-
Abdominal Radiology (New York) Aug 2019
Topics: Gender Identity; Surveys and Questionnaires
PubMed: 31161281
DOI: 10.1007/s00261-019-02070-8 -
Archives of Sexual Behavior May 2022Prior qualitative research has noted that gender dysphoria impacts sexual engagement and satisfaction for many trans masculine and nonbinary individuals. As such, the...
Prior qualitative research has noted that gender dysphoria impacts sexual engagement and satisfaction for many trans masculine and nonbinary individuals. As such, the current cross-sectional study aimed to investigate the exact relations between distinct aspects of gender dysphoria (i.e., genital, chest, other secondary sex characteristics, and social) and engagement in, and enjoyment of, specific sexual acts. To achieve this aim, a sample of 141 trans masculine and nonbinary participants who were assigned female at birth and whom had not undertaken a medical transition were recruited. Participants were identified as trans masculine (n = 52), nonbinary (n = 72), and agender (n = 17). Participants completed a survey rating both body and social gender dysphoria and their engagement and enjoyment of receptive and performative roles across six partnered sex act domains (i.e., insertion, oral sex, sex toys, manual stimulation, nipple stimulation, and anal stimulation), as well as masturbation and noncoital activities. The overall results demonstrated that gender dysphoria is more salient to sexual acts that involve receiving versus providing sexual pleasure. In addition, genital and chest dysphoria were often significantly related to lower ratings of engagement and enjoyment. These results support the understanding that trans masculine and nonbinary individuals are likely negotiating sexual encounters to avoid sexual acts that involve areas of their body they find most distressing and marks an important area for future interventions and research.
Topics: Cross-Sectional Studies; Female; Gender Dysphoria; Gender Identity; Humans; Infant, Newborn; Sexual Behavior; Transgender Persons; Transsexualism
PubMed: 35449364
DOI: 10.1007/s10508-021-02242-y -
JAMA Network Open Jul 2022Medical education, research, and clinical guidelines are available to support the initiation of gender-affirming care for transgender and nonbinary people. By contrast,...
IMPORTANCE
Medical education, research, and clinical guidelines are available to support the initiation of gender-affirming care for transgender and nonbinary people. By contrast, little is known about the clinical experiences of those who discontinue or seek to reverse gender-affirming medical or surgical interventions due to a change in gender identity, often referred to as detransition.
OBJECTIVE
To examine the physical and mental health experiences of people who initiated medical or surgical detransition to inform clinical practice.
DESIGN, SETTING, AND PARTICIPANTS
Using constructivist grounded theory as a qualitative approach, data were collected in the form of in-depth interviews. Data were analyzed using an inductive 2-stage coding process to categorize and interpret detransition-related health care experiences to inform clinical practice. Between October 2021 and January 2022, individuals living in Canada who were aged 18 years and older with experience of stopping, shifting, or reversing a gender transition were invited to partake in semistructured virtual interviews. Study advertisements were circulated over social media, to clinicians, and within participants' social networks. A purposive sample of 28 participants who discontinued, shifted, or reversed a gender transition were interviewed.
MAIN OUTCOMES AND MEASURES
In-depth, narrative descriptions of the physical and mental health experiences of people who discontinued or sought to reverse prior gender-affirming medical and/or surgical interventions.
RESULTS
Among the 28 participants, 18 (64%) were assigned female at birth and 10 (36%) were assigned male at birth; 2 (7%) identified as Jewish and White, 5 (18%) identified as having mixed race and ethnicity (which included Arab, Black, Indigenous, Latinx, and South Asian), and 21 (75%) identified as White. Participants initially sought gender-affirmation at a wide range of ages (15 [56%] were between ages 18 and 24 years). Detransition occurred for various reasons, such as an evolving understanding of gender identity or health concerns. Participants reported divergent perspectives about their past gender-affirming medical or surgical treatments. Some participants felt regrets, but a majority were pleased with the results of gender-affirming medical or surgical treatments. Medical detransition was often experienced as physically and psychologically challenging, yet health care avoidance was common. Participants described experiencing stigma and interacting with clinicians who were unprepared to meet their detransition-related medical needs.
