Chromosome Abnormalities Related to Reproductive and Sexual Development Disorders: A 5-Year Retrospective Study.

Chromosomal abnormalities are the main genetic risk factor associated with reproductive and sexual development disorders (DSD). The goal of this study is to retrospectively evaluate the frequency of chromosomal aberrations in Moroccan subjects with problems of procreation or sexual ambiguity. A total of 1005 individuals, including 170 infertile couples, underwent cytogenetic analysis in the Cytogenetic Laboratory of the Pasteur Institute of Morocco. Heparinized blood samples were processed according to the standard karyotype method. A total (81.5%) of the patients studied had a normal karyotype, while the remaining (18.5%) patients had an abnormal karyotype. Female patients had more chromosomal abnormalities (52%) than male patients (48%). These chromosomal aberrations included 154 cases (83%) of sex chromosomal abnormalities, the most common being Turner's syndrome and Klinefelter's syndrome, and 31 cases (17%) had autosomal aberrations, especially chromosome 9 reversal (inv(9)(p12;q13)). The present data shows that among 170 couples, 10.6% had chromosomal abnormalities mainly involved in the occurrence of recurrent miscarriages. Genotype-phenotype correlations could not be made, and therefore, studies using more resolutive molecular biology techniques would be desirable.

[Transgender in Adolescence: State of the Art and Future Research Needs]. / Transgender im Jugendalter: Forschungsstand und zukünftiger Forschungsbedarf.

Transgender in adolescence is currently a widely discussed topic, additionally reflected by an increasing prevalence in clinical practice. The present review of the available literature on transgender, trans* , gender dysphoria or gender incongruence in youth reports results on the long-term results of medical interventions for the psychological well-being, prevalence, referral rates and sex ratio, developmental pathways, current developments and the role of the social environment. Finally, implications for clinical care and future research will be discussed.

What urologists need to know about female-to-male genital confirmation surgery (phalloplasty and metoidioplasty): techniques, complications, and how to deal with them.

Transmasculine gender-affirming surgery (GAS) is technically challenging, and in the past associated with a high but improving complication rate. Few surgical centers are performing this surgery, which can include metoidioplasty and phalloplasty, and patients often travel great distances for their surgery. While many will continue care with their original surgeons, others cannot due to social/geographic factors, or because emergencies arise. Thus, patients may seek care with their local urologist for relief of delayed complications, the most common of which include urethral stricture, penile prosthesis issues and urethrocutaneous fistula. This review will discuss the surgical elements behind metoidioplasty and phalloplasty, and the diagnosis and treatment for the most common postoperative issues.

Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study.

OBJECTIVE: Despite professional recommendations to consider gender-affirming hormone and surgical interventions for transgender individuals experiencing gender incongruence, the long-term effect of such interventions on mental health is largely unknown. The aim of this study was to ascertain the prevalence of mood and anxiety disorder health care visits and antidepressant and anxiolytic prescriptions in 2015 as a function of gender incongruence diagnosis and gender-affirming hormone and surgical treatment in the entire Swedish population. METHODS: This study used the Swedish Total Population Register (N=9,747,324), linked to the National Patient Register and the Prescribed Drug Register. Among individuals who received a diagnosis of gender incongruence (i.e., transsexualism or gender identity disorder) between 2005 and 2015 (N=2,679), mental health treatment in 2015 was examined as a function of length of time since gender-affirming hormone and surgical treatment. Outcome measures were mood and anxiety disorder health care visits, antidepressant and anxiolytic prescriptions, and hospitalization after a suicide attempt. RESULTS: Compared with the general population, individuals with a gender incongruence diagnosis were about six times as likely to have had a mood and anxiety disorder health care visit, more than three times as likely to have received prescriptions for antidepressants and anxiolytics, and more than six times as likely to have been hospitalized after a suicide attempt. Years since initiating hormone treatment was not significantly related to likelihood of mental health treatment (adjusted odds ratio=1.01, 95% CI=0.98, 1.03). However, increased time since last gender-affirming surgery was associated with reduced mental health treatment (adjusted odds ratio=0.92, 95% CI=0.87, 0.98). CONCLUSIONS: In this first total population study of transgender individuals with a gender incongruence diagnosis, the longitudinal association between gender-affirming surgery and reduced likelihood of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them.

