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Transgender Health

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https://www.readbyqxmd.com/read/29756046/hormonal-treatment-of-transgender-women-with-oral-estradiol
#1
Matthew C Leinung, Paul J Feustel, Jalaja Joseph
Purpose: Maintaining cross-sex hormone levels in the normal physiologic range for the desired gender is the cornerstone of transgender hormonal therapy, but there are limited data on how to achieve this. We investigated the effectiveness of oral estradiol therapy in achieving this goal. Methods: We analyzed data on all transgender females seen in our clinic since 2008 treated with oral estradiol. We looked at the success of achieving serum levels of testosterone and 17-β estradiol in the normal range on various doses of estradiol (with and without antiandrogens spironolactone and finasteride)...
2018: Transgender Health
https://www.readbyqxmd.com/read/29756045/a-knowledge-based-assessment-of-dermatological-care-for-transgender-women
#2
James J Sabra, Celestia X Fang, Roopal V Kundu
Dermatologic care plays an important role in the transitioning process for transgender women, with changes occurring to the skin from hormone therapy (HT) and gender affirming procedures. We sought to identify knowledge gaps in a group of transgender women pertaining to both skin and hair changes during the transitioning process. The study was conducted as a cross-sectional survey. Our results demonstrate potential gaps in knowledge that transgender women have regarding HT and gender affirming procedures.
2018: Transgender Health
https://www.readbyqxmd.com/read/29756044/gender-dysphoria-in-adults-an-overview-and-primer-for-psychiatrists
#3
William Byne, Dan H Karasic, Eli Coleman, A Evan Eyler, Jeremy D Kidd, Heino F L Meyer-Bahlburg, Richard R Pleak, Jack Pula
Regardless of their area of specialization, adult psychiatrists are likely to encounter gender-variant patients; however, medical school curricula and psychiatric residency training programs devote little attention to their care. This article aims to assist adult psychiatrists who are not gender specialists in the delivery of respectful, clinically competent, and culturally attuned care to gender-variant patients, including those who identify as transgender or transsexual or meet criteria for the diagnosis of Gender Dysphoria (GD) as defined by The Diagnostic and Statistical Manual of Mental Disorders (5th edition)...
2018: Transgender Health
https://www.readbyqxmd.com/read/29713688/nurse-practitioner-knowledge-attitudes-and-beliefs-when-caring-for-transgender-people
#4
Catherine Paradiso, Robin M Lally
Purpose: The aim of this study was to explore Nurse Practitioner (NP) knowledge, attitudes, and beliefs when working with transgender people and to inform about Practitioner education needs. Methods: A qualitative descriptive design was used to explore (NP) experiences. Focused semistructured interviews were conducted in 2016 with 11 ( N =11) NPs in the northeastern United States who represent various years of experience and encounters with transgender patients. The interviews explored NP knowledge attitudes and beliefs when caring for transgender patients and described their overall experiences in rendering care in the clinical setting...
2018: Transgender Health
https://www.readbyqxmd.com/read/29713687/implementing-a-single-session-nurse-led-assessment-clinic-into-a-gender-service
#5
Donna M Eade, Michelle M Telfer, Michelle A Tollit
The Royal Children's Hospital Gender Service offers support, assessment, and medical care to transgender and gender diverse children and adolescents in Victoria, Australia. Referrals have rapidly increased leading to extended wait times. In response, a single-session nurse-led assessment clinic (SSNac) was introduced as the clinical entry point to the service, during which a biopsychosocial assessment is undertaken, and information, education, and support are provided. Outcomes of the SSNac include a significant reduction in wait times and a timely clinical triage system...
2018: Transgender Health
https://www.readbyqxmd.com/read/29682613/advocacy-for-gender-affirming-care-learning-from-the-injectable-estrogen-shortage
#6
Sophia Geffen, Tim Horn, Kimberleigh Joy Smith, Sean Cahill
Hormone therapy is medically necessary for many transgender individuals. The U.S. Food and Drug Administration (FDA) and pharmaceutical companies' failure to guarantee a supply of injectable estrogen in 2016 and 2017 for transgender individuals is a violation of their right to comprehensive medical treatment, free of discrimination. A series of advocacy actions eventually led to all formulations of injectable estrogen being restored to market; however, long-term solutions to supply interruptions of injectable estrogen are needed...
2018: Transgender Health
https://www.readbyqxmd.com/read/29503873/exploring-healthcare-experiences-for-incarcerated-individuals-who-identify-as-transgender-in-a-southern-jail
#7
Erin McCauley, Kristen Eckstrand, Bethlehem Desta, Ben Bouvier, Brad Brockmann, Lauren Brinkley-Rubinstein
Purpose: To document the health-related experiences and needs of jail detainees who self-identified as transgender women. Methods: Semistructured interviews with 10 transgender women of color were conducted in a county jail in a mid-sized southern city between 2015 and 2016. Interviews were recorded and transcribed, and later analyzed using a general inductive approach. Results: Participants experienced high levels of abuse and harassment, solitary confinement, mental health issues, and lack of access to hormone treatment...
