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1.
J Steroid Biochem Mol Biol ; 244: 106595, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39111705

RESUMEN

Transgender is a term for people whose gender identity or expression differs from their natal sex. These individuals often seek cross-hormonal therapy to simulate the individual´s desired gender. However, the use of estrogens and testosterone has side effects such as a higher propensity to cancer, weight changes and cardiovascular diseases. Testosterone has also been linked with hypertension. Still, little is known about the outcomes and prevalence of metabolic perturbations in the trans community. Here we aim to analyze if cross-administering sexual hormones affects heart mitochondrial function. Mitochondria produces the ATP needed for heart function. In fact, different studies show that mitochondrial dysfunction precedes cardiac damage. In this work we used either female rats castrated and injected with testosterone or male rats castrated and injected with estrogens for 4 months. We performed an electrocardiogram, and then we isolated heart mitochondria to measure the rate of oxygen consumption, calcium fluxes, membrane potential, superoxide dismutase activity, lipoperoxidation and cytokines. We detected wide modifications in all parameters associated to cross-hormonal administration.


Asunto(s)
Mitocondrias Cardíacas , Testosterona , Animales , Femenino , Masculino , Ratas , Mitocondrias Cardíacas/metabolismo , Mitocondrias Cardíacas/efectos de los fármacos , Testosterona/farmacología , Estrógenos/farmacología , Estrógenos/metabolismo , Ratas Wistar , Consumo de Oxígeno/efectos de los fármacos , Calcio/metabolismo , Peroxidación de Lípido/efectos de los fármacos , Terapia de Reemplazo de Hormonas
2.
Int Urogynecol J ; 35(8): 1663-1671, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38980327

RESUMEN

PURPOSE: The current study sought to evaluate the sexual function of transgender men and women and to identify associated factors. METHODS: Trans individuals who were outpatients at our gender incongruence (GI) center for follow-up of gender-affirming hormone therapy with age ranging 27 to 50 years were invited to participate in this cross-sectional study. Clinical data were collected from the medical records. Two scales, the Female Sexual Function Index (FSFI) and the Male Sexual Function Index (MSFI), were administered to all females (n = 50) and all males (n = 58). Each participant also responded to a semi-structured questionnaire that assessed feelings regarding being transgender and satisfaction with sexual life. RESULTS: Relative to trans women, trans men had a higher total FSFI score, and higher scores in the FSFI domains of arousal, lubrication, orgasm, and satisfaction (all p < 0.01), and in the total MSFI score, and higher scores in the MFSI domains of arousal, erection, orgasm, and satisfaction (all p < 0.01). A separate semi-structured evaluation indicated that more than half of the trans men and almost half of the trans women were satisfied or very satisfied with their sexual life. CONCLUSIONS: The total scores from the FSFI and MSFI indicated a high risk of sexual dysfunction in trans men and especially, in trans women. However, the semi-structured evaluation showed that more than half of the trans men and almost half of the trans women were satisfied with their sexual life.


Asunto(s)
Orgasmo , Personas Transgénero , Humanos , Masculino , Femenino , Adulto , Estudios Transversales , Personas Transgénero/psicología , Persona de Mediana Edad , Encuestas y Cuestionarios , Satisfacción Personal , Conducta Sexual , Disfunciones Sexuales Fisiológicas/etiología
3.
Psychoanal Q ; 93(2): 273-319, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38847749

RESUMEN

The aim of this article is twofold: firstly, to describe the seven-year analytic treatment of a TG adolescent (F "April" to M "Tran") and, secondly, based on the clinical observations, to propose a reflection on the intrapsychic events linked to gender transition. We could witness during this analysis that the dissonant anatomical sex, which is at the heart of the gender dysphoria, resists mentalization and consequently its psychological integration. The psychic events of transition, understood here on the model of a mourning process, could denote the various strategies necessary to the TG individual to negotiate the obstacle of mentalization.


