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Transgender Medicine

Jamie Lindemann Nelson
Feminism has fought the trivialization of women's experiences, championed women's security, and insisted on respect for women's choices. In so doing, feminism has developed important perspectives on the complicated connections between what gender means as it plays itself in people's lives, and the inequalities of power and authority that structure much of human experience. Here, I put a few of these perspectives into contact with an issue where the interactions of gender and power are squarely in play: medicine's role in assisting gender transitioning generally and, specifically, the enduring controversy between medicine and many transgender people about the pathologization of transgender and the role of clinicians as gatekeepers to gender-transition interventions...
November 1, 2016: AMA Journal of Ethics
Madeline B Deutsch, Asa Radix, Sari Reisner
Transgender medicine presents a particular challenge for the development of evidence-based guidelines, due to limitations in the available body of evidence as well as the exclusion of gender identity data from most public health surveillance activities. The guidelines that have been published are often based on expert opinion, small studies, and data gathered outside the US. The existence of guidelines, however, helps legitimate the need for gender-affirming medical and surgical interventions. Research conducted on transgender populations should be grounded in gender-affirming methodologies and focus on key areas such as health outcomes after gender-affirming interventions...
November 1, 2016: AMA Journal of Ethics
Joseph J Shatzel, Kara J Connelly, Thomas G DeLoughery
Clinicians, including hematologists,are more frequently encountering transgender individuals in practice; however,most lack training on the management and complications of transgender medicine. Hormonal therapy forms the backbone of medical interventions for patients undergoing gender transition. While supplementing an individual's intrinsic sex hormone is associated with a variety of hematologic complications including increased rates of venous thrombosis, cardiovascular events, erthyrocytosis, and malignancy, the risks of supplementing with opposing sex hormones are not well understood...
October 25, 2016: American Journal of Hematology
Kristi E Gamarel, Larry Brown, Christopher W Kahler, M Isabel Fernandez, Douglas Bruce, Sharon Nichols
OBJECTIVES: The purpose of this study was to better understand the prevalence and correlates of substance use behaviors among HIV-infected adolescents in HIV care settings. METHODS: A cross-sectional sample of 2216 youth living with HIV (YLWH; ages 12-26) were recruited through the Adolescent Trials Network for HIV Interventions. Participants completed a one-time survey on sociodemographic factors, substance use and health behaviors. We used logistic regression models to understand the correlates of substance use outcomes...
October 11, 2016: Drug and Alcohol Dependence
David A Fessler, Grace C Huang, Jennifer Potter, Joseph J Baker, Howard Libman
BACKGROUND: Declining mortality has led to a rising number of persons living with HIV (PLWH) and concerns about a future shortage of HIV practitioners. AIM: To develop an HIV Primary Care Track for internal medicine residents. SETTING: Academic hospital and community health center with a history of caring for PLWH and lesbian, gay, bisexual, and transgender (LGBT) patients. PARTICIPANTS: Internal medicine residents. PROGRAM DESCRIPTION: We enrolled four residents annually in a 3-year track with the goal of having each provide continuity care to at least 20 PLWH...
October 4, 2016: Journal of General Internal Medicine
Stef M Shuster
To alleviate uncertainty in the specialized field of transgender medicine, mental and physical healthcare providers have introduced the rhetoric of evidence-based medicine (EBM) in clinical guidelines to help inform medical decision making. However there are no diagnostic tests to assess the effectiveness of transgender medical interventions and no scientific evidence to support the guidelines. Using in-depth interviews with a purposive sample of 23 healthcare providers, I found that providers invoked two strategies for negotiating the guidelines...
September 2016: Journal of Health and Social Behavior
Maureen D Connolly, Marcus J Zervos, Charles J Barone, Christine C Johnson, Christine L M Joseph
This review provides an update on the growing body of research related to the mental health of transgender youth that has emerged since the 2011 publication of the Institute of Medicine report on the health of lesbian, gay, bisexual, and transgender people. The databases PubMed and Ovid Medline were searched for studies that were published from January 2011 to March 2016 in English. The following search terms were used: transgender, gender nonconforming, gender minority, gender queer, and gender dysphoria. Age limits included the terms youth, child, children, teenager*, and adolescen*...
November 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Cherrie B Boyer, Lauren Greenberg, Kate Chutuape, Bendu Walker, Dina Monte, Jennifer Kirk, Jonathan M Ellen
The goal of this research was to examine associations among sociodemographic factors, HIV risk, and community context (e.g., economic insecurity, job training, housing instability, crime victimization, and perceived community norms) in adolescents and young adults who ever exchanged sex for drugs or money. Anonymous survey data were collected using ACASIs at community venues where adolescents and young adults congregate in resource-challenged, STI prevalent, urban, US neighborhoods. Conventional descriptive statistics, Fisher's exact tests, and generalized estimating equations approaches were used to examine associations...
August 6, 2016: Journal of Community Health
Rona L Siskind, Michele Andrasik, Shelly T Karuna, Gail B Broder, Clare Collins, Albert Liu, Jonathan Paul Lucas, Gary W Harper, Philip O Renzullo
In 2009, the National Institutes of Health recognized the need to expand knowledge of lesbian, gay, bisexual, and transgender (LGBT) health and commissioned the Institute of Medicine to report on the health of these populations in the United States. The resulting Institute of Medicine publication called for more knowledge of the health of LGBT populations, as well as improved methodologies to reach them, more LGBT-focused research, and enhanced training programs and cultural competency of physicians and researchers...
