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1.
Cien Saude Colet ; 29(4): e19612023, 2024 Apr.
Artigo em Português, Inglês | MEDLINE | ID: mdl-38655969

RESUMO

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


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


Assuntos
Pessoas Transgênero , Humanos , Feminino , Gravidez , Pessoas Transgênero/psicologia , Masculino , Cuidado Pré-Natal , Transexualidade/psicologia , Assistência Perinatal/normas , Serviços de Saúde Reprodutiva/organização & administração , Saúde Reprodutiva
2.
Soc Sci Med ; 346: 116734, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38490912

RESUMO

Healthcare systems and providers have increasingly acknowledged the role and impact of social determinants in overall health. However, gender-diverse individuals face persistent health disparities due to their identities. There is limited research on the impact of clinical and sociodemographic characteristics on mood and quality of life (QoL) for transgender (TG) individuals. Our study aims to understand and better elucidate social and clinical characteristics of transmasculine (TM) and transfeminine (TF) individuals and their impact on quality of life and depressive symptoms. In this cross-sectional study, 298 TF and TM individuals on gender-affirming hormone therapy (GAHT) were surveyed about their demographic characteristics (age, gender identity, body mass index (BMI), and education), social needs, mood, and quality of life. Multivariable regression modelling was performed to assess the effect of each variable listed above on three domains of QoL (psychological, environmental, and physical) as well as depressive symptoms. We find that QoL scores are similar between TM and TF individuals, with scores in the psychological domain particularly low in both cohorts. TM individuals report higher rates of stress and restroom avoidance than TF individuals. In particular, psychological well-being (measured by the psychological domain of QoL and depressive symptoms) is significantly associated with increased BMI, financial instability, and stress in TM individuals while for TF individuals, psychological well-being is associated with stress and social integration. These data suggest that social circumstances are key drivers of QoL and psychological well-being among gender-diverse individuals receiving GAHT with specific differences between TF and TM individuals. This information may be utilized by healthcare providers and policymakers to address and improve clinical care and social policies to improve health equity for gender-diverse individuals.


Assuntos
Pessoas Transgênero , Transexualidade , Humanos , Feminino , Masculino , Identidade de Gênero , Qualidade de Vida/psicologia , Estudos Transversais , Transexualidade/psicologia , Pessoas Transgênero/psicologia , Hormônios
3.
J Psychiatr Res ; 172: 345-350, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38442450

RESUMO

Transgender adolescents have unique mental health needs. This demographic has increased rates of mood disorders, anxiety, and depression compared to their cisgender peers. Large-scale studies focused on mental health outcomes, including suicidality, in the transgender adolescent population remain unknown. This study tries to fill these gaps in the literature. Data for this study was taken from the National Inpatient Sample 2016-2018. Transgender adolescents were identified using the ICD-10 codes related to transsexualism diagnoses. These individuals were compared to adolescents without transsexualism diagnoses. To mitigate imbalances in baseline characteristics, we utilized a 1:2 nearest neighbor propensity score matching with a caliper width of 0.0001, considering variables such as age, year of hospitalization, and psychiatric disorders. Following propensity score matching, the study cohort comprised 2635 transgender and 5270 non-transgender adolescents (Mean age 15.2 years). The transgender group demonstrated a notably higher prevalence of mood disorders (91%) and anxiety disorders (65%). Furthermore, the prevalence of suicidal ideation was significantly higher in the transgender group (52.4% vs. 39.2%, p < 0.001). However, there was no significant difference in the prevalence of suicide attempts between the groups. After controlling for psychiatric comorbidities, age, and gender, the odds ratio for the composite outcome of suicidal ideation or attempt was 1.99 (95% CI 1.58-2.12, p < 0.001). Our study identifies elevated mood and anxiety disorders and suicidality rates in hospitalized transgender adolescents compared to cisgender peers. Mood disorders notably amplify the risk of suicidal attempts. These findings urgently call for targeted mental health interventions and policy changes to serve this vulnerable population in healthcare settings better.