Asunto(s)
Disforia de Género , Terapia Psicoanalítica , Personas Transgénero , Adolescente , Humanos , Disforia de Género/psicología , Disforia de Género/terapia , Identidad de Género , Terapia Psicoanalítica/métodos , Personas Transgénero/psicología
4.
Int Urogynecol J ; 35(6): 1271-1280, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38753049

RESUMEN

INTRODUCTION AND HYPOTHESIS: Transgender and gender-diverse people often experience discrimination or even outright exclusion when undergoing medical attention. It has been shown that gender-affirming treatments improve quality of life in transgender patients, and genital-affirming surgery (GAS) is increasingly spreading worldwide. Sexual function after male-to-female GAS has long been evaluated by using tools designed for assigned female at birth (AFAB), resulting in suboptimal assessments. Currently, the operated Male to Female Sexual Function Index (oMtFSFI) is the only validated questionnaire to assess the sexual function of operated transgender women. The current study was aimed at performing cross-cultural adaptation and to test the face validity of the Chilean version of the oMtFSFI. METHODS: We carried out an observational descriptive study. The questionnaire was translated into Spanish, adapted, and face validated in five phases with eight participants. The study was approved by the Universidad del Desarrollo Scientific Ethics Committee. RESULTS: According to participants, the questionnaire was shown to both pertinently and exhaustively evaluate the sexual function of post-feminizing genitoplasty transgender women. The questionnaire was well understood by the participants, except for a difficulty in understanding certain terms. Some participants criticized the perspective of the instrument in terms of the assumption of having a partner or having penetrative intercourse via the neovagina. The amendments to the Italian version of the questionnaire were discussed until an agreement on adaptation considering the patient´s perspective was reached. The present preliminary data support the face validity of the Chilean version of the oMtFSFI in the assessment of sexual function in operated transgender women. CONCLUSIONS: This adapted questionnaire could be a valuable tool for clinicians and researchers.


Asunto(s)
Personas Transgénero , Humanos , Chile , Femenino , Masculino , Encuestas y Cuestionarios/normas , Adulto , Personas Transgénero/psicología , Comparación Transcultural , Calidad de Vida , Traducciones , Reproducibilidad de los Resultados , Cirugía de Reasignación de Sexo , Conducta Sexual
5.
J Lesbian Stud ; : 1-15, 2024 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-38752335

RESUMEN

Few events evoke a divisive response amongst lesbians like the mentioning of the Michigan Womyn's Music Festival. Autoethnographies, interviews, podcasts, and books - just to name a few - continue to be crafted even after the forty-year festival's end. Unlike previous publications, this article approaches the festival using archival materials housed at Michigan State University donated by producer, Lisa Vogel, to unpack the signaling rhetoric of womyn-born-womyn (WBW). I center the experience Nancy Burkholder, a transsexual woman expelled from the festival, to navigate, as Nancy tried to navigate, the WBW "policy." I then take readers on a journey into the archive and articulate my research through calculated steps of tracing language through years of the festival. This article demonstrates how documents, created by festival producers, incited confusion for Nancy Burkholder during the festival and how these same documents now sustain an archival ambiguity.

6.
J Plast Reconstr Aesthet Surg ; 93: 30-35, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38631083

RESUMEN

BACKGROUND: To date, there are no studies investigating the safety and outcomes of facial feminization surgery (FFS) as an outpatient procedure. This is the first study of its kind analyzing the outcomes of ambulatory FFS based on a comparison of complications, post-operative emergency department or urgent care (ED/UC) visits, and readmissions between patients who underwent FFS with admission versus same-day surgery. METHODS: A retrospective analysis was conducted on all patients who underwent FFS in a single integrated healthcare system. Patient charts were reviewed for operative details, complications, post-operative ED/UC visits, readmission, and demographic factors. Major outcomes including complications, readmissions, and ED/UC visits were compared between groups with same-day discharge and post-operative hospital admission. RESULTS: Of 242 patients included in the study, ED/UC visits were comparable between patients discharged same-day (18.2%) and patients admitted post-operatively (21.6%, p = 0.52). Logistic regression showed no significant difference in the composite outcomes of minor complications, major complications, and readmissions (15.6% for ambulatory versus 19.3% for admission, p = 0.46). Temporary nerve palsy, infection, and hematoma were the most common post-operative complications. However, covariates of a lower face procedure and operative time were shown to have significant differences in the composite complication outcome (p = 0.04 and p = 0.045, respectively). CONCLUSION: Ambulatory FFS is a safe practice with no associated increase in adverse outcomes including complications, ED/UC visits, and readmission when compared to post-operative admission. Adoption of same-day FFS should be considered by high-volume gender health centers to potentially benefit from increased scheduling flexibility and efficiency, increased access to care, and lower healthcare costs.


