Eating disorder symptomatology in transgender patients: Differences across gender identity and gender affirmation

2021 ◽  
Author(s):  
Dustin Z. Nowaskie ◽  
Andrew T. Filipowicz ◽  
Yena Choi ◽  
Janine M. Fogel
Keyword(s):  
Eating Disorder ◽  
Gender Identity ◽  
Gender Affirmation ◽  
Eating Disorder Symptomatology ◽  
And Gender

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.

scholarly journals Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018121 ◽  
Author(s):  
Virginia P Quinn ◽  
Rebecca Nash ◽  
Enid Hunkeler ◽  
Richard Contreras ◽  
Lee Cromwell ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Status ◽  
Gender Identity ◽  
Index Date ◽  
Free Text ◽  
Kaiser Permanente ◽  
Transgender People ◽  
Transition Outcomes ◽  
Gender Affirmation ◽  
And Gender

PurposeThe Study of Transition, Outcomes and Gender (STRONG) was initiated to assess the health status of transgender people in general and following gender-affirming treatments at Kaiser Permanente health plans in Georgia, Northern California and Southern California. The objectives of this communication are to describe methods of cohort ascertainment and data collection and to characterise the study population.ParticipantsA stepwise methodology involving computerised searches of electronic medical records and free-text validation of eligibility and gender identity was used to identify a cohort of 6456 members with first evidence of transgender status (index date) between 2006 and 2014. The cohort included 3475 (54%) transfeminine (TF), 2892 (45%) transmasculine (TM) and 89 (1%) members whose natal sex and gender identity remained undetermined from the records. The cohort was matched to 127 608 enrollees with no transgender evidence (63 825 women and 63 783 men) on year of birth, race/ethnicity, study site and membership year of the index date. Cohort follow-up extends through the end of 2016.Findings to dateAbout 58% of TF and 52% of TM cohort members received hormonal therapy at Kaiser Permanente. Chest surgery was more common among TM participants (12% vs 0.3%). The proportions of transgender participants who underwent genital reconstruction surgeries were similar (4%–5%) in the two transgender groups. Results indicate that there are sufficient numbers of events in the TF and TM cohorts to further examine mental health status, cardiovascular events, diabetes, HIV and most common cancers.Future plansSTRONG is well positioned to fill existing knowledge gaps through comparisons of transgender and reference populations and through analyses of health status before and after gender affirmation treatment. Analyses will include incidence of cardiovascular disease, mental health, HIV and diabetes, as well as changes in laboratory-based endpoints (eg, polycythemia and bone density), overall and in relation to gender affirmation therapy.

scholarly journals Management of gender incongruence and gender affirmation surgeries – The Indian perspective, from a large volume gender identity clinic

2021 ◽  
Vol 0 ◽  
pp. 1-8
Author(s):  
Richie Gupta ◽  
Rajat Gupta
Keyword(s):  
Gender Identity ◽  
Large Volume ◽  
Tertiary Care ◽  
Senior Author ◽  
Standards Of Care ◽  
Care Hospital ◽  
Relative Paucity ◽  
Gender Affirmation ◽  
And Gender ◽  
Development Orientation

A mismatch between the birth sex of a person and psychological recognition of self (gender) leads to a gender expression, which is at variance with the societal norms, and thus gives rise to a persistent distress, which is known as gender incongruence (GI) (previously gender dysphoria). These persons are known as trans genders. A subset of these individuals feels that they are trapped in the wrong sexed body and need to bring their physical sex into alignment with their gender. The “gender” is already imprinted into the brain at birth, and hence cannot be changed, but the physical sex of a person can be, through gender affirmation surgeries (GAS). There has been relative paucity of data from India regarding medical and surgical affirmative management of trans-persons, and hence, the authors present their experience in GAS together with current demography, hypothesis regarding etiology and management, as carried out in India. Authors have been providing comprehensive affirmative management to trans persons, through their multi-specialty gender identity clinic (GIC) sited in a tertiary care hospital. Over past 27 years, the senior author has performed over 3,000 GAS. The authors have noticed a 20- fold rise in presentation of these cases (from six cases per year in 1993 to now around 150 cases in the year 2019), an observation, which is similar to the experience of large volume GICs worldwide, as well as many recent publications. There has been a steep rise in the number of persons with GI worldwide, and those reporting at GICs. In the face of this rising number, authors present their experience, together with current demographics and management. Authors have also contributed to the first version of Indian Standards of Care for persons with GI and people with differences in sexual development/orientation Indian standards of care 1in November 2020.