August 15, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Alan W Shindel, Abdulaziz Baazeem, Ian Eardley, Eli Coleman
INTRODUCTION: This article explores the evolution and current delivery of undergraduate medical education in human sexuality. AIM: To make recommendations regarding future educational needs, principles of curricular development, and how the International Society for Sexual Medicine (ISSM) should address the need to enhance and promote human sexuality education around the world. METHODS: The existing literature was reviewed for sexuality education, curriculum development, learning strategies, educational formats, evaluation of programs, evaluation of students, and faculty development...
July 2016: Journal of Sexual Medicine
Madeline B Deutsch
Transgender people have a gender identity different from their birth-assigned sex. Transgender people may seek gender-affirming surgeries to align their body with their identified gender. With increasing visibility of transgender identities, and recognition of the importance of gender-affirming care, has come a policy shift toward mandated coverage or provision of blanket exclusions of these procedures by insurance companies and Medicaid. The World Professional Association for Transgender Health provides guidance to mental health professionals evaluating patients for gender-affirming surgeries, including making a diagnosis and assessing for capacity to consent...
2016: Journal of Health Care for the Poor and Underserved
Amelia E Talley, Paul A Gilbert, Jason Mitchell, Jeremy Goldbach, Brandon D L Marshall, Debra Kaysen
ISSUES: In 2011, the Institute of Medicine released a report that constituted the first comprehensive effort by a federal body to understand the current state of science pertinent to the health needs of sexual and gender minority populations. This mini-review summarises recent empirical, methodological and theoretical advances in alcohol-related research among to lesbian, gay, bisexual and transgender (LGBT) populations and highlights progress towards addressing gaps, with a particular interest in those identified by the Institute of Medicine report...
July 2016: Drug and Alcohol Review
Sven E S Eriksson, Joshua D Safer
OBJECTIVE: Previous studies have demonstrated that the addition of transgender medicine content to a medical school curriculum increased students' comfort and willingness to treat transgender patients. We aimed to demonstrate that (1) evidence-based curricular content would improve knowledge of and change attitudes towards transgender medicine, and (2) students would consider cross-sex hormone therapy a legitimate treatment option for transgender patients. METHODS: Curricular content with a focus on the biologic evidence for the durability of gender identity was added to the first-year medical program at Boston University School of Medicine...
July 2016: Endocrine Practice
Sari L Reisner, Katie B Biello, Jaclyn M White Hughto, Lisa Kuhns, Kenneth H Mayer, Robert Garofalo, Matthew J Mimiaga
IMPORTANCE: Transgender youth, including adolescent and young adult transgender women assigned a male sex at birth who identify as girls, women, transgender women, transfemale, male-to-female, or another diverse transfeminine gender identity, represent a vulnerable population at risk for negative mental health and substance use outcomes. Diagnostic clinical interviews to assess prevalence of mental health, substance dependence, and comorbid psychiatric disorders in young transgender women remain scarce...
May 1, 2016: JAMA Pediatrics
Joshua D Safer, Eli Coleman, Wylie Hembree
No abstract text is available yet for this article.
April 2016: Current Opinion in Endocrinology, Diabetes, and Obesity
Shalender Bhasin
CONTEXT: Men's health and aging are emerging as important areas of research opportunity because of advances in reproductive biology and the recognition of men's health as a unique and important aspect of public health. EVIDENCE ACQUISITION: A perspective of the evolving landscape in male reproductive medicine. EVIDENCE SYNTHESIS: Remarkable discoveries in reproductive biology have greatly advanced the treatment of erectile dysfunction, androgen deficiency, infertility, hormone sensitive cancers, and prostate diseases...
March 2016: Journal of Clinical Endocrinology and Metabolism
Jessica Lapinski, Kristine M Diaz
No abstract text is available yet for this article.
February 2016: Journal of the American Osteopathic Association
Baligh R Yehia, Daniel Calder, Judd D Flesch, Rebecca L Hirsh, Eve Higginbotham, Nancy Tkacs, Beverley Crawford, Neil Fishman
Academic health centers are strategically positioned to impact the health of lesbian, gay, bisexual and transgender (LGBT) populations by advancing science, educating future generations of providers, and delivering integrated care that addresses the unique health needs of the LGBT community. This report describes the early experiences of the Penn Medicine Program for LGBT Health, highlighting the favorable environment that led to its creation, the mission and structure of the Program, strategic planning process used to set priorities and establish collaborations, and the reception and early successes of the Program...
December 2015: LGBT Health
Nelson F Sánchez, Susan Rankin, Edward Callahan, Henry Ng, Louisa Holaday, Kadian McIntosh, Norma Poll-Hunter, John Paul Sánchez
PURPOSE: Diversity efforts in the academic medicine workforce have often neglected the identification and inclusion of lesbian, gay, bisexual, and transgender (LGBT) health professionals. Many of these professionals have served as educators, researchers, administrators, and leaders at their academic institutions, but their perspectives on the barriers to and facilitators of pursuing academic careers, as well as the perspectives of trainees, have not been explored. METHODS: We applied a purposeful convenience sampling strategy to collect quantitative and qualitative data among LGBT health care professionals (HCP) and trainees...
December 2015: LGBT Health
Hendry Ton, W Suzanne Eidson-Ton, Ana-Maria Iosif, Nicole Sitkin, Shelly Henderson, Edward J Callahan
OBJECTIVE: Lesbian, gay, bisexual, and transgender (LGBT) populations experience significant health disparities, yet medical schools report devoting little educational time to the care of this population. In light of this, one School of Medicine utilized a daylong retreat to design a 4-year sexual orientation and gender identity (SOGI) curriculum. METHODS: The participants completed pre-and post-surveys on their perspectives and knowledge towards SOGI learning, and the school's curriculum database was reviewed 2 years later to ascertain the degree of implementation of the proposed curriculum...
October 2016: Academic Psychiatry
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