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Endocrine Practice : Official Journal... Apr 2022Gender-affirming surgeries are becoming increasingly common in the United States. For many transgender and gender-diverse patients, gender-affirming surgery is a... (Review)
Review
OBJECTIVE
Gender-affirming surgeries are becoming increasingly common in the United States. For many transgender and gender-diverse patients, gender-affirming surgery is a critical aspect of their overall health and wellness and has a significant impact on their social functioning. Although often the role of the primary care provider, endocrinology specialists may also need to counsel their patients and collaborate with surgical teams.
METHODS
This narrative review provides an overview of the preoperative assessment and perioperative management for the most common gender-affirming surgeries.
RESULTS
Preoperative assessment prior to gender-affirming surgeries can resemble assessment for other surgeries.
CONCLUSION
In the absence of data specific to gender-affirming surgeries, risk stratification and amelioration must use surrogate data from other populations.
Topics: Gender Identity; Humans; Perioperative Care; Sex Reassignment Surgery; Transgender Persons; Transsexualism; United States
PubMed: 35217191
DOI: 10.1016/j.eprac.2022.02.007 -
Zeitschrift Fur Kinder- Und... 2020Gender identities in transition In recent years, the healthcare system has been confronted with an increasing number of children and adolescents with gender... (Review)
Review
Gender identities in transition In recent years, the healthcare system has been confronted with an increasing number of children and adolescents with gender nonconformity, gender incongruence, and gender dysphoria. Medical professionals are still debating how to interpret this phenomenon and how best to meet the healthcare needs of this diverse group of young people. Meanwhile, the transgender and gender nonconforming youths themselves face enormous challenges in finding appropriate support and treatment in the mental healthcare system. This article reviews the available epidemiological data, the paradigm shift in the social, legal, and medical systems, the developments in diagnostic classifications (DSM-5, ICD-11) as well as important aspects of the AWMF S3 guideline for adults with gender incongruence and gender dysphoria. In addition, it describes the complexity of working with transgender, gender nonconforming, and gender-questioning youth in the context of the current discourse and the underlying ethical dilemmas. In conclusion, this article outlines the challenges facing child and adolescent psychiatry and psychotherapy in this complex environment.
Topics: Adolescent; Child; Delivery of Health Care; Gender Dysphoria; Gender Identity; Humans; Psychotherapy; Transgender Persons; Transsexualism
PubMed: 32162593
DOI: 10.1024/1422-4917/a000724 -
Revista Brasileira de Enfermagem 2022to identify scientific evidence on gender violence perpetrated against trans women. (Review)
Review
OBJECTIVES
to identify scientific evidence on gender violence perpetrated against trans women.
METHODS
integrative review, carried out in June 2020, without time frame, in the Scopus, MEDLINE, Embase, CINAHL, WoS, PsycInfo and LILACS databases. The controlled descriptors of DeCS, MeSH and their entry terms were used: "Transgender People", "Transgender", "Gender Identity", "Transsexuality", "Gender Violence", "Aggression", "Sexual Offenses", "Rape", "Violence", "Domestic Violence". The presentation and synthesis of the results were presented in the PRISMA-2009 flowchart.
RESULTS
the final sample, consisting of 16 articles, identified different types of violence (sexual, physical, verbal, psychological and financial), perpetrated by family members, strangers, police officers, intimate partners, health professionals, acquaintances, or friends.
CONCLUSIONS
trans women suffer violence and social exclusion that result from stigma and discrimination due to gender identity and result in unrestricted damage to physical health.
Topics: Domestic Violence; Female; Gender Identity; Gender-Based Violence; Humans; Intimate Partner Violence; Male; Sex Offenses; Transsexualism
PubMed: 35262561
DOI: 10.1590/0034-7167-2021-0173 -
Best Practice & Research. Clinical... Feb 2023Everyone has sexual rights and is entitled to enjoy sex, regardless of gender identity or expression. It is therefore encouraging to witness a recent growth in research... (Review)
Review
Everyone has sexual rights and is entitled to enjoy sex, regardless of gender identity or expression. It is therefore encouraging to witness a recent growth in research on sexuality in transgender individuals. We provide a short overview of extant research on sex and relationships in this population and argue that current research has mostly been conducted from a medical and functional approach; there is a strong focus on negative experiences and prevention; and there is a lack of data regarding psychological and socio-relational variables. Furthermore, many studies have been conducted in a cis- and hetero-normative setting and have methodological shortcomings such as applying questionnaires that have not been validated in a transgender population. We encourage researchers to expand their focus to positive variables such as sexual pleasure and (in accordance with the biopsychosocial model) investigate subjective experiences and relationship variables when studying sexuality in transgender individuals.