Assuntos
Suicídio , Pessoas Transgênero , Transexualidade , Humanos , Adolescente , Transexualidade/epidemiologia , Transexualidade/psicologia , Ideação Suicida , Estudos Transversais , Pacientes Internados , Pontuação de Propensão , Avaliação de Resultados em Cuidados de Saúde
4.
Endokrynol Pol ; 75(2): 222-229, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38497370

RESUMO

INTRODUCTION: Many transsexual women seek to feminise their voice through pitch elevation surgeries so that it becomes congruent with their gender identity. This study aims to determine the safety and effectiveness of Wendler glottoplasty (WG) in vocal feminisation through the assessment of acoustic and aerodynamic parameters of the voice, as well as voice-related quality of life (QoL) in male-to-female transsexuals. MATERIAL AND METHODS: We retrospectively reviewed the medical records of transsexual women who underwent WG for voice feminisation at our institution between 2016 and 2023. All acoustic and aerodynamic analyses, a voice self-assessment, and a videolaryngostroboscopic evaluation were performed in the immediate preoperative period and at the follow-up visit 6 weeks after the procedure. RESULTS: A total of 11 patients with a mean age of 32.73 years were included. After WG, there was a significant fundamental frequency and speaking fundamental frequency increase of 109.64 Hz and 83.48 Hz, respectively (p < 0.001), representing an average rise by 9.71 semitones and 8.36 semitones (STs), respectively. No significant differences were found between the mean pre- and postoperative values of fundamental frequencies, frequency range, upper limit of the frequency range of spoken voice, and maximum phonation time. Contrarily, the mean lower limit of frequency range rose by 75.56 Hz (p < 0.001), representing an average increase of 10.56 STs. None of the assessed spirometric parameters changed significantly after WG (p > 0.05). The mean overall Voice Handicap Index (VHI) and Voice-Related Quality of Life (V-RQOL) scores significantly improved after the surgery, decreasing by 24.54 points (p = 0.008) and 11.5 points (p = 0.001), respectively. A significant improvement was observed in the functional and emotional domains of VHI. Additionally, significantly fewer patients considered the overall quality of their voice to be "poor" after WG. CONCLUSIONS: WG constitutes an effective method of surgical voice feminisation in male-to-female transsexuals with concurrent improvement in their voice-related QoL. Furthermore, it remains a safe procedure without persistent complications and negative influence on the acoustic-aerodynamic measures of the voice.


Assuntos
Qualidade de Vida , Pessoas Transgênero , Transexualidade , Qualidade da Voz , Humanos , Adulto , Masculino , Estudos Retrospectivos , Feminino , Pessoas Transgênero/psicologia , Transexualidade/cirurgia , Transexualidade/psicologia , Glote/cirurgia , Resultado do Tratamento , Pessoa de Meia-Idade , Procedimentos de Readequação Sexual/métodos
5.
Arch Sex Behav ; 53(5): 1873-1884, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38388763

RESUMO

Gender dysphoria and autism spectrum disorder (ASD) co-occur at high rates. Yet, it is unknown whether gender dysphoria and ASD are associated with common or distinct neurobiological correlates or how they relate to experiences of gender-related body incongruence. Using the Social Responsiveness Scale, we assessed autistic traits in 99 transgender and 99 cisgender individuals and investigated their associations with gender-related body incongruence, measured via a visually based "Body Morph" test, and with cortical thickness in the brain. Autistic traits were significantly higher among transgender individuals, and those with higher autistic traits had higher body incongruence scoring. Among transgender individuals, higher autistic traits were linked with a thinner cortex bilaterally in the temporal pole and the superior and inferior temporal gyri. Autistic traits were only partly associated with cortical morphology patterns previously reported in transgender individuals; instead, they were primarily linked to temporal lobe areas mediating social cognition. While replicating the previous literature on the increased prevalence of autistic traits among transgender individuals, this study reports specific regions in the brains of transgender individuals where cortical thickness is associated with autistic traits.


Assuntos
Transtorno do Espectro Autista , Disforia de Gênero , Pessoas Transgênero , Humanos , Feminino , Masculino , Adulto , Transtorno do Espectro Autista/psicologia , Disforia de Gênero/psicologia , Pessoas Transgênero/psicologia , Imageamento por Ressonância Magnética , Adulto Jovem , Encéfalo/diagnóstico por imagem , Imagem Corporal/psicologia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia , Adolescente , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/patologia , Transexualidade/psicologia , Transtorno Autístico/psicologia
6.
J Sex Marital Ther ; 50(3): 379-394, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38238978