CONCLUSIONS AND RELEVANCE
This study's results suggest that further research and clinical guidance is required to address the unmet needs of this population who discontinue or seek to reverse prior gender-affirming interventions.
Topics: Delivery of Health Care; Ethnicity; Female; Gender Identity; Humans; Infant, Newborn; Male; Transgender Persons; Transsexualism
PubMed: 35877120
DOI: 10.1001/jamanetworkopen.2022.24717 -
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 -
Pediatric Annals Dec 2023
Topics: Humans; Adolescent; Transgender Persons; Gender Identity; Transsexualism; Pediatricians
PubMed: 38049187
DOI: 10.3928/19382359-20231016-01 -
Annals of Plastic Surgery Nov 2023Gender-affirming surgery is a quickly expanding field. However, it is facing a shortage of specialized surgeons for a population exceeding 1.4 million individuals. Many...
BACKGROUND
Gender-affirming surgery is a quickly expanding field. However, it is facing a shortage of specialized surgeons for a population exceeding 1.4 million individuals. Many studies comparing outcomes between cisgender and transgender patients fail to describe the technical differences of the operation. Breast augmentation in the transgender female patient involves important anatomical, technical, and clinical features that differ from the cisgender female. In this study, we aimed to describe and compare these characteristics between these 2 groups to better inform the new generation of gender-affirming surgeons.
METHODS
A retrospective cohort study of patients who underwent primary breast augmentation between 2009 and 2019 at a specialized tertiary center for transgender care was performed. Mastopexy, secondary augmentation, and reconstructive procedures were excluded. Demographic, operative, and clinical data were collected from medical records. All patients had a minimum of 1 year of follow-up after the initial surgery. Bivariate analysis was performed.
RESULTS
A total of 250 cisgender females and 153 transgender females were included. The transgender group showed higher rates of smoking ( P < 0.0001), immunosuppression ( P < 0.0001), obesity ( P < 0.0001), mental health disorders ( P < 0.0001), and hypertension ( P = 0.002). Median base width ( P < 0.0001), sternal notch to nipple distance ( P < 0.0001), and implant size (500 mL [interquartile range, 425-600 mL] vs 350 mL [interquartile range, 325-385 mL]; P < 0.0001) were larger in transgender patients. Transgender patients also demonstrated a stronger correlation between implant size and body surface area ( r = 0.71, P < 0.0001). Readmission, reoperation, and complication rates were similar between the groups; however, transgender females had a higher incidence of surgical site infections (3.9% vs 0.4%, P < 0.013). Capsular contracture was the most common complication and indication for reoperation in both groups.
CONCLUSIONS
There are important anatomical, clinical, and technical differences between reconstructive gender-affirming breast augmentation in transgender female patients and cosmetic breast augmentation in the cisgender female. The gender-affirming surgeon must know these differences to provide the best quality of care and help patients achieve better congruence between their gender identity and body image.
Topics: Humans; Female; Male; Transgender Persons; Retrospective Studies; Gender Identity; Transsexualism; Mammaplasty
PubMed: 37823620
DOI: 10.1097/SAP.0000000000003706 -
The Journal of Adolescent Health :... Mar 2021This study examined whether transmasculine, transfeminine, and nonbinary adolescents and young adults (AYA) experience different levels of gender minority stress and...
PURPOSE
This study examined whether transmasculine, transfeminine, and nonbinary adolescents and young adults (AYA) experience different levels of gender minority stress and resilience.
METHODS
Demographic and clinical information were abstracted from medical charts from AYA initiating gender-affirming care. Group comparisons between transgender and nonbinary groups were examined using one-way analyses of variance and Tukey's honestly significant difference post hoc tests.
RESULTS
Participants were 638 transgender and nonbinary AYA (65.5% transmasculine, 24.6% transfeminine, and 9.9% nonbinary). Transmasculine and transfeminine AYA reported more discrimination (ps = .008 and .006, respectively) compared to non-binary AYA. Transfeminine and nonbinary AYA reported more negative future expectations (ps = .006 and .016, respectively) and pride (ps ≤ .001 and .032, respectively) than transmasculine AYA.
