Mishandling the issue of gender dysphoria in India - an analysis of the transgender persons (Protection of Rights) Act, 2019

Manini Syali; Vinayak Jhamb

doi:10.1504/ijhrcs.2022.119450

Possible Neurobiological Underpinnings of Homosexuality and Gender Dysphoria

Cerebral Cortex ◽

10.1093/cercor/bhy090 ◽

2018 ◽

Vol 29 (5) ◽

pp. 2084-2101 ◽

Cited By ~ 14

Author(s):

A Manzouri ◽

I Savic

Keyword(s):

Magnetic Resonance Imaging ◽

Sexual Orientation ◽

Magnetic Resonance ◽

Gender Dysphoria ◽

Anterior Cingulate ◽

Sex Dimorphism ◽

Resonance Imaging ◽

Body Perception ◽

Functional Connections ◽

Transgender Persons

Abstract Although frequently discussed in terms of sex dimorphism, the neurobiology of sexual orientation and identity is unknown. We report multimodal magnetic resonance imaging data, including cortical thickness (Cth), subcortical volumes, and resting state functional magnetic resonance imaging, from 27 transgender women (TrW), 40 transgender men (TrM), and 80 heterosexual (40 men) and 60 homosexual cisgender controls (30 men). These data show that whereas homosexuality is linked to cerebral sex dimorphism, gender dysphoria primarily involves cerebral networks mediating self–body perception. Among the homosexual cisgender controls, weaker sex dimorphism was found in white matter connections and a partly reversed sex dimorphism in Cth. Similar patterns were detected in transgender persons compared with heterosexual cisgender controls, but the significant clusters disappeared when adding homosexual controls, and correcting for sexual orientation. Instead, both TrW and TrM displayed singular features, showing greater Cth as well as weaker structural and functional connections in the anterior cingulate-precuneus and right occipito-parietal cortex, regions known to process own body perception in the context of self.

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Gender incongruence and gender dysphoria in childhood and adolescence—current insights in diagnostics, management, and follow-up

European Journal of Pediatrics ◽

10.1007/s00431-020-03906-y ◽

2020 ◽

Author(s):

Hedi Claahsen - van der Grinten ◽

Chris Verhaak ◽

Thomas Steensma ◽

Tim Middelberg ◽

Joep Roeffen ◽

...

Keyword(s):

Mental Health Professionals ◽

Gender Dysphoria ◽

Medical Intervention ◽

Sex Characteristics ◽

Childhood And Adolescence ◽

Early Medical Intervention ◽

Gnrh Analogues ◽

Transgender Persons ◽

And Gender

AbstractGender incongruence (GI) is defined as a condition in which the gender identity of a person does not align with the gender assigned at birth. Awareness and more social acceptance have paved the way for early medical intervention about two decades ago and are now part of good clinical practice although much robust data is lacking. Medical and mental treatment in adolescents with GI is complex and is recommended to take place within a team of mental health professionals, psychiatrists, endocrinologists, and other healthcare providers. The somatic treatment generally consists of the use of GnRH analogues to prevent the progression of biological puberty and subsequently gender-affirming hormonal treatment to develop sex characteristics of the self-identified gender and surgical procedures. However to optimize treatment regimens, long-term follow-up and additional studies are still needed. What is known• The prevalence of gender dysphoria increased significantly in the past years and can lead to significant complaints and burdens especially during puberty.• Pubertal suppression and gender-affirmed treatment can be effectively used in adolescence with gender dysphoria.What is new• Transgender mental and medical healthcare is a long-lasting process during which not only the child/adolescent with GI but also their parents/family have to be counseled in making choices about their social, medical, and legal transitions.• There are an increasing number of transgender persons defining as nonbinary. Therefore, an individualized approach by an experienced team is necessary.