Asunto(s)
Procedimientos Quirúrgicos Ambulatorios , Readmisión del Paciente , Complicaciones Posoperatorias , Humanos , Femenino , Procedimientos Quirúrgicos Ambulatorios/efectos adversos , Estudios Retrospectivos , Complicaciones Posoperatorias/epidemiología , Adulto , Readmisión del Paciente/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Cara/cirugía , Resultado del Tratamiento , Servicio de Urgencia en Hospital/estadística & datos numéricos , Feminización , Cirugía de Reasignación de Sexo/métodos
7.
Arch Sex Behav ; 53(5): 1681-1694, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38383942

RESUMEN

The traditional gender binary constitutes an integral aspect of Islamic social ethics, which has a pivotal role in shaping religious obligations, legal proceedings, and interpersonal judgments within Muslim communities. Within the familial sphere, this gender binary underscores fundamental responsibilities encompassing parenthood, filial duties, and inheritance rights. Recent years have witnessed a growing challenge to the traditional concept of the gender binary within Islamic societies. This shift is driven by increasing social libertarianism that emphasizes gender fluidity and individual choice. Hence, this article aims to critically scrutinize evolving discussions and controversies about the rights of intersex and transgender individuals, particularly issues relating to sex reassignment or gender-affirming surgery, marriage, and reproduction, from the perspective of the Sunni tradition of Islam. To support the various interpretations and insights presented here, a comprehensive and rigorous analysis is carried out on various religious texts and scholarly sources to elucidate the theological and jurisprudential positions on gender issues. It is thus concluded that Shariah offers greater flexibility in the treatment of intersex individuals compared to those with gender dysphoria because the intersex condition is viewed as a physical impairment that is not the choice of the afflicted individual. By contrast, in the case of individuals with gender dysphoria, they are willfully attempting to change their recognized biological sex, that God had naturally given to them at birth. Therefore, it is recommended that such transgender individuals deserve respectful psychological and social rehabilitation with help and guidance from religious authorities, their families, and communities.


Asunto(s)
Islamismo , Matrimonio , Derechos Sexuales y Reproductivos , Cirugía de Reasignación de Sexo , Personas Transgénero , Humanos , Cirugía de Reasignación de Sexo/legislación & jurisprudencia , Personas Transgénero/psicología , Matrimonio/legislación & jurisprudencia , Matrimonio/psicología , Masculino , Derechos Sexuales y Reproductivos/legislación & jurisprudencia , Femenino , Trastornos del Desarrollo Sexual/psicología , Trastornos del Desarrollo Sexual/cirugía
8.
REVISA (Online) ; 13(1): 24-31, 2024.
Artículo en Portugués | LILACS | ID: biblio-1531567

RESUMEN

Objetivo: analisar as evidências da literatura sobre aassistência de enfermagem à população transexual na atenção básica. Método:Revisão integrativa da literatura, realizada nas bases de dados Biblioteca Virtual em Saúde, Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS) e na Biblioteca Eletrônica Cientifica Online (SCIELO), utilizando os descritores Cuidados de enfermagem AND Pessoas transgênero AND Enfermagem de Atenção Primária. Resultados:Encontrados 2 artigos, publicados nos últimos 5 anos. Ficou evidenciado lacunas importantes que vem desde a formação acadêmica, no despreparo e desconhecimento acerca da sexualidade. Conclusão:Conclui-se, portanto, que foram encontrados poucos artigos com essa temática, evidenciando a necessidade de realização de mais pesquisas acerca do tema assistência de enfermagem à população transexual.


Objective: to analyze the evidence in the literature on nursing care for the transsexual population in primary care. Method:Integrative literature review, carried out in the Virtual Health Library, Latin American and Caribbean Literature in Health Sciences (LILACS) and Online Scientific Electronic Library (SCIELO) databases, using the descriptors Nursing care AND Transgender people AND Primary Care Nursing. Results:Found 2 articles, published in the last 5 years. It was evidenced important gaps that come from the academic formation, in the unpreparedness and lack of knowledge about sexuality. Conclusion:It is concluded, therefore, that few articles were found with this theme, highlighting the need to carry out more research on the topic of nursing care for the transsexual population.


Objetivo: analizar las evidencias en la literatura sobre el cuidado de enfermería a la población transexual en la atención primaria. Método:Revisión integrativa de la literatura, realizada en las bases de datos Biblioteca Virtual en Salud, Literatura Latinoamericana y Caribeña en Ciencias de la Salud (LILACS) y Biblioteca Científica Electrónica en Línea (SCIELO), utilizando los descriptores Cuidados de Enfermería Y Personas trans y Enfermería de Atención Primaria. Resultados: Se encontraron 2 artículos, publicados en los últimos 5 años. Se evidenció importantes lagunas que provienen de la formación académica, en la falta de preparación y conocimiento sobre la sexualidad. Conclusión:Se concluye, por lo tanto, que fueron encontrados pocos artículos con esta temática, destacando la necesidad de realizar más investigaciones sobre el tema del cuidado de enfermería a la población transexual.


