Early adversity and sexual diversity: the importance of self-reported and neurobiological sexual reward sensitivity.

Work shows that sexually-diverse individuals face high rates of early life adversity and in turn increased engagement in behavioral outcomes traditionally associated with adversity, such as sexual risk taking. Recent theoretical work suggests that these associations may be attributable to heightened sexual reward sensitivity among adversity-exposed women. We aimed to test these claims using a combination of self-report and EEG measures to test the relationship between early adversity, sexual reward sensitivity (both self-reported and EEG measured) and sexual risk taking in a sexually diverse sample of cis-gender women (N = 208) (Mage = 27.17, SD = 6.36). Results showed that childhood SES predicted self-reported sexual reward sensitivity which in turn predicted numbers of male and female sexual partners. In contrast we found that perceived childhood unpredictability predicted neurobiological sexual reward sensitivity as measured by EEG which in turn predicted male sexual partner number. The results presented here provide support for the notion that heightened sexual reward sensitivity may be a pathway through which early life adversity augments future sexual behavior, and underscores the importance of including greater attention to the dynamics of pleasure and reward in sexual health promotion.

Making sense of COVID-19: manifestations of health capital during the pandemic.

BACKGROUND: Grounded in Bourdieu's theory of human practice, this study aims to examine how individuals as social agents made sense of and acted upon their COVID-19 experiences. A recent conceptualization of health capital is utilized to explain the practices of patients in the pandemic, in relation to their biographical background. METHODS: This is a qualitative research in which the data were collected by biographical narrative interviews through a theoretical sampling approach. Eighteen interviews with COVID-19 patients were conducted and 8 of them were analyzed by the Documentary Method. RESULTS: The informants made sense of their illness experiences through their health capital, which is manifested in their self-perception of health, their attitudes towards the healthcare system, their conception of terms such as luck, their work status, and the gendered division of labour at home in the COVID-19 pandemic. All the manifestations are mediated by the social, cultural, and economic capital of the informants, and their habitual practices are based on their symbolic capital. CONCLUSION: The study depicts how social agents' health capital manifested in the pandemic, relying on their symbolic capital, and shaping their practices. Further research across diverse contexts is needed to fully understand extra dimensions of health capital as a descriptor of the social determinants of health.

Exploring differences in substance use behaviours among gender minority and non-gender minority youth: a cross-sectional analysis of the COMPASS study. / Exploration des différences dans les comportements liés à la consommation de substances chez les jeunes faisant partie de minorités de genre et les jeunes ne faisant pas partie de minorités de genre : analyse transversale de l'étude COMPASS.

INTRODUCTION: Research characterizing substance use disparities between gender minority youth (GMY) and non-GMY (i.e. girls and boys) is limited. The aim of this study was to examine the differences in substance use behaviours among gender identity (GI) groups and identify associated risk and protective factors. METHODS: Cross-sectional data from Canadian secondary school students (n = 42 107) that participated in Year 8 (2019/20) or Year 9 (2020/21) of the COMPASS study were used. Hierarchal logistic regression models estimated current substance use (cigarettes, e-cigarettes, binge drinking, cannabis and nonmedical prescription opioids [NMPOs]). Predictor variables included sociodemographics, other substances, mental health outcomes, school connectedness, bullying and happy home life. Interaction terms were used to test mental health measures as moderators in the association between GI and substance use. RESULTS: Compared to non-GMY, GMY reported a higher prevalence for all substance use outcomes. In the adjusted analyses, GMY had higher odds of cigarette, cannabis and NMPO use and lower odds for e-cigarette use relative to non-GMY. The likelihood of using any given substance was higher among individuals who were involved with other substances. School connectedness and happy home life had a protective effect for all substances except binge drinking. Bullying victimization was associated with greater odds of cigarette, e-cigarette use and NMPOs. Significant interactions between GI and all mental health measures were detected. CONCLUSION: Findings highlight the importance of collecting a GI measure in youth population surveys and prioritizing GMY in substance use-related prevention, treatment and harm reduction programs. Future studies should investigate the effects of GI status on substance use onset and progression among Canadian adolescents over time.