Trastorno de identidad de género: Parte I. Definición, epidemiología, etiología, rol del endocrinólogo en diagnóstico y tratamiento / Gender identity disorders: definition, etiology,epidemiology and role of the endocrinologist in theirmanagement

Gender identity disorders (GID) or transsexuality have been a latent issue in Chile 20 years after the first sex reassignment treatment in 1973. Sexual minority groups have posed the problem and even present a bill for civil sexual change. Since the nineties, the number of consultants due to gender identity problems has increased steadily, including children and adolescents. The lack of medical expertise in the area, requires urgent training programs. The first part of this manuscript will deal with the definition, epidemiology, etiology and role of the endocrinologist in the process of sexual reassignment among patients with gender identity disorders. We review sexual differentiation, brain sexual dimorphism and Sexual Development Disorders (SDD) aiming to understand the neurobiological causes of GID and to perform a better differential diagnosis with Sexual Development Disorders. GID are not a psychiatric disease. However the suffering caused by stigmatization, exclusion andabuse generate emotional problems (gender dysphoria). SDD has a genetic and hormonal basis in most cases. Its clinical expression at birth can cause an erroneous civil sex assignation or a discordant civil sex with the sexual identity of the person when there is a surgical correction. GIS without gender dysphoria was excluded as a mental disease from DSM-V and it will also be excluded from the eleventh version of the international classification of diseases. It will maintained as a condition that should be differentiated from SDD and whose treatment should be financed by health systems.

Aspectos éticos en la atención sanitaria de la violencia de género / Ethical issues in health care of gender violence

La violencia de género es un problema de salud que, en ocasiones, causa controversias éticas en la consulta del médico de familia. Probablemente, el conflicto más importante se produce cuando una paciente que admite haber sido maltratada por su pareja, apelando a la confidencialidad, solicita que no se emita un parte de lesiones. Además, pueden producirse otras situaciones problemáticas. Este trabajo pretende ser una reflexión sobre estas eventualidades para contribuir a ayudar al profesional en la toma de decisiones (AU)

Gender violence is a health problem that occasionally gives rise to ethical dilemmas for the family doctor. One of the most important conflict is probably when a patient admits to being abused by her partner, but appeals to keep the information confidential, and refuses to present an injury report. There also other problematic situations. This essayattempts to reflect on these issues and help professionals in making decisions (AU)

The voice in transsexuals / La voz en los transexuales

Sex reassignment therapy, i.e. the process of transition in transgender clients, as a rule also includes voice therapy and as such the contribution of a speech language pathologist. Voice therapy in transgender clients is special, however, and is significantly different from what is usually understood by voice therapy in speech language pathology. As transsexualism is becoming more and more accepted in society, more speech language pathologists have a chance of being called upon for helping transsexual clients. The present paper is meant as an introduction to voice therapy in transgender clients. Based on a review of the literature and personal experience various procedures and treatment options are discussed

La terapia de reasignación sexual, es decir, el proceso de transición en clientes transexuales, incluye también como norma la terapia de voz y, por tanto, la mediación de un patólogo del habla y lenguaje. Sin embargo, la terapia de voz en los clientes transexuales es diferente a lo que normalmente entendemos como terapia de voz en la patología del habla y lenguaje. A medida que la sociedad va aceptando más la transexualidad se incrementa la posibilidad de que los patólogos del habla y lenguaje sean requeridos para ayudar a los clientes transexuales. El presente documento constituye una introducción a la terapia de voz en los pacientes transexuales. Basándonos en una revisión de la literatura y la experiencia personal, abordamos diversos procedimientos y opciones de tratamiento

Surgimiento, evolución y dificultades del diagnóstico de transexualismo / Emergence, evolution and difficulties of the transsexualism diagnosis

Se realiza un recorrido histórico a través de las distintas revisiones de la Clasificación Internacional de Enfermedades (C.I.E.) y del Manual Diagnóstico y Estadístico de los Trastornos Mentales (D.S.M.). Se pretende analizar la aparición del diagnóstico de transexualismo y su evolución hasta llegar a las clasificaciones actualmente en vigor (C.I.E.-10) y ( D.S.M.-IV-TR). Por último, se expondrán algunas de las dificultades encontradas en el proceso de diagnóstico(AU)