Asunto(s)
Personas Transgénero , Atención Primaria de Salud , Atención de Enfermería
9.
Ciênc. Saúde Colet. (Impr.) ; 29(4): e19612023, 2024. tab, graf
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1557473

RESUMEN

Resumo A promoção da saúde sexual e reprodutiva no contexto da transmasculinidade representa uma nova temática para a organização dos serviços de saúde. A presente revisão integrativa tem por objetivo compreender as evidências atuais sobre a gestação em homens transexuais no contexto da atenção à saúde sexual e reprodutiva. A partir da busca nas bases de dados BVS, PubMed, Science Direct, Scopus, Capes, SciELO e PEPSIC, foi selecionada uma amostra de 11 artigos publicados entre 2010 e 2020, submetidos à análise de conteúdo e agrupados em quatro categorias de análise: serviços de saúde cis heteronormativos; serviços de saúde - experiências positivas; implicações da gestação nos corpos transexuais; repercussões da terapia de afirmação de gênero e gravidez. Verificou-se predomínio da lógica cis heteronormativa na atenção à saúde, que implica experiências negativas durante o pré-natal e o parto entre os homens transexuais. Estes apresentam necessidades singulares em saúde durante o ciclo gravídico puerperal, devendo ser incluído o cuidado à saúde mental. Sugere-se adoção de estratégias de qualificação profissional com vistas aos cuidados perinatais inclusivos e respeitosos para esse grupo populacional, além de novos estudos sobre o tema.


Abstract Promoting sexual and reproductive health in the context of transmasculinity constitutes a new issue for health service organisation. This integrative review sought to understand the current evidence on pregnancy in transsexual men in the context of sexual and reproductive health care. From a search of the BVS, PubMed, Science Direct, Scopus, Capes, SciELO and PEPSIC databases, from 2010 to 2020, a sample of 11 articles was selected, treated by content analysis and grouped into four analytical categories: health services - positive experiences; cis heteronormative health services; implications of pregnancy for transsexual bodies; and repercussions of gender-affirming therapy and pregnancy. A cis heteronormative logic was found to predominate in health care, leading to negative experiences during antenatal care and childbirth among transsexual men. Their unique health needs during the pregnancy-puerperium cycle should include mental health care. It is suggested that strategies be adopted to build capacity in health professionals with a view to respectful, inclusive perinatal care for this population group, as well as further studies on the subject.

10.
Curr Oncol Rep ; 25(12): 1431-1443, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37910274

RESUMEN

PURPOSE OF REVIEW: To systematically review the evidence on prostate cancer (PCa) in transgender women (TGW). RECENT FINDINGS: A total of 25 studies were included. Fourteen articles were case reports or case series describing 21 TGW with PCa; 11 papers focused primarily on assessing the incidence or screening of PCa in TGW. The median (range) age of patients with PCa was 63 (45-78) years. Median (range) PSA at diagnosis was 7.5 (0.4-1710) ng/mL. Prostate biopsy detected ISUP 3-5 in 10 (67%) cases. T3-4 stages were described in 7 (64%) patients. Three (14.3%) cases of nodal involvement and 2 (9.5%) of metastases were reported at diagnosis. First-line therapy included radical prostatectomy or radiotherapy ± androgen deprivation therapy in 14 (74 %) subjects. Median (range) follow-up was 24 (2-120) months. A good response to first-line therapy was recorded in 8 (47.1%) cases. Median (range) incidence of PCa in TGW was 44.1 (4.34-140) cases per 100,000 person-years. PCa was significantly less frequent in TGW than in cisgender males (HR 0.4, 95% CI 0.2-0.9). Risk of death after PCa diagnosis was significantly higher in TGW compared to cisgender males (HR 1.91, 95% CI 1.06-3.45). TGW had lower lifetime PSA rates (48% vs. 64.6%, p = 0.048) than cisgender males. Few cases of PCa in TGW are currently reported. PCa seems significantly less frequent in TGW than in cisgender males; however, some data suggest a possible higher mortality in this cohort. TGW appear to have less access to PSA testing than cisgender men.