RESUMO

How gender-affirming treatments (GAT) influence the experienced sexuality of transgender, gender non-conforming, and non-binary (TGNB) individuals remains understudied. The aim of this research was to discern factors contributing to a satisfying sexual experience for TGNB individuals, explore the influence of GAT on this process, and identify potential areas for improvement in transition-related care. We conducted interviews with 21 participants at various stages of GAT. Participants identified as (trans)men (12), (trans)women (7), transgender (1), and genderqueer/gender non-conforming/non-binary (1). Thematic analysis was conducted and involved multiple researchers. Three themes emerged from the data: (i) the role sexuality plays in understanding and affirming one's gender, (ii) satisfaction with one's physical sexual function, (iii) positive communication about sex and its subsequent influence on relationships. Many participants associated satisfaction with physical sexual function with positive sexual experiences, often describing GAT-induced changes in sexual arousal, drive, and orgasm as gender-affirming. Emotional connection and affirmation from sexual partners also contributed to positive experiences. The ability to (re-)define what sex meant individually increased satisfaction levels. Moreover, understanding and affirming one's gender identity were closely related to a satisfactory sex life. This study offers valuable insights for healthcare providers working with TGNB individuals during GAT, particularly concerning their sexuality.


Assuntos
Pessoas Transgênero , Transexualidade , Feminino , Humanos , Masculino , Identidade de Gênero , Comportamento Sexual/psicologia , Sexualidade , Transexualidade/psicologia , Pessoas Transgênero/psicologia
7.
Arch Sex Behav ; 53(1): 57-76, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38038854

RESUMO

Persons who have renounced a prior transgender identification, often after some degree of social and medical transition, are increasingly visible. We recruited 78 US individuals ages 18-33 years who previously identified as transgender and had stopped identifying as transgender at least six months prior. On average, participants first identified as transgender at 17.1 years of age and had done so for 5.4 years at the time of their participation. Most (83%) participants had taken several steps toward social transition and 68% had taken at least one medical step. By retrospective reports, fewer than 17% of participants met DSM-5 diagnostic criteria for Gender Dysphoria in Childhood. In contrast, 53% of participants believed that "rapid-onset gender dysphoria" applied to them. Participants reported a high rate of psychiatric diagnoses, with many of these prior to trans-identification. Most participants (N = 71, 91%) were natal females. Females (43%) were more likely than males (0%) to be exclusively homosexual. Participants reported that their psychological health had improved dramatically since detransition/desistance, with marked decreases in self-harm and gender dysphoria and marked increases in flourishing. The most common reason given for initial trans-identification was confusing mental health issues or reactions to trauma for gender dysphoria. Reasons for detransition were more likely to reflect internal changes (e.g., the participants' own thought processes) than external pressures (e.g., pressure from family). Results suggest that, for some transgender individuals, detransition is both possible and beneficial.


Assuntos
Disforia de Gênero , Minorias Sexuais e de Gênero , Pessoas Transgênero , Transexualidade , Masculino , Feminino , Humanos , Adulto Jovem , Estudos Retrospectivos , Transexualidade/psicologia , Pessoas Transgênero/psicologia , Saúde Mental , Disforia de Gênero/diagnóstico , Disforia de Gênero/psicologia , Identidade de Gênero
8.
J Clin Endocrinol Metab ; 109(6): 1565-1579, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38099569

RESUMO

CONTEXT: The role of body modifications induced by gonadal suppression in transgender and gender diverse adolescents on psychological functioning has not yet been evaluated. OBJECTIVE: The main aim of the present study was to explore several hormone, physical and psychological functioning changes during gonadotropin-releasing hormone analog (GnRHa) treatment in transgender and gender diverse adolescents (TGDAs). The potential relationship between the physical and hormone effects of GnRHa and psychological well-being, along with its magnitude, was assessed for the first time. METHODS: This prospective multidisciplinary study included 36 TGDA (22 assigned female at birth, and 14 assigned male at birth) who received psychological assessment followed by triptorelin prescription after referring to the Florence Gender Clinic. This study consisted of 3 time points: first referral (T0), psychological assessment (T1); and treatment with intramuscular injections of triptorelin for 3 up to 12 months (T2). Psychometric questionnaires were administered at each time point, and clinical and biochemical evaluations were performed at T1 and T2. RESULTS: The following results were found: (1) GnRHa showed efficacy in inhibiting puberty progression in TGDAs; (2) an increase in psychopathology was observed before starting GnRHa (T1) compared with baseline levels; (3) during GnRHa treatment (T2), a significant improvement in psychological functioning, as well as decrease in suicidality, body uneasiness, depression, and anxiety levels were observed; (4) hormone and physical changes (in terms of gonadotropin and sex steroid levels, height and body mass index percentiles, waist-hip ratio, and acne severity) observed during triptorelin treatment significantly correlated with a reduction in suicidal ideation, anxiety, and body image concerns. CONCLUSION: Psychological improvement in TGDA on GnRHa seems to be related to the objective body changes induced by a GnRHa. Therefore, the rationale for treatment with a GnRHa may not only be considered an extension of the evaluation phase, but also the start of a medical (even if reversible) gender-affirming path, especially in TGDAs whose puberty has already progressed.


