scholarly journals Development of Hip Bone Geometry in Transgender Adolescents Resembles the Experienced Gender if GnRHa Treatment Is Started in Early, but Not Late, Puberty

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A789-A790
Author(s):  
Maria A T C van der Loos ◽  
Ilse Hellinga ◽  
Mariska C Vlot ◽  
Daniel T Klink ◽  
Martin Den Heijer ◽  
...  
Keyword(s):  
General Population ◽  
Sex Steroids ◽  
Mixed Model ◽  
Bone Geometry ◽  
Strength Analysis ◽  
Reference Curve ◽  
Time Data ◽  
Transgender People ◽  
Trans Men ◽  
Trans Women

Abstract Bone geometry can be described in terms of periosteal and endocortical growth and is partly determined by sex steroids. Periosteal and endocortical apposition are thought to be regulated by testosterone and estrogen, respectively. Gender-affirming hormone (GAH) treatment with sex steroids in transgender people might affect bone geometry. However, in adult transgender people no change in bone geometry during GAH was observed. In this study, we investigated changes in bone geometry among transgender adolescents using a gonadotropin-releasing hormone agonist (GnRHa) and GAH prior to achieving peak bone mass. Transgender adolescents treated with GnRHa and subsequent GAH at our center before the age of 18 years were eligible for inclusion. Participants were grouped based on their Tanner stage at the start of GnRHa treatment and divided into early, mid, and late puberty groups. Hip Strength Analysis software calculating subperiosteal width (SPW) and endocortical diameter (ED) was applied to dual-energy X-ray absorptiometry scans performed at start of GnRHa and GAH treatments, and after ≥ 2 years of GAH treatment. Mixed model analyses were performed to study differences over time. Data were visually compared with reference values of the general population retrieved from the literature. A total of 322 participants were included, of whom 106 trans women and 216 trans men. In both trans women and trans men participants resembled the reference curve for SPW and ED of the experienced gender, but only when GnRHa was started during early puberty. Those who started during mid- and late puberty remained within the reference curve of the gender assigned at birth. A possible explanation might be sought in the phenomenon of programming, which conceptualizes that stimuli during critical windows of development can have major consequences throughout one’s lifespan. Therefore, this study adds insights into sex-specific bone geometry development during puberty of transgender adolescents treated with GnRHa, as well as the general population.

scholarly journals Mental Health Inequities among Transgender People in Aotearoa New Zealand: Findings from the Counting Ourselves Survey

2020 ◽  
Vol 17 (8) ◽  
pp. 2862
Author(s):  
Kyle K.H. Tan ◽  
Sonja J. Ellis ◽  
Johanna M. Schmidt ◽  
Jack L. Byrne ◽  
Jaimie F. Veale
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
New Zealand ◽  
General Population ◽  
Age Groups ◽  
Health Inequities ◽  
Transgender People ◽  
Aotearoa New Zealand ◽  
Trans Women ◽  
Distress Scale

There has been little international research looking at differences in mental health across different age groups. This study examines mental health inequities between transgender people and the Aotearoa/New Zealand general population from youth to older adulthood. The 2018 Counting Ourselves survey (N = 1178) assessed participants’ mental health using the Kessler Psychological Distress Scale (K10) and diagnoses of depression and anxiety disorders, questions that were the same as those used in the New Zealand Health Survey. Our results showed significant mean score differences for transgender people on K10, and these differences were almost two standard deviations higher than the general population (Cohen’s d = 1.87). The effect size differences, however, decreased from youth to older adults. Regression analyses indicated trans women were less likely to report psychological distress than trans men and non-binary participants. There was an interaction effect for age and gender, with lower psychological distress scores found for younger trans women but higher scores for older trans women. The stark mental health inequities faced by transgender people, especially youth, demonstrate an urgent need to improve the mental health and wellbeing of this population by implementing inclusive institutional practices to protect them from gender minority stress.

scholarly journals Incident diabetes risk is not increased in transgender individuals using hormone therapy

2021 ◽  
Author(s):  
Daan van Velzen ◽  
Chantal Wiepjes ◽  
Nienke Nota ◽  
Daniel van Raalte ◽  
Renée de Mutsert ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
General Population ◽  
Hormone Therapy ◽  
Trans Men ◽  
Data Registry ◽  
Central Registry ◽  
In Trans ◽  
Trans Women

