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International Review of Psychiatry... 2016Some people have a gender which is neither male nor female and may identify as both male and female at one time, as different genders at different times, as no gender at... (Review)
Review
Some people have a gender which is neither male nor female and may identify as both male and female at one time, as different genders at different times, as no gender at all, or dispute the very idea of only two genders. The umbrella terms for such genders are 'genderqueer' or 'non-binary' genders. Such gender identities outside of the binary of female and male are increasingly being recognized in legal, medical and psychological systems and diagnostic classifications in line with the emerging presence and advocacy of these groups of people. Population-based studies show a small percentage--but a sizable proportion in terms of raw numbers--of people who identify as non-binary. While such genders have been extant historically and globally, they remain marginalized, and as such--while not being disorders or pathological in themselves--people with such genders remain at risk of victimization and of minority or marginalization stress as a result of discrimination. This paper therefore reviews the limited literature on this field and considers ways in which (mental) health professionals may assist the people with genderqueer and non-binary gender identities and/or expressions they may see in their practice. Treatment options and associated risks are discussed.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Female; Gender Identity; Homosexuality, Female; Homosexuality, Male; Humans; Male; Sexual Behavior; Transgender Persons; Transsexualism
PubMed: 26753630
DOI: 10.3109/09540261.2015.1106446 -
Behavior Genetics Mar 2018The American Psychological Association defines gender identity as, "A person's deeply-felt, inherent sense of being a boy, a man, or a male; a girl, a woman, or a... (Review)
Review
The American Psychological Association defines gender identity as, "A person's deeply-felt, inherent sense of being a boy, a man, or a male; a girl, a woman, or a female; or an alternative gender (e.g., genderqueer, gender nonconforming, gender neutral) that may or may not correspond to a person's sex assigned at birth or to a person's primary or secondary sex characteristics" (American Psychological Association, Am Psychol 70(9):832-864, 2015). Here we review the evidence that gender identity and related socially defined gender constructs are influenced in part by innate factors including genes. Based on the data reviewed, we hypothesize that gender identity is a multifactorial complex trait with a heritable polygenic component. We argue that increasing the awareness of the biological diversity underlying gender identity development is relevant to all domains of social, medical, and neuroscience research and foundational for reducing health disparities and promoting human-rights protections for gender minorities.
Topics: Female; Gender Dysphoria; Gender Identity; Humans; Male; Sex Characteristics; Sexual Behavior; Transgender Persons
PubMed: 29460079
DOI: 10.1007/s10519-018-9889-z -
Pain Research & Management 2018Despite the large body of research on sex differences in pain, there is a lack of knowledge about the influence of gender in the patient-provider encounter. The purpose... (Review)
Review
BACKGROUND
Despite the large body of research on sex differences in pain, there is a lack of knowledge about the influence of gender in the patient-provider encounter. The purpose of this study was to review literature on gendered norms about men and women with pain and gender bias in the treatment of pain. The second aim was to analyze the results guided by the theoretical concepts of hegemonic masculinity and andronormativity.
METHODS
A literature search of databases was conducted. A total of 77 articles met the inclusion criteria. The included articles were analyzed qualitatively, with an integrative approach.
RESULTS
The included studies demonstrated a variety of gendered norms about men's and women's experience and expression of pain, their identity, lifestyle, and coping style. Gender bias in pain treatment was identified, as part of the patient-provider encounter and the professional's treatment decisions. It was discussed how gendered norms are consolidated by hegemonic masculinity and andronormativity.
CONCLUSIONS
Awareness about gendered norms is important, both in research and clinical practice, in order to counteract gender bias in health care and to support health-care professionals in providing more equitable care that is more capable to meet the need of all patients, men and women.