scholarly journals Characterizing eating disorder diagnosis and related outcomes by sexual orientation and gender identity in a National Sample of college students

2021 ◽  
pp. 101528
Author(s):  
Anne Claire Grammer ◽  
Melissa Vazquez ◽  
Ellen E. Fitzsimmons-Craft ◽  
Lauren A. Fowler ◽  
Gavin N. Rackoff ◽  
...  
Keyword(s):  
College Students ◽  
Eating Disorder ◽  
Sexual Orientation ◽  
Gender Identity ◽  
National Sample ◽  
And Gender

scholarly journals Measuring Satisfaction and Comfort with Gender Identity and Gender Expression among Transgender Women: Development and Validation of the Psychological Gender Affirmation Scale

2021 ◽  
Vol 18 (6) ◽  
pp. 3298
Author(s):  
Jae M. Sevelius ◽  
Deepalika Chakravarty ◽  
Samantha E. Dilworth ◽  
Greg Rebchook ◽  
Torsten B. Neilands
Keyword(s):  
Factor Analysis ◽  
Gender Identity ◽  
High Reliability ◽  
Well Being ◽  
Transgender Women ◽  
Gender Expression ◽  
Gender Diverse ◽  
Gender Affirmation ◽  
Psychological Gender ◽  
And Gender

Among transgender and gender diverse people, psychological gender affirmation is an internal sense of valuing oneself as a transgender or gender diverse person, being comfortable with one’s gender identity, and feeling satisfied with one’s body and gender expression. Gender affirmation can reduce gender dysphoria and mitigate deleterious health effects of marginalization. We sought to create an instrument to measure psychological gender affirmation among transgender women. Following initial item development using qualitative interviews, we used self-administered survey data from two distinct samples (N1 = 278; N2 = 368) of transgender women living with HIV in the USA. We used data from Study 1 to perform exploratory factor analysis (EFA) and data from Study 2 to perform confirmatory factor analysis (CFA), yielding the five-item single-factor Psychological Gender Affirmation (PGA) scale with high reliability (α = 0.88). This scale is psychometrically sound as demonstrated by its convergent and discriminant validity via correlations with select measures and by its predictive validity through associations in hypothesized directions with measures of mental health and substance use. The PGA scale will aid research on psychological gender affirmation that can in turn inform interventions as well as gender-affirming clinical and social practices to promote the health and well-being of transgender and gender diverse people.

scholarly journals Descriptive Study of Transgender Youth Receiving Health Care in the Gender Identity Program in Southern Brazil

2021 ◽  
Vol 12 ◽  
Author(s):  
Bianca Machado Borba Soll ◽  
Anna Martha Fontanari ◽  
Angelo Brandelli Costa ◽  
Ítala Chinazzo ◽  
Dhiordan Cardoso Silva ◽  
...  
Keyword(s):  
Health Care ◽  
Gender Identity ◽  
Gender Dysphoria ◽  
Care Service ◽  
Health Care Service ◽  
Well Being ◽  
Southern Brazil ◽  
Transgender Youth ◽  
Gender Affirmation ◽  
And Gender

Since 2014, the Gender Identity Program (PROTIG) of Hospital de Clínicas de Porto Alegre (HCPA) has been assisting transgender youth seeking gender-affirmative treatment offered at a public health-care service specializing in gender in southern Brazil. This article aims to analyze sociodemographic and clinical data regarding the diagnoses of gender dysphoria and gender incongruence, psychiatric comorbidities, and clinical aspects of a sample of transgender youths seeking health care in the gender identity program. The research protocol consisted of a survey of the data collected in the global psychological evaluation performed at the health-care service for youths diagnosed with gender incongruence and their caretakers. Participating in this research were 24 transgender youths between 8 and 16 years old with diagnostic overlap of gender dysphoria [Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)] and gender incongruence [International Classification of Diseases, 11th Revision (ICD-11)] and 34 of their caregivers. Of the young people, 45.8% were positive for some psychiatric comorbidity throughout their lives, with almost half (45.4%) having two or more psychiatric comorbidities in addition to gender dysphoria. The mental health professionals comprising affirmation care teams face the challenge of adapting the care protocols to the uniqueness of each demand by developing individualized forms to promote healthy development. This can be done by focusing not only on medical and physical interventions for gender affirmation but also on the promotion of mental health and general emotional well-being. Thus, the gender affirmation model, which advocates for global assessment and personalized guidance, proved to be adequate. Nevertheless, access to multidisciplinary health services specializing in gender is essential for promoting the general well-being of the population of transgender youth.