Assuntos
Hormônio Liberador de Gonadotropina , Pessoas Transgênero , Pamoato de Triptorrelina , Humanos , Feminino , Masculino , Adolescente , Pessoas Transgênero/psicologia , Hormônio Liberador de Gonadotropina/análogos & derivados , Pamoato de Triptorrelina/uso terapêutico , Pamoato de Triptorrelina/administração & dosagem , Estudos Prospectivos , Puberdade/efeitos dos fármacos , Puberdade/psicologia , Puberdade/fisiologia , Transexualidade/tratamento farmacológico , Transexualidade/psicologia , Procedimentos de Readequação Sexual/métodos
9.
Drug Alcohol Depend ; 250: 110872, 2023 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-37406573

RESUMO

PURPOSE: Transgender and non-binary people (TGNB) have a higher rate of heavy episodic drinking than cisgender people; however, extant knowledge about predictors of hazardous alcohol drinking (HAD) among different TGNB groups is limited. This study examined predictors of HAD in a national sample of TGNB people in Canada. METHODS: Logistic regression models were fit to examine the effects of 1) minority stressors and 2) stress-buffering factors on the likelihood of HAD, stratified by gender, among 2324 TGNB individuals from the Trans PULSE Canada survey, a cross-sectional survey conducted in 2019 among trans and non-binary people aged 14+ in Canada. RESULTS: Almost 17% of participants reported past-year HAD. Lifetime day-to-day and lifetime major discrimination were associated with higher odds of HAD in the full sample [(AOR=1.37, 95% CI: 1.30, 1.44) and (AOR=1.69, 95% CI: 1.55, 1.86) respectively], and across all gender groups. Social support was associated with lower odds of HAD in trans men, non-binary people assigned female at birth (NB-AFAB), and non-binary people assigned male at birth (NB-AMAB) groups, but with higher odds of HAD in the trans women group. Misgendering was associated with lower odds of HAD in trans men and NB-AFAB, but higher odds of HAD in trans women and NB-AMAB. Mixed effects of gender distress, gender positivity, and gender-affirming medical care were also reported across groups. CONCLUSION: The study provided a more detailed understanding of the predictors of HAD across four TGNB groups. Public health interventions should focus on structural discrimination and social support for TGNB people.


Assuntos
Consumo de Bebidas Alcoólicas , Identidade de Gênero , Minorias Sexuais e de Gênero , Transexualidade , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Canadá/epidemiologia , Estudos Transversais , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Apoio Social , Pessoas Transgênero/psicologia , Pessoas Transgênero/estatística & dados numéricos , Transexualidade/psicologia , Fatores Sociodemográficos , Estresse Psicológico
10.
J Youth Adolesc ; 52(8): 1531-1548, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37199852

RESUMO

Even though previous studies have shown that transgender youth have poorer mental health and more experiences of being bullied than their cisgender counterparts, and that bullying associates with poorer mental health, knowledge on such associations in different gender identity groups is scarce. This study investigated how mental health problems and experiences of being bullied appear across different gender identity groups, and how bullying is associated with mental health among the groups in question. Data from the Finnish School Health Promotion 2021 study (n = 152,880, mean age 16.2 years (standard deviation 1.22)) was used and categorized into four gender identity groups: cisgender girls (n = 76,521), cisgender boys (n = 69,735), transfeminine youth (n = 1317), and transmasculine youth (n = 5307). Transgender youth experienced more bullying and reported poorer mental health than cisgender youth. While transfeminine youth faced the most bullying, transmasculine youth had the most mental health symptoms. In each group, bullying associated with poorer mental health. Compared to cisgender boys without bullying experiences, odds of poorer mental health were dozens-fold among transmasculine youth with weekly bullying experiences. In addition, compared to cisgender boys with bullying experiences, odds of poorer mental health were greater among all other gender identity groups with bullying experiences, and among transmasculine youth in particular (e.g., odds ratio of generalized anxiety = 8.36 (95% confidence interval, 6.59-10.6)). Bullying is associated with poorer mental health in all youth, but transgender youth, and especially transmasculine youth, may be in an even more vulnerable position for its implications. This suggests that there is a need for improving effective measures to decrease bullying in schools and to improve wellbeing of transgender youth.


