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Social Science & Medicine (1982) Jun 2024Bans on gender-affirming care (GAC) for transgender and gender-expansive (TGE) people are grounded in scientific disinformation and have been challenged in American...
CONTEXT
Bans on gender-affirming care (GAC) for transgender and gender-expansive (TGE) people are grounded in scientific disinformation and have been challenged in American courts.
METHODS
Five legal filings by state officials in defense of GAC restriction from initial litigation were analyzed using reflexive thematic analysis. Themes and subthemes of disinformation were identified after review and analysis of these filings.
FINDINGS
Five themes of disinformation emerged: False and misleading claims about (1) gender dysphoria and gender identity, (2) the evidence regarding GAC, (3) standard practice of GAC, (4) the safety of GAC, and finally, (5) rejection of medical authority. These themes were well represented across the analyzed documents.
CONCLUSIONS
The five disinformation themes and subthemes have been noted in lower courts, but have seen some purchase in appellate courts, suggesting that medical disinformation in law may have far-reaching consequences for medical policy.
Topics: Humans; United States; Transgender Persons; Female; Gender Dysphoria; Male; Gender Identity; Gender-Affirming Care
PubMed: 38759383
DOI: 10.1016/j.socscimed.2024.116943 -
Indian Journal of Medical Ethics 2024Transgender individuals seeking gender-affirming surgeries (GAS) are often denied or delayed by mental health professionals (MHPs). Studies on the gatekeeping of GAS...
BACKGROUND
Transgender individuals seeking gender-affirming surgeries (GAS) are often denied or delayed by mental health professionals (MHPs). Studies on the gatekeeping of GAS have been mainly conducted in the Global North and primarily focus on the perspectives of health professionals. This case study from India incorporates health professional, community, advocate, and activist perspectives to contribute new evidence about MHP gatekeeping in GAS. The study aims to examine the role of power and gender in MHP gatekeeping of GAS in India.
METHODS
A qualitative multi-method case study including thematic analyses of key informant interviews (n = 9) and policy analysis using the policy triangle framework.
RESULTS
Health professionals and transgender persons participate in the construction, performance, and reproduction of gender indicating the persistence of gender normativity in India which enables gatekeeping by MHPs. However, evidence suggests some signs of a change from binormativity to a culturally intelligible and historically familiar "trinormativity".
CONCLUSION
To understand MHP gatekeeping, there is a need to contextualise this example of biopower within the larger social construction of gender within which MHPs operate. A transition from binormativity to "trinormativity" enables MHP gatekeeping of transgender persons seeking GAS. This risks creating new forms of gender-related oppression, such as new hierarchies and class differences between the gender binary and the "third gender".
Topics: Humans; India; Transgender Persons; Male; Female; Gender Identity; Qualitative Research; Sex Reassignment Surgery; Gatekeeping; Power, Psychological; Health Personnel; Adult; Health Policy; Health Services Accessibility; Transsexualism
PubMed: 38755768
DOI: 10.20529/IJME.2024.011 -
PloS One 2024The present contribution provides ratings for a database of gender stereotypically congruent, stereotypically incongruent, semantically correct, and semantically...
The present contribution provides ratings for a database of gender stereotypically congruent, stereotypically incongruent, semantically correct, and semantically incorrect sentences in Polish and English. A total of 942 volunteers rated 480 sentences (120 per condition) in each language in terms of their meaningfulness, probability of use, and stereotypicality. The stimuli were highly controlled for their length and critical words, which were shared across the conditions. The results of the ratings revealed that stereotypically incongruent sentences were consciously evaluated as both less meaningful and probable to use relative to sentences that adhere to stereotype-driven expectations regarding males and females, indicating that stereotype violations communicated through language exert influence on language perception. Furthermore, the results yielded a stronger internalization of gender stereotypes among sex-typed individuals, thus pointing to the crucial role of gender schema in the sensitivity to gender stereotypical attributes. The ratings reported in the present article aim to broaden researchers' stimulus choices and allow for consistency across different laboratories and research projects on gender stereotype processing. The adaptation of this database to other languages or cultures could also enable a cross-cultural comparison of empirical findings on stereotype processing.
