Herman-Jeglińska, Anna; Grabowska, Anna; Dulko, Stanisław
This study examined the relationship between sex role and gender identity in a Polish transsexual population where, unlike in Western countries, male-to-female (MF) transsexualism is much less common than female-to-male (FM) transsexualism. One hundred and three FM (82 primary, 21 secondary) and 29 MF (16 primary, 13 secondary) transsexuals plus 135 control males (CM) and 303 control females (CF) completed a Sex Role Inventory, which measures sex-role identification, that is, the degree to which one self-identifies with masculine and feminine characteristics. Data obtained from primary transsexuals revealed that, on a femininity scale, MF transsexuals scores exceeded not only CM but also CF. On a masculinity scale, MF transsexuals rated themselves significantly lower than CM, but at a level comparable to CF. The comparison of FM transsexuals and controls showed that, on a masculinity scale, transsexuals scored higher than CF but were not different from CM. On the femininity scale, FM transsexuals rated themselves in between the two control groups: lower than CF but slightly higher than CM. The relations of secondary transsexuals' scores to CF and CM scores, on both masculine and feminine scales, were in the same direction as the primary transsexuals' scores. Secondary transsexuals rated themselves very similarly to their primary counterparts (the exception was a much higher score of MF-primary transsexuals than MF-secondary transsexuals on the femininity scale). Our study revealed that transsexualism does not imply a simple inversion of sex-role patterns: transsexuals differ not only from nontranssexual individuals of the same anatomical sex but also from those of the opposite sex. Moreover, MF transsexualism is not a mirror image of FM transsexualism: it constitutes a more extreme condition in the identification with feminine versus masculine personality traits. These differences seem to be universal for different countries and regions. The diagnostic value of our
Smith, Elke Stefanie; Junger, Jessica; Derntl, Birgit; Habel, Ute
Transsexualism describes the condition when a person's psychological gender differs from his or her biological sex and is commonly thought to arise from a discrepant cerebral and genital sexual differentiation. This review intends to give an extensive overview of structural and functional neurobiological correlates of transsexualism and their course under cross-sex hormonal treatment. Research in this field enables insight into the stability or variability of gender differences and their relation to hormonal status. For a number of sexually dimorphic brain structures or processes, signs of feminisation or masculinisation are observable in transsexual individuals, which, during hormonal treatment, partly seem to further adjust to characteristics of the desired sex. Still, it appears the data are quite inhomogeneous, mostly not replicated and in many cases available for male-to-female transsexuals only. As the prevalence of homosexuality is markedly higher among transsexuals than among the general population, disentangling correlates of sexual orientation and gender identity is a major problem. To resolve such deficiencies, the implementation of specific research standards is proposed. Copyright © 2015 Elsevier Ltd. All rights reserved.
Smith, YLS; van Goozen, SHM; Kuiper, AJ; Cohen-Kettenis, PT
The present study was designed to investigate whether transsexuals can be validly subdivided into subtypes on the basis of sexual orientation, and whether differences between subtypes of transsexuals are similar for male-to-female (ME) and female-to-male transsexuals (FMs). Within a large
Parker, G; Barr, R
The parental representations of 30 male-to-female transsexuals were rated using a measure of fundamental parental dimensions and shown to be of acceptable validity as a measure both of perceived and actual parental characteristics. Scores on that measure were compared separately against scores returned by matched male and female controls. The transsexuals did not differ from the male controls in their scoring of their mothers but did score their fathers as less caring and more overprotective. These differences were weaker for the comparisons made against the female controls. Item analyses suggested that the greater paternal "overprotection" experienced by transsexuals was due to their fathers being perceived as offering less encouragement to their sons' independence and autonomy. Several interpretations of the findings are considered.
Costa, Elaine Maria Frade; Mendonca, Berenice Bilharinho
Transsexual subjects are individuals who have a desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one's anatomic sex, and a wish to have surgery and hormonal treatment to make one's body as congruent as possible with one's preferred sex. They seek to develop the physical characteristics of the desired gender, and should undergo an effective and safe treatment regimen. The goal of treatment is to rehabilitate the individual as a member of society in the gender he or she identifies with. Sex reassignment procedures necessary for the treatment of transsexual patients are allowed in our country, at Medical Services that have a multidisciplinary team composed of a psychologist, a social worker, a psychiatrist, an endocrinologist and surgeons (gynecologists, plastic surgeons, and urologists). Patients must be between 21 to 75 years old and in psychological and hormonal treatment for at least 2 years. Testosterone is the principal agent used to induce male characteristics in female transsexual patients, and the estrogen is the chosen hormone used to induce the female sexual characteristics in male transsexual patients. Based on our 15 years of experience, we can conclude that testosterone and estradiol treatment in physiological doses are effective and safe in female and male transsexual patients, respectively.
Fleming, M; Costos, D; MacGowan, B
The ego development of 22 postoperative female-to-male transsexuals and their spouses or lovers with whom they had been living for a year or more was investigated. The transsexuals, their spouses, and a control group of 22 couples were administered the Washington University Sentence Completion Test of Ego Development, a projective measure of ego functioning. Ego development refers to the framework of meaning that the individual brings to an experience. The construct of ego development incorporates a series of sequential stages that integrate various frames of reference including cognitive style, interpersonal style, conscious preoccupation, and impulse control. These processes have received little attention in studies on female-to-male transsexuals who have successfully negotiated the social barrier of cross-living to the extent that they are living the male role in a heterosexual relationship. No significant differences in the distribution of ego development scores were found between the transsexuals and the control males, or between the transsexuals' spouses and the control spouses. Over 93% of the transsexuals and their spouses scored above the conformist level of ego development. These findings are discussed in terms of some of the previous literature on conformist thinking by transsexuals.
The aim of this paper was to present basic data about gender identity disorders and psychotic transsexual desires. From time to time in scientific literature there are descriptions of a diagnosis of psychotic disorders in persons previously diagnosed and treated as transsexuals, in whom the transsexual thinking disappears after using antipsychotic agents. Coexistence of transsexualism and schizophrenia causes a lot of doubt--it is observed in scientists opinions but also in the diagnostic criteria of DSM-IV and ICD-10. Moreover, delusions of sex change are probably more frequent than it is thought. It causes, that in some cases the differential diagnosis of psychosis and gender identity disorders may be very difficult. Transsexuals treatment is on one hand connected with expected effects but on the other hand with many serious, often irreversible health consequences (e.g. cardiovascular disease, risk of neoplasma development, infertility, consequences of surgical sex reassignment). That is why the differential diagnosis of transsexualism and schizophrenia should be made carefully and thoughtfully.
Full Text Available This paper makes a brief tour of some most important issues fortranssexual people in old age. Firstly, it exposes the current needs and difficulties on transsexualism aging and focuses upon studies of age on transsexuals. Finally, this review propose several proposals to improve wellbeing of older transsexual people.
Fleming, M; MacGowan, B; Costos, D
Dyadic adjustment, sexual activities, and marital stability in the relationships of female-to-male transsexuals and their spouses were examined. Participants were 22 female-to-male transsexuals who had undergone some form of surgery to alter their anatomical sex, their spouses, and a control group of married or cohabitating nontranssexual men and women. Participants were administered the Dyadic Adjustment Scale and additional items to assess quantitatively their marital relationships. The transsexuals and their spouses were also asked open-ended interview questions concerning marital and life adjustments. Generally, the transsexuals and their spouses reported good and mutually satisfying interpersonal relationships that are in many ways comparable to those of the matched control group. These findings lend support to the previous clinical interview studies that have reported that female-to-male transsexuals form stable and enduring intimate relationships.
Full Text Available The text comprises analysis of family relations of transsexual persons. Its aim is to present the legal solutions of international courts as the way of solving their legal status in family relations. The author presents sentences of the European Court of Human Rights and European Court of Justice as well as the whole range of international treaties, resolutions and other documents of international law, aiming to promote legal importance of the newly gained sex of the transsexuals who passed the genital reassignment process. This is important for the regulation of their marriage and family relations and other rights based on legally recognized status. In general perceptions of transsexuals have changed dramatically while the Serbian public still present some obsolete “moral” understandings that should be avoided if we want to avoid spending decades in discussions that have already been globally completed. The contemporary approach to transsexuals is based mainly on their unalienable human rights followed by duty of states to prevent violation of their rights as well as discrimination based on their transsexuality. There are still open questions regarding the legal status of transsexuals. The common answer is to enable changes in legal status to follow changes of their sex as logical consequence in completion of the sex reassignment process. [Projekat Ministarstva nauke Republike Srbije: Društvene transformacije u procesu evropskih integracija - multidisciplinarni pristup
Newman-Valentine, Douglas; Duma, Sinegugu
Transsexual women who are on the journey of sexual re-alignment will experience various health problems. These problems are related directly to the treatment regime that they are following in order to attain and maintain their physical embodiment as a woman. They are forced to negotiate a hetero-normative healthcare system in order to receive assistance and care for their health problems related to their sexual re-alignment process. The questions posed were: What are the unique health problems that transsexual women experience whilst on the journey of sexual re-alignment? What is the current context of the South African healthcare system in which transsexual women should negotiate healthcare? These questions were asked in order to explore the health problems with which transsexual women are faced and to describe the hetero-normative healthcare system in South Africa. An electronic literature search was executed via the EBSCO host with specific inclusion and exclusion criteria. The search words that were used were: Transsexual/s and Health/Healthcare. All studies had to be peer reviewed and published in the English language, from January 1972 up until February 2013. Literature on transsexual children was excluded. Transsexual women have the potential to suffer significant side-effects from their sexual re-alignment treatment, including cardio-vascular problems, endocrine problems and mental ill-health. They are also vulnerable to HIV infection. They have poor access to quality holistic healthcare and this may lead an increase in the mortality and morbidity figures of women. A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homo- and trans-phobia that will in turn strengthen the belief that transsexual women are un-African.
Luders, Eileen; Sánchez, Francisco J; Tosun, Duygu; Shattuck, David W; Gaser, Christian; Vilain, Eric; Toga, Arthur W
The degree to which one identifies as male or female has a profound impact on one's life. Yet, there is a limited understanding of what contributes to this important characteristic termed gender identity . In order to reveal factors influencing gender identity, studies have focused on people who report strong feelings of being the opposite sex, such as male-to-female (MTF) transsexuals. To investigate potential neuroanatomical variations associated with transsexualism, we compared the regional thickness of the cerebral cortex between 24 MTF transsexuals who had not yet been treated with cross-sex hormones and 24 age-matched control males. Results revealed thicker cortices in MTF transsexuals, both within regions of the left hemisphere (i.e., frontal and orbito-frontal cortex, central sulcus, perisylvian regions, paracentral gyrus) and right hemisphere (i.e., pre-/post-central gyrus, parietal cortex, temporal cortex, precuneus, fusiform, lingual, and orbito-frontal gyrus). These findings provide further evidence that brain anatomy is associated with gender identity, where measures in MTF transsexuals appear to be shifted away from gender-congruent men.
Luders, Eileen; Sánchez, Francisco J.; Gaser, Christian; Toga, Arthur W.; Narr, Katherine L.; Hamilton, Liberty S.; Vilain, Eric
Gender identity—one's sense of being a man or a woman—is a fundamental perception experienced by all individuals that extends beyond biological sex. Yet, what contributes to our sense of gender remains uncertain. Since individuals who identify as transsexual report strong feelings of being the opposite sex and a belief that their sexual characteristics do not reflect their true gender, they constitute an invaluable model to understand the biological underpinnings of gender identity. We analyzed MRI data of 24 male-to-female (MTF) transsexuals not yet treated with cross-sex hormones in order to determine whether gray matter volumes in MTF transsexuals more closely resemble people who share their biological sex (30 control men), or people who share their gender identity (30 control women). Results revealed that regional gray matter variation in MTF transsexuals is more similar to the pattern found in men than in women. However, MTF transsexuals show a significantly larger volume of regional gray matter in the right putamen compared to men. These findings provide new evidence that transsexualism is associated with distinct cerebral pattern, which supports the assumption that brain anatomy plays a role in gender identity. PMID:19341803
Cohen, L.; de Ruiter, C.; Ringelberg, H.; Cohen-Kettenis, P.T.
Adolescent transsexuals were compared with adolescent psychiatric out-patients and first-year university students to determine the extent to which other psychopathology is a necessary condition for the development of transsexualism. Three areas of psychological functioning associated with
Smith, Yolanda Louise Susanne
Prospective research supports the therapeutic effect of sex reassignment (SR) for adolescent and adult transsexuals. Data were used from 345 patients who applied for SR. Of these applicants, 232 started hormone treatment, 113 did not. The group who completed SR consisted of 196 transsexuals. Follow-up data were gathered one to five years after SR. The results of 171 treated adult transsexuals showed improvement in many areas of functioning after SR. The main symptom for which the patients had...
Smith, Yolanda Louise Susanne
Prospective research supports the therapeutic effect of sex reassignment (SR) for adolescent and adult transsexuals. Data were used from 345 patients who applied for SR. Of these applicants, 232 started hormone treatment, 113 did not. The group who completed SR consisted of 196 transsexuals.
Gooren, Louis; Lips, Paul
Guidelines for cross-sex hormone treatment of transsexual people are now in place. However, little attention has been paid to the issue of treatment suitability for older people. Does existing treatment need to be adapted as subjects age, and does it make a difference if treatment is only started when the subject is already older? To assess the necessity of adapting cross-sex hormone administration for elderly transsexual people. Risks/benefits of continued use of cross-sex hormones with regard to bone health, cardiovascular risks, and malignancies. Due to lack of data on the subject population, sex hormone treatment of other conditions in older non-transsexual people has been taken as the best available analogy to determine the extent to which these might be applicable to comparable transsexual persons. Findings in transsexual people receiving cross-sex hormone treatment sometimes modified the above approach of applying guidelines for the elderly to the aging transsexual population. Testosterone administration to female-to-male transsexual persons (FtoM) carries little risk with regard to cardiovascular disease and cancer. For those with high hematocrit or cardiac insufficiency the dose can be reduced. Administration of estrogens to male-to-female transsexual persons (MtoF), particularly when combined with progestins, does significantly increase the risk of developing cardiovascular disease (almost a twofold incidence compared with the general population). This may require dose adjustment or changing from oral to safer transdermal estrogens. Tumors of the breasts, prostate and pituitary may occur. In FtoM, breast cancer can occur even after breast ablation. Older subjects can commence cross-sex hormone treatment without disproportionate risks. Cross-sex hormones may be continued into old age but monitoring for cardiovascular disease and malignancies, both of the old and new sex, is recommended. MtoF will have more health complications in old age than Fto
Fontanari, Anna Martha Vaitses; Costa, Angelo Brandelli; Aguiar, Bianca; Tusset, Cíntia; Andreazza, Tahiana; Schneider, Maiko; da Rosa, Eduarda Dias; Soll, Bianca Machado Borba; Schwarz, Karine; da Silva, Dhiordan Cardoso; Borba, André Oliveira; Mueller, Andressa; Massuda, Raffael; Lobato, Maria Inês Rodrigues
Serum BDNF levels are significantly decreased in transsexual Brazilian women when compared to cis-sexual men. Since transsexual men are also exposed to chronic social stress and have a high prevalence of associated psychopathologies, it is plausible to inquire if BDNF serum levels are altered in transsexual men as well. Therefore, our objective was to evaluate differences in BDNF serum level of transsexual men when compared to cis-sexual men and women. Our sample comprises 27 transsexual men, 31 cis-sexual women and 30 cis-sexual men recruited between 2011 and 2015. We observed that BDNF serum concentration is decreased in transsexual men comparing to cis-sexual men and women. Cross-sex hormone treatment, chronic social stress or long-term gender dysphoria (GD) could explain the variation found in BDNF serum levels. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Bergmann, Karl Otto
As understood by the German "Transsexuellengesetz" (Gender Recognition Act) transsexualism is to be recognized as a gender identity disorder if a long-term diagnostic-therapeutic process has shown that the transposition of gender roles is irreversible and if, besides psychotherapeutic monitoring, only hormonal and surgical procedures are suitable to relieve the patient's distress related to his gender identity. The German Gender Recognition Act does not contain provisions regarding the diagnosis or medical treatment of transsexualism. Commissioned by the German Sexuality Research Association, the Academy for Sexual Medicine and the Association for Sexology, a committee of experts developed standards for the medical treatment and evaluation of transsexuals. These standards provide a basis and orientational guide for both medical and legal issues. In terms of liability, doctors should carefully consider the recommendations on patient education provided in these guidelines. The costs for hormonal treatment and genital corrective surgery are reimbursed by the Statutory Health Insurances (SHI) if a medical expert confirms that transsexualism is a medical disorder.
Weyers, S.; Villeirs, G.; Vanherreweghe, E.; Verstraelen, H.; Monstrey, S.; Van den Broecke, R.; Gerris, J.
Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.
Weyers, S., E-mail: email@example.com [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Villeirs, G.; Vanherreweghe, E. [Department of Radiology, Ghent University Hospital, Ghent (Belgium); Verstraelen, H. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Monstrey, S. [Department of Plastic Surgery, Ghent University Hospital, Ghent (Belgium); Van den Broecke, R.; Gerris, J. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)
Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.
Kanagalingam, Jeeve; Georgalas, Christos; Wood, Gary R.; Ahluwalia, Suki; Sandhu, Guri; Cheesman, Anthony D.
OBJECTIVES: To evaluate the medium-term outcome of cricothyroid approximation and subluxation (CTAS) with postoperative speech therapy for pitch elevation in male-to-female transsexuals. STUDY DESIGN: Retrospective study of male-to-female transsexuals who underwent pitch-raising surgery between
Barišić, Jasmina; Milosavljević, Marija; Duišin, Dragana; Batinić, Borjanka; Vujović, Svetlana; Milovanović, Srdjan
There have been few studies in the area of Self-Perception in transsexual persons, except for the population of transsexual adolescents. Bearing in mind its importance not only in the assessment of personality but also in predicting adaptive capacity, the goal of our research is based on the examination of Self-Perception of adult transsexual persons. The study was conducted using a Rorschach test, which provides an insight into various aspects of Self-Perception. The sample consisted of 15 transsexual persons, who passed the standard diagnostic procedure. The results suggest that transsexual persons manage to maintain Adequate Self-Esteem. Hypervigilance Index and Obsessive Style Index are negative, while the values showing a negative quality of Self-Regard and the capacity for introspection tend to increase. In the process of Self-Introspection, negative and painful emotional states are often perceived. The estimation of Self-Perception in adult transsexual persons indicates a trend of subjective perception of a personal imperfection or inadequacy. This is probably the result of experiencing discomfort for a number of years due to gender incongruence and dysphoria, in particular in persons who enter the sex reassignment procedure later in their adulthood.
Conclusion: A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homoand trans-phobia that will in turn strengthen the belief that transsexual women are un-African.
Rauchfleisch, U; Barth, D; Battegay, R
From 69 transsexual patients (48 men, 21 women) having consulted the Basel University Psychiatric Outpatient-Department between 1970 and 1990, 13 men-to-woman- and 4 woman-to-man-transsexuals could be examined in a follow-up (5-20 years after the operation). The social conditions and the quality of life of the 13 men-to-woman-transsexuals had significantly deteriorated: 9 of the 13 depend on life annuity or on social welfare assistance. The patients live socially very isolated. Eight of them report almost not being able to experience sexual pleasure, 10 suffer from anxieties, depression or addictions. Three regret having demanded the operation and two have passed a second operation for restoration of the original state. The 4 woman-to-man-transsexuals showed slightly better results: 2 of them are fully professionally active and live in constant personal relationships of several years of duration. The 2 others, however, suffer from depression and problems of addiction and give the impression of affective lability. The results lead to the following conclusions: 1. the criteria of indication for the operation of the transsexuals should be observed thoroughly, especially the psychotherapeutic accompaniment before the operation during at least 1 year; 2. the question of emotional stability, of frustration tolerance and of the danger of an outbreak of psychosis are to be examined carefully; 3. the professional and social integration before and after the operation is of central importance.
Sánchez, Francisco J; Vilain, Eric
The fear of experiencing discrimination often provokes symptoms of psychological distress. One coping resource is positive identification with one's social group-known as collective self-esteem. This preliminary study investigated whether collective self-esteem was related to fears regarding a transsexual identity and psychological distress among 53 self-identified male-to-female transsexuals (mean age = 50.79). Participants were recruited from transgender events held in Arizona and California. The majority (81%) reported living full-time as women (mean length of time living as a woman = 6.33 years). Negative feelings about the transsexual community and fears regarding the impact of a transsexual identity were positively related to psychological distress. A regression model revealed that the fear of how a transsexual identity would affect one's life was the best predictor of the severity of psychological distress. These results are consistent with findings from other historically marginalized groups whereby the stress of being stigmatized by society adversely affects mental health.
... stop in girls. In boys, development of a masculine body appearance will stop and the testicles will ... different androgen preparations can be used to develop masculine characteristics in FTM transsexual adults. Injections, skin gels, ...
Simon, Lajos; Kozák, Lajos R.; Simon, Viktória; Czobor, Pál; Unoka, Zsolt; Szabó, Ádám; Csukly, Gábor
Gender identity disorder (GID) refers to transsexual individuals who feel that their assigned biological gender is incongruent with their gender identity and this cannot be explained by any physical intersex condition. There is growing scientific interest in the last decades in studying the neuroanatomy and brain functions of transsexual individuals to better understand both the neuroanatomical features of transsexualism and the background of gender identity. So far, results are inconclusive but in general, transsexualism has been associated with a distinct neuroanatomical pattern. Studies mainly focused on male to female (MTF) transsexuals and there is scarcity of data acquired on female to male (FTM) transsexuals. Thus, our aim was to analyze structural MRI data with voxel based morphometry (VBM) obtained from both FTM and MTF transsexuals (n = 17) and compare them to the data of 18 age matched healthy control subjects (both males and females). We found differences in the regional grey matter (GM) structure of transsexual compared with control subjects, independent from their biological gender, in the cerebellum, the left angular gyrus and in the left inferior parietal lobule. Additionally, our findings showed that in several brain areas, regarding their GM volume, transsexual subjects did not differ significantly from controls sharing their gender identity but were different from those sharing their biological gender (areas in the left and right precentral gyri, the left postcentral gyrus, the left posterior cingulate, precuneus and calcarinus, the right cuneus, the right fusiform, lingual, middle and inferior occipital, and inferior temporal gyri). These results support the notion that structural brain differences exist between transsexual and healthy control subjects and that majority of these structural differences are dependent on the biological gender. PMID:24391851
Simon, Lajos; Kozák, Lajos R; Simon, Viktória; Czobor, Pál; Unoka, Zsolt; Szabó, Ádám; Csukly, Gábor
Gender identity disorder (GID) refers to transsexual individuals who feel that their assigned biological gender is incongruent with their gender identity and this cannot be explained by any physical intersex condition. There is growing scientific interest in the last decades in studying the neuroanatomy and brain functions of transsexual individuals to better understand both the neuroanatomical features of transsexualism and the background of gender identity. So far, results are inconclusive but in general, transsexualism has been associated with a distinct neuroanatomical pattern. Studies mainly focused on male to female (MTF) transsexuals and there is scarcity of data acquired on female to male (FTM) transsexuals. Thus, our aim was to analyze structural MRI data with voxel based morphometry (VBM) obtained from both FTM and MTF transsexuals (n = 17) and compare them to the data of 18 age matched healthy control subjects (both males and females). We found differences in the regional grey matter (GM) structure of transsexual compared with control subjects, independent from their biological gender, in the cerebellum, the left angular gyrus and in the left inferior parietal lobule. Additionally, our findings showed that in several brain areas, regarding their GM volume, transsexual subjects did not differ significantly from controls sharing their gender identity but were different from those sharing their biological gender (areas in the left and right precentral gyri, the left postcentral gyrus, the left posterior cingulate, precuneus and calcarinus, the right cuneus, the right fusiform, lingual, middle and inferior occipital, and inferior temporal gyri). These results support the notion that structural brain differences exist between transsexual and healthy control subjects and that majority of these structural differences are dependent on the biological gender.
Full Text Available Gender identity disorder (GID refers to transsexual individuals who feel that their assigned biological gender is incongruent with their gender identity and this cannot be explained by any physical intersex condition. There is growing scientific interest in the last decades in studying the neuroanatomy and brain functions of transsexual individuals to better understand both the neuroanatomical features of transsexualism and the background of gender identity. So far, results are inconclusive but in general, transsexualism has been associated with a distinct neuroanatomical pattern. Studies mainly focused on male to female (MTF transsexuals and there is scarcity of data acquired on female to male (FTM transsexuals. Thus, our aim was to analyze structural MRI data with voxel based morphometry (VBM obtained from both FTM and MTF transsexuals (n = 17 and compare them to the data of 18 age matched healthy control subjects (both males and females. We found differences in the regional grey matter (GM structure of transsexual compared with control subjects, independent from their biological gender, in the cerebellum, the left angular gyrus and in the left inferior parietal lobule. Additionally, our findings showed that in several brain areas, regarding their GM volume, transsexual subjects did not differ significantly from controls sharing their gender identity but were different from those sharing their biological gender (areas in the left and right precentral gyri, the left postcentral gyrus, the left posterior cingulate, precuneus and calcarinus, the right cuneus, the right fusiform, lingual, middle and inferior occipital, and inferior temporal gyri. These results support the notion that structural brain differences exist between transsexual and healthy control subjects and that majority of these structural differences are dependent on the biological gender.
Navarro-Pérez, Patricia; Ortiz-Gómez, Teresa; Gil-García, Eugenia
To explore the scientific output on transsexuality in the Spanish biomedical literature between 1973 and 2011, through bibliometric and content analyses. We carried out a descriptive, cross-sectional study of Spanish biomedical articles on transsexuality published between 1973 and 2011. The data sources consisted of Índice Médico Español and ISOC-Ciencias Sociales y Humanidades. Bibliometric and content analyses were performed. A total of 65 papers were analyzed. Knowledge on transsexuality in Spain began to appear in medical journals between 1973 and 1984. A decade of intense productivity began in 1996 and the number of journals publishing articles on transsexuality multiplied in the following years. Until 2006, the year with the most biomedical productivity, biomedical discourses reproduced representations of transsexuality anchored in biological determinism. From 2008-2011, professionals writing on the topic incorporated feminist theories and social perspectives in their discourses. In the last quarter of the twentieth century, the dominant medical discourse considered manifestations of transsexual people from a biologist perspective that conceives transsexuality as a configuration mismatch between sex and gender. The emergence of new identity categories and medical reflection from non-essentialist and non-normative gender perspectives has improved the clinical management of transsexuality. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Weiner, Brittany A; Zinner, Leah
This study examined American attitudes toward transsexual and gay male parenting, compared to straight parenting. After reporting levels of transphobia, participants read a vignette regarding a couple seeking child adoption. Individuals high in transphobia perceived nontraditional couples as more emotionally unstable than straight couples and were less willing to grant custody of a child to the nontraditional couples vs. the straight couples. In addition, the transsexual couple faced more prejudice and discrimination than the gay male couple. Implications of these findings are discussed.
Nieder, T.O.; Herff, M.; Cerwenka, S.; Preuss, W.F.; Cohen-Kettenis, P.T.; De Cuypere, G.; Haraldsen, I.R.H.; Richter-Appelt, H.
Introduction. With regard to transsexual developments, onset age (OA) appears to be the starting point of different psychosexual pathways. Aim. To explore differences between transsexual adults with an early vs. late OA. Methods. Data were collected within the European Network for the Investigation
Michel, A; Mormont, C
The Rorschach Ink Blot test is considered to be an essential analytical instrument when studying the personalities of individuals presenting identity disorders, in particular, in the context of a sex change request. Nevertheless, there exist less than 20 studies of transsexualism utilising the Rorschach since the creation of this diagnostic category in 1953. This research has mostly concerned itself with relations between psychopathology and transsexualism. Practically non-existent are studies investigating the psychological conditions that permit, shape or induce sex change requests in individuals. Transsexuals request the removal of their genitals through mutilation surgery, which can be seen as subjects literally crying out to be castrated. This request is all the more surprising given that castration, in psychoanalytic terms, is considered to be the most severe punishment that an individual (woman or man) can be threatened with. Therefore, we asked ourselves which psychic conditions could motivate such as request. Based on any earlier study where answers (some explicit, others symbolic) given by sex-change applicants tested on the Rorschach were analysed, results seemed to suggest a counter-phobic attitude underlying sex-reassignment requests (28). According to these hypotheses, the fear of castration (banal as such) can only be overcome through the active search for castration itself. In opting for castration, the transsexual puts an end to the states of anxious waiting that are dominated by feelings of the incertitude and unpredictability of an eventual castration. Once obtained, the threat it constituted disappears, and with it so does the fear. Thus, by taking this active and voluntary step, the subject is no longer exposed to an imminent danger in a passive manner. This in itself creates a great feeling of relief, if not of actual pleasure in the subject (28). In this article, we postulated in a purely speculative manner, the existence of one or several
Alegría, C Aramburu
• Transsexual persons are increasing their visibility in society, and health care providers and others (such as social workers) will be called upon to help with issues that transsexual persons face. Challenges that face transsexual persons often include issues involving relationships. Psychiatric and mental health nurses and other caregivers can increase their therapeutic skills in working with couples that include transsexual persons by becoming aware of these challenges and subsequent activities that can help with them. • This research study looks at couple relationships in which one partner reveals male-to-female transsexual identity. These are relationships that were established as man-woman and now will transition into relationships that include a male-to-female person and a female partner. • Common challenges for these couples include issues related to: (1) sexual identity and relationship uncertainty; (2) male-to-female transition decision making; and (3) presenting in public. • Relationship maintenance activities that helped the couples in the study maintain and strengthen their relationships through these challenges include: (1) communication; (2) self-talk (for example, putting the situation in perspective); (3) social networks; (4) positive interactions; (5) impression management (for example, managing displays of affection in public); and (6) social activism. This qualitative study describes the relational dynamics that help sustain relationships of couples that include male-to-female transsexual persons (MTF) and their natal female partners (NF) following disclosure of transsexualism. Relationship challenges and relationship maintenance activities are identified. Each partner in 17 MTF-NF couples participated in individual surveys and interviews. The data were coded for themes related to relationship challenges and activities. MTF-NF couples experience challenges within the contexts of their relationships and of society. These challenges
López Moratalla, Natalia; Calleja Canela, Amparo
Transsexualism describes the condition when a person's psychological gender differs from his or her biological sex. People with gender identity disorder suffer persistently from this incongruence and they search hormonal and surgical sex reassignment to the desired anatomical sex. This review, from an ethical perspective, intends to give an overview of structural and functional neurobiological correlations of transsexualism and their course under cross-sex hormonal administration. Several studies demonstrate an increased functional connectivity between cortex regions reaffirming psychosocial distress of psychologicalbiological sex incongruity. Such distress can be ascribed to a disharmonic body image due to changes in the functional connectivity of the key components of body representation network. These brain alterations seem to imply a strategic mechanism dissociating bodily emotions from bodily images. For a number of sexually dimorphic brain structures or processes, signs of feminization or masculinization are observable in transsexual individuals, who during hormonal administration seem to partly further adjust to characteristics of the desired sex. These changes allow a reduction of psychosocial distress. However, a model leading to a ″gender affirmation″ does not solve the problem, since brain disorders causing it are not corrected. This is a serious medical ethics issue. Prejudices should be left aside. To know what happens in the brain of transsexuals is a medical need, both to define what is and what is not, and so to choose an adequate treatment, and to decide and guide legal actions.
Baba, Tsuyoshi; Endo, Toshiaki; Ikeda, Keiko; Shimizu, Ayumi; Honnma, Hiroyuki; Ikeda, Hiroshi; Masumori, Naoya; Ohmura, Tousei; Kiya, Tamotsu; Fujimoto, Takashi; Koizumi, Motoiki; Saito, Tsuyoshi
The prevalence of transsexualism is thought to differ among socio-geographic backgrounds, and little is known about its prevalence in Japan. Polycystic ovary syndrome (PCOS), which is known to be associated with insulin resistance and metabolic syndrome, is often seen in female-to-male (FTM) transsexual patients. Consequently, detection of PCOS is an important part of health care for these individuals. The purpose of this study was to assess the prevalence of transsexuality in Japan, as well as the incidences of PCOS and insulin resistance among Japanese FTM transsexual patients. One hundred four male-to-female (MTF) and 238 FTM Japanese transsexual patients were studied. Medical histories, including histories of menstrual cycling and hormone treatment, were taken. To exclude other diseases, such as congenital adrenal hyperplasia and hormone-secreting tumors, thorough medical assessments, including transvaginal or transrectal ultrasonography and measurement of serum hormone levels and insulin resistance indexes, were performed. The diagnosis of PCOS was based on the Rotterdam 2003 criteria. Based on demographic statistics, the prevalences of MTF and FTM transsexuality are about 3.97 and 8.20 per 100,000 people, respectively, making the MTF-to-FTM ratio about 1:2. Of the FTM transsexual patients studied, 128 had not taken hormones before their initial assessment (untreated group); the remaining 50 self-administered androgen. Among the untreated group, 32.0% were diagnosed with PCOS, 30.1% were insulin-resistant, and 31.1% showed hypoadiponectinemia. The sex ratio among Japanese transsexuals is different than among Caucasians. PCOS and insulin resistance are common findings in FTM transsexual patients at initial presentation. © 2011 International Society for Sexual Medicine.
Blanco, Mark R.; Heritage, Jeanette G.
The designation "transsexual" refers to those who persistently believe their gender to be incongruous with their anatomical morphology. This study involves a group of 21 female sexual reversal surgery (SRS) candidates and a group of 59 male SRS candidates to observe if transsexual cognitive ability patterns are correlated with levels of…
Gómez-Gil, Esther; Zubiaurre-Elorza, Leire; Esteva, Isabel; Guillamon, Antonio; Godás, Teresa; Cruz Almaraz, M; Halperin, Irene; Salamero, Manel
The aim of the present study was to evaluate the presence of symptoms of current social distress, anxiety and depression in transsexuals. We investigated a group of 187 transsexual patients attending a gender identity unit; 120 had undergone hormonal sex-reassignment (SR) treatment and 67 had not. We used the Social Anxiety and Distress Scale (SADS) for assessing social anxiety and the Hospital Anxiety and Depression Scale (HADS) for evaluating current depression and anxiety. The mean SADS and HADS scores were in the normal range except for the HAD-Anxiety subscale (HAD-A) on the non-treated transsexual group. SADS, HAD-A, and HAD-Depression (HAD-D) mean scores were significantly higher among patients who had not begun cross-sex hormonal treatment compared with patients in hormonal treatment (F=4.362, p=.038; F=14.589, p=.001; F=9.523, p=.002 respectively). Similarly, current symptoms of anxiety and depression were present in a significantly higher percentage of untreated patients than in treated patients (61% vs. 33% and 31% vs. 8% respectively). The results suggest that most transsexual patients attending a gender identity unit reported subclinical levels of social distress, anxiety, and depression. Moreover, patients under cross-sex hormonal treatment displayed a lower prevalence of these symptoms than patients who had not initiated hormonal therapy. Although the findings do not conclusively demonstrate a direct positive effect of hormone treatment in transsexuals, initiating this treatment may be associated with better mental health of these patients. Copyright Â© 2011 Elsevier Ltd. All rights reserved.
de Vries, A.L.C.; Kreukels, B.P.C.; Steensma, T.D.; Doreleijers, T.A.H.; Cohen-Kettenis, P.T.
Sex, sexual orientation and age have been shown to be important in relation to psychological functioning in transsexuals. However, only few studies to date took these factors into account and not earlier have adolescent transsexuals participated. In this study the Minnesota Multiphasic Personality
Carrillo, Beatriz; Gómez-Gil, Esther; Rametti, Giuseppina; Junque, Carme; Gomez, Angel; Karadi, Kazmer; Segovia, Santiago; Guillamon, Antonio
There is strong evidence of sex differences in mental rotation tasks. Transsexualism is an extreme gender identity disorder in which individuals seek cross-gender treatment to change their sex. The aim of our study was to investigate if male-to-female (MF) and female-to-male (FM) transsexuals receiving cross-sex hormonal treatment have different patterns of cortical activation during a three-dimensional (3D) mental rotation task. An fMRI study was performed using a 3-T scan in a sample of 18 MF and 19 FM under chronic cross-sex hormonal treatment. Twenty-three males and 19 females served as controls. The general pattern of cerebral activation seen while visualizing the rotated and non-rotated figures was similar for all four groups showing strong occipito-parieto-frontal brain activation. However, compared to control males, the activation of MF transsexuals during the task was lower in the superior parietal lobe. Compared to control females, MF transsexuals showed higher activation in orbital and right dorsolateral prefrontal regions and lower activation in the left prefrontal gyrus. FM transsexuals did not differ from either the MF transsexual or control groups. Regression analyses between cerebral activation and the number of months of hormonal treatment showed a significant negative correlation in parietal, occipital and temporal regions in the MF transsexuals. No significant correlations with time were seen in the FM transsexuals. In conclusion, although we did not find a specific pattern of cerebral activation in the FM transsexuals, we have identified a specific pattern of cerebral activation during a mental 3D rotation task in MF transsexuals under cross-sex hormonal treatment that differed from control males in the parietal region and from control females in the orbital prefrontal region. The hypoactivation in MF transsexuals in the parietal region could be due to the hormonal treatment or could reflect a priori cerebral differences between MF transsexual
Kruijver, F. P.; Zhou, J. N.; Pool, C. W.; Hofman, M. A.; Gooren, L. J.; Swaab, D. F.
Transsexuals experience themselves as being of the opposite sex, despite having the biological characteristics of one sex. A crucial question resulting from a previous brain study in male-to-female transsexuals was whether the reported difference according to gender identity in the central part of
Lawrence, Anne A
There are two distinct subtypes of male-to-female (MtF) transsexuals: homosexual and nonhomosexual. The relative prevalence of these two subtypes varies dramatically between countries, but no explanation of this variability has yet been proposed. This study examined the hypothesis that the prevalence of nonhomosexual MtF transsexualism, relative to homosexual MtF transsexualism, would be higher in individualistic countries than in collectivistic countries. I analyzed data from 22 studies of MtF transsexualism, conducted in 16 countries, examining the association between percentage of nonhomosexual participants and Hofstede's (Culture's consequences: Comparing values, behaviors, institutions, and organizations across nations, 2001) Individualism Index (IDV). IDV accounted for 77% of observed variance in the percentage of nonhomosexual MtF participants (r = 0.88, p individualistic countries for socially disruptive gender transitions by nonhomosexual gender dysphoric men, and the availability within many collectivistic countries of socially approved transgender roles for pervasively feminine homosexual gender dysphoric men, are plausible contributors.
Vanderlaan, Doug P; Blanchard, Ray; Zucker, Kenneth J; Massuda, Raffael; Fontanari, Anna Martha Vaitses; Borba, André Oliveira; Costa, Angelo Bradelli; Schneider, Maiko Abel; Mueller, Andressa; Soll, Bianca Machado Borba; Schwarz, Karine; Da Silva, Dhiordan Cardoso; Lobato, Maria Inês Rodrigues
Previous research has indicated that biological older brothers increase the odds of androphilia in males. This finding has been termed the fraternal birth order effect. The maternal immune hypothesis suggests that this effect reflects the progressive immunization of some mothers to male-specific antigens involved in fetal male brain masculinization. Exposure to these antigens, as a result of carrying earlier-born sons, is hypothesized to produce maternal immune responses towards later-born sons, thus leading to female-typical neural development of brain regions underlying sexual orientation. Because this hypothesis posits mechanisms that have the potential to be active in any situation where a mother gestates repeated male fetuses, a key prediction is that the fraternal birth order effect should be observable in diverse populations. The present study assessed the association between sexual orientation and birth order in androphilic male-to-female transsexuals in Brazil, a previously unexamined population. Male-to-female transsexuals who reported attraction to males were recruited from a specialty gender identity service in southern Brazil (n=118) and a comparison group of gynephilic non-transsexual men (n=143) was recruited at the same hospital. Logistic regression showed that the transsexual group had significantly more older brothers and other siblings. These effects were independent of one another and consistent with previous studies of birth order and male sexual orientation. The presence of the fraternal birth order effect in the present sample provides further evidence of the ubiquity of this effect and, therefore, lends support to the maternal immune hypothesis as an explanation of androphilic sexual orientation in some male-to-female transsexuals.
Muñoz León, Fernando
Do transsexual people in Chile have a right to have their gender identity or their sex reassignment legally recognized? The absence of any legislation on gender identity or transsexualism could lead us to believe that it is not the case. However, a quantitative review of decisions issued by Chilean courts during the last years on name-and sex-change requests filed by transsexual people reveals that most of these courts have accepted these requests. From the perspective of the well-being of transsexual people, this is a positive result. However, the fact that a few rejections exist reminds us of the need to enact an explicit legislation in this issue. Lastly, a qualitative analysis of those decisions suggests that the traditional reluctance of courts to interpret the law in a creative way has been overcome in these cases by the use of knowledge and discourses belonging to healthcare sciences. This is an example of an epistemological complementariness between medicine and law.
Warmuz-Stangierska, Izabela; Stangierski, Adam; Ziemnicka, Katarzyna; Gołąb, Monika; Zdanowska, Joanna; Lodyga, Martha; Komarowska, Hanna; Głowacka, Maria Danuta; Ruchała, Marek
Transsexuals have to face multiple medical, social and bureaucratic problems. These problems are not only encountered before the transformation, but also during and after medical procedures. In the search for improvement of transsexual individuals' quality of life during therapy, it seems desirable to supplement hormonal treatments with psychological explorations. This study was conducted with the aim of defining emotional conditions and included 28 transsexual female-to-male (F/M) patients and two gender-divided control groups (males and females) of similar age. The following psychometric scales were used: CECS (Courtauld Emotional Control Scale constructed by M. Watson and S. Greer in the Polish Adaptation by Z. Juczyński), ISCL (the Polish Adaptation of the State-Trait Anxiety Inventory for Adults by T. Sosnowski), and GSES (the Polish Adaptation of the R. Schwarzer, M. Jerusalem Generalized Self-Efficacy Scaleby Z. Juczyński and K. Wrześniewski). Transsexual F/M patients appeared very similar to males in the male control group in terms of their subjective selfefficacy and state-trait anxiety, while their subjective belief of anxiety and fear control was more comparable to that of the female controls. It was also found to be statistically significantly lower than in the male controls.
Gooren, L.J.; Kreukels, B.P.C.; Lapauw, B.; Giltay, E.J.
There is a limited body of knowledge of desired and undesired effects of cross-sex hormones in transsexual people. Little attention has been given to the fact that chromosomal configurations, 46,XY in male-to-female transsexuals subjects (MtoF) and 46,XX in female-to-male transsexual subjects
Roque, Alberto; Rodríguez, R Mayra
Gender identity is a sociocultural construct based (in nearly every society) on a binary norm: female and male. Transsexual individuals suffer from intense family and social discrimination because they express a dissident sexuality incongruent with this norm. They assert they feel trapped in a body that does not belong to them, so they seek help from health professionals to modify their bodies, to "adapt their bodies to their minds." This essay discusses health care for transsexual persons in Cuba from a human rights perspective that does not pathologize their gender identification.
Jordi Mas Grau
Full Text Available This paper analyses how transsexuality has been conceptualized in the Diagnostic and Statistical Manual of Mental Disorders (DSM. We will see how the successive changes in the denomination and diagnostic criteria are largely due to the pressure that the editors of the manual have received by scientists, academics, political organisations and organisations for the transgender rights. As a result of these tensions the transsexuality has been reconceptualised in several occasions, although the connotations inherent to the diagnostic category which treat it as a disease have endured. Likewise, we will address the current debate on pathologisation of transsexuality which is dominated by two opposed discourses: one which justifies the inclusion of transsexuality in the DSM because it considers that the diagnostic guarantees the access to hormonal and surgical therapy, and the other which criticises its inclusion because it considers that it contributes to the stigmatisation of the transgender people. The paper concludes that the trans-specific health resources should be regarded as a fundamental right which cannot be subject to clinical requirements.
Case, Kim A.; Stewart, Briana
The transgender community encounters pervasive prejudice, discrimination, and violence, yet social science literature lacks research that focuses on reduction of antitransgender prejudice. This experimental study examined the effectiveness of three interventions aimed at decreasing negative attitudes toward transsexuals, correcting participants'…
Bozkurt, Ali; Bozkurt, Ozlem Hekim; Sonmez, Ipek
Western studies have consistently found that androphilic (sexually attracted to men) male-to-female transsexuals have a later birth order and a relative excess of brothers compared with appropriate control participants. However, non-Western studies on birth order and sibling sex ratio in androphilic males (transsexual or non-transsexual) are rare. The objective of the study was to test the hypothesis that androphilic male-to-female transsexuals have a late birth order and a relative excess of brothers in a non-Western culture with a higher fertility rate. The participants were 60 androphilic male-to-female transsexuals and 61 male heterosexual controls. The transsexual participants had significantly more older brothers than the control participants, but the groups did not differ in their numbers of older sisters, younger brothers, or younger sisters. The foregoing pattern is usually referred to as the "fraternal birth order effect." Slater's and Berglin's Indexes both showed that the mean birth order of the control participants was very close to that expected from a random sample drawn from a demographically stable population whereas the mean birth order of the transsexual participants was later. A measure of sibship composition, brothers/all siblings, showed that the transsexual group had a higher proportion of male siblings compared with the control group. In conclusion, the present study found that Turkish androphilic male-to-female transsexuals show the same high fraternal birth order that has been found in comparable androphilic samples in Western Europe, North America, and the South Pacific, which suggests a common underlying biological causal mechanism.
Fleming, M Z; MacGowan, B R; Salt, P
The sex-role-based perceptions of self and spouse in a group of female-to-male transsexuals, their wives, and a matched control group were studied. Each participant was given four copies of the Personal Attributes Questionnaire and asked to rate self, spouse, ideal self, and ideal spouse. The transsexual group rated themselves significantly higher than the control male group on the F scale, while there were no significant differences between the two groups on the M and M-F scales. The transsexuals' wives rated their spouses higher than did the control women on the F scale, and this difference approached significance. There were no significant differences between the spouse ratings of these two groups on the M and M-F scales. These results are discussed in terms of the relationship between sex role and gender identity and in terms of the theories that propose role strain as the cause of transsexualism.
Sánchez, Francisco J.; Vilain, Eric
The fear of experiencing discrimination often provokes symptoms of psychological distress. One coping resource is positive identification with one’s social group—known as collective self-esteem. This preliminary study investigated whether collective self-esteem was related to fears regarding a transsexual identity and psychological distress among 53 self-identified male-to-female transsexuals (mean age = 50.79). Participants were recruited from transgender events held in Arizona and Californi...
Full Text Available Anatomical studies have suggested that one of the brain structures involved in gender identity is the bed nucleus of the stria terminalis, though this brain structure is probably not the only one to control gender identity. We hypothesized that, if this brain area also affected gonadotropin secretion in humans, transsexual individuals might produce different gonadotropin levels in response to exogenous stimulation. In the present study, we examined whether estrogen combined with progesterone might lead to a change in luteinizing hormone (LH secretion in female-to-male (FTM transsexual individuals. We studied female control subjects (n = 9, FTM transsexual subjects (n = 12, and male-to-female (MTF transsexual subjects (n = 8. Ethinyl estradiol (50 μg/tablet was administered orally, twice a day, for five consecutive days. After the first blood sampling, progesterone (12.5 mg was injected intramuscularly. Plasma LH was measured with an immunoradiometric assay. The combination of estrogen and progesterone resulted in increased LH secretion in female control subjects and in MTF subjects, but this increase appeared to be attenuated in FTM transsexual subjects. In fact, the %LH response was significantly reduced in FTM subjects (P < 0.05, but not in MTF subjects (P > 0.5, compared to female control subjects. In addition, the peak time after progesterone injection was significantly delayed in FTM subjects (P < 0.05, but not in MTF subjects (P > 0.5, compared to female control subjects. We then compared subjects according to whether the combination of estrogen and progesterone had a positive (more than 200% increase or negative (less than 200% increase effect on LH secretion. A χ2 analysis revealed significantly different (P < 0.05 effects on LH secretion between female controls (positive n = 7, negative n = 2 and FTM transsexual subjects (positive n = 4, negative n = 8, but not between female
Full Text Available Although the epidemiological data is generally obtained from the patients that applied for gender reassignment surgery, it is known that transsexualism is not seen as rarely as it was estimated in the past and should be evaluated in detail because of its psychological and social consequences. Etiology remains to be unclear and biological and psychosocial factors are thought to be responsible for its development. Gender identity stabilizes approximately in 3-4 ages and it is impossible to change it after these ages. For this reason the aim of treatment approaches is to improve the conformity of individuals to their identity and life, but not to change the gender identity. The World Professional Association for Transgender Health [WPATH] published a guideline including standards of care [SOC] and SOC provide clinical guidance in follow-up and treatment of transsexual individuals. There is a detailed code in civil law about gender reassignment but when this code implemented strictly, the use of it is very limited and it is clear that a new arrangement is needed in this issue.
Meilius, Kazimieras; Juškevičius, Jonas; Širinskienė, Agnė
Transsexualism is a gender identity disorder that is defined by the ICD-10 Classification of Mental and Behavioural Disorders as a “desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make one’s body as congruent as possible with one’s preferred sex through surgery and hormonal treatment”. Gender identity disorder, especially after a surgical operation has been performed in order to achieve the desired sex of a transsexual, can create serious pro...
Coleman, E.; Bockting, W.; Botzer, M.; Cohen-Kettenis, P.T.; DeCuypere, G.; Feldman, J.; Fraser, L.; Green, J.; Knudson, G.; Meyer, W.J.; Monstrey, S.; Adler, R.K.; Brown, G.R.; Devor, A.H.; Ehrbar, R.; Ettner, R.; Eyler, E.; Garofalo, R.; Karasic, D.H.; Lev, A.I.; Mayer, G.; Meyer-Bahlburg, H.; Hall, B.P.; Pfaefflin, F.; Rachlin, K.; Robinson, B.; Schechter, L.S.; Tangpricha, V.; van Trotsenburg, M.A.A.; Vitale, A.; Winter, S.; Whittle, S.; Wylie, K.R.; Zucker, K.J.
The Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People is a publication of the World Professional Association for Transgender Health (WPATH). The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual,
Wierckx, Katrien; Van Caenegem, Eva; Elaut, Els; Dedecker, David; Van de Peer, Fleur; Toye, Kaatje; Weyers, Steven; Hoebeke, Piet; Monstrey, Stan; De Cuypere, Griet; T'Sjoen, Guy
Although sexual health after genital surgery is an important outcome factor for many transsexual persons, little attention has been attributed to this subject. To provide data on quality of life and sexual health after sex reassignment surgery (SRS) in transsexual men. A single-center, cross-sectional study in 49 transsexual men (mean age 37 years) after long-term testosterone therapy and on average 8 years after SRS. Ninety-four percent of the participants had phalloplasty. Self-reported physical and mental health using the Dutch version of the Short Form-36 Health Survey; sexual functioning before and after SRS using a newly constructed specific questionnaire. Compared with a Dutch reference population of community-dwelling men, transsexual men scored well on self-perceived physical and mental health. The majority reported having been sexually active before hormone treatment, with more than a quarter having been vaginally penetrated frequently before starting hormone therapy. There was a tendency toward less vaginal involvement during hormone therapy and before SRS. Most participants reported an increase in frequency of masturbation, sexual arousal, and ability to achieve orgasm after testosterone treatment and SRS. Almost all participants were able to achieve orgasm during masturbation and sexual intercourse, and the majority reported a change in orgasmic feelings toward a more powerful and shorter orgasm. Surgical satisfaction was high, despite a relatively high complication rate. Results of the current study indicate transsexual men generally have a good quality of life and experience satisfactory sexual function after SRS. © 2011 International Society for Sexual Medicine.
After the description of transsexualism as a nosological entity by Harry Benjamin standards of care emerged which are useful and protective for patients and doctors involved in treatment. The diagnosis is established by the finding of an irreversibly transposed gender identity. This has to be confirmed by an expert who is competent in counselling gender identity problems. He will give his written opinion which is the indication for the hormonal treatment to be done at least for half a year prior to operation and which leads to virilization or effeminization and which is the preparation for genital surgery. Standards of female-to-male surgery are: 1. Breast-transformation 2. Colpohysterectomy with adnexectomy, possibly by the vaginal route. Surrogates for testes and phalloplasties are only in the experimental stage and not standard. Standards of male-to-female surgery are: 1. Castration by extirpation of testes. 2. Resection of penis shaft with total resection of the spongy bodies. 3. Neovagina by inverted penis-skin technique. 4. Plasty of labia majora and minora and a clitoris. 5. In case of insufficient gynecomastia breast-augmentation. After the operation, follow-up examinations are necessary by the surgeon until complete healing. A supportive psychological care by the expert who has evaluated the transposition of gender identity would be useful. It could be done also by the gynecologist who makes the follow-up examinations in male to female transsexuals. He is also competent for the life-long hormonal substitution.
Silva, Glauber Weder Dos Santos; Souza, Emanoel Fhilipe Leite; Sena, Romeika Carla Ferreira de; Moura, Izabella Bezerra de Lima; Sobreira, Maura Vanessa Silva; Miranda, Francisco Arnoldo Nunes de
Objective To analyze cases of violence against transvestites and transsexuals based on their sociodemographic profile. Method Cross-sectional, descriptive research performed in Cajazeiras / Paraíba, consisting of 16 transvestites and transsexuals. Data collection took place in April 2014 and was analyzed descriptively. Results The typology of violence that victimized transvestites and transsexuals were: verbal (91.96%), psychological (58.33%) and physical (33.33%), often between 24 hours and six months preceding the survey. Regarding the spatiality: the street, school and health services were all scenarios of aggression. With respect to the offending agent, the findings point towards neighbors, family members and health professionals. All forms of violence happened between agents and spaces of aggression. Conclusions Violence among this population, silence around the situations of abuse became more pronounced as did its invisibility in the social and institutional context, reflecting the inhibition of human rights and concealment of reality.