Asunto(s)
Neoplasias de la Próstata , Personas Transgénero , Masculino , Humanos , Persona de Mediana Edad , Anciano , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/terapia , Antígeno Prostático Específico , Antagonistas de Andrógenos/uso terapéutico , Prostatectomía
11.
Ann Chir Plast Esthet ; 68(5-6): 491-497, 2023 Nov.
Artículo en Francés | MEDLINE | ID: mdl-37659876

RESUMEN

René Sève recalls that Contemporary Law in the Western World is based on autonomy of equal subjects, mutually recognizing the right to each carry out their own life project. The LGBTQIA+ person therefore exercises their ability to be their own species, according to Kirkegaard's word. It remains that "life project" also implies a constraint of stability and rationality. The author then shows, using Canadian and French statistical data, the difficulties of achieving this ideal for minors and, for adults, the other medical, paramedical and social conditions required. The rights of LGBT people cannot be considered independently of the physical and financial limits of the health system and therefore of the public debate on its priorities.


Asunto(s)
Personas Transgénero , Adulto , Humanos , Canadá , Derechos Humanos
12.
Healthcare (Basel) ; 11(18)2023 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-37761693

RESUMEN

Sexual violence is an understudied issue in the population of gay and bisexual men, although the existing articles to date demonstrate that it is a problem that merits public attention. This study aims to approach the problem of invisibility around the matter, as well as presenting a number of variables that have been usually overlooked in Spanish research or have not been assessed at all. Lifetime sexual victimization, sociodemographic characteristics, situational characteristics and social support were examined among 550 gay and bisexual males living in Spain using a self-administrated questionnaire. Results analysis show that 90.00% (87.18-92.38%) of participants reported at least one experience of unwanted insinuation, 87.27% (84.19-89.94%) reported at least one experience of sexual coercion, 64.00% (59.83-68.02%) reported at least one experience of sexual assault, and specifically 19.82% (16.57-23.40%) reported being raped during their lifetime. Significant differences have been found between some categories regarding gender identity, sexual orientation, age, race/ethnicity and educational level. Overall, these results showcase sexual violence as a pervasive problem in the Spanish gay and bisexual community.

13.
JMIR Dermatol ; 6: e45351, 2023 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-37616418

RESUMEN

BACKGROUND: Acne often worsens in transmasculine patients who are on prolonged testosterone therapy. Isotretinoin is an oral retinoid used in the treatment of severe or refractory cases of acne, but it has the potential to cause delayed wound healing. Transmasculine patients may potentially be prescribed treatment for acne with isotretinoin while also planning to undergo chest masculinization surgery. OBJECTIVE: This scoping review aims to determine whether isotretinoin has a negative impact on postoperative healing in transmasculine patients undergoing chest masculinization surgery. METHODS: A scoping review was performed using the PubMed and Ovid databases. A total of 16 publications were selected for inclusion. RESULTS: Acne tends to peak in transmasculine patients 6 months after initiation of testosterone treatment. Severe cases can be treated with isotretinoin; however, acne may recur once treatment is discontinued, given ongoing hormone therapy. There is little to no evidence in the medical literature regarding perioperative use of isotretinoin specifically among transmasculine patients undergoing chest masculinization surgery. In general, however, recent studies have found no evidence of increased hypertrophic scars or keloids in patients taking isotretinoin. CONCLUSIONS: Further studies are required to strengthen the current evidence that suggests that isotretinoin does not need to be discontinued before or after incisional or excisional surgeries, including chest masculinization surgery in transmasculine patients.

14.
Femina ; 51(6): 380-384, 20230630. ilus, tab
Artículo en Portugués | LILACS | ID: biblio-1512430

RESUMEN

Transgênero (trans) é um termo que alberga toda a diversidade de gênero. A incongruência de gênero faz parte desse espectro e refere-se à pessoa cuja identidade de gênero é oposta ao sexo que lhe foi atribuído no nascimento. A terapia hormonal de afirmação de gênero, bem como a cirurgia de afirmação de gênero, é necessária para adequar o corpo ao gênero ao qual a pessoa se identifica. Os homens trans necessitam da terapia com testosterona, que visa reduzir as concentrações de estradiol e incrementar a testosterona circulante para níveis fisiológicos masculinos, resultando em masculinização. A mulher trans receberá o estradiol, associado ou não a um antiandrogênico, visando reduzir a testosterona e incrementar o estrogênio para níveis femininos, resultando em feminização. A cirurgia de afirmação de gênero é, frequentemente, requerida para completar as modificações fenotípicas para o homem e a mulher trans. O ginecologista e obstetra tem um papel crucial no provimento de cuidados a essa população. O presente artigo visa sistematizar algumas ações que o ginecologista e obstetra pode oferecer e que têm potencial para melhorar a qualidade de vida dos homens e mulheres trans. (AU)