Fluid face but not gender: Enfacement illusion through digital face filters does not affect gender identity.

It has been shown that observing a face being touched or moving in synchrony with our own face increases self-identification with the former which might alter both cognitive and affective processes. The induction of this phenomenon, termed enfacement illusion, has often relied on laboratory tools that are unavailable to a large audience. However, digital face filters applications are nowadays regularly used and might provide an interesting tool to study similar mechanisms in a wider population. Digital filters are able to render our faces in real time while changing important facial features, for example, rendering them more masculine or feminine according to normative standards. Recent literature using full-body illusions has shown that participants' own gender identity shifts when embodying a different gendered avatar. Here we studied whether participants' filtered faces, observed while moving in synchrony with their own face, may induce an enfacement illusion and if so, modulate their gender identity. We collected data from 35 female and 33 male participants who observed a stereotypically gender mismatched version of themselves either moving synchronously or asynchronously with their own face on a screen. Our findings showed a successful induction of the enfacement illusion in the synchronous condition according to a questionnaire addressing the feelings of ownership, agency and perceived similarity. However, we found no evidence of gender identity being modulated, neither in explicit nor in implicit measures of gender identification. We discuss the distinction between full-body and facial processing and the relevance of studying widely accessible devices that may impact the sense of a bodily self and our cognition, emotion and behaviour.

Identifying 2SLGBTQ+ individuals experiencing homelessness using Point-in-Time counts: Evidence from the 2021 Toronto Street Needs Assessment survey.

INTRODUCTION: The objective of this study was to utilize the data generated by the City of Toronto, Street Needs Assessment conducted in 2021 to explore the prevalence, causes, experiences, and characteristics of 2-spirit, lesbian, gay, bisexual, transgender, queer, and questioning (2SLGBTQ+) individuals experiencing homelessness in Toronto, Ontario, Canada. METHODS: Data was collected by the City of Toronto during its Street Needs Assessment in April 2021. The Street Needs Assessment is a needs assessment survey and Point-in-Time count of people experiencing homelessness across the city of Toronto. Homelessness included any individual who was sleeping outdoors or staying in City-administered emergency/transitional shelters and shelter motels/hotels on the night of data collection. The Street Needs Assessment survey was administered to clients by trained shelter and outreach staff using a computer or mobile device. To ensure that survey questions were 2SLGBTQ+ inclusive, questions on sexual orientation, gender identity, and 2SLGBTQ+ identity were included in the survey. RESULTS: Two hundred and eighty-eight 2SLGBTQ+ individuals completed the survey. Compared to non-2SLGBTQ+ individuals experiencing homelessness, 2SLGBTQ+ respondents were younger at the time of survey completion and when they first experienced homelessness, were more likely to have been in foster care or a group home, reported higher rates of conflict with and/or abuse by a parent/guardian as their main pathway into homelessness, and were more likely to experience chronic homelessness. CONCLUSION: Our study results demonstrate that Street Needs Assessments and Point-in-Time counts can be used to examine homelessness in marginalized populations, including 2SLGBTQ+ individuals and that sexual orientation and gender identity questions need to be included on future government surveys. The consistency of findings from this study and previous research suggests that 2SLGBTQ+ individuals experience a significant need for population-based housing and social support services aimed at meeting the needs of 2SLGBTQ+ populations.

"It's about how you take in things with your brain" - young people's perspectives on mental health and help seeking: an interview study.