Topics: Chronic Pain; Databases, Bibliographic; Emotions; Gender Identity; Humans; Sexism
PubMed: 29682130
DOI: 10.1155/2018/6358624 -
The Journal of Neuroscience : the... Jan 2020Phoenix et al. (1959) reported that treating pregnant guinea pigs with testosterone had enduring effects on the sex-related behavior of their female offspring. Since... (Review)
Review
Phoenix et al. (1959) reported that treating pregnant guinea pigs with testosterone had enduring effects on the sex-related behavior of their female offspring. Since then, similar enduring effects of early testosterone exposure have been found in other species, including humans, and for other behaviors that show average sex differences. In humans, the affected outcomes include gender identity, sexual orientation, and children's sex-typical play behavior. The evidence linking early testosterone exposure to sex-typed play is particularly robust, and sex-typed play is also influenced by many other factors, including socialization by parents and peers and self-socialization, based on cognitive understanding of gender. In addition to influencing behavior, testosterone and hormones produced from testosterone affect mammalian brain structure. Studies using human autopsy material have found some sex differences in the human brain similar to those seen in other species, and have reported that some brain sex differences correlate with sexual orientation or gender identity, although the causes of these brain/behavior relationships are unclear. Studies that have imaged the living human brain have found only a small number of sex differences, and these differences are generally small in magnitude. In addition, they have not been linked to robust psychological or behavioral sex differences. Future research might benefit from improved imaging technology, and attention to other brain characteristics. In addition, it might usefully explore how different types of factors, such as early testosterone exposure and parental socialization, work together in the developmental system that produces sex/gender differences in human brain and behavior.
Topics: Adrenal Hyperplasia, Congenital; Adult; Aggression; Animals; Brain; Child; Child Rearing; Empathy; Environment; Female; Forecasting; Gender Identity; Humans; Male; Neurosciences; Organ Size; Parent-Child Relations; Peer Group; Play and Playthings; Pregnancy; Prenatal Exposure Delayed Effects; Puberty; Sex; Sex Characteristics; Sexual Behavior; Spatial Navigation; Species Specificity; Testosterone
PubMed: 31488609
DOI: 10.1523/JNEUROSCI.0750-19.2019 -
Annual Review of Medicine Jan 2023Increasing numbers of transgender and gender-diverse (TGD) youth, from early puberty through late adolescence, are seeking medical services to bring their physical sex... (Review)
Review
Increasing numbers of transgender and gender-diverse (TGD) youth, from early puberty through late adolescence, are seeking medical services to bring their physical sex characteristics into alignment with their gender identity-their inner sense of self as male or female or elsewhere on the gender spectrum. Numerous studies, primarily of short- and medium-term duration (up to 6 years), demonstrate the clearly beneficial-even lifesaving-mental health impact of gender-affirming medical care in TGD youth. However, there are significant gaps in knowledge and challenges to such care. Long-term safety and efficacy studies are needed to optimize medical care for TGD youth.
Topics: Humans; Male; Female; Adolescent; Transgender Persons; Gender Identity; Mental Health
PubMed: 36260812
DOI: 10.1146/annurev-med-043021-032007 -
International Journal of Environmental... Sep 2019: Research has consistently reported gender differences in mental health, but studies on differences in psychological well-being between women and men have not yielded...
: Research has consistently reported gender differences in mental health, but studies on differences in psychological well-being between women and men have not yielded conclusive results. The aim of this study was to examine the relevance of gender to the psychological well-being of adult individuals. A cross-sectional study with a sample of 1700 men and 1700 women from the general Spanish population was conducted. Their ages ranged from 21 to 64 years, and they were assessed with Ryff's Psychological Well-Being Scales and the Bem Sex Role Inventory. : Men scored higher than women in self-acceptance and autonomy, and women scored higher than men in personal growth and positive relations with others. The most relevant variable in the psychological well-being of both women and men was high masculinity. Other relevant variables in women's well-being were high femininity, not having a manual occupation, not being homemakers, and professional occupation. Men´s well-being also was higher in professional men and in men with a skilled non-manual occupation, men with high femininity and men who were not single, divorced or widowed. : Adherence to traditional gender roles is relevant to the psychological well-being of women and men, and women and men whose self-concept includes both masculine-instrumental and feminine-expressive characteristics have greater well-being.
