; Steroids
PubMed: 37499299
DOI: 10.1016/j.psyneuen.2023.106336 -
Journal of Homosexuality Jun 2024Despite the psychosocial strain of homonegative religious attitudes, many people with minoritized sexual identities also hold religious identities and benefit from...
Despite the psychosocial strain of homonegative religious attitudes, many people with minoritized sexual identities also hold religious identities and benefit from integrating their sexual minority and religious identities. However, for research and clinical practice to advance, a reliable and valid measure of sexual and religious identity integration is needed. The present study reports on the development and validation of the Sexual Minority and Religious Identity Integration (SMRII) Scale. Participants were comprised of two subsamples for whom sexual and religious identity is particularly salient (Latter-day Saints and Muslims) as well as a third subsample of the general sexual minority population-totaling 1,424 individuals (39% POC, 62% cisman, 27% ciswoman, 11% trans/non-binary/genderqueer). Exploratory and confirmatory factor analyses indicated that the 5-item scale measures a single unidimensional construct. This scale demonstrated good internal consistency in the total sample (α = .80) as well as metric and scalar invariance along relevant demographics. The SMRII also evidenced strong convergent and discriminant validity, significantly correlating with other measures of religious and sexual minority identity typically between = .2 and = .5. Taken together, initial findings indicate that the SMRII is a psychometrically sound measure that is brief enough to be utilized in research and clinical settings.: This article introduces the Sexual Minority and Religious Identity Integration Scale (SMRII) as a reliable and valid assessment of the degree to which individuals integrate their sexual minority and religious identities. This five-item measure is brief enough to be utilized in both research and clinical settings.
Topics: Humans; Sexual and Gender Minorities; Gender Identity; Minority Groups; Sexual Behavior; Islam
PubMed: 37140591
DOI: 10.1080/00918369.2023.2201870 -
Barriers and Facilitators to Gender-affirming Hormone Therapy in the Veterans Health Administration.Annals of Behavioral Medicine : a... Nov 2023In 2011, the Veterans Health Administration (VHA) established a policy for the delivery of transition-related services, including gender-affirming hormone therapy...
BACKGROUND
In 2011, the Veterans Health Administration (VHA) established a policy for the delivery of transition-related services, including gender-affirming hormone therapy (GAHT), for transgender and gender diverse (TGD) patients. In the decade since this policy's implementation, limited research has investigated barriers and facilitators of VHA's provision of this evidence-based therapy that can improve life satisfaction among TGD patients.
PURPOSE
This study provides a qualitative summary of barriers and facilitators to GAHT at the individual (e.g., knowledge, coping mechanisms), interpersonal (e.g., interactions with other individuals or groups), and structural (e.g., gender norms, policies) levels.
METHODS
Transgender and gender diverse patients (n = 30) and VHA healthcare providers (n = 22) completed semi-structured, in-depth interviews in 2019 regarding barriers and facilitators to GAHT access and recommendations for overcoming perceived barriers. Two analysts used content analysis to code and analyze transcribed interview data and employed the Sexual and Gender Minority Health Disparities Research Framework to organize themes into multiple levels.
RESULTS
Facilitators included having GAHT offered through primary care or TGD specialty clinics and knowledgeable providers, with patients adding supportive social networks and self-advocacy. Several barriers were identified, including a lack of providers trained or willing to prescribe GAHT, patient dissatisfaction with prescribing practices, and anticipated or enacted stigma. To overcome barriers, participants recommended increasing provider capacity, providing opportunities for continual education, and enhancing communication around VHA policy and training.
CONCLUSIONS
Multi-level system improvements within and outside the VHA are needed to ensure equitable and efficient access to GAHT.
Topics: Humans; Veterans Health; Gender Identity; Transgender Persons; Sexual and Gender Minorities; Hormones
PubMed: 37436725
DOI: 10.1093/abm/kaad035 -
Clinics in Geriatric Medicine May 2024Lesbian and bisexual (LB) women are a growing and understudied population in the United States. LB women have unique histories and health experiences and encounter... (Review)
Review
Lesbian and bisexual (LB) women are a growing and understudied population in the United States. LB women have unique histories and health experiences and encounter numerous resource and health care disparities that impact healthy aging. Despite LB population growth, little research has investigated the experiences of LB women separately from the broader lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity (LGBTQ+) community. The research that does exist largely focuses on the experiences of younger LB women. Nonetheless, there are unique care considerations providers can enact to improve clinical care and address lifetimes of disparities and discrimination.
Topics: Female; Humans; Male; United States; Gender Identity; Sexual and Gender Minorities; Healthcare Disparities
PubMed: 38521596
DOI: 10.1016/j.cger.2023.12.001 -
Current Nutrition Reports Dec 2023To synthesize differences in familial negative weight talk and health-related correlates across gender identities and to highlight gaps relevant to the unique... (Review)
Review
PURPOSE OF REVIEW
To synthesize differences in familial negative weight talk and health-related correlates across gender identities and to highlight gaps relevant to the unique experiences and health correlates of boys and transgender and gender diverse youth.
RECENT FINDINGS
Most of the studies included in this review observed no difference by gender in familial negative weight talk health correlates. Gender biases in existing measures, however, may have contributed to underreporting of health correlates in boys. Moreover, transgender and gender diverse youth are severely underrepresented in this research. Future research should consistently examine effect modification across gender identities and include measures that are specific to the weight-based concerns and experiences of boys and transgender and gender diverse youth.
Topics: Male; Adolescent; Humans; Gender Identity; Transgender Persons
PubMed: 37837600
DOI: 10.1007/s13668-023-00501-z -
Psychological Reports Oct 2023The notion of psychological androgyny as a research tool loiters on in an incapacitated state. The lack of a general theory and the belief that the biological gender... (Review)
Review
The notion of psychological androgyny as a research tool loiters on in an incapacitated state. The lack of a general theory and the belief that the biological gender differences are insignificant to non-existent has been the seeds for its de-construction. Over the decades, the testing of ideas associated with androgyny has declined. Indeed, the debates over its usefulness as a construct ended long ago. The judgment nowadays is that debating the constructs of masculinity, femininity, and androgyny as behavioral traits has been long settled, and a contemporary revisiting of androgyny is not warranted. However, from another contemporary viewpoint, if androgyny is to have any future, it needs a new theory devoid of masculinity and femininity. We present a novel theory with the potential to do just that. This article details a new de-gendered theory of psychological androgyny, neo-androgyny, as a candidate to replace traditional models that are now considered outdated and irrelevant. We present five potential factors for inclusion in a de-gendered model: social efficacy, creativity, capability, eminence, and determination. We review these factors concerning the future of androgyny theory.
Topics: Male; Female; Humans; Gender Identity; Masculinity; Creativity; Sex Factors
PubMed: 35343328
DOI: 10.1177/00332941221076759 -
Reproduction & Fertility Apr 2024The rights of transgender and intersex people have become a contentious issue in our current political climate. Whether it be the rights of intersex athletes such as...
The rights of transgender and intersex people have become a contentious issue in our current political climate. Whether it be the rights of intersex athletes such as Caster Semenya (who identifies as a woman) to compete in elite sport, or the rights of transgender women to use women's only spaces, there is an increasingly fierce debate as to the legitimacy of people's gender and sexual identities and what parameters should be used to define them. A common argument accepted by most in our society is that while gender may be a spectrum, sex is an inalienable binary.
Topics: Animals; Female; Humans; Gender Identity; Sports; Athletes; Transsexualism; Transgender Persons
PubMed: 38492308
DOI: 10.1530/RAF-24-0005