Dörner, G; Poppe, I; Stahl, F; Kölzsch, J; Uebelhack, R
Sexual brain organization is dependent on sex hormone and neurotransmitter levels occurring during critical developmental periods. The higher the androgen levels during brain organization, caused by genetic and/or environmental factors, the higher is the biological predisposition to bi- and homosexuality or even transsexualism in females and the lower it is in males. Adrenal androgen excess, leading to heterotypical sexual orientation and/or gender role behavior in genetic females, can be caused by 21-hydroxylase deficiency, especially when associated with prenatal stress. The cortisol (F) precursor 21-deoxycortisol (21-DOF) was found to be significantly increased after ACTH stimulation in homosexual as compared to heterosexual females. 21-DOF was increased significantly before and even highly significantly after ACTH stimulation in female-to-male transsexuals. In view of these data, heterozygous and homozygous forms, respectively, of 21-hydroxylase deficiency represent a genetic predisposition to androgen-dependent development of homosexuality and transsexualism in females. Testicular androgen deficiency in prenatal life, giving rise to heterotypical sexual orientation and/or gender role behavior in genetic males, may be induced by prenatal stress and/or maternal or fetal genetic alterations. Most recently, in mothers of homosexual men--following ACTH stimulation--a significantly increased prevalence of high 21-DOF plasma values and 21-DOF/F ratios was found, which surpassed the mean + 1 SD level of heterosexual control women. In homosexual men as well--following ACTH stimulation--most of the 21-DOF plasma values and 21-DOF/F ratios also surpassed the mean + 1 SD level of heterosexual men. In only one out of 9 homosexual males, neither in his blood nor in that of his mother increased 21-DOF values and 21-DOF/F ratios were found after ACTH stimulation. In this homosexual man, however, the plasma dehydroepiandrosterone sulfate (DHEA-S) values and the DHEA-S/1000 x A
Gorin-Lazard, Audrey; Baumstarck, Karine; Boyer, Laurent; Maquigneau, Aurélie; Gebleux, Stéphanie; Penochet, Jean-Claude; Pringuey, Dominique; Albarel, Frédérique; Morange, Isabelle; Loundou, Anderson; Berbis, Julie; Auquier, Pascal; Lançon, Christophe; Bonierbale, Mireille
Although the impact of sex reassignment surgery on the self-reported outcomes of transsexuals has been largely described, the data available regarding the impact of hormone therapy on the daily lives of these individuals are scarce. The objectives of this study were to assess the relationship between hormonal therapy and the self-reported quality of life (QoL) in transsexuals while taking into account the key confounding factors and to compare the QoL levels between transsexuals who have, vs. those who have not, undergone cross-sex hormone therapy as well as between transsexuals and the general population (French age- and sex-matched controls). This study incorporated a cross-sectional design that was conducted in three psychiatric departments of public university teaching hospitals in France. The inclusion criteria were as follows: 18 years or older, diagnosis of gender identity disorder (302.85) according to the Diagnostic and Statistical Manual, fourth edition text revision (DSM-IV TR), inclusion in a standardized sex reassignment procedure following the agreement of a multidisciplinary team, and pre-sex reassignment surgery. QoL was assessed using the Short Form 36 (SF-36). The mean age of the total sample was 34.7 years, and the sex ratio was 1:1. Forty-four (72.1%) of the participants received hormonal therapy. Hormonal therapy and depression were independent predictive factors of the SF-36 mental composite score. Hormonal therapy was significantly associated with a higher QoL, while depression was significantly associated with a lower QoL. Transsexuals' QoL, independently of hormonal status, did not differ from the French age- and sex-matched controls except for two subscales of the SF-36 questionnaire: role physical (lower scores in transsexuals) and general health (lower scores in controls). The present study suggests a positive effect of hormone therapy on transsexuals' QoL after accounting for confounding factors. These results will be useful for
Selvaggi, Gennaro; Ceulemans, Peter; De Cuypere, Griet; VanLanduyt, Koen; Blondeel, Phillip; Hamdi, Moustapha; Bowman, Cameron; Monstrey, Stan
After studying this article, the participant should be able to discuss: 1. The terminology related to male-to-female gender dysphoria. 2. The different theories regarding cause, epidemiology, and treatment of gender dysphoria. 3. The surgical goals of sex reassignment surgery in male-to-female transsexualism. 4. The surgical techniques available for sex reassignment surgery in male-to-female transsexualism. Gender identity disorder (previously "transsexualism") is the term used for individuals who show a strong and persistent cross-gender identification and a persistent discomfort with their anatomical sex, as manifested by a preoccupation with getting rid of one's sex characteristics, or the belief of being born in the wrong sex. Since 1978, the Harry Benjamin International Gender Dysphoria Association (in honor of Dr. Harry Benjamin, one of the first physicians who made many clinicians aware of the potential benefits of sex reassignment surgery) has played a major role in the research and treatment of gender identity disorder, publishing the Standards of Care for Gender Dysphoric Persons. The authors performed an overview of the terminology related to male-to-female gender identity disorder; the different theories regarding cause, epidemiology, and treatment; the goals expected; and the surgical technique available for sex reassignment surgery in male-to-female transsexualism. Surgical techniques available for sex reassignment surgery in male-to-female transsexualism, with advantages and disadvantages offered by each technique, are reviewed. Other feminizing nongenital operative interventions are also examined. This review describes recent etiopathogenetic theories and actual guidelines on the treatment of the gender identity disorder in male-to-female transsexuals; the penile-scrotal skin flap technique is considered the state of the art for vaginoplasty in male-to-female transsexuals, whereas other techniques (rectosigmoid flap, local flaps, and isolated skin
Transsexualism offers a unique perspective on gender identity, sex-role stereotyping, and sex differences in a patriarchal society. It is also an important medical ethical issue which raises questions of bodily mutilation and integrity, nature versus technology, medical research priorities, unnecessary surgery, and the medical model, as well as…
Amy A. Jensen
Full Text Available Transamerica, by Duncan Tucker, released in 2005, addresses lesbian, gay, bisexual, transgender and queer- (LGBTQ- related themes through a transsexual female protagonist, Bree. This article discusses the film as an important step in the direction of representing the complexity of gender, which, by today’s standards, is more generally appreciated. Because of its subject matter, Transamerica is a contentious film, lauded and condemned in mainstream media for how it dealt with and represented transsexual identities. Despite nominations for a number of awards, the film’s portrayal of transsexual identities was largely ignored in academic discourse at the time. I argue here that the film provides insight into the challenges, requirements, concerns, as well as the consequences of gender-fluid expression, which has been recognised in academia for years and has become a more discussed topic in mainstream society, but the manner in which the film examines these insights was overlooked. I do this by contextualising the film in terms of contemporary examples of transgender existence, which have brought the topic to mainstream discourse, and by applying gender theory concepts to the film. I discuss the protagonist’s physical and emotional journey to self-discovery in the context of the road movie trope. I then look into the protagonist’s gender performance, as well as how the protagonist negotiates this performance in the various places she visits while on the journey. I show that the film encourages open and honest discourse about gender identity and expression; the opportunity for this discussion was not taken in the year of the film’s release.
Schöning, Sonja; Engelien, Almut; Bauer, Christine; Kugel, Harald; Kersting, Anette; Roestel, Cornelia; Zwitserlood, Pienie; Pyka, Martin; Dannlowski, Udo; Lehmann, Wolfgang; Heindel, Walter; Arolt, Volker; Konrad, Carsten
Neuropsychological abnormalities in transsexual patients have been reported in comparison with subjects without gender identity disorder (GID), suggesting differences in underlying neurobiological processes. However, these results have not consistently been confirmed. Furthermore, studies on cognitive effects of cross-sex hormone therapy also yield heterogeneous results. We hypothesized that untreated transsexual patients differ from men without GID in activation pattern associated with a mental rotation task and that these differences may further increase after commencing of hormonal treatment. The present study investigated 11 male-to-female transsexual (MFTS) patients prior to cross-sex hormone therapy and 11 MFTS patients during hormone therapy in comparison with healthy men without GID. Using functional magnetic resonance imaging at 3-Tesla, a mental rotation paradigm with proven sexual dimorphism was applied to all subjects. Data were analyzed with SPM5. Patterns of brain activation associated with a mental rotation task. The classical mental rotation network was activated in all three groups, but significant differences within this network were observed. Men without GID exhibited significantly greater activation of the left parietal cortex (BA 40), a key region for mental rotation processes. Both transsexual groups revealed stronger activation of temporo-occipital regions in comparison with men without GID. Our results confirmed previously reported deviances of brain activation patterns in transsexual men from men without GID and also corroborated these findings in a group of transsexual patients receiving cross-sex hormone therapy. The present study indicates that there are a priori differences between men and transsexual patients caused by different neurobiological processes or task-solving strategies and that these differences remain stable over the course of hormonal treatment.
Asscheman, H.; Giltay, E.J.; Megens, J.A.J.; de Ronde, W.; van Trotsenburg, M.A.A.; Gooren, L.J.G.
Objective: Adverse effects of long-term cross-sex hormone administration to transsexuals are not well documented. We assessed mortality rates in transsexual subjects receiving long-term cross-sex hormones. Design: A cohort study with a median follow-up of 18.5 years at a university gender clinic.
Magno, Laio; Dourado, Inês; Silva, Luis Augusto Vasconcelos da
This was a qualitative study based on an analysis of narratives produced by travestis and transsexual women in Salvador, Bahia State, Brazil, with the aim of analyzing their experiences with stigmatization by describing events, actors, and contexts that have marked their life stories, as well as elucidating the relationship between stigma and their female performances. The narratives came from 19 in-depth interviews during an epidemiological survey, based on a prior script that explored the production of narratives on lifestyles and experiences of travestis and transsexual women in the city of Salvador. The life stories that emerged in the field were transcribed and analyzed from a theoretical and narrative perspective. The narratives of many travestis and transsexual women described an "effeminate" gender performance that had been identified since their childhood by family and community members. This performance was presented as insubordination to the power established by heteronormative society's legal system. The process of stigmatization begins to operate when social expectations concerning the coherence between "biological sex" and "gender performance" are frustrated in social interactions, submitting the individuals to discrimination and violence. Thus, stigmatization is operated through the power exercised over bodies by the laws of compulsory heterosexuality. However, during the life stories of travestis and transsexual women, strategies of resistance to stigma are produced, with the potential to transform this situation.
Full Text Available Testosterone therapy in men and women results in decreased high-density lipoprotein cholesterol (HDL and increased low-density lipoprotein cholesterol (LDL. We sought to determine whether testosterone therapy has this same effect on lipid parameters and adipocyte hormones in female-to-male (FTM transsexuals. Twelve FTM transsexuals provided a fasting lipid profile including serum total cholesterol, HDL, LDL, and triglycerides prior to and after 1 year of testosterone therapy (testosterone enanthate or cypionate 50–125 mg IM every two weeks. Subjects experienced a significant decrease in mean serum HDL (52±11 to 40±7 mg/dL (P<.001. The mean LDL (P=.316, triglyceride (P=.910, and total cholesterol (P=.769 levels remained unchanged. In a subset of subjects, we measured serum leptin levels which were reduced by 25% but did not reach statistical significance (P=.181 while resistin levels remained unchanged. We conclude that testosterone therapy in FTM transsexuals can promote an increased atherogenic lipid profile by lowering HDL and possibly reduce serum leptin levels. However, long-term studies are needed to determine whether decreases in HDL result in adverse cardiovascular outcomes.
The author reflects on his contrasting analytic work with two transsexual patients. He uses three previous psychoanalytic studies (Stoller, Morel and Lemma) to explore whether effective analytic work with the issues driving a person's determined wish for sex reassignment surgery (SRS) is possible. Particular consideration is given to how such work might navigate a path between traumatizing and pathologizing the patient on the one hand and avoiding important analytic material out of fear of so doing on the other. The author proceeds to ask whether it is possible to tell in advance, with any degree of reliability, who is and who is not likely to benefit from surgery. He considers certain diagnostic issues in relation to these questions. Illustrations are given of how, in practice, countertransference anxieties about psychopathologizing transsexual patients can contribute to significant difficulties in working clinically with them. It is argued that the understanding and containment of such anxieties could eventually lead to more effective analytic work, and that such work might be further facilitated by considering the contribution of mind-body dissociation to transsexualism. © 2015, The Society of Analytical Psychology.
Dörner, G; Rohde, W; Seidel, K; Haas, W; Schott, G S
In transsexual men with homosexual behaviour and intact testicular function, as well as in homosexual men with normal gender identity, following a negative oestrogen feedback effect a delayed positive oestrogen feedback action on LH secretion was evoked. By contrast, in transsexual men with hypo- or asexuality and intact testes or hypergonadotrophic hypo- or agonadism, as well as in heterosexual men with normal gender identity, a negative oestrogen feedback effect was not followed by a positive feedback action on LH release. In transsexual women with homosexual behaviour and oligo- and/or hypomenorrhoea, only a weak or at best moderate positive oestrogen feedback action on LH release was evocable, similarly as in castrated and oestrogen-primed heterosexual men. By contrast, in a transsexual woman with bisexual behaviour and eumenorrhoea, a strong positive oestrogen feedback action on LH secretion was evocable, as well as in heterosexual women with normal gender identity.
Kranz, Georg S; Hahn, Andreas; Kaufmann, Ulrike; Küblböck, Martin; Hummer, Allan; Ganger, Sebastian; Seiger, Rene; Winkler, Dietmar; Swaab, Dick F; Windischberger, Christian; Kasper, Siegfried; Lanzenberger, Rupert
Biological causes underpinning the well known gender dimorphisms in human behavior, cognition, and emotion have received increased attention in recent years. The advent of diffusion-weighted magnetic resonance imaging has permitted the investigation of the white matter microstructure in unprecedented detail. Here, we aimed to study the potential influences of biological sex, gender identity, sex hormones, and sexual orientation on white matter microstructure by investigating transsexuals and healthy controls using diffusion tensor imaging (DTI). Twenty-three female-to-male (FtM) and 21 male-to-female (MtF) transsexuals, as well as 23 female (FC) and 22 male (MC) controls underwent DTI at 3 tesla. Fractional anisotropy, axial, radial, and mean diffusivity were calculated using tract-based spatial statistics (TBSS) and fiber tractography. Results showed widespread significant differences in mean diffusivity between groups in almost all white matter tracts. FCs had highest mean diffusivities, followed by FtM transsexuals with lower values, MtF transsexuals with further reduced values, and MCs with lowest values. Investigating axial and radial diffusivities showed that a transition in axial diffusivity accounted for mean diffusivity results. No significant differences in fractional anisotropy maps were found between groups. Plasma testosterone levels were strongly correlated with mean, axial, and radial diffusivities. However, controlling for individual estradiol, testosterone, or progesterone plasma levels or for subjects' sexual orientation did not change group differences. Our data harmonize with the hypothesis that fiber tract development is influenced by the hormonal environment during late prenatal and early postnatal brain development. Copyright © 2014 the authors 0270-6474/14/3415466-10$15.00/0.
Kranz, Georg S.; Hahn, Andreas; Kaufmann, Ulrike; Küblböck, Martin; Hummer, Allan; Ganger, Sebastian; Seiger, Rene; Winkler, Dietmar; Swaab, Dick F.; Windischberger, Christian; Kasper, Siegfried; Lanzenberger, Rupert
Biological causes underpinning the well known gender dimorphisms in human behavior, cognition, and emotion have received increased attention in recent years. The advent of diffusion-weighted magnetic resonance imaging has permitted the investigation of the white matter microstructure in unprecedented detail. Here, we aimed to study the potential influences of biological sex, gender identity, sex hormones, and sexual orientation on white matter microstructure by investigating transsexuals and healthy controls using diffusion tensor imaging (DTI). Twenty-three female-to-male (FtM) and 21 male-to-female (MtF) transsexuals, as well as 23 female (FC) and 22 male (MC) controls underwent DTI at 3 tesla. Fractional anisotropy, axial, radial, and mean diffusivity were calculated using tract-based spatial statistics (TBSS) and fiber tractography. Results showed widespread significant differences in mean diffusivity between groups in almost all white matter tracts. FCs had highest mean diffusivities, followed by FtM transsexuals with lower values, MtF transsexuals with further reduced values, and MCs with lowest values. Investigating axial and radial diffusivities showed that a transition in axial diffusivity accounted for mean diffusivity results. No significant differences in fractional anisotropy maps were found between groups. Plasma testosterone levels were strongly correlated with mean, axial, and radial diffusivities. However, controlling for individual estradiol, testosterone, or progesterone plasma levels or for subjects’ sexual orientation did not change group differences. Our data harmonize with the hypothesis that fiber tract development is influenced by the hormonal environment during late prenatal and early postnatal brain development. PMID:25392513
Geijtenbeek, Lydia; Plug, Erik
We study the earnings of transsexuals using Dutch administrative labor force data. First, we compare transsexuals to other women and men, and find that transsexuals earn more than women and less than men. Second, we compare transsexuals before and after transition using worker fixed effects models, and find a fall in earnings for men who become women and a smaller rise (if any) in earnings for women who become men. These earnings patterns, which hold for annual as well as hourly earnings, are...
Ayanian, S; Irwig, M S
The global obesity epidemic is having a profound impact on the health of populations. From a reproductive standpoint, obesity has been associated with infertility and hypogonadism. We present the case of a 29-year-old male-to-female transsexual with super obesity (body mass index >50) who was found to have profound hypogonadism with total and free testosterone levels in the normal female reference range. There is virtually no literature on the hormonal sequelae of obesity in transsexual people. The patient was prescribed an aromatase inhibitor, letrozole 2.5 mg twice daily for 2 weeks, to determine the role of oestrogen in the hypogonadism. The aromatase inhibitor reduced the serum oestradiol concentration from 125 to 6.9 pm. There were dramatic corresponding rises in total testosterone (2.8 to 10.7 nm), luteinising hormone (4.1 to 20.5 mIU ml(-1) ) and follicle stimulating hormone (1.8 to 15.3 mIU ml(-1) ). This diagnostic test demonstrated the important role of oestrogen in mediating the hypogonadism. After the testing, the patient was started on oestrogen therapy after a careful discussion of the benefits versus risks of oestrogen therapy. We anticipate that similar cases of hypogonadism in male-to-female transsexuals will likely become more common in an era of increased obesity rates. © 2012 Blackwell Verlag GmbH.
Weyers, Steven; Verstraelen, Hans; Gerris, Jan; Monstrey, Stan; Santiago, Guido dos Santos Lopes; Saerens, Bart; De Backer, Ellen; Claeys, Geert; Vaneechoutte, Mario; Verhelst, Rita
The microflora of the penile skin-lined neovagina in male-to-female transsexuals is a recently created microbial niche which thus far has been characterized only to a very limited extent. Yet the knowledge of this microflora can be considered as essential to the follow-up of transsexual women. The primary objective of this study was to map the neo-vaginal microflora in a group of 50 transsexual women for whom a neovagina was constructed by means of the inverted penile skin flap technique. Secondary objectives were to describe possible correlations of this microflora with multiple patients' characteristics, such as sexual orientation, the incidence of vaginal irritation and malodorous vaginal discharge. Based on Gram stain the majority of smears revealed a mixed microflora that had some similarity with bacterial vaginosis (BV) microflora and that contained various amounts of cocci, polymorphous Gram-negative and Gram-positive rods, often with fusiform and comma-shaped rods, and sometimes even with spirochetes. Candida cells were not seen in any of the smears. On average 8.6 species were cultured per woman. The species most often found were: Staphylococcus epidermidis, Streptococcus anginosus group spp., Enterococcus faecalis, Corynebacterium sp., Mobiluncus curtisii and Bacteroides ureolyticus. Lactobacilli were found in only one of 30 women. There was no correlation between dilatation habits, having coitus, rinsing habits and malodorous vaginal discharge on the one hand and the presence of a particular species on the other. There was however a highly significant correlation between the presence of E. faecalis on the one hand and sexual orientation and coitus on the other (p = 0.003 and p = 0.027 respectively). Respectively 82%, 58% and 30% of the samples showed an amplicon after amplification with M. curtisii, Atopobium vaginae and Gardnerella vaginalis primer sets. Our study is the first to describe the microflora of the penile skin-lined neovagina of transsexual
Full Text Available Abstract Background The microflora of the penile skin-lined neovagina in male-to-female transsexuals is a recently created microbial niche which thus far has been characterized only to a very limited extent. Yet the knowledge of this microflora can be considered as essential to the follow-up of transsexual women. The primary objective of this study was to map the neo-vaginal microflora in a group of 50 transsexual women for whom a neovagina was constructed by means of the inverted penile skin flap technique. Secondary objectives were to describe possible correlations of this microflora with multiple patients' characteristics, such as sexual orientation, the incidence of vaginal irritation and malodorous vaginal discharge. Results Based on Gram stain the majority of smears revealed a mixed microflora that had some similarity with bacterial vaginosis (BV microflora and that contained various amounts of cocci, polymorphous Gram-negative and Gram-positive rods, often with fusiform and comma-shaped rods, and sometimes even with spirochetes. Candida cells were not seen in any of the smears. On average 8.6 species were cultured per woman. The species most often found were: Staphylococcus epidermidis, Streptococcus anginosus group spp., Enterococcus faecalis, Corynebacterium sp., Mobiluncus curtisii and Bacteroides ureolyticus. Lactobacilli were found in only one of 30 women There was no correlation between dilatation habits, having coitus, rinsing habits and malodorous vaginal discharge on the one hand and the presence of a particular species on the other. There was however a highly significant correlation between the presence of E. faecalis on the one hand and sexual orientation and coitus on the other (p = 0.003 and p = 0.027 respectively. Respectively 82%, 58% and 30% of the samples showed an amplicon after amplification with M. curtisii, Atopobium vaginae and Gardnerella vaginalis primer sets. Conclusion Our study is the first to describe the
Background The microflora of the penile skin-lined neovagina in male-to-female transsexuals is a recently created microbial niche which thus far has been characterized only to a very limited extent. Yet the knowledge of this microflora can be considered as essential to the follow-up of transsexual women. The primary objective of this study was to map the neo-vaginal microflora in a group of 50 transsexual women for whom a neovagina was constructed by means of the inverted penile skin flap technique. Secondary objectives were to describe possible correlations of this microflora with multiple patients' characteristics, such as sexual orientation, the incidence of vaginal irritation and malodorous vaginal discharge. Results Based on Gram stain the majority of smears revealed a mixed microflora that had some similarity with bacterial vaginosis (BV) microflora and that contained various amounts of cocci, polymorphous Gram-negative and Gram-positive rods, often with fusiform and comma-shaped rods, and sometimes even with spirochetes. Candida cells were not seen in any of the smears. On average 8.6 species were cultured per woman. The species most often found were: Staphylococcus epidermidis, Streptococcus anginosus group spp., Enterococcus faecalis, Corynebacterium sp., Mobiluncus curtisii and Bacteroides ureolyticus. Lactobacilli were found in only one of 30 women There was no correlation between dilatation habits, having coitus, rinsing habits and malodorous vaginal discharge on the one hand and the presence of a particular species on the other. There was however a highly significant correlation between the presence of E. faecalis on the one hand and sexual orientation and coitus on the other (p = 0.003 and p = 0.027 respectively). Respectively 82%, 58% and 30% of the samples showed an amplicon after amplification with M. curtisii, Atopobium vaginae and Gardnerella vaginalis primer sets. Conclusion Our study is the first to describe the microflora of the penile skin
Full Text Available Brazilian Transvestites and transsexuals women suffer helplessness in family, academic, social and labor from the moment they take their transgender identity. To improve this situation, we should look through the social bias of Human Resources and study the inclusion of women in the formal labor market, in contrast to statistics that reduce this population group to prostitution or informal jobs. Through interviews conducted with transgender women, this article aims to expose the current employability of transvestites and transsexuals in Brazil. It intends to propose a new perspective for organizations to have inclusive and diverse environments, to fight prejudice and discrimination that this group faces. The results show the lack of policies and practices of Human Resources for making the work environment open and inclusive for those professionals.
The author describes the analysis of a transsexual who had undergone a vaginoplasty as a young man and had since been living as a woman. The complexity of the psychic reality is epitomised by the analyst's difficulty in deciding whether to use masculine or feminine grammatical forms to refer to this patient. The author tells how she assumed the fantasy role of parents expecting a baby whose sex they did not yet know. She discusses at length her hesitation about accepting a transsexual patient into analysis and reports how she overcame her misgivings after analysing her own countertransference and consulting the literature. Noting that this borderline analysand resorted to both psychotic and neurotic mechanisms, the analyst decided to rely on the capacity for symbolisation and mental representation evinced in the latter. On the psychotic level, the delusional neo-reality of the appearance of a woman sought to replace the unbearable reality of being a man, whereas the neurotic part was aware that s/he could never really be a woman. The author observes that in this analysand sexualisation served to conceal a fundamental narcissistic fault. She also describes how she worked with her own madness to help the patient emerge from a situation of paradoxical fusion with the mother in madness.
Chadha, D.; Pache, T.D.; Huikeshoven, Frans; Brinkmann, Albert; Kwast, Theo
textabstractAndrogen receptor (AR) modulation in human uteri and ovaries of long term androgen-treated transsexual female patients was investigated. Androgen receptor expression was evaluated immunohistochemically in the ovaries of 11 and the endometria and myometria of six androgen-treated transsexual female patients. This was compared with AR expression in the ovaries and uteri of premenopausal and postmenopausal women not receiving treatment and in 10 ovaries of female patients with polycy...
Gizewski, Elke R; Krause, Eva; Schlamann, Marc; Happich, Friederike; Ladd, Mark E; Forsting, Michael; Senf, Wolfgang
Transsexuals harbor the strong feeling of having been born to the wrong sex. There is a continuing controversial discussion of whether or not transsexualism has a biological representation. Differences between males and females in terms of functional imaging during erotic stimuli have been previously described, revealing gender-specific results. Therefore, we postulated that male-to-female (MTF) transsexuals may show specific cerebral activation differing from their biological gender. Cerebral activation patterns during viewing of erotic film excerpts in functional magnetic resonance imaging (fMRI). Twelve male and 12 female heterosexual volunteers and 12 MTF transsexuals before any treatment viewed erotic film excerpts during fMRI. Additionally, subjective rating of sexual arousal was assessed. Statistics were performed using the Statistical Parametric Mapping software. Significantly enhanced activation for men compared with women was revealed in brain areas involved in erotic processing, i.e., the thalamus, the amygdala, and the orbitofrontal and insular cortex, whereas no specific activation for women was found. When comparing MTF transsexuals with male volunteers, activation patterns similar to female volunteers being compared with male volunteers were revealed. Sexual arousal was assessed using standard rating scales and did not differ significantly for the three groups. We revealed a cerebral activation pattern in MTF transsexuals compared with male controls similar to female controls compared with male controls during viewing of erotic stimuli, indicating a tendency of female-like cerebral processing in transsexualism.
Gressgård , Randi
Abstract The Muslim woman wearing the veil, the female anorexic and the from-male-to-female transsexual constitute three different figures that, despite their striking differences, have a common symbolic ground. By focusing on the similarity between the veiled woman and the other two figures, the article sheds a different light on the debate about the Muslim veil in western societies. It is argued that the ...
José Arturo Granados Cosme
Full Text Available The World Health Organization and the American Psychological Association consider transsexuality a pathology and suggest sex-gender reassignment for the biopsychic adjustment of trans people. Through the discursive analysis of experience, this study describes the processes of medicalization and gender performativity in relation to the health of a group of trans women from Mexico City. For this purpose, a qualitative study was conducted in which 10 semi-structured interviews were carried out in 2015. As part of medicalization, the pathologization of transsexuality generated psychic suffering; on the other hand, sex-gender reassignment also entailed additional risks. It is possible to conclude that in trans women, violence and exclusion constitute the primary experiences explaining their foremost health problems. Therefore, it is suggested that it is necessary for discrimination be reduced and for advancements to be made in safer medical interventions.
Cosme, José Arturo Granados; Ramírez, Pedro Alberto Hernández; Muñoz, Omar Alejandro Olvera
The World Health Organization and the American Psychological Association consider transsexuality a pathology and suggest sex-gender reassignment for the biopsychic adjustment of trans people. Through the discursive analysis of experience, this study describes the processes of medicalization and gender performativity in relation to the health of a group of trans women from Mexico City. For this purpose, a qualitative study was conducted in which 10 semi-structured interviews were carried out in 2015. As part of medicalization, the pathologization of transsexuality generated psychic suffering; on the other hand, sex-gender reassignment also entailed additional risks. It is possible to conclude that in trans women, violence and exclusion constitute the primary experiences explaining their foremost health problems. Therefore, it is suggested that it is necessary for discrimination be reduced and for advancements to be made in safer medical interventions.
Spizzichino, L; Zaccarelli, M; Rezza, G; Ippolito, G; Antinori, A; Gattari, P
The Azienda Sanitaria Locale Roma E (ASL-RME) outpatient clinic is the main reference center in Rome for HIV testing of foreign people. To define the prevalence and incidence of HIV infection among foreign transsexual sex workers attending the center. A cross-sectional, follow-up study was conducted. Between 1993 and 1999, 353 transsexuals attended the ASL-RME. They were from Colombia (n = 208), Brazil (n = 122), and other countries (n = 23). Most of these transsexuals reported having 5 to 10 partners per day. The overall HIV prevalence was 38.2%, which multivariate analysis found to be associated with origin from Brazil and a higher number of sex partners. The observed HIV seroconversion rate was 4.1 per 100 person-years, and non-regular condom use was the only factor related to seroconversion. The data from this study suggest that promotion of safer sex practices and regular condom use still is the main priority among marginalized population subgroups, such as foreign prostitutes, involved in sex activities that put them at risk for HIV infection.
Bruck, J C
Gender alignment surgery was introduced into German law in 1981. Judicial guidelines for the change of first names and gender were established and transsexuality was labelled as a psychosomatic and somatopsychic syndrome and disorder, thus opening the way for treatment to the social health-care under well-defined conditions requesting cross-dressing and hormone therapy as well as psychological counselling by 2 independent psychologists or psychiatrists. In a retrospective, chart-related survey of questionnaires on male to female transsexuals it was found that patients start to suspect being born into the wrong gender at the onset of puberty, it takes them however approximately 20 years to have gender alignment surgery. More than half the patients are single at this time, while the remaining group is married or divorced with equal rates. 68% regard themselves as heterosexual, 21% lesbian and 11% were undecided. About half the patients experienced support by their families for their decision. Despite numerous secondary corrections of the surgical alignment, patients were content with the result, although emotional acceptance of the desired result took about one year. In general plastic surgical gender alignment treatment was perceived as the major contribution to harmonise their phenotype with their identity. © Georg Thieme Verlag KG Stuttgart · New York.
Ishak, Mohd Shuhaimi Bin Haji; Haneef, Sayed Sikandar Shah
The birth of people with confused or ambiguous sex makeup as a biological fact since the annals of history has posed the challenge of accommodating them within the binary gender of sociocultural systems. In this process, the role of religion as a defining factor in social engineering has been paramount. Major religions, such as Islam and Christianity, have addressed this issue within the frame of their God-ordained laws by devising a set of moral and legal imperatives specific to the "third gender." Modern developments in medicine and biology, however, have made sex reassignment possible for this category of people, today called transsexuals. The question is: How do Islam and Christianity respond to it. After presenting an analytical view of both Muslim scholars and Christian religious authorities on the legitimacy of sex reassignment for transsexuals, this paper attempts to explore if such a dilemma can be resolved.
This essay provides a review of a resource guide written by Kristopher Wells, Gayle Roberts, and Carol Allan (2012) titled "Supporting Transgender and Transsexual Students in K-12 Schools: A Guide for Educators". The guide is an invaluable resource for educators in schools and teacher education programs.
Tsujimura, Akira; Kiuchi, Hiroshi; Soda, Tetsuji; Takezawa, Kentaro; Fukuhara, Shinichiro; Takao, Tetsuya; Sekiguchi, Yuki; Iwasa, Atsushi; Nonomura, Norio; Miyagawa, Yasushi
Very little has been elucidated about sexual interest in female-to-male (FtM) transsexual persons. To investigate the sexual interest of FtM transsexual persons vs that of men using an eye-tracking system. The study included 15 men and 13 FtM transsexual subjects who viewed three sexual videos (clip 1: sexy clothed young woman kissing the region of the male genitals covered by underwear; clip 2: naked actor and actress kissing and touching each other; and clip 3: heterosexual intercourse between a naked actor and actress) in which several regions were designated for eye-gaze analysis in each frame. The designation of each region was not visible to the participants. Visual attention was measured across each designated region according to gaze duration. For clip 1, there was a statistically significant sex difference in the viewing pattern between men and FtM transsexual subjects. Longest gaze time was for the eyes of the actress in men, whereas it was for non-human regions in FtM transsexual subjects. For clip 2, there also was a statistically significant sex difference. Longest gaze time was for the face of the actress in men, whereas it was for non-human regions in FtM transsexual subjects, and there was a significant difference between regions with longest gaze time. The most apparent difference was in the gaze time for the body of the actor: the percentage of time spent gazing at the body of the actor was 8.35% in FtM transsexual subjects, whereas it was only 0.03% in men. For clip 3, there were no statistically significant differences in viewing patterns between men and FtM transsexual subjects, although longest gaze time was for the face of the actress in men, whereas it was for non-human regions in FtM transsexual subjects. We suggest that the characteristics of sexual interest of FtM transsexual persons are not the same as those of biological men. Tsujimura A, Kiuchi H, Soda T, et al. The Pattern of Sexual Interest of Female-to-Male Transsexual Persons
von Vogelsang, Ann-Christin; Milton, Camilla; Ericsson, Ingrid; Strömberg, Lars
To describe transsexual persons' experiences of encounters with healthcare professionals during the sex reassignment process. Transsexual persons are individuals who use varying means to alter their natal sex via hormones and/or surgery. Transsexual persons may experience stigma, which increases the risk of psychological distress. Mistreatments by healthcare professionals are common. Qualitative studies addressing transsexual persons' experiences of healthcare are scarce. Qualitative descriptive design. A Swedish non-clinical convenience sample was used, consisting of six persons who had been diagnosed as transsexual, gone through sex reassignment surgery or were at the time of the interview awaiting surgery. Semi-structured interviews were undertaken, and data were analysed using manifest qualitative content analysis. Three categories and 15 subcategories were identified. The encounters were perceived as good when healthcare professionals showed respect and preserved the transsexual person's integrity, acted in a professional manner and were responsive and built trust and confidence. However, the participants experienced that healthcare professionals varied in their level of knowledge, exploited their position of power, withheld information, expressed gender stereotypical attitudes and often used the wrong name. They felt vulnerable by having a condescending view of themselves, and they could not choose not to be transsexual. They felt dependent on healthcare professionals, and that the external demands were high. Transsexual persons are in a vulnerable position during the sex reassignment surgery process. The encounters in healthcare could be negatively affected if healthcare professionals show inadequate knowledge, exploit their position of power or express gender stereotypical attitudes. A good encounter is characterised by preserved integrity, respect, responsiveness and trust. Improved education on transgender issues in nursing and medical education is
Pepper, Shanti M.; Lorah, Peggy
The field of career counseling has addressed the needs of several minority groups; however, the transsexual community has consistently been overlooked. Transsexual individuals may face many personal and professional obstacles due to the complex psychological aspects and expensive medical procedures inherent in "transitioning" (the complex and…
St Peter, Matthew; Trinidad, Anton; Irwig, Michael S
The out-of-pocket cost for an elective orchiectomy, which is often not covered by health insurance, is a significant barrier to male-to-female transsexuals ready to proceed with their physical transition. This and other barriers (lack of access to a surgeon willing to perform the operation, waiting times, and underlying psychological and psychiatric conditions) lead a subset of transsexual women to attempt self-castration. Little information has been published on the financial costs and implications of self-castration to both patients and health care systems. We compare the financial and psychological costs of elective surgical orchiectomy vs. self-castration in the case of a transsexual woman in her 40s. We interviewed the patient and her providers and obtained financial information from local reimbursement and billing specialists. After experiencing minor hemorrhage following the self-castration, our patient presented to the emergency department and underwent a bilateral inguinal exploration, ligation and removal of bilateral spermatic cords, and complicated scrotal exploration, debridement, and closure. She was admitted to the psychiatric service for a hospital stay of three days. The total bill was U.S. $14,923, which would compare with U.S. $4,000 for an elective outpatient orchiectomy in the patient's geographical area. From a financial standpoint, an elective orchiectomy could have cost the health care system significantly less than a hospital admission with its associated additional costs. From a patient safety standpoint, elective orchiectomy is preferable to self-castration which carries significant risks such as hemorrhage, disfigurement, infection, urinary fistulae, and nerve damage. Healthcare providers of transsexual women should carefully explore patient attitudes toward self-castration and work toward improving access to elective orchiectomy to reduce the number of self-castrations and costs to the overall health care system. Further research on the
Oh, Seok Kyun; Kim, Gwang Won; Kang, Heoung Keun; Jeong, Gwang Woo [Chonnam National University, Gwangju (Korea, Republic of); Yang, Jong Chul [Chonbuk National University Medical School, Jeonju (Korea, Republic of); Kim, Seok Kwun [Dong-A University College of Medicine, Busan (Korea, Republic of)
This study used functional magnetic resonance imaging (fMRI) to contrast the differential brain activation patterns in response to visual stimulation with both male and female erotic nude pictures in male-to-female (MTF) transsexuals who underwent a sex reassignment surgery. A total of nine healthy MTF transsexuals after a sex reassignment surgery underwent fMRI on a 3.0 Tesla MR Scanner. The brain activation patterns were induced by visual stimulation with both male and female erotic nude pictures. The sex hormone levels of the postoperative MTF transsexuals were in the normal range of healthy heterosexual females. The brain areas, which were activated by viewing male nude pictures when compared with viewing female nude pictures, included predominantly the cerebellum, hippocampus, putamen, anterior cingulate gyrus, head of caudate nucleus, amygdala, midbrain, thalamus, insula, and body of caudate nucleus. On the other hand, brain activation induced by viewing female nude pictures was predominantly observed in the hypothalamus and the septal area. Our findings suggest that distinct brain activation patterns associated with visual sexual arousal in postoperative MTF transsexuals reflect their sexual orientation to males.
Oh, Seok Kyun; Kim, Gwang Won; Kang, Heoung Keun; Jeong, Gwang Woo; Yang, Jong Chul; Kim, Seok Kwun
This study used functional magnetic resonance imaging (fMRI) to contrast the differential brain activation patterns in response to visual stimulation with both male and female erotic nude pictures in male-to-female (MTF) transsexuals who underwent a sex reassignment surgery. A total of nine healthy MTF transsexuals after a sex reassignment surgery underwent fMRI on a 3.0 Tesla MR Scanner. The brain activation patterns were induced by visual stimulation with both male and female erotic nude pictures. The sex hormone levels of the postoperative MTF transsexuals were in the normal range of healthy heterosexual females. The brain areas, which were activated by viewing male nude pictures when compared with viewing female nude pictures, included predominantly the cerebellum, hippocampus, putamen, anterior cingulate gyrus, head of caudate nucleus, amygdala, midbrain, thalamus, insula, and body of caudate nucleus. On the other hand, brain activation induced by viewing female nude pictures was predominantly observed in the hypothalamus and the septal area. Our findings suggest that distinct brain activation patterns associated with visual sexual arousal in postoperative MTF transsexuals reflect their sexual orientation to males.
Wierckx, Katrien; De Zaeytijd, Julie; Elaut, Els; Heylens, Gunter; T'Sjoen, Guy
We present a case report on a 53-year-old transsexual woman who developed acute painless vision loss in both eyes during cross-sex hormone treatment. After 10 months of cross-sex hormone treatment, she experienced total vision loss of the right eye and, 6 months later, vision loss to 20/63 in the left eye. After a full ophthalmic exam, bilateral sequential non-arteritic ischemic optic neuropathy (NA-ION) was diagnosed. Extensive etiological work-up revealed no cardiac abnormalities or inherited blood-clotting disorders. A manifest self-administered overdose of transdermal estrogen treatment with serum estradiol levels of 5,765 pg/ml was possibly related to the sequential bilateral NA-ION resulting in nearly total vision loss in this transsexual woman.
Cardoso da Silva, Dhiordan; Schwarz, Karine; Fontanari, Anna Martha Vaitses; Costa, Angelo Brandelli; Massuda, Raffael; Henriques, Alexandre Annes; Salvador, Jaqueline; Silveira, Esalba; Elias Rosito, Tiago; Lobato, Maria Inês Rodrigues
The 100-item World Health Organization Quality of Life Assessment (WHOQOL-100) evaluates quality of life as a subjective and multidimensional construct. Currently, particularly in Brazil, there are controversies concerning quality of life after sex reassignment surgery (SRS). To assess the impact of surgical interventions on quality of life of 47 Brazilian male-to-female transsexual individuals using the WHOQOL-100. This was a prospective cohort study using the WHOQOL-100 and sociodemographic questions for individuals diagnosed with gender identity disorder according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The protocol was used when a transsexual person entered the ambulatory clinic and at least 12 months after SRS. Initially, improvement or worsening of quality of life was assessed using 6 domains and 24 facets. Subsequently, quality of life was assessed for individuals who underwent new surgical interventions and those who did not undergo these procedures 1 year after SRS. The participants showed significant improvement after SRS in domains II (psychological) and IV (social relationships) of the WHOQOL-100. In contrast, domains I (physical health) and III (level of independence) were significantly worse after SRS. Individuals who underwent additional surgery had a decrease in quality of life reflected in domains II and IV. During statistical analysis, all results were controlled for variations in demographic characteristics, without significant results. The WHOQOL-100 is an important instrument to evaluate the quality of life of male-to-female transsexuals during different stages of treatment. SRS promotes the improvement of psychological aspects and social relationships. However, even 1 year after SRS, male-to-female transsexuals continue to report problems in physical health and difficulty in recovering their independence. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc
Full Text Available CONTEXT: The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment. OBJECTIVE: To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons. DESIGN: A population-based matched cohort study. SETTING: Sweden, 1973-2003. PARTICIPANTS: All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males in Sweden, 1973-2003. Random population controls (10:1 were matched by birth year and birth sex or reassigned (final sex, respectively. MAIN OUTCOME MEASURES: Hazard ratios (HR with 95% confidence intervals (CI for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]. RESULTS: The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8-4.3 than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8-62.9. Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9-8.5 and psychiatric inpatient care (aHR 2.8; 95% CI 2.0-3.9. Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls. CONCLUSIONS: Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.
The author describes the termination of an analysis, which, while relating to the particular case of a male-to-female transsexual patient, may be relevant to all analysts, particularly those whose patients need to integrate disavowed and split-off parts of themselves. The patient had undergone sex-change surgery at the age of 20. Having lived as a woman thereafter, she had asked for analysis some twenty years later. The author, who discussed the first three years of that analysis in an earlier paper, as well as her hesitation about undertaking it, considers that its termination after seven years illustrates not only the specific problems posed by transsexuals but also the general ones presented by "heterogeneous patients". To the best of her knowledge, this is the first published case history of a transsexual patient who has undergone surgery. In the author's view, the patient has acquired a new sense of internal unity based on a notion of sex differentiation in which mutual respect between the sexes has replaced confusion and mutual hate, and her quality of life has improved. On the general level, this termination shows how the reduction of paranoid-schizoid anxieties and the reintegration of split-off parts of the personality lead, as the depressive position is worked through, to a better toleration of internal contradictions, a new sense of cohesion of the self and a diminution of the fear of madness.
Leriche, Albert; Timsit, Marc-Olivier; Morel-Journel, Nicolas; Bouillot, André; Dembele, Diala; Ruffion, Alain
To assess the long-term outcome of forearm free-flap phalloplasty in transsexuals, as obtaining a satisfying neophallus in female-to-male transsexuals is a surgical challenge. We analysed retrospectively 56 transsexuals who had a phalloplasty using a radial forearm free-flap in our department from 1986 to 2002. The complication rate was assessed by regular examination. Patient satisfaction was evaluated by a questionnaire about cosmetic aspects, sexual life and overall satisfaction. The mean follow up was 110 months; 53 of the 56 patients (95%) currently have a neophallus, after a mean of six surgical procedures. Satisfaction was assessed in 53 patients using a specific questionnaire: 51 (93%) of the patients reported that the phalloplasty allowed them to accord their physical appearance with their feeling of masculinity. There were flap complications in 14 patients (25%); three (5%) flaps were lost, with one each due to early haematoma, cellulitis and late arterial thrombosis. The other 11 flap complications were all transitory, e.g. infection, haematomas and vascular thrombosis. There were prosthesis complications in 11 of 38 patients (29%). Moreover, seven of 19 patients (37%) who had a urethroplasty presented with complex strictures and fistulae that led to perineal urethrostomy. Our study shows that phalloplasty with a forearm free-flap leads to good results in term of flap survival and patient satisfaction. However, there was a high rate of complications. Patients must be clearly informed that the procedure can seldom be achieved in one stage.
Kim, Gwang-Won; Kim, Seok-Kwun; Jeong, Gwang-Woo
The purpose of this study was to evaluate the brain activation pattern associated with sexual orientation and its correlation with the level of the free testosterone (free T) in postoperative female-to-male (FtM) transsexuals using a 3.0-Tesla functional magnetic resonance imaging (fMRI). Eleven postoperative FtM transsexuals with sex reassignment surgery underwent fMRI on a 3.0-T MR scanner. Brain activity was measured while viewing erotic male and female nude pictures. The average level of free T in the FtM transsexuals was in the normal range of heterosexual men. The brain areas with predominant activities during viewing female nude pictures in contrast to male pictures included the hippocampus, parahippocampal gyrus, anterior cingulate gyrus, putamen, amygdala, hypothalamus, and insula (p < 0.005). The free T levels were positively correlated with the BOLD signal changes in the parahippocampal gyrus (Spearman's rho = 0.91, p < 0.001), hippocampus (rho = 0.90, p < 0.001), insula (rho = 0.68, p < 0.05), putamen (rho = 0.66, p < 0.05), and amygdala (rho = 0.64, p < 0.05). Compared to FtM transsexuals with deficient level of free T, the FtM transsexuals with normal range of free T showed significantly higher activities in the parahippocampal gyrus, hippocampus, insula, putamen, and amygdala during viewing female nude pictures (p < 0.005). This study revealed the specific brain activation pattern associated with sexual orientation and its correlation with free T in the postoperative FtM transsexuals. These findings are applicable in understanding the neural mechanism on sexual arousal in FtM transsexuals and their sexual orientation in connection with the free T levels.
Tsujimura, Akira; Kiuchi, Hiroshi; Soda, Tetsuji; Takezawa, Kentaro; Fukuhara, Shinichiro; Takao, Tetsuya; Sekiguchi, Yuki; Iwasa, Atsushi; Nonomura, Norio; Miyagawa, Yasushi
Introduction: Very little has been elucidated about sexual interest in female-to-male (FtM) transsexual persons. Aims: To investigate the sexual interest of FtM transsexual persons vs that of men using an eye-tracking system. Methods: The study included 15 men and 13 FtM transsexual subjects who viewed three sexual videos (clip 1: sexy clothed young woman kissing the region of the male genitals covered by underwear; clip 2: naked actor and actress kissing and touching each other; and cl...
Cella, Stefania; Iannaccone, Mara; Cotrufo, Paolo
The primary aim of this study was to investigate the relationship between gender role orientation and eating disorder attitudes and behaviors and body dissatisfaction in a sample of homosexuals, heterosexuals, and transsexuals. We screened 132 homosexuals, 178 heterosexuals (both male and female), and 15 MtF transsexuals by means of an ad hoc socio-demographic schedule; the Eating Disorders Inventory-2 and Symptom Checklist; the Body Uneasiness Test and the Bem Sex Role Inventory. Differences between homosexual, heterosexual, and transsexual participants emerged, but those data seem to be best explained by the constructs of femininity and masculinity than by the biological gender. The empirical evidence of a positive correlation between femininity and eating problems, and the negative correlation between masculinity and eating problems, is full of implications. Eating disorders appear to be diseases of femininity; masculinity seems to be a protective factor, independently by the biological gender.
Oh, Seok-Kyun; Kim, Gwang-Won; Yang, Jong-Chul; Kim, Seok-Kwun; Kang, Heoung-Keun
Objective This study used functional magnetic resonance imaging (fMRI) to contrast the differential brain activation patterns in response to visual stimulation with both male and female erotic nude pictures in male-to-female (MTF) transsexuals who underwent a sex reassignment surgery. Materials and Methods A total of nine healthy MTF transsexuals after a sex reassignment surgery underwent fMRI on a 3.0 Tesla MR Scanner. The brain activation patterns were induced by visual stimulation with both male and female erotic nude pictures. Results The sex hormone levels of the postoperative MTF transsexuals were in the normal range of healthy heterosexual females. The brain areas, which were activated by viewing male nude pictures when compared with viewing female nude pictures, included predominantly the cerebellum, hippocampus, putamen, anterior cingulate gyrus, head of caudate nucleus, amygdala, midbrain, thalamus, insula, and body of caudate nucleus. On the other hand, brain activation induced by viewing female nude pictures was predominantly observed in the hypothalamus and the septal area. Conclusion Our findings suggest that distinct brain activation patterns associated with visual sexual arousal in postoperative MTF transsexuals reflect their sexual orientation to males. PMID:22563262
Zubiaurre-Elorza, Leire; Junque, Carme; Gómez-Gil, Esther; Guillamon, Antonio
Untreated transsexuals have a brain cortical phenotype. Cross-sex hormone treatments are used to masculinize or feminize the bodies of female-to-male (FtMs) or male-to-female (MtFs) transsexuals, respectively. A longitudinal design was conducted to investigate the effects of treatments on brain cortical thickness (CTh) of FtMs and MtFs. This study investigated 15 female-to-male (FtMs) and 14 male-to-female (MtFs) transsexuals prior and during at least six months of cross-sex hormone therapy treatment. Brain MRI imaging was performed in a 3-Tesla TIM-TRIO Siemens scanner. T1-weighted images were analyzed with FreeSurfer software to obtain CTh as well as subcortical volumetric values. Changes in brain CTh thickness and volumetry associated to changes in hormonal levels due to cross-sex hormone therapy. After testosterone treatment, FtMs showed increases of CTh bilaterally in the postcentral gyrus and unilaterally in the inferior parietal, lingual, pericalcarine, and supramarginal areas of the left hemisphere and the rostral middle frontal and the cuneus region of the right hemisphere. There was a significant positive correlation between the serum testosterone and free testosterone index changes and CTh changes in parieto-temporo-occipital regions. In contrast, MtFs, after estrogens and antiandrogens treatment, showed a general decrease in CTh and subcortical volumetric measures and an increase in the volume of the ventricles. Testosterone therapy increases CTh in FtMs. Thickening in cortical regions is associated to changes in testosterone levels. Estrogens and antiandrogens therapy in MtFs is associated to a decrease in the CTh that consequently induces an enlargement of the ventricular system. © 2014 International Society for Sexual Medicine.
Bonierbale, Mireille; Baumstarck, Karine; Maquigneau, Aurélie; Gorin-Lazard, Audrey; Boyer, Laurent; Loundou, Anderson; Auquier, Pascal; Lançon, Christophe
The assessment of co-existing psychological and psychiatric disorders is advocated in the Standards of Care for the health of transsexual people. This study aimed to determine the psychopathological characteristics of transsexuals based on a large sample of French individuals and to identify whether these characteristics differed according to the individual's sociodemographic or clinical characteristics. The aim of this study was to determine the psychopathological characteristics of transsexuals from a large sample of French individuals and whether these differed by sociodemographic or clinical characteristics. This cross-sectional study was conducted in a French public university hospital. The inclusion criteria were 18 years or older, diagnosis of gender dysphoria, and eligibility for a standardized sex reassignment procedure. Personality characteristics were assessed using the Minnesota Multiphasic Personality Inventory 2 (MMPI-2). A total of 108 individuals provided a valid MMPI-2 between January 2007 and December 2010. The final sample had a median age of 31 years and included 54 (50%) Female-to-Male individuals. In multivariate models, hormonal therapy status was significantly related to the scales of MMPI-2 (Psychasthenia and Masculinity/Femininity). Personality assessment can help a multidisciplinary gender dysphoria team detect potential psychopathological factors of vulnerability.
Norma Licciardi; Gabriel Waitmann; Matheus Henrique Marques de Oliveira
Brazilian Transvestites and transsexuals women suffer helplessness in family, academic, social and labor from the moment they take their transgender identity. To improve this situation, we should look through the social bias of Human Resources and study the inclusion of women in the formal labor market, in contrast to statistics that reduce this population group to prostitution or informal jobs. Through interviews conducted with transgender women, this article aims to expose the current...
Full Text Available O artigo tem como objetivo discutir a transexualidade no contexto das políticas de saúde pública no Brasil. Para isto, num primeiro momento, problematiza-se a necessidade do diagnóstico de transtorno de identidade de gênero como condição de acesso ao tratamento na rede pública, buscando compreender de que forma se deu historicamente a patologização da transexualidade. Em seguida, analisa-se o debate sobre as políticas de saúde para transexuais, considerando o processo de legalização da cirurgia de transgenitalização no país, as resoluções do Conselho Federal de Medicina e os fóruns que se constituíram com representantes do Ministério da Saúde, profissionais da área e representantes do movimento social. Finalmente, tendo como referência trabalhos que se destacaram pela crítica à patologização da transexualidade nas áreas da saúde coletiva e das ciências sociais, pretende-se destacar a importância de compreendermos a diversidade de formas de subjetivação e de construção de gênero na transexualidade. Discute-se a questão da autonomia dos transexuais e sugerem-se políticas públicas que, embora sigam um protocolo de assistência, não tenham como única referência terapêutica a realização do diagnóstico e a cirurgia de transgenitalização.The article aims to discuss transsexuality in the context of the Brazilian public health policies. Firstly, it questions the necessity of the diagnosis of Gender Identity Disorder as a condition of access to treatment in the public health service, searching to understand the historical construction of transsexuality as a pathological phenomenon. After that, it analyzes the debate on public health policies for transsexuals, considering the process of legalization of the reassignment surgery in the country, the resolutions of the Federal Council of Medicine and the constitution of representative forums of the Health Ministry, as well as professionals of the area and
Djordjevic, Miroslav L; Stanojevic, Dusan; Bizic, Marta; Kojovic, Vladimir; Majstorovic, Marko; Vujovic, Svetlana; Milosevic, Alexandar; Korac, Gradimir; Perovic, Sava V
Metoidioplasty represents one of the variants of phalloplasty in female transsexuals. Its main characteristic is that it is a one-stage procedure. It involves lengthening and straightening of hypertrophied clitoris to create a neophallus, urethral lengthening to enable voiding while standing, and scrotal reconstruction with insertion of testicle prostheses. Our aim is to describe our technique and highlight its advantages. Between September 2002 and April 2007, 82 female transsexuals, aged 18-54 years (mean age 31) underwent one-stage metoidioplasty. Clitoris is lengthened and straightened by division of clitoral ligaments and short urethral plate. Urethroplasty is done with combined buccal mucosa graft and genital skin flaps. Scrotum is created from labia majora in which two testicle prostheses are inserted. Simultaneously, female genitalia are removed. Patients' personal satisfaction about sensitivity and length of neophallus, possibility to void in standing position, real length of reconstructed urethra as well as complication rate comparing to other published data. The median follow-up was 32 months (range 14-69). The mean neophallic length was 5.7 cm (range 4-10). Voiding in standing position was reported in all patients, while dribbling and spraying were noticed in 23 cases and solved spontaneously. There were two urethral strictures and seven fistulas that required secondary minor revision. All patients reported preserved sensation and normal postoperative erection. Testicle prostheses rejection was not observed in any of the patients. Metoidioplasty is a single-stage and time-saving procedure. It could be an alternative to total phalloplasty in female transsexuals who do not wish to have sexual intercourse. Also, it represents a first step in cases where additional augmentation phalloplasty is required.