Assuntos
Bullying , Pessoas Transgênero , Transexualidade , Humanos , Masculino , Adolescente , Feminino , Pessoas Transgênero/psicologia , Identidade de Gênero , Saúde Mental , Transexualidade/psicologia , Bullying/psicologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-36833645

RESUMO

Sociodemographic and psychosocial family factors have profound implications for adolescent development, identity formation and mental health during the adolescent years. We explored the associations of sociodemographic and psychosocial family factors with transgender identity in adolescence and the role of these factors in the associations between gender identity and emotional disorders. Data from a large adolescent population survey from Finland were analysed using logistic regression models. Reporting transgender identity was associated with mother's low level of education, accumulating family life events, lack of family cohesion, perceived lack of family economic resources and female sex. A lack of family cohesion further differentiated between adolescents reporting identifying with the opposite sex and those reporting non-binary/other gender identification. The associations between transgender identity, depression and anxiety were attenuated but did not level out when family factors were controlled for. Transgender identity in adolescence is associated with socioeconomic and psychosocial family factors that are known correlates of negative outcomes in mental health and psychosocial well-being. However, transgender identification is also associated with emotional disorders independent of these family factors.


Assuntos
Pessoas Transgênero , Transexualidade , Adolescente , Humanos , Feminino , Masculino , Pessoas Transgênero/psicologia , Identidade de Gênero , Transexualidade/psicologia , Inquéritos e Questionários , Características da Família
12.
Arch Sex Behav ; 52(3): 991-1007, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36287302

RESUMO

Prior work suggests that some cisgender people do not consider gender identity when thinking about what being transgender means, and that exposure to a definition of transgender can reduce negative attitudes toward transgender people. In two studies, we sought to integrate these lines of research by examining whether anti-transgender attitudes are associated with how cisgender people define the term transgender. In Study 1, 293 participants (132 female and 157 male; four participants did not report their sex/gender) recruited via Mechanical Turk were randomly assigned to one of two conditions. Participants in one condition first read a definition of "transgender" that referred to gender identity and then reported their attitudes toward transgender people. Participants in the other condition did not read the definition and instead simply reported their attitudes toward transgender people. Contrary to predictions, exposure (vs. lack thereof) to the definition did not affect attitudes. However, participants who identified gender identity as a central component of the definition of transgender on a manipulation check endorsed more positive attitudes. In Study 2, 295 cisgender participants (165 women and 130 men; recruited via Mechanical Turk) wrote down their own definitions of transgender. Participants who spontaneously included (vs. did not include) gender identity in their definitions reported distinctively positive attitudes. Observed effects held over and above individual differences in cognitive style, gender identification, contact with transgender people, and participant gender. How cisgender people think about gender identity may thus index their attitudes toward transgender people.


Assuntos
Pessoas Transgênero , Transexualidade , Feminino , Humanos , Masculino , Identidade de Gênero , Pessoas Transgênero/psicologia , Transexualidade/psicologia , Atitude
13.
J Homosex ; 70(11): 2374-2394, 2023 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-35452371

RESUMO

Because transgender people often suffer from concerns such as increased depression and anxiety, promoting positive and healthy mental well-being within this community is valuable. Two aspects of well-being that may be particularly relevant to the trans community are identity development and self-esteem. We hypothesized that a better overall transition experience (access to medical and psychological care, support from friends and family, etc.) would predict better identity development, individual self-esteem, and collective self-esteem in transgender men. This prediction was supported in a sample of 145 transmen from 15 different countries. Further exploratory analyses reveal that the direct effects of the transition process on identity development and individual self-esteem were significantly mediated by participants' perceived masculinity-but this mediation did not apply to collective self-esteem. We also found that when comparing overall transition experiences in the countries represented in our sample, the process was most positive in transmen from Australia and New Zealand, with experiences in the U.S., Canada, and Europe as less positive. Providing a supportive transition process and validating transmen's masculinity are important factors in paving the way for them to have healthy identity development and self-esteem.