CONCLUSIONS
Findings suggest that transmasculine, transfeminine, and nonbinary AYA experience different levels of gender minority stress and resilience. Future research is warranted to further examine between-group differences and differential impact on mental health outcomes.
Topics: Adolescent; Gender Identity; Humans; Sexual and Gender Minorities; Transgender Persons; Transsexualism; Young Adult
PubMed: 33046360
DOI: 10.1016/j.jadohealth.2020.06.014 -
Endocrine Practice : Official Journal... Apr 2023Accumulating evidence demonstrates that gender affirming hormone therapy (GAHT) improves mental health outcomes in transgender persons. Data specific to the risks... (Review)
Review
OBJECTIVE
Accumulating evidence demonstrates that gender affirming hormone therapy (GAHT) improves mental health outcomes in transgender persons. Data specific to the risks associated with GAHT for transgender persons continue to emerge, allowing for improvements in understanding, predicting, and mitigating adverse outcomes while informing discussion about desired effects. Of particular concern is the risk of venous thromboembolism (VTE) in the context of both longitudinal GAHT and the perioperative setting. Combining what is known about the risk of VTE in cisgender individuals on hormone therapy (HT) with the evidence for transgender persons receiving HT allows for an informed approach to assess underlying risk and improve care in the transgender community.
OBSERVATIONS
Hormone formulation, dosing, route, and duration of therapy can impact thromboembolic risk, with transdermal estrogen formulations having the lowest risk. There are no existing risk scores for VTE that consider HT as a possible risk factor. Risk assessment for recurrent VTE and bleeding tendencies using current scores may be helpful when assessing individual risk. Gender affirming surgeries present unique perioperative concerns, and certain procedures include a high likelihood that patients will be on exogenous estrogens at the time of surgery, potentially increasing thromboembolic risk.
CONCLUSIONS AND RELEVANCE
Withholding GAHT due to potential adverse events may cause negative impacts for individual patients. Providers should be knowledgeable about the management of HT in transgender individuals of all ages, as well as in the perioperative setting, to avoid periods in which transgender individuals are off GAHT. Treatment decisions for both anticoagulation and HT should be individualized and tailored to patients' overall goals and desired outcomes, given that the physical and mental health benefits of gender affirming care may outweigh the risk of VTE.
Topics: Humans; Venous Thromboembolism; Gender Identity; Transgender Persons; Transsexualism; Estradiol
PubMed: 36539066
DOI: 10.1016/j.eprac.2022.12.008 -
Giornale Italiano Di Cardiologia (2006) Nov 2020
Topics: Gender Identity; Humans; Sex Factors
PubMed: 33077998
DOI: 10.1714/3455.34446 -
Advances in Life Course Research Sep 2022Transgender and nonbinary people's life experiences are highly heterogenous and shaped by broader structural and cultural forces. We analyze experiences identified on...
Transgender and nonbinary people's life experiences are highly heterogenous and shaped by broader structural and cultural forces. We analyze experiences identified on lifeline interviews from 87 transgender and nonbinary adults in Atlanta, New York City, and San Francisco. We find that the type, timing, and relative importance of these experiences varied across categories. For example, experiences related to "Rejection and violence" were more often identified in childhood and in the past, whereas experiences related to "Gender-affirming medical interventions" were more often in adulthood and anticipated futures. Experiences related to "Community involvement," "Extracurriculars," "Gender exploration and revelation," and "Gender-affirming medical interventions" were labeled by respondents as relatively more important compared to other experiences, whereas experiences related to "Family of origin relationships," "Place of residence," "Rejection and violence," and "Sexuality" less important. These experiences were patterned according to the respondents' gender, birth cohort, race/ethnicity, and geographic location. In analyzing these lifeline data, we advance theoretical understandings of the salience of a variety of key experiences for transgender and nonbinary people at different points in the life course. Our life course approach provides empirical analyses of intra-individual processes over time for transgender and nonbinary people and provides insight into the usefulness of a lifeline method for life course studies more generally as it draws attention to within-person assessments of the distribution and importance of events over the course of a lifetime.
Topics: Adult; Humans; Transgender Persons; Transsexualism; Gender Identity; Ethnicity; New York City
PubMed: 36381170
DOI: 10.1016/j.alcr.2022.100482