scholarly journals Gender identity and the management of the transgender patient: a guide for non-specialists

2017 ◽  
Vol 110 (4) ◽  
pp. 144-152 ◽  
Author(s):  
Albert Joseph ◽  
Charlotte Cliffe ◽  
Miriam Hillyard ◽  
Azeem Majeed
Keyword(s):  
Gender Identity ◽  
Gender Dysphoria ◽  
General Medical Council ◽  
Legal Framework ◽  
Medical Council ◽  
Transgender People ◽  
Self Harm ◽  
Exact Size ◽  
And Gender ◽  
The Uk

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.

Gender Dysphoria, Eating Disorders and Body Image: An Overview

2020 ◽  
Vol 20 (4) ◽  
pp. 518-524 ◽  
Author(s):  
Walter Milano ◽  
Paola Ambrosio ◽  
Francesa Carizzone ◽  
Valeria De Biasio ◽  
Giuseppina Foggia ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Gender Identity ◽  
Gender Dysphoria ◽  
Eating Behaviors ◽  
The Body ◽  
Prevention Measures ◽  
Transgender People ◽  
Effective Prevention ◽  
Biological Sex ◽  
And Gender

Background:: Gender dysphoria is a clinical condition in which a state of inner suffering, stress and anxiety is detected when biological sex and a person's gender identity do not coincide. People who identify themselves as transgender people are more vulnerable and may have higher rates of dissatisfaction with their bodies which are often associated with a disorderly diet in an attempt to change the bodily characteristics of the genus of birth and, conversely, to accentuate the characteristics of the desired sexual identity. Aim:: The purpose of this work is to examine the association between dissatisfaction with one's own body and eating and weight disorders in people with gender dysphoria. Results:: Gender dysphoria and eating disorders are characterized by a serious discomfort to the body and the body suffers in both conditions. The results of our study suggest that rates of pathological eating behaviors and symptoms related to a disordered diet are high in patients with gender dysphoria and that standard screening for these symptoms must be considered in both populations at the time of evaluation and during the course of the treatment. Conclusions:: In light of this evidence, clinicians should always investigate issues related to sexuality and gender identity in patients with eating disorders, to develop more effective prevention measures and better strategies for therapeutic intervention..

Gender diversity

2019 ◽  
pp. 41-46
Keyword(s):  
Health Service ◽  
Gender Identity ◽  
Sexual Health ◽  
Gender Dysphoria ◽  
Cervical Screening ◽  
Gender Diversity ◽  
Gender Recognition ◽  
Sexual Health Service ◽  
And Gender ◽  
The Uk

This chapter on gender diversity focuses on the care of transgender and non-binary (NB) people. It provides a list of definitions that help to differentiate between terms such as gender identity, gender expression, gender role, and gender dysphoria. Diagnostic frameworks, and social and medical transition are defined. The differing genital surgery options (vaginoplasty, vulvoplasty, metoidioplasty, phalloplasty) for trans, including NB, people are explained and the UK Gender Recognition Act is outlined. The chapter then focuses on information that may assist those who are providing a sexual health service for trans, including NB, people including potential presentations to such services and advice on contraception and cervical screening.

The Duties of Doctors In Medical Education: A Letter To The Editor (Preprint)

2019 ◽  
Author(s):  
Sneha Barai
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Role Models ◽  
Role Model ◽  
General Medical Council ◽  
Future Generations ◽  
Medical Council ◽  
Positive Role ◽  
The Uk ◽  
And Training

UNSTRUCTURED The UK General Medical Council (GMC) explicitly states doctors have a duty to ‘contribute to teaching and training…by acting as a positive role model’. However, recent studies suggest some are not fulfilling this, which is impacting medical students' experiences and attitudes during their training. As such, doctors have a duty to act as role models and teachers, as specified by the GMC, which it seems are not currently being fulfilled. This would improve the medical students’ learning experiences and demonstrate good professional values for them to emulate. Therefore, these duties should be as important as patient care, since this will influence future generations.

scholarly journals Medical Students’ Experience of Mindfulness Training in the UK: Well-Being, Coping Reserve, and Professional Development

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Alice Malpass ◽  
Kate Binnie ◽  
Lauren Robson
Keyword(s):  
Medical Education ◽  
Mental Health Problems ◽  
Qualitative Interviews ◽  
General Medical Council ◽  
Well Being ◽  
Mindfulness Training ◽  
The Body ◽  
Free Text ◽  
Medical Council ◽  
The Uk