INTRODUCTION: Poor mental health in young people has become a growing problem globally over the past decades. However, young people have also been shown to underutilize available healthcare resources. The World Health Organisation (WHO) has formulated guidelines for youth-friendly health services (YFHSs) to increase youth participation in healthcare. Still, little is known about how young people using these services perceive mental health, indicating a knowledge gap concerning the subjective evaluation of their mental health. AIM: To investigate how young people visiting youth health clinics (YHC) perceive the concept of mental health and factors they view as central to maintaining mental health. METHODS: In total 21 interviews were carried out, 16 in 2018, and 5 in 2023 to assure no changes in findings after the COVID-19 pandemic. Subjects were recruited during visits to youth health clinics (YHCs) in mid-Sweden and were aged 15-23 years. Recruitment strived to achieve heterogeneity in the sample concerning gender, sexual orientation, gender identity and age. Interviews were transcribed and analysed using qualitative content analysis. FINDINGS: Findings of the analysis revealed two themes, "Mental health is helped and hindered by the surroundings" and "Mental health is difficult to understand and difficult to achieve". The participants described their health as highly dependent on their social surroundings, and that these are important to maintaining health but may also affect health negatively. They described mixed experiences of the health care services and mentioned prerequisites for seeking care for mental health problems such as accessibility and respect for their integrity, including the right to turn down offered treatment. The informants also viewed mental health as an ongoing undertaking that one must work for, and that it is sometimes difficult to know what constitutes mental health. They also expressed a need from healthcare services to enquire about their health, and to show an active interest in how they are doing. CONCLUSIONS: Findings underline the need of young people's individual needs to be met in the healthcare system and their vulnerability to their social surroundings. Health status assessments in young people should consider social and individual factors to fully capture mental health.

Estrés comunitario frente a múltiples desastres durante la erupción volcánica y la pandemia covid-19: un estudio transversal / Community stress facing multiple disasters during the volcanic eruption and the covid-19 pandemic: a cross-sectional study

Objetivo: Este estudio tiene como objetivo determinar el estrés durante la pandemia de COVID-19 y afrontar las erupciones volcánicas y analizar los factores relacionados. Métodos: Esta investigación fue de tipo observacional analítica cuantitativa con un diseño transversal. El número de muestras fue de 352 pacientes mediante la técnica de muestreo accidental. El instrumento de investigación utiliza la escala de estrés percibido (PSS) -10 ítems y la escala de estrés COVID-19. Para el análisis de los datos se utilizaron las pruebas Kendal Tau y Chi-Cuadrado. Resultados: La mayoría de los encuestados experimentaron estrés leve durante la pandemia de COVID-19 (66,2%) y estrés moderado al lidiar con erupciones volcánicas (98,9%). Las variables relacionadas con el estrés durante una pandemia fueron género (p.017), educación (p.027), ingresos (p<.001) y distancia desde casa hasta la cima del volcán (p<0.036), mientras que las relacionadas con el estrés que enfrentan las erupciones volcánicas es sólo una experiencia de desastre de entrenamiento (p.033). Conclusiones: El estudio encontró que el nivel de estrés al enfrentar una erupción volcánica era mayor que durante la pandemia de COVID-19. El género, la educación, los ingresos y la distancia desde el hogar hasta la cima de un volcán están relacionados con el estrés durante una pandemia. Al mismo tiempo, la experiencia de la formación en desastres fue el único factor asociado con el estrés al afrontar las erupciones volcánicas. (AU)

Primary Goal: This study is to determine stress during the COVID-19 pandemic and dealing with volcanic eruptions and analyze the related factors. Methods: This research was an analytic observational quantitative with a cross-sectional design. The number of samples was 352 patients using the accidental sampling technique. The research instrument uses the Perceived stress scale (PSS)-10 items and the COVID-19 Stress Scale. Kendal Tau and Chi-Square tests were used for data analysis. Results: Most respondents experienced mild stress during the COVID-19 pandemic (66.2%) and moderate stress when dealing with volcanic eruptions (98.9%). Variables related to stress during a pandemic were gender (p.017), education (p.027), income (p<.001), and distance from home to the top of the volcano (p<0.036), while those related to the stress faced Volcanic eruptions are just a training disaster experience (p.033). Conclusions: The study found that the stress level of facing a volcanic eruption was higher than during the COVID-19 pandemic. Gender, education, income, and distance from home to the top of a volcano are related to stress during a pandemic. At the same time, the experience of disaster training is the only factor associated with stress in dealing with volcanic eruptions. (AU)

