Observations in a Gender Diversity Clinic

2019 ◽  
Vol 44 (2) ◽  
pp. 1-4
Author(s):  
Monique Robles ◽  
Keyword(s):  
Children And Adolescents ◽  
Social Worker ◽  
Gender Dysphoria ◽  
Gender Diversity ◽  
Adolescent Medicine ◽  
Ethical Concerns ◽  
Pediatric Endocrinologist ◽  
Number Of Patients ◽  
Medicine Physician ◽  
Treatment Plans

Recently, I was a physician-observer in a clinic for children and adolescents who are struggling with gender identity. Since the clinic opened several years ago, the number of patients seen annually has grown well over six hundred. The staff includes an adolescent-medicine physician, a pediatric endocrinologist, a nurse, and a social worker. I spent twenty-four hours over three clinic days observing the interactions of staff and listening to intake synopses of patients and discussions of treatment plans. My aim was to better understand the working diagnosis of gender dysphoria, the protocols used in treatment, and the ethical concerns. These objectives were not achieved in the way I expected.

The Co-Occurrence of Autism and Gender Diversity

2020 ◽  
pp. 197-211
Author(s):  
Jill C. Fodstad ◽  
Rebecca Elias ◽  
Shivali Sarawgi
Keyword(s):  
Gender Dysphoria ◽  
Gender Diversity ◽  
Gender Nonconforming ◽  
Medical Interventions ◽  
Gender Diverse ◽  
Nonbinary Gender ◽  
Psychiatric Conditions ◽  
The Common ◽  
And Gender

Gender diversity refers to gender expressions and/or gender identity experiences that vary from the common experiences of gender. Gender-diverse people may be gender nonconforming, gender nonbinary, gender fluid, gender exploring, transgender, and so forth. Some gender-diverse individuals experience gender dysphoria and/or gender incongruence and may require gender-affirming supports, including gender-affirming medical interventions. The co-occurrence of autism and gender diversity has been highlighted in a series of studies internationally as well as through rich community expressions. Studies in gender-referred individuals reveal high rates of autism traits as well as high rates of existing autism diagnoses. Studies in autistic populations reveal greater gender diversity characteristics. The long-term course of gender diversity in autistic individuals is poorly understood. Clinical guidelines have been developed for adolescents with the co-occurrence, but much work remains: No gender-related measures have been developed and tested for use in neurodiverse populations, no programs exist to support gender-diverse neurodiverse adults, and little is known about co-occurring mental health profiles, risks, or protective factors for people with the co-occurrence. The inclusion of this chapter on co-occurring autism and gender diversity within a book on “co-occurring psychiatric conditions” is problematic, because gender diversity is not a “psychiatric condition,” but instead a form of human diversity. The diagnosis of Gender Dysphoria is useful only insomuch as it allows individuals to obtain necessary gender-related supports. The authors’ choice to include this chapter in this book reflects a compromise, motivated by the need for educating both autism and gender specialists in this common co-occurrence.

scholarly journals Deep Learning: A New Horizon for Personalized Treatment of Depression?

2018 ◽  
Vol 16 (1) ◽  
Author(s):  
David Benrimoh ◽  
Robert Fratila ◽  
Sonia Israel ◽  
Kelly Perlman
Keyword(s):  
Deep Learning ◽  
Decision Aid ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Personalized Care ◽  
Treatment Of Depression ◽  
Number Of Patients ◽  
Treatment Plans ◽  
Patient Responses ◽  
Deep Learning Model

Globally, depression affects 300 million people and is projected be the leading cause of disability by 2030. While different patients are known to benefit from different therapies, there is no principled way for clinicians to predict individual patient responses or side effect profiles. A form of machine learning based on artificial neural networks, deep learning, might be useful for generating a predictive model that could aid in clinical decision making. Such a model’s primary outcomes would be to help clinicians select the most effective treatment plans and mitigate adverse side effects, allowing doctors to provide greater personalized care to a larger number of patients. In this commentary, we discuss the need for personalization of depression treatment and how a deep learning model might be used to construct a clinical decision aid.

scholarly journals Molecular Karyotyping in Children and Adolescents with Gender Dysphoria

2018 ◽  
Vol 3 (1) ◽  
pp. 147-153 ◽  
Author(s):  
Ken C. Pang ◽  
Debi Feldman ◽  
Ralph Oertel ◽  
Michelle Telfer
Keyword(s):  
Children And Adolescents ◽  
Gender Dysphoria ◽  
Molecular Karyotyping

scholarly journals Early Medical Treatment of Children and Adolescents With Gender Dysphoria: An Empirical Ethical Study

2015 ◽  
Vol 57 (4) ◽  
pp. 367-373 ◽  
Author(s):  
Lieke Josephina Jeanne Johanna Vrouenraets ◽  
A. Miranda Fredriks ◽  
Sabine E. Hannema ◽  
Peggy T. Cohen-Kettenis ◽  
Martine C. de Vries
Keyword(s):  
Medical Treatment ◽  
Children And Adolescents ◽  
Gender Dysphoria

Brief Report: Autistic Features in Children and Adolescents with Gender Dysphoria

2015 ◽  
Vol 45 (8) ◽  
pp. 2628-2632 ◽  
Author(s):  
Elin Skagerberg ◽  
Domenico Di Ceglie ◽  
Polly Carmichael
Keyword(s):  
Children And Adolescents ◽  
Gender Dysphoria

scholarly journals Invasive aspergillosis in children and adolescents with solid tumors: clinical cases and registry analysis

2019 ◽  
Vol 14 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Yu. V. Dinikina ◽  
O. V. Shadrivova ◽  
M. B. Belogurova ◽  
Yu. E. Melekhina ◽  
S. M. Ignatyeva ◽  
...  
Keyword(s):  
Invasive Aspergillosis ◽  
Children And Adolescents ◽  
Solid Tumors ◽  
Wilms Tumor ◽  
Underlying Disease ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Hematopoietic Stem ◽  
Additional Risk ◽  
Number Of Patients

We presented two cases of invasive aspergillosis (IA) in children with solid tumors, data of IA patients register, and a literature review. In theregister of patients with IA (1997–2018), we found 57 patients with IA from 0 to 18 years. It was established that the number of patients with solid tumors was 15.7 %. Background diseases were: central nervous system tumors – 33.5 %, neuroblastoma – 33.5 %, osteosarcoma – 11.0 %, Wilms tumor – 11.0 %, hemangioblastoma – 11.0 %. Chemotherapy-induced neutropenia was reported in 100 % of IA cases in children and adolescents with solid tumors. The additional risk factors were treatment in intensive care unit – 22.2 %, high-dose chemotherapy with autologous hematopoietic stem cell transplantation – 22.2 %, concomitant bacterial infection – 33.0 %. Surgical intervention for the underlying disease was performed in 77.7 % of patients. The most common clinical site of IA was the lungs – 88.9 %. The predominant clinical sign was fever – 66.7 %, cough and respiratory failure were seen less frequently – 33.4 % and33.4 %, respectively. The etiologicalagents of IA were Aspergillus fumigatus – 33.3 %, Aspergillus nidulans – 33.3 % and Aspergillus ustus – 33.3 %. 88.9 % of patients received antimycotic therapy, voriconazole predominantly – 66.7 %. Combination therapy was used in 33.3 % of patients. The overall 12-week survival in children and adolescents with IA in case of solid tumors was 77.8 %.

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