Abstract Background In trans women receiving hormone therapy, body fat and insulin resistance increases, with opposite effects in trans men. These metabolic alterations may alter the risk of developing type 2 diabetes in trans women and trans men. We aimed to compare the incidence of type 2 diabetes of adult trans women and trans men during hormone therapy with rates from their birth sex in the general population. Methods Retrospective data from the Amsterdam Cohort of Gender Dysphoria with transgender individuals on hormone therapy between 1972 and 2018 were linked to a nationwide health data registry. Because no central registry of diabetes is available, the occurrence of diabetes was inferred from the first dispense of a glucose-lowering agent. Standardized incidence ratios (SIR) were computed for trans women and trans men in comparison with the same birth sex from the general population. Results Compared to their birth sex in the general population, no difference in the incidence of type 2 diabetes mellitus was observed in trans women (N=2585, 90 cases, SIR 0.94 95%CI 0.76–1.14) or trans men (N=1514, 32 cases, SIR 1.40 95%CI 0.96–1.92). Conclusion Despite studies reporting an increase in insulin resistance in feminizing hormone therapy and a decrease in insulin resistance in masculinizing hormone therapy, the incidence of diabetes in transgender individuals after initiation of hormone therapy was not different compared to the general population.

Categorical Exclusions: How Racialized Gender Regulation Reproduces Reentry Hardship

2018 ◽  
Vol 66 (4) ◽  
pp. 548-563
Author(s):  
Joss T Greene
Keyword(s):  
Service Providers ◽  
Formerly Incarcerated ◽  
Transgender People ◽  
Trans Men ◽  
Gender Categorization ◽  
Housing Programs ◽  
Stable Housing ◽  
Trans Women ◽  
Gender Regulation ◽  
Racialized Gender

AbstractSince gender organizes key reentry services such as housing, formerly incarcerated people seeking resources must successfully inhabit a gender category. Drawing on seven months of ethnography and 79 interviews with service providers and formerly incarcerated transgender people, I show that these organizational practices of gender categorization are racialized and impact resource access. Most gender-segregated housing programs rely on biology-based definitions of gender. These gender rules create workable options for trans men to stay with women, but bar trans women from women’s spaces. Once in gendered housing programs, clients need to navigate gender assessment in interactions. Trans men employed several strategies to establish gendered selves who were easily categorized as either male or female, which allowed them to access stable housing. Gender sanctioning posed a major problem for black trans women. Black trans women were highly scrutinized in women’s programs, characterized as illegitimate based on biological definitions of gender, and harassed for any perceived deviation from gender norms. When harassment escalated into conflict, they were expelled from programs. Regulation of black trans women’s womanhood led to systematic material deprivation. By understanding the connections between categorical exclusions and exclusion from resources we can better understand the reproduction of reentry hardship and inequality more broadly.

scholarly journals Breast cancer risk in transgender people receiving hormone treatment: nationwide cohort study in the Netherlands

BMJ ◽  
2019 ◽  
pp. l1652 ◽  
Author(s):  
Christel J M de Blok ◽  
Chantal M Wiepjes ◽  
Nienke M Nota ◽  
Klaartje van Engelen ◽  
Muriel A Adank ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
The Netherlands ◽  
Confidence Interval ◽  
Invasive Breast Cancer ◽  
Hormone Treatment ◽  
Transgender People ◽  
Trans Men ◽  
In Trans ◽  
Trans Women

AbstractObjectiveTo investigate the incidence and characteristics of breast cancer in transgender people in the Netherlands compared with the general Dutch population.DesignRetrospective, nationwide cohort study.SettingSpecialised tertiary gender clinic in Amsterdam, the Netherlands.Participants2260 adult trans women (male sex assigned at birth, female gender identity) and 1229 adult trans men (female sex assigned at birth, male gender identity) who received gender affirming hormone treatment.Main outcome measuresIncidence and characteristics (eg, histology, hormone receptor status) of breast cancer in transgender people.ResultsThe total person time in this cohort was 33 991 years for trans women and 14 883 years for trans men. In the 2260 trans women in the cohort, 15 cases of invasive breast cancer were identified (median duration of hormone treatment 18 years, range 7-37 years). This was 46-fold higher than in cisgender men (standardised incidence ratio 46.7, 95% confidence interval 27.2 to 75.4) but lower than in cisgender women (0.3, 0.2 to 0.4). Most tumours were of ductal origin and oestrogen and progesterone receptor positive, and 8.3% were human epidermal growth factor 2 (HER2) positive. In 1229 trans men, four cases of invasive breast cancer were identified (median duration of hormone treatment 15 years, range 2-17 years). This was lower than expected compared with cisgender women (standardised incidence ratio 0.2, 95% confidence interval 0.1 to 0.5).ConclusionsThis study showed an increased risk of breast cancer in trans women compared with cisgender men, and a lower risk in trans men compared with cisgender women. In trans women, the risk of breast cancer increased during a relatively short duration of hormone treatment and the characteristics of the breast cancer resembled a more female pattern. These results suggest that breast cancer screening guidelines for cisgender people are sufficient for transgender people using hormone treatment.