Validez e invariancia de medida de la Escala de Homonegatividad Moderna en alumnado del ámbito de la educación / Validity and measurement invariance of the Modern Homonegativi-ty Scale for students in the field of education

Aquellas investigaciones orientadas a analizar las actitudes hacia la homosexualidad sugieren el uso de instrumentos que detecten los aspectos sutiles en la discriminación hacia hombres gais y mujeres lesbianas. Asimismo, se señala que la invariancia de medida de los constructos es imprescindible para que las comparaciones entre grupos sean válidas. Este trabajo pretende validar la Escala de Homonegatividad Moderna (MHS) en estudiantes universitarios del ámbito de la educación (N = 1.283) con un rango de edad entre los 17 y los 49 años (M = 2.88; DT = 3,02). Del mismo modo, se interesa por examinar la invariancia de medida de la MHS en relación con ciertas variables sociodemográficas y personales (p. ej. identidad de género), así como ideológicas (p. ej. inclinación política). Los resultados aportaron evidencias sobre la unidimensionalidad de la escala y un alto grado de consistencia interna (wMHS-G = .879; wMHS-L = .906), además de unos índices de ajuste (CFIMHS-G = .95, CFIMHS-L = .97; RMSEAMHS-G = .064, 90% IC: .057-.071, RMSEAMHS-L = .059, 90% IC: .052-.066) y unos valores de validez externa (MHS-G y AN-T: r = .753, I.C. 95% = .722-.785; MHS-L y AN-T: r = .76. I.C. 95% = .730-.790) satisfactorios. Asimismo, sugirieron que tanto la subescala hacia hombres gais (MHS-G) como mujeres lesbianas (MHS-L) son constructos invariantes conforme a las variables estudiadas. Las conclusiones apuntan a la validez y la invariancia de medida del modelo propuesto para comparar los niveles de homonegatividad moderna entre los grupos estudiados.(AU)

The research aimed at analysing attitudes towards homosexuality recommends the use of instruments that can detect subtle aspects of dis-crimination against gay men and lesbian women. It also asserts that the measurement invariance of constructs is essential for valid comparisons between groups. The present study aims to validate the Modern Ho-monegativity Scale (MHS) in university students in the fieldof education (N= 1.283) with an age range of 17 to 49 years old (M = 2.88; SD = 3.02). In addition, we seekto examine the measurement invariance of the MHS in relation to certain sociodemographic and personal variables (e.g. gender identity), as well as ideological variables (e.g. political inclination). The re-sults provided evidence of the scale'sunidimensionality and a high degree of internal consistency (MHS-G= .879; MHS-L= .906), as well as satisfac-tory fit indices (CFIMHS-G= .95, CFIMHS-L= .97; RMSEAMHS-G= .064, 90% CI: .057-.071, RMSEAMHS-L= .059, 90% CI: .052-.066) and external validity values (MHS-G and AN-T: r= .753, CI 95% = .722-.785; MHS-L and AN-T: r= .76. CI 95% = .730-.790). They also indicated that both the subscales –towards gay men (MHS-G) and lesbian women (MHS-L) –are invariant constructs according to the variables studied. The findings point to the validity and measurement invariance of the proposed model for comparing levels of modern homonegativity between the groups studied.(AU)

Examining the mental health impacts of climate change on young people in Canada: a national cross-sectional survey.