This paper aims to contribute to understanding of emergent gender/sexual identities in Thailand. Thailand has become a popular destination for sex change operations by providing the medical technology for a complete transformation, with relatively few procedures and satisfactory results at a reasonable price. Data were gathered from 24 transsexual male-to-female sex workers working in Pattaya and Patpong, well-known sex-tourism hot spots in Thailand. Findings suggest the emergence of new understandings of gender/sexual identity. Sex-tourism/sex work significantly illuminates the process through which gender is contested and re-imagined. The coming together of cultures in Thailand's sex industry, coupled with advances in medical technology, has resulted in the emergence of new concepts of gender.
Full Text Available The growing number of families formed by homosexual, transvestite, and transsexual fathers/mothers has not only become a social, but also socio-anthropological fact, requiring traditional convictions to be rethought. This paper aims at demonstrating how a traditional model of family - that is, a "normal" family - has been able to influence the construction of parenthoods considered, until recently, unthinkable, whether social or legally. I therefore believe that it is time to face new demands and deconstruct former certainties of Anthropology, Psychology and Psychoanalysis, and Law, so that these new families may find their place in society.
P. H. Saldanha
Full Text Available O transexualismo é caracterizado como uma entidade psiquiátrica, distinta do homossexualismo e travestismo, revendo-se suas manifestações sindrômicas. Discutem-se as duas principais causas etiológicas plausíveis do transexualismo, a saber: a hipótese psicoanalítica fundamentada na regressão psicossexual com estampagem da figura materna e o modelo neuro-endócrino que pressupõe alterações nos centros de identidade sexual do hipotámo. Com base nesta última explicação propõe-se, a exemplo do que parece ocorrer na síndrome de Morris, cujas células (XY não respondem ao efeito masculinizante da testosterona plasmática, que os transexuais devem possuir mosaicismo detectável ou críptico, quanto aos cromossomos sexuais, nos centros hipotalâmicos de identidade sexual que não respondem à secreção androgênica produzida pela gônada primitiva. Esta possibilidade explicaria a excessiva prevalência da síndrome entre homens, bem como a sua manifestação com feições típicas no sexo masculino e ainda a ocorrência esporádica da síndrome. O estudo citogenético revelou que a frequência (32% de mosaicismo quanto aos cromossomos sexuais em 25 transexuais é estatisticamente superior aos valores observados em 14 homossexuais e 40 controles normais, nos quais a proporção de mosaicismo é praticamente nula. Considera-se a possibilidade do critério cariotípico constituir valioso subsídio na diagnose da síndrome.By reviewing the syndromic manifestation, transsexualism in characterized as a psychiatric entity, apart from homossexualism and transvestism. The two main feasible etiologic causes of transsexualism are discussed: the psychoanalytical hypothesis based upon psycossexual regression with imprinting of maternal figure and the neuroendocrine model which assumes alterations of the gender role identity centers in the hypothalamus. On the grounds of the latter explanation and after the scheme that seems to occur in the Morris
Caanen, M.R.; Soleman, R.S.; Kuijper, E.A.M.; Kreukels, B.P.C.; De Roo, C.; Tilleman, K.; De Sutter, P.; van Trotsenburg, M.A.A.; Broekmans, F.J.; Lambalk, C.B.
Objective To investigate the effect of hormonal androgenic treatment on antimüllerian hormone (AMH) serum levels in female-to-male (FtM) transsexuals. Polycystic ovary syndrome (PCOS) is associated with elevated AMH levels. Some hypothesize that the high AMH level is a consequence of
Rikke Simonsen, MA
Conclusions: As approximately half of MtF started cross-sex hormonal SR without attending a gender unit, future treatment needs to focus on this group of MtF individuals in order to accommodate the medical risks of self-initiated hormonal treatment.Earlier intervention with adolescents appears necessary since three-quarters of FtM individuals before age 12 had problems with their assigned sex. For both MtF and FtM, we found problems in areas of school, education, and employment and recommend further help in these core areas. Simonsen R, Hald GM, Giraldi A, and Kristensen E. Sociodemographic study of danish individuals diagnosed with transsexualism. Sex Med 2015;3:109–117.
Smith, Y. L. S.; Van Goozen, Stephanie Helena Maria; Kuiper, A. J.; Cohen-Kettenis, P. T.
Background. We prospectively studied outcomes of sex reassignment, potential differences between subgroups of transsexuals, and predictors of treatment course and outcome.\\ud \\ud Method. Altogether 325 consecutive adolescent and adult applicants for sex reassignment participated: 222 started hormone treatment, 103 did not; 188 completed and 34 dropped out of treatment. Only data of the 162 adults were used to evaluate treatment. Results between subgroups were compared to determine post-operat...
D. Chadha; T.D. Pache; F.J. Huikeshoven (Frans); A.O. Brinkmann (Albert); Th.H. van der Kwast (Theo)
textabstractAndrogen receptor (AR) modulation in human uteri and ovaries of long term androgen-treated transsexual female patients was investigated. Androgen receptor expression was evaluated immunohistochemically in the ovaries of 11 and the endometria and myometria of six androgen-treated
Blanchard, R; Collins, P I
This study was a preliminary exploration of gynandromorphophilia, that is, sexual interest in cross-dressed or anatomically feminized men. Subjects were male subscribers to a voice mail system devoted to personal advertisements for sexual or romantic partners. These comprised 51 gynandromorphophiles who sought cross-dressers, transvestites, transsexuals, or she-males for such relationships, 37 gynandromorphophilic cross-dressers who identified themselves as cross-dressers and sought similar men, and 31 residual cross-dressers who sought masculine or unspecified male partners. Analysis of advertisement content suggested that gynandromorphophilia constitutes a distinct erotic interest.
Paula Nunes Chaves
Full Text Available We reflect the sport as a important space for constructions of ways of being, a place of sociability that develop countless fights of sexual identities. In such context, this paper aims to reflect on the film Beautiful Boxer (2004, making notes about the subject of sexuality and genres deviant of standard heteronormative (gays, transvestites, transsexuals in the sport from the history of the filme: a boxing fighter transsexual that breaks the traditional image of the virile and manly men how the only possibility for a boxer. By showing a fighter who moves between a muscular body condition and delicate at the same time, capable of extreme force movements and delicate gestures in the ring, the film decentralizes the markings of classic genre and binary notions of masculine and feminine, that polarize strength and delicacy in the sport and makes us think about the sport from a queer approach.
Full Text Available Background: Subcutaneous mastectomy for female- to-male transsexuals is usually the first surgical pro- cedure in sexual reassignment. The main objective of subcutaneous mastectomy is to create an aesthetically pleasing male chest contour by removing all glandular tissue while minimizing chest wall scars. Aims: In this paper, we present our experience with subcutaneous mastectomy performed in female-to- male transsexual patients. The authors recommend their point of view to aid in selecting the most suitable subcutaneous mastectomy technique depending on breast characteristics. Study Design: Retrospective cross-sectional study. Methods: Between March 2011 and December 2014, 52 patients underwent bilateral subcutaneous mastec- tomies (total of 104 mastectomies, performed using the following four techniques: Webster semicircular, concentric circular, vertical, and apron flap. The tech- nique decision depended on the breast size, degree of skin excess, skin elasticity, chest width, nipple areolar complex size and position. Results: Seventeen patients (32.7% were operated with Webster semicircular, 7 patients (13.5% with con- centric periareolar, 12 patients with vertical (23%; and 16 patients (30.8% with the apron flap technique. The overall postoperative complication rate was 13.4%. All patients were satisfied with the aesthetic results of their subcutaneous mastectomies within the follow-up period. Conclusion: To obtain higher patient satisfaction with aesthetic results and lower postoperative complication rates, breast characteristics are evaluated in a detailed fashion, while choosing the ideal technique of Female-to-Male (FtM subcutaneous mastectomy. The presented surgical new algorithm facilitates the selection of the most reliable surgical technique
Quinn, Gwendolyn P.; Sanchez, Julian A.; Sutton, Steven K.; Vadaparampil, Susan T.; Nguyen, Giang T.; Green, B. Lee; Kanetsky, Peter A.; Schabath, Matthew B.
This article provides an overview of the current literature on seven cancer sites that may disproportionately affect lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. For each cancer site we present and discuss the descriptive statistics, primary prevention, secondary prevention and preclinical disease, tertiary prevention and late stage disease, and clinical implications. Finally, an overview of psychosocial factors related to cancer survivorship is offered as well as strategies for improving access to care. PMID:26186412
Turo, Rafal; Jallad, Samer; Prescott, Stephen; Cross, William Richard
The incidence of prostate cancer in transsexual patients is very low with only few reported cases. Many years before presenting with prostate cancer, these patients receive hormone ablation as a part of their gender therapy. Their disease is already defined as castrate resistant, and the treatment and follow-up of such patients remains a challenge. We report a case of a male-to-female transgender woman who was diagnosed with metastatic prostate cancer, 31 years post-feminization.
Turo, Rafal; Jallad, Samer; Prescott, Stephen; Cross, William Richard
The incidence of prostate cancer in transsexual patients is very low with only few reported cases. Many years before presenting with prostate cancer, these patients receive hormone ablation as a part of their gender therapy. Their disease is already defined as castrate resistant, and the treatment and follow-up of such patients remains a challenge. We report a case of a male-to-female transgender woman who was diagnosed with metastatic prostate cancer, 31 years post-feminization.
Caanen, Mirte R.; Soleman, Remi S.; Kuijper, Esther A. M.; Kreukels, Baudewijntje P. C.; De Roo, Chloe; Tilleman, Kelly; De Sutter, Petra; van Trotsenburg, Mick A. A.; Broekmans, Frank J.; Lambalk, Cornelis B.
Objective: To investigate the effect of hormonal androgenic treatment on antimullerian hormone (AMH) serum levels in female-to-male (FtM) transsexuals. Polycystic ovary syndrome (PCOS) is associated with elevated AMH levels. Some hypothesize that the high AMH level is a consequence of
Flavia do Bonsucesso Teixeira
Full Text Available A partir de fragmentos das histórias de vida de pessoas (transexuais, tento explicitar a diversidade das suas vivências, experiências singulares, modos de dar sentido ao processo de ruptura das normas de gênero e da sexualidade. Analiso a insuficiência dos discursos médico e jurídico, ancorados numa verdade essencializada sobre o corpo sexuado, para capturar as possibilidades de experiências na transexualidade. Argumento que o potencial desestabilizador da transexualidade reside no distanciamento da máxima reducionista que considera os sujeitos como pessoas presas num corpo equivocado cuja inteligibilidade dependeria unicamente da cirurgia de transgenitalização.From fragments of life stories of (transsexual people, I try to explain the diversity of their livings, unique experiences, ways of making sense of the process of breaking the gender norms and sexuality. I analyze the inadequacy of medical-legal discourse, anchored in an essencialized truth on the sexualized body, to capture the possibilities of experiences in transsexuality. I argue that the destabilizing potential of transsexuality lies in withdrawing from the reductionist view, which considerss transsexuals as misguided people trapped in a body whose intelligibility would depend solely upon reassignment surgery.
Ploeger, A; Flamm, R
A general review of literature delivers information about relevant publications pertaining to the question of transvestism and transsexualism. By and large German and Angloamerican literature is quoted on this subject. Consideration has been given to the variations of the syndrome in both males and females. The display of these symptoms is mainly in accordance with the psychopathological structure of the clinical picture. Symptomatologic and psychodynamically related sexual deviations (fetishism, effeminated homosexuality) as well as endogenous psychoses have been considered from a differential diagnostic point of view. The differential nosology characterizes the efforts made in dealing with the heterogenity of the syndromes. Moreover it is indicative of the sexually specific styles of manifestation. In the etiological approach somatogenic (chromosomal, hormonal and cerebral) and psychogenetic types are differentiated. Interesting results in child and family therapy have been mentioned on the latter type. The contributions of psychotherapy, behavior therapy and surgical operations aiming at sexual transformation including their legal repercussions have been given full consideration in the therapy chapter.
Casado, Juan C; O'Connor, Carlos; Angulo, María S; Adrián, José A
With the development of new ENT techniques, many male transsexuals who wish to become women usually request a surgical procedure to raise the fundamental frequency of the voice (feminization). The ENT specialist and the voice-therapist have to use an interdisciplinary approach to this growing social demand. The aim of this study was to show the results in a group of transsexual patients after Wendler's anterior synechiae, with additional voice-therapy treatment. Ten male transexulas who wish to become women patients who had Wendler glottoplasty and voice-therapy were assessed. The surgical procedure consisted of a de-epithelialization of the anterior third of both vocal folds; this area was sutured and the surface of both vocal folds was vaporised with laser diode. Pre- and postsurgery voice assessment consisted of measuring fundamental frequency (Fo) and maximum phonation time, administering the transgender self-assessment questionnaire (TSEQ) and obtaining perceptual voice assessment by inter-rater agreement. All the male transsexuals who wish to become women patients significantly increased their Fo (106 Hz on average) after the treatment. Furthermore, significant improvements were shown in self-reported satisfaction and in the degree of voice feminization. No improvements in the maximum phonation time were observed. Wendler glottoplasty is a surgical procedure to contribute to feminising the voice, with good medium-term results and without noteworthy medical complications. The increase in vocal tone was observed using several pre- and post-surgery control measures and voice therapy. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.
Simonsen, Rikke; Hald, Gert Martin; Giraldi, Annamaria
INTRODUCTION: Male-to-female (MtF) and female-to-male (FtM) individuals with transsexualism (International Classification of Diseases-10) may differ in core clinical and sociodemographic variables such as age, sexual orientation, marriage and parenthood, school, educational level, and employment......F individuals. Compared with MtF, FtM had a significantly lower onset age (before 12 years of age) and lower age when permission for SRS was granted. Further, FtM individuals were significantly more often gynephilic (sexually attracted to females) during research period and less likely to start self......-initiated hormonal sex reassignment (SR) (treatment with cross-sex hormones). The MtF and FtM groups did not differ in years of school, educational level, employment, or engagement in marriage and cohabitation. CONCLUSIONS: As approximately half of MtF started cross-sex hormonal SR without attending a gender unit...
我国现在以变性手术的实施作为法律承认变性的条件。在现行法律规定下，变性人的生育权和收养权无法得到保障。在变性人缔结婚姻后，由于生育能力的欠缺，需要法律制度完善对其生育权的保护。因此，我国应尽快对变性人家庭开放局部代孕并设计具体法律制度。%Nowadays, implementation of sex reassignment surgery is regarded as one of the conditions for legal recognition of transgender in China. Under the current law, reproductive rights and adoption rights of transsexuals can not get good protection. After transsexual marriage, due to lack of fertility, they need to protect their reproductive rights by improving the legal system. Therefore, partial surrogacy should be allowed for transsexual families and specific law should be produced as soon as possible in China.
Lingiardi, Vittorio; Giovanardi, Guido; Fortunato, Alexandro; Nassisi, Valentina; Speranza, Anna Maria
The main aim of this study was to investigate the associations between personality features and attachment patterns in transsexual adults. We explored mental representations of attachment, assessed personality traits, and possible personality disorders. Forty-four individuals diagnosed with gender identity disorder (now gender dysphoria), 28 male-to-female and 16 female-to-male, were evaluated using the Shedler-Westen assessment procedure-200 (SWAP-200) to assess personality traits and disorders; the adult attachment interview was used to evaluate their attachment state-of-mind. With respect to attachment, our sample differed both from normative samples because of the high percentage of disorganized states of mind (50% of the sample), and from clinical samples for the conspicuous percentage of secure states of mind (37%). Furthermore, we found that only 16% of our sample presented a personality disorder, while 50% showed a high level of functioning according to the SWAP-200 scales. In order to find latent subgroups that shared personality characteristics, we performed a Q-factor analysis. Three personality clusters then emerged: Healthy Functioning (54% of the sample); Depressive/Introverted (32%) and Histrionic/Extroverted (14%). These data indicate that in terms of personality and attachment, GD individuals are a heterogeneous sample and show articulate and diverse types with regard to these constructs.
Hasegawa, Kenjiro; Namba, Yuzaburo; Kimata, Yoshihiro
Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of first choice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with a negative Allen test, we achieved good results by performing phalloplasty with an innervated island pedicled anterolateral thigh flap using the "tube within a tube" technique, in which the penis and urethra are constructed with a single flap. While phalloplasty with an island-pedicled or free anterol...
Full Text Available The aim of this paper is to analyze the process of individuation of a transsexual female to male using the dream analysis in Jungian perspectives. The dreams were amplified using fairy-tales, alchemy, and archetypes theory. After a description of some dreams of the beginning of therapy it was suggest that was symbolized image of androgynous as representation of emersion of the archetypes of Anima and Animus and the integration of this image can facilitated individuation process and Self constellation. It seems that take place in a dream with a Self image confirming that analytical process can facilitate personal growth and the integration between consciousness and unconsciousness.
Hierl, T; Börcsök, I; Ziegler, R; Kasperk, C
A 31-year-old man presented at the endocrinology out-patient clinic for the initiation of sex-change treatment. His manifestly transsexual male-to-female appearance was confirmed by a psychiatric-sexological expert report. The patient had been living as a woman for one year. Physical examination showed normal male physique with typical secondary hair growth and normal male genitals. The serum testosterone level was at the upper limits of normal, that for oestrogen at the lower limit. Bone densitometry showed bone density at the upper limit of normal. Other laboratory tests were unremarkable. During 30 months on cyproterone, 100 mg daily, bone mass fell at the rate of 5% per year. Bone biopsy revealed high turnover osteoporosis. Bone mass rose by 4% per year after the additional oral intake of oestradiol valerate, 2 mg daily. Osteoblastic cells, isolated from part of the biopsy tissue, with the patient's consent, was found to be stimulated by oestradiol in vitro. The described bone mass changes indicate the important role played by sex hormones in the maintenance of bone mass acquired during adolescence. The findings confirm that in males not only testosterone but also oestrogens has an anabolic effect on bone.
Full Text Available Individuals with gender identity disorder (GID, who are commonly referred to as transsexuals (TXs, are afflicted by negative psychosocial stressors. Central to the psychological complex of TXs is the conviction of belonging to the opposite sex. Neuroanatomical and functional brain imaging studies have demonstrated that the GID is associated with brain alterations. In this study, we found that TXs identify, when viewing male-female couples in erotic or non-erotic ("neutral" interactions, with the couple member of the desired gender in both situations. By means of functional magnetic resonance imaging, we found that the TXs, as opposed to controls (CONs, displayed an increased functional connectivity between the ventral tegmental area, which is associated with dimorphic genital representation, and anterior cingulate cortex subregions, which play a key role in social exclusion, conflict monitoring and punishment adjustment. The neural connectivity pattern suggests a brain signature of the psychosocial distress for the gender-sex incongruity of TXs.
In the mid-1970s, following a series of police raids on prostitution inside downtown nightclubs, a community of approximately 200 sex workers moved into Vancouver's West End neighborhood, where a small stroll had operated since the early 1970s. This paper examines the contributions made by three male-to-female (MTF) transsexuals of color to the culture of on-street prostitution in the West End. The trans women's stories address themes of fashion, working conditions, money, community formation, violence, and resistance to well-organized anti-prostitution forces. These recollections enable me to bridge and enrich trans history and prostitution history – two fields of inquiry that have under-represented the participation of trans women in the sex industry across the urban West. Acutely familiar with the hazards inherent in a criminalized, stigmatized trade, trans sex workers in the West End manufactured efficacious strategies of harm reduction, income generation, safety planning, and community building. Eschewing the label of “victim”, they leveraged their physical size and style, charisma, contempt towards pimps, earning capacity, and seniority as the first workers on the stroll to assume leadership within the broader constituency of “hookers on Davie Street”. I discover that their short-lived outdoor brothel culture offered only a temporary bulwark against the inevitability of eviction via legal injunction in July 1984, and the subsequent rise in lethal violence against all prostitutes in Vancouver, including MTF transsexuals.
Heloisa Helena Barboza
Full Text Available A Constituição Brasileira assegura o direito ao planejamento familiar com fundamento nos princípios da dignidade da pessoa humana e da paternidade responsável. Esse direito é reconhecido não só ao casal, como ao homem e à mulher, que podem constituir sozinhos uma comunidade familiar, denominada família monoparental, constitucionalmente amparada. O Conselho Federal de Medicina adotou normas éticas para a utilização das técnicas de reprodução assistida destinadas a todas as pessoas capazes, abrindo assim tal possibilidade para qualquer pessoa independentemente de sua orientação ou situação sexual. Indispensável, neste momento, analisar o caso dos transexuais, que podem ter sua capacidade de reproduzir comprometida pelo processo transexualizador, para que seus direitos reprodutivos sejam resguardados.Brazilian Constitution ensures the right to family planning founded on the principles of the dignity of the human person and that of responsible parenthood. Such right is ensured not only to different sex couples but, individually, to men and women alike, for Brazilian Constitution also acknowledges individuals as a family community, that is, a "monoparental family". In order to ensure to every capable person a better fulfillment of that right, disregarding his or her sexual orientation, Brazilian Federal Medicine Council has established ethical norms to assisted reproductive techniques. Regarding transsexuals, it is of utmost importance to critically analyze Trans-sexualizing Process for it might compromise their reproductive capacities and rights.
Tubbs , Meghan
This thesis aims to explore autobiography as a rhetorical genre and to explore the personal narrative of Aleshia Brevard, an MTF (male to female) transsexual. The critical analysis employs a form of narrative criticism created from the work of several rhetorical critics. Narrative coherence is examined through looking at Brevardâ s arrangement of events, and narrative fidelity is examined through looking at Brevardâ s use of ultimate terms. This thesis suggests that the personal narratives ...
Tsujimura A, Kiuchi H, Soda T, et al. The Pattern of Sexual Interest of Female-to-Male Transsexual Persons With Gender Identity Disorder Does Not Resemble That of Biological Men: An Eye-Tracking Study. Sex Med 2017;5:e169–e174.
Stojanovic, Borko; Bizic, Marta; Bencic, Marko; Kojovic, Vladimir; Majstorovic, Marko; Jeftovic, Milos; Stanojevic, Dusan; Djordjevic, Miroslav L
Female-to-male gender-confirmation surgery (GCS) includes removal of breasts and female genitalia and complete genital and urethral reconstruction. With a multidisciplinary approach, these procedures can be performed in one stage, avoiding multistage operations. To present our results of one-stage sex-reassignment surgery in female-to-male transsexuals and to emphasize the advantages of single-stage over multistage surgery. During a period of 9 years (2007-2016), 473 patients (mean age = 31.5 years) underwent metoidioplasty. Of these, 137 (29%) underwent simultaneous hysterectomy, and 79 (16.7%) underwent one-stage GCS consisting of chest masculinization, total transvaginal hysterectomy with bilateral adnexectomy, vaginectomy, metoidioplasty, urethral lengthening, scrotoplasty, and implantation of bilateral testicular prostheses. All surgeries were performed simultaneously by teams of experienced gynecologic and gender surgeons. Primary outcome measurements were surgical time, length of hospital stay, and complication and reoperation rates compared with other published data and in relation to the number of stages needed to complete GCS. Mean follow-up was 44 months (range = 10-92). Mean surgery time was 270 minutes (range = 215-325). Postoperative hospital stay was 3 to 6 days (mean = 4). Complications occurred in 20 patients (25.3%). Six patients (7.6%) had complications related to mastectomy, and one patient underwent revision surgery because of a breast hematoma. Two patients underwent conversion of transvaginal hysterectomy to an abdominal approach, and subcutaneous perineal cyst, as a consequence of colpocleisis, occurred in nine patients. There were eight complications (10%) from urethroplasty, including four fistulas, three strictures, and one diverticulum. Testicular implant rejection occurred in two patients and testicular implant displacement occurred in one patient. Female-to-male transsexuals can undergo complete GCS, including mastectomy
Prunas, Antonio; Bandini, Elisa; Fisher, Alessandra D; Maggi, Mario; Pace, Valeria; Quagliarella, Luca; Todarello, Orlando; Bini, Maurizio
The present study aims to provide an overview of experiences of discrimination, harassment, and violence in a sample of Italian transsexuals who have undergone sex-reassignment surgery (SRS). Lack of support for gender transition from family members was also assessed, before and after SRS. Data were collected in the context of a multicentric study (Milan, Florence, and Bari) on SRS outcome. Patients who underwent SRS were contacted and asked to fill out a questionnaire concerning experiences of discrimination, harassment, violence, and crime they might have experienced in previous years. Seventy-two participants took part in the research: 46 were male-to-female (MtF; 64%) and 26 were female-to-male (FtM; 36%). Thirty-six percent of the total sample (with no differences between MtF and FtM) experienced at least one episode of harassment, violence, or discrimination. The workplace was reported to be the social area with the highest risk of discrimination and harassment (22% of participants). Reports of more than one incident of discrimination, harassment, and violence characterized the majority of participants in the MtF sample. Compared with previous studies carried out in other countries, a much larger proportion of participants could count on a supportive family environment before and after transition. Our results show that Italian society at large is prejudiced against transsexuals, but at a more "micro" level, having a trans person as a family member might result in a protective and tolerant attitude.
Inoue, Hiromasa; Nishida, Naoki; Ikeda, Noriaki; Tsuji, Akiko; Kudo, Keiko; Hanagama, Masakazu; Nata, Masayuki
A 32-year-old woman, who was intramuscularly injected with testosterone enanthate (125 mg) once or twice a month over a two-year period for female-to-male transsexualism, died suddenly. A forensic autopsy was performed to investigate the cause of death. Concentric cardiac hypertrophy was macroscopically observed. In the left and right coronary arteries, atherosclerosis was generally observed within the endothelium. In particular, there was severe stenosis (>90%) at the start of the left descending branch. In the myocardium, both coagulation necrosis and contraction band necrosis were microscopically observed. Moreover, myocardial fibrosis and myocardial calcification were diffusely detected, respectively. The cause of death was diagnosed as ischemic heart disease due to coronary stenosis. There is some debate as to whether cross-hormone replacement is related to the occurrence of coronary artery disease or not, however, it is possible that the development of ischemic heart disease was aggravated by the administration of testosterone enanthate in the current case.
Ahmadi Jazi, Ghazaleh; Eftekhar, Mehrdad; Mobasher, Pezhman; Saeedi Tehrani, Saeedeh; Ahmadi, Khosro; Rastgouy Fahim, Maria
Physicians' knowledge of therapy and counseling stands among the most important issues in the viewpoints of clients who refer to psychiatric centers. Transsexual patients are very important in this regard. The goal of this research is to study their attitude toward doctors' empathy. A group of transsexual patients who referred to the Tehran Institute of Psychiatry, Iran, answered the Jefferson Scale of Empathy. The relationship of the patients' age, gender, education level, and lifestyle with their attitude was measured. This study was conducted on 40 patients, including 16 women (40%) and 24 men (60%). In terms of education, 8 patients had a degree below high school diploma (20%), 9 had high school diploma (22.5%), and 23 patients were university students or of higher education level (57.5%). Among these patients, 6 were unemployed (15%), 10 were students (25%), and the rest were employed. Moreover, 8 participants lived alone (20%), 5 lived with their friends (12.5%), and 27 lived with their family (67.5%). Gender had no influence on the average score of the questionnaires, yet level of education had some influence. Lifestyle also had a significant influence on the patients' attitude. On the other hand, patients whose problems began before the age of 12 had lower score than others. Experienced psychologists in referential centers can express greater levels of empathy to specific diseases and this trend is very effective on the patients' cooperation level. In order to create an effective relationship between physicians and patients, the efficiency of the health system and increasing satisfaction of specific patients should be considered.
Imbimbo, Ciro; Verze, Paolo; Palmieri, Alessandro; Longo, Nicola; Fusco, Ferdinando; Arcaniolo, Davide; Mirone, Vincenzo
Gender identity disorder or transsexualism is a complex clinical condition, and prevailing social context strongly impacts the form of its manifestations. Sex reassignment surgery (SRS) is the crucial step of a long and complex therapeutic process starting with preliminary psychiatric evaluation and culminating in definitive gender identity conversion. The aim of our study is to arrive at a clinical and psychosocial profile of male-to-female transsexuals in Italy through analysis of their personal and clinical experience and evaluation of their postsurgical satisfaction levels SRS. From January 1992 to September 2006, 163 male patients who had undergone gender-transforming surgery at our institution were requested to complete a patient satisfaction questionnaire. The questionnaire consisted of 38 questions covering nine main topics: general data, employment status, family status, personal relationships, social and cultural aspects, presurgical preparation, surgical procedure, and postsurgical sex life and overall satisfaction. Average age was 31 years old. Seventy-two percent had a high educational level, and 63% were steadily employed. Half of the patients had contemplated suicide at some time in their lives before surgery and 4% had actually attempted suicide. Family and colleague emotional support levels were satisfactory. All patients had been adequately informed of surgical procedure beforehand. Eighty-nine percent engaged in postsurgical sexual activities. Seventy-five percent had a more satisfactory sex life after SRS, with main complications being pain during intercourse and lack of lubrication. Seventy-eight percent were satisfied with their neovagina's esthetic appearance, whereas only 56% were satisfied with depth. Almost all of the patients were satisfied with their new sexual status and expressed no regrets. Our patients' high level of satisfaction was due to a combination of a well-conducted preoperative preparation program, competent surgical skills
Ibrahim, C; Haddad, R; Richa, S
The question of whether gender dysphoria is associated with psychiatric comorbidity has been addressed in several studies. Several cohort studies have shown that psychiatric comorbidity is one of the main features of poor prognosis following sex change therapy. Gender dysphoria is rare, with an estimated prevalence of 0.001% to 0.002% globally. The literature shows a high prevalence of psychiatric comorbidities in people with gender dysphoria, and that they are more common in male to female transsexuals. Data on long-term mortality show that transsexuals present a 51 % increase in mortality compared to the general population. This is mainly attributed to a six-fold increase in the number of suicides and a higher rate of psychiatric disorders and risky behaviors leading to HIV infection and substance abuse. Assess psychiatric comorbidity in a population of Lebanese transgender individuals and compare it to the general population. The hypothesis of our study is that the Lebanese transgenders suffer from more psychiatric comorbidities than the general population. Our second objective was to determine the specific mental health needs of this population in order to adapt our services to their medical needs and their specific concerns. Our objective was to acquire 20 transgender participants and 20 control subjects. We chose a snowball sampling method. The evaluation consisted of three questionnaires including a general demographic questionnaire, the MINI 5.0.0 Arabic version for axis I disorders and the SCID-II for axis II disorders. The mean age of both groups was 23.55 years. Fifty-five percent (n=11) transgender participants had active suicidal thoughts against 0 % in controls. Within the group of transgender, 45 % (n=9) had a major depressive episode, 5 % (n=1) had a generalized anxiety disorder, 5 % (n=1) had a posttraumatic stress disorder and 10 % (n=2) had a major depressive episode with comorbid posttraumatic stress disorder. We noted a significant
Full Text Available In this paper, we want to explore the modifications and procedures that delineate limits between the notions of body, sexuality, and nature. Based on ethnographic fieldwork in public institutions of Buenos Aires and La Plata (Argentina, we examine the medical-legal process concerning "sex reassignment" in transsexual people, which illuminates the unfold senses about the plasticity and precariousness of 'human essences', as well as the tensions between what human is (identity and what he/she wants to be (project. We discuss the proposals of transhumanism, accepting that the soteriological dimension of biosciences enable the hopes of techno-redemption. Finally, we intend to contribute with a reflection about the role of scientific categories and the political perspective of the emergence of identities and collective resistances about the tutelage of cognitive and material control of the biosciences.
Edwards, Jordan W; Fisher, Dennis G; Reynolds, Grace L
Data on HIV risk were collected with the Countywide Risk Assessment Survey from 2126 participants; 92 were male-to-female transgender persons (i.e., cross-dressers, and those who identify with the opposite sex), and 9 were male-to-female transsexual individuals (i.e., those who have undergone gender-reassignment surgery or other procedures). Transgender-identified individuals were more likely than the rest of the sample to have received hormone injections, offensive comments, and HIV testing; injected hormones with a used needle; been Asian or American Indian; been paid for sexual intercourse; and lived in unstable housing but less likely to have used heroin. Transgender-identified individuals are at high risk for HIV infection because of reuse of needles and being paid for sexual intercourse.
Hasegawa, Kenjiro; Namba, Yuzaburo; Kimata, Yoshihiro
Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of firstchoice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with anegative Allen test, we achieved good results by performing phalloplasty with an innervated islandpedicled anterolateral thigh flap using the “tube within a tube” technique, in which the penis and urethraare constructed with a single flap. As compared to a forearm flap, use of an innervated islandpedi...
Cerwenka, Susanne; Nieder, Timo Ole; Richter-Appelt, Hertha
Diverse partner relationship constellations of gender dysphoric women and men with different sexual orientations are explored in a sample of 93 persons before gender-confirming interventions in persons with female gender identity and male body characteristics (MF) and persons with male gender identity and female body characteristics (FM). While in both gender groups the majority is single, relationship patterns show differences. Apart from working life, FM already live predominantly in the new, male gender role and have partners by whom they are desired as males. In contrast, only a small proportion of MF already conduct their private lives in the new, female gender role, and they often have relationships with partners sexually attracted to males and not to their female gender identity. The findings indicate a need for differing resources for gender dysphoric women and men in the process of a transsexual course of development. © Georg Thieme Verlag KG Stuttgart · New York.
Antonio José Mattos do Amaral
Full Text Available Comes this study on changing the legal name of origin by social behalf of transgender individuals, without the need for judiciary intervention. To this end, it is imperative to change the art. 58 of Law 6.015/1973 - Laws of Public Records. Justified this amendment by the legislative admissibility already portrayed by the State in the use of the social name by transsexuals, to identify themselves various situations, including in public bodies and activities. Depicts the brief study the problem of discrimination suffered by these people in their daily lives, embedded in a society where intolerance and discrimination permeate the social fabric, fueling abuses and promoting the kick man on his journey. Relevant is the subject of analysis, as regards the conquest of rights by transgender individuals and the consequent non-discrimination in society of sexual freedoms, combined with the change in their marital name for the social name as well as the identification of sex without that to it have that bail laws that dignify man and the Judiciary. Still, due to the subject, it shows the need for without the need for transsexual name change to undergo a sex reassignment process on the grounds that such a procedure is not necessary to register peace and comfort in their transgender status.
Gorin-Lazard, Audrey; Baumstarck, Karine; Boyer, Laurent; Maquigneau, Aurélie; Penochet, Jean-Claude; Pringuey, Dominique; Albarel, Frédérique; Morange, Isabelle; Bonierbale, Mireille; Lançon, Christophe; Auquier, Pascal
Few studies have assessed the role of cross-sex hormones on psychological outcomes during the period of hormonal therapy preceding sex reassignment surgery in transsexuals. The objective of this study was to assess the relationship between hormonal therapy, self-esteem, depression, quality of life (QoL), and global functioning. This study incorporated a cross-sectional design. The inclusion criteria were diagnosis of gender identity disorder (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) and inclusion in a standardized sex reassignment procedure. The outcome measures were self-esteem (Social Self-Esteem Inventory), mood (Beck Depression Inventory), QoL (Subjective Quality of Life Analysis), and global functioning (Global Assessment of Functioning). Sixty-seven consecutive individuals agreed to participate. Seventy-three percent received hormonal therapy. Hormonal therapy was an independent factor in greater self-esteem, less severe depression symptoms, and greater "psychological-like" dimensions of QoL. These findings should provide pertinent information for health care providers who consider this period as a crucial part of the global sex reassignment procedure.
Aramburu Alegría, C
This paper reports on a study examining sexuality in females who remain partnered with male-to-female transsexual persons. Participants' self-view and sexual fluidity following their partners' transition from man to woman is examined. Sixteen females participated in in-depth, semi-structured interviews. An inductive process of data analysis was conducted, using the constant comparative method, an iterative process by which data are compared within and across subjects. Data were collected until thematic saturation was achieved. Four themes related to sexuality emerged: (1) questioning of sexual orientation; (2) sexual orientation categorization; (3) relational fluidity without sexual relations; and (4) relational fluidity with sexual relations. Participants maintained a heterosexual identity, yet modified their self-view to include an identity that reflected their reformed relationship. The majority of the respondents reported sexual lives that were active or evolving. Others remained in relationships that no longer included sexual activity. The study findings highlight the potential fluidity within the sexual and relational lives of females, and can enhance healthcare providers' preparedness and efficacy with diverse populations. Providers are in a unique position to offer resources to patients who identify as sexually or gender-diverse, or who are in relationships with sexually or gender-diverse persons. © 2012 Blackwell Publishing.
Clarindo Epaminondas de Sá Neto
Full Text Available Visibility and invisibility are very meaningful words to the community of lesbian, gay, bisexual, transgender and intersex - LGBTTI. Compose this “alphabet soup” that represents the sex-diverse community means transit, lifelong, between invisibility and visibility. For lesbians and gays be visible implies publicly assume their sexual orientation; for transsexuals, transvestites, transgender and intersex people, visibility is compulsory at some point in their lives, since, unlike sexual orientation, which can be concealed by a lie by omission or by “closet”, the identity of Gender is experienced by people “trans” as a stigma that can not be hidden, as with skin color, for black men and women. In this paper will seek to analyze the performance of identities “trans” on the premise that free traffic between genders can not be treated as an issue linked to human sexuality, namely sexual orientation of the subject, but from a gender perspective, which will lead us to understand this issue as a fact linked to identity and not to psychological disorders. Also we analyze the contribution that the principle of fraternity can give to the exercise of such identities, taking into account the fact that freedom and equality (members of the French revolutionary triad do not lend, isolated in both. With regard to methodology, we opted for the inductive approach method and procedure as the monographic method, using as a data collection technique the literature.
Full Text Available Body image is the internal representation of an individual's own physical appearance. Individuals with gender identity disorder (GID, commonly referred to as transsexuals (TXs, are unable to form a satisfactory body image due to the dissonance between their biological sex and gender identity. We reasoned that changes in the resting-state functional connectivity (rsFC network would neurologically reflect such experiential incongruence in TXs. Using graph theory-based network analysis, we investigated the regional changes of the degree centrality of the rsFC network. The degree centrality is an index of the functional importance of a node in a neural network. We hypothesized that three key regions of the body representation network, i.e., the primary somatosensory cortex, the superior parietal lobule and the insula, would show a higher degree centrality in TXs. Twenty-three pre-treatment TXs (11 male-to-female and 12 female-to-male TXs as one psychosocial group and 23 age-matched healthy cissexual control subjects (CISs, 11 males and 12 females were recruited. Resting-state functional magnetic resonance imaging was performed, and binarized rsFC networks were constructed. The TXs demonstrated a significantly higher degree centrality in the bilateral superior parietal lobule and the primary somatosensory cortex. In addition, the connectivity between the right insula and the bilateral primary somatosensory cortices was negatively correlated with the selfness rating of their desired genders. These data indicate that the key components of body representation manifest in TXs as critical function hubs in the rsFC network. The negative association may imply a coping mechanism that dissociates bodily emotion from body image. The changes in the functional connectome may serve as representational markers for the dysphoric bodily self of TXs.
De Wert, G; Dondorp, W; Shenfield, F; Barri, P; Devroey, P; Diedrich, K; Tarlatzis, B; Provoost, V; Pennings, G
This Task Force document discusses ethical issues arising with requests for medically assisted reproduction from people in what may be called 'non-standard' situations and relationships. The document stresses that categorically denying access to any of these groups cannot be reconciled with a human rights perspective. If there are concerns about the implications of assisted reproduction on the wellbeing of any of the persons involved, including the future child, a surrogate mother or the applicants themselves, these concerns have to be considered in the light of the available scientific evidence. When doing so it is important to avoid the use of double standards. More research is needed into the psychosocial implications of raising children in non-standard situations, especially with regard to single women, male homosexual couples and transsexual people. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Djordjevic, Miroslav L; Bizic, Marta R; Duisin, Dragana; Bouman, Mark-Bram; Buncamper, Marlon
Sex reassignment surgery (SRS) has proved an effective intervention for patients with gender identity disorder. However, misdiagnosed patients sometimes regret their decision and request reversal surgery. This review is based on our experience with seven patients who regretted their decision to undergo male-to-female SRS. To analyze retrospectively seven patients who underwent reversal surgery after regretting their decision to undergo male-to-female SRS elsewhere. From November 2010 through November 2014, seven men 33 to 53 years old with previous male-to-female SRS underwent reversal phalloplasty. Preoperatively, they were examined by three independent psychiatrists. Surgery included three steps: removal of female genitalia with scrotoplasty and urethral lengthening, total phalloplasty with microvascular transfer of a musculocutaneous latissimus dorsi flap, and neophallus urethroplasty with penile prosthesis implantation. Self-reported esthetic and psychosexual status after reversion surgery and International Index of Erectile Function scores for sexual health after phalloplasty and penile prosthesis implantation. Follow-up was 13 to 61 months (mean = 31 months). Good postoperative results were achieved in all patients. In four patients, all surgical steps were completed; two patients are currently waiting for penile implants; and one patient decided against the penile prosthesis. Complications were related to urethral lengthening: two fistulas and one stricture were observed. All complications were repaired by minor revision. According to patients' self-reports, all patients were pleased with the esthetic appearance of their genitalia and with their significantly improved psychological status. Reversal surgery in regretful male-to-female transsexuals after SRS represents a complex, multistage procedure with satisfactory outcomes. Further insight into the characteristics of persons who regret their decision postoperatively would facilitate better future
Jokić-Begić, Nataša; Jurin, Tanja
In Croatia, transgender individuals face numerous social and medical obstacles throughout the process of transition. The aim of this study was to depict the factors contributing to the psychosocial adjustment of six transsexual individuals living in Croatia following sex reassignment surgery (SRS). A combination of quantitative and qualitative self-report methods was used. Due to the specificity of the sample, the data were collected online. Standardized questionnaires were used to assess mental health and quality of life alongside a series of open-ended questions divided into 4 themes: the decision-making process regarding SRS; social and medical support during the SRS process; experience of discrimination and stigmatizing behaviors; psychosocial adjustment after SRS. Despite the unfavorable circumstances in Croatian society, participants demonstrated stable mental, social, and professional functioning, as well as a relative resilience to minority stress. Results also reveal the role of pretransition factors such as high socioeconomic status, good premorbid functioning, and high motivation for SRS in successful psychosocial adjustment. During and after transition, participants reported experiencing good social support and satisfaction with the surgical treatment and outcomes. Any difficulties reported by participants are related to either sexual relationships or internalized transphobia. The results also demonstrate the potentially protective role that a lengthier process of transition plays in countries such as Croatia. PMID:24790589
Becerra-Fernández, Antonio; Pérez-López, Gilberto; Román, Miriam Menacho; Martín-Lazaro, Juan F; Lucio Pérez, María Jesús; Asenjo Araque, Nuria; Rodríguez-Molina, José Miguel; Berrocal Sertucha, María Carmen; Aguilar Vilas, María Victorina
Prevalence of hyperandrogenism (HA), including the polycystic ovary syndrome (PCOS), in female-to-male transsexuals (FMT) is high. This has been related to metabolic syndrome (MS), which appears to increase cardiovascular morbidity and mortality throughout cross-sex hormone (CSH) therapy. To assess the prevalence of HA and PCOS in FMT patients before the start of CSH therapy, and their association to MS and its components, insulin resistance (IR) and other cardiovascular risk (CVR) factors. Seventy-seven FMTs underwent clinical and biochemical assessment for HA before the start of CSH therapy. CVR, IR, and other MS parameters were also assessed. Prevalence of HA was 49.4% (73.7% were cases of PCOS [Rotterdam criteria]), and prevalence of PCOS in the overall sample was 36.4%. Prevalence of MS was 38.4% and 51.7% according to ATP-III and IDF criteria respectively). MS (according to ATP-III and IDF criteria respectively) was found in 36.8% and 57.9% as compared to 25.6% and 41% of patients with and without HA respectively (p<0.0001 and P<0.01 respectively). Of total patients, 54.5% had normal weight (body mass index [BMI] 18.5-24.9 kg.m(-2)), 26% were overweight (BMI 25-29.9 kg.m(-2)), and 19.5% were obese (BMI ≥ 30 kg.m(-2)). After adjusting for BMI, the comparison of hormonal, metabolic, and anthropometric parameters showed statistically significant differences in plasma glucose, HOMA-IR, and abdominal circumference (P<0.001 for all), as well as HDL cholesterol (HDL) (P=0.033), but not in total testosterone or calculated free testosterone levels. In the total sample, 27.3% had HDL levels less than 50mg/dL. Overall HA, and PCOS in particular, are highly prevalent in FMTs. HA and PCOS are related to early development of SM, IR, and other CVR factors with unknown consequences in adulthood. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.
Alvarez-Díaz, Jorge Alberto
The presence of a transsexual pregnant male in the mass media has made people reassess if transsexuals should have access to assisted reproduction. The bioethical discussion should focus on the future child best interests. This article describes the story of this transsexual man, legally married to a woman in the state of Oregon in the United States. A brief overview of transsexuality and the specific characteristics of this case, with special considerations towards fertility in transsexual people is included. We suggest reflections on what constitutes motherhood and fatherhood and bioethical considerations brought forth by this groundbreaking event.
Full Text Available In Croatia, transgender individuals face numerous social and medical obstacles throughout the process of transition. The aim of this study was to depict the factors contributing to the psychosocial adjustment of six transsexual individuals living in Croatia following sex reassignment surgery (SRS. A combination of quantitative and qualitative self-report methods was used. Due to the specificity of the sample, the data were collected online. Standardized questionnaires were used to assess mental health and quality of life alongside a series of open-ended questions divided into 4 themes: the decision-making process regarding SRS; social and medical support during the SRS process; experience of discrimination and stigmatizing behaviors; psychosocial adjustment after SRS. Despite the unfavorable circumstances in Croatian society, participants demonstrated stable mental, social, and professional functioning, as well as a relative resilience to minority stress. Results also reveal the role of pretransition factors such as high socioeconomic status, good premorbid functioning, and high motivation for SRS in successful psychosocial adjustment. During and after transition, participants reported experiencing good social support and satisfaction with the surgical treatment and outcomes. Any difficulties reported by participants are related to either sexual relationships or internalized transphobia. The results also demonstrate the potentially protective role that a lengthier process of transition plays in countries such as Croatia.
Carobene, Mauricio; Bolcic, Federico; Farías, María Sol Dos Ramos; Quarleri, Jorge; Avila, María Mercedes
Commercial sex work is frequent among male-to-female transvestites, transsexuals and transgenders in Argentina, leading to high susceptibility to HIV, HBV, and HCV among other sexually transmitted infections. In a global context of scarce data on the trans sex workers population, this study was aimed to study the genomic characterization of these viruses. Plasma presence of HIV, HBV, and HCV genomic material was evaluated in samples from 273 trans sex workers. Genomic sequences of HIV-gag, pol, and vif-vpu genes, HBV-S gene, and HCV-5'UT and NS5B genes were obtained. Molecular characterization involved phylogenetic analysis and several in silico tools. Resistance-associated mutations in HIV and HBV pol genes were also analyzed. The HIV genomic characterization in 62 trans sex workers samples showed that 54.8% of the isolates corresponded to BF intersubtype recombinants, and 38.7% to subtype B. The remaining were classified as subtypes C (4.8%) and A (1.6%). HBV and HCV co-infection prevalence among HIV positive trans sex workers yielded rates of 3.2% and 6.5% respectively. Drug resistance-associated mutations were found in 12/62 (19%) HIV pol sequences, but none among HBV. Based on phylogenetic relationships, HIV isolates characterized as subtypes BF and B appeared intermingled with those from other high-risk groups. Despite trans sex workers declared not to have received antiviral treatment, complex drug resistance-associated mutation patterns were found in several HIV isolates. Planned prevention, screening, and treatment are needed to reduce further transmission and morbidity. © 2013 Wiley Periodicals, Inc.
Full Text Available The aspect of social issues becomes one of the concerns of contemporary Islam. This aspect is usually discussed and became the hottest news in social life. One might feel having lack of unanimity in the provision of public attitudes towards him/her self. This is what happened to transsexual and genital surgery people. Those who have and do the things that feel cornered because people assume the actions carried out under the assumption that they have been violated. Transsexual is a person whose way of behaving not same to the appearance of gender roles in general. Transsexual is a person who in the various levels of "breaking" cultural norms about how men and women should have it. A woman, for example, is culturally soft and tender. If a man has such kind of girl character, it's called transsexuals. Some transsexual people are wearing the opposite sex clothes. Transsexual people might change his or her gender, as male changes into a woman, and vice versa. Many things can affect the formation of transsexual behavior; from biological aspect, social-psychological, and cultural aspects. Muslims take a stand against the potential problems that may result from the presence of the transsexual behavior. In spite of these problems, Muslims should be wise in maintaining harmony in the social life of this world.
Isabel Esteva de Antonio
current situation of healthcare for transexualism in the publicly-funded health service in Spain. Materials and methods: A descriptive study based on data provided by the Spanish Society of Endocrinology Group on Identity and Sexual Differentiation was performed. The resources in the regions that have created specific gender units for these disorders are described. Results: Nine autonomous regions (55% have started to provide various procedures, although only four provide genitoplastic procedures. The first region to include all sex reassignment surgeries was Andalusia (year 1999. At the same time, Madrid and Catalonia also began to provide specialized mental health care and endocrinology but did not include surgical procedures until 2007 and institutional recognition until 2008. Since 2007 other regions have incorporated healthcare for transsexual patients. Overall, 3,303 patients (a male-to female/female-to-male transsexual ratio of 1.9/1 and 864 surgical procedures have been registered in this study. The composition and proportion of working hours of specialists, as well as the kinds of treatments provided, differ widely in each region. Conclusions: The geographical distribution of healthcare to transsexual persons and the services provided vary. Few regions offer genitoplastic procedures. The number of applicants exceeds the number estimated by the national health system.
Full Text Available Forty years after transsexual coming out, from the beginning of a physical, cultural and historic transit, what has changed in Italy today? It is certainly the visibility that filled a historical vacuum. It allows us to speak, understand, read the trans experience: for some, as a phenomenon, for others, as category, pathology, gender incongruity. Open questions are several about a complex and varied experience on a socio-cultural contexts at same time complex and varied. One answer is certain: we can no longer talk about transsexualism / transgender in the singular, but rather about plural transsexualism. The Transsexualism is different, various, diversified according to several possible variations that the Post-modern presents us.
Lawrence, Anne A
Autogynephilia is defined as a male's propensity to be sexually aroused by the thought of himself as a female. It is the paraphilia that is theorized to underlie transvestism and some forms of male-to-female (MtF) transsexualism. Autogynephilia encompasses sexual arousal with cross-dressing and cross-gender expression that does not involve women's clothing per se. The concept of autogynephilia defines a typology of MtF transsexualism and offers a theory of motivation for one type of MtF transsexualism. Autogynephilia resembles a sexual orientation in that it involves elements of idealization and attachment as well as erotic desire. Nearly 3% of men in Western countries may experience autogynephilia; its most severe manifestation, MtF transsexualism, is rare but increasing in prevalence. Some theorists and clinicians reject the transsexual typology and theory of motivation derived from autogynephilia; their objections suggest a need for additional research. The concept of autogynephilia can assist clinicians in understanding some otherwise puzzling manifestations of nonhomosexual MtF transsexualism. Autogynephilia exemplifies an unusual paraphilic category called 'erotic target identity inversions', in which men desire to impersonate or turn their bodies into facsimiles of the persons or things to which they are sexually attracted. Copyright © 2011 S. Karger AG, Basel.
This research explains about transsexual and its position in Islamic inheritance.Transsexual included in gender identity disorders. The main characteristic of thisproblem is the mismatch between the genitals and gender identity. Gender identity is thefeeling of a person belonging to a particular gender, in other words the realization thathe is male or female. The law of transsexual (genital surgery) is absolutely haram.Whereas, genital operation in order to enchantment/improvement of double g...
Kaličanin Milena M.
Full Text Available The paper is divided into four sections. In the first section entitled 'Introducing and Defining Trans (Issues', the basic terms of transgender, transvestite, and transsexual are defined by relying on Stryker's Transgender History (2008. The second part of the paper, 'Trans Studies: In-Between Feminist and Queer Theory?', places transgender studies into an academic context by referring to the theoretical framework provided by trans theorists Stryker, Stone, and Ranck who unanimously claim that transgender studies should have a place of its own within the academia and that trans theory should solely be written by transsexuals. These ideas are applied in the interpretation of Lochhead's story 'Not Changed' in the third segment of the paper. The critical insights of Butler (Gender Trouble, 1990; Undoing Gender, 2004 are found to be most helpful in the interpretation of Lochhead's story about Michael who has willingly undergone Hormone Replacement Therapy to become transsexual Michele. Finally, in the concluding remarks, Lochhead's story is viewed as a trans woman manifesto, urging both non-transsexual and transsexual persons to embrace new beginnings in their relationship.