scholarly journals A Tale of Two Trans Men: Transmasculine Identity and Trauma in Two Fairy-Tale Retellings

2021 ◽  
Vol 5 (1) ◽  
pp. 181-193
Author(s):  
Jeana Jorgensen
Keyword(s):  
Fairy Tales ◽  
Fairy Tale ◽  
Trauma Victim ◽  
Transgender People ◽  
Gender Fluidity ◽  
Trans Men

Abstract Transgender identities in fairy tale retellings are rare, but can reveal much about gender fluidity. Helen Oyeyemi’s novel Boy, Snow, Bird conflates transgender identities with mirrored falsehoods and fairy-tale spells, pathologizing a trauma victim who turns out to also become an abuser, while Gabriel Vidrine’s novella “A Pair of Raven Wings” depicts a queer transgender man with dignity, making it clear that the trauma he suffers is at the hands of bigots rather than being an invention of a sick mind or the cause of his transition. Pairing these fairy-tale retellings illuminates the topic of gender fluidity in fairy tales by demonstrating that gender is indeed fluid, but that representations of gender fluidity due to trauma are misguided at best and harmful at worst, while those representations that assert the dignity of transgender people, even as they face trauma at the hands of bigoted people, are another stellar example of the genre’s potential to represent people who are culturally marginalized, connecting identity to power in a classic magical fairy-tale move.

scholarly journals Factors Associated With Ruminative Thinking in Individuals With Gender Dysphoria

2021 ◽  
Vol 12 ◽  
Author(s):  
Dhiordan Cardoso Silva ◽  
Leonardo Romeira Salati ◽  
Anna Paula Villas-Bôas ◽  
Karine Schwarz ◽  
Anna Martha Fontanari ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Gender Dysphoria ◽  
Self Report ◽  
Psychological State ◽  
Trans Men ◽  
Gender Affirmation ◽  
History Of ◽  
Trans Women ◽  
Gender Affirmation Surgery ◽  
Brooding And Reflection

This study aimed to examine psychosocial factors and medical history as well as symptoms of depression, anxiety, and stress associated with ruminative thinking in transgender people with gender dysphoria (GD) before undergoing gender affirmation surgery (GAS). This study evaluated 189 participants with GD (111 trans women and 78 trans men) from a specialized service for GAS in southern Brazil. Semi-structured interviews were conducted, and participants were asked to complete self-report questionnaires. We recovered participants' sociodemographic and psychosocial data (e.g., history of sexual abuse, expulsion from home, and history of drug use) and data regarding their clinical history (e.g., medication, history of suicidal ideation and attempted suicide, and HIV status). Further, we implemented the Depression, Anxiety and Stress Scale (DASS-21) to examine participants' psychological state, as well as the Ruminative Response Scale (RRS) to assess ruminative thinking, which includes brooding and reflection. The predictor variables were those that exhibited a minimum level of significance of p ≤ 0.05 in multivariate linear regression. The ruminative thinking scores for trans women were higher than those of trans men (Brooding p = 0.014; Reflection p = 0.052).In the multivariate model, suicidal ideation, moderate depression, and severe/very severe anxiety were associated with both brooding and reflection. Feminine gender identity and stress symptoms moderated only brooding, while anxiety symptoms moderated only reflection. Our findings show that trans women had the highest ruminative thinking scores, and that depression, anxiety, stress, and suicidal ideation were associated with ruminative thinking in total sample. Psychological symptoms should be examined in the context of gender affirmation surgery to minimize the possibility of adverse mental health outcomes. Follow-up studies are required to measure ruminative thinking levels more accurately and to identify its predictors.

Projects Improving QoS of the Voice Real-Time Data Based on IP Network

2012 ◽  
Vol 220-223 ◽  
pp. 2471-2474
Author(s):  
Jin Hua Liang ◽  
Xuan Zen
Keyword(s):  
Mixed Model ◽  
Integrated Services ◽  
Differentiated Services ◽  
Small Scale ◽  
Time Data ◽  
Delay Jitter ◽  
Model Combining ◽  
Ip Network ◽  
Scale Network ◽  
The Voice

The reasons influencing the VoIP QoS include transmission delay, jitter and data packet drop. The main measures improving the VoIP QoS are the integrated services and the differentiated services. But the integrated service is only suitable for the small-scale network, and the differentiated services can’t guarantee QoS from the source end to the destination end for every IP data stream alone. The paper sets forth a kind of mixed model combining integrated Services with differentiated Services to support the VoIP QoS on the bases analysis of their defects.

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