BACKGROUND: Climate change poses a substantial threat to the mental wellbeing of young people. Population-level research is urgently needed to help inform policies and interventions to ensure that young people are not burdened by long-term mental health impacts from climate change. We sought to identify the prevalence, distribution, and factors associated with climate change-related mental and emotional health outcomes among young people (aged 13-34 years) in Canada. METHODS: This study is part of a larger cross-sectional survey, which examined mental and emotional health responses to climate change among individuals aged 13 years or older from across Canada. We used a multi-stage, multi-stratified random probability sampling procedure. Participants were randomly recruited through either an addressed letter or a telephone call. Online and telephone questionnaires were used to interview individuals in English, French, or Inuktitut between April 1, 2022, and March 31, 2023. Data were weighted by age and province using population estimates from Statistics Canada and analysed using descriptive statistics, factor analyses, and multivariable regression analyses. FINDINGS: The full survey included 2476 participants, with a subgroup of 409 young people. Of the 401 respondents who provided their gender identity, 215 (54%) identified as cisgender women, 167 (42%) identified as cisgender men, and 19 (5%) identified as non-binary. Preliminary results suggest that young people in Canada experience a wide range of climate-related emotional and mental health outcomes. More than 70% of respondents in the young people subgroup reported having at least mild levels of sadness, anger, worry, anxiety, concern, helplessness, hopelessness, or powerlessness related to climate change. The severity of climate-related emotional responses differed by gender, with non-binary respondents and cisgender women reporting higher average levels of distress than cisgender men. Regional differences were also observed, with northern regions and urban locations reporting more severe reactions. INTERPRETATION: This study builds on the understanding of the burden of climate change on the mental health of young people. If unaddressed, the impact of this burden could have long-standing and wide-reaching public health and related socioeconomic effects. FUNDING: Canadian Institutes of Health Research, ArcticNet, Social Sciences and Humanities Research Council Doctoral Fellowship, Izaak Walton Killam Memorial Scholarship, and Alberta Innovates Graduate Student Scholarship.

Adolescent gender dysphoria management: position paper from the Italian Academy of Pediatrics, the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, the Italian Society of Adolescent Medicine and the Italian Society of Child and Adolescent Neuropsychiatry.

BACKGROUND: In response to the imperative need for standardized support for adolescent Gender Dysphoria (GD), the Italian Academy of Pediatrics, in collaboration with the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, Italian Society of Adolescent Medicine and Italian Society of Child and Adolescent Neuropsychiatry is drafting a position paper. The purpose of this paper is to convey the author's opinion on the topic, offering foundational information on potential aspects of gender-affirming care and emphasizing the care and protection of children and adolescents with GD. MAIN BODY: Recognizing that adolescents may choose interventions based on their unique needs and goals and understanding that every individual within this group has a distinct trajectory, it is crucial to ensure that each one is welcomed and supported. The approach to managing individuals with GD is a multi-stage process involving a multidisciplinary team throughout all phases. Decisions regarding treatment should be reached collaboratively by healthcare professionals and the family, while considering the unique needs and circumstances of the individual and be guided by scientific evidence rather than biases or ideologies. Politicians and high court judges should address discrimination based on gender identity in legislation and support service development that aligns with the needs of young people. It is essential to establish accredited multidisciplinary centers equipped with the requisite skills and experience to effectively manage adolescents with GD, thereby ensuring the delivery of high-quality care. CONCLUSION: Maintaining an evidence-based approach is essential to safeguard the well-being of transgender and gender diverse adolescents.

Vocation as tragedy: Love and knowledge in the lives of the Mills, the Webers, and the Russells.

Can love affect knowledge and knowledge affect love? John Stuart Mill and Harriet Taylor-Mill, Max and Marianne Weber, and Bertrand and Dora Russell had a definite vocation: they wanted to change the world. They questioned traditional gender arrangements through publications on equality, marriage, and education. They were liberal thinkers, advocating individual freedom and autonomy, vis à vis the constraints of state and society. Their partnership inspired their work, a living experiment conducted through their own unconventional relationship. Over time, their increasingly radical, avant-garde ideas on marriage complicated the ongoing negotiation over power and intimacy which typified their marriages. Building on the historiography of social science couples, and by means of an analysis of the micro-social dynamics of marriage as documented in the life writings of the Mills, the Webers, and the Russells, I analyse the connections between gender, intimacy, and creativity. These couples' experiences highlight the non-rational dimension of a most rational endeavour.