The guideline for the treatment of people with gender identity disorder (GID) of the Japanese Society of Psychiatry and Neurology was revised in January 2012. The guideline eased restrictions for the endocrine treatment of transsexual adolescents. A medical specialist can start treating transsexual adolescents at the age of 15 after the diagnosis of GID. It recommends that transsexual adolescents (Tanner stage 2 [mainly 12-13 years of age]) are treated by endocrinologists to suppress puberty with gonadotropin-releasing hormone (GnRH) agonists until the age of 15 years old, after which cross-sex hormones may be given. Female-to-male transsexuals do not necessarily want to start androgen therapy before presenting female secondary sexual characteristics because androgen can easily stop menstruation, cause beard growth, and lower the voice. On the contrary, male-to-female transsexuals want to start estrogen therapy before presenting male secondary sexual characteristics because estrogen cannot alter the beard and low voice. It is important to identify children with gender dysphoria in school and help them receive medical advice. However, approximately half of school teachers think that children with gender dysphoria are very rare and they do not know of the notification from Ministry of Education, Culture, Sports, Science and Technology, JAPAN, which aims to help children with gender dysphoria. The revision of the guideline for the treatment of transsexual people and endocrine treatment of transsexual adolescents by medical specialists may prevent them from attempting suicide, being depressive, and refusing to attend school. Furthermore, the treatment may help avoid mental disorders, aid being employed with the desired sexuality, and, subsequently, getting married and having children.
Basterra, V; Ruiz, R; Toni, M; Rebolé, A; Pérez de Mendiola, Y; Forga, L
Transexuality has been recognized in Navarre as a clinical entity that must be attended to in a multidisciplinary form in the Navarre Health Service. An analysis was made of the epidemiological data of 35 subjects who have attended the Navarre Transexual and Intersex Unit (UNATI - Unidad Navarra de Transexuales e Intersexos) since April 2011. The variables related to socio-demographic parameters, transexuality and treatment were collected. The average age was 37.3 years. Sixty-five point seven percent of the subjects were born in Spain. Seventy-one point four percent of the users are feminine transsexuals. At present 62.9% of the subjects are receiving hormonal treatment. Amongst the feminine transexuals 20% have had a mamoplasty, 4% have had a vaginoplasty and 20% have had both operations. Ten percent of the masculine transsexuals have had a mastectomy, 10% have had a hysterectomy with double anexectomy and 10% have had both operations. The majority of the transsexuals in Navarre are being evaluated in the UNATI. More feminine transsexuals have attended than masculine ones. The feminine transsexuals more frequently have reassignation surgery, while the masculine ones have extirpative surgery.
Colizzi, Marco; Costa, Rosalia; Pace, Valeria; Todarello, Orlando
Gender identity disorder may be a stressful situation. Hormonal treatment seemed to improve the general health as it reduces psychological and social distress. The attachment style seemed to regulate distress in insecure individuals as they are more exposed to hypothalamic-pituitary-adrenal system dysregulation and subjective stress. The objectives of the study were to evaluate the presence of psychobiological distress and insecure attachment in transsexuals and to study their stress levels with reference to the hormonal treatment and the attachment pattern. We investigated 70 transsexual patients. We measured the cortisol levels and the perceived stress before starting the hormonal therapy and after about 12 months. We studied the representation of attachment in transsexuals by a backward investigation in the relations between them and their caregivers. We used blood samples for assessing cortisol awakening response (CAR); we used the Perceived Stress Scale for evaluating self-reported perceived stress and the Adult Attachment Interview to determine attachment styles. At enrollment, transsexuals reported elevated CAR; their values were out of normal. They expressed higher perceived stress and more attachment insecurity, with respect to normative sample data. When treated with hormone therapy, transsexuals reported significantly lower CAR (P treatment seemed to have a positive effect in reducing stress levels, whatever the attachment style may be. © 2013 International Society for Sexual Medicine.
Full Text Available Les kathoey, transgenres et transsexuels Male-to-Female thaïlandais s’adaptent pour trouver le rôle ou la présentation identitaire convenant aux contextes et aux interactions auxquels elles doivent faire face. Elles peuvent adopter une apparence ou un rôle plus masculin lorsque la situation dans laquelle elles se trouvent ne leur permet pas d’affirmer leur féminité ou que celle-ci pourrait leur nuire socialement. Elles peuvent également accentuer leur féminité pour exprimer leur sentiment identitaire. Les kathoey négocient leur place en faisant preuve de leurs qualités personnelles et de leurs compétences et en mettant également en évidence leurs autres privilèges : statut socio-économique, beauté, etc. pour gagner une reconnaissance sociale. Malgré leur marginalité due à leur différence de genre, elles tentent de s’intégrer dans leurs milieux sociaux en adaptant leur image identitaire, en assumant leurs responsabilités et en réussissant leur vie familiale et professionnelle.Thai male-to-female transsexuals, “kathoey” adapt themselves and adjust their roles and their physical identity i.e., their appearances to different interactional situations. They can adopt their appearance and play masculine roles in the situation in which revealing femininity would be inacceptable or would cause them problem socially. Occasionally, in some situations, they can do the opposite by showing off their femininity they confirm to others who they really are. Kathoey negotiate their identity and their social position by proving and emphasizing on their personal qualities, capacities and others privileges such as social and economical status, beauty, professional competency etc. to gain social acceptation and admiration. Even though they have been marginalized by the society, they tend to reintegrate themselves in their social environment by using different strategies of such as personal identities, showing of their professional
Simonsen, Rikke Kildevæld; Hald, Gert Martin; Kristensen, Ellids
Introduction: Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgica......, specific types of hormonal or surgical treatment received and somatic morbidity and mortality....
Full Text Available German Society for Sexual Research, Academy of Sexual Medicine and Society of Sexology formulated standards for evaluation and treatment of transsexuals. The creation of the standards involved Sophinette Becker, Hartmut A. G. Bosinski, Ulrich Clement, Wolf Eicher, Thomas M. Goerlich, Uwe Hartmann, Götz Kockott, Dieter Langer, Wilhelm E. Preuss, Gunter Schmidt, Alfred Springer, Reinhard Wille. Since 1980, the Federal Republic of Germany has a law on transsexualism, which regulates the right of the individual to change the sex. However, until now there were no specifically defined standards of assessment and treatment of transsexuals. For the first time, in 1979 Harry Benjamin invited the International Medical Association of Germany to revise the standards of medical care for gender dysphoria. The following standards of assessment and treatment of transsexuals have been developed at a conference convened by the German Society for Research Expert Committee under the leadership of Sophinette Becker. The review of currently valid standards for evaluation and treatment of transgender is the subject of this article
The third versions of the guideline for treatment of people with gender identity disorder (GID) of the Japanese Society of Psychiatry and Neurology does not include puberty-delaying hormone therapy. It is recommended that feminizing/masculinizing hormone therapy and genital surgery should not be carried out until 18 year old and 20 year old, respectively. On the other hand, the sixth (2001) and the seventh (2011) versions of the standards of care for the health of transsexual, transgender, and gender nonconforming people of World Professional Association for Transgender Health (WPATH) recommend that transsexual adolescents (Tanner stage 2, [mainly 12-13 years of age]) are treated by the endocrinologists to suppress puberty with gonadotropin-releasing hormone (GnRH) agonists until age 16 years old, after which cross-sex hormones may be given. A questionnairing on 181 people with GID diagnosed in the Okayama University Hospital (Japan) showed that female to male (FTM) transsexuals hoped to begin masculinizing hormone therapy at age of 15.6 +/- 4.0 (mean +/- S.D.) whereas male to female (MTF) transsexuals hoped to begin feminizing hormone therapy as early as age 12.5 +/- 4.0, before presenting secondary sex characters. After confirmation of strong and persistent cross-gender identification, adolescents with GID should be treated with cross-gender hormone or puberty-delaying hormone to prevent developing undesired sex characters. These treatments may prevent transsexual adolescents from attempting suicide, being depressive, and refusing to attend school. Subsequent early breast and genital surgery may help being employed in desired sexuality.
Lawrence, Anne A
Desire for amputation of a healthy limb has usually been regarded as a paraphilia (apotemnophilia), but some researchers propose that it may be a disorder of identity, similar to Gender Identity Disorder (GID) or transsexualism. Similarities between the desire for limb amputation and nonhomosexual male-to-female (MtF) transsexualism include profound dissatisfaction with embodiment, related paraphilias from which the conditions plausibly derive (apotemnophilia and autogynephilia), sexual arousal from simulation of the sought-after status (pretending to be an amputee and transvestism), attraction to persons with the same body type one wants to acquire, and an elevated prevalence of other paraphilic interests. K. Freund and R. Blanchard (1993) proposed that nonhomosexual MtF transsexualism represents an erotic target location error, in which men whose preferred erotic targets are women also eroticize their own feminized bodies. Desire for limb amputation may also reflect an erotic target location error, occurring in combination with an unusual erotic target preference for amputees. This model predicts that persons who desire limb amputation would almost always be attracted to amputees and would display an increased prevalence of gender identity problems, both of which have been observed. Persons who desire limb amputation and nonhomosexual MtF transsexuals often assert that their motives for wanting to change their bodies reflect issues of identity rather than sexuality, but because erotic/romantic orientations contribute significantly to identity, such distinctions may not be meaningful. Experience with nonhomosexual MtF transsexualism suggests possible directions for research and treatment for persons who desire limb amputation.
Maiko A. Schneider
Full Text Available Abstract Introduction: Transsexualism (ICD-10 is a condition characterized by a strong and persistent dissociation with one's assigned gender. Sex reassignment surgery (SRS and hormone therapy provide a means of allowing transsexual individuals to feel more congruent with their gender and have played a major role in treatment over the past 70 years. Brain-derived neurotrophic factor (BDNF appears to play a key role in recovery from acute surgical trauma and environmentally mediated vulnerability to psychopathology. We hypothesize that BDNF may be a biomarker of alleviation of gender incongruence suffering. Objectives: To measure preoperative and postoperative serum BDNF levels in transsexual individuals as a biomarker of alleviation of stress related to gender incongruence after SRS. Methods: Thirty-two male-to-female transsexual people who underwent both surgery and hormonal treatment were selected from our initial sample. BDNF serum levels were assessed before and after SRS with sandwich enzyme linked immunosorbent assay (ELISA. The time elapsed between the pre-SRS and post-SRS blood collections was also measured. Results: No significant difference was found in pre-SRS or post-SRS BDNF levels or with relation to the time elapsed after SRS when BDNF levels were measured. Conclusion: Alleviation of the suffering related to gender incongruence after SRS cannot be assessed by BDNF alone. Surgical solutions may not provide a quick fix for psychological distress associated with transsexualism and SRS may serve as one step toward, rather than as the conclusion of, construction of a person's gender identity.
SOCIOLOGY. March 1982. pp. i032-1063. The strong taboos against homosexuality, bestiality and transvestism that exist in many Western societies are...Transsexualism, and Transvestism ." JOURNAL OF THE AMERICAN ACADEMY OF PSYCHOANALYSIS. No Date. Ovesey and Person define gender identity and describe how it...transsexualism, and transvestism . For each disorder a psychodynamic analysis of the symptoms is provided, and a hypothesis for their developmental
Atenção integral à saúde e diversidade sexual no Processo Transexualizador do SUS: avanços, impasses, desafios Comprehensiveness and sexual diversity in the Brazilian norm in the process of health care for transsexuals: progress, dilemmas, challenges
Full Text Available A publicação da norma sobre o Processo Transexualizador no SUS, apesar de refletir importante conquista do segmento populacional de transexuais, denuncia a complexidade do avanço dos direitos sexuais no campo da Saúde Coletiva. O artigo tem por objetivo a consideração crítica dos avanços, impasses e desafios na instituição dessa política pública de saúde, discutindo a ambivalência no processo de construção da norma técnica. Resgata duas correntes paralelas de inserção do debate sobre saúde de transexuais no Ministério da Saúde: a judicialização e o compromisso com o programa de governo Brasil sem Homofobia. Sinaliza a qualidade parcial do avanço conquistado pela publicação da norma, já que estabeleceu, ao mesmo tempo em que afirmou o direito à saúde para transexuais, campos de exclusão para possíveis beneficiários das mesmas ações de saúde previstas, especificamente as travestis. A hipótese sustentada é a da incidência da heteronormatividade e do binarismo de gênero como fator limitador da democratização dessa política de saúde.The Brazilian norm that establishes the conditions for the health care for transsexuals, despite reflecting important achievements of this population, reveals the complexity of the advancement of sexual rights in the field of public health. This paper aims to review the advances, challenges and dilemmas in the establishment of this public health policy, discussing the ambivalence in the process of building the technical standard. It releases two parallel chains of the inclusion of the debate about transgender health care in the Health Ministry: the judicialization and the committment with the government program "Brazil without Homophobia". It indicates the partial progress achieved by the publication of the standard, as it established exclusion areas for potential beneficiaries of the same set of health actions, specifically the transvestites, at the same time it stated the
Jorge Manrique de Lara Seminario
Full Text Available This article studies people relegated to invisibility: the LGTB (lesbians, gays, transsexuals and bisexuals from constitutional and international law point of view. Thoughts will be focused on transsexuals and their rights to be treated according to an early internalized gender and some rights emerged from this treatment. Peruvian State role in this subject and the existing challenges will also be analyzed in the same way.
Dacakis, Georgia; Oates, Jennifer; Douglas, Jacinta
The Transsexual Voice Questionnaire (TVQ MtF ) was designed to capture the voice-related perceptions of individuals whose gender identity as female is the opposite of their birth-assigned gender (MtF women). Evaluation of the psychometric properties of the TVQ MtF is ongoing. To investigate associations between TVQ MtF scores and (1) self-perceptions of voice femininity and (2) acoustic parameters of voice pitch and voice quality in order to evaluate further the validity of the TVQ MtF . A strong correlation between TVQ MtF scores and self-ratings of voice femininity was predicted, but no association between TVQ MtF scores and acoustic measures of voice pitch and quality was proposed. Participants were 148 MtF women (mean age 48.14 years) recruited from the La Trobe Communication Clinic and the clinics of three doctors specializing in transgender health. All participants completed the TVQ MtF and 34 of these participants also provided a voice sample for acoustic analysis. Pearson product-moment correlation analysis was conducted to examine the associations between TVQ MtF scores and (1) self-perceptions of voice femininity and (2) acoustic measures of F0, jitter (%), shimmer (dB) and harmonic-to-noise ratio (HNR). Strong negative correlations between the participants' perceptions of their voice femininity and the TVQ MtF scores demonstrated that for this group of MtF women a low self-rating of voice femininity was associated with more frequent negative voice-related experiences. This association was strongest with the vocal-functioning component of the TVQ MtF . These strong correlations and high levels of shared variance between the TVQ MtF and a measure of a related construct provides evidence for the convergent validity of the TVQ MtF . The absence of significant correlations between the TVQ MtF and the acoustic data is consistent with the equivocal findings of earlier research. This finding indicates that these two measures assess different aspects of the voice
Transsexualism is characterised by a discrepancy between biological sex and gender identification, in spite of hormonal levels that are normal with respect to the biological sex. Generally, having the diagnosis ‘transsexualism’ or ‘Gender Identity Disorder’ (GID) is a prerequisite for hormonal and surgical treatment. Since transsexualism is such a rare phenomenon, and a so-called ‘gold standard’ against which the diagnosis could be evaluated is lacking, it is of utmost importance that reliabl...
Pedersen, Jesper Christian; Christensen, Peter Raunkjær; Gravesen, Ida Dal; Kongshøj, Gertrud Hjelm; Larsen, Christian; Stubager, Karen-Maria
This project aims to discover how the narratives of transsexuals stress the importance of the material body in post structural sex-studies. With an inspiration from Judith Butler and Jay Prosser we seek to distinct the constructivist queer-theory of gender as solely a performativity. The transsexuals tell us that gender must be something relating the psysical body, which is the subject of performativity. But this performance can only be understood to the degree that there is a language and wo...
The aspect of social issues becomes one of the concerns of contemporary Islam. This aspect is usually discussed and became the hottest news in social life. One might feel having lack of unanimity in the provision of public attitudes towards him/her self. This is what happened to transsexual and genital surgery people. Those who have and do the things that feel cornered because people assume the actions carried out under the assumption that they have been violated. Transsexual is a person whos...
The aspect of social issues becomes one of the concerns of contemporary Islam. This aspect is usually discussed and became the hottest news in social life. One might feel having lack of unanimity in the provision of public attitudes towards him/her self. This is what happened to transsexual and genital surgery people. Those who have and do the things that feel cornered because people assume the actions carried out under the assumption that they have been violated. Transsexual is a person whos...
Taziaux, Melanie; Staphorsius, Annemieke S; Ghatei, Mohammad A; Bloom, Stephen R; Swaab, Dick F; Bakker, Julie
Since the discovery of its central role in reproduction, our functional neuroanatomical knowledge of the hypothalamic kisspeptin system is predominantly based on animal studies. Although sex differences in kisspeptin expression have been shown in humans in adulthood, the developmental origin of this sex difference is unknown. Our objectives were to determine the following: 1) when during development the sex difference in kisspeptin expression in the infundibular nucleus would emerge and 2) whether this sex difference is related to sexual orientation or transsexuality. Postmortem hypothalamic tissues were collected by The Netherlands Brain Bank, and sections were stained for kisspeptin by immunohistochemistry. Hypothalami of 43 control subjects were categorized into three periods: infant/prepubertal (six girls, seven boys), adult (11 women, seven men), and elderly (six aged women, six aged men). Eight male-to-female (MTF) transsexuals, three HIV(+) heterosexual men, and five HIV(+) homosexual men were also analyzed. We estimated the total number of kisspeptin-immunoreactive neurons within the infundibular nucleus. Quantitative analysis confirmed that the human infundibular kisspeptin system exhibits a female-dominant sex difference. The number of kisspeptin neurons is significantly greater in the infant/prepubertal and elderly periods compared with the adult period. Finally, in MTF transsexuals, but not homosexual men, a female-typical kisspeptin expression was observed. These findings suggest that infundibular kisspeptin neurons are sensitive to circulating sex steroid hormones throughout life and that the sex reversal observed in MTF transsexuals might reflect, at least partially, an atypical brain sexual differentiation.
Full Text Available There are established guidelines for the endocrine and overall treatment of transsexual persons. These guidelines provide information about the optimal endocrine management of male-to-female and female-to-male transsexual persons. India has a large community of eunuchs, also known as hijras, who are men with gender identity disorders. While this community has been studied from a social and medical point of new, no endocrine work has been done in them. This exploratory article tries to discuss the endocrine status, health, and management of the eunuchs.
Munkholm, Natalie Videbæk
The chapter explains the legal framework concerning transgender and transsexual persons in Denmark, statistics, the procedures and requirements for changing legal sex and/or gender, the legal consequences of the changes as regards rights and duties of the person, and the legal challenges of the r......The chapter explains the legal framework concerning transgender and transsexual persons in Denmark, statistics, the procedures and requirements for changing legal sex and/or gender, the legal consequences of the changes as regards rights and duties of the person, and the legal challenges...
Dreger, Alice D
In 2003, psychology professor and sex researcher J. Michael Bailey published a book entitled The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism. The book's portrayal of male-to-female (MTF) transsexualism, based on a theory developed by sexologist Ray Blanchard, outraged some transgender activists. They believed the book to be typical of much of the biomedical literature on transsexuality-oppressive in both tone and claims, insulting to their senses of self, and damaging to their public identities. Some saw the book as especially dangerous because it claimed to be based on rigorous science, was published by an imprint of the National Academy of Sciences, and argued that MTF sex changes are motivated primarily by erotic interests and not by the problem of having the gender identity common to one sex in the body of the other. Dissatisfied with the option of merely criticizing the book, a small number of transwomen (particularly Lynn Conway, Andrea James, and Deirdre McCloskey) worked to try to ruin Bailey. Using published and unpublished sources as well as original interviews, this essay traces the history of the backlash against Bailey and his book. It also provides a thorough exegesis of the book's treatment of transsexuality and includes a comprehensive investigation of the merit of the charges made against Bailey that he had behaved unethically, immorally, and illegally in the production of his book. The essay closes with an epilogue that explores what has happened since 2003 to the central ideas and major players in the controversy.
This article takes as its point of departure the numerous amounts of video blogs (vlogs) on YouTube (youtube.com) where transsexuals (using hormones and/or surgery to alter their body) document and discuss their gender transition. The transition is often articulated as a birth or a re-birth signa......This article takes as its point of departure the numerous amounts of video blogs (vlogs) on YouTube (youtube.com) where transsexuals (using hormones and/or surgery to alter their body) document and discuss their gender transition. The transition is often articulated as a birth or a re...
Karhunen-Enckell, Ulla; Kolehmainen, Maija; Kääriäinen, Minna; Suominen, Sinikka
For a female-to-male transgender person, mastectomy is the most important procedure making the social interaction easier. Along with the size of the breasts, the quantity and quality of skin will influence the selection of surgical technique. Although complications are rare, corrective surgery is performed for as many as 40% of the patients. Of male-to-female transsexual persons, 60 to 70% opt for breast enlargement. Breast enlargement can be carried out by using either silicone implants or fat transplantation. Since the surgical procedures on breasts are irreversible, their implementation requires confirmation of the diagnosis of transsexualism by a multidisciplinary team.
Meyer, J K
Experience with more than 500 patients over the last decade has led to the conclusion that the quest for sex reassignment is a symptomatic compromise formation serving defensive and expressive functions. The symptoms are the outgrowth of developmental trauma affecting body ego and archaic sense of self and caused by peculiar symbiotic and separation-individuation phase relationships. The child exists in the pathogenic (and reparative) maternal fantasy in order to repair her body image and to demonstrate the interconvertability of the sexes. Gender identity exists not as a primary phenomenon, but in a sense as a tertiary one. There is, no doubt, a tendency to gender-differentiate in a way concordant with biological endowment. Nevertheless, gender formation is seriously compromised by earlier psychological difficulty. Gender identity is a fundamental acquisition in the developing personality, but it is part of a hierarchical series beginning with archaic body ego, early body image, and primitive selfness, representing their extension into sexual and reproductive spheres. Gender identity consolidates during separation-individuation and gender pathology bears common features with other preoedipal syndromes. Transsexualism is closely linked to perversions, and the clinical syndromes may shade from one into another. However, what is kept at the symbolic level in the perversions must be made concrete in transsexualism. In this regard there is a close relation to psychosis. The clinical complaint of the transsexual is a condensation of remarkable proportions. When the transsexual says that he is a girl trapped in a man's body, he sincerely means what he says. As with other symptoms, however, it takes a long time before he begins to say what he means.
Full Text Available Transvestites are always identified as God's creatures are far from religion, even more extream is an attitude to life that challenges the will of God. This perception has been inherited from generation to generation making transvestites as people marginalized in society. The study wants to answer academic anxiety about how the religiousity of transsexual beauty salons worker in the city of Padang. The study used a qualitative research method, in which the collected data to rely on in-depth interviews as well as continuous observation so get data that can be accounted for by an academic. To analyze the data, using descriptive data that will show and describe the facts and nature of the informant based on the understanding and religious activity of transvestite.The result are; 1 The religious knowledge of transsexual beauty salons worker in Padang city is divided into three categories; high, moderate and low. 2 Religious practice of transsexual beauty salons worker in the city of Padang is divided into three, namely: transvestite salon workers who have a religious practice strong, moderate and weak.
Meyer-Bahlburg, H F
To ascertain the validity of hormonal theories of human homosexuality, which are based on animal research, this article reviews psychoendocrine data on lesbian and transsexual women. Sex hormone levels were found to be normal in the majority of homosexual women, but about a third of the subjects studied had elevated androgen levels. In women with prenatal androgen excess, heterosexuality appears to be more frequent than bisexuality, and exclusive homosexuality is rare. Two recent reports suggest abnormalities of the neuroendocrine regulation of LH secretion in female transsexuals. Clearly, prenatal or postpubertal hormone levels do not determine the development of sexual orientation, but a facilitating neuroendocrine predisposition cannot be ruled out at present.
Guilherme Paiva de Carvalho
Full Text Available O artigo analisa a relação entre gênero, transexualidade e educação, refletindo sobre o reconhecimento do sujeito transexual na instituição educacional no Brasil. Para tanto, o estudo discute o conceito de identidade de gênero e transexualidade a partir do ponto de vista do saber médico e das ciências humanas. Por meio de entrevistas com professores/as do ensino superior no Estado do Rio Grande do Norte, a pesquisa mostra que a problemática de gênero é pouco estudada no sistema educacional. Considerando a perspectiva dos/as professores/ as entrevistados/as, apesar do questionamento acerca da teoria da oposição binária da sexualidade, os discursos evidenciam a falta de reconhecimento do sujeito transexual na educação superior no Brasil. Palavras-chave: Gênero. Transexualidade. Educação. Gender, transsexuality and education: recognition and difficulties for emancipation ABSTRACT This paper analyses the relationship between gender, transsexuality and education, refl ecting about the recognition of the transsexual subject in the educational institution in Brazil. In order to do so, the study discusses the concept of gender identity and transsexuality from the standpoint of medicals knowledge and humans sciences. By means of interviews with professors of the higher education in the state of Rio Grande do Norte, the research shows that the gender problematic is little studied in the educational system. Considering the vision of the professors interviewed, in spite of the questioning about the theory of the binary opposition of sexuality, the discourses evidences the lack of recognition of the transsexual subject in higher education in Brazil. Keywords: Gender. Transsexuality. Education. Género, transexualidad y educación: reconocimiento y dificultades para emancipación RESUMEN El artículo analiza la relación entre género, transexualidad y educación, refl exionando sobre el reconocimiento del sujeto transexual en la
Murders of Transvestites and Transsexual in Rio Grande do Sul: crimes based in gender? Asesinatos de travestis y transexuales en Rio Grande do Sul: ¿crímenes basados en el género? Assassinatos de Travestis e Transexuais no Rio Grande do Sul: crimes pautados em gênero?
Cristian Fabiano Guimarães
Full Text Available Transvestites and transsexuals represent an exposed population to the different situations of vulnerabilities, in relation to sexual orientation, gender identities and relations with the society. We proposed this research to analyze the murders of this population in the Rio Grande do Sul, understood as homicides based in gender. This article presents the methodological changes throughout the process of the research that occurred during the immersion of researchers in the field, from four areas of analysis: context of the research; the murders of transvestites and transsexuals as gender murders; the process of data generation and the reflections to build of a comprehensive field. Through this study, we hope to contribute for building methodologies to address this issue.Travestis y transexuales son una población expuesta a diferentes situaciones de vulnerabilidad debido a la orientación sexual, identidad de género y las relaciones con la sociedad. Hemos propuesto este estudio para analizar los asesinatos de esta población en Rio Grande do Sul, entendidos como asesinatos por razones de género. Este artículo presenta los cambios metodológicos que se han producido durante el proceso de investigación y la inmersión de los investigadores en el campo, a partir de cuatro ejes: la contextualización de la investigación, los asesinatos de travestis y transexuales como homicidios de género, la generación de datos y reflexiones para apoyar la construcción de un campo explicativo. Con este estudio, esperamos poder contribuir a la construcción de metodologías para abordar esta cuestión.Travestis e transexuais constituem uma população exposta a diferentes situações de vulnerabilidade, devido à orientação sexual, identidade de gênero e relações com a sociedade. Propusemos esta pesquisa para analisar os assassinatos dessa população no Rio Grande do Sul, entendidos como homicídios baseados em gênero. Este artigo apresenta as mudan
Matthias K Auer
Full Text Available Sexual orientation is usually considered to be determined in early life and stable in the course of adulthood. In contrast, some transgender individuals report a change in sexual orientation. A common reason for this phenomenon is not known.We included 115 transsexual persons (70 male-to-female "MtF" and 45 female-to-male "FtM" patients from our endocrine outpatient clinic, who completed a questionnaire, retrospectively evaluating the history of their gender transition phase. The questionnaire focused on sexual orientation and recalled time points of changes in sexual orientation in the context of transition. Participants were further asked to provide a personal concept for a potential change in sexual orientation.In total, 32.9% (n = 23 MtF reported a change in sexual orientation in contrast to 22.2% (n = 10 FtM transsexual persons (p = 0.132. Out of these patients, 39.1% (MtF and 60% (FtM reported a change in sexual orientation before having undergone any sex reassignment surgery. FtM that had initially been sexually oriented towards males ( = androphilic, were significantly more likely to report on a change in sexual orientation than gynephilic, analloerotic or bisexual FtM (p = 0.012. Similarly, gynephilic MtF reported a change in sexual orientation more frequently than androphilic, analloerotic or bisexual MtF transsexual persons (p =0.05.In line with earlier reports, we reveal that a change in self-reported sexual orientation is frequent and does not solely occur in the context of particular transition events. Transsexual persons that are attracted by individuals of the opposite biological sex are more likely to change sexual orientation. Qualitative reports suggest that the individual's biography, autogynephilic and autoandrophilic sexual arousal, confusion before and after transitioning, social and self-acceptance, as well as concept of sexual orientation itself may explain this phenomenon.
Auer, Matthias K; Fuss, Johannes; Höhne, Nina; Stalla, Günter K; Sievers, Caroline
Sexual orientation is usually considered to be determined in early life and stable in the course of adulthood. In contrast, some transgender individuals report a change in sexual orientation. A common reason for this phenomenon is not known. We included 115 transsexual persons (70 male-to-female "MtF" and 45 female-to-male "FtM") patients from our endocrine outpatient clinic, who completed a questionnaire, retrospectively evaluating the history of their gender transition phase. The questionnaire focused on sexual orientation and recalled time points of changes in sexual orientation in the context of transition. Participants were further asked to provide a personal concept for a potential change in sexual orientation. In total, 32.9% (n = 23) MtF reported a change in sexual orientation in contrast to 22.2% (n = 10) FtM transsexual persons (p = 0.132). Out of these patients, 39.1% (MtF) and 60% (FtM) reported a change in sexual orientation before having undergone any sex reassignment surgery. FtM that had initially been sexually oriented towards males ( = androphilic), were significantly more likely to report on a change in sexual orientation than gynephilic, analloerotic or bisexual FtM (p = 0.012). Similarly, gynephilic MtF reported a change in sexual orientation more frequently than androphilic, analloerotic or bisexual MtF transsexual persons (p =0.05). In line with earlier reports, we reveal that a change in self-reported sexual orientation is frequent and does not solely occur in the context of particular transition events. Transsexual persons that are attracted by individuals of the opposite biological sex are more likely to change sexual orientation. Qualitative reports suggest that the individual's biography, autogynephilic and autoandrophilic sexual arousal, confusion before and after transitioning, social and self-acceptance, as well as concept of sexual orientation itself may explain this phenomenon.
Simonsen, Rikke Kildevæld; Hald, Gert Martin; Kristensen, Ellids; Giraldi, Annamaria
Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgically reassigned transsexual individuals in Denmark. To investigate somatic morbidity before and after SRS and cause of death and its relation to somatic morbidity after SRS in Danish individuals who underwent SRS from 1978 through 2010. Somatic morbidity and mortality in 104 sex-reassigned individuals were identified retrospectively by data from the Danish National Health Register and the Cause of Death Register. Somatic morbidity and cause of death. Overall, 19.2% of the sample were registered with somatic morbidity before SRS and 23.1% after SRS (P = not significant). In total, 8.6% had somatic morbidity before and after SRS. The most common diagnostic category was cardiovascular disease, affecting 18 individuals, 9 before and 14 after SRS, and 5 of those 14 who were affected after SRS had cardiovascular disease before and after SRS. Ten individuals died after SRS at an average age of 53.5 ± 7.9 years (male to female) and 53.5 ± 7.3 years (female to male). Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality. Copyright © 2016. Published by Elsevier Inc.
Lawrence, Anne A
Based on studies of heterosexual male fetishists, transvestites, and transsexuals, Blanchard (1991) proposed the existence of a hitherto unrecognized paraphilic dimension, erotic target location errors (ETLEs), involving the erroneous location of erotic targets in the environment. ETLEs can involve preferential attention to a peripheral or inessential part of an erotic target, manifesting as fetishism, or mislocation of an erotic target in one's own body, manifesting as the desire to impersonate or become a facsimile of the erotic target (e.g., transvestism or transsexualism). Despite its potential clinical and heuristic value, the concept that ETLEs define a paraphilic dimension is underappreciated. This review summarizes the studies leading to the concept of ETLEs and describes how ETLEs are believed to manifest in men whose preferred erotic targets are women, children, men, amputees, plush animals, and real animals. This review also describes ETLEs in women; discusses possible etiologies of ETLEs; considers the implications of the ETLE concept for psychoanalytic theories of transvestism and male-to-female transsexualism, as well as for the forthcoming revision of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; suggests reasons why the concept of ETLEs has been underappreciated; and describes what might result if the concept were more widely appreciated.
Baltieri, Danilo Antonio; De Andrade, Arthur Guerra
According to the Brazilian Federal Medical Association, transsexualism is recognized as a gender identity disorder if a long-term diagnostic therapeutic process has demonstrated that the transposition of gender roles is irreversible, and if only hormonal and surgical procedures are appropriate to relieve the stress associated with the gender identity. Although such treatment will only be initiated with caution and after a long phase of intense diagnostic screening, the differentiation between pure identity disorders and transsexual feelings secondary to an ongoing psychopathologic process, such as schizophrenia, can be arduous for many health professionals. To report a case of a female patient with schizophrenia and transsexualism and the risks of a potential diagnostic confusion. A 19-year-old black woman, with an 8-year history of undifferentiated schizophrenia and intense gender dysphoria, was referred for sex reassignment surgery evaluation in the Ambulatory for the Treatment of Sexual Disorders of the ABC Medical School. After a more adequate antipsychotic treatment, her masculine behavior has persisted, but her desire to change her own genital organs has decreased. A better acceptance of the multiplicity of possible genders should neither contribute to inadequate interpretations of the signs and symptoms of our patients nor facilitate dangerous clinical or surgical recommendations.
Gooren, Louis J
Hormonal treatment of transgender people is becoming a normal part of medicine, though numbers of subjects remain small because of low prevalence. Information on treatment is scattered and this review brings together the latest information on treatment goals and potential side-effects of androgen treatment of female-to-male transsexual subjects. Androgen treatment of female-to-male transsexuals is usually uneventful, with a good patient compliance. Goals of hormonal treatment are elimination of secondary sex characteristics of the female sex and induction of those of the male sex. Completion takes approximately 2 years. Hormonal treatment is eventually followed by surgical ablation of breasts and removal of uterus and ovaries. Phalloplasty may be considered. Concerns are the sequelae of hypogonadism following surgery, such as loss of bone mass. Contrary to earlier expectations, there is no increase in cardiovascular disease. (Hormone-related) cancers are rare, but vaginal, cervical, endometrial carcinomas have been reported. Cancers of the breasts are of greater concern and have been found in residual mammary tissue after breast ablation. So far, androgen treatment has not raised major safety concerns. Regrets about changing sex have not been reported. Testosterone treatment of female-to-male transsexuals is effective and well tolerated.
Full Text Available This paper discusses transsexualism and intersexuality as two phenomena that challenge dimorphic conceptions of body anatomy and binary conceptions of sex and gender. In this defiance of the medical and social norm, transsexual and intersexual subjects build a place of resistance, suggesting, through self-designation, the concept of a new transgender subject. And finally, I will point out some ethical issues related to the medical treatments of sex assignment of intersexuals and sex reassignment of transsexuals, concerning the autonomy and dignity of these transgender subjects.
En este artículo se analiza la transexualidad y la intersexualidad como dos fenómenos que desafían las concepciones dimórficas de la anatomía corporal, así como las concepciones binarias del sexo y del género. En este desafío de la norma cultural y médica, los sujetos transexuales e intersexuales construyen un lugar de resistencia, proponiendo, en un movimiento de autodesignación, la concepción de un nuevo sujeto transgenérico. Por último, se reseñan algunas cuestiones éticas vinculadas a los tratamientos médicos de la asignación de sexo a los intersexuales y a la reasignación de los transexuales, relativas a la autonomía y dignidad de estos sujetos transgenéricos.
Full Text Available We presented a study of the features of gender identity in people undergoing gender, psychological and psychiatric examination to address the issue of gender reassignment. We analyze the specifics of gender identity, levels of masculinity and femininity, the similarities and differentiation within four nosological groups, which include persons with gender identity disorders (GID with transsexualism, personality disorders, diseases of the schizophrenia spectrum, and with organic mental disorders. We address the question of the differential diagnosis in the process of psychological screening of people with transsexualism and other types of GID. The analytical description of the four algorithms and their comparison are psychologically specific, qualitative research, almost impossible using statistical method of data processing. The data presented may be useful to specialists involved in the study of persons with gender identity disorders
Limites e possibilidades do exercício da autonomia nas práticas terapêuticas de modificação corporal e alteração da identidade sexual Limits and possibilities to the exercise on autonomy in therapeutic practices of physical modification and sexual identity alteration
Full Text Available As normas brasileiras condicionam o acesso às modificações corporais para alteração da identidade sexual à confirmação do diagnóstico psiquiátrico de transexualismo - transtorno de identidade de gênero ou sexual -, e o acompanhamento psiquiátrico por dois anos para sua realização. O desconforto com o sexo anatômico e o desejo de a pessoa modificar a genitália para a do sexo oposto é o principal critério definidor do diagnóstico de transexualismo. A cirurgia de transgenitalização é considerada etapa final do tratamento, e vem sendo admitida pela instância judicial como condição necessária para a alteração da identidade sexual legal. O artigo discute o conflito moral entre o sujeito transexual e as normas vigentes em relação ao exercício da autonomia individual nas práticas terapêuticas, aplicando as ferramentas da bioética, a partir da análise dos argumentos utilizados pelas instâncias de saúde e judicial sobre o tema, nos artigos, documentos e decisões judiciais nacionais. Observa-se que houve avanços no acesso aos recursos terapêuticos e legais, mas as limitações e restrições ainda impostas ao exercício da autonomia do/a transexual podem ter efeitos negativos para a saúde e os direitos daqueles não considerados pela norma vigente como "verdadeiros transexuais". Os direitos da pessoa transexual à assistência integral à saúde, inclusive sexual, e ao livre desenvolvimento de sua personalidade são infringidos no momento em que a autonomia do paciente não é adequadamente preservada pelas normas vigentes, convertendo-se os direitos humanos num tipo de dever de a pessoa adequar-se à moralidade sexual dominante.According to current Brazilian health authority policies, one's access to physical modifications to have his/her sexual identity altered is dependent upon an established psychiatric diagnosis of transsexualism - gender or sexual identity disorder - in addition to two years of psychiatric
short-term exposures to certain disruptive chemicals may have occurred only ... Persistent effects of short-term .... performance on visual memory, verbal memory, divided ..... A study of short-term and long-term hormone effects in transsexuals.
Hess, J; Kurth, I; Henkel, A; Panic, L; Rübben, H; Rossi Neto, R; Hess-Busch, Y
Gender reassignment surgery (GRS) can lead to discrimination. This transition makes great demands on the individual and also affects the social environment. To evaluate the social support of male-to-female (MtF) transgender people. Group A comprised 254 consecutive MtF transsexuals, who received a penile inversion vaginoplasty between 2004 and 2010. These women were surveyed retrospectively. Group B comprised 144 consecutive MtF transsexuals who presented for preoperative counselling. These patients were asked to answer the survey in advance of the planned GRS. The return rate was 46.9 % (A) and 95.1 % (B). In both groups, approximately two-thirds lived with their parents or children at ease. About 13.4 % (A) and 16.9 % (B) estimated the relationship towards their parents and one- seventh (A) or one-sixth (B) woman rated their relationship towards their children as poor. The acceptance of the parents regarding GRS was 65.6 % (A) and 77.1 % (B). In total 20 % (A) and 9.2 % (B) did not, however, accept GRS in their children. The acceptance of children regarding GRS was 64.9 % (A) and 71.1 % (B) with 10.8 % (A) and 6.7 % (B) who did not approve the decision. Social support is an important resource in the context of gender reassignment surgery. Understanding can help to improve the situation for transsexuals and to reduce consecutive healthcare utilisation.
Psychopatho- logy In Men: A Psychodynar,.ic Analysis Of I!omosexuality, Trans- sexualismt, Plnd Transvestism ." JOURNAL OF THE AMERICAN ACADEMY OF...identity and sexual behavior are markedly aberrant; homosexuality, transsexualism, and transvestism . For each disorder a psychodynamic analysis of the
Maganto Pavón, Emilio
closing her vagina and placed a device to simulate she was a male. At the end, after the opinion of the counter experts of the Inquisition Francisco Diaz had to retract, confirmed that the accused was a female, and accused her of witchcraft to save his responsibility. Nevertheless, in the work we conclude that the accused was a male transsexual, which, in part, would excuse the urologist's error 400 years later.
Bishop, Bryan M
Transgender and transsexual individuals have unique health care needs and risks compared with the population at large. It is estimated that 1 in 100,000 individuals in the United States is a transgender woman and 1 in 400,000 is a transgender man, although these estimates of prevalence are likely conservative. Transgender individuals are at an increased risk of tobacco, alcohol, and substance abuse; they have an increased lifetime suicide attempt risk; and they are more likely to experience significant stressors in their lives. Transgender patients may elect to transition their appearance to the gender with which they identify. Hormone treatment (and possibly sex reassignment surgery) is a significant part of this transition, and pharmacists must understand the pharmacotherapeutic principles involved so they can better recommend therapeutic agents, provide dosing recommendations, and anticipate and manage adverse effects. It is critical to be culturally sensitive when providing care for transgender patients including using their preferred gender identity, preferred names, and preferred pronouns. It is also essential to be able to identify transgender and transsexual patients correctly within electronic health records to ensure that appropriate care and monitoring are provided. For pharmacists, this means they should know the biologic sex for performing calculations such as creatinine clearance and to prevent teratogenic agents from reaching a transgender or transsexual man who could be pregnant or is capable of becoming pregnant. Promoting knowledge of transgender health issues will enable pharmacists to provide better, more holistic care to their transgender patients. © 2015 Pharmacotherapy Publications, Inc.
van der Pijl, I.H.; Oude Breuil, B.C.M.; Swetzer, Lene; Drymioti, M.; Goderie, M.J.H.
Although the Netherlands is renowned for its forerunner position in lesbian, gay, bisexual, transgender/transsexual, and intersex (LGBTI) rights, this study urges one to question whether it can still live up to that image. Reports, news items, and signals from non-governmental organizations, such as
Hahn, Andreas; Kranz, Georg S.; Küblböck, Martin; Kaufmann, Ulrike; Ganger, Sebastian; Hummer, Allan; Seiger, Rene; Spies, Marie; Winkler, Dietmar; Kasper, Siegfried; Windischberger, Christian; Swaab, Dick F.; Lanzenberger, Rupert
Although previous investigations of transsexual people have focused on regional brain alterations, evaluations on a network level, especially those structural in nature, are largely missing. Therefore, we investigated the structural connectome of 23 female-to-male (FtM) and 21 male-to-female (MtF)
Cerwenka, S.; Nieder, T.O.; Cohen-Kettenis, P.T.; De Cuypere, G.; Haraldsen, I.R.H.; Kreukels, B.P.C.; Richter-Appelt, H.
A transsexual course of development that starts before puberty (early onset) or during or after puberty, respectively (late onset), may lead to diverse challenges in coping with sexual activity. The authors explored the sexual behavior of 380 adult male-to-female and female-to-male individuals
Fredman, Amy J.; Schultz, Nicole J.; Hoffman, Mary F.
Scholars have become more attentive to lesbian/gay/bisexual/transsexual/queer/questioning (LGBTQ) topics as queer perspectives become increasingly prevalent in middle and high school environments. This study examines how educators navigate social and academic environments in order to incorporate inclusive pedagogical practices and cultivate safe…
Rekers, George A.; Lovaas, O. Ivar
This study demonstrated reinforcement control over pronounced feminine behaviors in a male child. The clinical history of S paralleled the retrospective reports of adult transsexuals, including (a) cross-gender clothing preferences, (b) actual or imaginal use of cosmetic articles, (c) feminine behavior mannerisms, (d) aversion to masculine…
Kreukels, B.P.C.; Cohen-Kettenis, P.T.
The use of gonadotropin-releasing hormone analogs (GnRHa) to suppress puberty in adolescents with gender dysphoria is a fairly new intervention in the field of gender identity disorders or transsexualism. GnRHa are used to give adolescents time to make balanced decisions on any further treatment
de Vries, A.L.C.; Steensma, T.D.; Doreleijers, T.A.H.; Cohen-Kettenis, P.T.
Introduction. Puberty suppression by means of gonadotropin-releasing hormone analogues (GnRHa) is used for young transsexuals between 12 and 16 years of age. The purpose of this intervention is to relieve the suffering caused by the development of secondary sex characteristics and to provide time to
Holst, Nicolaj Sivan; Henricson, Ib Lennart
The chapter explains the legal framework concerning transgender and transsexual persons in Denmark, statistics, the procedures and requirements for changing legal sex and/or gender, the legal consequences of the changes as regards rights and duties of the person, and the legal challenges of the r...
Davies, Michelle; Hudson, Jenefer
There has been an increasing amount of research interest into perceptions of male rape in recent years. However, no research has assessed how people react when a transgendered person is raped. The aim of this study was to investigate the effects of transgendered status and sexuality on victim blame and perceived severity in a depicted rape scenario. The sexuality of the victim was manipulated to include a heterosexual, homosexual, cross-dresser, female-to-male transsexual, and male-to-female transsexual. It was predicted that the heterosexual victims would be judged the most positively and that heterosexual male participants would make the most anti-victim judgments. One hundred thirty-three lesbian, gay male, and heterosexual members of the general population read a scenario depicting a rape and then completed a questionnaire measuring victim blame and perceived severity of the assault. Results conformed to the predictions. Results are discussed in relation to traditional gender roles and homophobia.
Brown, G R
Gender dysphoric patients are not infrequently encountered in the clinical practice of psychiatry. A comprehensive review of the world literature reveals that the systematic study of severe gender disorders--as exemplified by transsexualism--is relatively new, consisting of just over 25 years of collective experience. While the formal diagnosis of transsexualism is rare, this disorder represents the most severe form of the gender dysphoric conditions. Many nontranssexual patients with a variety of other psychiatric disorders present to psychiatrists desperately requesting somatic treatments (cross-gender hormones, sex reassignment surgery, and other cosmetic surgical procedures). A lengthy differential diagnosis needs to be considered, and a specialized approach to interviewing gender dysphoric patients is highly recommended. Available treatments and their efficacy are discussed. Large prospective controlled studies of treatments for gender dysphoria, such as sex reassignment surgery and psychotherapy, are lacking. Countertransference issues are noted to be particularly relevant in the care of gender dysphoric individuals.
HIV-related needs for safety among male-to-female transsexuals (mak nyah) in Malaysia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT ... Gender differences in university students\\' HIV/AIDS-related knowledge and sexual behaviours in Malawi: a pilot study · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT
Hofer, SOP; Damen, A; Nicolai, JPA
This report concerns a 26-year-old male-to-female transsexual who had received a large volume liquid silicone injection of unknown grade into her upper lateral thighs to gain female contour. She presented at our outpatient clinic 4 years after the silicone injection with complaints of pain and
Most attempts to identify biological underpinnings of gender identity and sexual orientation in humans have investigated effects of sex steroids, so pivotal in the differentiation of the genitalia, showing strong parallels between animals and the human. The information on humans is derived from the so-called 'experiments of nature', clinical entities with a lesser-than-normal androgen exposure in XY subjects and a higher than normal androgen exposure in XX subjects. Prenatal androgenization appears to predispose to a male gender identity development, but apparently not decisively since 40-50% of 46,XY intersexed children with a history of prenatal androgen exposure do not develop a male gender identity. Obviously, male-to-female transsexuals, with a normal androgen exposure prenatally (there is no serious evidence to the contrary) develop a female gender identity, through unknown biological mechanisms apparently overriding the effects of prenatal androgens. The latest studies in 46, XX subjects exposed to prenatal androgens show that prenatal androgenization of 46,XX fetuses leads to marked masculinization of later gender-related behavior but does not lead to gender confusion/dysphoria. The example of female-to-male transsexuals, without evidence of prenatal androgen exposure, indicates that a male gender identity can develop without a significant androgen stimulus. So we are far away from any comprehensive understanding of hormonal imprinting on gender identity formation. Brain studies in homosexuals have not held up in replication studies or are in need of replication in transsexuals. Genetic studies and the fraternal birth order hypothesis provide indications of familial clustering of homosexuality but in many homosexuals these genetic patterns cannot be identified. The biological explanations advanced for the birth order hypothesis lack any experimental support.
'versatile', i.e., that the individuals take turns to be the dominant or passive partner. Herein lies a domestic construct where tasks and responsibilities are also often shared equitably and equally. But less well understood, are the gender minorities – that is, transsexuals and transgender persons, whose relationships are even ...
Goozen, S.H.M.; Frijda, N.H.; van de Poll, N.E.
Conducted a role-playing study on anger to identify the influence of sex hormones on individual and gender differences in irritation, anger arousal, and aggression. 10 female-to-male (FMTs; mean age 27 yrs) and 6 male-to-female transsexuals (MFTs; mean age 29 yrs) were studied after 3 mo of
Bickford, John H., III
This content analysis research examined how lesbian, gay, bisexual, transsexual, transgender, and queer (LGBTQ) individuals and issues are represented in elementary-level trade books. The data pool included every LGBTQ-based trade book with intended audiences of primary (grades K-2) and intermediate (grades 3-5) elementary students. Trade books…
Baker, Jean M.
This book examines the challenges facing gay, lesbian, bisexual, and transsexual youth, suggesting ways to bring about significant and positive differences in homes, schools, and communities. It presents the experiences of such children, in their own words, as they gradually discover they are different from most other children in their sexual…
Becking, Alfred G.; Tuinzing, D. Bram; Hage, J. Joris; Gooren, Louis J. G.
In transsexualism, there is a strong and ongoing cross-gender identification, and a desire to live and be accepted as a member of the opposite gender; thus there is a wish for somatic treatment to make one's body as congruent as possible with gender identity. Makeup and change in hairstyle and
Although instances of unreliability occur in the two novels, Sibiya has enriched isiZulu literature with these two novels; this is mainly due to his ability to write narrative prose that captivates the reader. He has also captivated the reader with the novel topic of homosexuality and transsexuality in Bengithi lizokuna.
Bhargava, Subhash C.; Sethi, Sujata
Delusion of sex change is not uncommon as a pan] of the schizophrenic illness. But the coexistence of gender identity disorder (GID) and schizophrenia is rare and show differential response to treatment with antipsychotics.
Leung, Yeptain; Oates, Jennifer; Chan, Siew Pang
Purpose: The aim of this study was to provide a systematic review of the aspects of verbal communication contributing to listener perceptions of speaker gender with a view to providing clinicians with guidance for the selection of the training goals when working with transsexual individuals. Method: Preferred reporting items for systematic review…
Janošová, Pavlína; Říčan, Pavel
Roč. 49, č. 6 (2005), s. 579-589 ISSN 0009-062X R&D Projects: GA AV ČR(CZ) IAA700250502 Institutional research plan: CEZ:AV0Z70250504 Keywords : gender * manhood * womanhood * homosexuality * transsexuality * gender identity disorder (GID) * intersexuality Subject RIV: AN - Psychology Impact factor: 0.241, year: 2005
Budge, Stephanie L.
Given the extensiveness of rejection and discrimination that transgender individuals experience (Lombardi, Wilchins, Priesing, & Malouf, 2001), the purpose of the current study was to examine the process of coping and how this relates to well-being at different stages of the gender transition. A total of 357 transsexual individuals (n = 226…
White, Geoffry D.
A course option in abnormal psychology involves students in interviewing and observing the activities of individuals in the off-campus community who are concerned with some aspect of abnormal psychology. The technique generates student interest in the field when they interview people about topics such as drug abuse, transsexualism, and abuse of…
Grissett, Judy Orton; Kaufmann, Jodi; Greenberg, Daphne; Hilton, Krista
Although prior research has indicated a relationship between educational climate and educational outcomes, there is a lack of research in this area in adult literacy programs. The purpose of this qualitative case study was to assess the actual and perceived educational climate for lesbian, gay, bisexual, and transsexual (LGBT) students at an adult…
Korte, Alexander; Lehmkuhl, Ulrike; Goecker, David; Beier, Klaus Michael; Krude, Heiko; Grüters-Kieslich, Annette
Gender identity disorders (GID) can appear even in early infancy with a variable degree of severity. Their prevalence in childhood and adolescence is below 1%. GID are often associated with emotional and behavioral problems as well as a high rate of psychiatric comorbidity. Their clinical course is highly variable. There is controversy at present over theoretical explanations of the causes of GID and over treatment approaches, particularly with respect to early hormonal intervention strategies. This review is based on a selective Medline literature search, existing national and international guidelines, and the results of a discussion among experts from multiple relevant disciplines. As there have been no large studies to date on the course of GID, and, in particular, no studies focusing on causal factors for GID, the evidence level for the various etiological models that have been proposed is generally low. Most models of these disorders assume that they result from a complex biopsychosocial interaction. Only 2.5% to 20% of all cases of GID in childhood and adolescence are the initial manifestation of irreversible transsexualism. The current state of research on this subject does not allow any valid diagnostic parameters to be identified with which one could reliably predict whether the manifestations of GID will persist, i.e., whether transsexualism will develop with certainty or, at least, a high degree of probability. The types of modulating influences that are known from the fields of developmental psychology and family dynamics have therapeutic implications for GID. As children with GID only rarely go on to have permanent transsexualism, irreversible physical interventions are clearly not indicated until after the individual's psychosexual development ist complete. The identity-creating experiences of this phase of development should not be restricted by the use of LHRH analogues that prevent puberty.