Medical school can be a stressful experience for students, resulting in stress-related mental health problems. Policy recommendations from the General Medical Council (GMC), the body responsible for improving medical education in the UK, recommend the use of mindfulness training to increase well-being and resilience to stress. Students participating in an eight-week mindfulness training between Autumn 2011 and Spring 2015 were invited to complete a free text survey at the end of their mindfulness course. In addition, six qualitative interviews were conducted lasting between 60 and 90 minutes. Interviews used a topic guide and were recorded and transcribed verbatim. We used the framework approach to analyse the data. Students reported a new relationship to their thoughts and feelings which gave a greater sense of control and resiliency, an ability to manage their workload better, and more acceptance of their limitations as learners. The small group context was important. Students described improved empathy and communication skills through building inner awareness of thoughts and feelings, noticing judgments, and developing attentive observation. The findings show how resiliency and coping reserve can be developed within medical education and the role of mindfulness in this process. We present a conceptual model of a learnt cycle of specific vulnerability and describe how MBCT intercepts at various junctures in this self-reinforcing cycle through the development of new coping strategies that embrace an “allowed vulnerability.”

scholarly journals Mandating doctors to attend counter-terrorism workshops is medically unethical

2016 ◽  
Vol 40 (2) ◽  
pp. 87-88 ◽  
Author(s):  
Derek Summerfield
Keyword(s):  
Medical Association ◽  
Ethical Leadership ◽  
Ethical Issues ◽  
Civil Liberties ◽  
General Medical Council ◽  
British Medical Association ◽  
Medical Council ◽  
Counter Terrorism ◽  
Mandatory Training ◽  
The Uk

SummaryThis is a brief exploration of the ethical issues raised for psychiatrists, and for universities, schools and wider society, by the demand that they attend mandatory training as part of the UK government's Prevent counter-terrorism strategy. The silence on this matter to date on the part of the General Medical Council, medical Royal Colleges, and the British Medical Association is a failure of ethical leadership. There is also a civil liberties issue, reminiscent of the McCarthyism of 1950s USA. We should refuse to attend.

Thinking about ethnicity and gender diversity in children and young people

2018 ◽  
Vol 24 (2) ◽  
pp. 291-303 ◽  
Author(s):  
Nastasja M de Graaf ◽  
Ilham I Manjra ◽  
Anna Hames ◽  
Claudia Zitz
Keyword(s):  
Young People ◽  
Identity Development ◽  
Gender Identity ◽  
Gender Diversity ◽  
Age Groups ◽  
Chi Square ◽  
Children And Young People ◽  
And Gender ◽  
The Uk ◽  
Ethnicity Data

Background: Little is known about how social and cultural variants interact with gender identity development. This article aims to identify the ethnicities of children and young people referred to the United Kingdom’s national Gender Identity Development Service (GIDS), and compare the ethnicity data with the UK child population and referrals to Child and Adolescent Mental Health Services (CAMHS). Methods: GIDS referrals made between April 2012 and April 2015 for children and young people were retrieved. Ethnicity data were obtained by the ‘16 + 1’ ethnicity list. Chi-square and t-tests were performed on the demographics. Results: Less than 10% of the 995 referrals at GIDS were from Black and minority ethnic (BME) groups – an underrepresentation as compared with both the national population and CAMHS figures. No significant differences in ethnic representation were found between the demographic birth-assigned sexes, across age groups, or year of referral. Conclusions: Hypotheses proposed for this underrepresentation take into account both the potential barriers to accessing services and the possibility of cross-cultural variations in the conceptualisations of gender, gender roles and gender diversity. Ethnicity, culture and religion, and their overlapping relationship with gender need further exploration.

An adolescent requesting to pause puberty

2021 ◽  
pp. 203-212
Author(s):  
Cordelia Y. Ross ◽  
Alex S. Keuroghlian
Keyword(s):  
Gender Identity ◽  
Hormone Therapy ◽  
Gender Dysphoria ◽  
Social Stigma ◽  
Developmental History ◽  
Psychiatric Assessment ◽  
Gender Expression ◽  
Gender Affirmation ◽  
History Of ◽  
And Gender

Gender dysphoria occurs when a patient has distress associated with incongruence between a person’s experienced gender and the gender traditionally associated with their sex assigned at birth. This must occur for at least six months. The psychiatric assessment of a patient with gender dysphoria should include exploration of the child’s developmental history of gender-expansive identification and expression; sources of distress relating to familial, community, and social stigma; and ways to help families adopt an accepting and nurturing response. Gender affirmation can include psychological, social, legal, and biological interventions. The goal of psychotherapy is to help a person explore, discover, and affirm their gender identity. Social affirmation may include changing names, pronouns, and gender expression. Legal gender affirmation may take place through a name or gender marker change on official documents. Biological affirmation may include pubertal suppression for younger adolescents, gender-affirming hormone therapy, and/or gender-affirming surgery.

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