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Principles of Transgender Care for the Primary Care Physician

Osteopathic Family Physician ◽

10.33181/12064 ◽

2020 ◽

pp. 30-37

Author(s):

Robert Gotfried

Keyword(s):

Health Care ◽

Gender Identity ◽

Health Care Providers ◽

Gender Dysphoria ◽

Mental Health Problems ◽

Care Physician ◽

Internal Conflict ◽

Care Providers ◽

Transgender People ◽

Transgender Persons

The term transgender includes people whose gender identity differs from their sex assigned at birth. People identified as male at birth but possess a female gender identity are called transwomen and people identified as female at birth but experience a male gender identity are called transmen. Transgender individuals may also identify outside the binary norm. The prevalence of transgender people who seek medical treatment has dramatically increased in recent years. Transgender individuals have a higher prevalence of mental health problems, suicidality and premature mortality risk versus the general population. However, many transgender persons avoid medical care due to perceived stigma, in conjunction with transgender-specific knowledge deficits among health care providers. Integral to understanding transgender health is the concept of gender dysphoria. This refers to the internal conflict individuals experience due to incongruence between their birth sex and their self-perceived gender. For these individuals, the inconsistency causes significant internal conflict, often to the point that it interferes with functioning. To address gender dysphoria, many transgender people elect to transition to a gender role that is consistent with their gender identity. These individuals opt for medical and/or surgical interventions to do so. Medical therapy incorporates the use of cross-sex hormones to facilitate the acquisition of secondary sexual characteristics consistent with the individual’s internalized identity. Many transgender people choose to undergo gender-confirming surgeries in conjunction with hormonal therapy. Health care is transgender-affirming when it supports the patient’s inherent identity. Educating providers about this population’s unique needs can help reduce health disparities and promote respectful transgender care.

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Mishandling the issue of gender dysphoria in India - an analysis of the transgender persons (Protection of Rights) Act, 2019

International Journal of Human Rights and Constitutional Studies ◽

10.1504/ijhrcs.2021.10040579 ◽

2021 ◽

Vol 1 (1) ◽

pp. 1

Author(s):

Vinayak Jhamb ◽

Manini Syali

Keyword(s):

Gender Dysphoria ◽

Transgender Persons

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Safety and rapid efficacy of guideline-based gender-affirming hormone therapy: an analysis of 388 individuals diagnosed with gender dysphoria

Acta Endocrinologica ◽

10.1530/eje-19-0463 ◽

2020 ◽

Vol 182 (2) ◽

pp. 149-156

Author(s):

Gesine Meyer ◽

Moritz Mayer ◽

Antonia Mondorf ◽

Anna Katharina Flügel ◽

Eva Herrmann ◽

...

Keyword(s):

Hormone Therapy ◽

Gender Dysphoria ◽

Tanner Stage ◽

Hormone Treatment ◽

Breast Development ◽

Testosterone Levels ◽

Transgender Persons ◽

Gender Reassignment ◽

Male To Female ◽

Estradiol Levels

Objective Hormone treatment is an important part of gender reassignment therapy in gender dysphoria. Previous data about efficacy and safety are commonly based on small cohorts or they comprise former cohorts under meanwhile obsolete therapy regimes. Our objective was to investigate these topics in a large cohort of individuals under guideline-based treatment. Design/methods Cohort study of medical files of n = 155 male-to-female (transwomen) and n = 233 female-to-male transgender persons (transmen) of an Endocrine outpatient clinic between 2009 and 2017. Results Median time to reach amenorrhoea in transmen under testosterone monotherapy was 3 months, regardless of whether testosterone undecanoat or gel was used. Transmen with higher levels of hemoglobin 3–4 months after onset of GAHT had a greater chance to reach amenorrhea early, whereas testosterone levels showed no significant correlation (hemoglobin: HR: 1.639; 95% CI: 1.036–2.591, P = 0.035; testosterone: HR: 0.999; 95% CI: 0.998–1.001, P = 0.490). Estradiol levels (ρ −0.117; P = 0.316) had no significant influence on breast development in transwomen. Testosterone levels (ρ −0.398; P < 0.001) and FAI (ρ 0.346; P = 0.004) were significantly negatively correlated with reached Tanner stage. Liver values and blood lipids showed an alignment to reference range of the required sex in both groups. Relevant elevations of liver values were rare (2.44% in transmen, 4.23% in transwomen) and transient in most cases. Most relevant side effects were acne (44.8%), respectively erythrocytosis (up to 5.6%) in transmen and venous thrombembolism (1.9%) in transwomen. Conclusions Gender-affirming hormone therapy in accordance with current clinical practice guidelines is efficient and safe.

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