Selvaggi, Gennaro; Bellringer, James
Gender reassignment (which includes psychotherapy, hormonal therapy and surgery) has been demonstrated as the most effective treatment for patients affected by gender dysphoria (or gender identity disorder), in which patients do not recognize their gender (sexual identity) as matching their genetic and sexual characteristics. Gender reassignment surgery is a series of complex surgical procedures (genital and nongenital) performed for the treatment of gender dysphoria. Genital procedures performed for gender dysphoria, such as vaginoplasty, clitorolabioplasty, penectomy and orchidectomy in male-to-female transsexuals, and penile and scrotal reconstruction in female-to-male transsexuals, are the core procedures in gender reassignment surgery. Nongenital procedures, such as breast enlargement, mastectomy, facial feminization surgery, voice surgery, and other masculinization and feminization procedures complete the surgical treatment available. The World Professional Association for Transgender Health currently publishes and reviews guidelines and standards of care for patients affected by gender dysphoria, such as eligibility criteria for surgery. This article presents an overview of the genital and nongenital procedures available for both male-to-female and female-to-male gender reassignment.
The legal process of gender transition in Hungary had previously been more developed as in most European countries, as the law enabled transsexual people to change their name and gender before or without a medical treatment, which was unique at the time. Over the years, however, lots of European countries developed legal frameworks and accepted international standards of care for the treatment of gender dysphoria that Hungary did not follow. Currently in Hungary there is no consistent legal framework of gender transition, there is no official regulation or guidelines regarding gender transition process, no institution with the obligation to accommodate the process, and there is no nominated specialist in the state health care system whose remit included dealing with transsexual patients. The information on gender transition options both to the professionals and to the patients is limited and incoherent. This paper reviews the legal aspects and clinical management process of gender dysphoria in Hungary. Some issues regarding the Hungarian practice and possible solutions based on examples from the United Kingdom are addressed within the paper.
Chloe Rutter- Jensen
Full Text Available Catalina de Erauso's story, La historia de la monja alférez escrita por ella misma / Catalina de Erauso recounts her adventures as a man, her later confession of being a woman and virgin, her pension from the king, and even the Pope's legitimization of her dressing as a man. The author examines this text in terms of its contribution and resistance to the construction of gender in Spain and the Spanish American colonies in the early 17th century. The transatlantic voyages open a space in which the figure of Catalina de Erauso transits from one gender category to another. With an emphasis on the prefix 'trans', reading the text through the lens of the 'transsexual' narrative creates new borders and limits, and accentuates the text as a site of struggle over gender identity. The 'transsexual' narrative can help us see the text not only as a site of transition and combination of social categories, but also for interrupting the binary structure of sex and gender that appears so natural today.
Transsexuality in Iran has gained much attention and media coverage in the past few years, particularly in its questionable depiction as a permitted loophole for homosexuality, which is prohibited under Iran's Islamic-inspired legal system. Of course, attention in the West is also encouraged by the “shock” that sex change is available in Iran, a country that Western media and society delights in portraying as monolithically repressive. As a result, Iranian filmmakers inevitably have their own agendas, which are unsurprisingly brought into the film making process—from a desire to sell a product that will appeal to the Western market, to films that endorse specific socio-political agendas. This paper is an attempt to situate sex change and representations of sex change in Iran within a wider theoretical framework than the frequently reiterated conflation with homosexuality, and to open and engage with a wider debate concerning transsexuality in Iran, as well as to specifically analyze the representation of transexuality, in view of its current prominent presence in media.
Reeser, J C
This review examines gender identity issues in competitive sports, focusing on the evolution of policies relating to female gender verification and transsexual participation in sport. The issues are complex and continue to challenge sport governing bodies, including the International Olympic Committee, as they strive to provide a safe environment in which female athletes may compete fairly and equitably.
This article begins from imagining what it would be like to target recruitment for teachers at lesbian, gay, bisexual, transsexual (LGBT) people, and then examines in some detail two kinds of discrimination (or pathology) which makes life in the world of education problematic. It then turns to why, in spite of these difficulties, lesbian and gay…
Cohen-Kettenis, P.T.; Delemarre-van d Waal, H.A.; Gooren, L.J.G.
Introduction. Treatment of individuals with gender identity disorder (GID) has in medicine nearly always met with a great deal of skepticism. Professionals largely follow the Standards of Care of the World Professional Association for Transgender Health. For adolescents, specific guidelines have
As many gender teachers know, distinctions between and among complex terms in the lesbian, gay, bisexual, trans (gender or sexual), queer (LGBTQ) group are often difficult for students to articulate and identify. In fact, terms like "sex" and "gender" are often conflated in public discourse, and terms like…
Dina Bisara Lolong
Full Text Available Abstract. Although Indonesia's HIV epidemic was classified as low epidemic in general, however since2000 in some high risk groups population classified as concentrated such asFSW (Female Sex Workers,IDUs (Injecting Drug Users and transsexual, HIV prevalence tend to increase. While in Papua and WestPapua (Tanah Papua,the increase of the disease is growing further that have been reaching generalizedclassification namely 2.41% (>1%. This article examines the behaviour on usingcomdom amongcommunity in Tanah Papua and among risk groups namely FSW (Female Sex Workers, FSW clients,transsexual, Gay, Male Sex Workers and IDUs in Indonesia. The data were obtained from communitybased of the Integrated Behavioral and Biological Surveillance Survey(IBBS 2006 in 10 districts in Tanah Papua.The other data were obtained from Behavioral Surveillance Survey (BSS 2004-2005 ofFSW and FSW clients in 14 provinces, transsexual in four districts, Gay and Male Sex Workers in three districts andIDUs in five cities. This survey reveals that knowledge of three programmatically important ways toprevent from HIV transmission ABC: abstinent, being faithful and using condom is still concern. Theyoungest and the oldest ages know less the three ways to preventing from HIV transmission. It is verycorcern that always using condoms among risk groups when they commit commercial sexual activity werevery low, ranging from 3% to 56% for sex workers and their clients, 17% for IDUs. While amongcommunity in Tanah Papua ranging from 2% (highland to 35% (easy land when they commit the lastsexual activity with payment. Findings also show that the use in condoms is affected by condomavailability and frequency in suggesting condom use among sex workres. Therefore it is needed to maintainthe continuity of campaign on 100% condom use and provide condoms in work places of commercial sexworkers and also in all areas in Tanah Papua.
Xu Boqun; Dai Xiaonan; Cui YuGui; Gao Lingling; Dai Xue; Chao Gao; Diao Feiyang; Liu Jiayin; Li Gao; Mei Li; Yuan Zhang; Xiang Ma
Background. We previously found that expression of SET gene was up-regulated in polycystic ovaries by using microarray. It suggested that SET may be an attractive candidate regulator involved in the pathophysiology of polycystic ovary syndrome (PCOS). In this study, expression and cellular localization of SET protein were investigated in human polycystic and normal ovaries. Method. Ovarian tissues, six normal ovaries and six polycystic ovaries, were collected during transsexual operation and ...
Oliveira Júnior,Eudes Quintino de; Oliveira,Pedro Bellentani Quintino de
Research on human beings has expanded greatly due to progress and the evolution of society as well as customs. Not only the unceasing development of research on human beings, but also interference in the beginning and end of life with homologous and heterogonous human reproduction, surrogate motherhood, cloning, gene therapies, eugenics, euthanasia, dysthanasia, orthothanasia, assisted suicide, genetic engineering, reassignment surgery in cases of transsexuality, the use of recombinant DNA te...
Dhabuwala, C.B.; Ramakrishna, C.V.; Anderson, G.F.
Beta adrenergic receptor binding was performed with /sup 125/I iodocyanopindolol on human cavernous tissue membrane fractions from normal tissue and transsexual procedures obtained postoperatively, as well as from postmortem sources. Isotherm binding studies on normal fresh tissues indicated that the receptor density was 9.1 fmoles/mg. with a KD of 23 pM. Tissue stored at room temperature for 4 to 6 hours, then at 4C in saline solution for 19 to 20 hours before freezing showed no significant changes in receptor density or affinity, and provided evidence for the stability of postmortem tissue obtained within the same time period. Beta receptor density of 2 cavernous preparations from transsexual procedures was not significantly different from normal control tissues, and showed that high concentrations of estrogen received by these patients had no effect on beta adrenergic receptor density. Displacement of /sup 125/iodocyanopindolol by 5 beta adrenergic agents demonstrated that 1-propranolol had the greatest affinity followed by ICI 118,551, zinterol, metoprolol and practolol. When the results of these displacement studies were subjected to Scatfit, non- linear regression line analysis, a single binding site was described. Based on the relative potency of the selective beta adrenergic agents it appears that these receptors were of the beta 2 subtype.
Miyajima, Eiichi; Taira, Naoki; Koda, Munenaga; Kondo, Tsuyoshi
The present study aimed to investigate differences in personality traits among male-to-female (MtF), female-to-male (FtM) gender identity disorder (GID) subjects and non-transsexual male (M) and female (F) controls. Subjects were 72 MtF and 187 FtM GID subjects without psychiatric comorbidities together with 184 male and 159 female non-transsexual controls. Personality traits were assessed using a short version of the Temperament and Character Inventory (TCI-125). Group comparisons were made by two-way ANOVA. Statistical significances were observed as follows: 1) lower novelty seeking in FtM than in M or MtF, 2) higher reward dependence in FtM than in M, 3) higher cooperativeness in FtM than in M or MtF, 4) the highest self-transcendence in MtF among all the groups. The highest self-transcendence in MtF subjects may reflect their vulnerable identity and constrained adaptation to society as the minority. Nevertheless, higher reward dependence and cooperativeness in FtM subjects can be related to more determined motivation for the treatments of GID and might promise better social functioning and adjustment than MtF subjects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Saleem, Fatima; Rizvi, Syed W
Transgender or gender dysphoria has been defined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), as distress resulting from the incongruence between one's experienced gender and one's assigned gender, along with a persistent and strong desire to be of another gender, and accompanied by clinically significant distress. Adolescents referred for evaluation often want hormonal therapy and several among them also express a desire for gender reassignment surgery. Furthermore, evidence shows that adolescents and adults with gender dysphoria without a sex development disorder, before gender reassignments, are at increased risk for suicide. For this review, a search of the English language scientific literature was conducted using the PubMed database. This summary discusses the associations and comorbidities of gender dysphoria and reiterates the evidence that its etiology is multifactorial. Transsexualism involves prenatal neuroanatomical changes, has a psychiatric association, and is found to be more prevalent in conjunction with schizophrenia and autism spectrum disorders. Childhood adversities and neglect are also linked to having a transgender identity. Moreover, the evidence favors a genetic predisposition. Likewise, there seems to be a growing concern with regards to the relationship between endocrine disruptors and transsexuals as well as other gender minority populations. More research needs to be done to understand the exact pathways.
高橋,義雄; 難波,祐三郎; 岸本,晃司; 光嶋,勲
GENDER IDENTITY DISORDER (GID) is a unique human condition that is classified behaviorally and treated medically with hormones and surgery in the severe form. This condition has been and still somewhat remains controversial by religious belief, social institutions and health care delivery systems. We described the surgical management of transsexuals, so called SEX REASSGINMENT SURGERY (SRS) and showed the team for gender treatment, GENDER CLINIC. A gender treatment team composing staff member...
M. S. Bhatia; Priyanka Gautam
Gender identity disorder (GID) and homosexuality are complex entities debated over decades, whether should be categorized as a disorder or not. There are a number of problems specifically related to the criteria of the GID diagnosis like differences in the terms trans-sexualism and GID, failure of the proposed criteria in conceptualizing the whole spectrum of gender variance phenomena, the potential risk of physically invasive examinations to rule out intersex conditions and the application o...
Caproni Neto, Henrique Luiz
Full Text Available This teaching case deals with Luciana experience, a travestite, specifically about her transformation from a male to a female identity and effects to world of work and organizations. Theoretical support is related to stigma about gender subject, to sexual orientation specially focusing travestites and transsexuals work experiences. It is indicate as a resource to discuss diversity management and the differences in organizations under minorities point of view in a reflexive approach.
Kaličanin Milena M.
The paper is divided into four sections. In the first section entitled 'Introducing and Defining Trans (Issues)', the basic terms of transgender, transvestite, and transsexual are defined by relying on Stryker's Transgender History (2008). The second part of the paper, 'Trans Studies: In-Between Feminist and Queer Theory?', places transgender studies into an academic context by referring to the theoretical framework provided by trans theorists Stryker, Stone, and Ranck who unanimously claim t...
This bachelor thesis deals with the transgender issue from a social worker perspective, as an assistant profession. The goal of the thesis is to provide a theoretical background for social workers, who work with transgender clients. It focuses on basic information related to classifying transgender individuals and its specifics. Most of my thesis covers the transsexuals, as the most widespread group within transgender category. The thesis shows contemporary trends in field of transgender than...
The Metamorphoses Greek myth includes a story about a woman raised as a male falling in love with another woman, and being transformed into a man prior to a wedding ceremony and staying with her. It is therefore considered that people who desire to live as though they have the opposite gender have existed since ancient times. People who express a sense of discomfort with their anatomical sex and related roles have been reported in the medical literature since the middle of the 19th century. However, homosexual, fetishism, gender identity disorder, and associated conditions were mixed together and regarded as types of sexual perversion that were considered ethically objectionable until the 1950s. The first performance of sex-reassignment surgery in 1952 attracted considerable attention, and the sexologist Harry Benjamin reported a case of 'a woman kept in the body of a man', which was called transsexualism. John William Money studied the sexual consciousness about disorders of sex development and advocated the concept of gender in 1957. Thereafter the disparity between anatomical sex and gender identity was referred to as the psychopathological condition of gender identity disorder, and this was used for its diagnostic name when it was introduced into DSM-III in 1980. However, gender identity disorder encompasses a spectrum of conditions, and DSM-III -R categorized it into three types: transsexualism, nontranssexualism, and not otherwise specified. The first two types were subsequently combined and standardized into the official diagnostic name of 'gender identity disorder' in DSM-IV. In contrast, gender identity disorder was categorized into four groups (including transsexualism and dual-role transvestism) in ICD-10. A draft proposal of DSM-5 has been submitted, in which the diagnostic name of gender identity disorder has been changed to gender dysphoria. Also, it refers to 'assigned gender' rather than to 'sex', and includes disorders of sexual development
Auer, M.; Fuss, J.; Höhne, N.; Stalla, G.; Sievers, C.
Objective Sexual orientation is usually considered to be determined in early life and stable in the course of adulthood. In contrast, some transgender individuals report a change in sexual orientation. A common reason for this phenomenon is not known. Methods We included 115 transsexual persons (70 male-to-female “MtF” and 45 female-to-male “FtM”) patients from our endocrine outpatient clinic, who completed a questionnaire, retrospectively evaluating the history of their gender transition pha...
Cohen-Kettenis, P.T.; Pfafflin, F.
Apart from some general issues related to the Gender Identity Disorder (GID) diagnosis, such as whether it should stay in the DSM-V or not, a number of problems specifically relate to the current criteria of the GID diagnosis for adolescents and adults. These problems concern the confusion caused by similarities and differences of the terms transsexualism and GID, the inability of the current criteria to capture the whole spectrum of gender variance phenomena, the potential risk of unnecessar...
Caravaca-Morera, Jaime Alonso; Padilha, Maria Itayra
Abstract OBJECTIVE To analyze the social representations of the body among Brazilian and Costa Rican transsexual people through their life stories. METHOD Qualitative and descriptive multicenter research. The study population consisted of 70 participants. Two organizations cooperated to collect the information, one in Florianópolis, SC-Brazil and one in San José, the capital of Costa Rica. Content Analysis was used to analyze the data. RESULTS Based on the results, a single social represen...
Full Text Available The purpose of this study is to investigate anti-EU and anti- LGBT attitudes in Poland on the basis of quantitative evidence (statistical data and qualitative evidence (discourse analysis of statements expressed on the Internet. As Euroscepticism seems to frequently appear in conjunction with prejudice against LGBT (lesbian, gay, bisexual and transsexual or transgender persons, the task of this article is to find out whether they may have a common foundation and what it may be.
Transitar para onde?: monstruosidade, (despatologização, (insegurança social e identidades transgêneras Transit to where?: monstrosity, (despathologization, social insecurity and transgender identities
Jorge Leite Junior
Full Text Available O objetivo deste artigo é discutir a categoria "monstro" e sua íntima relação com a patologização e/ou criminalização de determinadas pessoas vistas como 'desviantes sexuais', em especial travestis, transexuais e intersexuais. No início do século XXI, com o questionamento da autoridade médica, a politização dos movimentos sociais de travestis e transexuais e a batalha por sua despatologização, para onde se encaminham os "transtornos" de sexo ou gênero, as "parafilias" e as "perversões" com toda a persistente estigmatização a elas referidas? Voltarão a ser redimensionadas como algo potencialmente perigoso através da cada vez mais abrangente cultura da segurança?The aim of this paper is to discuss the category of "monster" and its close relation with the pathologization and criminalization of people seen as "sexual deviants", especially transvestites, transsexuals and intersex. At the beginning of the XXI century, with the questioning of medical authority, the politicization of the social movements of transvestites and transsexuals and their battle for despathologization, where to direct the "disorders" of sex or gender, "paraphilias'" and "perversions" with all the persistent stigma attached to them? Will they be understood again as potentially dangerous by the increasingly widespread culture of security?
Sánchez Lorenzo, Isabel; Mora Mesa, Juan José; Oviedo de Lúcas, Olga
In the clinical literature, the term gender dysphoria is used to define the perception of rejection that a person has to the fact of being male or female. In children and adolescents, gender identity dysphoria is a complex clinical entity. The result of entity is variable and uncertain, but in the end only a few will be transsexuals in adulthood. METHODOLOGY: RESULTS AND CONCLUSIONS. Copyright © 2015 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.
The objective of the article is to present as well as compare 21st century anti-homophobia campaigns in Poland, France, and Italy. The information found in the printed press was used as the research material. The author presents legal situations of the LGBT communities in the aforementioned countries and moves on to analyzing lexical and visual means used in the campaigns that attempt to persuade society that the ‘odd’ ones (mostly homosexuals, lesbians, bisexuals, and transsexuals) are deser...
Gianella-Malca, Camila; Wilson, Bruce
In a surprising turn of events, a “rainbow revolution” has blossomed in Latin America. In spite of the region’s long history of deep-rooted patriarchy, machismo, homophobia, and political and social marginalization of lesbian, gay, bisexual, and transsexual (LGBT) people, Latin America is currently home to twenty five percent of the world’s countries with same sex marriage laws. This CMI Brief examines the fight for legal equality in two Latin American countries, Costa Rica and Colombia, expl...
Using the Defensive Style Questionnaire to evaluate the impact of sex reassignment surgery on defensive mechanisms in transsexual patients Aplicação do Defensive Style Questionnaire para avaliar o impacto da cirurgia de redesignação sexual nos mecanismos de defesa de pacientes transexuais
Maria Inês Lobato
Full Text Available Objective: To evaluate the impact of sex reassignment surgery on the defense mechanisms of 32 transsexual patients at two different points in time using the Defensive Style Questionnaire. Method: The Defensive Style Questionnaire was applied to 32 patients upon their admission to the Gender Identity Disorder Program, and 12 months after they had undergone sex reassignment surgery. Results: There were changes in two defense mechanisms: anticipation and idealization. However, no significant differences were observed in terms of the mature, neurotic and immature categories. Discussion: One possible explanation for this result is the fact that the procedure does not resolve gender dysphoria, which is a core symptom in such patients. Another aspect is related to the early onset of the gender identity disorder, which determines a more regressive defensive structure in these patients. Conclusion: Sex reassignment surgery did not improve the defensive profile as measured by the Defensive Style Questionnaire.Objetivo: Avaliar o efeito da cirurgia de redesignação sexual nos mecanismos de defesa de 32 pacientes transexuais em dois momentos do estudo usando o Defensive Style Questionnaire. Método: O Defensive Style Questionnaire foi aplicado a 32 pacientes quando ingressaram no Programa de Transtorno de Identidade de Gênero e 12 meses após a cirurgia de redesignação sexual. Resultados: Houve modificações em dois mecanismos de defesa: antecipação e idealização; porém, sem mudanças significativas nos fatores maduro, neurótico e imaturo. Discussão: Uma possibilidade para esse resultado é o fato de a intervenção cirúrgica não resolver a disforia de gênero (principal sintoma desses pacientes. Outro aspecto está relacionado com o fato de o transtorno de identidade de gênero ser instalado precocemente, o que determina uma estrutura defensiva mais regressiva para esses pacientes. Conclusão: A cirurgia de redesignação sexual não foi
Chokrungvaranont, Prayuth; Tiewtranon, Preecha
Many years ago Thai society considered transsexualism (Gender identity disorder or Gender dysphoria) which is commonly known as Kathoey (a word originally used to denote hermaphrodites), Sao Prapet Song or Tut (as in 'Tootsie') were low class citizens, dirty dressing and had to hide in a dark corner selling their services as prostitutes. This made us unwilling to do sex reassignment surgery for this group of people because the idea of eradicating normal sexual organs for the purpose that was not accepted by the society. Consequently the authors have experience in cases where these people wandered seeking doctors who had no competency nor enough experience to do the surgery. The authors could not inhibit the desire of these people who usually suffer from gender identity disorder from strongly wishing to change their genital sex to the sex they want. The outcome of the surgery was not satisfactory for the patients. There were complications and sequelae which caused the authors to correct them later which might be more difficult than doing the original surgery. In addition there were more studies about the etiology and affect of the disorder on these people that changed the social point of view. The women who wanted to be a him and men who would like to be a her should be considered as patients who need to be cured to set the harmony about their genetic sex and the desire to be the opposite sex and also to be regarded by others as a member of that other sex. The treatments of transsexualism usually begin with conventional psychiatric and endocrinological treatment to adjust the mind to the body. For those who failed conservative treatment in adjusting the mind to the body then sex reassignment surgery will be the only way to transform their body to their mind and give the best result in properly selected patients. Preecha Tiewtranon, the pioneer in sex reassignment surgery in Thailand, did his transsexualism case in 1975 together with Dr. Prakob Thongpeaw. Sex
Full Text Available The article addresses the issue how various religious and legal systems cope with current developments that undermine binary opposition of man and woman including definition of their sexual and cultural identities. More concretely, it tries to explain, how concrete societies and legislations deal with claims of lesbians, gays, bisexuals, and transsexuals (LGBT that claim broader recognition. It elucidates differences among Western provisions and policies of the relevant legal bodies such as the General Assembly of the United Nations, the European Court of Human Rights and the Supreme Court concerning these issues. It also points to the nature and real impact of international civil society forces such as Yogyakarta principles that formulate extension of rights concerning lesbians, gays, bisexuals, and transsexuals. On the basis of comparison of various legal and religious discourses it explains current practices of direct and indirect discrimination and in some non-European national systems even extra-judicial killings, torture and ill-treatment, sexual assault, rape and other violations of human rights. When emphasizing substantial differences among current European states and non-European ones concerning policies toward lesbian, gay, bisexual and transgender people (LGBT, it shows current tendencies of advancement in the field by common policies of Council of Europe, recent judgments issued by the European Court of Human Rights as well as civil society efforts such as Yogyakarta principles. Swedish standards have been introduced in order to emphasize existing progressive attitudes to LGBT people concerning gay marriages and adoption procedures.
Docter, R F; Prince, V
One thousand and thirty-two male periodic cross-dressers (transvestites) responded to an anonymous survey patterned after Prince and Bentler's (1972) report. With few exceptions, the findings are closely related to the 1972 survey results. Eighty-seven percent described themselves as heterosexual. All except 17% had married and 60% were married at the time of this survey. Topics surveyed included demographic, childhood, and family variables, sexual orientation and sexual behavior, cross-gender identity, cross-gender role behavior, future plans to live entirely as a woman, and utilization of counseling or mental health services. Of the present sample, 45% reported seeking counseling compared to 24% of the 1972 survey, and those reporting strong transsexual inclinations were up by 5%. Today's transvestites strongly prefer both their masculine and feminine selves equally. A second research objective was to identify variables discriminating between so-called Nuclear (stable, periodic cross-dressers) and Marginal transvestites (more transgendered or transsexually inclined); 10 strongly discriminating parameters were found. The most important are (i) cross-gender identity, (ii) commitment to live entirely as a woman, (iii) taking steps toward body feminization, (iv) low sexual arousal to cross-dressing. Neither age nor experience as a cross-dresser were found to be correlates of cross-gender identity. Although the present generation of transvestites describe themselves much as did similar subjects 20 years ago, the percentage migrating toward full-time living as a woman is greater.
Garcia-Falgueras, Alicia; Ligtenberg, Lisette; Kruijver, Frank P M; Swaab, Dick F
The intermediate nucleus (InM) in the preoptic area of the human brain, also known as the sexually dimorphic nucleus of the preoptic area (SDN-POA) and the interstitial nucleus of the anterior hypothalamus-1 (INAH-1) is explored here. We investigated its population of galanin-immunoreactive (Gal-Ir) neurons in relation to sex, age, and gender identity in the postmortem brain of 77 subjects. First we compared the InM volume and number of Gal-Ir neurons of 22 males and 22 females in the course of aging. In a second experiment, we compared for the first time the InM volume and the total and Gal-Ir neuron number in 43 subjects with different gender identities: 14 control males (M), 11 control females (F), 10 male-to-female (MtF) transsexual people, and 5 men who were castrated because of prostate cancer (CAS). In the first experiment we found a sex difference in the younger age group ( 45 years. In the second experiment the MtF transsexual group presented an intermediate value for the total InM neuron number and volume that did not seem different in males and females. Because the CAS group did not have total neuron numbers that were different from the intact males, the change in adult circulating testosterone levels does not seem to explain the intermediate values in the MtF group. Organizational and activational hormone effects on the InM are discussed. Copyright © 2011 Wiley-Liss, Inc.
Since the beginning of the last century, clinical observers have described the propensity of certain males to be erotically aroused by the thought or image of themselves as women. Because there was no specific term to denote this phenomenon, clinicians' references to it were generally oblique or periphrastic. The closest available word was transvestism. The definition of transvestism accepted by the end of the twentieth century, however, did not just fail to capture the wide range of erotically arousing cross-gender behaviors and fantasies in which women's garments per seplay a small role or none at all; it actually directed attention away from them. The absence of an adequate terminology became acute in the writer's research on the taxonomy of gender identity disorders in biological males. This had suggested that heterosexual, asexual, and bisexual transsexuals are more similar to each other-and to transvestites-than any of them is to the homosexual type, and that the common feature in transvestites and the three types of non-homosexual transsexuals is a history of erotic arousal in association with the thought or image of themselves as women. At the same time, the writer was becoming aware of male patients who are sexually aroused only by the idea of having a woman's body and not at all by the idea of wearing women's clothes. To fill this terminological and conceptual gap, the writer introduced the term autogynephilia(love of oneself as a woman).
Rikke Kildevæld Simonsen, MA
Conclusion: Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality.
Boyd, N A
SUMMARY Lesbian and transgender histories often recuperate the same historical figures; however, many lesbian spaces (like the Michigan Womyn's Music Festival) have excluded lesbian-identified male-to-female transsexuals. Through an analysis of historical inclusion and socio-political exclusion, this essay examines the relationship between "birth bodies," gender and sexuality. It argues that the lesbian body appears in history through the naturalization of "birth-bodies" and the recuperation of cross-gender behavior. In this way, the body becomes a template for lesbian historical recuperation and an organizing principle for contemporary lesbian communities.
Carmen Camero Pérez
Full Text Available From the studies of mythocritique and mythanalyse, this article proposes a study of Mygale, Thierry Jonquet’s story, where the stereotypes of the crime novel pass in the background for the benefit of the treatment of the problem of the metamorphosis, the transsexuality and the processing of the identity. The analysis of the structural constituents of the novel: characters, narrative authorities, speech, writing and mythical transposition (Pygmalion, reveal the interest of a novel strongly anchored in the contemporary reality which does not give up for all that the ancient imagination.
Djordjevic, M L; Bizic, M; Stanojevic, D; Bumbasirevic, M; Kojovic, V; Majstorovic, M; Acimovic, M; Pandey, S; Perovic, S V
To develop a technique for urethral reconstruction using a combined labia minora flap and buccal mucosa graft. Urethral lengthening is the most difficult part in female transsexuals and poses many challenges. From April 2005 to February 2008, 38 patients (aged 19-53 years) underwent single-stage metoidioplasty. The technique starts with clitoral lengthening and straightening by division of both clitoral ligaments dorsally and the short urethral plate ventrally. The buccal mucosa graft is quilted to the ventral side of the corpora cavernosa between the native orifice and the tip of the glans. The labia minora flap is dissected from its inner surface to form the ventral aspect of the neourethra. All suture lines are covered by the well-vascularized subcutaneous tissue originating from the labia minora. The labia majora are joined in the midline and 2 silicone testicular implants are inserted to create the scrotum. The neophallus is covered with the remaining clitoral and labial skin. The median follow-up was 22 months (range 11-42). The median neophallic length was 5.6 cm (range 4-9.2). The total length of the neourethra was 9.4-14.2 cm (median 10.8). Voiding while standing was reported by all 38 patients, and temporary dribbling and spraying were noted by 12. Two fistulas and one urethral erosion resulted from the testicular implant and required secondary revision. A combined buccal mucosa graft and labia minora flap present a good choice for urethral reconstruction in female-to-male transsexuals, with minimal postoperative complications.
Corsello, S M; Di Donna, V; Senes, P; Luotto, V; Ricciato, M P; Paragliola, R M; Pontecorvi, A
The scientific community is very interested in the biological aspects of gender disorders and sexual orientation. There are different levels to define an individual's sex: chromosomal, gonadic, and phenotypic sex. Concerning the psychological sex, men and women are different by virtue of their own gender identity, which means they recognize themselves as belonging to a determinate sex. They are different also as a result of their own role identity, a set of behaviors, tendencies, and cognitive and emotional attitudes, commonly defined as "male" and "female". Transsexuality is a disorder characterized by the development of a gender identity opposed to phenotypic sex, whereas homosexuality is not a disturbance of gender identity but only of sexual attraction, expressing sexual orientation towards people of the same sex. We started from a critical review of literature on genetic and hormonal mechanisms involved in sexual differentiation. We re-examined the neuro-anatomic and functional differences between men and women, with special reference to their role in psychosexual differentiation and to their possible implication in the genesis of homosexuality and identity gender disorders. Homosexuality and transsexuality are conditions without a well defined etiology. Although the influence of educational and environmental factors in humans is undeniable, it seems that organic neurohormonal prenatal and postnatal factors might contribute in a determinant way in the development of these two conditions. This "organicistic neurohormal theory" might find support in the study of particular situations in which the human fetus is exposed to an abnormal hormonal environment in utero.
Liza García Reyes
Full Text Available Este artículo evidencia los principales resultados de la investigación cualitativa titulada: Putas y trans. Narrativas sobre mujeres trans en España –desarrollada en 2010–, la cual estudió su presencia en textos académicos sobre prostitución en España, producidos entre los años 2000-2009. El análisis de contenido de 34 narrativas evidenció que las referencias a mujeres trans resulta escasa en ellas, aun siendo ellas quienes tienen mayor presencia en la prostitución, en proporción con las mujeres biológicas. Solo nueve textos mencionan la experiencia trans al interior de la prostitución y, entre estos, el asunto solo aparece asertivamente descrito cuando son las propias mujeres trans quienes escriben. AbstractThis paper shows the results of a qualitative research entitled: Hookers and Trans Women: Narratives about trans women in Spain. This study was developed in 2010 and it is based on presence of trans women in the academic texts of prostitution in Spain produced between 2000 and 2009. The content analysis of thirty four narratives showed that the references to in transsexual women in these texts were few, although they have more presence into prostitution, in relation to the biological women. Only nine texts show an experience of prostitution and among these, transexperience only is described assertively when transsexual women write the texts themselves.
Vara Hernández, Ainara
Atrapada en el cos d'un home, la Carol Barangé, amb seixanta-nou anys, pren la decisió més important de la seva vida: deixar enrere la família, els amics i la seva posició social acomodada. Les trobades setmanals a Enfemme, un peculiar local clandestí, la convenceran per emprendre el viatge a Tailàndia i complir el seu somni: recuperar la seva joventut i reafirmar-se com a dona. Aficionada als cotxes, vol ser la primera dona transsexual en córrer el Rally Històric de Montecarlo. El trajecte q...
Mandlis, Lane R
By probing the processes of exclusion of transsexuals from the political sphere, this article offers contributions to social and political theory through an examination of the processes of exclusion from the category "human." This article considers how the erasure of investment in their own embodied sex constructs a platform from which to blame others for sex/gender variance, as well as to justify that blaming. Bringing together Giorgio Agamben, Georges Bataille, Judith Butler, and Nikolas Rose with transphobia, medicalization in psychiatry, law, and ethopolitics, this article questions whose investment in sexed embodiment counts and why that investment might be seen as "crazy."
Full Text Available Genital self-mutilation (GSM is a rare event that is commonly associated with psychotic disorders. However, such injuries have also been reported in nonpsychotic patients as a result of either bizarre autoerotic acts and attempts at crude sex-change operation by transsexuals or secondary complex religious beliefs and delusions regarding sexual guilt. We report a case of GSM in a human immunodeficiency virus (HIV-positive individual who not only severed his penis, scrotum, and testes completely as a result of internal conflict and frustration but also refused any further treatment toward reconstruction owing to his guilt.
This research, commissioned by the Malaysian AIDS Council in 2007, is qualitative and descriptive in nature. In depth face-to-face interviews were carried out with 15 mak nyah respondents from five major towns. The interviews were guided by an interview schedule that had seven main topics: brief background; ...
Folaron, Irene; Lovasz, Monica
Retention standards and policies applied to active duty members in the U.S. military who identify as transgender have recently been in evolution. The Secretary of Defense recently released a new directive allowing transgender members to serve openly with the option to transition gender while in active duty, abrogating the old policy disqualifying transgender members from continued service. There is a reasonable expectation that some may pursue medical and surgical options toward gender transition. The clinical pathway for gender transition relies heavily on Mental Health and Endocrinology services. This article highlights the medical aspects of gender transition and how they can affect readiness and the delivery of military health care. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
Roberts, Lesley F; Brett, Michelle A; Johnson, Thomas W; Wassersug, Richard J
A number of men have extreme castration ideations. Many only fantasize about castration; others actualize their fantasies. We wish to identify factors that distinguish those who merely fantasize about being castrated from those who are at the greatest risk of genital mutilation. Seven hundred thirty-one individuals, who were not castrated, responded to a survey posted on http://www.eunuch.org. We compared the responses of these "wannabes" to those of 92 men who were voluntarily castrated and responded to a companion survey. Main Outcome Measures. Respondents answered the questionnaire items relating to demographics, origin of interest in castration, and ambition toward eunuchdom. Two categories of wannabes emerged. A large proportion ( approximately 40%) of wannabes' interest in castration was singularly of a fetishistic nature, and these men appeared to be at a relatively low risk of irreversible genital mutilation. Approximately 20% of the men, however, appeared to be at great risk of genital mutilation. They showed a greater desire to reduce libido, change their genital appearance, transition out of male, and prevent sexually offensive behavior. Nineteen percent of all wannabes have attempted self-castration, yet only 10% have sought medical assistance. We identify several motivating factors for extreme castration ideations and provide a classification for reasons why some males desire orchiectomies. Castration ideations fall under several categories of the Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (DSM-IV), most notably a Gender Identity Disorder other than male-to-female (MtF) transsexual (i.e., male-to-eunuch) and a Body Identity Integrity Disorder. Physicians need to be aware of males who have strong desires for emasculation without a traditional MtF transsexual identity.
Selvaggi, Gennaro; Giordano, Simona
Recent literature has raised an important ethical concern relating to the way in which surgeons approach people with gender dysphoria (GD): it has been suggested that referring transsexual patients to mental assessment can constitute a form of unjust discrimination. The aim of this paper is to examine some of the ethical issues concerning the role of the mental health professional in gender reassignment surgeries (GRS). The role of the mental health professional in GRS is analyzed by presenting the Standards of Care by the World Professional Association of Transgender Health, and discussing the principles of autonomy and non-discrimination. Purposes of psychotherapy are exploring gender identity; addressing the negative impact of GD on mental health; alleviating internalized transphobia; enhancing social and peer support; improving body image; promoting resilience; and assisting the surgeons with the preparation prior to the surgery and the patient's follow-up. Offering or requesting psychological assistance is in no way a form of negative discrimination or an attack to the patient's autonomy. Contrarily, it might improve transsexual patients' care, and thus at the most may represent a form of positive discrimination. To treat people as equal does not mean that they should be treated in the same way, but with the same concern and respect, so that their unique needs and goals can be achieved. Offering or requesting psychological assistance to individuals with GD is a form of responsible care, and not unjust discrimination. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Mas Grau, Jordi
Full Text Available This paper analyses the two major paradigms through which the trans phenomenon has been conceptualized in Western societies: transsexuality and transgenderism. Based on data obtained from two qualitative research projects conducted in Catalonia (Spain, we show the existence of conflicts between individuals and groups close to both paradigms. Some who consider themselves to fall within the realm of transsexuality criticize those whose bodies and subjectivities do not conform to gender binary believing them to compromise their social integration project. On the other hand, some transgenderist activists complain that certain sectors rejecting their trans condition, seeking social normalization. The paper concludes with a problematization of trans people’s ability to reinforce or subvert the sex/gender system.En este artículo analizamos los dos grandes paradigmas desde los que se ha conceptuado el fenómeno trans en las sociedades occidentales: la transexualidad y el transgenerismo. Basándonos en los datos obtenidos de dos investigaciones cualitativas realizadas en Cataluña (España, mostraremos la existencia de conflictos entre personas y grupos cercanos a uno y otro paradigma. Algunas personas que se sitúan en la órbita de la transexualidad critican a aquellas cuyos cuerpos y subjetividades no se ajustan a la lógica binaria porque consideran que comprometen su proyecto de integración social, mientras que algunas activistas transgeneristas lamentan que desde ciertos sectores se reniegue de lo trans y se busque la normalización social. El artículo concluye con una problematización sobre la capacidad de las personas trans para reforzar o subvertir el sistema de sexo/género.
Tuanny Soeiro Sousa
Full Text Available This essay seeks to make an examination on how the gender category influences in the development process, based on the concept of development as freedom by Amartya Sen. In view of this purpose, we analyze the main human rights violations suffered by travesties and transsexuals due to the female and male identity construction in contrast to social norms establishing hierarchical positions of men and women as constituents of male and female categories. In other words, conflicts made in the wake of gender relations. This study is the result of a literature review and analysis of data on homophobic violence against trans experience.
Merryfeather, Lyn; Bruce, Anne
Academic discourse proscribes a particular way of writing that may leave the reader informed but uninspired. There are three intentions for this paper: to create a counter-discourse for academic writing, to illustrate autoethnograpy as a compelling approach to nursing inquiry, and to demonstrate how autoethnography is well suited to research the experience of people who identify as transgender or transsexual. The setting is a doctoral nursing seminar where the student is introducing autoethnography to fellow students. All characters are fictionalized compositions. The writing is in the style of creative non-fiction and illustrates the use of evocative prose and poetry. © 2014 Wiley Periodicals, Inc.
Dietz, P E; Evans, B
The authors classified 1,760 heterosexual pornographic magazines according to the imagery of the cover photographs. Covers depicting only a woman posed alone predominated in 1970 but constituted only 10.7% of the covers in 1981. Bondage and domination imagery was the most prevalent nonormative imagery and was featured in 17.2% of the magazines. Smaller proportions of material were devoted to group sexual activity (9.8%), tranvestism and transsexualism (4.4%), and other nonnormative imagery. The authors suggest that pornographic imagery is an unobtrusive measure of the relative prevalence of those paraphilias associated with preferences for specific types of visual imagery and for which better data are lacking.
Full Text Available This paper presents a state of the art on the relationship between the trans universe and education, from 2008 to 2014. We identified twenty publications disseminated in the form of annals of events, journal articles, book chapters, dissertations and theses. The material was analyzed in the light of post-critical theories and under a qualitative approach. The emergence of larger studies on the inclusion and permanence of trans people in the school is one of the most significant findings highlighted. Within the various dimensions covering discussions about gender and sexuality dissidents, transvestites, transsexuals and transgender historically remain the social segment most exposed to forms of vulnerability and exclusion.
Tackling the mimetic logic of sex-gender that limits the transsexual subject's sexuality into seeming a poor representation, the author argues that trans pornography and autoethnographic accounts from trans scholars emphasize the affective dimension of trans sex, a material remainder absent from mimetic theories of sexuality. Developing concepts from Alfred North Whitehead's process philosophy, in tandem with Morty Diamond's film Trans Entities: The Nasty Love of Papí and Wil (2007) and a selection of trans theorists, this article elaborates on the horizon of affective potential opened by transgender, brown, kinky, and pornographic "nastiness." The event of "nasty love" solicits a differential becoming, growing the edge of self.
Perrone, Anna Myriam; Scifo, Maria Cristina; Martelli, Valentina; Casadio, Paolo; Morselli, Paolo Giovanni; Pelusi, Giuseppe; Meriggiola, Maria Cristina
Objective. To report on the use of laparoendoscopic single-site surgery (LESS) for the management of total hysterectomy (TH) with bilateral salpingoovariectomy (BSO) in a subject affected by gender identity disorder. Design. Case report. Setting. University Hospital. Patient(s). A 27-year-old affected by Gender Identity Disorder underwent a hysterectomy and BSO as part of surgical sex reassignment. Intervention(s). Laparoendoscopic single-site surgery access for TH and BSO. Main Outcome ...
Jain, A; Bradbeer, C
As sex reassignment surgeries become more common and advanced, health professionals are more likely to see patients with gender identity disorders (GID) in their clinics. This can be challenging in many ways, and the challenges continue even after gender reassignment surgery as each case may present with unique anatomy. This article reviews the definition and treatment of GID, service provision in National Health Service and post-transition care of such patients.
van Kammen, Daniel P.; Money, John
After nearly 30 years of marriage, a 51-year-old man castrated himself to fulfill a long-standing fantasy of being a girl. It led the patient to elect low-dose maintenance on androgen to permit some degree of continued marital sex. The rehabilitative program as a transvestite man has continued for three years. (Author)
Johansson, Annika; Sundbom, Elisabet; Höjerback, Torvald; Bodlund, Owe
This follow-up study evaluated the outcome of sex reassignment as viewed by both clinicians and patients, with an additional focus on the outcome based on sex and subgroups. Of a total of 60 patients approved for sex reassignment, 42 (25 male-to-female [MF] and 17 female-to-male [FM]) transsexuals completed a follow-up assessment after 5 or more years in the process or 2 or more years after completed sex reassignment surgery. Twenty-six (62%) patients had an early onset and 16 (38%) patients had a late onset; 29 (69%) patients had a homosexual sexual orientation and 13 (31%) patients had a non-homosexual sexual orientation (relative to biological sex). At index and follow-up, a semi-structured interview was conducted. At follow-up, 32 patients had completed sex reassignment surgery, five were still in process, and five-following their own decision-had abstained from genital surgery. No one regretted their reassignment. The clinicians rated the global outcome as favorable in 62% of the cases, compared to 95% according to the patients themselves, with no differences between the subgroups. Based on the follow-up interview, more than 90% were stable or improved as regards work situation, partner relations, and sex life, but 5-15% were dissatisfied with the hormonal treatment, results of surgery, total sex reassignment procedure, or their present general health. Most outcome measures were rated positive and substantially equal for MF and FM. Late-onset transsexuals differed from those with early onset in some respects: these were mainly MF (88 vs. 42%), older when applying for sex reassignment (42 vs. 28 years), and non-homosexually oriented (56 vs. 15%). In conclusion, almost all patients were satisfied with the sex reassignment; 86% were assessed by clinicians at follow-up as stable or improved in global functioning.
Full Text Available Transgender have been considered as someone who always marginalized in their life, so they always get moral discrimination, social and even religion. Development of the transgender community in Yogyakarta is currently getting a response from various groups, namely the general public, religious leaders, sociologists and psychologists. As for job transsexual Kebaya NGOs joined in Yogyakarta, located in very small scope, include: ngamen, nyebong, salon and sewing. It was done since the transvestites are out of work in the formal sector. The concept of marriage in transgender community in Kebaya NGOs does not have clear rules because there is no basis or guidelines. Same-sex marriage in Indonesia is not recognized legally as well as normative, so the concept of transsexual marriage does not exist according to Islamic law. Kebaya NGOs consider that the rules about marriage in Indonesia violate the human rights, because it does not facilitate and accommodate the same-sex marriage. [Waria selama ini dianggap sebagai sosok yang selalu termarginalkan di dalam kehidupannya, sehingga mereka selalu mendapatkan diskriminasi baik moral, sosial, maupun agama. Perkembangan komunitas waria di Yogyakarta saat ini mendapat respon dari berbagai kalangan, yaitu masyarakat umum, tokoh Agama, Sosiolog, dan Psikolog. Adapun pekerjaan Waria Yogyakarta yang tergabung dalam LSM Kebaya, berada dalam skala yang sangat kecil meliputi : Ngamen, Nyebong, salon dan menjahit. Hal itu dikerjakan semenjak waria tidak mendapat pekerjaan dalam sektor formal. Konsep perkawinan dalam komunitas waria di LSM Kebaya belum mempunyai aturan yang jelas karena tidak ada landasan atau pedomannya. Perkawinan sesama jenis di Indonesia tidak mendapatkan pengakuan secara yuridis maupun normatif, sehingga konsep perkawinan waria tidak eksis menurut Hukum Islam. LSM Kebaya menganggap bahwa peraturan tentang perkawinan di Indonesia melanggar hak asasi manusia, karena tidak memfasilitasi perkawinan
Rodríguez-Madera, Sheilla L; Padilla, Mark; Varas-Díaz, Nelson; Neilands, Torsten; Vasques Guzzi, Ana C; Florenciani, Ericka J; Ramos-Pibernus, Alíxida
Violence is a public health concern faced on a daily basis by transgender women. Literature has documented how it adversely affects quality of life and health and in some instances leads to homicide. Considering the lack of research documenting the experiences of violence among transgender women, the objective of this article was to explore manifestations of violence among this population in Puerto Rico. The data presented in this article are part of a larger study on transgender/transsexual health in Puerto Rico. For the purpose of this article we focus on the quantitative data analysis. Participants (N = 59 transgender women) were recruited via respondent driven sampling. Implications and specific recommendations are discussed in light of these findings.
The incidence of Asperger's syndrome is reported as above average in young people presenting with gender dysphoria. Patients with Asperger's syndrome, however, are prone to obsessive preoccupations. This paper points out that the apparent dysphoria may in some cases prove to be a transient obsession. Cases from the author's clinical practice were reviewed. Two young men with histories suggesting Asperger's syndrome presented with strong convictions of gender dysphoria, asking for hormonal and surgical treatment. Treatment was withheld and after several years both came to repudiate their 'transgender phase'. Patients asking for sex reassignment should be assessed for indications of Asperger's syndrome. Irreversible treatments should be withheld until it is clear there is a genuine issue of transsexualism.
This article explores trans identities, as articulated within a few historical texts. From early literary depictions of gender difference, to medicalized conceptions of transsexualism, to a proliferation of trans and queer identities represented by an ever-expanding "alphabet soup" of identity labels, our understandings of identities, sexualities, and queer community-building continue to change. I use the notion of "kind-making," as elaborated on in the work of Ian Hacking, to illustrate that some queer and trans identifications are affiliative, whereas others are contrastive or oppositional in nature, and these structural differences have important implications with respect to understanding identity and sexuality, and also trans inclusion within LGBT communities and activist efforts.
Kranz, Georg S; Hahn, Andreas; Kaufmann, Ulrike; Küblböck, Martin; Hummer, Allan; Ganger, Sebastian; Seiger, Rene; Winkler, Dietmar; Swaab, Dick F; Windischberger, Christian; Kasper, Siegfried; Lanzenberger, Rupert
Biological causes underpinning the well known gender dimorphisms in human behavior, cognition, and emotion have received increased attention in recent years. The advent of diffusion-weighted magnetic resonance imaging has permitted the investigation of the white matter microstructure in
Full Text Available Before the new cartography of gender relationships and sexualities in contemporary culture, we intend to discuss in which way psychoanalysis presents itself as one of the devices of sexuality as conceived by Foucault, which tries to reinstate the traditional model of sexual difference trough the reiteration of the heterosexual norm of male domination. Furthermore, we inquire how psychoanalysis can remain a critical theory and a clinical practice that allow a productive relationship with the new configurations of gender, which disclose the conception of new forms of subjectivity. With this aim, we will analyze the psychoanalytical debate on (1 the displacements of feminine and the positiveness of femininity; (2 the homosexual marriage and the homoparentality; and (3 the clinics of transsexuality.
This article explores how lesbian, gay, bisexual, and transgender/transsexual (LGBT) people's perception of increasing conservative trends and negative public attitudes affected the development of LGBT rights activism in Russia. It includes following sections: (1) the analysis of the development of LGBT community and activism in Russia; (2) the investigation of public perception of same-sex relations and how LGBT people's views of it affected their readiness to join activism; and (3) the examination of the state's policy toward LGBT people in a wake of conservative discourse and its impact on LGBT activism and LGBT people's willingness to get involved in it. The article concludes by considering implications that LGBT rights activism face nowadays in order to survive and continue its existence.
Full Text Available According to literature, genital self-mutilation (GSM is more commonly associated with psychosis as compared with self-mutilation as a whole. There have been many case reports of GSM in psychotic disorders. We describe herein a case of a Caucasian, employed, and married male suffering from bipolar disorder type II with history of self-mutilating behavior, who amputated his penis during symptom-free phase of his illness. Several features are reflected as risky elements for genital self-mutilation, for example, homosexual and transsexual tendencies, abandonment of the male genitals, lack of competent male for identification during childhood, feeling of guilt for sexual offences, and self-injuries in anamnesis. This report will highlight various factors responsible for self-mutilation in nonpsychotic and nondelusional person.
Full Text Available Apesar das mudanças políticas e sociais em relação às transexualidades e travestilidades, elas ainda são consideradas pela Associação de Psiquiatria Norte-Americana (APA e pela Organização Mundial da Saúde (OMS como transtornos mentais. Essas entidades divulgarão em 2013 as novas versões do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM - APA e do Código Internacional de Doença (CID - OMS, o que tem mobilizado ativistas trans que reivindicam a retirada da transexualidade do rol das doenças identificáveis como transtornos mentais. A campanha Stop Trans Pathologization (Pare a Patologização! se internacionalizou e envolvia, até o início de 2012, mais de 29 países. Neste artigo, discutiremos algumas iniciativas dessa campanha, analisaremos a ideologia de gênero presente no DSM e no CID, que incorporam o gênero como uma categoria diagnóstica, e, por fim, apresentaremos argumentos pelo fim do diagnóstico de gênero.Despite the social and political changes in respect of transsexualities and tranvestilities, they are still considered by the APA (American Psychiatric Association and by the WHO (World Health Organization as mental disorders. These organizations will disclose in 2013 the new versions of the DSM (Diagnostic and Statistical Manual of Mental Disorders - APA and the ICD (International Code of Illness-WHO. This has mobilized trans activists claiming the withdrawal of transsexuality from the list of diseases considered as mental disorders. The Stop Trans Pathologization (Stop Pathologizing! has become a global campaign, reaching 29 countries by early 2012. In this article, we will discuss some initiatives within this campaign and review the gender ideology present in the DSM and the ICD which incorporate the genre as a diagnostic category. Finally, we will present arguments against the gender diagnosis.
Byne, William; Karasic, Dan H.; Coleman, Eli; Eyler, A. Evan; Kidd, Jeremy D.; Meyer-Bahlburg, Heino F.L.; Pleak, Richard R.; Pula, Jack
Abstract Regardless of their area of specialization, adult psychiatrists are likely to encounter gender-variant patients; however, medical school curricula and psychiatric residency training programs devote little attention to their care. This article aims to assist adult psychiatrists who are not gender specialists in the delivery of respectful, clinically competent, and culturally attuned care to gender-variant patients, including those who identify as transgender or transsexual or meet criteria for the diagnosis of Gender Dysphoria (GD) as defined by The Diagnostic and Statistical Manual of Mental Disorders (5th edition). The article will also be helpful for other mental health professionals. The following areas are addressed: evolution of diagnostic nosology, epidemiology, gender development, and mental health assessment, differential diagnosis, treatment, and referral for gender-affirming somatic treatments of adults with GD. PMID:29756044
Juan Manuel Sánchez Freyre
Full Text Available Constitutional transcendence of the requirement of majority for the recognition of the right to sexual identity and the change in the registration of sex in the Civil Registry in the case of transsexual people and their incardination in the limitations to the capacity to act Minors. Diversity of legal treatment of the age and its legislative and jurisprudential treatment in attention to the progressive acquisition of discernment and ability to understand and to issue its will in the best interest of the minor. The principle of the best interest of the child as a frame of reference to analyze each specific case in defense of fundamental rights in general and its concretion in the case of minors. The difficulty of assessing this indeterminate legal concept.
Conclusion: Our data suggest that long-term testosterone administration to female-to-male patients during reproductive age induces a low proliferative active endometrium, associated with some hypertrophic myometrial changes.
Shimamura, Yuto; Fujikawa, Aoi; Kubota, Keisuke; Ishii, Naoki; Fujita, Yoshiyuki; Ohta, Keiichiro
There are several techniques for creation of a neovagina in male-to-female reassignment surgery. Although vaginoplasty with the sigmoid colon is not a common procedure, it is becoming more common. Perforation of the recto-sigmoid neovagina after sex reassignment surgery is very rare. We hereby report a case of perforation of the neovagina that presented as acute peritonitis, with a massive abscess in the intra-abdominal cavity. This case report describes a 33-year-old Asian woman presenting with mild persistent abdominal pain, nausea, and vomiting who had undergone male-to-female sex reassignment surgery four years prior. Physical examination revealed mild abdominal pain without rebound tenderness. An abdominal computed tomography scan showed a massive abscess that occupied a significant portion of the intra-abdominal cavity. Perforation of the neovagina was confirmed by exploratory laparotomy and surgical drainage with primary closure was performed without any complications. This is a rare case involving perforation of the neovagina that was successfully treated with surgical intervention. This case emphasizes the importance of taking a detailed medical history and to make physicians and patients aware that bowel vaginoplasty can result in a weak vagina.
