-
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 -
The Journal of Analytical Psychology Sep 2021Within the last decade, there has been a sharp global rise in the number of young people identifying as transgender. More recently, there appears to be an increase in...
Within the last decade, there has been a sharp global rise in the number of young people identifying as transgender. More recently, there appears to be an increase in the numbers of young people detransitioning or returning to identifying with their natal sex after pursuing medical transition. A case is presented of a young woman who pursued a gender transition and returned to identifying as female after almost two years on testosterone. The author considers and critiques the affirmative model of care for gender dysphoric youth in light of this case.
Topics: Adolescent; Female; Humans; Transgender Persons; Transsexualism
PubMed: 34758129
DOI: 10.1111/1468-5922.12711 -
JAMA Network Open Nov 2022
Topics: Humans; Gender Dysphoria; Sex Reassignment Surgery; Gender Identity
PubMed: 36318212
DOI: 10.1001/jamanetworkopen.2022.39763 -
Palliative Medicine Apr 2022Lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) adults face challenges accessing end-of-life care. Understanding the experiences of LGBTQ+ persons within... (Review)
Review
BACKGROUND
Lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) adults face challenges accessing end-of-life care. Understanding the experiences of LGBTQ+ persons within the end-of-life context is crucial in addressing their needs and supporting equity at end of life.
AIM
Review recent literature documenting the experiences of LGBTQ+ adults nearing end-of-life, identifying needs, barriers to care, and translating this into clinical recommendations.
DESIGN
A rapid review design was chosen for prompt results. The process was streamlined by limiting the literature search to peer-reviewed articles, dissertations, theses, by date and language. Data collection used a predetermined set of items based on Meyer's Minority Stress and Bronfenbrenner's Ecological Models including participants' voices, needs, and barriers. Thematic analysis of collected data was conducted and presented results in a narrative summary.
DATA SOURCES
We searched six electronic databases (PubMed, Medline, ProQuest Dissertations and Theses A&I, ProQuest Dissertations and Theses, Open Access Theses and Dissertations, CINAHL, and Google Scholar) for articles published from 2016 to 2020.
RESULTS
We included and appraised for quality 33 articles. We uncovered three latent themes: systemic barriers, a lack of lived experience within the literature, and treatment of LGBTQ+ as one homogeneous group.
CONCLUSIONS
The hybrid Meyer's Minority Stress and Bronfenbrenner Ecological model elucidated how stressors and social contexts may impact LGBTQ+ adults when accessing end-of-life care. Incorporating LGBTQ+ cultural competence training into continuing education and ensuring that LGBTQ+ individuals participate in the development of end-of-life care programming may better attend to the needs of this population.
Topics: Adult; Death; Female; Gender Identity; Humans; Sexual Behavior; Sexual and Gender Minorities; Transgender Persons
PubMed: 35176932
DOI: 10.1177/02692163221078475 -
International Journal of Environmental... Mar 2021People who identify as trans and gender non-binary experience many challenges in their lives and more interest is being paid to their overall health and wellbeing.... (Review)
Review
People who identify as trans and gender non-binary experience many challenges in their lives and more interest is being paid to their overall health and wellbeing. However, little is known about their experiences and perceptions regarding their distinct psychosocial needs. The aim of this systematic review is to critically evaluate and synthesize the existing research evidence relating to the unique psychological and social experiences of trans people and identify aspects that may help or hinder access to appropriate psychosocial interventions and supports. The PRISMA procedure was utilized. A search of relevant databases from January 2010 to January 2021 was undertaken. Studies were identified that involved trans people, and addressed issues related to their psychosocial needs. The search yielded 954 papers in total. Following the application of rigorous inclusion and exclusion criteria a total of 18 papers were considered suitable for the systematic review. Quality was assessed using the MMAT instrument. Following analysis, four themes were identified: (i) stigma, discrimination and marginalization (ii) trans affirmative experiences (iii) formal and informal supports, and (iv) healthcare access. The policy, education and practice development implications are highlighted and discussed. Future research opportunities have been identified that will add significantly to the body of evidence that may further the development of appropriate health interventions and supports to this population.
Topics: Gender Identity; Humans; Perception; Psychosocial Support Systems; Qualitative Research; Social Stigma
PubMed: 33806008
DOI: 10.3390/ijerph18073403 -
Current Psychiatry Reports May 2023Sexual victimization is a significant public health concern. Compared to heterosexual and cisgender peers, sexual and gender minoritized (SGM) individuals are at... (Review)
Review
PURPOSE OF THE REVIEW
Sexual victimization is a significant public health concern. Compared to heterosexual and cisgender peers, sexual and gender minoritized (SGM) individuals are at elevated risk for sexual victimization. Prominent theories suggest that this risk is due in part to the stigma SGM individuals face when navigating heteronormative cultures. The goal of this article is to review the prevalence, risk factors, and consequences of sexual victimization in SGM individuals.
RECENT FINDINGS
Studies continue to show that SGM individuals-bisexual and/or gender minoritized in particular-are at higher risk for sexual victimization. Little work has focused on risk factors, though recent research continues to highlight post-victimization disparities among SGM individuals. Emerging studies also point to theoretically informed factors that may influence victimization risk and recovery, including sexual and gender-related stigma. To inform prevention and intervention efforts, future research would benefit from streamlining assessment, methodology, and dissemination practices.
Topics: Humans; Sexual Behavior; Gender Identity; Crime Victims; Sexual and Gender Minorities; Bullying
PubMed: 37014545
DOI: 10.1007/s11920-023-01420-0 -
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 -
Science and Engineering Ethics Nov 2022Achieving energy sovereignty is increasingly gaining prominence as a goal in energy politics. The aim of this paper is to provide a conceptual analysis of this principle...
Achieving energy sovereignty is increasingly gaining prominence as a goal in energy politics. The aim of this paper is to provide a conceptual analysis of this principle from an ethics and social justice perspective. We rely on the literature on food sovereignty to identify through a comparative analysis the elements energy sovereignty will most likely demand and thereafter distinguish the unique constituencies of the energy sector. The idea of energy sovereignty embraces a series of values, among which we identified: (i) accessibility, to allow access to everyone, (ii) empowerment and recognition, to develop and sustain capabilities to collaboratively produce solution-oriented energy system knowledge and effectively participate in governance, (iii) stewardship and sustainability, to be able to design and manage decentralised renewable systems in view of protecting the environment, (iv) self-sufficiency, to reduce the negative shocks of exploitative business practises, (v) resilience, to maintain production capacities while withstanding socioeconomic, political, environmental and climatic shocks, (vi) peace, to establish production systems that do not involve hostile relations, (vii) transparency and self-determination, to establish democratic decision-making mechanisms that give a voice to previously underrepresented groups and limit corporate takeover (viii) gender-justice, by acknowledging the contributions of women and eliminate barriers to their empowerment. With a conceptual framework of energy sovereignty, we present a rationale that draws on the key values to be considered when formulating policy solutions for the energy sector.
Topics: Female; Humans; Social Justice; Politics; Knowledge; Gender Identity
PubMed: 36329262
DOI: 10.1007/s11948-022-00409-x -
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