Transgenero (trans) is an umbrella term that encompasses all gender diversity. Gender Incongruity is part of this spectrum and refers to the person whose gender identity is opposed to the sex assigned to them at birth. Gender-affirming hormone therapy as well as gender-affirming surgery are necessary to adapt the body to the gender to which the person identifies. Trans men require testosterone therapy to reduce estradiol concentrations and increase circulating testosterone to male physiological levels resulting in masculinization. Trans women will receive estradiol associated or not with an antiandrogenic to reduce testosterone and increase estrogen to female levels resulting in feminization. gender-affirming surgery is often required to complete phenotypic modifications for trans men and women. The gynecologist and obstetrician plays a crucial role in to provide care to this population. This article aims to systematize some actions that the gynecologist and obstetrician can offer to improve the quality of life of trans men and women. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Atención a la Salud/ética , Ginecología , Neoplasias de la Próstata/prevención & control , Testosterona/administración & dosificación , Neoplasias de la Mama/prevención & control , Anticoncepción , Técnicas Reproductivas Asistidas , Estradiol/administración & dosificación , Estrógenos/administración & dosificación , Tromboembolia Venosa/prevención & control , Ginecólogos , Obstetras
15.
J Endocr Soc ; 7(5): bvad040, 2023 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-37063700

RESUMEN

Context: The effects of androgen therapy on arterial function in transgender men (TM) are not fully understood, particularly concerning long-term androgen treatment. Objective: To evaluate arterial stiffness in TM receiving long-term gender-affirming hormone therapy by carotid-femoral pulse wave velocity (cf-PWV). Methods: A cross-sectional case-control study at the Gender Dysphoria Unit of the Division of Endocrinology, HC-FMUSP, Sao Paulo, Brazil. Thirty-three TM receiving intramuscular testosterone esters as regular treatment for an average time of 14 ± 8 years were compared with 111 healthy cisgender men and women controls matched for age and body mass index. Aortic stiffness was evaluated by cf-PWV measurements using Complior device post-testosterone therapy. The main outcome measure was aortic stiffness by cf-PWV as a cardiovascular risk marker in TM and control group. Results: The cf-PWV after long-term testosterone therapy was significantly higher in TM (7.4 ± 0.9 m/s; range 5.8-8.9 m/s) than in cisgender men (6.6 ± 1.0 m/s; range 3.8-9.0 m/s, P < .01) and cisgender women controls (6.9 ± .9 m/s; range 4.8-9.1 m/s, P = .02). The cf-PWV was significantly and positively correlated with age. Analysis using blood pressure as a covariate showed a significant relationship between TM systolic blood pressure (SBP) and cf-PWV in relation to cisgender women but not to cisgender men. Age, SBP, and diagnosis of hypertension were independently associated with cf-PWV in the TM group. Conclusion: The TM group on long-term treatment with testosterone had higher aging-related aortic stiffening than the control groups. These findings indicate that aortic stiffness might be accelerated in the TM group receiving gender-affirming hormone treatment, and suggest a potential deleterious effect of testosterone on arterial function. Preventive measures in TM individuals receiving testosterone treatment, who are at higher risk for cardiovascular events, are highly recommended.

16.
J Appl Physiol (1985) ; 134(4): 1032-1037, 2023 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-36927141

RESUMEN

There is current scientific and legal controversy about sports competition eligibility regulations for transgender athletes. In this case study, we quantified performances by an elite, transgender woman (male sex, female gender identity) college swimmer who competed in both the men's and women's National Collegiate Athletic Association (NCAA) categories. We also contextualized her performances with respect to world-record performances and contemporary elite college swimmers. These data demonstrate that the declines in freestyle swimming performances of a transgender woman after about 2 yr of reported feminizing gender-affirming hormone treatment (0.5% for the 100 to 7.3% for the 1,650 yard distance) are smaller than the observed sex-related differences in performance of top 200 world record performances in metric distances of similar durations (11.4% for the 100 m to 9.3% for the 1,500 m distance). Despite slower performances, the transgender woman swimmer experienced improvements in performance for each freestyle event (100 to 1,650 yards) relative to sex-specific NCAA rankings, including producing the best swimming time in the NCAA for the 500-yard distance (65th in the men's category in 2018-2019 to 1st in the women's, 2022). Similarly, NCAA-ranked male swimmers had no improvements in rank in the men's category during the same time frame. Our findings suggest that the performance times of the transgender woman swimmer in the women's NCAA category were outliers for each event distance and suggest that the transgender woman swimmer had superior performances relative to rank-matched swimmers. Our analysis may be useful as a framework for regulators considering participation guidelines, which promote fair competition for all athletes-irrespective of gender identity.NEW & NOTEWORTHY This case study, longitudinal analysis of freestyle swimming performances before and after 2 yr of feminizing gender-affirming hormone therapy of an elite transgender woman (male sex, female gender identity), demonstrates superior performance relative to rank-matched female swimmers and a lower performance gap than previously observed between elite male and female swimmers.