Amirian, Ilda; Gögenur, Ismail; Rosenberg, Jacob
An unknown number of patients have had male to female gender transformation. Various surgical techniques have been employed to construct the neovagina. The more traditional techniques include inverted penile grafts and vascular pedicle grafts, but also the small bowel and sigmoid colon have been ...... with contrast through the neovagina showed leakage from the neovaginal top. The patient was treated conservatively with antibiotics and discharged after 7 days....
Full Text Available This article is based on a research project studying political discussions in the Swedish LGBT (Lesbian, Gay, Bi-, Transsexual community Qruiser. These discussions were very antagonistic and rude. The aim is therefore to understand what motivated participation in these heated discussions. The focus is on Qruiser political forum threads. The research is nethnographic through online interviews, participant observations in, and content analyses of, political discussions threads during the month of November 2012. By using framing theory as an analytical tool, the paper seeks to answer which frames attracted and mobilized participation and how this was done. In the article I find that polarizing frames of the left vs the right, the xenophobic vs the political correct, together with a truth and a game frame was used to motivated participation in the Qruiser forum threads.
Full Text Available When the Danish painter Einar Wegener underwent several operations in 1930 in order to subsequently live as Lili Elvenes, the case was of great interest for both the public and the media. In the beginning of 1931 the Danish newspapers Politiken and Ekstra Bladet published a series of efficacious interlinked articles that were staged as a self-contained whole. Along with emphasizing the discursive competence of medicine and legislation this staging focused on the perpetuation of a heteronormative order. Employing the variables sex, gender and desire as well as their interconnections highlights the normalizing processes of (re-construction tied to such a perpetuation. At the same time it discloses staging strategies, which enable an analysis of Lili Elvenes’ agency. By pursuing this notion of agency such an analysis demonstrates how the transsexual subject is embedded in dominant discourses.
Full Text Available The basic aim of the paper is an attempt to find out how Van Dijk's critical discourse analysis of LGBTT (Lesbian, Gay, Bisexual, Transvestite, Transsexual individuals who are represented at the local press. Sabah, Hâkimiyet, Express, Gaziantep27, Olay and Telgraf newspapers were selected from Gaziantep Printed Local Press for the study and how these LGBTT people were represented in these newspapers. The articles reviewed for the study were published between 2009 and 2014 is a key criterion for LGBTT people to be involved directly or indirectly (with links to various topics under different headings. In the context of Van Dijk's critical discourse analysis based on the study, and in the light of the determined criteria, the existing news obtained were carefully scanned from newspapers, examined and analyzed in detail by the method of critical discourse analysis.
ía extrema.The central themes in the life-thoughts-thesis of Norma Mejía. PhD in Social Anthropology and postoperative transsexual woman, are presented here in interview format. Mejía describes and analyzes everything she has seen and experienced from the perspective of extreme ethnography, in which object and subject become one, as well as the etic and emic visions, and the person who observes is part of the observed group. The peculiarity of her case resides in the strong autobiographical content of her discourse, which renders imposible the intended subject/object separation, so characteristic of social sciences. Mejía explains that when she was an eight-year-old boy living in Bogotá. his home town. The case of a male to female transexual person after going through Sex Reassignment Surgery (SRS was widely covered by the mass media. It was then that he realized he wanted to be a transsexual person. Forty years later, when she was a transsexual prostitute living in Barcelona, she decided to write an Anthropology PhD thesis on the gods of traditional societies. but she ended up writing it about transsexualism. In the university, she learned that biology and genetics do not influence psychology due to the fact that human beings are social constructs. She had health problems in 2001 and quitted prostitution and anthropology. She got herself a modest job and a loan. She traveled to Thailand, underwent SRS and when she returned. she finished and presented her thesis, titled Transgenderisms. She then noticed that SRS had changed her, and not only physically speaking, so she reached the conclusion that, contrarily to what she had declared in her thesis, biology does influence people’s personalities. That is why, when the Government passed a law to make non-surgical sex change legal, she was against it. The article tackles this issue and several others that are offered here in an exercise of what Mejía defines as extreme ethnography.
Fabiana Bacellar Villani
Full Text Available Progress of Social Services in Care Population "T" 1: a path in the logic of human rightsResumo: O presente artigo perfaz um resgate histórico do Serviço Social com o objetivo de identificar quais e como se deram as evoluções sócio históricas da profissão, verificando quais foram os progressos brasileiros na Assistência Social e nas suas políticas em relação ao atendimento às demandas da População T. Nessa retomada das evoluções históricas da profissão dos Assistentes Sociais desde a atribuição assistencialista, o movimento de reconceituação, até a regulamentação como profissão para, desse modo, reforçar a necessidade de uma prática profissional pautada na defesa e na promoção dos direitos humanos. Para tal, adota-se a metodologia histórico-documental a partir da análise dos dispostos no Código de Ética dos/as Assistentes Sociais, no Projeto Ético Político Profissional do Serviço Social, nas orientações do conjunto CFESS-CRESS, na Política Nacional de Assistência Social, na Norma Operacional Básica NOB/SUAS, na Tipificação Nacional de Serviços Socioassistenciais,nos Princípios de Yogyakarta e na Cartilha Nascidos Livres e Iguais. Constatou-se alguns avanços nestes dispositivos que orientam a prática profissional tais como a inclusão dos termos “orientação sexual” e “identidade de gênero” porém percebeu-se que o Serviço Social tem um longo caminho a percorrer junto à população T. Palavras-chaves: Serviço Social, direitos humanos, transexualidade.Abstract: This paper represents a historical rescue of the Social Service in order to identify the social and historical evolution of the profession, verifying the Brazilian progress in Social Assistance and its policies in relation to the demands of the Transvestite and Transsexual Population. In this resumption of the historical evolution of the profession of Social Workers from the attribution of assistance, the movement of
Full Text Available Transsexualism, or gender incongruence, presents a state in which a person's assigned sex at birth conflicts with their psychological gender. It is classified in International Classification of Diseases as F64. Treating these persons require multidisciplinary approach, including psychiatrist, endocrinologist, gynecologist, urologist, plastic and reconstructive surgeon. Genital reconstruction is the final step in transition, and can be performed when all other conditions required by World Professional Association for Transgender Health (WPATH are accomplished. Female to male sex reassignment surgery Several surgical procedures can be done in female to male transsexuals, including mastectomy, removal of female genitalia, metoidioplasty, scrotoplasty with implantation of testicular implants, as well as total phalloplasty. The current operative technique of metoidioplasty comprise the following steps: vaginal removal, the release of the ventral chordee and clitoral ligaments, straightening and lengthening of the clitoris, urethroplasty by combining buccal mucosa graft and genital flaps and scrotoplasty with insertion of testicle prostheses. The goal is to perform all these procedures in one stage, and that makes our team famous worldwide. Metoidioplasty results in excellent cosmetic outcome with completely preserved sensitivity and sexual arousal, enables voiding while standing, but without ability to penetrate due to small size of the neophallus. Considering these advantages, including low complication rate, patients often choose this option. For those who require bigger phallus which enables implantation of penile prosthesis, several surgical techniques have been reported using either available local vascularized tissue or microvascular tissue transfer. However, none of them satisfy all the goals of modern penile construction, i.e. reproducibility, tactile and erogenous sensation, a competent neourethra with a meatus at the top of the neophallus
Travestis e transexuais profissionais do sexo: implicações da Psicologia Travestis y transexuales profesionales del sexo: implicaciones de la Psicología Sex profissional travestites and trans - sexuals: implications in Psychology
Carmem Regina Giongo
Full Text Available Este trabalho teve como objetivo analisar e discutir as demandas de travestis e transexuais profissionais do sexo com relação à saúde mental. Participaram do estudo 10 travestis e 2 transexuais, e todas se declararam profissionais do sexo. A coleta de dados se deu por meio de grupos focais, sendo a análise dos dados qualitativa pautada na análise de conteúdo. Os resultados da pesquisa apontaram uma fragilidade na rede de apoio social e afetiva dos participantes, representada pelo sentimento de abandono e de solidão. Os resultados evidenciaram a necessidade de implementação de políticas públicas e de intervenções no âmbito da saúde mental.Este trabajo tuvo como objetivo analizar y discutir las demandas de travestis y transexuales profesionales del sexo con relación a la salud mental. Participaron del estudio 10 travestis y 2 transexuales, y todas se declararon profesionales del sexo. La recogida de datos se dio por medio de grupos focales, siendo el análisis de los datos cualitativo pautado en el análisis de contenido. Los resultados de la investigación apuntaron una fragilidad en la red de apoyo social y afectivo de los participantes, representada por el sentimiento de abandono y de soledad. Los resultados evidenciaron la necesidad de implementación de políticas públicas y de intervenciones en el ámbito de la salud mental.This work had as a goal to analyze and discuss the demands of sex professionals, as transvestites and trans-sexual in relation to mental health. Ten transvestites and two trans-sexuals participated in this study. All the participants declared themselves sex professionals. The collection of data happened through focal groups, being the qualitative analysis of the data ruled in the content analysis. The results of the survey pointed to a fragility in the social and affectionate support of the participants, represented by the feeling of desertion and solitude. The results showed the necessity of the
Witten, Tarynn M
We review the recent psychosocial literature on transgender aging. We also report relevant in-press results from the Trans MetLife Survey on Later-Life Preparedness and Perceptions in Transgender-Identified Individuals (TMLS) on end-of-life and later-life trans-aging. To obtain relevant literature, we employed the search engines Google Scholar, Stanford Highwire, and PubMed/Medline. Databases searched included Web of Science, Cinhal, PsyINFO, Gender Studies Database, Sociological Abstracts, and Social Services Abstracts. Keyword searches included "transgender" and "transsexual." Key phrases included "transgender aging," "transsexual aging," and "LGBT aging." Years searched were from January 1, 2011, through April 26, 2013. We found two types of articles: LGBT aging-related (or lumped aging) articles and articles that focused specifically on transgender aging, or trans-aging. We found that the articles spoke of concerns and fears regarding discrimination, potential abuse at the hands of caregivers, inability to live out their lives in their true identities, risk of becoming homeless, loss of independence, and dementia, among other concerns. We note that the elder trans-identified population is significantly ill-prepared for the major legal issues that arise and events that occur in the later-life to end-of-life time periods. Despite these difficulties, a few articles spoke of resilience and successful aging in the population. Some TMLS respondents indicated that they were considering either "detransitioning," that is, changing social presentation to the pretransition gender identity, or suicide (which some referred to as euthanasia) as means of managing the severe problems they expected to encounter later in the aging process. A number of potentially modifiable risk factors exist within this population. Modification strategies include increasing the population awareness of the need for end-of-life legal preparations for members of the trans-identified community as
Papadopulos, Nikolaos A; Lellé, Jean-Daniel; Zavlin, Dmitry; Herschbach, Peter; Henrich, Gerhard; Kovacs, Laszlo; Ehrenberger, Benjamin; Kluger, Anna-Katharina; Machens, Hans-Guenther; Schaff, Juergen
Surveys on quality of life (QOL) of male-to-female (MTF) transsexuals have found low QOL scores before and increased satisfaction scores after sex-reassignment surgery (SRS). To our knowledge, many of them lack standardized questionnaires and comparisons with normative data to evaluate different vaginoplasty techniques. To analyze patient satisfaction and QOL after SRS. Forty-seven patients participated in this study. All patients had surgery with our self-developed combined technique on average 19 months before the survey. They completed a self-developed indication-specific questionnaire concerning demographic and socioeconomic issues and postoperative satisfaction. Furthermore, a standardized self-assessment questionnaire on satisfaction and QOL (Fragen zur Lebenszufriedenheit Module [FLZ M ]; Questions on Life Satisfaction Modules ) was used. The FLZ M consists of three modules (general life satisfaction, satisfaction with health, and satisfaction with body image) with scores of weighted satisfaction for each item. Results of the general and health modules were compared with normative data. Demographics, QOL, general life satisfaction, satisfaction with health, and satisfaction with body image. The self-developed indication-specific questionnaire showed that 91% experienced an improvement of QOL. All patients stated they would undergo SRS again and did not regret it at all. Patients stated their femininity significantly increased. For the FLZ M , the sum score for general life satisfaction (P patient satisfaction of this complex and non-standardized surgery. This is the first description of a new surgical technique (combined technique) for MTF SRS. QOL was assessed by a large number of patients by standardized questionnaires and could be compared with normative data. Because this is a retrospective study, we can draw only careful conclusions for pre- and postoperative changes. Our self-developed combined surgical technique seemed to have a positive influence on
Swaab, D. F.
Male sexual differentiation of the brain and behavior are thought, on the basis of experiments in rodents, to be caused by androgens, following conversion to estrogens. However, observations in human subjects with genetic and other disorders show that direct effects of testosterone on the developing
Male sexual differentiation of the brain and behavior are thought, on the basis of experiments in rodents, to be caused by androgens, following conversion to estrogens. However, observations in human subjects with genetic and other disorders show that direct effects of testosterone on the developing
Koon Teh, Yik
This research, commissioned by the Malaysian AIDS Council in 2007, is qualitative and descriptive in nature. In depth face-to-face interviews were carried out with 15 mak nyah respondents from five major towns. The interviews were guided by an interview schedule that had seven main topics: brief background; hormone-taking behaviour; safe sex; health care; substance abuse; harassment from authorities; and HIV prevention. The HIV problem among the mak nyah, mak nyah sex workers and their clients is critical. Many do not have in-depth HIV/AIDS knowledge and do not practise safe sex. The problem gets worse when most mak nyah do not consider HIV/AIDS as a primary concern because of other pressing problems like employment and discrimination. There are also no HIV prevention activities in many parts of Malaysia. Mak nyah also face constant harassment from enforcement authorities for prostitution. This hampers HIV prevention work.
Torres, A; Gómez-Gil, E; Vidal, A; Puig, O; Boget, T; Salamero, M
To review scientific evidence on gender differences in cognitive functions and influence of sex hormones on cognitive performance. Systematical search of related studies identified in Medline. Women outperform men on verbal fluency, perceptual speed tasks, fine motor skills, verbal memory and verbal learning. Men outperform women on visuospatial ability, mathematical problem solving and visual memory. No gender differences on attention and working memory are found. Researchers distinguish four methods to investigate hormonal influence on cognitive performance: a) patient with hormonal disorders; b) neuroimaging in individuals during hormone administration; c) in women during different phases of menstrual cycle, and d) in patients receiving hormonal treatment (idiopathic hypogonadotropic hypogonadism, postmenopausal women and transsexuals). The findings mostly suggest an influence of sex hormones on some cognitive functions, but they are not conclusive because of limitations and scarcity of the studies. There are gender differences on cognitive functions. Sex hormones seem to influence cognitive performance.
Santos, Ana Cristina
This article analyzes how both the Portuguese state and civil society have addressed the AIDS issue, focusing on participation by the lesbian, gay, bisexual, and transsexual community (LGBT) in the struggle against AIDS. The article begins by describing the situation of LGBT individuals in Portugal during the 1990s, when the Portuguese LGBT movement emerged and grew, and then characterizes the evolution of HIV/AIDS in Portugal, analyzing the relationship between civil society and sexuality in general and the situation of the epidemic in the country in particular, considering key facts, nongovernmental organizations, and state initiatives. Special attention is given to the role played by LGBT organizations in the struggle against HIV. Finally, the article reflects on the future of the struggle against both AIDS and discrimination in the 21st century, considering recent events in the country and the guidelines recommended by international policies.
Nureña, César R; Zúñiga, Mario; Zunt, Joseph; Mejía, Carolina; Montano, Silvia; Sánchez, Jorge L
In Peru, commercial sex involving men and male-born travestis, transgenders and transsexuals (CSMT) is usually represented as a dangerous practice carried out on the streets by people experiencing economic hardship and social exclusion. However, in reality little is known about the complexities of this practice in Peru. This paper presents findings from an ethnographic study of the characteristics, patterns and sociocultural aspects of CSMT in three Peruvian cities. The study included participant observation in sex work venues and interviews with 42 sex workers and 25 key informants. We found that CSMT in Peru takes many forms (some not previously described in the country) and is practised in different places by people from various socioeconomic levels. In many cases, the practice appears linked to ideals of social mobility, migratory experiences and other economic activities. In addition, the increasing use of the Internet and mobile phones has changed patterns of sex work in Peru. We review the implications of these findings for future research and public health interventions.
Leyva-Flores, René; Infante, César; Servan-Mori, Edson; Quintino-Pérez, Frida; Silverman-Retana, Omar
HIV prevalence was estimated among migrants in transit through Mexico. Data were collected on 9108 Central American migrants during a cross-sectional study performed in seven migrant shelters from 2009 to 2013. Considerations focused on their sociodemographic characteristics, sexual and reproductive health, and experience with violence. Based on a sample of 46.6 % of respondents who agreed to be HIV tested, prevalence of the virus among migrants came to 0.71 %, reflecting the concentrated epidemic in their countries of origin. A descriptive analysis was performed according to gender: the distribution of the epidemic peaked at 3.45 % in the transvestite, transgender and transsexual (TTT) population, but fell to less than 1 % in men and women. This gender differential is characteristic of the epidemic in Central America. Furthermore, 23.5 % of TTTs and 5.8 % of women experienced sexual violence. The predominant impact of sexual violence on TTTs and women will influence the course of the AIDS epidemic.
Gil-Borrelli, Christian; Velasco, César; Martí-Pastor, Marc; Latasa, Pello
The Spanish Health Information System (HIS) collects health information. Trans people have poorer health status. This paper aimed to assess the adequacy of the HIS to collect the health data on trans individuals. The HIS sources available in the Statistical Portal of the National Health System were reviewed. The sources containing population health data were selected. The variables "sex" and "gender identity" were searched. Nineteen sources were identified. In all of them the variable "sex" was found, whereas "gender identify" did not appear in any of the 19. In two sources, the variable "sex" allowed values of "transsexual". The SIS contains little information regarding gender identity. This leads to the invisibility of trans people in Spanish health statistics. Obtaining this information would allow for a better understanding of the barriers to health care access, and the health needs of one of the most discriminated groups in our society. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Isaias Batista de Oliveira Júnior
Full Text Available Levels resulting from the disqualification of “compulsory heteronormativity” process that focus on Lesbians, Gays, Bisexuals, Bigenders, Transvestites, Transsexuals, Transgenders, Queers, Questioners, Intersexes, Indecisives, Asexuals and Allies people emerge in several instances. As a dialog agent, the school has been characterized asa strategic place to implement public policies and, in this context, emerge actions as the School without Homophobia and Health and Prevention in School programs. In order to promote the discussion on strategies developed in the national scenario, it is discussed its products: Gay Kit, Adolescents and Youth Peer Education Guide and Comic Books. Using bibliographical research as a methodology, excerpts of a master’s thesis are used so as to bring the theory of Cultural Studies as a mainstay of discourse. Given the government’s suspension of these materials, one realizes how difficult it is to stand up against public opinion. However, the refusal of the majority does not give the State the right to withhold basic rights of minorities.
Fernando Luiz Cardoso
Full Text Available This article discusses some common categories used in the field of Sexology, that are somewhat unclear in terms of definitions. Sexology, while a very recent science, has been built up through the contribution of researchers from many different areas of knowledge who usually work with different epistemological assumptions and categories. Such a multi-disciplinary approach brings, on the one hand, a rich contribution to the field, but, on the other hand, also creates much confusion and lack of communication between scientists. I tried to identify and compare these categories using empirical evidence and explanatory studies in the actual literature. Interpretative research was left out of the review because it does not contribute to this attempt at interdisciplinary theorizing. This critical review, written in English, provides a contribution to one such category "transsexualism," illustrating some of the recent ways of approaching this issue in academic and clinical terms.
Social Insertion of Transgender by Education: Transcidadania Project and Resolution No. 12/2015, of the National Council to Fight Against Discrimination and Promotion of Lesbian, Gay, Bisexual, Transvestites and Transgenders Rights
Leandro Reinaldo da Cunha
Full Text Available The transgender people's condition in actual society deserves a special attention because it is a social minority in situation of deep vulnerability. It is an attribution of the State to protect everyone, being inacceptable that, under a huge bias, segregate and marginalize those who should protect. Concerning the education aspect is important the adoption of directives that to ensure the transsexual full access to education, either through measures to prevent school evasion, as by the implantation of projects that allow his return to the student benches and a better qualification for the job. Measures such as resolution No. 12 of the National Council to Combat Discrimination and promotion of lesbian, gay, bisexual and transgender, an agency of the Department of Human Rights, and the Transcidadania project of the São Paulo City Hall has this purpose as this paper seeks to demonstrate. To reach this goal, will use in this paper the scientific-deductive method of bibliography.
Levine, S B
Adolescent and adult cross-dressing or "transvestism" is the most common antecedent behavioral pattern among those who request sex reassignment surgery. Transvestites are actually a diverse group of men who differ in their gender identities, orientation, and intention. They do, however, have in common a soothing image of themselves as women. Because of this, whether cross-dressing occurs among masculine or feminine males or heterosexuals, homosexuals, bisexuals, or asexuals, or among those with paraphilia, the behavior should be considered the expression of their consciously felt femininity. The confusing differences among cross-dressing males may be explained by their diversity along three dimensions: 1) the ambition for heterosexual intercourse; 2) the natural history of their sexual arousal to female clothing; 3) their current capacity to integrate their masculine and feminine strivings into separate compartments. When cross-dressers give up all vestiges of male gender role behaviors and successfully live and work full time as women, the appropriate descriptive term for them becomes "transsexual."
Schott, R L
This article reports a survey of childhood experiences and family dynamics reported by a sample of 85 cross-dressing males drawn from the readership of a magazine for transvestites. The sample had a higher percentage of only children and eldest children compared to a national sample and also a much closer relationship with their mothers than with their fathers. Their identification as nuclear or marginal transvestites or transsexuals is related to the quality of the reported relationship with the mother, to the factors they identify as associated with their cross-dressing, and to their sexual orientation. Covert cross-dressers account for over three fourths of the subjects, but those who were overt (their cross-dressing openly encouraged by female family members) show significantly different patterns and distributions on several variables. A constellation of family and parental relationships is proposed--drawn in part from the insights of object relations and family systems theory--which may contribute to the development of transvestism.
Awofeso, Niyi; Naoum, Raymond
Prisons are invariably unisex institutions where, besides many deprivations, heterosexual expression in its normal sense is absent. It is this characteristic that make prisons settings potentially fertile grounds for sexual aberrations. Since definite and accurate data concerning sexual activities among prison inmates are difficult to obtain, the phenomenon of sexual practices in prisons has traditionally been a topic of much speculation. However, the descriptions and explanations of most authors on the subject are often contradictory, and some of the best information are from unpublished sources. This article is an attempt to subsume many fragmented explanations about seven main types of sexual issues in prisons (i.e. consensual homosexuality, masturbation, transsexualism, prostitution, conjugal visits, sex between prisoners and prison staff, and rape among prison inmates) under more general criminological and management concepts. Suggestions for prison administrators on how to manage these complex issues in the best interests of security and inmates' health are also provided.
Perversion had been viewed as oedipally determined and in a reciprocal relationship with neurosis. In our widening scope, however, pre-oedipal and traumatic contributions have been increasingly emphasized. While both perspectives represent aspects of clinical reality, the tendency has been to overlook sexual and aggressive drive derivatives, with their related conflicts, object representations, and symbolic enactments, even though they may make significant contributions to the analytic situation. These latter, 'classical' patients have what I consider 'organized' perversions: complex, evolved, neurotic-level, stable psychopathological formations that may be distinguished from borderline or near psychotic syndromes enlisting perverse mechanisms to ward off disorganization. This paper will review Freud's work, briefly consider some recent trends in conceptualizing perversion and perverse mechanisms, characterize organized perversion, and present clinical material to illustrate its evolution, clinical manifestations, and analysis. Transsexualism, overtly similar to transvestism but not functioning as an organized perversion, will serve as a point of contrast. Copyright © 2011 Institute of Psychoanalysis.
Analídia Rodolpho Petry
Full Text Available OBJECTIVE: This article seeks to understand the experiences of transgender women in relation to the hormone therapy and sex reassignment surgery that make up the Gender Reassignment Process. METHOD: It is a qualitative study inserted into the field of cultural and gender studies. Data collection used narrative interviews, conducted in 2010 and 2011, with seven transsexual women who had been undergoing the Gender Reassignment Process for at least two years. The data was submitted to a thematic analysis. RESULTS: The results show that the transformation processes for construction of the female body include behavior adaptation, posture modification, voice modulation, hormone use, vaginal canal dilation and surgical complications. Such processes subject the body to be built as idealized to fit the gender identity, infringing on pleasures and afflictions. CONCLUSION: We concluded that the discussion involving the Gender Reassignment Process brings allowances for nursing regarding body changes experienced by transgender women.
Walsh, David; Hendrickson, Sherry Garrett
As nurses, we advocate for the most vulnerable and underserved, who, within the lesbian, gay, bisexual, and transgender (LGBT) community, are transgender individuals. Yet, the existence of LGBT education in nursing schools has not been examined. After approval by the university institutional review board, 113 nursing programs in Texas were surveyed between November 2013 and January 2014, with a 12-question, Web-based questionnaire. A Verisign certificate and 128-bit encryption program supported compliance with the Health Insurance Portability and Accountability Act of 1996. Nineteen percent of the surveys were returned. Ten (47.62%) of 21 respondents addressed transgender or transsexual individuals. Fifteen (71.43%) of 21 answered a free-text question to estimate the number of hours spent addressing LGBT content, reporting an average of 1.6 hours. Our study suggests that, in Texas, nursing students may not be receiving sufficient content, nor do they understand transgender health needs or how to best deliver competent, compassionate care to this population. Copyright 2015, SLACK Incorporated.
Colocación de implantes glúteos y de cadera: una alternativa para mejorar el contorno en hipoplasia glúteo-trocantérea Placement of buttock and hip implants: an alternative for contour improvement in buttock and hips hypoplasia
Full Text Available La mejoría del contorno glúteo y de caderas en un paciente varón que desea un contorno femenino es difícil de conseguir cuando no es posible disponer de una cantidad de grasa suficiente para inyectar y lograr una mejoría integral. Presentamos la técnica quirúrgica utilizada en un paciente transexual masculino que había tenido dos intentos fallidos de feminizar su contorno de glúteos y caderas. Utilizamos implantes ovales de silicona cohesiva, tanto para la región glútea como para las caderas, inyectando grasa en las áreas de transición entre los dos implantes. Con esta combinación obtuvimos un contorno femenino integral, eliminando por completo el aspecto masculino de la región glúteo-trocantérea. En conclusión, pensamos que la combinación empleada supone una opción novedosa y no descrita hasta el momento para el tratamiento de pacientes transexuales que buscan un contorno glúteo más femenino de forma integral, con resultados predecibles y muy gratificantes, que mejora las deficiencias que los pacientes masculinos tienen en esta zona en comparación con el contorno de los glúteos femeninos.Improvement of the gluteal and hip contour in patients seeking a more feminine shape is difficult to achieve, specially for those who don't have enough fat to transfer from other areas of the body. We describe the surgical technique used to improve hips and buttocks contour in a genetic male transsexual. This patient previously underrwent two unsuccessful surgeries to feminize his hip and buttock contour. Our successful approach involved the use of an oval-shaped cohesive silicone gel implants placed in both, the hip and buttock areas, along with fat injection in the areas between the two implants. A natural, feminine contour was achieved using the combination of buttock and hip implants with lipofilling using patient's own fat. These procedures completely eliminated the male contour previously noted in the gluteal trochanteric region
Titia F Beek
Full Text Available The World Health Organization (WHO is currently updating the tenth version of their diagnostic tool, the International Classification of Diseases (ICD, WHO, 1992. Changes have been proposed for the diagnosis of Transsexualism (ICD-10 with regard to terminology, placement and content. The aim of this study was to gather the opinions of transgender individuals (and their relatives/partners and clinicians in the Netherlands, Flanders (Belgium and the United Kingdom regarding the proposed changes and the clinical applicability and utility of the ICD-11 criteria of 'Gender Incongruence of Adolescence and Adulthood' (GIAA. A total of 628 participants were included in the study: 284 from the Netherlands (45.2%, 8 from Flanders (Belgium (1.3%, and 336 (53.5% from the UK. Most participants were transgender people (or their partners/relatives (n = 522, 89 participants were healthcare providers (HCPs and 17 were both healthcare providers and (partners/relatives of transgender people. Participants completed an online survey developed for this study. Most participants were in favor of the proposed diagnostic term of 'Gender Incongruence' and thought that this was an improvement on the ICD-10 diagnostic term of 'Transsexualism'. Placement in a separate chapter dealing with Sexual- and Gender-related Health or as a Z-code was preferred by many and only a small number of participants stated that this diagnosis should be excluded from the ICD-11. In the UK, most transgender participants thought there should be a diagnosis related to being trans. However, if it were to be removed from the chapter on "psychiatric disorders", many transgender respondents indicated that they would prefer it to be removed from the ICD in its entirety. There were no large differences between the responses of the transgender participants (or their partners and relatives and HCPs. HCPs were generally positive about the GIAA diagnosis; most thought the diagnosis was clearly defined and
Geoffroy, Marie; Chamberland, Line
Despite legislative advances in terms of workplace equality for sexual and gender minorities (SGM), available data ascertains the persistence of workplace discrimination of lesbian, gay, bisexual, and especially of transgender/transsexual employees. This article, based on an extensive literature review, explores the relationship between different types of workplace discrimination experiences and their impacts on the mental health of SGM and of different sub-populations: men who have sex with men, non-heterosexual women, lesbian and gay parents, and trans people. Furthermore, the article explores certain individual and systemic protection and risk factors that have an impact on this relationship, such as coming-out at work and organisational support. Finally, the existing literature on workplace discrimination and mental health of sexual and gender minorities highlights the importance, in the current legal and social context, of intersectional approaches and of research on homo- and trans-negative microaggressions. The article ends with a discussion on the implications for practice, research, and workplace settings, as well as with several recommendations for these settings.
Full Text Available Sexism and hostile attitudes towards people who differ from heteronormative model (gay, lesbian, bisexual, transsexual, transgender and intersex are the result of socio-cultural phenomena such as patriarchy and heterocentrism. The draft of such attitudes in Social Work is a positive element in the revictimization of users. Since there is no research to analyze jointly homophobia, biphobia and Transphobia student of Social Work quantitative research arises in order to identify whether there are such attitudes in students in this discipline in Mexico. And identify whether these attitudes are related to each other and to the ambivalent sexism. To this end, various scales have been applied in analyzing paths liket format attitudes to 120 students from the Universidad Autónoma de Nuevo León. The results show average levels of sexism, homophobia, and transphobia biphobia, being decisive variables related to sex, age, religion and education level. Based on these results it is considered necessary to include content on gender and sexual diversity in the training plans of the degree of Social Work.
Barsties, Ben; Verfaillie, Rudi; Dicks, Peter; Maryn, Youri
The aim of the study was to determine the impact of body height on speaking fundamental frequency (SF0) while controlling for as many as possible influencing factors such as habits, biophysical conditions, medication, diseases, and others. Fifty-eight females were analyzed during spontaneous speech (i.e. explaining driving directions or a cooking recipe) of at least 60 seconds at comfortable pitch and loudness. The subjects showed a moderate negative and significant correlation between body height and SF0 (r = -0.40, P = 0.002). With r(2) = 0.16, however, a reasonable portion (16%) of the variance in SF0 is explained by the variance in body height. In comparison with other factors for which a correlation with SF0 was mentioned in literature (hypothyrodism, hemodialysis, auditory-maleness after female-to-male transsexualism, body weight, body mass index, and body fat), body height accounted for most of the proportion of SF0 in females. It is therefore possible to validate body height as a factor to account for in clinical F0 measurement.
Van Der Miesen, Anna I R; Hurley, Hannah; De Vries, Annelou L C
The current literature shows growing evidence of a link between gender dysphoria (GD) and autism spectrum disorder (ASD). This study reviews the available clinical and empirical data. A systematic search of the literature was conducted using the following databases: PubMed, Web of Science, PsycINFO and Scopus; utilizing different combinations of the following search terms: autism, autism spectrum disorder (ASD), Asperger's disorder (AD), co-morbidity, gender dysphoria (GD), gender identity disorder (GID), transgenderism and transsexualism. In total, 25 articles and reports were selected and discussed. Information was grouped by found co-occurrence rates, underlying hypotheses and implications for diagnosis and treatment. GD and ASD were found to co-occur frequently - sometimes characterized by atypical presentation of GD, which makes a correct diagnosis and determination of treatment options for GD difficult. Despite these challenges there are several case reports describing gender affirming treatment of co-occurring GD in adolescents and adults with ASD. Various underlying hypotheses for the link between GD and ASD were suggested, but almost all of them lack evidence.
Costello, Katherine A
One of the most read novels of lesbian, transgender, and queer criticism, Radclyffe Hall's novel The Well of Loneliness (1928) has given rise to numerous and contradictory interpretations of the protagonist Stephen Gordon's complex relationship to her body. Some have argued that she is a historically specific example of female masculinity, others that she is a lesbian who wishes she were more feminine, and others still that she is a prototypical transsexual character. Focusing on the exemplary essays by Jack Halberstam, Teresa de Lauretis, and Jay Prosser, I argue that the coexistence of mutually exclusive interpretations of Stephen Gordon's relationship to her femaleness suggests that the novel is, in fact, a demand to readers to unmoor identity from sex and to recognize what I call "sexual indeterminacy." Lesbian, transgender, and queer theory's tendency to elide the literariness of literary objects and their reliance on critique as the primary mode of reading and argumentation have made it impossible for critics to see that the novel is explicitly about what cannot be settled.
Díaz-Acosta, Rodrigo; Shiba-Matsumoto, Andrey Ryo; Gutiérrez, Juan Pablo
To develop a socioeconomic index for brief surveys that allows a classification in relation to a reference population with a parsimonious approach. A socioeconomic index was created using assets and use of services indicators to predict income level within a national representative survey of income (ENIGH, National Survey of Households Income and Expenditures) and then tested with data from a survey among key populations (men who have sex with men/transvestite, transgender, transsexual/female sex workers) and compared to an already published indicator. The concordance for quintiles 1, 2, 3, 4, and 5 between the two indexes were 94, 94, 82, 83, and 89%, respectively. The Spearman's rank correlation coefficient was 0.85. The proposed parsimonious index captures the socioeconomic level heterogeneity in the MSM/TTT/FSW survey. The use of this index is suggested for short surveys because of the next advantages: a) it uses dichotomic variables; b) the variables used do not imply the fulfillment of any statistical assumption; c) it is easily calculated; d) it can be used for comparing groups.
Boqun, Xu; Xiaonan, Dai; Yugui, Cui; Lingling, Gao; Xue, Dai; Gao, Chao; Feiyang, Diao; Jiayin, Liu; Gao, Li; Li, Mei; Zhang, Yuan; Ma, Xiang
Background. We previously found that expression of SET gene was up-regulated in polycystic ovaries by using microarray. It suggested that SET may be an attractive candidate regulator involved in the pathophysiology of polycystic ovary syndrome (PCOS). In this study, expression and cellular localization of SET protein were investigated in human polycystic and normal ovaries. Method. Ovarian tissues, six normal ovaries and six polycystic ovaries, were collected during transsexual operation and surgical treatment with the signed consent form. The cellular localization of SET protein was observed by immunohistochemistry. The expression levels of SET protein were analyzed by Western Blot. Result. SET protein was expressed predominantly in the theca cells and oocytes of human ovarian follicles in both PCOS ovarian tissues and normal ovarian tissues. The level of SET protein expression in polycystic ovaries was triple higher than that in normal ovaries (P polycystic ovaries more than that in normal ovaries. Combined with its localization in theca cells, SET may participate in regulating ovarian androgen biosynthesis and the pathophysiology of hyperandrogenism in PCOS.
Ichihara, Koji; Masumori, Naoya
We herein report and discuss our first experience about a sex reassignment surgery (SRS) with laparoscopic sigmoid colon vaginoplasty for a 40s male to female gender identity disorder. SRS for this subject included bilateral orchiectomy, penectomy, clitoroplasty, vaginoplasty, and vulvoplasty. About 20 cm of the sigmoid colon was harvested laparoscopicaly for the neovagina. Total operating time was about 9 hours, and the estimated blood loss was 900 ml without transfusion. There was no trouble during the postoperative course, and a sufficient length of vagina has been maintained.
Giltay, E.J.; Kho, K.H.; Blansjaar, B.A.; Verbeek, M.M.; Geurtz, P.B.; Geleijnse, J.M.; Gooren, L.J.G.
There is a close relationship between the brain and the endocrine system. The brain expresses receptors for sex steroids and is capable of metabolizing these hormones. We explored (1) sex differences in homovanillic acid (HVA), a metabolite of the neurotransmitter dopamine, and (2) the effects of
Giltay, E.J.; Kho, King H.; Blansjaar, B.A.; Verbeek, M.M.; Geurtz, P.B.H.; Geleijnse, J.M.
There is a close relationship between the brain and the endocrine system. The brain expresses receptors for sex steroids and is capable of metabolizing these hormones. We explored (1) sex differences in homovanillic acid (HVA), a metabolite of the neurotransmitter dopamine, and (2) the effects of
Ana Cristina Joaquim
Full Text Available This is an essay whose motto focuses on the junction between criticism and poetry, between ethics and aesthetics, in the long poem named Indulgência plenária of Alberto Pimenta. For present purposes it is important to consider criticism in a double sense: first of all, a way of explanation of some of the procedure language, so that poetic writing is presented as a procedure that folds over their own means, which allows reflection and valorization on the writing evidence; and, in another possible approach, criticism towards a detailed examination followed by evaluation about the motivating fact on which this long poem was wrote (violence - followed by death - suffered by the transsexual Gisberta Salce in Porto/Portugal –, at this moment of the analyses, the conjunction of ethics and aesthetics will be relevant. Alberto Pimenta also wrote critical essays, which matter consider this third meaning of criticism: a characteristic literary genre that will be the basis of some of the reflections raised by the poem. We intend to think how the criticism and the poetry are confluents achievements in Alberto Pimenta activity.
Sharp, L A
The human body--and its parts--has long been a target for commodification within myriad cultural settings. A discussion of commodification requires that one consider, first, the significance of the body within anthropology and, second, what defines a body "part." After exploring these initial questions, this article outlines dominant theoretical approaches to commodification within anthropology, with Mauss and Marx figuring prominently. The discussion then turns to historically well-documented forms of body commodification: These include slavery and other oppressive labor practices; female reproduction; and the realms of sorcery and endocannibalism. An analysis here uncovers dominant established approaches that continue to drive current studies. The remainder of this article concerns emergent biotechnologies, whose application in clinical and other related scientific arenas marks a paradigmatic shift in anthropological understandings of the commodified, fragmented body. The following contexts are explored with care: reproductive technologies; organ transplantation; cosmetic and transsexual surgeries; genetics and immunology; and, finally, the category of the cyborg. The article concludes with suggestions for an integrated theoretical vision, advocating greater cross-fertilization of analytical approaches and the inclusion of an ethics of body commodification within anthropology.
Full Text Available In 1976, prisoners acquired the right to medical treatment from the U.S. Supreme Court through the Eighth Amendment to the United States Constitution, which forbade, in part, cruel and unusual punishment. The following year, a Fourth Circuit Court of Appeals ruled that medical treatment included psychiatric or mental health treatment. These rulings applied to general prisoners, but not initially prisoners who suffered from gender identity disorder. Courts ruled then that gender identity disorder was not a serious mental disorder—a critical component of the right to medical care and mental health treatment. Later, a few appeals courts ruled that gender identity disorder was a serious mental disorder, triggering a prisoner’s right to medical care and mental health treatment for this disorder. Prisoners with gender identity disorder have litigated for sex realignment surgery as part of their treatment, which prison administrators have balked. The latest ruling unequivocally ordered the Massachusetts Department of Corrections to give a prisoner suffering from gender identity disorder sex reassignment surgery, but the prison system has appealed. This ruling, and previous rulings, has furthered policy towards transsexual prisoners.
Lucía Inés Coppa
Full Text Available The following article intends to approach some aspects of bourdiean thoughts in order to develop an approach to the notion of gender and the way in which – within an androcentric symbolic order and a normative heterosexual matrix – function these diagrams in the way gender makes up the subjective corporal form. From those notions, we want to reflect about the emergency of sexual identities that transgress the cultural precepts around gender founded in doxic experience. Likewise, we will sketch a brief reference among inconscient dimension across psychoanalytical tradition and performative theory across Judith Butler in the feminists debates.Through this conceptual framework we will attempt to examine how may the dominant representations of femininity, androcentric and heterosexually regulated, influence the identity formation of a feminine transsexual person, founded in the morphological ideal which has sustenance in the man-woman dichotomy, leaving the questioning open about the ways that the transgressive assumption of sex of what appears like the order of things may take in a binomic gender matrix, examining the reception of this debates in te Gender Identity Law N° 26.743
Ruben Marc Hackler
Full Text Available Judith Butler beschäftigt sich in dieser Aufsatzsammlung mit den politischen und rechtlichen Anliegen von Homo- und Transsexuellen. Im Mittelpunkt stehen die Menschenrechte und die gesetzlichen Bestimmungen, durch die homosexuelle Paare bei der Familiengründung benachteiligt werden. Der Bedarf nach einer theoretisch gehaltvollen Kritik und nach praktischen Verbesserungen ist groß. Exemplarisch analysiert Butler den öffentlich verhandelten Fall einer operativen Geschlechtsveränderung, in dem weder die Kritiker/-innen noch die Befürworter/-innen ausreichend darauf eingingen, was sich die betroffene Person wünschte. Ein Schwachpunkt des Bandes liegt im vieldeutigen Gebrauch des Begriffs Gender.Judith Butler focuses in this collection of essays on the political and legal concerns of homo- and transsexuals. She concentrates on human rights and statutory provisions through which homosexual pairs are discriminated against in family planning. There exists a great need for a theoretically rich critique and for practical improvements. Butler exemplarily analyses the publically debated case of an operative sex change, in which neither the critics nor the supporters sufficiently notes the concerned person’s own wishes. The weakness of the volume lies in the ambiguous use of the term gender.
Luis Miguel Rojas-Berscia
Full Text Available Not long after the premiere of Loxoro in 2011, a short-film by Claudia Llosa which presents the problems the transgender community faces in the capital of Peru, a new language variety became visible for the first time to the Lima society. Lóxoro [‘lok.so.ɾo] or Húngaro [‘uŋ.ga.ɾo], as its speakers call it, is a language spoken by transsexuals and the gay community of Peru. The first clues about its existence were given by a comedian, Fernando Armas, in the mid 90’s, however it is said to have appeared not before the 60’s. Following some previous work on gay languages by Baker (2002 and languages and society (cf. Halliday 1978, the main aim of the present article is to provide a primary sketch of this language in its phonological, morphological, lexical and sociological aspects, based on a small corpus extracted from the film of Llosa and natural dialogues from Peruvian TV-journals, in order to classify this variety within modern sociolinguistic models (cf. Muysken 2010 and argue for the “anti-language” (cf. Halliday 1978 nature of it.
Rotondi, Nooshin Khobzi; Bauer, Greta R; Scanlon, Kyle; Kaay, Matthias; Travers, Robb; Travers, Anna
We examined the extent of nonprescribed hormone use and self-performed surgeries among transgender or transsexual (trans) people in Ontario, Canada. We present original survey research from the Trans PULSE Project. A total of 433 participants were recruited from 2009 to 2010 through respondent-driven sampling. We used a case series design to characterize those currently taking nonprescribed hormones and participants who had ever self-performed sex-reassignment surgeries. An estimated 43.0% (95% confidence interval = 34.9, 51.5) of trans Ontarians were currently using hormones; of these, a quarter had ever obtained hormones from nonmedical sources (e.g., friend or relative, street or strangers, Internet pharmacy, herbals or supplements). Fourteen participants (6.4%; 95% confidence interval = 0.8, 9.0) reported currently taking nonprescribed hormones. Five indicated having performed or attempted surgical procedures on themselves (orchiectomy or mastectomy). Past negative experiences with providers, along with limited financial resources and a lack of access to transition-related services, may contribute to nonprescribed hormone use and self-performed surgeries. Promoting training initiatives for health care providers and jurisdictional support for more accessible services may help to address trans people's specific needs.
Full Text Available Text analysis Suzana Tratnik’s novel “My name is Damjan”, which was first published in 2001, and in 2014 reprinted. The novel deals with topical issues: in a perfect way it draws a story of a young person with a socially unconventional, transgender identity. Damjan’s articulation of his own identity is the essence of the novel, which, in a perfect way, tells a story, increasingly articulated and actualized in recent decades, to the public, the story of forced gender identity and individual ways of liberation from it. Let us repeat after Patrick Califia, transsexual activist: “I hope that young people with different gender identities will not allow to be destroyed by the sexual frenzy of our culture.” Nataša Velikonja’s article was commissioned as an afterword to the second edition of the novel for the Mladinska knjiga publishing house, the text was by the editorial staff of youth literature initially accepted and approved without comment, but later rejected, saying it would be too difficult for youth readership.
Full Text Available In an analysis of what presents itself as a cinematic transposition of a literary text, it is difficult to break away from the “binary oppositions [...] literature versus cinema, high culture versus mass culture, original versus copy" (James Naremore. In the case of Princesa (2001, directed by Henrique Goldman, it is questionable whether we can speak about an adaptation at all. As Goldman himself stated, he got the idea for making the film after reading the eponymous 1994 book written by Fernanda Farias de Albuquerque in collaboration with Maurizio Jannelli. In his film, Goldman has made drastic changes to the autobiographical story of Fernanda, the Brazilian transsexual prostitute who travels to Europe in order to earn money for her sex-change operation. However, the film was in fact dedicated to the memory of the real Fernanda, who had passed away in the meantime. In this contribution, the two works will be examined in their relationship to a third source-text by paying special attention to the processes of worldmaking as developed in Nelson Goodman's seminal 1978 book and expanded in the 2010 collection of essays Cultural Ways of Worldmaking. Media and Narratives.
Full Text Available Depois dos estudos das masculinidades, não é possível pensar a produção das identidades de gênero sem referenciá-las ao caráter relacional. Esta mudança deveu-se à incorporação da perspectiva relacional nesse campo de estudos e à crítica ao conceito de gênero assentado em uma suposta natureza feminina e masculina para construir as interpretações sobre o lugar dos corpos da ordem de gênero. Os objetivos desse artigo são: 1 apontar como um determinado conceito de gênero pode visibilizar múltiplas expressões de gênero, a exemplo das identidades trans (transexuais, travestis, cross dress, drag queen, drag king, transgêneros ou invisibilizá-las e contribuir para sua patologização. O segundo objetivo será apresentar narrativas de homens trans e de mulheres trans, que nos contarão suas vivências sexuais. Os saberes médicos-psi advogam a inexistência de sexualidade em seus corpos, sendo este um dos indicadores para produção do diagnóstico de transexualidade. Tentarei argumentar que a base teórica que sustenta a patologização das identidades trans e a afirmação que as pessoas trans são assexuadas tem como fundamento uma concepção que atrela e condiciona as identidades de gênero às estruturas biológicas.In the aftermath of studies on masculinity, it is impossible to consider the production of gender identities without linking them to the relationship aspect. This change was due to the incorporation of the relationship perspective in this field of study and criticism of the concept of gender founded upon an alleged concept of femininity and masculinity to create interpretations of the place of bodies in the gender order. The objectives of this paper are: 1 to show how a given concept of gender can render multiple expressions of gender visible, like the trans identities (transsexuals, transvestites, cross dressers, drag queens, drag kings, transgenders or sublimate them and contribute to their pathologization
Scheim, Ayden I; Bauer, Greta R
Recent estimates suggest that as many as 1 in 200 adults may be trans (transgender, transsexual, or transitioned). Knowledge about dimensions of sex and gender in trans populations is crucial to development of inclusive policy, practice, and research, but limited data have been available, particularly from probability samples. The Trans PULSE community-based research project surveyed trans Ontarians (n=433) in 2009-2010 using respondent-driven sampling. Frequencies were weighted by recruitment probability to produce estimates for the networked Ontario trans population. An estimated 30% of trans Ontarians were living their day-to-day lives in their birth gender, and 23% were living in their felt gender with no medical intervention. In all, 42% were using hormones, while 15% of male-to-female spectrum persons had undergone vaginoplasty and 0.4% of female-to-male spectrum persons had had phalloplasty. Of those living in their felt gender, 59% had begun to do so within the past four years. A minority of trans Ontarians reported a linear transition from one sex to another, yet such a trajectory is often assumed to be the norm. Accounting for this observed diversity, we recommend policy and practice changes to increase social inclusion and service access for trans persons, regardless of transition status.
Scheim, Ayden I.; Bauer, Greta R.
Recent estimates suggest that as many as 1 in 200 adults may be trans (transgender, transsexual, or transitioned). Knowledge about dimensions of sex and gender in trans populations is crucial to development of inclusive policy, practice, and research, but limited data have been available, particularly from probability samples. The Trans PULSE community-based research project surveyed trans Ontarians (n = 433) in 2009–2010 using respondent-driven sampling. Frequencies were weighted by recruitment probability to produce estimates for the networked Ontario trans population. An estimated 30% of trans Ontarians were living their day-to-day lives in their birth gender, and 23% were living in their felt gender with no medical intervention. In all, 42% were using hormones, while 15% of male-to-female spectrum persons had undergone vaginoplasty and 0.4% of female-to-male spectrum persons had had phalloplasty. Of those living in their felt gender, 59% had begun to do so within the past four years. A minority of trans Ontarians reported a linear transition from one sex to another, yet such a trajectory is often assumed to be the norm. Accounting for this observed diversity, we recommend policy and practice changes to increase social inclusion and service access for trans persons, regardless of transition status. PMID:24750105
Villepelet, A; Jafari, A; Baujat, B
The demand for facial feminization is increasing in transsexual patients. Masculine foreheads present extensive supraorbital bossing with a more acute glabellar angle, whereas female foreheads show softer features. The aim of this article is to describe our surgical technique for fronto-orbital feminization. The mask-lift technique is an upper face-lift. It provides rejuvenation by correcting collapsed features, and fronto-orbital feminization through burring of orbital rims and lateral canthopexies. Depending on the size of the frontal sinus and the thickness of its anterior wall, frontal remodeling is achieved using simple burring or by means of the eggshell technique. Orbital remodeling comprises a superolateral orbital opening, a reduction of ridges and a trough at the lateral orbital rim to support the lateral canthopexy. Frontal, corrugator and procerus myectomies, plus minimal scalp excision, complete the surgery. Our technique results in significant, natural-looking feminization. No complications were observed in our series of patients. The eggshell technique is an alternative to bone flap on over-pneumatized sinus. Fronto-orbital feminization fits into a wider surgical strategy. It can be associated to rhinoplasty, genioplasty, mandibular angle remodeling, face lift and laryngoplasty. Achieving facial feminization in 2 or 3 stages improves psychological and physiological tolerance. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Kreukels, Baudewijntje P C; Cohen-Kettenis, Peggy T
The use of gonadotropin-releasing hormone analogs (GnRHa) to suppress puberty in adolescents with gender dysphoria is a fairly new intervention in the field of gender identity disorders or transsexualism. GnRHa are used to give adolescents time to make balanced decisions on any further treatment steps, and to obtain improved results in the physical appearance of those who opt to continue with sex reassignment. The effects of GnRHa are reversible. However, concerns have been raised about the risk of making the wrong treatment decisions, as gender identity could fluctuate during adolescence, adolescents in general might have poor decision-making abilities, and there are potential adverse effects on health and on psychological and psychosexual functioning. Proponents of puberty suppression emphasize the beneficial effects of GnRHa on the adolescents' mental health, quality of life and of having a physical appearance that makes it possible for the patients to live unobtrusively in their desired gender role. In this Review, we discuss the evidence pertaining to the debate on the effects of GnRHa treatment. From the studies that have been published thus far, it seems that the benefits outweigh the risks. However, more systematic research in this area is needed to determine the safety of this approach.
O'Shea, T; Crowley, R K; Farrell, M; MacNally, S; Govender, P; Feeney, J; Gibney, J; Sherlock, M
Meningioma growth has been previously described in patients receiving oestrogen/progestogen therapy. We describe the clinical, radiological, biochemical and pathologic findings in a 45-year-old woman with congenital adrenal hyperplasia secondary to a defect in the 21-hydroxylase enzyme who had chronic poor adherence to glucocorticoid therapy with consequent virilisation. The patient presented with a frontal headache and marked right-sided proptosis. Laboratory findings demonstrated androgen excess with a testosterone of 18.1 nmol/L (0-1.5 nmol) and 17-Hydroxyprogesterone >180 nmol/L (transsexual patients undergoing therapy with high-dose oestrogen and progestogens. Progesterone receptor positivity has been described previously in meningiomas. 17-Hydroxyprogesterone is elevated in CAH and has affinity and biological activity at the progesterone receptor. Therefore, we hypothesise that patients who have long-standing increased adrenal androgen precursor concentrations may be at risk of meningioma growth. Patients with long-standing CAH (particularly if not optimally controlled) may present with other complications, which may be related to long-standing elevated androgen or decreased glucocorticoid levels.Chronic poor control of CAH is associated with adrenal myelolipoma and adrenal rest tissue tumours.Meningiomas are sensitive to endocrine stimuli including progesterone, oestrogen and androgens as they express the relevant receptors.
Full Text Available Introduction. Controversies on clitoral anatomy and its role in female sexual function still make clitoral reconstructive surgery very challenging. We evaluated the role of clitoral anatomic features in female to male sex reassignment surgery. Material and Methods. The study included 97 female transsexuals, aged from 18 to 41 years, who underwent single stage metoidioplasty between March 2008 and January 2013. The operative technique involved vaginectomy, the release of clitoral ligaments and urethral plate, urethroplasty by combining buccal mucosa graft and genital flaps, and scrotoplasty with insertion of testicle prostheses. Postoperative questionnaire was used to evaluate aesthetic, functional, and sexual outcome. Results. The mean followup was 30 months. The mean length of the neophallus was 7 cm, compared to mean preoperative length of the hypertrophied clitoris of 3.3 cm. Complications occurred in 27.84% of all patients, related mostly to urethroplasty. Voiding while standing was achieved in all cases. None of the patients had problems in sexual arousal, masturbation, or orgasms. Conclusion. Accurate knowledge of the clitoral anatomy, physiology, and neurovascular supply is crucial for a successful outcome of female to male sex reassignment surgery. Our approach appears to ensure overall satisfaction and high quality of sexual life.