Effects of Gender, Parental Role, and Time on Infant- and Adult-Directed Read and Spontaneous Speech

2019 ◽  
Vol 62 (11) ◽  
pp. 4001-4014
Author(s):  
Melanie Weirich ◽  
Adrian Simpson
Keyword(s):  
Parental Involvement ◽  
Gender Identity ◽  
Spontaneous Speech ◽  
First Year ◽  
Space Size ◽  
Vowel Space ◽  
Potential Impact ◽  
Phonetic Features ◽  
And Gender ◽  
Description Task

Purpose The study sets out to investigate inter- and intraspeaker variation in German infant-directed speech (IDS) and considers the potential impact that the factors gender, parental involvement, and speech material (read vs. spontaneous speech) may have. In addition, we analyze data from 3 time points prior to and after the birth of the child to examine potential changes in the features of IDS and, particularly also, of adult-directed speech (ADS). Here, the gender identity of a speaker is considered as an additional factor. Method IDS and ADS data from 34 participants (15 mothers, 19 fathers) is gathered by means of a reading and a picture description task. For IDS, 2 recordings were made when the baby was approximately 6 and 9 months old, respectively. For ADS, an additional recording was made before the baby was born. Phonetic analyses comprise mean fundamental frequency (f0), variation in f0, the 1st 2 formants measured in /i: ɛ a u:/, and the vowel space size. Moreover, social and behavioral data were gathered regarding parental involvement and gender identity. Results German IDS is characterized by an increase in mean f0, a larger variation in f0, vowel- and formant-specific differences, and a larger acoustic vowel space. No effect of gender or parental involvement was found. Also, the phonetic features of IDS were found in both spontaneous and read speech. Regarding ADS, changes in vowel space size in some of the fathers and in mean f0 in mothers were found. Conclusion Phonetic features of German IDS are robust with respect to the factors gender, parental involvement, speech material (read vs. spontaneous speech), and time. Some phonetic features of ADS changed within the child's first year depending on gender and parental involvement/gender identity. Thus, further research on IDS needs to address also potential changes in ADS.

Effect of Heart Rate Variability on Defensive Reaction and Eating Disorder Symptomatology in Chocolate Cravers

2009 ◽  
Vol 23 (3) ◽  
pp. 95-103 ◽  
Author(s):  
Sonia Rodríguez-Ruiz ◽  
Elisabeth Ruiz-Padial ◽  
Nieves Vera ◽  
Carmen Fernández ◽  
Lourdes Anllo-Vento ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Eating Disorder ◽  
Eating Behavior ◽  
Rest Period ◽  
Food Craving ◽  
Defensive Reaction ◽  
Relevant Role ◽  
Eating Disorder Symptomatology ◽  
Uncontrolled Eating

The study examines the effect of heart rate variability (HRV) on the cardiac defence response (CDR) and eating disorder symptomatology in chocolate cravers. Female chocolate cravers (n = 36) and noncravers (n = 36) underwent a psychophysiological test to assess their HRV during a 5-min rest period, followed by three trials to explore the CDR, elicited by an intense white noise, during the viewing of chocolate, neutral, and unpleasant pictures. After the test, participants completed a questionnaire to measure eating disorder symptomatology. The HRV was inversely related to the magnitude of the CDR and to eating disorder symptomatology in chocolate cravers. In addition, the HRV was inversely related to the magnitude of the CDR when viewing unpleasant pictures but not to neutral or chocolate ones, across all participants. These findings support the idea that poor autonomic regulation, indexed by low HRV, plays a relevant role in food craving and uncontrolled eating behavior.

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