Asunto(s)
Traumatismos en Atletas , Personas Transgénero , Humanos , Masculino , Femenino , Identidad de Género , Natación , Atletas , Hormonas
17.
J Health Care Chaplain ; 29(2): 196-210, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-35776733

RESUMEN

Spiritual support has been a staple of healthcare before hospitals in western civilizations were established by communities of faith. Research has demonstrated that wellbeing is associated with balanced care for the body, mind, and spirit. Healthcare disparities are being identified as disproportionally impacting transgender and gender nonconforming (TGNC) individuals. The root cause of this disparity is being studied as are medical and wellbeing interventions, including the benefit of spiritual support. This author's objective was two-fold. First, to identify opportunities for extending spiritual support to TGNC individuals in healthcare by chaplains. Secondly, to identify evidence of current spiritual support advocacy initiatives and interventions for TGNC patients in healthcare by chaplains.


Asunto(s)
Personas Transgénero , Transexualidad , Humanos , Identidad de Género , Disparidades en Atención de Salud
18.
J Voice ; 37(6): 957-962, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34452779

RESUMEN

PURPOSE: Transgender individuals strive to match their voice and gender identity. An increased glottal gap is often noted on stroboscopy without a clear etiology. We hypothesize this gap can be quantified and results from hormone replacement therapy impacting laryngeal tissues. METHODS: Videostroboscopy exams were retrospectively collected for transgender patients from a tertiary care laryngology practice over two years. Data included hormone duration/type and voice therapy duration. Modal pitch videostroboscopy frame counts determined the open quotient in consecutive vocal fold cycles. Glottal opening was measured using the widest still frame gap during stroboscopy with fully adducted arytenoids. RESULTS: Sixteen transgender patients, along with male and female controls, were included, with 15 patients on hormone therapy (mean = 18 months). Voice therapy, employed in 9/16 patients, ranged from 0 to 23 months (mean = 10.67). One-way ANOVA testing revealed a difference between the open quotient in transgender individuals, males, and females.Tukey's post hoc test identified transgender patients as different from both male (P <0.001) and female (P = 0.037) controls. Length of hormone therapy did not correlate to glottal area measurement or open quotient. Conversely, voice therapy length correlated to increased glottal area (Kendall's Tau = 0.03). Mean phonation time, VHI-10, and mean pitch did not correlate to measured glottal area on stroboscopy. CONCLUSIONS: The increased glottal gap noted in many transgender patients, quantified via the open quotient, differs from male and female controls. Results suggest these findings may correlate to duration of voice therapy.


Asunto(s)
Personas Transgénero , Humanos , Femenino , Masculino , Pliegues Vocales/diagnóstico por imagen , Estudios Retrospectivos , Identidad de Género , Hormonas , Fonación , Estroboscopía
19.
Rio de Janeiro; s.n; 2023. 173 f p. il.
Tesis en Portugués | LILACS | ID: biblio-1427276