The term body integrity identity disorder (BIID) describes the extremely rare phenomenon of persons who desire the amputation of one or more healthy limbs or who desire a paralysis. Some of these persons mutilate themselves; others ask surgeons for an amputation or for the transection of their spinal cord. Psychologists and physicians explain this phenomenon in quite different ways; but a successful psychotherapeutic or pharmaceutical therapy is not known. Lobbies of persons suffering from BIID explain the desire for amputation in analogy to the desire of transsexuals for surgical sex reassignment. Medical ethicists discuss the controversy about elective amputations of healthy limbs: on the one hand the principle of autonomy is used to deduce the right for body modifications; on the other hand the autonomy of BIID patients is doubted. Neurological results suggest that BIID is a brain disorder producing a disruption of the body image, for which parallels for stroke patients are known. If BIID were a neuropsychological disturbance, which includes missing insight into the illness and a specific lack of autonomy, then amputations would be contraindicated and must be evaluated as bodily injuries of mentally disordered patients. Instead of only curing the symptom, a causal therapy should be developed to integrate the alien limb into the body image.
Medicine, social conditions, culture and politics are inextricably bound as determinants of health and wellbeing. In Cuba, perhaps this is nowhere more evident than in the arduous struggle to consider non-discriminatory analysis of gender-sensitive components as fundamental to population health, medical practice and research; national policy; and above all, public consciousness. Among the standard-bearers of this cause is Mariela Castro, psychologist and educator with a master's degree in sexuality, who directs the National Sex Education Center (CENESEX), its journal Sexologia y Sociedad, and the National Commission for Comprehensive Attention to Transsexual People. The Center's work is at the vortex of national polemics on sexuality, approaches to sex education and health, and respect for the human rights of people of differing sexual orientations and gender identities. The daughter of President Raúl Castro and the late Vilma Espín--who, as founder and leader of the Federation of Cuban Women, pioneered the defense of both women and homosexuals--Mariela Castro nevertheless speaks with her own voice in national as well as international debates. MEDICC Review talked with her about the range of issues that link gender to WHO's broad definition of health as the highest level of physical and mental wellbeing.
Wise, T N
Proper categorization of individuals with gender dysphoria allows rational psychotherapy. The treatment of an aging transvestite who requested sexual reassignment is presented to demonstrate the clinical features of the disorder and the course of the illness. The initial task was to place the patient into the proper clinical category of individuals with gender dysphorias. The clinical details of this disorder include an episoidic course with individuals who have previously had clear masculine identities. In the past they have been labeled secondary or marginal transsexuals as well as fetishtic cross-dressers. The patient, who had a long-standing history of cross-dressing, reacted to specific life stresses by the symptomatic wish for sexual reassignment. The individual psychotherapy consisted of phases of symptomatic expression, emerging depression, interpersonal awareness, symptom resolution and disavowel of the wish for sexual reassignment. The genesis of this perversion appears to be identification with a phallic maternal figure. Discussion of the descriptive and dynamic literature is reported in relation to the reported case. Identification of important losses in this patient's recent life allowed proper diagnosis and appropriate ongoing therapy to prevent the patient from irreversible surgery for a condition that was a symptom not an ingrained belief of gender dysphoria.
Akın, Yiğit; Şahiner, İlker Fatih; Usta, Mustafa Faruk
To evaluate the changing cavernosal length of patients with diabetes mellitus (DM) and organic erectile dysfunction (ED) who were treated with inflatable, three-piece penile prostheses, a current surgical treatment option in our clinic, over the course of 12 years. Between April 2000 and December 2012, we retrospectively investigated data from patients who were diagnosed with organic ED and undergone penile prosthesis implantation (PPI). Of the 239 patients, 235 of them were included in the study. Four patients who were operated on for trans-sexuality were excluded from the study. All patients were divided into two groups as those with (Group 1) or without DM (Group 2). Data, including age, body mass index (BMI) in kg/m(2), surgical history, comorbidities, International Index of Erectile Function (IIEF) questionnaire scores, combined intracavernous injection and stimulation (CIS) test results, length of corpus cavernosum while implanting the penile prosthesis, complications, operative times, mean hospital stay, and satisfaction of the patient and partner, were recorded. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis. A p-value of 0.05). The length of the corpus cavernosum and the destruction of cavernosal tissues do not depend only on DM. We conclude that these features may have multifactorial causes.
Speer, Susan A; McPhillips, Rebecca
To explore transsexual patients' perceptions of communication with psychiatrists in a Gender Identity Clinic and advance understanding of patient centered communication (PCC) in psychiatric, 'gatekeeping' settings. 21 qualitative interviews with a convenience sample of clinic patients. Interviews were coded at a semantic level and subject to an inductive thematic analysis. Patients' perceptions clustered into three themes: (1) aspects of communication that patients described liking; (2) aspects of communication that patients described disliking; and (3) aspects of communication that patients deemed challenging but necessary or useful. Patients described liking or disliking aspects of communication that reflect existing understandings of PCC. However, a striking feature of their accounts was how they were able to rationalize and reflect pragmatically on their negative communication experiences, welcoming doctors' challenges as an opportunity to consider their life-changing decision to transition from their natal gender. In certain clinical settings, current operationalizations of PCC may not apply. Patients' perceptions of communication may be enhanced if an analysis of their experiences formed part of the professional training of doctors, who could be invited to consider the functional specificity of communication across settings and the consequences (both immediate and post hoc) of their communication practices. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Chi, Xinli; Hawk, Skyler T; Winter, Sam; Meeus, Wim
The purpose of this study was to evaluate whether a comprehensive sexual education program for college students in Southwest China (a) improved sexual health knowledge in reproduction, contraception, condom use, sexually transmitted diseases, and HIV; (b) increased accepting attitudes toward lesbian, gay, bisexual, and transsexual individuals; and (c) altered participants' attitudes toward premarital sex and monogamy. The program used diverse teaching methods, providing 6 sessions over a period of 9 weeks about sexual health knowledge and sexual attitudes to college students (age 18-26 years) in Southwest China. Sexual health knowledge and sexual attitudes of 80 comprehensive sexual education class students (education group) and 92 general mental health education class students (control group) were measured at baseline, the end of course (posttest), and 3 weeks after the end of course (follow-up). There were significant effects of the program on (a) sexual health knowledge, including reproductive health, contraception, condom use, and HIV/AIDS and (b) positive attitudes toward sexual minorities, although these changes may require further reinforcement. In contrast, the program did not alter students' attitudes about premarital sex or monogamy. The results are discussed in terms of recommendations of sex education in China and future directions for research. © 2013 APJPH.
Proctor, Kimberly; Haffer, Samuel C.; Ewald, Erin; Hodge, Carla; James, Cara V.
Abstract Purpose: To identify and describe the transgender population in the Medicare program using administrative data. Methods: Using a combination of International Classification of Diseases ninth edition (ICD-9) codes relating to transsexualism and gender identity disorder, we analyzed 100% of the 2013 Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service (FFS) “final action” claims from both institutional and noninstitutional providers (∼1 billion claims) to identify individuals who may be transgender Medicare beneficiaries. To confirm, we developed and applied a multistage validation process. Results: Four thousand ninety-eight transgender beneficiaries were identified, of which ∼90% had confirmatory diagnoses, billing codes, or evidence of a hormone prescription. In general, the racial, ethnic, and geographic distribution of the Medicare transgender population tends to reflect the broader Medicare population. However, age, original entitlement status, and disease burden of the transgender population appear substantially different. Conclusions: Using a variety of claims information, ranging from claims history to additional diagnoses, billing modifiers, and hormone prescriptions, we demonstrate that administrative data provide a valuable resource for identifying a lower bound of the Medicare transgender population. In addition, we provide a baseline description of the diversity and disease burden of the population and a framework for future research. PMID:28861539
This paper looks at systems of gender within the context of analysis. It explores the unique challenges of individuation faced by transsexual, transgender, gender queer, gender non-conforming, cross-dressing and intersex patients. To receive patients generously we need to learn how a binary culture produces profound and chronic trauma. These patients wrestle with being who they are whilst simultaneously receiving negative projections and feeling invisible. While often presenting with the struggles of gender conforming individuals, understanding the specifically gendered aspect of their identity is imperative. An analyst's unconscious bias may lead to iatrogenic shaming. The author argues that rigorous, humble inquiry into the analyst's transphobia can be transformative for patient, analyst, and the work itself. Analysis may, then, provide gender-variant patients with their first remembered and numinous experience of authentic connection to self. Conjuring the image of a hinge, securely placed in the neutral region of a third space, creates a transpositive analytic temenos. Invoking the spirit of the Trickster in the construction of this matrix supports the full inclusion of gender-variant patients. Nuanced attunement scaffolds mirroring and the possibility of play. Being mindful that gender is sturdy and delicate as well as mercurial and defined enriches the analyst's listening. © 2017, The Society of Analytical Psychology.
This article examines the case files of patients diagnosed with Transvestitismus [transvestism] in the Psychiatric Clinic of the Helsinki University Central Hospital in the years 1954–68. These individuals did not only want to cross-dress, but also had a strong feeling of being of a different sex from their assigned one. The scientific concept of transsexuality had begun to take form, and this knowledge reached Finland in phases. The case files of the transvestism patients show that they were highly aware of their condition and were very capable of describing it, even if they had no medical name for it. Psychiatrists were willing to engage in dialogue with the patients, and did not treat them as passive objects of study. Although some patients felt that they had been helped, many left the institution as frustrated, angered or desperate as before. They had sought medical help in the hope of having their bodies altered to correspond to their identity, but the Clinic psychiatrists insisted on seeing the problem in psychiatric terms and did not recommend surgical or hormonal treatments in most cases. This attitude would gradually change over the course of the 1970s and 1980s. PMID:29199927
David D.J. Sander Scheidt
Full Text Available According to my claim that voice as a phenomenon cannot be materialised or located, neither in the (voice organ of the self nor in the (ear of the other, I coined the term [au]/[o]-tophonography for my examination of the possibilities of performing subjectivity in writing and in sound productions. Drawing on the theory of performativity in its deconstructive senses (see BUTLER, 1993, 1997, 1999/1990; DERRIDA, 1988/1972, 1997/1967, 2002/1981; SMITH, 1995 my performative epistemology reaches beyond the theoretical, including the practical and the aesthetical, aiming at questioning notions of "self", "audience", "voice", "writing" and "communication". "The show with the voice" (http://www.qualitative-research.net/fqs-texte/2-08/08-2-27_audio.mp3 is an example of this practice. It parodies the medico-scientific approach to the human voice by presenting some of its possible appearances (the "normal", the "disordered", the "homosexual" and the "transsexual" voice in an audio collage that takes the shape of a mock tutorial. Through re-contextualising and re-compiling voice samples from different sources that are usually kept apart (e.g. the lecturer's voice, the researcher's voice, the artist's voice, the autobiographer's voice I open a space for a multidisciplinary and creative perspective to the examination of voice. URN: urn:nbn:de:0114-fqs0802279
Vaucher, R; Dast, S; Assaf, N; Sinna, R
The surgical approach of gynecomastia, sexual reassignment surgery in female-to-male transsexuals and the increase of number of obese wishing to turn to plastic surgery led us to deepen the anatomical knowledge of the nipple areola complex (NAC) in men, poorly retailed in the literature. By inspiring us of the methodology of a Japanese study, we studied 50 healthy volunteers male, from 18 to 55 years old, from July till August 2015. We measured various distances relative to the NAC to define its vertical and horizontal position, as well as the internipple distance according to the size, to the weight and to the body mass index (BMI). At the end of the analysis, we were able to underline a lower vertical thoracic position of the NAC in the tall category of person, a more side horizontal position to the subject presenting a high BMI and a linear relation between the BMI and the internipple (Em) defined by (Em)=8.96×BMI. The surgeon's judgment and the desires of the patient are essentials basis of therapeutics decisions that could be lean on this anatomical study, which allowed to establish an idea of the cartography of the NAC in man. It will be interesting and necessary to confront it with other studies with larger scale. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
van de Grift, Tim C; Elaut, Els; Cerwenka, Susanne C; Cohen-Kettenis, Peggy T; De Cuypere, Griet; Richter-Appelt, Hertha; Kreukels, Baudewijntje P C
The aim of this study from the European Network for the Investigation of Gender Incongruence is to investigate the status of all individuals who had applied for gender confirming interventions from 2007 to 2009, irrespective of whether they received treatment. The current article describes the study protocol, the effect of medical treatment on gender dysphoria and body image, and the predictive value of (pre)treatment factors on posttreatment outcomes. Data were collected on medical interventions, transition status, gender dysphoria (Utrecht Gender Dysphoria Scale), and body image (Body Image Scale for transsexuals). In total, 201 people participated in the study (37% of the original cohort). At follow-up, 29 participants (14%) did not receive medical interventions, 36 hormones only (18%), and 136 hormones and surgery (68%). Most transwomen had undergone genital surgery, and most transmen chest surgery. Overall, the levels of gender dysphoria and body dissatisfaction were significantly lower at follow-up compared with clinical entry. Satisfaction with therapy responsive and unresponsive body characteristics both improved. High dissatisfaction at admission and lower psychological functioning at follow-up were associated with persistent body dissatisfaction. Hormone-based interventions and surgery were followed by improvements in body satisfaction. The level of psychological symptoms and the degree of body satisfaction at baseline were significantly associated with body satisfaction at follow-up.
Kidd, Sean A; Howison, Meg; Pilling, Merrick; Ross, Lori E; McKenzie, Kwame
There is increasing attention to diversity in psychiatric services and widespread recognition of the mental health implications of stigma for individuals from sexual or gender minority groups. However, these areas remain markedly underdeveloped in the area of severe mental illness. The aim of this review was to map out the existing base of knowledge in these areas to help inform future research, practice, and policy directions. A review of the literature was conducted to answer the following question: What factors and strategies need to be considered when developing services for individuals from sexual or gender minority groups who are experiencing severe mental illness? A comprehensive search of MEDLINE, PsycINFO, and Google Scholar was completed by using Arksey and O'Malley's methodological framework for scoping reviews. A total of 27 publications were identified for review. Mental health services research indicated generally lower levels of service satisfaction among lesbian, gay, bisexual, transgender, and transsexual (LGBT) individuals and minimal evidence regarding specific interventions. Descriptive research suggested an increased risk of severe mental illness in LGBT populations, an association between this increased risk and discrimination, and the potential benefit of cultivating spaces where individuals can be "out" in all aspects of themselves. There is a pressing need for research into interventions for LGBT populations with severe mental illness as well as descriptive studies to inform efforts to reduce illness morbidity linked to discrimination.
O'Hanlan, Katherine A
Homosexuality and transsexuality are still widely viewed by lay individuals as morally negative and deserving of legal proscription. Peer-reviewed data confirm that experiences of legal discrimination are associated with stress-related health problems, reduced utilization of health care, and financial and legal challenges for individuals and families, especially those with children. In the last 3 years, the American Psychiatric Association, American Psychological Association, and American Psychoanalytic Association have each reviewed the research on sexual orientation and identity, and each has confirmed that sexual orientation and gender identity do not correlate with mental illness or immorality. They have each endorsed laws that confer equality to sexual minorities, including nondiscrimination in employment, medical insurance coverage, adoption, and access to civil marriage. The American College of Obstetricians and Gynecologists (ACOG), by virtue of its history of advocacy for women's health, is in a position to promote policy and make similar recommendations, recognizing that sexual minority women's health and their family issues are an integral component of taking care of all women. The College should review the policies of America's premier mental health associations and consider including sexual orientation and gender identity in its own nondiscrimination policy, and ACOG should issue a policy statement in support of laws to provide safety from violence and discrimination, equal employment opportunities, equal health insurance coverage, and equal access to civil marriage.
Full Text Available Pride and prejudice. The significance of election of a transsexual person as a “representative of Nation” Ms. Anna Grodzka’s election to the Polish Parliament in 2011 was a crucial event because for the first time in Europe a transsexual person became a Member of Parliament, and thus was to represent all Poles at the national level. This event resulted in mixed reactions and comments: from euphoria to trauma, from great pride to deep prejudice. It is instrumental in self identification of Poles, nevertheless two different Polish “nations” make use of it, presenting two different languages and two absolutely separate pictures of Polish identity. The first approach is associated with such notions as freedom, equity, minority rights, multiculturalism. The other is connected with such phrases as original values, genuine Poles, God, and the regular family. Therefore contemporary war of cultures, that is a general conflict over values and collective identity, came to focus on the fact that Anna Grodzka became an MP. The author of the article, relying on Allan McKee’s interpretative analysis of cultural texts, in this case press articles, aims at an analysis of the role of Ms. Grodzka’s election for identity shaping processes among Poles. Duma i uprzedzenie. Znaczenie wyboru osoby transseksualnej na „przedstawiciela Narodu” Wybór Anny Grodzkiej na posłankę był przełomowym wydarzeniem, ponieważ po raz pierwszy w Europie osoba transseksualna została przedstawicielką wszystkich rodaków. Wydarzenie to wywołało jednak różne reakcje: od euforii do traumy, od wielkiej dumy do głębokich uprzedzeń. Służy ono bowiem samookreślaniu się Polaków, ale w taki sposób, że korzystają z niego w procesie samoidentyfikacji co najmniej dwa polskie „narody”, posługujące się językami uosabiającymi dwie zupełnie inne wizje polskości. Naród tych, którzy boją się o Polskę, utożsamianą z wiarą katolicką, tradycyjn
Soleman, Remi S; Staphorsius, A.S.; Cohen-Kettenis, Peggy T; Lambalk, Cornelis B; Veltman, Dick J; van Trotsenburg, M.A.A.; Hompes, Peter G A; Drent, M L; de Ronde, W P; Kreukels, Baudewijntje P C
Although the prevailing opinion is that emotional processes are influenced by sex hormones, the literature is still inconclusive. The aim of the current study was to examine the effects of gonadal suppression on brain activity during affective picture processing. Twenty-one female-to-male (FtM)
Eudes Quintino de Oliveira Júnior
Full Text Available Research on human beings has expanded greatly due to progress and the evolution of society as well as customs. Not only the unceasing development of research on human beings, but also interference in the beginning and end of life with homologous and heterogonous human reproduction, surrogate motherhood, cloning, gene therapies, eugenics,euthanasia, dysthanasia, orthothanasia, assisted suicide, genetic engineering, reassignment surgery in cases of transsexuality, the use of recombinant DNA technology and embryonic stem cells, transplantation of human organs and tissues, biotechnology and many other scientific advances. Scientific progress goes faster than the real needs of human beings, who are the final recipient of the entire evolutionary progress. Hence, there is the need to scrutinize whether new technologies are necessary, suitable and timely so that humanity can achieve its postulate of bene vivere. Human cloning, as an abrupt scientific fact, has presented itself to the world community as a procedure that can be performed with relative success and with little difficulty, since it achieved its objectives with the cloning of Dolly the sheep. This issue became the topic of discussion not only in the scientific community but in the lay population, and it received from both, global disapproval. The conclusion is that the human being is unique, with a life cycle defined by the rules of nature. Reversal will cause a violation of the genetic heritage and, above all, will confront the constitutional principle of human dignity.
Full Text Available Research into the neurobiological origins of same-sex attraction is inconclusive. A recent theory of homosexuality posited that maternal thyroid dysfunction during pregnancy is associated with an increased rate of homosexual orientation in offspring. Relevant studies from the prenatal thyroid model perspective were reviewed, the major findings of which are as follows: i An increased prevalence of Hashimoto’s disease in lesbian women suggests a maternal and even familial presence of the same autoimmune thyroid disease. Female-tomale transsexuals and lesbian women were also reported to have higher rates of polycystic ovary syndrome (PCOS. Over the last several years, reports suggesting a strong link between PCOS and thyroid autoimmunity have accumulated. ii The increased risk of autism spectrum disorders (ASD in the offspring of mothers with thyroid autoimmunity in pregnancy and the association between ASD and gender dysphoria indicate a link between maternal thyroid dysfunction and gender dysphoria/same-sex attraction in the offspring. iii The high risk of miscarriage and retarded fetal growth in pregnancies of mothers who give birth to homosexual offspring can be explained by the impact of maternal thyroid dysfunction during pregnancy. This perspective review highlights relevant research findings and integrates them into the prenatal thyroid model of homosexuality. A better understanding of the mechanisms involved in the generation of same-sex orientation will contribute to the betterment of individual lives, as well as of society.
Mitchell, Olivia; Malatzky, Christina; Bourke, Lisa; Farmer, Jane
The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated. © 2018 National Rural Health Alliance Ltd.
Ruppin, Ulrike; Pfäfflin, Friedemann
The aim of this study was to re-examine individuals with gender identity disorder after as long a period of time as possible. To meet the inclusion criterion, the legal recognition of participants' gender change via a legal name change had to date back at least 10 years. The sample comprised 71 participants (35 MtF and 36 FtM). The follow-up period was 10-24 years with a mean of 13.8 years (SD = 2.78). Instruments included a combination of qualitative and quantitative methods: Clinical interviews were conducted with the participants, and they completed a follow-up questionnaire as well as several standardized questionnaires they had already filled in when they first made contact with the clinic. Positive and desired changes were determined by all of the instruments: Participants reported high degrees of well-being and a good social integration. Very few participants were unemployed, most of them had a steady relationship, and they were also satisfied with their relationships with family and friends. Their overall evaluation of the treatment process for sex reassignment and its effectiveness in reducing gender dysphoria was positive. Regarding the results of the standardized questionnaires, participants showed significantly fewer psychological problems and interpersonal difficulties as well as a strongly increased life satisfaction at follow-up than at the time of the initial consultation. Despite these positive results, the treatment of transsexualism is far from being perfect.
Cohen-Kettenis, Peggy T; Pfäfflin, Friedemann
Apart from some general issues related to the Gender Identity Disorder (GID) diagnosis, such as whether it should stay in the DSM-V or not, a number of problems specifically relate to the current criteria of the GID diagnosis for adolescents and adults. These problems concern the confusion caused by similarities and differences of the terms transsexualism and GID, the inability of the current criteria to capture the whole spectrum of gender variance phenomena, the potential risk of unnecessary physically invasive examinations to rule out intersex conditions (disorders of sex development), the necessity of the D criterion (distress and impairment), and the fact that the diagnosis still applies to those who already had hormonal and surgical treatment. If the diagnosis should not be deleted from the DSM, most of the criticism could be addressed in the DSM-V if the diagnosis would be renamed, the criteria would be adjusted in wording, and made more stringent. However, this would imply that the diagnosis would still be dichotomous and similar to earlier DSM versions. Another option is to follow a more dimensional approach, allowing for different degrees of gender dysphoria depending on the number of indicators. Considering the strong resistance against sexuality related specifiers, and the relative difficulty assessing sexual orientation in individuals pursuing hormonal and surgical interventions to change physical sex characteristics, it should be investigated whether other potentially relevant specifiers (e.g., onset age) are more appropriate.
McKeganey, N P
A review of the literature indicates that the association between human immunodeficiency virus (HIV) and prostitution varies by geographic region and can be altered substantially by well-planned public health interventions. In most African countries and in Asian countries such as Thailand, the rate of HIV infection among female prostitutes is substantially higher than the rate in the general population. Relatively few commercial sex workers in South and Central America are HIV-positive; however, their extremely high rates of infection with sexually transmitted diseases indicates the potential for future epidemic spread of HIV. In Europe and North America, HIV infection is most prevalent among drug-injecting or crack-using prostitutes. Neglected has been research on the high incidence of HIV among male transvestite and transsexual prostitutes. The lowest levels of condom use in commercial sex encounters have been recorded in regions in developing countries with the highest HIV prevalence. Also of concern are high condom breakage rates (20-50%) among female prostitutes who use petroleum-based lubricants and male prostitutes who practice anal sex. Valuable would be quantification of the additional HIV risk resulting from sex with a prostitute. Other recommended research areas include estimates of the number of male and female prostitutes working in certain geographic areas, mechanisms for monitoring condom use and substance abuse among prostitutes, the impact of HIV infection on movement into and out of prostitution, the dynamics of prostitute-client condom negotiation, and profiles of the clients of male prostitutes.
Full Text Available Several andrological diseases require surgical repair or reconstruction of tunica albuginea, which envelops the corpora cavernosa penis. Despite intense research efforts involving a variety of biological materials, such as skin, muscle aponeurosis, human dura mater, tunica vaginalis, and pericardium, engineered tunica albuginea suitable for graft use is yet to be obtained. The study investigates microsurgical tunica albuginea allotransplantation in an animal model with the purpose of creation of an organ-specific tissue bank to store penile tissue, from cadaveric donors and male-to-female trans-sexual surgery, for allogeneic transplantation. Materials were tunica albuginea tissue explanted from 15 donor rats, cryopreserved at −80°C, gamma-irradiated, and implanted in 15 recipient rats, of which three rats were used as controls. Penile grafts were explanted at different time intervals; after macroscopic evaluation of the organ, the grafts were processed to morphological, histochemical, and immunohistochemical examinations by light microscopy. Detection of pro-inflammatory cytokines was also performed. Examination of the tunica albuginea allografts collected 1, 3, or 6 months after surgery and of control tunica albuginea fragments showed that tunica albuginea implants achieved biointegration with adjacent tissue at all-time points. The integration of cryopreserved rat tunica albuginea allografts, documented by our study, encourages the exploration of tunica albuginea allotransplantation in humans. In conclusion, the effectiveness and reliability of the tunica albuginea conditioning protocol described here suggest the feasibility of setting up a tunica albuginea bank as a further tissue bank.
Full Text Available Gonadotropin-releasing hormone (GnRH agonists are derived from native GnRH by amino acid substitution which yields the agonist resistant to degradation and increases its half-life. The hypogonadotropic hypogonadal state produced by GnRH agonists has been often dubbed as "pseudomenopause" or "medical oophorectomy," which are both misnomers. GnRH analogues (GnRH-a work by temporarily "switching off" the ovaries. Ovaries can be "switched off" for the therapy and therapeutic trial of many conditions which include but are not limited to subfertility, endometriosis, adenomyosis, uterine leiomyomas, precocious puberty, premenstrual dysphoric disorder, chronic pelvic pain, or the prevention of menstrual bleeding in special clinical situations. Rapidly expanding vistas of usage of GnRH agonists encompass use in sex reassignment of male to female transsexuals, management of final height in cases of congenital adrenal hyperplasia, and preserving ovarian function in women undergoing cytotoxic chemotherapy. Hypogonadic side effects caused by the use of GnRH agonists can be tackled with use of "add-back" therapy. Goserelin, leuprolide, and nafarelin are commonly used in clinical practice. GnRH-a have provided us a powerful therapeutic approach to the treatment of numerous conditions in reproductive medicine. Recent synthesis of GnRH antagonists with a better tolerability profile may open new avenues for both research and clinical applications. All stakeholders who are partners in women′s healthcare need to join hands to spread awareness so that these drugs can be used to realize their full potential.
De Preester, Helena
Body integrity identity disorder (BIID), formerly also known as apotemnophilia, is characterized by a desire for amputation of a healthy limb and is claimed to straddle or to even blur the boundary between psychiatry and neurology. The neurological line of approach, however, is a recent one, and is accompanied or preceded by psychodynamical, behavioural, philosophical, and psychiatric approaches and hypotheses. Next to its confusing history in which the disorder itself has no fixed identity and could not be classified under a specific discipline, its sexual component has been an issue of unclarity and controversy, and its assessment a criterion for distinguishing BIID from apotemnophilia, a paraphilia. Scholars referring to the lived body-a phenomenon primarily discussed in the phenomenological tradition in philosophy-seem willing to exclude the sexual component as inessential, whereas other authors notice important similarities with gender identity disorder or transsexualism, and thus precisely focus attention on the sexual component. This contribution outlines the history of BIID highlighting the vicissitudes of its sexual component, and questions the justification for distinguishing BIID from apotemnophilia and thus for omitting the sexual component as essential. Second, we explain a hardly discussed concept from Maurice Merleau-Ponty's Phenomenology of Perception (1945a), the sexual schema, and investigate how the sexual schema could function in interaction with the body image in an interpretation of BIID which starts from the lived body while giving the sexual component its due.
Full Text Available O aumento do número de famílias formadas por pais/mães homossexuais, travestis e transexuais tem se tornado não apenas um fato social, como também um fato socioantropológico, requerendo uma revisão das nossas convicções tradicionais. O propósito deste artigo é demonstrar como o modelo tradicional da família - considerada uma família "normal" - tem influenciado a construção de parentalidades consideradas, até recentemente, impensáveis, seja socialmente ou perante a lei. O desafio deste momento é enfrentar as novas demandas e desconstruir antigas certezas da antropologia, da psicologia/psicanálise e do direito, favorecendo a legitimação dessas famílias dentro da sociedade.The rising number of families formed by homosexual, transvestites and transsexual fathers/mothers has become, not only a social fact, but also a socio-anthropological one, requiring a mandatory review of traditional convictions. The purpose of the present paper is to demonstrate how a traditional model of family - considered a "normal" family - has been is to able to influence the construction of parenthoods considered, until recently unthinkable, either socially or in the law. Therefore, I suggest it is time to face the new demands and deconstruct former certainties of Anthropology, of Psicology/Psicanalisis and of the Law, for the sake of the families.
van de Grift, Tim C; Kreukels, Baudewijntje P C; Elfering, Lian; Özer, Müjde; Bouman, Mark-Bram; Buncamper, Marlon E; Smit, Jan Maerten; Mullender, Margriet G
Transmen are generally dissatisfied with their breasts and often opt for mastectomy. However, little is known about the specific effects of this procedure on this group's body image. To prospectively assess the effect of mastectomy on the body image of transmen, including cognitive, emotional, and behavioral aspects. During a 10-month period, all transmen applying for mastectomy were invited to participate in this study. The 33 participants completed assessments preoperatively and at least 6 months postoperatively. Participants were surveyed on body satisfaction (Body Image Scale for Transsexuals), body attitudes (Multidimensional Body-Self Relations Questionnaire), appearance schemas (Appearance Schemas Inventory), situational bodily feelings (Situational Inventory of Body Image Dysphoria), body image-related quality of life (Body Image Quality of Life Inventory), and self-esteem (Rosenberg Self-Esteem Scale). Control values were retrieved from the literature and a college sample. Before surgery, transmen reported less positive body attitudes and satisfaction, a lower self-esteem and body image-related quality of life compared with cisgender men and women. Mastectomy improved body satisfaction most strongly, although respondents reported improvements in all domains (eg, decreased dysphoria when looking in the mirror and improved feelings of self-worth). Most outcome measurements were strongly correlated. Mastectomy improves body image beyond satisfaction with chest appearance alone. Body satisfaction and feelings of "passing" in social situations are associated with a higher quality of life and self-esteem. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Nelson, Michael D.; Szczepaniak, Lidia S.; Wei, Janet; Szczepaniak, Edward; Sánchez, Francisco J.; Vilain, Eric; Stern, Jennifer H.; Bergman, Richard N.; Bairey Merz, C. Noel; Clegg, Deborah J.
Abstract Background: Male-to-female transsexual women or transwomen who undergo cross-sex hormone treatments experience increased health-related risks (e.g., increased rates of cardiovascular disease and premature death). Yet, the exact mechanism by which altering biochemistry leads to metabolic impairment remains unclear. While much attention has been paid to cross-sex hormone therapy, little is known about the metabolic risk associated with orchiectomy. Methods: To address the above limitation, we prospectively enrolled 12 transwomen: 4 who had undergone bi-lateral orchiectomy and 8 who had not. Both groups were using cross-sex hormones. Glucose tolerance was assessed using a standard 75g oral glucose tolerance test. Hepatic steatosis was assessed by 1H magnetic resonance spectroscopy. The amount of subcutaneous and visceral abdominal fat was determined from a single abdominal axial image at the level between the vertebral L2 and L3 bodies. Baseline venous fasting blood sampling was performed for measurement of hemoglobin A1c, glucose, insulin, sex hormones, and sex hormone binding globulin. Results: The major novel findings were: (1) orchiectomy and cross-sex hormone therapy is associated with less hepatic steatosis and insulin resistance; (2) orchiectomy may be metabolically protective, and (3) circulating concentrations of sex hormones may be a major determinant of metabolic health in transwomen. Conclusions: To our knowledge, this is the first study to suggest an independent and protective role of orchiectomy on the metabolic health of transwomen. PMID:29159307
Kruijver, F. P.; Fernández-Guasti, A.; Fodor, M.; Kraan, E. M.; Swaab, D. F.
In a previous study we found androgen receptor (AR) sex differences in several regions throughout the human hypothalamus. Generally, men had stronger nuclear AR immunoreactivity (AR-ir) than women. The strongest nuclear labeling was found in the caudal hypothalamus in the mamillary body complex
Barber, Thomas M; Vojtechova, Petra; Franks, Stephen
Polycystic ovary syndrome (PCOS) is a common condition characterized by reproductive and hyperandrogenic features and is often associated with obesity and metabolic dysfunction. Overall, women with PCOS have a substantially greater prevalence of metabolic syndrome than women from the general population. Furthermore, PCOS per se (independent of its frequent association with obesity) often confers cardiometabolic risk (including insulin resistance), and its concurrence with obesity often represents a metabolic "double-whammy" from the adverse effects of PCOS and obesity. The introduction of the Rotterdam diagnostic criteria for PCOS in 2003 has broadened the scope of this condition. The Rotterdam diagnostic criteria have also introduced two new phenotypic subgroups (including normoandrogenemic women with PCOS) that have provided novel insights into a potential role for hyperandrogenism in the development of adverse cardiometabolic risk in women with PCOS. Based on evidence from cross-sectional and interventional studies, hyperandrogenism, obesity, and cardiometabolic risk in women appear to be linked through complex and multidirectional pathways. Furthermore, data from obese women without a formal diagnosis of PCOS also suggest that these interrelationships often exist in female obesity per se (in milder forms than occurs in PCOS). Data from female-to-male transsexuals are particularly informative because these show direct effects of hyperandrogenism (induced through exogenous use of androgenic therapies) on fat distribution and cardiometabolic risk in women. A challenge for the future will be to disentangle and improve our understanding of this complex pathogenic web, thereby facilitating novel and targeted therapies for the hyperandrogenic and adverse cardiometabolic manifestations of PCOS.
Byne, William; Bradley, Susan J; Coleman, Eli; Eyler, A Evan; Green, Richard; Menvielle, Edgardo J; Meyer-Bahlburg, Heino F L; Pleak, Richard R; Tompkins, D Andrew
Both the diagnosis and treatment of Gender Identity Disorder (GID) are controversial. Although linked, they are separate issues and the DSM does not evaluate treatments. The Board of Trustees (BOT) of the American Psychiatric Association (APA), therefore, formed a Task Force charged to perform a critical review of the literature on the treatment of GID at different ages, to assess the quality of evidence pertaining to treatment, and to prepare a report that included an opinion as to whether or not sufficient credible literature exists for development of treatment recommendations by the APA. The literature on treatment of gender dysphoria in individuals with disorders of sex development was also assessed. The completed report was accepted by the BOT on September 11, 2011. The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low; however, areas of broad clinical consensus were identified and were deemed sufficient to support recommendations for treatment in all subgroups. With subjective improvement as the primary outcome measure, current evidence was judged sufficient to support recommendations for adults in the form of an evidence-based APA Practice Guideline with gaps in the empirical data supplemented by clinical consensus. The report recommends that the APA take steps beyond drafting treatment recommendations. These include issuing position statements to clarify the APA's position regarding the medical necessity of treatments for GID, the ethical bounds of treatments of gender variant minors, and the rights of persons of any age who are gender variant, transgender or transsexual.
Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J
To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of prostate cancer (CaP) in transgender women. In addition, this article aims to present a recent case report of a transgender woman with a unique presentation at the author's institution. An electronic nonsystematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer," "male to female transsexual," "transgender patient," "androgen + prostate cancer," "estrogen therapy + prostate cancer," and "health care barrier." In addition, a clinical case managed at our institution was reviewed and critically discussed. Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective as initially thought. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a nontransgender men. Barriers to care in the transgender female population include accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs pathologizing transgender patients, financial restrictions of the patient, and health system determinants. Although rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development are unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients. Published by Elsevier Inc.
Nieder, Timo O; Köhler, Andreas; Eyssel, Jana; Briken, Peer
Both internationally and nationally, the objective has been set to offer specialized, coordinated, and interdisciplinary treatment to individuals with rare clinical needs, such as trans individuals (e. g., transsexual, transgender). The Interdisciplinary Transgender Health Care Center Hamburg (ITHCCH) is the first and only center in Germany to integrate all disciplines relevant to trans healthcare (THC).The research project seeks to generate valid information to support quality development and assure high-quality treatment at the ITHCCH. This was done by (a) investigating needs and concerns of trans individuals regarding interdisciplinary THC, and (b) analyzing attitudes and interests of key stakeholders.Using a participatory approach involving a work group (representatives of trans support groups and local THC professionals), researchers developed an online survey focusing on trans individuals' needs and concerns. Data from N = 415 trans-identified participants were analyzed using quantitative and qualitative methods. In addition, a short survey was used to record key stakeholders' attitudes and interests towards the ITHCCH.Healthcare offers accessed by trans individuals as part of transition related treatment vary in focus and number. For example, take-up numbers of genital surgery differ between binary and non-binary trans individuals. Crucial aspects impacting on THC quality are structural characteristics, communication/social aspects, individuality, and professionalism/quality.To ensure successful, high-quality interdisciplinary THC, feedback from (potential) patients and stakeholders is crucial. In addition, both structural development and optimizing individuality and flexibility throughout the treatment process are key. This poses a considerable challenge to the sector of THC provision.
Djordjevic, Miroslav L; Bizic, Marta R
Metoidioplasty presents one of the variants of phalloplasty in female transsexuals. Urethral lengthening is the most difficult part in this surgery and poses many challenges. We evaluated 207 patients who underwent metoidioplasty, aiming to compare two different surgical techniques of urethral lengthening, postoperative results, and complications. The study encompassed a total of 207 patients, aged from 18 to 62 years, who underwent single stage metoidioplasty between September 2002 and July 2011. The procedure included lengthening and straightening of the clitoris, urethral reconstruction, and scrotoplasty with implantation of testicular prostheses. Buccal mucosa graft was used in all cases for dorsal urethral plate formation and joined with one of the two different flaps: I-longitudinal dorsal clitoral skin flap (49 patients) and II-labia minora flap (158 patients). Results were analyzed using Z-test to evaluate the statistical difference between the two approaches. Also, postoperative questionnaire was used, which included questions on functioning and esthetical appearance of participating subjects as well as overall satisfaction. The median follow-up was 39 months (ranged 12-116 months). The total length of reconstructed urethra was measured during surgery in both groups. It ranged from 9.1 to 12.3 cm (median 9.5) in group I and from 9.4 to 14.2 cm (median 10.8) in group II. Voiding while standing was significantly better in group II (93%) than in group I (87.82%) (P lengthening confirmed combined buccal mucosa graft and labia minora flap as a method of choice for urethroplasty in metoidioplasty, minimizing postoperative complications. © 2013 International Society for Sexual Medicine.
De Gascun, C
Gender Identity Disorder (GID) is a relatively rare condition of atypical gender development in which there is a psychological perception of self as masculine or feminine which is incongruent with ones phenotype. GID replaced the term Transsexualism in DSM-IV in 1994. The demographics of GID in Ireland have not been established. Since 2000 we have received 52 referrals of individuals with confirmed GID to our endocrine service for consideration for hormonal treatment (HT). Of the 52 patients 45 have male to female (MTF) GID (mean age 38.9 years) and 7 have female to male (FTM) GID (mean age 30.7 years). The age at presentation in this group is approximately 9 years older than in international series for both MTF (39 years v 30yrs) and FTM (31 yrs v 22yrs). The karyotype where analysed has been normal for their phenotypic sex. Twenty-three of the patients had received HT prior to attending our clinic that in only one case had been prescribed by a specialist. A number of patients had obtained HT via the internet or from overseas sources without medical review. Eighteen of the patients have been or are married and 14 of the group have children. The scale of referrals confirms that GID exists in the Irish population to a significant degree. Thus an appropriate care pathway for people with the condition needs to be established. This will facilitate optimum medical management of the patient group and a coherent approach to the many difficult social issues faced individuals with this disorder.
Full Text Available Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF or the pedicled anterolateral thigh flap (ALTF has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age 15 to 42 years were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months. Aesthetic and functional results were evaluated. Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula. Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion. Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps.
Savic, Ivanka; Garcia-Falgueras, Alicia; Swaab, Dick F
It is believed that during the intrauterine period the fetal brain develops in the male direction through a direct action of testosterone on the developing nerve cells, or in the female direction through the absence of this hormone surge. According to this concept, our gender identity (the conviction of belonging to the male or female gender) and sexual orientation should be programmed into our brain structures when we are still in the womb. However, since sexual differentiation of the genitals takes place in the first two months of pregnancy and sexual differentiation of the brain starts in the second half of pregnancy, these two processes can be influenced independently, which may result in transsexuality. This also means that in the event of ambiguous sex at birth, the degree of masculinization of the genitals may not reflect the degree of masculinization of the brain. There is no proof that social environment after birth has an effect on gender identity or sexual orientation. Data on genetic and hormone independent influence on gender identity are presently divergent and do not provide convincing information about the underlying etiology. To what extent fetal programming may determine sexual orientation is also a matter of discussion. A number of studies show patterns of sex atypical cerebral dimorphism in homosexual subjects. Although the crucial question, namely how such complex functions as sexual orientation and identity are processed in the brain remains unanswered, emerging data point at a key role of specific neuronal circuits involving the hypothalamus. Copyright © 2010 Elsevier B.V. All rights reserved.
Kim, S; Dennis, M; Holland, J; Terrell, M; Loukas, M; Schober, J
Transgender surgeries are becoming more frequent and visual interpretation of anatomy is essential for both surgeons and patients. Since the forearm free flap phalloplasty was introduced in 1984, it has been known to provide reliable cosmetic and functional results for transitioning men compared with phalloplasty by different flaps. Surgical text descriptions were enhanced by the creation of new anatomic illustrations. The forearm free flap consists of the anterior forearm skin, subcutaneous tissue, fascia containing the radial artery as the perforator and its venae comitantes, cephalic and basilic veins, and lateral and medial antebrachial cutaneous nerves are demonstrated in relation to the surgically derived flap. Song's forearm free flap phalloplasty requires two surgical stages with a three-month interval between the stages: prelamination of a neourethra and construction of a neophallus. The neophallus created by forearm flap phalloplasty is reported to achieve acceptable aesthetical and psychological satisfaction, appropriate size and shape, and satisfying sexual intercourse. Despite increasing experiences in gender confirming surgery with modifications made by many authors, urethral complications including fistula and/or stricture formation are the leading causes of reoperation. The poor esthetic outcome of the forearm donor site and a decrease in rigidity of the neophallus are the main limitations. Illustrations of anatomy help inform surgical choice and understanding of risks and benefits by patients. The anatomy of the free forearm flap phalloplasty supports creation of a neophallus for transsexual anatomy revision. Clin. Anat. 31:145-151, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Guerino, Paul; Ewald, Erin; Laffan, Alison M.
Abstract Purpose: Data on the health and well-being of the transgender population are limited. However, using claims data we can identify transgender Medicare beneficiaries (TMBs) with high confidence. We seek to describe the TMB population and provide comparisons of chronic disease burden between TMBs and cisgender Medicare beneficiaries (CMBs), thus laying a foundation for national level TMB health disparity research. Methods: Using a previously validated claims algorithm based on ICD-9-CM codes relating to transsexualism and gender identity disorder, we identified a cohort of TMBs using Medicare Fee-for-Service (FFS) claims data. We then describe the demographic characteristics and chronic disease burden of TMBs (N = 7454) and CMBs (N = 39,136,229). Results: Compared to CMBs, a greater observed proportion of TMBs are young (under age 65) and Black, although these differences vary by entitlement. Regardless of entitlement, TMBs have more chronic conditions than CMBs, and more TMBs have been diagnosed with asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders. TMBs also have higher observed rates of potentially disabling mental health and neurological/chronic pain conditions, as well as obesity and other liver conditions (nonhepatitis), compared to CMBs. Conclusion: This is the first systematic look at chronic disease burden in the transgender population using Medicare FFS claims data. We found that TMBs experience multiple chronic conditions at higher rates than CMBs, regardless of Medicare entitlement. TMBs under age 65 show an already heavy chronic disease burden which will only be exacerbated with age. PMID:29125908
Lo Russo, Giulia; Tanini, Sara; Innocenti, Marco
Chest-wall contouring surgery is one of the first steps in sexual reassignment in female-to-male (FtM) transsexuals that contributes to strengthening of the self-image and facilitates living in the new gender role. The main goal is to masculinize the chest by removing the female contour. Chest contour, scar placement, scar shape, scar length, nipple-areola position, nipple size and the areola size are the key points. Between July 2013 and June 2016, 25 FtM transgender patients underwent surgical procedures to create a masculine chest-wall contour. In our study, we just considered 16 patients who have undergone chest surgery with the double incision method. The patients' survey revealed a high satisfaction rate with the aesthetic result. In our group, no complications occurred, and two patients have undergone supplementary surgery for axillary dog-ear revision and nipple reconstruction. The authors propose a new technical approach and indications for FtM transgender patients' surgery. A longer scar that emphasizes the pectoralis muscle, a smaller nipple and a resized and refaced areola are the key points of our technique to give a masculine appearance to the chest. The scars are permanent, but most of them will fade and the patients are enthusiastic with their new "male" chest appearance. The high level of satisfaction, the great aesthetic result and the low rate of complications suggest to us the use of this technique in medium- and large-size breasts. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Johnson, Thomas W; Brett, Michelle A; Roberts, Lesley F; Wassersug, Richard J
Some males desire to be emasculated for no medical reason. These individuals are often secretive about their desires and little is known about their background and motivation. We sought to characterize these modern eunuchs and to identify risk factors for genital self-mutilation or self-administered chemical castration. We posted a questionnaire on the Eunuch Archive ( http://www.eunuch.org) that was responded to by 135 voluntarily castrated males. Questionnaire data were supplemented by accompanying narrative responses and several personal interviews. Participants answered questionnaire items pertaining to their knowledge about androgen deprivation, the nature of their castration, and the length of time between initial presentation of castration paraphilia and castration. These questionnaire data allowed us to compare and contrast voluntary chemical and physical eunuchs. The physical castrations were largely premeditated, with an average of 18 years from the time that an individual developed interest in being a eunuch to the time of their actual castration. We identified four factors that may promote castration ideations: (i) abuse sustained during childhood, including parental threats of castration; (ii) homosexuality; (iii) exposure to animal castration during youth; and (iv) religious condemnation of sexuality. Chemical eunuchs were more likely to have sought castration for libido control or to advance transition from male to female (P Body Integrity Identity Disorder and Gender Identity Disorders occur among those who self-identify as eunuch. We present evidence that the majority of self-identified voluntary eunuchs are not male-to-female transsexuals. Whereas the majority identify as male, many view themselves as in an alternate nonmale, nonfemale, gender space. We therefore suggest that male-to-eunuch is a valid transgender identity.
Bradley, Janet; Rajaram, Subramanian Potty; Isac, Shajy; Gurav, Kaveri; Ramesh, B M; Gowda, Chandrashekhar; Moses, Stephen; Alary, Michel
Despite their large numbers, and important role in the HIV epidemic in India, male clients of female sex workers (FSWs) are a difficult to reach population and little is known about their sexual behaviors. Using data from an integrated behavioral and biological assessment of 684 clients in Bangalore in 2012, we examined factors associated with their reports of having sex with three or more different female sex workers in the last month, and anal sex with sex workers. We included sociodemographic and sexual behavior factors and, for the first time in client studies in India, included data on the use of pornography and sexual enhancement products (SEPs) such as pills, oils, and sprays, in our multivariable analyses of client risk. Seventy-eight percent of clients had seen pornographic material and 8% reported ever having used SEPs. The profiles of men practicing the two risk behaviors examined were quite different. Travel in the past year, drunkenness in the past month, young age at first commercial sex, non-use of condoms at last sex, and finding sex workers in public places (but not use of pornography and SEPs) were independently associated with multiple partnering. Sex with a man or transsexual, being a white collar worker, seeking out FSWs at home, pornography and SEP use, and condom use at last FSW sex, were all independently associated with anal sex with an FSW. More research is needed to better understand the links between pornography and SEPs, and HIV risk behaviors, and HIV prevention programs need to be cognizant of the importance of ensuring that condom use is adequately promoted and supported in the context of anal sex in female sex worker-client interactions.
Evidence is presented that RHO, RHCE, and other RH genes, may be interesting candidates to consider when searching for the genetic basis of hair whorl rotation (i.e., clockwise or counterclockwise), handedness (i.e., right handed, left handed or ambidextrous), speech laterality (i.e., right brained or left brained), speech dyslexia (e.g., stuttering), sexual orientation (i.e., heterosexual, homosexual, bisexual, or transsexual), schizophrenia, bipolar disorder, and autism spectrum disorder. Such evidence involves the need for a genetic model that includes maternal immunization to explain some of the empirical results reported in the literature. The complex polymorphisms present among the maternally immunizing RH genes can then be used to explain other empirical results. Easily tested hypotheses are suggested, based upon genotypic (but not phenotypic) frequencies of the RH genes. In particular, homozygous dominant individuals are expected to be less common or lacking entirely among the alternative phenotypes. If it is proven that RH genes are involved in brain architecture, it will have a profound effect upon our understanding of the development and organization of the asymmetrical vertebrate brain and may eventually lead to a better understanding of the developmental processes which occur to produce the various alternative phenotypes discussed here. In addition, if RH genes are shown to be involved in the production of these phenotypes, then the evolutionary studies can be performed to demonstrate the beneficial effect of the recessive alleles of RHO and RHCE, and why human evolution appears to be selecting for the recessive alleles even though an increase in the frequency of such alleles may imply lower average fecundity among some individuals possessing them.
Bultynck, Charlotte; Pas, Charlotte; Defreyne, Justine; Cosyns, Marjan; den Heijer, Martin; T'Sjoen, Guy
Self-perception of voice has a significant psychosocial impact on transgender persons. Research about the evolution of self-perception of voice during cross-sex hormone therapy (CSHT) is lacking. The aim of this study was to examine if self-perception of voice changes during CSHT, and if a change of serum testosterone levels as a result of CSHT can predict a change of self-perception of voice. Prospective longitudinal study. The Transsexual Voice Questionnaire (TVQ), consisting of three factors-anxiety and avoidance (AA), gender identity (GI), and voice quality (VQ)-was used. Transgender persons completed the TVQ at baseline (80 trans men and 103 trans women), after 3 and 12 months of CSHT follow-up. Trans men: From 0 to 3 months, 0 to 12 months, and 3 to 2 months of CSHT, the AA and GI scores improved. From 0 to 3 months of CSHT, the increasing testosterone level was predictive for the improvements of AA and GI scores. Trans women: From 0 to 3 months, the GI score improved. From 0 to 12 months, the AA, GI, and VQ scores improved. Improvements of self-perception of voice could not be predicted by changing serum testosterone levels. During CSHT, self-perception of voice improves in both trans men and trans women. In trans men only, the improving self-perception of voice during the first 3 months can be attributed to the CSHT. For trans women, this study supports that testosterone has acted irreversibly virializing to the voice before CSHT, if they already went through male puberty. 4. Laryngoscope, 127:2796-2804, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Carabez, Rebecca; Pellegrini, Marion; Mankovitz, Andrea; Eliason, Mickey; Scott, Megan
To describe nurses confusion around trans* terminology and to provide a lesson in Trans* 101 for readers. Of the estimated 9 million persons in the United States of America who are identified as lesbian, gay, bisexual and transgender, about 950,000 (0.2-0.5% of adult population) are identified as trans* (a term that encompasses the spectrum, including transgender, transsexual, trans man, trans woman and other terms). The Institute of Medicine (2011, The health of lesbian, gay, bisexual and transgender people: Building a foundation for better understanding. The National Academies Press, Washington, DC) identified transgender persons as an understudied population with significant need for health research, yet the nursing literature contains little guidance for educating nurses on trans* issues. This is a mixed methods structured interview design with nurse key informants. The scripted interview was based on the Health Care Equality Index, which evaluates patient-centred care to lesbian, gay, bisexual and transgender patients and families. These data were part of a larger research study that explored the current state of lesbian, gay, bisexual and transgender-sensitive nursing practice. Undergraduate nursing students recruited and interviewed 268 nurse key informants about gender inclusive forms (capable of identifying trans* patients) at their agencies. Only 5% reported use of gender inclusive forms, 44% did not know about inclusive forms, 37% did not understand what a gender inclusive form was and 14% confused gender with sexual orientation. The study demonstrated a critical need for education in gender identity and sexual orientation terminology. The lack of understanding of concepts and terminology may affect basic care of lesbian, gay, bisexual and transgender patients especially those who identify as transgender. © 2015 John Wiley & Sons Ltd.
Majumder, Anirban; Sanyal, Debmalya
Gender dysphoria (GD) is an increasingly recognized medical condition in India, and little scientific data on treatment outcomes are available. Our objective is to study the therapeutic options including psychotherapy, hormone, and surgical treatments used for alleviating GD in male-to-female (MTF) transgender subjects in Eastern India. This is a retrospective study of treatment preferences and outcome in 55 MTF transgender subjects who were presented to the endocrine clinic. Descriptive statistical analysis is carried out in the present study, and Microsoft Word and Excel are used to generate graphs and tables. The mean follow-up was 1.9 years and 14 subjects (25.5%) were lost to follow-up after a single or 2-3 contact sessions. Rest 41 subjects (74.5%) desiring treatment had regular counseling and medical monitoring. All 41 subjects were dressing to present herself as female and all of them were receiving cross-sex hormone therapy either estrogen only (68%), or drospirenone in combination with estrogen (12%) or gonadotropin-releasing hormone agonist (GnRH) in combination with estrogens (19.5%). Most of the subjects preferred estrogen therapy as it was most affordable and only a small number of subjects preferred drospirenone or GnRH agonist because of cost and availability. 23.6% subjects underwent esthetic breast augmentation surgery and 25.5% underwent orchiectomy and/or vaginoplasty. Three subjects presented with prior breast augmentation surgery and nine subjects presented with prior orchiectomy without vaginoplasty, depicting a high prevalence of poorly supervised surgeries. Standards of care documents provide clinical guidance for health professionals about the optimal management of transsexual people. The lack of information among health professionals about proper and protocolwise management leads to suboptimal physical, social, and sexual results.