A historical path is made through the different reviews of the International Classification of Diseases (I.C.D.) and the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.). The aim is to analyze the emergence of the transsexualism diagnosis and its evolution into the classifications currently in force (I.C.D.-10) and ( D.S.M.-IV-TR). Finally, some of the difficulties found during the diagnostic process will be presented(AU)

Gender-role’s attitude, perceived similarity, and sexual prejudice against gay men

Two hundred and twenty-six heterosexual participants (115 women and 111 men) were asked to indicate their attitude toward gender-roles, their perceived similarities with gay men, and their attitude toward gay men (i.e., sexual prejudice). As expected, male participants showed more sexual prejudice than female participants, and perceived dissimilarities were related to a greater sexual prejudice. Support for gender-roles was related to sexual prejudice for male participants, but not for female participants. More interestingly, the three-way interaction suggested that perceived similarities moderated the link between gender-roles and sexual prejudice among heterosexual men, but not among heterosexual women. Attitude in favor of traditional gender-roles was related to sexual prejudice for male participants who perceived gay men as different, but not for those who perceived gay men as similar. These findings are discussed in terms of the defensive function of men’s attitude toward homosexuality as a result of threat to masculinity (AU)

En una muestra de 226 participantes heterosexuales (115 mujeres y 111 hombres) se ha medido la actitud hacia el rol de género, la similitud personal con los hombres homosexuales y la actitud hacia éstos (prejuicio sexual). Tal y como se esperaba, los hombres muestran más prejuicio que las mujeres, y la percepción de disimilitud está asociada a un mayor prejuicio. En los hombres, pero no en las mujeres, la actitud favorable hacia los roles tradicionales de género está relacionada con el prejuicio. Aún más interesante, la interacción triple sugiere que la percepción de similitud modera en los hombres, pero no en las mujeres, la relación entre la actitud hacia el rol de género y el prejuicio sexual. Una actitud más favorable hacia los roles tradicionales está asociada a un mayor prejuicio sexual en los hombres que perciben una mayor diferencia entre sí mismos y los homosexuales, pero no en aquellos que perciben una mayor semejanza. Estos resultados se discuten de acuerdo con la función defensiva de la actitud hacia la homosexualidad como resultado de la amenaza a la masculinidad (AU)

Consecuencias psicológicas a largo plazo del abuso sexual infantil / No disponible

El objetivo de este trabajo es ofrecer una revisión actualizada de las principales consecuencias psicológicas a largo plazo encontradas en los estudios llevados a cabo con víctimas de abuso sexual infantil en la última década. Se clasificaron los distintos síntomas en cinco categorías: problemas emocionales, problemas de relación, problemas funcionales, problemas de adaptación y problemas sexuales. Los resultados confirman la gravedad de los problemas que pueden presentar estas víctimas y su extensión a lo largo del ciclo evolutivo, siendo necesario que los profesionales sean capaces de detectar estas problemáticas para poder intervenir en estos casos de forma adecuada y eficaz (AU)

The main aim of the present study is to offer an update of the long-term consequences of child sexual abuse found in current empirical studies in the last decade. Psychological symptoms were classified as follows: emotional problems, relationship problems, functional problems, adaptation problems and sexual problems. Results confirmed the serious difficulties developed by these victims through the years. Psychologists need to know these problems to detect sexual abuse and effectively intervene with its victims (AU)

Género y sexualidad: consideraciones contemporáneas a partir de una reflexión en torno a la transexualidad y los estados intersexuales / Gender and sexuality: contemporary considerations from a reflexion over transexuality and intersexuality states

En el texto se hace un acercamiento a las teorías contemporáneas del género a partir del análisis del caso de la transexualidad y la intersexualidad. Se revisa tanto de los conceptos actuales desde la perspectiva biomédica como de la contestación que se hace desde el campo de las ciencias sociales (AU)

The text gives an approximation to the gender contemporary theories from the analysis of transexuality and intersexuality. Gives a review as the current concepts from the biomedical perspective as the answer that is done from the field of the social sciences (AU)

Familiality of gender identity disorder in non-twin siblings.