Mental health impact of multiple sexually minoritized and gender expansive stressors among LGBTQ+ young adults: a latent class analysis.

AIMS: In the United States, lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexually minoritized and gender expansive (LGBTQ+) young adults are at increased risk for experiencing mental health inequities, including anxiety, depression and psychological distress-related challenges associated with their sexual and gender identities. LGBTQ+ young adults may have unique experiences of sexual and gender minority-related vulnerability because of LGBTQ+-related minority stress and stressors, such as heterosexism, family rejection, identity concealment and internalized homophobia. Identifying and understanding specific LGBTQ+-related minority stress experiences and their complex roles in contributing to mental health burden among LGBTQ+ young adults could inform public health efforts to eliminate mental health inequities experienced by LGBTQ+ young adults. Therefore, this study sought to form empirically based risk profiles (i.e., latent classes) of LGBTQ+ young adults based on their experiences with familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment, and then identify associations of derived classes with psychological distress. METHODS: We recruited and enrolled participants using nonprobability, cross-sectional online survey data collected between May and August 2020 (N = 482). We used a three-step latent class analysis (LCA) approach to identify unique classes of response patterns to LGBTQ+-related minority stressor subscale items (i.e., familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment), and multinomial logistic regression to characterize the associations between the derived classes and psychological distress. RESULTS: Five distinct latent classes emerged from the LCA: (1) low minority stress, (2) LGBTQ+ identity concealment, (3) family rejection, (4) moderate minority stress and (5) high minority stress. Participants who were classified in the high and moderate minority stress classes were more likely to suffer from moderate and severe psychological distress compared to those classified in the low minority stress class. Additionally, relative to those in the low minority stress class, participants who were classified in the LGBTQ+ identity concealment group were more likely to suffer from severe psychological distress. CONCLUSION: Familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment are four constructs that have been extensively examined as predictors for mental health outcomes among LGBTQ+ persons, and our study is among the first to reveal nuanced gradients of these stressors. Additionally, we found that more severe endorsement of minority stress was associated with greater psychological distress. Given our study results and the previously established negative mental health impacts of minority stressors among LGBTQ+ young adults, findings from our study can inform research, practice, and policy reform and development that could prevent and reduce mental health inequities among LGBTQ+ young adults.

Considering inequities in national dementia strategies: breadth, depth, and scope.

BACKGROUND: Considering that dementia is an international public health priority, several countries have developed national dementia strategies outlining initiatives to address challenges posed by the disease. These strategies aim to improve the care, support, and resources available to meet the needs of persons living with dementia and their care partners and communities. Despite the known impact of social determinants of health on dementia risk, care, and outcomes, it is unclear whether dementia strategies adequately address related inequities. This study aimed to describe whether and how national dementia strategies considered inequities associated with social determinants of health. METHODS: We conducted an environmental scan of the national dementia strategies of countries that are part of the Organisation for Economic Cooperation and Development (OECD). Included strategies had to be accessible in English or French. Sub-national or provincial plans were excluded. We synthesised information on strategies' considerations of inequity through a thematic analysis. RESULTS: Of the 15 dementia strategies that met inclusion criteria, 13 mentioned at least one inequity (M = 2.4, median = 2, range:0-7) related to Race/Ethnicity; Religion; Age; Disability; Sexual Orientation/Gender Identity; Social Class; or Rurality. Age and disability were mentioned most frequently, and religion most infrequently. Eleven strategies included general inequity-focused objectives, while only 5 had specific inequity-focused objectives in the form of tangible percentage changes, deadlines, or allocated budgets for achieving equity-related goals outlined in their strategies. CONCLUSIONS: Understanding if and how countries consider inequities in their dementia strategies enables the development of future strategies that adequately target inequities of concern. While most of the strategies mentioned inequities, few included tangible objectives to reduce them. Countries must not only consider inequities at a surface-level; rather, they must put forth actionable objectives that intend to lessen the impact of inequities in the care of all persons living with dementia.