2018: Transgender Health
https://www.readbyqxmd.com/read/29445772/a-review-of-evidence-based-treatments-for-transgender-youth-diagnosed-with-social-anxiety-disorder
#8
REVIEW
Samantha Busa, Aron Janssen, Mallika Lakshman
In addition to the high prevalence of gender dysphoria among transgender youth, this population is at greater risk of suffering from additional mental health disorders, including social anxiety disorder, compared to their cisgender peers. Cognitive behavioral therapy (CBT) has been established as an effective form of treatment for social anxiety disorder. It is recommended that therapists modify and adapt CBT when working with minority groups such as transgender youth to ensure that the treatment is efficacious and culturally sensitive...
2018: Transgender Health
https://www.readbyqxmd.com/read/29372185/case-report-induced-lactation-in-a-transgender-woman
#9
Tamar Reisman, Zil Goldstein
Objective: Our report describes a case of nonpuerperal induced lactation in a transgender woman. Methods: We present the relevant clinical and laboratory findings, along with a review of the relevant literature. Results: A 30-year-old transgender woman who had been receiving feminizing hormone therapy for the past 6 years presented to our clinic with the goal of being able to breastfeed her adopted infant. After implementing a regimen of domperidone, estradiol, progesterone, and breast pumping, she was able to achieve sufficient breast milk volume to be the sole source of nourishment for her child for 6 weeks...
2018: Transgender Health
https://www.readbyqxmd.com/read/29359198/beyond-the-binary-differences-in-eating-disorder-prevalence-by-gender-identity-in-a-transgender-sample
#10
Elizabeth W Diemer, Jaclyn M White Hughto, Allegra R Gordon, Carly Guss, S Bryn Austin, Sari L Reisner
Purpose: To investigate whether the prevalence of eating disorders (EDs) differs across diverse gender identity groups in a transgender sample. Methods: Secondary analysis of data from Project VOICE, a cross-sectional study of stress and health among 452 transgender adults (ages 18-75 years) residing in Massachusetts. Age-adjusted logistic regression models were fit to compare the prevalence of self-reported lifetime EDs in female-to-male (FTM), male-to-female (MTF), and gender-nonconforming participants assigned male at birth (MBGNC) to gender-nonconforming participants assigned female at birth (FBGNC; referent)...
2018: Transgender Health
https://www.readbyqxmd.com/read/29344576/clinical-exposure-to-transgender-medicine-improves-students-preparedness-above-levels-seen-with-didactic-teaching-alone-a-key-addition-to-the-boston-university-model-for-teaching-transgender-healthcare
#11
Jason A Park, Joshua D Safer
Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients...
2018: Transgender Health
https://www.readbyqxmd.com/read/29344575/mammary-myofibroblastoma-in-a-transgender-patient-on-feminizing-hormones-literature-review-and-case-report
#12
Jane O'Bryan, Carolyn Wolf-Gould, Yoshiro Matsuo
Purpose: Defining the risk of neoplasia associated with gender-affirming hormone therapy (GAHT) is a priority for transgender medical research. The purposes of this article are to present a unique case of breast neoplasia in a transgender individual and to review the existing evidence base on GAHT as a potential risk for breast pathology. Methods: We present the case of a 76-year-old transgender patient who developed an estrogen receptor-positive mammary myofibroblastoma (MFB) after 13 months of treatment on feminizing hormones...
2018: Transgender Health
https://www.readbyqxmd.com/read/29279875/enacted-stigma-mental-health-and-protective-factors-among-transgender-youth-in-canada
#13
Jaimie F Veale, Tracey Peter, Robb Travers, Elizabeth M Saewyc
Purpose: We aimed to assess the Minority Stress Model which proposes that the stress of experiencing stigma leads to adverse mental health outcomes, but social supports (e.g., school and family connectedness) will reduce this negative effect. Methods: We measured stigma-related experiences, social supports, and mental health (self-injury, suicide, depression, and anxiety) among a sample of 923 Canadian transgender 14- to 25-year-old adolescents and young adults using a bilingual online survey. Logistic regression models were conducted to analyze the relationship between these risk and protective factors and dichotomous mental health outcomes among two separate age groups, 14- to 18-year-old and 19- to 25-year-old participants...
2017: Transgender Health
https://www.readbyqxmd.com/read/29177196/to-refer-or-not-to-refer-general-pediatricians-perspectives-on-their-role-in-caring-for-transgender-youth
#14
Deirdre A Shires, Ashley Schnaar, Maureen D Connolly, Daphna Stroumsa
Little is known about general pediatricians' experience and knowledge regarding the care of transgender youth. We surveyed N =50 general pediatricians practicing in an integrated Midwest health system. Few respondents had participated in medical management care for transgender patients, but one-third were willing to do so if training opportunities were made available. Notably, <60% of respondents were comfortable providing routine care for transgender youth. At a minimum, pediatricians need the training to feel capable of providing routine care for transgender pediatric patients...