Topics: Humans; Male; Female; Gender Identity; Transsexualism; Sexual Behavior; Transgender Persons
PubMed: 36635133
DOI: 10.1016/j.bpobgyn.2022.102294 -
Brain Imaging and Behavior Aug 2020Gender identity development is complex and involves several key processes. Transgender people experience incongruence between their biological and identified gender.... (Review)
Review
Gender identity development is complex and involves several key processes. Transgender people experience incongruence between their biological and identified gender. This incongruence can cause significant impairment in overall functioning and lead to gender dysphoria (GD). The pathophysiology of GD is complex and is poorly understood. A PubMed search based on predetermined eligibility criteria was conducted to review neuropsychiatric articles focused on neurological, biological and neuroimaging aspects of gender development, transgender identity and GD. The information obtained from the literature was then used to formulize a GD model. Distinct gray matter volume and brain activation and connectivity differences were found in individuals with GD compared to controls, suggesting a neurobiological basis of GD; which leads to the concept of brain gender. Individuals with GD encounter a recurrent conflict between their brain gender and the societal feedback; which causes recurrent and ongoing cognitive dissonance, finally leading to GD and functional connectivity and activation changes in the transgender brain. GD has neurobiological basis, but it is closely associated with the individuals' interaction with the external world, their self-perception and the feedback received in return. We propose a novel model where the development of GD includes cognitive dissonance, involving anterior cingulate cortex and ventral striatum as the key brain structures. This model can be used to generate testable hypotheses using behavioral and neuroimaging techniques to understand the neuropsychobiology of GD.
Topics: Female; Gender Dysphoria; Gender Identity; Humans; Magnetic Resonance Imaging; Male; Neuroimaging; Transsexualism
PubMed: 31134582
DOI: 10.1007/s11682-019-00121-8 -
Perspectives on Psychological Science :... Mar 2023Opposition to gender-affirmative approaches to care for transgender youths by some clinicians has recently begun to consolidate around "gender exploratory therapy" as a...
Opposition to gender-affirmative approaches to care for transgender youths by some clinicians has recently begun to consolidate around "gender exploratory therapy" as a proposed alternative. Whereas gender-affirmative approaches follow the client's lead when it comes to gender, gender-exploratory therapy discourages gender affirmation in favor of exploring through talk therapy the potential pathological roots of youths' trans identities or gender dysphoria. Few detailed descriptions of the approach's parameters have been offered. In this article, I invite clinicians to reflect on gender-exploratory therapy through a series of questions. The questions are followed by an exploration of the strong conceptual and narrative similarities between gender-exploratory therapy and conversion practices. Finally, the ethical dimensions of gender-exploratory therapy are discussed from the lenses of therapeutic neutrality, patient-centered care, loving attention, and therapeutic alliance, suggesting that the approach may be unethical.
Topics: Adolescent; Humans; Transgender Persons; Gender Identity; Transsexualism; Gender Dysphoria
PubMed: 36068009
DOI: 10.1177/17456916221102325 -
Pediatric Annals Dec 2023Gender identity development is conceptualized as a biopsychosocial process that is influenced by broader historical, social, and cultural contextual factors. This review... (Review)
Review
Gender identity development is conceptualized as a biopsychosocial process that is influenced by broader historical, social, and cultural contextual factors. This review outlines the current understanding of the biopsychosocial and contextual factors that influence gender identity development in children and adolescents. Developmental milestones for gender identity development in youth are presented, and unique developmental needs for transgender and gender diverse (TGD) youth are reviewed. This article also reviews emerging areas of relevance for TGD populations, such as detransitioning and transition regret. Clinicians working with TGD populations should aim to develop individualized, evidence-based care plans that flexibly meet each youth's distinct developmental and contextual psychosocial and health care needs. .
Topics: Adolescent; Child; Humans; Female; Male; Transgender Persons; Gender Identity; Transsexualism; Delivery of Health Care; Emotions
PubMed: 38049193
DOI: 10.3928/19382359-20231016-05 -
Soins. Psychiatrie 2023Identity is a widely debated topic. The fact that human beings want to change sex and gender poses a fundamentally societal question. Long marginalized, this reality has...
Identity is a widely debated topic. The fact that human beings want to change sex and gender poses a fundamentally societal question. Long marginalized, this reality has become a phenomenon with varying degrees of media coverage. The definition and place of sex, gender, its acceptance and transformation are anthropologically characteristic of the human race and its very nature. The question is that of the limits of the body, of biology and anatomy. We are entering a process of transition through transgenderism, its medicalization and change of civil status. Things can be seen as a trajectory, not a state.
Topics: Male; Female; Humans; Gender Identity; Mental Disorders
PubMed: 37479353
DOI: 10.1016/j.spsy.2023.06.006 -
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 -
Archivos de Prevencion de Riesgos... Oct 2021
Topics: Gender Identity; Socioeconomic Factors
PubMed: 34965323
DOI: 10.12961/aprl.2021.24.04.01