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Social Science & Medicine (1982) Jun 2024The inclusion of "something else" as a response option for survey questions about sexual identity has been shown to significantly moderate estimated differences between... (Randomized Controlled Trial)
Randomized Controlled Trial
Does the approach used to measure sexual identity affect estimates of health disparities differently by race? A randomized experiment from the National Survey of Family Growth.
The inclusion of "something else" as a response option for survey questions about sexual identity has been shown to significantly moderate estimated differences between sexual identity subgroups in the distributions of various health outcomes in national health surveys, specifically for substance use/misuse and reproductive health. This moderation effect may be larger depending on the respondent's race, possibly due to the intersectionality of multiple minority identities and compounding minority stressors. To test this hypothesis, we conducted secondary analyses of data from five consecutive years of the National Survey of Family Growth (2015-2019) [n = 18,903 (8510 males, 10,393 females)] in the United States, where respondents were randomly assigned to receive either a four-category version of the sexual identity question that included "something else" as a response option along with lesbian/gay, bisexual, and heterosexual, or a three-category version that omitted "something else." We focused on model-based estimates of distributions of health outcomes across subgroups defined by both race and sexual identity and tested the race moderation hypothesis using three-way interactions involving sexual identity, question type received (four-category vs. three-category), and race (Black, White, and other). Based on this randomized experiment, we found evidence of significant differences between the four-category and three-category question versions of sexual identity, in terms of the associations between sexual identity and several health outcomes, along with moderation of these differences by the respondent's race. For some outcomes, such as wanting a child or another child, the magnitudes of the estimated sexual identity differences among racial minority individuals, specifically between bisexual and heterosexual women, were sensitive to the measurement of sexual identity. These results further suggest a need for improved sexual minority measurement, especially among racial minorities. These differences were also mostly found among women, suggesting further intersectionality of groups exposed to specific stressors.
Topics: Humans; Female; Male; United States; Adult; Sexual and Gender Minorities; Health Status Disparities; Racial Groups; Surveys and Questionnaires; Adolescent; Gender Identity; Young Adult; Middle Aged
PubMed: 38678646
DOI: 10.1016/j.socscimed.2024.116887 -
Lancet (London, England) Apr 2024
Topics: Humans; Neoplasms; Female; Male; Biomedical Research; Sex Factors; Gender Identity
PubMed: 38677852
DOI: 10.1016/S0140-6736(24)00593-2 -
Pediatric Neurology Jun 2024Functional tic disorders are among the least common functional movement disorders, but their prevalence rose during the coronavirus disease 2019 (COVID-19) pandemic....
BACKGROUND
Functional tic disorders are among the least common functional movement disorders, but their prevalence rose during the coronavirus disease 2019 (COVID-19) pandemic. Although female adolescents develop functional neurological disorders at higher rates than males, investigations into sexual orientation and gender identity (SOGI) status of these patients are limited.
METHODS
We completed a retrospective, cross-sectional time series examining the incidence of new-onset functional tic disorders in youth presenting to the Massachusetts General Hospital Movement Disorder clinics before and during the COVID-19 pandemic. Data were collected by searching for relevant International Classification of Diseases (ICD)-10 diagnostic codes in youth aged nine to 26 years using a hospital-wide data repository. Individual cases were reviewed for inclusion based on clinical criteria and expert consensus.
RESULTS
The prevalence of functional tic presentations in youth rose 8.6-fold from pre- to postpandemic levels (Fisher exact test P < 0.001), whereas the prevalence of developmental tic presentations pre- and postpandemic remained stable (114 vs 112). SOGI minority youth comprised 37% of those with functional tics (total n = 19). Ninety five percent of patients with functional tics identified as female, with 10% of these identifying as transgender.
CONCLUSIONS
Our data confirm previously demonstrated dramatic rises in functional tic presentations during the COVID-19 pandemic and, more notably, reveal a strong association with SOGI minority status. We highlight the potential link between functional tic disorders and SOGI minority status. Providing a safe and supportive clinical environment and addressing stress linked to SOGI minority status may help to improve patient prognosis.