Assuntos
Minorias Sexuais e de Gênero , Pessoas Transgênero , Transexualidade , Masculino , Humanos , Masculinidade , Pessoas Transgênero/psicologia , Autoimagem , Transexualidade/psicologia
14.
J Interpers Violence ; 38(1-2): NP1738-NP1761, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35466782

RESUMO

The prevalence of experiencing sexual assault is alarmingly high among Transgender and Gender Diverse people (TGD; people whose gender identities and/or expressions are not traditionally associated with their sex assigned at birth) and is associated with various mental health sequalae. Perceived social support has been shown to abate the negative outcomes of sexual assault among cisgender individuals, yet little is known about this association among TGD people, especially which provider of support (i.e., family, friends, or significant others) may be most beneficial. To that end, 191 TGD adults were recruited through Amazon's Mechanical Turk to examine perceived social support as a potential moderator of the association between sexual assault victimization and post-sexual assault trauma symptomology. Results showed an interaction trending toward significance between sexual assault and support from a significant other. Decomposition of this interaction demonstrated that sexual assault was associated with post-assault trauma symptoms when support from a significant other was low (ß = .25, p < .05) but not high (ß = .10, p = .089). The interaction between sexual assault and perceived social support was not significant for perceived support from friends (p = .133) or family (p = .954). Findings highlight the need for additional research on perceived social support as a potential buffering mechanism between sexual assault and post-assault symptomology in TGD people.


Assuntos
Vítimas de Crime , Delitos Sexuais , Pessoas Transgênero , Transexualidade , Adulto , Recém-Nascido , Humanos , Pessoas Transgênero/psicologia , Identidade de Gênero , Transexualidade/psicologia , Delitos Sexuais/psicologia , Vítimas de Crime/psicologia
15.
Rev Bras Enferm ; 76Suppl 2(Suppl 2): e20220183, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38558029

RESUMO

OBJECTIVE: to analyze the repercussions of transphobia on trans men's and transmasculine people's health. METHOD: a qualitative study carried out with 38 participants, 35 trans men and three trans men, who attended specialized transgender health services in Bahia, Brazil. In-depth interviews were carried out between June 2019 and February 2020. The Discourse of Collective Subject technique was used and interpretation based on the theoretical concept of transphobia. RESULTS: transphobia has intra and interpersonal repercussions on the life and health of trans men and transmasculine people who attend health services. There were experiences of violence in the private space, fraying of family ties; discrimination in the school space; limitation in professional/work opportunities; barriers to self-care and access to health services; elaboration of trans identity protection strategies; consequences of transphobia on psycho-emotional health. CONCLUSION: transphobia is a social disease that affects different life and health dimensions. It causes damage to the socialization of trans men and transmasculine people, in addition to health service spaces as well as in family environments, schools, universities and at work, which result in non-adherence to self-care, distancing from health services and psycho-emotional distress.


Assuntos
Pessoas Transgênero , Transexualidade , Masculino , Humanos , Pessoas Transgênero/psicologia , Transexualidade/psicologia , Pesquisa Qualitativa , Violência , Condições Sociais
16.
BMC Public Health ; 22(1): 2312, 2022 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-36496355