Topics: Humans; Female; Male; Stereotyping; Semantics; Language; Adult; Poland; Young Adult; Gender Identity; Adolescent
PubMed: 38753698
DOI: 10.1371/journal.pone.0302594 -
Pediatrics Jun 2024
Topics: Humans; Gender Identity; Adolescent; Female; Male; Data Collection; Child; Transgender Persons
PubMed: 38752290
DOI: 10.1542/peds.2024-065932 -
Frontiers in Endocrinology 2024Differences/disorders of sex development (DSD) comprise a large group of rare congenital conditions. 46,XX DSD, excluding congenital adrenal hyperplasia (CAH), represent... (Review)
Review
Differences/disorders of sex development (DSD) comprise a large group of rare congenital conditions. 46,XX DSD, excluding congenital adrenal hyperplasia (CAH), represent only a small number of these diseases. Due to the rarity of non-CAH 46,XX DSD, data on this sex chromosomal aberration were confined to case reports or case series with small numbers of patients. As the literature is still relatively sparse, medical data on the long-term effects of these pathologies remain scarce. In this review, we aim to provide an overview of current data on the long-term follow-up of patients with non-CAH 46,XX DSD, by covering the following topics: quality of life, gender identity, fertility and sexuality, global health, bone and cardiometabolic effects, cancer risk, and mortality. As non-CAH 46,XX DSD is a very rare condition, we have no accurate data on adult QoL assessment for these patients. Various factors may contribute to a legitimate questioning about their gender identity, which may differ from their sex assigned at birth. A significant proportion of gender dysphoria has been reported in various series of 46,XX DSD patients. However, it is difficult to give an accurate prevalence of gender dysphoria and gender reassignment in non-CAH 46,XX DSD because of the rarity of the data. Whatever the aetiology of non-CAH 46,XX DSD, fertility seems to be impaired. On the other hand, sexuality appears preserved in 46,XX men, whereas it is impaired in women with MRKH syndrome before treatment. Although there is still a paucity of data on general health, bone and cardiometabolic effects, and mortality, it would appear that the 46,XX DSD condition is less severely affected than other DSD conditions. Further structured and continued multi-center follow-up is needed to provide more information on the long-term outcome of this very rare non-CAH 46,XX DSD condition.
Topics: Female; Humans; Male; 46, XX Disorders of Sex Development; Adrenal Hyperplasia, Congenital; Disorders of Sex Development; Fertility; Gender Identity; Quality of Life
PubMed: 38752171
DOI: 10.3389/fendo.2024.1372887 -
Social Science & Medicine (1982) Jun 2024The minority stress model has become a well-used framework to explain and analyse health among LGBTQ people, and specifically among transgender and gender-diverse people...
The minority stress model has become a well-used framework to explain and analyse health among LGBTQ people, and specifically among transgender and gender-diverse people (TGD), when it is sometimes called 'the gender minority stress model'. Scholars have argued the need for critical discussions about some of the assumptions underlying the gender minority stress model and how it has been used and discussed. Drawing on a pluralistic understanding of theories and employing a Foucauldian understanding of critique, we discuss implicit assumptions and epistemological standpoints of the gender minority stress model and the connected limitations. We also ask what the concept of cisnormativity can give rise to in comparison with the minority stress framework. We make four arguments: 1) the calls for extensions to the model could be seen as a desire to understand and analyse TGD people's health from an all-encompassing perspective, resulting in theoretical vagueness and the silencing of excluded aspects; 2) in the gender minority stress literature, identity is largely taken for granted and there is no consideration of how power is constitutive for all subjects; 3) the model risks individualising the effects of social norms, and internalisation could be further theoretically developed in relation to the repression hypothesis; 4) in the translation process from LGB minorities to TGD, as well as in thinking about cisnormativity, the issue of gender-affirming care has largely been neglected. By initiating a critical discussion around these issues and illustrating how different theories and frameworks can illuminate different possibilities for thinking and knowing, we aim to open up new routes for thinking about TGD health and medicine.
Topics: Humans; Stress, Psychological; Sexual and Gender Minorities; Transgender Persons; Male; Female; Gender Identity
PubMed: 38749253
DOI: 10.1016/j.socscimed.2024.116957 -
Cuadernos de Bioetica : Revista Oficial... 2024The differences between the male and female brain in cisgender individuals, those in whom there is no incongruence between the so-called biological sex and the perceived...
The differences between the male and female brain in cisgender individuals, those in whom there is no incongruence between the so-called biological sex and the perceived sex, are known. The genetic basis that underlies the differences observed in the brains of transgender individuals compared to cisgender individuals is also becoming known. In transgender individuals, there is a fundamental change in the connectivity of neurons in the body perception network, which may give rise to gender dysphoria. This knowledge allows for the characterization of the transgender condition and distinguishes it from transgender identities such as non-binary gender, gender fluidity, or genderqueer. Articles published assume, from the perspective of depathologization imposed by Gender Ideology, that these differences are due to a different sexual development. The societal acceptance of this perspective over the last two decades paved the way for medical interventions aimed at affirming the perceived gender, different from the genetic sex, through the continuous administration of cross-sex hormones and, in some cases, mutilating surgery. In adolescents and children, affirmation treatment of the perceived gender begins with puberty blockers, which have negative consequences for ossification and growth. The importance and irreversibility of these 'side effects' require the utmost rigor and complete information about them. Spanish law pushes the ideology to the maximum, infringing on the rights of transgender individuals. Medical ethics emphasize the necessity - the right - of a medical and psychological diagnosis, free from ideological approaches, before initiating what is being called treatment. This includes the right to information, prior to consent, about the positive and negative effects of hormonal administration. It also includes the right to the recognition of diversity among transgender individuals, especially the right to research that allows for treating the brain without altering the body. These rights must be recognized and demanded by the laws.