Topics: Humans; COVID-19; Adolescent; Female; Male; Retrospective Studies; Child; Cross-Sectional Studies; Sexual and Gender Minorities; Young Adult; Tic Disorders; Adult; Sexual Behavior; Prevalence; Gender Identity; Massachusetts
PubMed: 38677240
DOI: 10.1016/j.pediatrneurol.2024.03.027 -
Ciencia & Saude Coletiva Apr 2024Promoting sexual and reproductive health in the context of transmasculinity constitutes a new issue for health service organisation. This integrative review sought to... (Review)
Review
Promoting sexual and reproductive health in the context of transmasculinity constitutes a new issue for health service organisation. This integrative review sought to understand the current evidence on pregnancy in transsexual men in the context of sexual and reproductive health care. From a search of the BVS, PubMed, Science Direct, Scopus, Capes, SciELO and PEPSIC databases, from 2010 to 2020, a sample of 11 articles was selected, treated by content analysis and grouped into four analytical categories: health services - positive experiences; cis heteronormative health services; implications of pregnancy for transsexual bodies; and repercussions of gender-affirming therapy and pregnancy. A cis heteronormative logic was found to predominate in health care, leading to negative experiences during antenatal care and childbirth among transsexual men. Their unique health needs during the pregnancy-puerperium cycle should include mental health care. It is suggested that strategies be adopted to build capacity in health professionals with a view to respectful, inclusive perinatal care for this population group, as well as further studies on the subject.
Topics: Humans; Female; Pregnancy; Transgender Persons; Male; Prenatal Care; Transsexualism; Perinatal Care; Reproductive Health Services; Reproductive Health
PubMed: 38655969
DOI: 10.1590/1413-81232024294.19612023 -
Ciencia & Saude Coletiva Apr 2024This qualitative study, with five participating interlocutors, sought to understand the senses and meanings of parenting among trans men who became pregnant before...
This qualitative study, with five participating interlocutors, sought to understand the senses and meanings of parenting among trans men who became pregnant before gender transition. Analysis was conducted in light of social theories of gender. The results demonstrated an experience of parenthood subject to a field of tensions and negotiations, as well as subjective production that oscillated between transgression and accommodation of the cultural perspective of their own experience. The forms of violence found to be practiced reiterated social vulnerabilities, exposed healthcare service weaknesses and produced harmful effects on transgender men who become pregnant before gender transition.
Topics: Humans; Male; Transgender Persons; Pregnancy; Female; Parenting; Adult; Qualitative Research; Parents; Violence; Gender Identity
PubMed: 38655967
DOI: 10.1590/1413-81232024294.19532023 -
Hormones and Behavior Jun 2024Sex/gender differences in personality associated with gender stereotyped behavior are widely studied in psychology yet remain a subject of ongoing debate. Exposure to...
Sex/gender differences in personality associated with gender stereotyped behavior are widely studied in psychology yet remain a subject of ongoing debate. Exposure to testosterone during developmental periods is considered to be a primary mediator of many sex/gender differences in behavior. Extensions of this research has led to both lay beliefs and initial research about individual differences in basal testosterone in adulthood relating to "masculine" personality. In this study, we explored the relationships between testosterone, gender identity, and gender stereotyped personality attributes in a sample of over 400 university students (65 % female assigned at birth). Participants provided ratings of their self-perceived masculinity and femininity, resulting in a continuous measure of gender identity, and a set of agentic and communal personality attributes. A saliva sample was also provided for assay of basal testosterone. Results showed no compelling evidence that basal testosterone correlates with gender-stereotyped personality attributes or explains the relationship between sex/gender identity and these attributes, across, within, or covarying out sex assigned at birth. Contributing to a more gender diverse approach to assessing sex/gender relationships with personality and testosterone, our continuous measure of self-perceived masculinity and femininity predicted additional variance in personality beyond binary sex and showed some preliminary but weak relationships with testosterone. Results from this study cast doubt on the activational testosterone-masculinity hypothesis for explaining sex differences in gender stereotyped traits and within-sex/gender variation in attributes associated with agency and communality.
Topics: Humans; Male; Female; Testosterone; Personality; Gender Identity; Young Adult; Adult; Stereotyping; Adolescent; Masculinity; Saliva; Femininity; Self Concept; Sex Characteristics
PubMed: 38652981
DOI: 10.1016/j.yhbeh.2024.105540 -
Breastfeeding Medicine : the Official... May 2024
Topics: Humans; Female; Gender Identity; Language; Breast Feeding; Male
PubMed: 38651592
DOI: 10.1089/bfm.2024.0114 -
Lancet (London, England) Apr 2024
Topics: Humans; Gender Identity; Female; Transgender Persons; Male; United Kingdom; Health Care Reform
PubMed: 38643770
DOI: 10.1016/S0140-6736(24)00808-0 -
BMC Public Health Apr 2024Poor mental health in young people has become a growing problem globally over the past decades. However, young people have also been shown to underutilize available...