RESUMO

BACKGROUND: While there is growing research considering the experiences of transgender youth whose identities align with the gender binary, especially among young trans women, there are significantly fewer studies that accurately capture data about nonbinary youth, and even fewer studies capturing the experiences of transgender and gender diverse (TGD) youth of color. The purpose of this research was to assess the prevalence of sexual health behaviors, mental health challenges, substance use, and healthcare utilization among Black/African American, Latinx, Asian/Pacific Islander, indigenous and multi-racial/ethnic TGD youth, who have been largely underrepresented in research. METHODS: A total of 108 TGD youth ages 16-24 were recruited into the Trans Youth of Color Study (TRUTH). Each participant completed a 90-min survey administered by a research assistant with more sensitive information collected using ACASI. In addition to a completing a survey administered by research staff, participants also participated in specimen collection, which included urine sampling to assess recent substance use without a prescription, self-collected rectal/frontal and throat swabs to test for gonorrhea and chlamydia, and a blood draw to test for recent use of drugs, gonorrhea and chlamydia, and syphilis. The sample was recruited at public venues, community outreach and referral, through social media outreach, and via participant referral. Cross-sectional analyses were from a single study visit. RESULTS: Compared to rates among their cisgender peers, participants reported experiencing adverse social and structural determinants of health-e.g. food insecurity (61%), housing instability (30%), and limited access to healthcare (26% had no place to go for healthcare)-and elevated rates of illicit drug use (19-85%), mental health problems (e.g. 60% self-reported depression), and involvement in sexual risk-related behaviors (e.g. among those reporting penetrative sex 57-67% reported sex without a condom). CONCLUSIONS: This study adds descriptions of both mental and sexual health outcomes of a non-clinical sample of TGD youth to the literature, particularly among young transgender men and gender nonbinary youth, who have frequently been excluded from previous studies of sexual health. The findings document experiences and behaviors among TGD youth that contribute to mental and sexual health concerns, including rates of substance use, and healthcare utilization.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Pessoas Transgênero , Transexualidade , Adolescente , Masculino , Humanos , Feminino , Adulto Jovem , Adulto , Estudos Transversais , Pessoas Transgênero/psicologia , Identidade de Gênero , Transexualidade/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
17.
Salud Colect ; 18: e4136, 2022 11 04.
Artigo em Espanhol | MEDLINE | ID: mdl-36520490

RESUMO

Cisnormativity in the health field has involved the pathologization of identities that do not align with gender binaries. The aim of this study was to analyze the scope and influence of cisnormative discourses on the care and health of trans youth. Semi-structured interviews were carried out between March 2021 and May 2022, and results were analyzed from a social constructivist approach. Five young trans people between 20 and 29 years old participated in the study (2 trans women and 3 trans men). Results showed that aspects of cisnormative gender discourse were evident in their narratives; however, at the same time they generated alternative narratives, where psycho-emotional and bodily care led them to position themselves outside of common tropes such as dysphoria and "the wrong body". We conclude that this study contributes to dismantling the medical view of trans people by showing how they adopt self-care practices by mobilizing their own resources. Furthermore, it reflects the importance of building dialogues with trans people that will allow more and better care strategies to be generated.


La cisnormatividad en el ámbito de la salud ha implicado la patologización de identidades que no se identifican con los criterios de la lógica binaria del género. El objetivo de este estudio fue analizar el alcance y la influencia que los discursos cisnormativos tienen en el cuidado y la salud de las y los jóvenes trans. Entre marzo de 2021 y mayo de 2022, se llevaron a cabo entrevistas semiestructuradas que se analizaron a la luz de la perspectiva socioconstruccionista. Participaron cinco jóvenes trans (dos mujeres trans y tres varones trans), de entre los 20 y 29 años. Los resultados mostraron la incorporación en sus relatos de aspectos del discurso cisnormativo del género; no obstante, a la par generan narrativas alternativas, en las que el cuidado psicoemocional y del cuerpo les lleva a posicionarse lejos de tropos narrativos como la disforia y "el cuerpo equivocado". Concluimos que este trabajo contribuye a desmantelar la visión médica de las personas trans, mostrando cómo a través de sus recursos, adoptan prácticas de autocuidado. Asimismo, refleja la importancia de construir diálogos con las personas trans que permitan generar más y mejores estrategias de atención.


Assuntos
Pessoas Transgênero , Transexualidade , Masculino , Adolescente , Feminino , Humanos , Adulto Jovem , Adulto , Pessoas Transgênero/psicologia , México , Transexualidade/psicologia , Identidade de Gênero
18.
Ann Plast Surg ; 89(4): 431-436, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-36149983