Topics: Humans; Male; Female; Transgender Persons; Gender Dysphoria; Brain; Gender Identity; Sex Reassignment Procedures; Adolescent; Transsexualism; Child; Sex Reassignment Surgery
PubMed: 38734925
DOI: 10.30444/CB.168 -
CBE Life Sciences Education Jun 2024Cisheteronormative ideologies are infused into every aspect of society, including undergraduate science. We set out to identify the extent to which students can identify...
Cisheteronormative ideologies are infused into every aspect of society, including undergraduate science. We set out to identify the extent to which students can identify cisheteronormative language in biology textbooks by posing several hypothetical textbook questions and asking students to modify them to make the language more accurate (defined as "correct; precise; using language that applies to all people"). First, we confirmed that textbooks commonly use language that conflates or confuses sex and gender. We used this information to design two sample questions that used similar language. We examined what parts of the questions students modified, and the changes they recommended. When asked to modify sample textbook questions, we found the most common terms or words that students identified as inaccurate were related to infant gender identity. The most common modifications that students made were changing gender terms to sex terms. Students' decisions in this exercise differed little across three large biology courses or by exam performance. As the science community strives to promote inclusive classrooms and embrace the complexity of human gender identities, we provide foundational information about students' ability to notice and correct inaccurate language related to sex and gender in biology.
Topics: Humans; Students; Biology; Language; Male; Female; Gender Identity; Educational Measurement
PubMed: 38728229
DOI: 10.1187/cbe.23-07-0125 -
Annals of Epidemiology Jul 2024To assess the association between transgender or gender-questioning identity and screen use (recreational screen time and problematic screen use) in a demographically...
OBJECTIVE
To assess the association between transgender or gender-questioning identity and screen use (recreational screen time and problematic screen use) in a demographically diverse national sample of early adolescents in the U.S.
METHODS
We analyzed cross-sectional data from Year 3 of the Adolescent Brain Cognitive Development Study (ABCD Study®, N = 9859, 2019-2021, mostly 12-13-years-old). Multiple linear regression analyses estimated the associations between transgender or questioning gender identity and screen time, as well as problematic use of video games, social media, and mobile phones, adjusting for confounders.
RESULTS
In a sample of 9859 adolescents (48.8% female, 47.6% racial/ethnic minority, 1.0% transgender, 1.1% gender-questioning), transgender adolescents reported 4.51 (95% CI 1.17-7.85) more hours of total daily recreational screen time including more time on television/movies, video games, texting, social media, and the internet, compared to cisgender adolescents. Gender-questioning adolescents reported 3.41 (95% CI 1.16-5.67) more hours of total daily recreational screen time compared to cisgender adolescents. Transgender identification and questioning one's gender identity was associated with higher problematic social media, video game, and mobile phone use, compared to cisgender identification.
CONCLUSIONS
Transgender and gender-questioning adolescents spend a disproportionate amount of time engaging in screen-based activities and have more problematic use across social media, video game, and mobile phone platforms.
Topics: Humans; Adolescent; Female; Male; Transgender Persons; Video Games; Cross-Sectional Studies; Screen Time; Social Media; Adolescent Behavior; Gender Identity; Cognition; Child; United States; Adolescent Development
PubMed: 38719179
DOI: 10.1016/j.annepidem.2024.04.013 -
The Journal of the Acoustical Society... May 2024The perceived level of femininity and masculinity is a prominent property by which a speaker's voice is indexed, and a vocal expression incongruent with the speaker's...
The perceived level of femininity and masculinity is a prominent property by which a speaker's voice is indexed, and a vocal expression incongruent with the speaker's gender identity can greatly contribute to gender dysphoria. Our understanding of the acoustic cues to the levels of masculinity and femininity perceived by listeners in voices is not well developed, and an increased understanding of them would benefit communication of therapy goals and evaluation in gender-affirming voice training. We developed a voice bank with 132 voices with a range of levels of femininity and masculinity expressed in the voice, as rated by 121 listeners in independent, individually randomized perceptual evaluations. Acoustic models were developed from measures identified as markers of femininity or masculinity in the literature using penalized regression and tenfold cross-validation procedures. The 223 most important acoustic cues explained 89% and 87% of the variance in the perceived level of femininity and masculinity in the evaluation set, respectively. The median fo was confirmed to provide the primary cue, but other acoustic properties must be considered in accurate models of femininity and masculinity perception. The developed models are proposed to afford communication and evaluation of gender-affirming voice training goals and improve voice synthesis efforts.
Topics: Humans; Female; Male; Adult; Cues; Speech Acoustics; Voice Quality; Young Adult; Speech Perception; Masculinity; Middle Aged; Femininity; Adolescent; Gender Identity; Acoustics
PubMed: 38717212
DOI: 10.1121/10.0025932