Familial studies and reports of co-occurrence of gender identity disorder (GID) within a family may help to clarify the question of whether transsexualism is a familial phenomenon. In a sample of 995 consecutive transsexual probands (677 male-to-female [MF] and 318 female-to-male [FM]), we report 12 pairs of transsexual non-twin siblings (nine pairs of MF siblings, two pairs of MF-FM siblings, and one pair of FM siblings). The present study doubles the number of case reports of co-occurrence of transsexualism in non-twin siblings available in the literature. According to our data, the probability that a sibling of a transsexual will also be transsexual was 4.48 times higher for siblings of MF than for siblings of FM transsexual probands, and 3.88 times higher for the brothers than for the sisters of transsexual probands. Moreover, the prevalence of transsexualism in siblings of transsexuals (1/211 siblings) was much higher than the range expected according to the prevalence data of transsexualism in Spain. The study suggests that siblings of transsexuals may have a higher risk of being transsexual than the general population, and that the risk is higher for brothers than sisters of transsexuals, and for siblings of MF than FM transsexuals. Nevertheless, the risk is low.

Envejecimiento activo y desigualdades de género / Active ageing and gender inequalities

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No disponible

Problemas de género que subyacen a los problemas de salud sexual / Gender problems underlying sexual health problems

No disponible

No disponible

Infecciones de transmisión sexual / Sexual transmission infections

Con este nombre se han agrupado más de 20 entidades patógenas diferentes que sólo tienen en común el hecho de poder transmitirse durante las relaciones sexuales. No todas se transmiten exclusivamente por vía sexual, algunas de ellas también se difunden por contacto con sangre, vía parenteral y otras a través de fómites, objetos contaminados. Son causadas por virus, bacterias, protozoos y parásitos. Sin embargo son contraídas por personas de cualquier edad, raza y medio social. El factor de riesgo más común a todas ellas y en todo el mundo es ser mujer, lo que pone de manifiesto la indefensión de muchas jóvenes para proteger del contagio. En este artículo se visibilizarán los factores de género que son clave en la propagación y en la prevención. Este artículo resalta la importancia que las infecciones de transmisión sexual tienen sobre la salud de la población joven a nivel mundial, debido a su alta incidencia y prevalencia, ya que constituyen la segunda causa de morbilidad en las mujeres en edad fértil y en muchos países empobrecidos son en su conjunto una pandemia que afecta a más del 40% de su población. Cuando las ITS doblegan las defensas del huésped tienen repercusiones devastadoras sobre la salud, fundamentalmente en las poblaciones más vulnerables, adolescentes, mujeres y niñas y niños y en especial en los países más pobres. Son la causa directa de muerte más importante en población joven afectada por VIH y no tratada, como sucede en países de África subsahariana, India y Asia. Y así mismo causan muerte de manera indirecta en mujeres a través de enfermedad inflamatoria pélvica, abortos sépticos, complicaciones del embarazo, parto y puerperio. A más largo plazo son la causa directa del cáncer de cuello uterino, que no tratado produce muerte. Es imprescindible diagnosticar las ITS con prontitud, para tratar a las personas que las padecen adecuadamente para erradicar su propagación y evitar complicaciones y secuelas (AU)

More tan 20 different diseases are known as STD, they have all in common that they are transmitted during the sexual intercourse. They are caused by viruses, bacteria, protozoa and parasites. This article reviews he most relevant ones for it´s frequency and intensity of the damage caused. This article treats about the importance that the sexually transmitted diseases have on the health of the world´s population. Especially its incidence, prevalence and consequence on the health of the most vulnerable people: adolescents, women, girl and boys that have suffered a sexual assault, especially in poor countries. Sexually transmitted diseases may be contracted by people of any age, race and social standing. STD must be diagnosed and treated early in order to avoid its propagation. The sexual education is the fundamental tool of the prevention of STD. the young people must be provided with the knowledge to live their sexuality with enjoyment and without risk for their health. This is a worthy objective that ennobles any adolescent health program (AU)