RESUMO

BACKGROUND: Gender dysphoria is a condition that often leads to significant patient morbidity and mortality. Although gender-affirming surgery (GAS) has been offered for more than half a century with clear significant short-term improvement in patient well-being, few studies have evaluated the long-term durability of these outcomes. METHODS: Chart review identified 97 patients who were seen for gender dysphoria at a tertiary care center from 1970 to 1990 with comprehensive preoperative evaluations. These evaluations were used to generate a matched follow-up survey regarding their GAS, appearance, and mental/social health for standardized outcome measures. Of 97 patients, 15 agreed to participate in the phone interview and survey. Preoperative and postoperative body congruency score, mental health status, surgical outcomes, and patient satisfaction were compared. RESULTS: Both transmasculine and transfeminine groups were more satisfied with their body postoperatively with significantly less dysphoria. Body congruency score for chest, body hair, and voice improved significantly in 40 years' postoperative settings, with average scores ranging from 84.2 to 96.2. Body congruency scores for genitals ranged from 67.5 to 79 with free flap phalloplasty showing highest scores. Long-term overall body congruency score was 89.6. Improved mental health outcomes persisted following surgery with significantly reduced suicidal ideation and reported resolution of any mental health comorbidity secondary to gender dysphoria. CONCLUSION: Gender-affirming surgery is a durable treatment that improves overall patient well-being. High patient satisfaction, improved dysphoria, and reduced mental health comorbidities persist decades after GAS without any reported patient regret.


Assuntos
Disforia de Gênero , Cirurgia de Readequação Sexual , Pessoas Transgênero , Transexualidade , Seguimentos , Disforia de Gênero/cirurgia , Humanos , Pessoas Transgênero/psicologia , Transexualidade/psicologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-35897291

RESUMO

Some trans people experience gender dysphoria, which refers to psychological distress that results from an incongruence between one's gender assigned at birth and one's gender identity. People who are trans masculine or nonbinary assigned-female-at-birth may pursue multiple domains of gender affirmation, including surgical affirmation (e.g., masculine chest reconstruction, penile reconstruction, etc.). The present study aimed to investigate the possible factors involved in trans people's desire to undergo gender-affirming genital surgery. Trans masculine and nonbinary participants (N = 127; mean age = 26.90) were recruited through a web-based survey and completed self-report instruments (i.e., the Internalized Transphobia subscale of the Gender Minority Stress and Resilience Measure, the Trans Positive Identity Measure, the Gender Congruence and Life Satisfaction Scale, an ad hoc scale on transnormativity, and a single-item on desire to undergo genital affirmation surgery). A path analysis showed that higher levels of internalized transphobia led to more significant genital discomfort via a dual parallel mediation of transnormativity and positive identity. Moreover, this genital discomfort fueling pattern was the most significant predictor of the desire to undergo genital surgery as the effect of internalized transphobia was fully mediated by increased genital discomfort. Findings are discussed in the light of the recent strand of research on gender dysphoria as a multifaceted construct, with social components.


Assuntos
Disforia de Gênero , Pessoas Transgênero , Transexualidade , Adulto , Feminino , Identidade de Gênero , Genitália/cirurgia , Humanos , Recém-Nascido , Masculino , Pessoas Transgênero/psicologia , Transexualidade/psicologia , Transexualidade/cirurgia
20.
Front Public Health ; 10: 878348, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35874999

RESUMO

Objective: To analyze the impact on the psychological and social aspects caused by the COVID-19 pandemic in individuals diagnosed with Gender Dysphoria (GD). Methods: Google Forms inventory was sent via WhatsApp, including qualitative and quantitative questions evaluating three life dimensions denominated as Sociodemographic, Economic, and COVID-19 pandemic. It was applied in two periods: At the beginning of the pandemic (June-2020) (P1) and one year later (June-2021) (P2). The inventory also included questions about economic dimensions before the pandemic for individual comparison purposes (P0). 48 individuals (28 transsexual women, 20 transsexual men) participated in both periods. Results: 77.1% (n = 37) lived in Rio Grande do Sul, 50.0% (n = 24) refereed incomplete high school; Monthly Income increased significantly between the periods (P0) and (P1). Emergence aid approval was significantly higher in (P2), 56.3% (n = 27), compared to (P1), 39.6% (n = 19). A statistically significant difference was detected in the feeling of depression in the (P2) among the cases that requested Emergency Aid. Conclusion: The studied population presented deterioration regarding their condition of social vulnerability in relation to formal employment, access to health services, and mental health.


Assuntos
COVID-19 , Disforia de Gênero , Transexualidade , COVID-19/epidemiologia , Feminino , Disforia de Gênero/epidemiologia , Disforia de Gênero/psicologia , Humanos , Masculino , Saúde Mental , Pandemias , Transexualidade/psicologia
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