Que direito à saúde para a população GLBT? Considerando direitos humanos, sexuais e reprodutivos em busca da integralidade e da eqüidade What do health rights mean for the GLBT population?Considering human, sexual and reproductive rights in the search for equity and integrality in the health system
Full Text Available Este artigo tem como objetivo problematizar a pertinência de uma política de saúde para a população de Gays, Lésbicas, Bissexuais, Travestis e Transexuais - GLBT. A partir da consideração dos processos de violação de seus direitos humanos, sistematicamente comprometidos devido a estigmas e processos discriminatórios, busca-se evidenciar a necessidade de uma política de saúde específica a esta população, na perspectiva da integralidade da atenção e da eqüidade no sistema de saúde. O desafio da construção de uma política de atenção integral à saúde dessa população, tal como prevista no programa de governo federal Brasil sem Homofobia, implica a complexificação e alargamento do que se compreende por direitos sexuais e reprodutivos para a efetiva promoção da eqüidade e universalidade do acesso aos bens e serviços.This paper discusses whether a specific health policy for Gays, Lesbians, Bisexuals, Transvestites and Transsexuals is a good way to improve their lives and health situation, recognizing that their human rights are systematically violated by prejudice and discrimination processes. A health policy could be a strong political and technical instrument for achieving integrality in health care and equity in the health system. Building a health policy according to the constitutional right of universality and integrality in health care is proposed by the Federal Government's program called No Homophobia in Brazil. For its consolidation, we need to broaden what we understand by sexual and reproductive rights.
Full Text Available Resumen Ni el género ni la sexualidad se dejan encorsetar dentro de unas normas que informan cómo deben ser y actuar hombres y mujeres para ser reconocidos socialmente como normales. Tanto el género como el sexo son susceptibles de desbordamiento de dichos encuadres rígidos, porque tal desbordamiento responde a lo real vivenciado por cualquier hombre o mujer. Las normas son un constructo artificial que no responde a la auténtica identidad genérica y sexual de cada sujeto, que es mucho más compleja que el reduccionismo monolítico que quiere demarcar la diferencia entre masculino y femenino. Dicha separación tan tajante no puede explicar la coexistencia de ambas características en un mismo sujeto ni las pretensiones de los transgéneros de ser considerados con una identidad que desmiente su sexo biológico, ni la angustia de los transexuales convencidos de estar atrapados en un cuerpo equivocado. Abstract Neither gender nor sexuality is allowed to be curtailed within norms that inform how men and women should be and act to be socially recognized as normal. Both gender and sex are susceptible to overflowing of such rigid frames, because such an overflow responds to the real thing experienced by any man or woman. Norms are an artificial construct that does not respond to the authentic generic and sexual identity of each subject, which is much more complex than the monolithic reductionism that wants to demarcate the difference between male and female. Such a clear separation can not explain the coexistence of both characteristics in the same subject nor the claims of transgenders to be considered with an identity that belies their biological sex, nor the anguish of transsexuals convinced to be trapped in a wrong body.
Full Text Available Diante da nova cartografia das relações entre gêneros e das sexualidades na cultura contemporânea, pretendemos discutir em que medida a psicanálise se apresenta como mais um dispositivo da sexualidade tal como concebido por Foucault, o qual procura reinstaurar o modelo tradicional da diferença sexual, através da reiteração da norma heterossexual da dominação masculina. Além disso, indagamos ainda em que medida a psicanálise pode permanecer como uma teoria crítica e uma prática clínica que permita uma relação produtiva com as novas configurações de gênero no contemporâneo, abrindo brechas para a concepção de novas formas de subjetivação. Com esse objetivo analisaremos o debate psicanalítico sobre 1 os deslocamentos do feminino e a positivação da feminilidade; 2 o casamento homossexual e a homoparentalidade e 3 a clínica da transexualidadeBefore the new cartography of gender relationships and sexualities in contemporary culture, we intend to discuss in which way psychoanalysis presents itself as one of the devices of sexuality as conceived by Foucault, which tries to reinstate the traditional model of sexual difference trough the reiteration of the heterosexual norm of male domination. Furthermore, we inquire how psychoanalysis can remain a critical theory and a clinical practice that allow a productive relationship with the new configurations of gender, which disclose the conception of new forms of subjectivity. With this aim, we will analyze the psychoanalytical debate on (1 the displacements of feminine and the positiveness of femininity; (2 the homosexual marriage and the homoparentality; and (3 the clinics of transsexuality
de Vries, Annelou L C; Steensma, Thomas D; Doreleijers, Theo A H; Cohen-Kettenis, Peggy T
Puberty suppression by means of gonadotropin-releasing hormone analogues (GnRHa) is used for young transsexuals between 12 and 16 years of age. The purpose of this intervention is to relieve the suffering caused by the development of secondary sex characteristics and to provide time to make a balanced decision regarding actual gender reassignment. To compare psychological functioning and gender dysphoria before and after puberty suppression in gender dysphoric adolescents. Of the first 70 eligible candidates who received puberty suppression between 2000 and 2008, psychological functioning and gender dysphoria were assessed twice: at T0, when attending the gender identity clinic, before the start of GnRHa; and at T1, shortly before the start of cross-sex hormone treatment. Behavioral and emotional problems (Child Behavior Checklist and the Youth-Self Report), depressive symptoms (Beck Depression Inventory), anxiety and anger (the Spielberger Trait Anxiety and Anger Scales), general functioning (the clinician's rated Children's Global Assessment Scale), gender dysphoria (the Utrecht Gender Dysphoria Scale), and body satisfaction (the Body Image Scale) were assessed. Behavioral and emotional problems and depressive symptoms decreased, while general functioning improved significantly during puberty suppression. Feelings of anxiety and anger did not change between T0 and T1. While changes over time were equal for both sexes, compared with natal males, natal females were older when they started puberty suppression and showed more problem behavior at both T0 and T1. Gender dysphoria and body satisfaction did not change between T0 and T1. No adolescent withdrew from puberty suppression, and all started cross-sex hormone treatment, the first step of actual gender reassignment. Puberty suppression may be considered a valuable contribution in the clinical management of gender dysphoria in adolescents. © 2010 International Society for Sexual Medicine.
Full Text Available Context: Gender dysphoria (GD is an increasingly recognized medical condition in India, and little scientific data on treatment outcomes are available. Aims: Our objective is to study the therapeutic options including psychotherapy, hormone, and surgical treatments used for alleviating GD in male–to–female (MTF transgender subjects in Eastern India. Subjects and Methods: This is a retrospective study of treatment preferences and outcome in 55 MTF transgender subjects who were presented to the endocrine clinic. Statistical Analysis Used: Descriptive statistical analysis is carried out in the present study, and Microsoft Word and Excel are used to generate graphs and tables. Results: The mean follow-up was 1.9 years and 14 subjects (25.5% were lost to follow-up after a single or 2–3 contact sessions. Rest 41 subjects (74.5% desiring treatment had regular counseling and medical monitoring. All 41 subjects were dressing to present herself as female and all of them were receiving cross-sex hormone therapy either estrogen only (68%, or drospirenone in combination with estrogen (12% or gonadotropin-releasing hormone agonist (GnRH in combination with estrogens (19.5%. Most of the subjects preferred estrogen therapy as it was most affordable and only a small number of subjects preferred drospirenone or GnRH agonist because of cost and availability. 23.6% subjects underwent esthetic breast augmentation surgery and 25.5% underwent orchiectomy and/or vaginoplasty. Three subjects presented with prior breast augmentation surgery and nine subjects presented with prior orchiectomy without vaginoplasty, depicting a high prevalence of poorly supervised surgeries. Conclusions: Standards of care documents provide clinical guidance for health professionals about the optimal management of transsexual people. The lack of information among health professionals about proper and protocolwise management leads to suboptimal physical, social, and sexual results.
Schwarz, Karine; Fontanari, Anna Martha Vaitses; Costa, Angelo Brandelli; Soll, Bianca Machado Borba; da Silva, Dhiordan Cardoso; de Sá Villas-Bôas, Anna Paula; Cielo, Carla Aparecida; Bastilha, Gabriele Rodrigues; Ribeiro, Vanessa Veis; Dorfman, Maria Elza Kazumi Yamaguti; Lobato, Maria Inês Rodrigues
Voice is an important gender marker in the transition process as a transgender individual accepts a new gender identity. The objectives of this study were to describe and relate aspects of a perceptual-auditory analysis and the fundamental frequency (F0) of male-to-female (MtF) transsexual individuals. A case-control study was carried out with individuals aged 19-52 years who attended the Gender Identity Program of the Hospital de Clínicas of Porto Alegre. Vocal recordings from the MtF transgender and cisgender individuals (vowel /a:/ and six phrases of Consensus Auditory Perceptual Evaluation Voice [CAPE-V]) were edited and randomly coded before storage in a Dropbox folder. The voices (vowel /a:/) were analyzed by consensus on the same day by two judge speech therapists who had more than 10 years of experience in the voice area using the GRBASI perceptual-auditory vocal evaluation scale. Acoustic analysis of the voices was performed using the advanced Multi-Dimensional Voice Program software. The resonance focus and the degrees of masculinity and femininity for each voice recording were determined by listening to the CAPE-V phrases, for the same judges. There were significant differences between the groups regarding a greater frequency of subjects with F0 between 80 and 150 Hz (P = 0.003), and a greater frequency of hypernasal resonant focus (P < 0.001) in the MtF cases and greater frequency of subjects with absence of roughness (P = 0.031) in the control group. The MtF group of individuals showed altered vertical resonant focus, more masculine voices, and lower fundamental frequencies. The control group showed a significant absence of roughness. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Brown, G R; Wise, T N; Costa, P T; Herbst, J H; Fagan, P J; Schmidt, C W
The literature on cross-dressing men has been primarily limited to self-identified patients at psychiatric clinics who are in distress. To understand the personality trait characteristics and sexual functioning of nonpatient cross-dressers, 188 non-treatment-seeking male cross-dressers completed the NEO Personality Inventory (NEO-PI) and the Derogatis Sexual Functioning Inventory (DSFI). Respondents were classified as transvestites (TV; N = 83), transgenderists (TG; N = 61), or transsexuals (TS; N = 44) based on self-report and the nature of their cross-gender activities (e.g., use of female hormones, desire for sex reassignment, and amount of time spent in female role). These diagnostic groups did not differ on the five broad personality domains of the NEO-PI, but TS men scored higher than TV and TG men on the Aesthetics facet scale of Openness to Experience (O). In terms of the DSFI scales, TS men reported lower sexual drive than TV and TG men, and TS and TG men exhibited greater psychiatric symptoms and feminine gender role, and poorer body image than TV men. Upon exclusion of a group of 49 respondents who previously sought treatment for psychological problems, no significant differences emerged among the three diagnostic groups on the NEO-PI domain and facet scales. Consideration of the DSFI scales showed that TS men experienced less sexual drive, more psychiatric symptoms, and a greater feminine gender role than TV or TG men. This study suggests that cross-dressers not seen for clinical reasons are virtually indistinguishable from non-cross-dressing men using a measure of personality traits, a sexual functioning inventory, and measures of psychological distress. These results emphasize the importance of using clinical significance criteria as required by DSM-IV guidelines before diagnosing men who cross-dress with an axis I disorder.
Bauer, Greta R; Scheim, Ayden I; Deutsch, Madeline B; Massarella, Carys
Transgender, transsexual, or transitioned (trans) people have reported avoiding medical care because of negative experiences or fear of such experiences. The extent of trans-specific negative emergency department (ED) experiences, and of ED avoidance, has not been documented. The Trans PULSE Project conducted a survey of trans people in Ontario, Canada (n=433) in 2009 to 2010, using respondent-driven sampling, a tracked network-based method for studying hidden populations. Weighted frequencies and bootstrapped 95% confidence intervals (CIs) were estimated for the trans population in Ontario and for the subgroup (n=167) reporting ED use in their felt gender. Four hundred eight participants completed the ED experience items. Trans people were young (34% aged 16 to 24 years and only 10% >55 years); approximately half were female-to-male and half male-to-female. Medically supervised hormones were used by 37% (95% CI 30% to 46%), and 27% (95% CI 20% to 35%) had at least 1 transition-related surgery. Past-year ED need was reported by 33% (95% CI 26% to 40%) of trans Ontarians, though only 71% (95% CI 40% to 91%) of those with self-reported need indicated that they were able to obtain care. An estimated 21% (95% CI 14% to 25%) reported ever avoiding ED care because of a perception that their trans status would negatively affect such an encounter. Trans-specific negative ED experiences were reported by 52% (95% CI 34% to 72%) of users presenting in their felt gender. This first exploratory analysis of ED avoidance, utilization, and experiences by trans persons documented ED avoidance and possible unmet need for emergency care among trans Ontarians. Additional research, including validation of measures, is needed. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.
Exercício da cidadania e luta pela vida: precariedade das vidas de travestis e transexuais no estado de Alagoas (Citizenship and struggle for life: precariousness of travesti and transexuals lives in Alagoas state Doi: 10.5212/Emancipacao.v.16i1.0003
Carolina Cavalcante Lins
Full Text Available Resumo: O presente artigo traz resultados de uma pesquisa de mestrado realizada com ativistas do movimento social travesti e transexual da cidade de Maceió, concentradas na Associação das Travestis e Transexuais de Alagoas (ASTTAL. O texto trará uma discussão dos direitos humanos voltada para essa população e atrelada à questão da transfobia, através da noção de precariedade. A metodologia utilizada na pesquisa contou com um desenho variado, que abrangeu a observação participante, diários de campo e entrevistas semiestruturadas. Os resultados nos mostraram que tal violência direcionada às pessoas trans é encarada de uma maneira diversificada, trazendo à tona a culpabilização, o medo e a ausência de ações estatais que as retirem do lugar de quase humano no qual são inseridas.Palavras-chave: Movimentos sociais trans. Cidadania. Violência.Abstract: This article presents results of a master’s research conducted with travesti and transexual social movement activists from Maceió city, concentrated in the Association of Travestis and Transsexuals of Alagoas (ASTTAL. The text provides a discussion of human rights related to this population and linked to the issue of transphobia through precariousness notion. The methodology used in the survey had a varied design, which included participant observation, field diaries and semistructured interviews. The results had shown that such violence directed to transgender people is viewed in a diverse way, bringing up blame, fear and the absence of state actions that remove them from the place of almost human in which they are inserted.Keywords: Trans social movements. Citizenship. Violence.
Claes, Laurence; Bouman, Walter Pierre; Witcomb, Gemma; Thurston, Megan; Fernandez-Aranda, Fernando; Arcelus, Jon
There is a paucity of systematic research in the area of non-suicidal self-injury (NSSI) in trans people. The aim of this study was to investigate the prevalence of NSSI in trans people and the associations with intra- and interpersonal problems. Participants were 155 untreated individuals with a diagnosis of transsexualism (according to International Classification of Disease-10 criteria) attending a national gender identity clinic. All participants completed the Self-Injury Questionnaire, the Symptom Checklist-90-Revised, the Rosenberg Self-Esteem Scale, the Hamburg Body Drawing Scale, the Experiences of Transphobia Scale, the Inventory of Interpersonal Problems-32, and the Multidimensional Scale of Perceived Social Support. The sample consisted of 66.5% trans women and 33.5% trans men and 36.8% of them had a history of engaging in NSSI. The prevalence of NSSI was significantly higher in trans men (57.7%) compared with trans women (26.2%). Trans individuals with NSSI reported more psychological and interpersonal problems and perceived less social support compared with trans individuals without NSSI. Moreover, the probability of having experienced physical harassment related to being trans was highest in trans women with NSSI (compared with those without NSSI). The study found that with respect to psychological symptoms, trans women reported significantly more intrapersonal and interpersonal symptoms compared with trans men. Finally, the results of the regression analysis showed that the probability of engaging in NSSI by trans individuals was significantly positively related to a younger age, being trans male, and reporting more psychological symptoms. The high levels of NSSI behavior and its association with interpersonal and interpersonal difficulties and lack of social support need to be taken into consideration when assessing trans individuals. The effect of cross-sex hormones and sex reassignment surgery on psychological functioning, including NSSI behavior
Dina Bisara Lolong
Full Text Available The major routes for HIV transmission in Indonesia are injecting drug use and heterosexual activity. More than halve of the proportion of estimation 2006 of people living with HIV/AIDS were IDUs. Around 70 percent of all reported AIDS cases of IDUs in Indonesia occur among those in the age group of15-29 years. It indicates that young people are not only at high risk of contracting HIV infection but already constitute a significant percentage of people living with HIV/AIDS. This article is examines adolescent risk behavior on HIV transmission in Indonesia. The data were obtained from Behavioral Surveillance Survey 2004-2005 of 6352 female sex workers and 2969 their clients in 14 provinces, 1052 transsexual in four provinces, and 1795 IDUs in five cities as well as 1001 male student and 1159 female student in two cities. This survey reveals that adolescent's high risk behavior on HIV transmission is not only through injecting drug use but also through heterosexual. Of great concern is that 40 percent of the female sex workers and more than halve of IDUs aged 15-24 years. Findings also show that risk behavior is associated with age of respondent. Younger ages of IDUs were more like to have more than one sex partners and sharing needle; and again 27 percent of younger ages 15-19 year have started to be involved in high risk behavior as IDUs age below 15 compared to age 20-24 and 25+ nine and one percent respectively. Furthermore, the younger ages of sex workers and their clients were less likely to use condoms; and around 25-60 percent of them have begun to work as commercial sex workers age below 20.The findings of this survey raise concern about risk behavior of HIV transmission among adolescent. The need to focus more policy and program attention on adolescent sexuality and drug use behavior is compelling. Keywords : adolescence, risk behavior, HIV transmission
Gregori Flor, Nuria
Full Text Available Hermaphrodites, intersexes, androgynes, transsexuals and homosexuals symbolise the place of the fissure, the border and dissent in relation to bodies and sexes/genders/ sexualities. They represent a privileged discursive space from where we can explore some of the certainties that have been produced and reproduced from the different fields of knowledge and power throughout Western history. The analysis of social and medical categories such as hermaphroditism, intersexuality, or the recently known as DSD shows us a complex and simultaneously controversial panorama that has, nevertheless, enough potential to shed some light on the performative role of social categories. Moreover, it allows us to go into a bioethical debate about the limits of medical practices, and to explore questions about the body’s control and normalisation, or about the incorporation of new technologies in recreating bodies and identities.Hermafroditas, intersexos, andróginos, transexuales u homosexuales simbolizan el lugar de la fisura, de la frontera, de la disidencia en relación a los cuerpos sexuados, los géneros y las sexualidades. Constituyen a su vez un espacio discursivo privilegiado desde donde recorrer algunas de las certezas que se han ido produciendo y reproduciendo desde los distintos campos de conocimiento y poder a lo largo de la historia de Occidente. El análisis de categorías médico-sociales como el “hermafroditismo”, la “intersexualidad”, o la más recientemente conocida como “DSD/ADS”, nos descubre un panorama complejo y a la vez controvertido, pero con el potencial suficiente para indagar en el carácter performativo de las categorías sociales. Además, nos permite adentrarnos en un debate bioético más amplio sobre los límites de las prácticas médicas, las cuestiones relativas al control y la normalización de cuerpos, o sobre la incorporación de nuevas tecnologías en la conformación de cuerpos e identidades.
Full Text Available Transgender is social deviation in the community. Deviations made transvestites difficulty in placing itself as part of society in general. Doesn’t easy to all people can accept the transvestites are allowed to live and settle in their communities. This article contains the pattern of life of transvestites amongst in the Jorong Mandiangin, to fully accept their existence, and to describe the factors that cause a person to become a transvestite in Jorong Mandiangin District Kinali in West Pasaman. The research approach used a qualitative, descriptive type. Collect data by observation and interviews. The results showed a good relationship between transvestites and society. Although people know that transvestites are an aberration, but the public does not necessarily treat transsexuals with victimization. People are realizing that transvestites are also human beings of divine creation which also has the right to run their lives by working according to his ability. No different to life among fellow transvestites, the visible existence of some form of interaction processes that can unite the transvestites in maintaining the gender status. Waria merupakan penyimpangan yang terjadi dalam masyarakat. Penyimpangan yang dilakukan membuat waria kesulitan dalam menempatkan dirinya sebagai bagian dari masyarakat pada umumnya. Tidak semua masyarakat bisa menerima keberadaanya meskipun para waria tersebut dibiarkan hidup dan menetap dalam lingkungan masyarakatnya. Artikel ini memuat pola kehidupan waria ditengah-tengan masyarakat Jorong Mandiangin, yang sepenuhnya menerima keberadaan mereka, serta mendeskripsikan faktor-faktor yang menyebabkan seseorang menjadi waria di Jorong Mandiangin Kecamatan Kinali Kabupaten Pasaman Barat. Pendekatan penelitian yang digunakan dalam kualitatif, tipe deskriptif. Cara mengumpulkan data dilakukan dengan cara observasi dan wawancara. Hasil penelitian menunjukkan terdapat hubungan yang baik antara waria dan masyarakat
Morgan-thomas, R; Overs, C
Most sex work research examines the impact of HIV on prostitutes and on society and involves testing prostitutes for HIV antibodies, but it does not examine the role of others in the sex industry. Sex industry workers include female prostitutes, transvestites, transsexuals, and male prostitutes, bar and brothel owners, taxi drivers, sex workers' partners, and sex business managers. Since sex workers provide sexual services to clients, they are in a perfect position to teach them about sexual health. Society must recognize that we cannot wish the sex industry away and that we need an effective health promotion strategy now. Some successful relevant AIDS education campaigns provide us some guidelines on how to develop campaigns. Any campaign targeting the sex industry should also target the public. Sex workers should participate in developing health messages and educational activities. They should also participate in the project. Any campaign must deal with major obstacles to safer sexual practices of which sex workers are aware and be consulted. Common obstacles are client demand for unprotected sex and irregular and inadequate supply of inexpensive condoms. A health promotion strategy cannot be effective, however, if sex workers do not have access to social support and health care services. Health promotion workers should also encourage local authorities to end discrimination of sex workers so they can freely obtain needed services. In some countries, sex workers operate fantasy workshops providing peers with ideas to sell sex services which reduce the risk of HIV transmission. Other campaigns distribute safer sex messages on small cards, cigarette lighters, key rings, condom packages, and T shirts. Training of sex workers other than prostitutes to reinforce safer sex messages to clients is also effective, e.g., taxi drivers can say they will take a client to a woman who uses condoms rather than to a clean girl. Street theater and puppets have also successfully
Full Text Available This paper examines the emergence of non-normative sexual orientations in contemporary Indonesian films. Unlike the representation of sexuality in New Order Indonesian films, which centred on the female reproductive role and presented the nation as constructed of heterosexual families rather than individual citizens, a number of 200(s Indonesian films can be seen as negotiations of new understandings of sexual diversity and individual subjectivity. These films represent a challenge to monolithic and essentialist constructions of sexuality in Indonesia, and portray characters and situations in ways that seem to fulfil the five selection criteria which Griffin and Benshoff (2006 apply to the definition of 'queer' cinema. As such, they are indicative of a paradigm shift in Indonesian cinema, which needs to be studied in association with broader patterns of social and political change. The paper describes three categories in the representation of sexual minorities in contemporary Indonesian films. The first category is represented by films such as Arisanl and , Gie, which portray characters and situations deal with male homosexual subjectivity or homoeroticism. The second category concerns films of this type that portray female characters, such as Detik Terakhirand TentangDia. In the third category are films which depict waria (male to female transgender characters and transsexuals, represented by Panggil Aku Puspa and Realita Cinta dan Rock n Roll. The paper examines these films in the light of Boellstorff's (2005 study of gay and lesbi communities and subjectivities in Indonesia, as a way of situating them in a larger cultural picture. It suggests that the makers of these films are attempting to change the perception of their audiences about non-normative sexualities, and investigates the strategic devices used by the film makers to subvert censorship codes and social taboos in a country where homosexual behaviour is accommodated, but homosexual
Boutin, C A; Venne, S; Fiset, M; Fortin, C; Murphy, D; Severini, A; Martineau, C; Longtin, J; Labbé, A C
Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis genotypes L 1 , L 2 and L 3 . This LGV is associated with significant morbidity and increased risk of HIV transmission. While fewer than two cases per year were reported in Quebec before 2005, LGV emerged in 2005-2006 with 69 cases, followed by a period of low incidence (2007-2012), and subsequent re-emergence since 2013. To describe the incidence of LGV in Quebec and the characteristics of the affected population, including demographics and risk factors, clinical manifestations, laboratory tests, treatments and reinfection rates. Descriptive data were collected from the notifiable diseases records through the Institut national de santé publique du Québec (INSPQ) infocentre portal. Questionnaires were obtained through the enhanced surveillance system and transmitted anonymously to the Quebec Ministry of Health. In-depth analysis was performed on cases from 2013 to 2016. There were 338 cases of LGV over the four-year period in Quebec. All cases were male, excluding one transsexual. Mean age was 41 years. Most lived in Montréal (81%) and were men who have sex with men (MSM; 99%). The majority (83%) reported four sexual partners or more in the last year, met mostly through the Internet (77%) and in saunas (73%). Frequency of sexual intercourse with out-of-province residents decreased in 2013-2016 (27%) compared with 2005-2012 (38%). History of STIs was frequent: 83% were HIV-infected, 81% reported previous syphilis and 78% previous gonorrhea. Recreational drug use was frequent (57%), reaching 71% in 2016. Most cases were symptomatic, a proportion which decreased in 2016 (68%) compared with 2013-2015 (82%; p =0.006). Clinical presentations included proctitis (86%), lymphadenopathy (13%) and ulcer/papule (12%). Reinfections, mostly within two years of first infection, occurred in 35 individuals (10%). Conclusion: The re-emergence of LGV in Quebec involves an urban
Full Text Available During the past few years, the Internet has been transformed more and more towards a global participatory network. Facebook, YouTube, Flickr, Wikipedia are outstanding examples of this development. At least theoretically everybody linked to the Internet can participate in the social web. In fact, that offers new possibilities like expanded ways of connecting people. On the other hand there are new challenges, e.g. the handling of private data in the Internet. Another transformation concerns the role of the media recipient. He/she is no longer just consuming, but also producing contents. That is why the recipients in the Web 2.0 are now called ‚prosumers’. These important changes lead not only to the consequence of redefining media literacy. They also modify our view on the contents of the participatory net and on the possibilities of interaction. For example the category ‚gender’ should be reanalyzed under the conditions of the Web 2.0. Gender is in the Internet, indeed, as in any other arena of everyday life, a central category of interpreting our social life. The gender studies define gender as constructed. With the term ‚doing gender’ the ongoing active construction of gender affiliation is emphasized. Exponents of the theory of doing gender criticize gender stereotypes which predefine gender in fixed categories and in the exclusive poles of ‘felinity’ and 'masculinity'. These are assignations which exclude fluid gender identities (transsexuals, transgender …. Moreover they legitimate a conventional gender-specific division of labour and gender hierarchies. However, what is constructed can also be de-constructed in the sense of an ‘undoing gender’. Stereotypes can be laid open, new subversive constructions and pictures of gender can be promoted. In my assumption, purposeful interactions in the Web 2.0 which follow the principles of media literacy and gender competence can contribute to a liberation of gender conventions
Full Text Available The article investigates a debate on the issues of legal recognition of gender which took place in the Latvian Parliament in 2009 and which is considered a rich source of material for a two-fold analysis. As an example of gendered discourse, it shows the differences between female and male MPs’ ways of tackling this uncomfortable subject. As a discourse about gender, which allows one to study the speakers’ arguments and attitudes, it reveals prejudice, lack of knowledge and conservative thinking. The analysis thus illustrates the language and arguments employed in the public sphere when discussing face-threatening, taboo topics.
G-I/R needs to be both multivariate and sequential in type. It must be applicable to all of the syndromes of hermaphroditism, and to the genesis of all the G-I/R phenomena, including transvestism and transsexualism, as well as to the genesis of a heterosexual G-I/R.
Full Text Available Sexual violence within the lesbian, gay, bisexual, transgender/transsexual, intersex and queer (LGBTIQ communities remains largely under-researched and under-theorised. Yet, emerging research suggests that sexual violence is a significant issue within the LGBTIQ communities. Additionally, the occurrence of sexual violence and unwanted sexual attention within specific social and cultural contexts is, for the most part, insufficiently examined. This article draws on research exploring young LGBTIQ adults’ perceptions and experiences of unwanted sexual attention in licensed venues. Firstly, I consider the theoretical and conceptual underpinnings of ‘unwanted sexual attention’ as a category of analysis. I then move on to consider participants’ use of licensed venues, the particular significance of pubs and clubs to LGBTIQ young people, and their perceptions and experiences of unwanted sexual attention. Finally, I discuss the implications of these findings for theoretical and conceptual understandings of unwanted sexual attention and sexual violence. En general, se ha investigado y teorizado muy poco sobre la violencia sexual dentro de las comunidades de lesbianas, gays, bisexuales, transgénero / transexuales, intersex y queer (LGBTIQ. Sin embargo, investigaciones recientes sugieren que la violencia sexual es un problema importante en estas comunidades. Además, la incidencia de la violencia sexual y atención sexual no deseada dentro de contextos sociales y culturales específicos no está, en su mayor parte, suficientemente examinada. Este artículo se basa en la investigación de la percepción y experiencias de atención sexual no deseada en locales con licencia para vender alcohol. En primer lugar, se tienen en cuenta los fundamentos teóricos y conceptuales de “atención sexual no deseada” como una categoría de análisis. A continuación, se considera el uso de locales con licencia por parte de los participantes, el significado
for the hormonal treatment-induced better mental well-being. In conclusion, this review indicates that gender dysphoria-related mental distress may benefit from hormonal treatment intervention, suggesting a transient reaction to the nonsatisfaction connected to the incongruent body image rather than a stable psychiatric comorbidity. In this perspective, timely hormonal treatment intervention represents a crucial issue in gender dysphoria individuals’ mental health-related outcome. Keywords: estrogen, testosterone, transsexualism, psychiatry, psychosocial wellbeing
Case, Laura K; Ramachandran, Vilayanur S
Between the two extreme ends of human sexuality - male and female - lie a poorly understood and poorly studied spectrum of ambiguously defined sexual identities that are very much a part of the human condition but defy rigid classification. "Bigender" is a recently formed sub-category of transgenderism, describing individuals who experience a blending or alternation of gender states. While recognized nominally by the APA, no scientific work to our knowledge has addressed this fascinating condition, or proposed any physiological basis for it. In addition, the alternation aspect has not been proposed as a nosological entity distinct from blending. We present descriptive data suggesting that many bigender individuals experience an involuntary switching of gender states without any amnesia for either state. In addition, similar to transsexual individuals, the majority of bigender individuals experience phantom breasts or genitalia corresponding to the non-biologic gender when they are in a trans-gender state. Finally, our survey found decreased lateralization of handedness in the bigender community. These observations suggest a biologic basis of bigenderism and lead us to propose a novel gender condition, "alternating gender incongruity" (AGI). We hypothesize that AGI may be related to an unusual degree or depth of hemispheric switching and corresponding callosal suppression of sex appropriate body maps in parietal cortex- possibly the superior parietal lobule- and its reciprocal connections with the insula and hypothalamus. This is based on two lines of reasoning. First, bigender individuals in our survey sample reported an elevated rate of bipolar disorder, which has been linked to slowed hemispheric switching. We hypothesize that tracking the nasal cycle, rate of binocular rivalry, and other markers of hemispheric switching will reveal a physiological basis for AGI individuals' subjective reports of gender switches. Switching may also trigger hormonal cascades
Ewen, Janine Elizabeth
This article considers the public health implications that were predicted by sex workers a year prior to the FIFA World Cup 2014, with considerations towards the Olympic Games in 2016. Primary research conducted in 2013 in Brazil's second largest city, Rio de Janeiro, gave sex workers and civil society organizations the opportunity to voice concerns of the everyday disadvantages faced by those involved in the sex industry, with emphasis on what could cause further detriments from acting as a double draw international sporting host. This research largely took place through invitation at the 2013 Rio State Conference on HIV/AIDS, Equality and Human Rights. Mixed methods research - pre-arrival questionnaires and interviews led by a semi-structured interview guide - was deemed suitable for the primary research collection. The use of the research software NVivo allowed data to be categorised into key themes to form the basis of this research article. Working with a Portuguese translator, case studies of transsexual sex workers and civil society organizations were developed. Police violence was the main re-occurring theme expressed as a continued fear, alongside the added increase of security measures that the games would bring, to reduce organized crime, and through the Pacification programme. The majority of sex workers and organizations believed that there was no support from the Brazilian government to continue to provide services of high demand, including social care and legal assistance. Sex workers also felt prejudice in receiving HIV/AIDS treatment from government-led health services. A desirable outcome for the sex worker community would be for the government to consider the following: recommendations devised for further health and well being support; an act or law of non-violence against them; and recommendations to decimalize the sex industry. The Brazilian government has received global recognition for its response to the HIV/AIDS epidemic, however the
Fernando Luiz Cardoso
contribution to one such category - "transsexualism," - illustrating some of the recent ways of approaching this issue in academic and clinical terms.
Bauer Greta R
Full Text Available Abstract Background Studies of HIV-related risk in trans (transgender, transsexual, or transitioned people have most often involved urban convenience samples of those on the male-to-female (MTF spectrum. Studies have detected high prevalences of HIV-related risk behaviours, self-reported HIV, and HIV seropositivity. Methods The Trans PULSE Project conducted a multi-mode survey using respondent-driven sampling to recruit 433 trans people in Ontario, Canada. Weighted estimates were calculated for HIV-related risk behaviours, HIV testing and self-reported HIV, including subgroup estimates for gender spectrum and ethno-racial groups. Results Trans people in Ontario report a wide range of sexual behaviours with a full range of partner types. High proportions – 25% of female-to-male (FTM and 51% of MTF individuals – had not had a sex partner within the past year. Of MTFs, 19% had a past-year high-risk sexual experience, versus 7% of FTMs. The largest behavioural contributors to HIV risk were sexual behaviours some may assume trans people do not engage in: unprotected receptive genital sex for FTMs and insertive genital sex for MTFs. Overall, 46% had never been tested for HIV; lifetime testing was highest in Aboriginal trans people and lowest among non-Aboriginal racialized people. Approximately 15% of both FTM and MTF participants had engaged in sex work or exchange sex and about 2% currently work in the sex trade. Self-report of HIV prevalence was 10 times the estimated baseline prevalence for Ontario. However, given wide confidence intervals and the high proportion of trans people who had never been tested for HIV, estimating the actual prevalence was not possible. Conclusions Results suggest potentially higher than baseline levels of HIV; however low testing rates were observed and self-reported prevalences likely underestimate seroprevalence. Explicit inclusion of trans people in epidemiological surveillance statistics would provide much
Ana Cristina Santos
Full Text Available O presente artigo analisa a forma como o Estado português e a sociedade civil têm tratado a questão da AIDS, enfatizando o envolvimento da comunidade lésbica, gay, bissexual e transexual (LGBT no combate ao vírus. Começamos pela descrição da situação dos membros dessa comunidade em Portugal ao longo da década de 90, período da emergência e consolidação do movimento LGBT português. Num segundo momento, caracterizamos a evolução do complexo HIV/AIDS no citado país, analisando a relação entre a sociedade civil e as questões relacionadas com a sexualidade em geral, por um lado, e a situação da epidemia, por outro, considerando fatos, iniciativas estatais e associações existentes. Num terceiro momento, consagramos especial atenção ao papel desempenhado pelas associações LGBT na luta contra o HIV/AIDS. Finalmente, refletimos acerca do futuro da luta contra a epidemia e a discriminação no século XXI, tendo em conta os desenvolvimentos verificados no País e as linhas orientadoras da política de combate à AIDS adotadas por organismos internacionais.This article analyzes how both the Portuguese state and civil society have addressed the AIDS issue, focusing on participation by the lesbian, gay, bisexual, and transsexual community (LGBT in the struggle against AIDS. The article begins by describing the situation of LGBT individuals in Portugal during the 1990s, when the Portuguese LGBT movement emerged and grew, and then characterizes the evolution of HIV/AIDS in Portugal, analyzing the relationship between civil society and sexuality in general and the situation of the epidemic in the country in particular, considering key facts, nongovernmental organizations, and state initiatives. Special attention is given to the role played by LGBT organizations in the struggle against HIV. Finally, the article reflects on the future of the struggle against both AIDS and discrimination in the 21st century, considering recent events
Grinsztejn, Beatriz; Jalil, Emilia Moreira; Monteiro, Laylla; Velasque, Luciane; Moreira, Ronaldo I.; Garcia, Ana Cristina F.; Castro, Cristiane V.; Krüger, Alícia; Luz, Paula M.; Liu, Albert Y.; Farland, Willi Mc; Buchbinder, Susan; Veloso, Valdilea G.; Wilson, Erin C.
Background The burden of HIV in transgender women (transwomen) in Brazil remains unknown. We aimed to estimate HIV prevalence among transwomen, and identify the factors associated with newly diagnosed HIV infections. Methods “Transcender” was a respondent driven sampling study of transwomen in Rio de Janeiro, Brazil, conducted from August 2015 to January 2016. Twelve seeds were recruited from social movements and formative phase. Eligibility criteria were: self-identification as transwomen, being 18 years of age or older, living in Rio de Janeiro or metropolitan area, and having a valid peer recruitment coupon. Participants were categorized as HIV-negative, known HIV infected, or newly diagnosed as HIV infected. Predictors of newly diagnosed HIV infections were assessed by comparing the newly diagnosed with the HIV-negative. Population estimates were adjusted using the RDSII estimator. Findings In total, 345 eligible transwomen were enrolled. The study sample was young and diverse on gender identity. Population estimates of no prior HIV testing, HIV-infection and newly diagnosed as HIV-infected were 29·1%, 32·1% and 7·0%, respectively (based on n=60 with no prior testing, n=141 HIV-infected, n=40 newly diagnosed). Syphilis, rectal chlamydia and gonorrhea infection were diagnosed in 28·9%, 14·6%, and 13·5%, respectively. Newly diagnosed HIV infections were associated with black race (22·8; 95%CI 2·9–178·9), travesti (34·1; 95%CI 5·8–200·2) or transsexual woman (41·3; 95%CI 6·3–271·2) gender identity, history of sex work (30·7; 95%CI 3·5–267·3), and history of sniffing cocaine (4·4; 95%CI 1·4–14·1). Interpretation Our results suggest that transwomen bear the largest burden of HIV among any population at risk in Brazil. The high proportion of HIV diagnosis among young participants points to the need for tailored long-term health care and prevention services in order to curb the HIV epidemic and improve the quality-of-life of
Beek, Titia F.; Cohen-Kettenis, Peggy T.; Bouman, Walter P.; de Vries, Annelou L. C.; Steensma, Thomas D.; Witcomb, Gemma L.; Arcelus, Jon; Richards, Christina; Elaut, Els; Kreukels, Baudewijntje P. C.
The World Health Organization (WHO) is currently updating the tenth version of their diagnostic tool, the International Classification of Diseases (ICD, WHO, 1992). Changes have been proposed for the diagnosis of Transsexualism (ICD-10) with regard to terminology, placement and content. The aim of this study was to gather the opinions of transgender individuals (and their relatives/partners) and clinicians in the Netherlands, Flanders (Belgium) and the United Kingdom regarding the proposed changes and the clinical applicability and utility of the ICD-11 criteria of ‘Gender Incongruence of Adolescence and Adulthood’ (GIAA). A total of 628 participants were included in the study: 284 from the Netherlands (45.2%), 8 from Flanders (Belgium) (1.3%), and 336 (53.5%) from the UK. Most participants were transgender people (or their partners/relatives) (n = 522), 89 participants were healthcare providers (HCPs) and 17 were both healthcare providers and (partners/relatives of) transgender people. Participants completed an online survey developed for this study. Most participants were in favor of the proposed diagnostic term of ‘Gender Incongruence’ and thought that this was an improvement on the ICD-10 diagnostic term of ‘Transsexualism’. Placement in a separate chapter dealing with Sexual- and Gender-related Health or as a Z-code was preferred by many and only a small number of participants stated that this diagnosis should be excluded from the ICD-11. In the UK, most transgender participants thought there should be a diagnosis related to being trans. However, if it were to be removed from the chapter on “psychiatric disorders”, many transgender respondents indicated that they would prefer it to be removed from the ICD in its entirety. There were no large differences between the responses of the transgender participants (or their partners and relatives) and HCPs. HCPs were generally positive about the GIAA diagnosis; most thought the diagnosis was clearly
Lukas Heckendorn Urscheler
Full Text Available The Nepali legal tradition is a legal hybrid in many regards. Nepal was not colonised by a Western state, and the Hindu legal tradition therefore dominated all areas of law until the middle of the 20th century. Since the 1950s there has been a strong influence of Indian common law. It is probably for this reason that comparative classifications that include Nepal see the legal system as a mixture of common law and customary law. However, other mixtures mark the Nepali legal tradition. French law inspired the ruler in the 19th century, and that influence can still be found in the formal law. In addition, the plurality of Nepalese society made it necessary to provide space for different customary regimes to coexist with the formal Hindu law. When it comes to innovations within the legal system, including international law, the different ingredients interact.In family-related matters, the case-law of the Nepali Supreme Court illustrates the confrontation between international legal standards and the traditional rules. The Supreme Court has referred to the culturally conditioned discrimination against women and called for a thorough (political analysis in order to eliminate discrimination without a radical change of culture. In the area of discrimination against homo- and transsexuals the Supreme Court took a more innovative approach. It remains to be seen, however, if such a change is effective beyond the courtroom. In the area of private financial compensation for wrongs, the formal (written Nepali law does not have a general concept of tort. Compensation is generally integrated within the ambit of criminal law. Field research indicates that it would be possible to resort to existing customary principles of compensation rather than to the relatively complex common law of torts favoured by some Nepali scholars. However, this approach might not be without difficulty, as it might imply admitting the “superiority” of the customary practices of
Beer, G M; Budi, S; Seifert, B; Morgenthaler, W; Infanger, M; Meyer, V E
The causes of bilateral absence of the nipple-areola complex in men are seldom congenital, but attributable rather to destruction as a result of trauma, or after mastectomy in female-to-male transsexuals and in male breast cancer, or after the correction of extreme bilateral gynecomastia. Such a bilateral loss becomes a major reconstructive challenge with respect to the configuration and localization of a new nipple-areola complex. Because there is very little information available in the literature, we carried out a cross-sectional study on the configuration and localization of the nipple-areola complex in men.A total of 100 healthy men aged 20 to 36 years were examined under standardized conditions. The first part of the study dealt with the configuration of the nipple-areola complex (dimensions, round or oval shape). The second part concentrated on the localization of the complex on the thoracic wall with respect to anatomic landmarks and in correlation to various parameters such as weight and height of the body, circumference of the thorax, length of sternum, and position in the intercostal space. Of the 100 subjects examined, 91 had oval and seven had a round nipple-areola complex. An asymmetry between the right and the left side was found in two cases. The mean ratio of the horizontal/vertical diameter of an oval nipple-areola complex was 27:20 mm and the mean diameter for a round nipple-areola complex was 23 mm. The center of the nipple-areola complex was in the fourth intercostal space in 75 percent and in the fifth intercostal space in 23 percent of the subjects. To localize the nipple-areola complex on the thoracic wall de novo, at least two reproducible measurements proved to be necessary, composed of a horizontal line (distance from the midsternal line to the nipple = A) and a vertical line (distance from the sternal notch to the intersection of line A, = B). The closest correlation for the horizontal distance A was given by the circumference of the
Grinsztejn, Beatriz; Jalil, Emilia M; Monteiro, Laylla; Velasque, Luciane; Moreira, Ronaldo I; Garcia, Ana Cristina F; Castro, Cristiane V; Krüger, Alícia; Luz, Paula M; Liu, Albert Y; McFarland, Willi; Buchbinder, Susan; Veloso, Valdilea G; Wilson, Erin C
The burden of HIV in transgender women (transwomen) in Brazil remains unknown. We aimed to estimate HIV prevalence among transwomen in Rio de Janeiro and to identify predictors of newly diagnosed HIV infections. We recruited transwomen from Rio de Janeiro, Brazil, by respondent-driven sampling. Eligibility criteria were self-identification as transwomen, being 18 years of age or older, living in Rio de Janeiro or its metropolitan area, and having a valid peer recruitment coupon. We recruited 12 seed participants from social movements and formative focus groups who then used peer recruitment coupons to refer subsequent peers to the study. We categorised participants as HIV negative, known HIV infected, or newly diagnosed as HIV infected. We assessed predictors of newly diagnosed HIV infections by comparing newly diagnosed with HIV-negative participants. We derived population estimates with the Respondent-Driven Sampling II estimator. Between Aug 1, 2015, and Jan 29, 2016, we enrolled 345 eligible transwomen. 29·1% (95% CI 23·2-35·4) of participants had no previous HIV testing (adjusted from 60 participants), 31·2% (18·8-43·6) had HIV infections (adjusted from 141 participants), and 7·0% (0·0-15·9) were newly diagnosed as HIV infected (adjusted from 40 participants). We diagnosed syphilis in 28·9% (18·0-39·8) of participants, rectal chlamydia in 14·6% (5·4-23·8), and gonorrhoea in 13·5% (3·2-23·8). Newly diagnosed HIV infections were associated with black race (odds ratio 22·8 [95% CI 2·9-178·9]; p=0·003), travesti (34·1 [5·8-200·2]; p=0·0001) or transsexual woman (41·3 [6·3-271·2]; p=0·0001) gender identity, history of sex work (30·7 [3·5-267·3]; p=0·002), and history of sniffing cocaine (4·4 [1·4-14·1]; p=0·01). Our results suggest that transwomen bear the largest burden of HIV among any population at risk in Brazil. The high proportion of HIV diagnosis among young participants points to the need for tailored long-term health
Koehler, Andreas; Eyssel, Jana; Nieder, Timo O
Health care for transgender and transsexual (ie, trans) individuals has long been based on a binary understanding of gender (ie, feminine vs masculine). However, the existence of non-binary or genderqueer (NBGQ) genders is increasingly recognized by academic and/or health care professionals. To gain insight into the individual health care experiences and needs of binary and NBGQ individuals to improve their health care outcomes and experience. Data were collected using an online survey study on experiences with trans health care. The non-clinical sample consisted of 415 trans individuals. An individual treatment progress score was calculated to report and compare participants' individual progress toward treatment completion and consider the individual treatment needs and definitions of completed treatment (ie, amount and types of different treatments needed to complete one's medical transition). Main outcome measures were (i) general and trans-related sociodemographic data and (ii) received and planned treatments. Participants reported binary (81.7%) and different NBGQ (18.3%) genders. The 2 groups differed significantly in basic demographic data (eg, mean age; P < .05). NBGQ participants reported significantly fewer received treatments compared with binary participants. For planned treatments, binary participants reported more treatments related to primary sex characteristics only. Binary participants required more treatments for a completed treatment than NBGQ participants (6.0 vs 4.0). There were no differences with regard to individual treatment progress score. Because traditional binary-focused treatment practice could have hindered NBGQ individuals from accessing trans health care or sufficiently articulating their needs, health care professionals are encouraged to provide a holistic and individual treatment approach and acknowledge genders outside the gender binary to address their needs appropriately. Because the study was made inclusive for non
Daniel Francisco Mello
after this period. RESULTS: We treated 12 patients, eight were male, seven transsexuals. The volume injected ranged from 5ml to 2000ml, being unknown in three cases. The most often used injected sites were the thighs and buttocks. Eight patients had early manifestations, with inflammation and/or infection. Surgical debridement was necessary in five cases. Three patients with a history of injection in the breast region underwent adenomastectomy. There was one death due to refractory septic shock. CONCLUSION: The use of industrial liquid silicone should be completely contraindicated as a filling material and modification of body contouring, and may have serious complications, even death.
López-Ibor, Juan J; Ortiz, Tomás; López-Ibor, María I
there is a confrontation between the body object and the body subject that has made it possible to investigate how the perception of the own body is and how the brain generates the schema and the body image. The study of the body experience, from the phenomenology and the anthropological psychiatry perspective, has made it possible to go greater in-depth into the knowledge of the alterations of the experience of the own body in different mental diseases, especially in those in which a confrontation between the body and the personal identity arises makes it necessary to consider the process of individual identification and a category of personal identity disorders that would include body dysmorphic disorder, erythrophobia, anorexia nervosa, body integrity identity as well as the gender-type disorders (transsexualism, nonfetishistic transvestism, gender identity disorder during childhood). Key words: Dualism, Monism, Agnosia, Phantom limb, Cenesthesia, Body schema, Body image, Body experience, Personal identity disorders, Body dysmorphic disorder, Anorexia nervosa, Personal integrity identity disorder.
Background On numerous islands of the Pacific, under various names, there are people considered to be neither men nor women but half-men/half-women. In French Polynesia, there is a sociological and anthropological condition called RaeRae or Mahu. A RaeRae is a man who behaves as and considers himself to be a woman. RaeRae and Mahu are good examples of culture-bound transsexuality or cross-dressing. Being Mahu has a cultural meaning, recognized in the history of Polynesian society, and cannot be considered as a medical or psychiatric condition. Being RaeRae extends the transformation to possible hormone therapy and surgery; the traditional social role (education, tourism) of Mahu is retained but in some cases is influenced by prostitution and at-risk homosexuality.Bibliographic sources and method We conducted a literature search using several medical, social, and anthropological bibliographic sources (MedLine, Google Scholar, PsycINFO, DUMAS). We used the terms RaeRae, Mahu, Polynesian androphilia, and Polynesian sexuality. We found 20 articles and theses. Some articles discuss a very similar condition in Samoa (fa'afafine). In addition, Mahu seems to be a derogatory term for a male homosexual or drag queen in the Hawaiian Islands.Results and contents RaeRae and Mahu is broadly defined as men with sweetness [OK?] or women who are prisoners of men's bodies. There is evidence of their presence and social functions in ancient times. The arrival of the missionaries and Christian morality resulted in the emergence of a new moral and sexual order. RaeRae and Mahu remain present and visible today. They are integrated into local professional and cultural life and are accepted, as long as their sexuality remains unspoken and invisible, which is more difficult for RaeRae. We describe the phenomenon and its context and the sociocultural hypotheses. We retain a reference connected to tacit knowledge of Polynesian sacrificial rites: Mahu did not undergo sacrifices the victims
性别苦恼（Gender dysphoria）既往称为性别认同障碍（Gender identity disorder ），又称性别改变症（T ranssexualism ）。是指一个人在心理上无法认同自己与生俱来的性别，相信自己应该属于另一种性别。或是指性别方面的心理障碍者深信称之为自己是另一性别的人，并可能考虑改变自己的性别角色，对自己的身体进行女性化或男性化处理，以取得更大的舒适性与自我认同的性身份。美国精神病学会在2013年5月出版了《精神疾病诊断与统计手册》第5版（DSM －5）。DSM －5去除“性别认同障碍”诊断名称，而改为“性别苦恼”。这等同于“性别认同”的“去病化”，肯定性别认同的“多元性”。自此，性别认同的差异不再有正常与不正常之分。近年来，在人类性学、精神病学和临床心理学领域对性别苦恼进行了大量的临床研究。根据DSM －5的标准和新的临床研究成果，本文对性别苦恼的病因和发病机制、临床表现、诊断标准、诊断和鉴别诊断、治疗、预防和保健进行了分析。%Gender dysphoria(GD)previously called gender identity disorder (GID) ,also known transsexualism .It refers to a discomfort with one’s gender assigned at birth I.ndividuals who have persistent gender dysphoria typically have an experienced gender identity that differs significantly from the sex they were assigned at birth ,and may con-sider changing their gender role and feminize or masculinize their body to achieve greater comfort with self and iden-tity .American Psychiatry Association (APA)has published (DSM -5)in 2013 .DSM -5 has removed the "gender identity disorder"’s diagnosis name and change to "gender dysphoria".This is equivalent to "gender identity"into "treat illness",and affirmed gender identity of "di-versity"S.ince then ,difference of gender identity is no normal or abnormal points I.n recent years ,A lot of clinical
Marco Aurélio Máximo Prado
-hegemônico. Já estratégia de aliança é definida como a construção de vínculo, em torno de demandas especificas, entre sujeitos políticos na construção de ações conjuntas, sem que isso implique, necessariamente, na promoção de uma relação de equivalência entre os grupos. Entendemos essas duas formas de estratégia política não como opostas, a priori, mas como modos complementares de se construir a mudança social. As estratégias debatidas podem ser úteis para pesquisas no campo dos movimentos sociais, sobretudo, na análise dos modos de construção da luta política.This article aims to discuss strategies for political struggle developed by the social movements in Brazilian society, focusing in the question: what are the possibilities of social democratization since the decentralization of the political space and the plurality of political subjects have been characterized the last decades of contemporary Western societies? We interviewed leaderships of groups from the feminist movement (World March of Women - MMM, the afrobrazilian movement (Black Active - NA, the peasant movement (Landless Rural Workers Movement - MST, the trade union movement (Central Union of Workers - CUT, the Movement of Unemployed Workers (MTD and the Popular Brigades (BP. In addition, we interviewed the secretary of the Popular Assembly of Belo Horizonte - Minas Gerais (AP-MBH and vice-president "Trans" of the Brazilian Association of Gays, Lesbians, Bisexuals, and Transsexuals (ABGLT. All those entities we named as a public space where different political subjects are linked. We also collect materials from the groups about the actions undertaken by them, the history of the groups, and their political demands. For data analysis, we focus on a specific theory of democracy named Plural Radical and Democratic Theory, developed by Ernesto Laclau and Chantal Mouffe since the mid-1980s. From reading the interviews, the documents collected from the groups and the considerations of the