2017: Transgender Health
https://www.readbyqxmd.com/read/29159312/perceived-parental-attitudes-of-gender-expansiveness-development-and-preliminary-factor-structure-of-a-self-report-youth-questionnaire
#15
Marco A Hidalgo, Diane Chen, Robert Garofalo, Catherine Forbes
Purpose: Parental acceptance of gender identity/expression in lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) youth moderates the effects of minority stress on mental health outcomes. Given this association, mental health clinicians of gender-expansive adolescents often assess the degree to which these youth perceive their parents/primary caregivers as accepting or nonaffirming of their gender identity and expression. While existing measures may reliably assess youth's perceptions of general family support, no known tool aids in the assessment an adolescent's perceived parental support related to adolescent gender-expansive experiences...
2017: Transgender Health
https://www.readbyqxmd.com/read/29159311/the-response-of-the-menstrual-cycle-to-initiation-of-hormonal-therapy-in-transgender-men
#16
Shazia Ahmad, Matthew Leinung
Purpose: Transition from female to male gender after initiation of hormonal therapy involves both phenotypic and physiological changes. The response to treatment can vary widely from person to person. In this study, we looked at the response of the menstrual cycle after the initiation of testosterone therapy and we wished to determine the time period and dose of testosterone leading to the cessation of menses in transgender men. Methods: A retrospective chart review of 114 transgender men (individuals assigned female gender at birth but later identify themselves as males) seen for hormonal therapy in our transgender clinic from 2006 through 2016...
2017: Transgender Health
https://www.readbyqxmd.com/read/29159310/factors-associated-with-gender-affirming-surgery-and-age-of-hormone-therapy-initiation-among-transgender-adults
#17
Noor Beckwith, Sari L Reisner, Shayne Zaslow, Kenneth H Mayer, Alex S Keuroghlian
Purpose: Gender-affirming surgeries and hormone therapy are medically necessary treatments to alleviate gender dysphoria; however, significant gaps exist in the research and clinical literature on surgery utilization and age of hormone therapy initiation among transgender adults. Methods: We conducted a retrospective review of electronic health record data from a random sample of 201 transgender patients of ages 18-64 years who presented for primary care between July 1, 2010 and June 30, 2015 (inclusive) at an urban community health center in Boston, MA...
2017: Transgender Health
https://www.readbyqxmd.com/read/29159309/hiv-testing-in-urban-transgender-individuals-a-descriptive-study
#18
Adrian Juarez-Cuellar, Yu-Ping Chang
HIV testing is considered the initial component of HIV eradication strategies. This study aimed to describe HIV testing in urban, transgender individuals in western New York. The study uses HIV testing intake data from a sample of self-identified transgender males and females volunteering for an HIV test at a community-based healthcare organization. Transgender individuals with some characteristics were found to have more HIV tests including female gender, black, HIV status (positive), a history of incarceration, sex worker, housing situation, and self-referral...
2017: Transgender Health
https://www.readbyqxmd.com/read/29159308/transgender-and-gender-nonconforming-youths-public-facilities-use-and-psychological-well-being-a-mixed-method-study
#19
Lance S Weinhardt, Patricia Stevens, Hui Xie, Linda M Wesp, Steven A John, Immaculate Apchemengich, David Kioko, Shannon Chavez-Korell, Katherine M Cochran, Jennifer M Watjen, Nickolas H Lambrou
Purpose: In this study, we explored experiences and feelings of safety in public facilities in relation to psychological well-being among transgender and gender nonconforming (TGNC) youth in the Midwest in the summer of 2016, in the context of ongoing legislative proposals and regulations regarding school and public bathroom use in the United States. Methods: We used a mixed-method approach, with (1) a self-administered, paper-and-pencil survey of 120 TGNC youth, focusing on differences of self-esteem, resilience, quality of life (QoL), perceived stigma, feelings of safety, and experiences of public facility use and (2) two focus group interviews ( n =9) in which TGNC youth discussed individual perceptions, attitudes, and experiences of bathroom use outside participants' homes...
2017: Transgender Health
https://www.readbyqxmd.com/read/29142910/induction-and-maintenance-of-amenorrhea-in-transmasculine-and-nonbinary-adolescents
#20
REVIEW
Jeremi M Carswell, Stephanie A Roberts
The treatment of persistent uterine bleeding in those patients who identify as transmasculine or nonbinary is often straightforward, but can be difficult in a subset of patients. This article reviews the physiology of the normal menstrual cycle and the hormonal influences on the endometrium, and then explores options for the treatment of persistent bleeding for people both already on testosterone and for those who are either not ready for or who do not desire testosterone.
2017: Transgender Health
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