RESUMEN

Este trabalho analisa vivências parentais de mulheres trans, e utiliza a categoria analítica de transparentalidade. As pessoas trans, bem como as suas vidas, as suas percepções de si e os seus relacionamentos, principalmente com seus familiares, são inquestionavelmente marcados por um dos valores hegemonicamente estabelecidos na sociedade brasileira, chamado neste trabalho de cisheteronormatividade compulsória. Em paralelo a isso, o rápido avanço de tecnologias de comunicação das últimas décadas permitiu que cada vez mais pessoas acessassem internet, canais de televisão e outras ferramentas que viabilizam o conhecimento de diversas e diferentes informações e concepções de mundo, portanto de possibilidades de ser e estar no mundo. Essa maior acessibilidade torna mais visíveis as narrativas acerca das experiências de vidas não hegemônicas, como as de pessoas trans, que são representadas até hoje quase que exclusivamente pelos vieses e falas de pessoas cisgêneras. Tais representações são muito recorrentemente pejorativas, reiterando estigmas a elas associados, de abjetas, pecaminosas, doentias, criminosas, sofridas, vítimas, anormais, controversas e desprovidas de autonomia; e salientando vínculos de pessoas trans com temáticas de HIV/AIDS, prostituição, violência, criminalidade e marginalização. No entanto, desde os anos finais do século XX, as pessoas trans estão gozando de alguma possibilidade de falar por conta própria e de si próprias, quando, por exemplo, são convidadas a participar de documentários e programas de auditório de televisão, ou quando publicam vídeos e textos com seus próprios relatos e reflexões na internet. E este trabalho pretende analisar esses registros públicos dessas narrativas sobre mulheres trans que foram feitas por elas mesmas, enaltecendo suas falas. Mais especificamente, serão analisados os registros que tratam de casos de mulheres trans que exercem a parentalidade e em tais registros falam sobre como a transparentalidade afeta suas experiências de vida, suas identidades e seus relacionamentos. Cabe ressaltar que este trabalho é feito a partir da perspectiva de uma pesquisadora que também se configura como uma pessoa trans, que em sua subjetividade se enuncia como uma mulher transgênera não binária. Sem a pretensão de esgotar a discussão do tema com respostas que se presumam universalizantes ou desmistificadoras, busca-se levantar questões que permitam pensar como mulheres trans experimentam a parentalidade, por exemplo, ao enunciar a si mesmas como pais de seus filhos, numa peculiar forma de autoafirmação que foge a uma perspectiva binária de gênero, imposta pela cisheteronormatividade compulsória. Para tanto, será feita uma pesquisa qualitativa que se baseia na análise de registros textuais e audiovisuais que se encontram disponíveis para acesso público acerca de três mulheres trans. Tais registros consistem em documentários, entrevistas, participações em programas de auditório, falas em congressos, publicações textuais e autobiografias, nos quais tais mulheres trans e seus parentes dão relatos de suas vivências e percepções de mundo a respeito da temática da transparentalidade e questões outras que atravessem tal tema. Buscamos verificar a existência de tensão entre a trajetória de construção de identidade de gênero e as vivências parentais dessas mulheres trans que, concluímos, vivenciam uma parentalidade hierarquizada que nomeamos de parentalidade curinga.


This work analyzes parenting experiences of trans women, and uses the analytical category of transparenting. Trans people, as well as their lives, their perceptions of themselves and their relationships, especially with their families, are unquestionably marked by one of the hegemonically established values ​​in Brazilian society, called in this work compulsory cisheteronormativity. In parallel to this, the rapid advancement of communication technologies in recent decades has allowed more and more people to access the internet, television channels and other tools that enable the acquisition of diverse information and worldviews, therefore making it possible to live different lives. This greater accessibility makes narratives about non-hegemonic life experiences more visible, such as those of trans people, which are represented until today almost exclusively by the biases and speeches of cisgender people. Such representations are recurrently pejorative, reiterating stigmas associated with trans people, such as: abject, sinful, sick, criminal, victims and devoid of autonomy. These representations also reiterate the link between trans people and subjects such as HIV/AIDS, prostitution, violence, criminality and marginalization. However, since the final years of the 20th century, trans people have been enjoying some possibility of speaking on their own and about themselves, when, for example, they are invited to participate in documentaries and television auditorium programs, or when they publish videos and texts with their own reports and reflections on the internet. And this work intends to praise the speeches of trans women, by analyzing these public records of these narratives about trans women that were made by themselves. This work will analyze records dealing with cases of trans women who exercise parenthood, in which they talk about how transparenting affects their life experiences, their identities and their relationships. It should be noted that this work is done from the perspective of a researcher who also configures herself as a trans person, who enunciates herself as a non-binary trans woman. Without intending to exhaust the discussion of the subject with answers that are presumed to be universal or demystifying, the aim of this work is to raise questions that allow thinking about how trans women experience parenthood, for example, when enunciating themselves as fathers of their children, in a peculiar way of self-affirmation that escapes a binary perspective of gender, imposed by compulsory cisheteronormativity. A qualitative research will be carried out based on the analysis of textual and audiovisual records that are available for public access about three trans women. Such records consist of documentaries, interviews, participation in auditorium programs, speeches at congresses, textual publications and autobiographies, in which such trans women and their relatives give reports of their experiences and perceptions of the world regarding the theme of transparenting and other themes that relate to this topic. We seek to verify the existence of tension between the trajectory of construction of gender identity and the parenting experiences of these trans women who, we conclude, experience a hierarchical parenting that we call joker parenting.


Asunto(s)
Humanos , Masculino , Femenino , Paternidad , Transexualidad , Responsabilidad Parental , Personas Transgénero , Investigación Cualitativa , Acontecimientos que Cambian la Vida , Antropología Cultural
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