Topics: Adult; Cross-Sectional Studies; Female; Gender Identity; Humans; Male; Masculinity; Mental Health; Middle Aged; Self Concept; Sex Factors; Young Adult
PubMed: 31547223
DOI: 10.3390/ijerph16193531 -
Journal of the Royal Society of Medicine Apr 2017In this review, we introduce the topic of transgender medicine, aimed at the non-specialist clinician working in the UK. Appropriate terminology is provided alongside... (Review)
Review
In this review, we introduce the topic of transgender medicine, aimed at the non-specialist clinician working in the UK. Appropriate terminology is provided alongside practical advice on how to appropriately care for transgender people. We offer a brief theoretical discussion on transgenderism and consider how it relates to broader understandings of both gender and disease. In respect to epidemiology, while it is difficult to assess the exact size of the transgender population in the UK, population surveys suggest a prevalence of between 0.2 and 0.6% in adults, with rates of referrals to gender identity clinics in the UK increasing yearly. We outline the legal framework that protects the rights of transgender people, showing that is not legal for physicians to deny transgender people access to services based on their personal beliefs. Being transgender is often, although not always, associated with gender dysphoria, a potentially disabling condition in which the discordance between a person's natal sex (that assigned to them at birth) and gender identity results in distress, with high associated rates of self-harm, suicidality and functional impairment. We show that gender reassignment can be a safe and effective treatment for gender dysphoria with counselling, exogenous hormones and surgery being the mainstay of treatment. The role of the general practitioner in the management of transgender patients is discussed and we consider whether hormone therapy should be initiated in primary care in the absence of specialist advice, as is suggested by recent General Medical Council guidance.
Topics: Female; Gender Dysphoria; Gender Identity; General Practitioners; Humans; Male; Prejudice; Sex Reassignment Procedures; State Medicine; Transgender Persons; Transsexualism; United Kingdom
PubMed: 28382847
DOI: 10.1177/0141076817696054 -
Anales de Pediatria Apr 2022Some people, including minors, have a gender identity that does not correspond to the sex assigned at birth. They are known as trans* people, which is an umbrella term...
Some people, including minors, have a gender identity that does not correspond to the sex assigned at birth. They are known as trans* people, which is an umbrella term that encompasses transgender, transsexual, and other identities not conforming to the assigned gender. Healthcare units for trans* minors require multidisciplinary working, undertaken by personnel expert in gender identity, enabling, when requested, interventions for the minor and their social-familial environment, in an individualized and flexible way during the gender affirmation path. This service model also includes hormonal treatments tailored as much as possible to the individual's needs, beyond the dichotomic goals of a traditional binary model. This guide addresses the general aspects of professional care of trans* minors and presents the current evidence-based protocol of hormonal treatments for trans* and non-binary adolescents. In addition, it details key aspects related to expected body changes and their possible side effects, as well as prior counselling about fertility preservation.
Topics: Adolescent; Female; Gender Dysphoria; Gender Identity; Humans; Male; Minors; Practice Guidelines as Topic; Transgender Persons; Transsexualism
PubMed: 35534418
DOI: 10.1016/j.anpede.2022.02.002 -
The Journal of Clinical Endocrinology... Sep 2022
Topics: Adolescent; Adult; Gender Identity; Hormones; Humans; Transgender Persons; Transsexualism
PubMed: 35678284
DOI: 10.1210/clinem/dgac356 -
Pediatrics Mar 2016Transgender children who have socially transitioned, that is, who identify as the gender "opposite" their natal sex and are supported to live openly as that gender, are...
OBJECTIVE
Transgender children who have socially transitioned, that is, who identify as the gender "opposite" their natal sex and are supported to live openly as that gender, are increasingly visible in society, yet we know nothing about their mental health. Previous work with children with gender identity disorder (GID; now termed gender dysphoria) has found remarkably high rates of anxiety and depression in these children. Here we examine, for the first time, mental health in a sample of socially transitioned transgender children.
METHODS
A community-based national sample of transgender, prepubescent children (n = 73, aged 3-12 years), along with control groups of nontransgender children in the same age range (n = 73 age- and gender-matched community controls; n = 49 sibling of transgender participants), were recruited as part of the TransYouth Project. Parents completed anxiety and depression measures.
RESULTS
Transgender children showed no elevations in depression and slightly elevated anxiety relative to population averages. They did not differ from the control groups on depression symptoms and had only marginally higher anxiety symptoms.
CONCLUSIONS
Socially transitioned transgender children who are supported in their gender identity have developmentally normative levels of depression and only minimal elevations in anxiety, suggesting that psychopathology is not inevitable within this group. Especially striking is the comparison with reports of children with GID; socially transitioned transgender children have notably lower rates of internalizing psychopathology than previously reported among children with GID living as their natal sex.
Topics: Anxiety; Child; Child, Preschool; Depression; Female; Gender Identity; Humans; Incidence; Male; Mental Health; Transgender Persons; Transsexualism; Washington
PubMed: 26921285
DOI: 10.1542/peds.2015-3223