Who has the worst attitudes toward sexual minorities? Comparison of transphobia and homophobia levels in gender dysphoric individuals, the general population and health care providers.

PURPOSE: To date, few studies have addressed attitudes toward transgender individuals. In addition, little is known about health care providers' (HCP) attitudes toward sexual minorities. The aim of the present study is to compare attitudes toward homosexual and transgender individuals between gender dysphoric individuals (GDs), general population controls (C) and HCP. METHODS: A total of 310 subjects were considered, including 122 GDs (63 transwomen and 59 transmen), 53 heterosexual HCP (26 males and 27 females) and 135 C. Participants completed the Modern Homophobia Scale (MHS) and the Attitudes Toward Transgendered Individuals Scale (ATTI) in order to assess attitudes toward gay men and lesbian women and toward transgender individuals, respectively. In addition, GDs completed the Gender Identity/Gender Dysphoria Questionnaire (GIDYQ-AA) and ATTI to measure, respectively, gender dysphoria levels and internalized transphobia. Religious attitudes were evaluated by means of the Religious Fundamentalism Scale (RFS), and Discrimination and Stigma Scale (DISC-12) was used to measure perceived discrimination. RESULTS: (1) Men showed significantly higher levels of homophobia and transphobia when compared to women (p < 0.001); (2) perceived discrimination was higher in lesbian women compared to gay men and in transwomen compared to transmen (p < 0.001 and p < 0.05, respectively); and (3) religious fundamentalism was associated with both homophobia and transphobia (both p < 0.001). CONCLUSIONS: Our results underline the need to promote awareness and acceptance of the sexual minorities, who are more at risk of discriminatory attitudes, which are strongly dependent on religious precepts and dogma.

An integrated approach with vardenafil orodispersible tablet and cognitive behavioral sex therapy for treatment of erectile dysfunction: a randomized controlled pilot study.

Erectile Dysfunction is considered a multifactorial disease, where organic and psychological aspects are often interconnected. In a randomized controlled pilot study, we compared the efficacy of combined vardenafil orodispersible tablet (VARD) and cognitive-behavioral sex therapy (CBST) vs. VARD alone in improving sexual symptoms in both male and female partners. Thirty male patients with erectile dysfunction, and their partners were randomly assigned with a 2 : 1 ratio, to two different arms and treated for 10 weeks with VARD (Group A; n = 19) or VARD+CBST (Group B; n = 11). International Index of Erectile Dysfunction (IIEF-15), Female Sexual Function Index (FSFI) and Index of Sexual Satisfaction (ISS) were, respectively, administered to male, female, and both partners at times (T) 0, 1 (+5 weeks of therapy) and 2 (+10 weeks of therapy). Groups A and B were similar in their sociodemographic and clinical characteristics. Pre-treatment (T0) test scores did not significantly differ among the groups. In both group A and B, the IIEF-Erectile Function domain showed a significant improvement from T0 to T1 (p = 0.005 and p < 0.0001 vs. T0, respectively) and from T0 to T2 only in group B (p = 0.013). In group A, FSFI and both male and female ISS did not show any significant change at T1 and T2 vs. T0. In group B, a significant improvement at final time-point in FSFI and male and female ISS scores was reported (p < 0.05, T2 vs. T0 in all scores). The results of our study suggest that both VARD alone and VARD+CBST improved erectile function, however, only VARD+CBST improved couple sexual satisfaction and female sexual function.

Movements of the prostate due to rectal and bladder distension: implications for radiotherapy.

Precision radiotherapy depends upon the accurate definition of a target volume. Conformal therapy of prostate cancer requires an understanding of the prostate volume and its potential movements. This study was performed to quantify movement of the prostate due to rectal or bladder distention. Eighteen men with localized prostate cancer (clinical stages A, B, and C) were included in this study. Following simulation, treatment planning computed tomography (CT) scans were performed. The scans were first obtained with a small amount of contrast in the rectum and the bladder. Identical CT cuts were then obtained after filling the rectum with contrast. In 11 patients, the bladder was then filled with contrast and the same CT cuts were obtained again. Movement of the prostate and seminal vesicles secondary to distension of the rectum and bladder was measured. Distension of the rectum shifted the posterior margin of the prostate anteriorly from 0 to 0.9 cm. (median = 0.1 cm). The posterior border of the prostate was displaced anteriorly by more than 0.5 cm in 3 of the 18 (17%) patients with rectal distension. Distension of the bladder shifted the posterior border of the prostate posteriorly from 0 to 0.8 cm. (median = 0.2 cm). The posterior border of the prostate was shifted more than 0.5 cm. in 1 of 11 (9%) patients with bladder distension. Movements of other margins of the prostate and seminal vesicles were measured. The available literature is reviewed and suggestions are given regarding the movement of the prostate and treatment planning.

Radiotherapy treatment planning for prostate cancer in patients with prosthetic hips.

Patients diagnosed with prostate cancer may also have a prosthetic hip. When planning radiotherapy for these patients, one must consider the attenuation of the dose when the beam passes through the prosthetic hip. It is best to avoid administration of radiation to the target through the prosthesis. Example treatment plans are evaluated. The potential advantages and disadvantages of each plan are reviewed.