INTRODUCTION
Poor mental health in young people has become a growing problem globally over the past decades. However, young people have also been shown to underutilize available healthcare resources. The World Health Organisation (WHO) has formulated guidelines for youth-friendly health services (YFHSs) to increase youth participation in healthcare. Still, little is known about how young people using these services perceive mental health, indicating a knowledge gap concerning the subjective evaluation of their mental health.
AIM
To investigate how young people visiting youth health clinics (YHC) perceive the concept of mental health and factors they view as central to maintaining mental health.
METHODS
In total 21 interviews were carried out, 16 in 2018, and 5 in 2023 to assure no changes in findings after the COVID-19 pandemic. Subjects were recruited during visits to youth health clinics (YHCs) in mid-Sweden and were aged 15-23 years. Recruitment strived to achieve heterogeneity in the sample concerning gender, sexual orientation, gender identity and age. Interviews were transcribed and analysed using qualitative content analysis.
FINDINGS
Findings of the analysis revealed two themes, "Mental health is helped and hindered by the surroundings" and "Mental health is difficult to understand and difficult to achieve". The participants described their health as highly dependent on their social surroundings, and that these are important to maintaining health but may also affect health negatively. They described mixed experiences of the health care services and mentioned prerequisites for seeking care for mental health problems such as accessibility and respect for their integrity, including the right to turn down offered treatment. The informants also viewed mental health as an ongoing undertaking that one must work for, and that it is sometimes difficult to know what constitutes mental health. They also expressed a need from healthcare services to enquire about their health, and to show an active interest in how they are doing.
CONCLUSIONS
Findings underline the need of young people's individual needs to be met in the healthcare system and their vulnerability to their social surroundings. Health status assessments in young people should consider social and individual factors to fully capture mental health.
Topics: Adolescent; Humans; Female; Male; Mental Health; Pandemics; Gender Identity; Brain; Qualitative Research
PubMed: 38643072
DOI: 10.1186/s12889-024-18617-4 -
Italian Journal of Pediatrics Apr 2024In response to the imperative need for standardized support for adolescent Gender Dysphoria (GD), the Italian Academy of Pediatrics, in collaboration with the Italian...
Adolescent gender dysphoria management: position paper from the Italian Academy of Pediatrics, the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, the Italian Society of Adolescent Medicine and the Italian Society of Child and Adolescent Neuropsychiatry.
BACKGROUND
In response to the imperative need for standardized support for adolescent Gender Dysphoria (GD), the Italian Academy of Pediatrics, in collaboration with the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, Italian Society of Adolescent Medicine and Italian Society of Child and Adolescent Neuropsychiatry is drafting a position paper. The purpose of this paper is to convey the author's opinion on the topic, offering foundational information on potential aspects of gender-affirming care and emphasizing the care and protection of children and adolescents with GD.
MAIN BODY
Recognizing that adolescents may choose interventions based on their unique needs and goals and understanding that every individual within this group has a distinct trajectory, it is crucial to ensure that each one is welcomed and supported. The approach to managing individuals with GD is a multi-stage process involving a multidisciplinary team throughout all phases. Decisions regarding treatment should be reached collaboratively by healthcare professionals and the family, while considering the unique needs and circumstances of the individual and be guided by scientific evidence rather than biases or ideologies. Politicians and high court judges should address discrimination based on gender identity in legislation and support service development that aligns with the needs of young people. It is essential to establish accredited multidisciplinary centers equipped with the requisite skills and experience to effectively manage adolescents with GD, thereby ensuring the delivery of high-quality care.
CONCLUSION
Maintaining an evidence-based approach is essential to safeguard the well-being of transgender and gender diverse adolescents.
Topics: Humans; Child; Adolescent; Male; Female; Gender Identity; Adolescent Medicine; Gender Dysphoria; Neuropsychiatry; Diabetes Mellitus; Italy
PubMed: 38637868
DOI: 10.1186/s13052-024-01644-7