Mental health consequences of exercise withdrawal: A systematic review

IntroductionThe adverse physical consequences of female genital mutilation/cutting (FGM/C) have been thoroughly investigated and documented. Yet, we know little about the adverse mental health consequences of the practice. To fill this research gap, we systematically reviewed studies that assessed any adverse mental health consequences related to FGM/C.MethodsWe searched four databases from inception to 21 December 2018. We then reviewed all titles and abstracts for relevant studies. We used the National Institutes of Health quality assessment tool to appraise the quality of each study and the Newcastle-Ottawa Scale to rate the risk of bias within studies.ResultsWe included 16 studies in this review; only six studies examined the association between FGM/C and adverse mental health outcomes as the sole research question. Among the included studies, 10 were conducted at the participants’ country of origin. The sample size of the populations studied ranged from 3 to 4800 participants. Only one study received a rating of ‘good’ methodological quality.Fourteen of the 16 studies reported an association between FGM/C and at least adverse mental health outcome. These included eight studies that reported a higher burden of adverse mental health outcomes among women who underwent FGM compared with women who did not undergo FGM/C. Four studies reported a correlation between the severity of FGM/C and the severity of adverse mental health outcomes.ConclusionThis systematic review documents an association between FGM/C and adverse mental health outcomes. Importantly, our review demonstrates the need for more rigorous research on the topic.

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Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review

BMJ Open ◽

10.1136/bmjopen-2018-022425 ◽

2018 ◽

Vol 8 (12) ◽

pp. e022425 ◽

Cited By ~ 5

Author(s):

Talen Wright ◽

Bridget Candy ◽

Michael King

Keyword(s):

Mental Health ◽

Systematic Review ◽

Methodological Quality ◽

Healthcare Providers ◽

Case Series ◽

Access Barriers ◽

Health Consequences ◽

Transgender People ◽

Published Evidence ◽

And Gender

ObjectivesConversion is a term for treatments that seek to suppress or change a person’s sexual orientation or gender. Our review focuses on transgender and gender-diverse (TGD) people. Our aims were to (1) describe the frequency, nature and structure of conversion practices; (2) document difficulties in accessing transition-related healthcare and (3) evaluate the mental health consequences of such practices and access barriers.MethodSystematic review and narrative synthesis using the Critical Appraisals Skills Programme and Joanne Briggs Institute critical appraisal tools. Data sources include Embase, MEDLINE, PsychINFO, PsychARTICLES and Web of Science between 1990 and June 2017.ParticipantsStudies were included that (1) document use of conversion therapies or access barriers to transition-related healthcare; and/or (2) describe how such therapeutic practices and access barriers have been applied and/or (3) evaluate the mental health impacts of such therapies and difficulties accessing transition-related healthcare. Two reviewers screened papers for eligibility. Data were then grouped according to the objectives. Narratives and themes were presented per study.ResultsSeven studies met inclusion criteria. Four reports were on ‘realignment’, involving case studies or case series. Two involved psychoanalysis, one self-exposure therapy and one open-ended play psychotherapy. All four studies concerning ‘realignment’ were of poor methodological quality. The other three studies explored access barriers from the view point of TGD youth, their parents and healthcare providers. All papers reported access barriers, such as inability to access puberty-delaying medications. The papers concerning barriers to access were of good methodological quality.ConclusionWe found limited published evidence on use, nature, structure and/or health consequences of conversion therapies and access barriers to transition in TGD people. However, reports of restriction to access may indicate a more widespread problem. Research is needed into TGD people’s experiences of conversion therapy and access barriers to transition-related healthcareTrial registration numberCRD42017062149.

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