Social and structural drivers of HIV vulnerability among a respondent-driven sample of feminine and non-feminine presenting transgender women who have sex with men in Zimbabwe.

INTRODUCTION: We sought to characterize social and structural drivers of HIV vulnerability for transgender women (TGW) in Zimbabwe, where TGW are not legally recognized, and explore differences in vulnerability by feminine presentation. METHODS: A secondary analysis was conducted with a sub-sample of participants recruited from a 2019 respondent-driven sampling survey that comprised men who have sex with men, TGW and genderqueer individuals assigned male sex at birth, from two cities in Zimbabwe. Survey questionnaires captured information related to socio-demographics, sexual and substance use behaviours, and social and structural barriers to HIV services. Secondary analyses were restricted to participants who identified as female, transfemale or transwomen (236/1538) and were unweighted. Descriptive statistics were used to calculate sample estimates and chi-square and Fisher's exact tests were used to assess differences in vulnerability by feminine presentation. RESULTS: Among 236 TGW, almost half (45.3%) presented as feminine in the 6 months preceding the survey and 8.5% had ever used hormones to affirm their gender identities. Median age among TGW was 23 years (interquartile range: 20-26). Feminine presenting TGW in our sample had higher prevalence of arrest (15.9% vs. 3.9%), rejection by family/friends (38.3% vs. 14.0%), employment termination (11.2% vs. 3.9%), employment refusal (14.0% vs. 3.9%), denial of healthcare (16.8% vs. 2.3%), physical, sexual or verbal harassment or abuse (59.8% vs. 34.1%), alcohol dependence (32.7% vs. 12.4%), recent transactional sex with a male or TGW partner (30.8% vs. 13.3%) and recent non-injection drug use (38.3% vs. 20.2%) than non-feminine presenting TGW (all p-value <0.05). CONCLUSIONS: Findings suggest that TGW, particularly feminine presenting TGW, experience social and structural inequities which may contribute to HIV vulnerability. Interventions aimed at addressing inequities, including trans competency training for providers and gender-affirming, psychosocial and legal support services for TGW, might mitigate risk.

Comparison of Clinical Characteristics, Gender Perceptions, and Rape-Related Beliefs of People Assessed for Criminal Liability for Rape Against Children and Adults. / Çocuga ve Eriskine Yönelik Tecavüz Suçu Nedeniyle Ceza Sorumlulugu Degerlendirilen Kisilerin Klinik Özelliklerinin, Toplumsal Cinsiyet Algilarinin ve Tecavüze Iliskin Inançlarinin Karsilastirilmasi.

OBJECTIVE: This study aimed to compare the criminal, sociodemographic and clinical characteristics, paraphilic behaviors, sexual attitudes, gender perceptions, and rape-related beliefs of people assessed for criminal liability for rape against adults and children. METHOD: The study compared 40 people investigated for criminal liability for rape against an adult (RAA) with 40 individuals investigated for criminal liability for crime of rape against a child (RAC), and 43 age, sex and education matched individuals without any sexual crime history using the Structured Clinical Interview form for DSM-5 disorders, Hendrick Brief Sexual Attitude Scale, Gender Perception Scale, Illinois Rape Myth Acceptance Scale, and Barratt Impulsiveness Scale-11. RESULTS: All participants were male. There was no difference between the groups in terms of lifelong or existing psychiatric diseases. All participants had full criminal responsibility during the crime. No participant in any group was diagnosed with a paraphilic disorder. It was determined that people in both RAC and RAA groups tended to use sexuality as a tool, paid less attention to birth control methods, had a far less egalitarian perception of gender, and their myths about rape were significantly higher compared to the control group. The control group was much more impulsive than the sex offenders. CONCLUSION: Our results show that the act of sexual assault should not be explained only by impulsivity or psychiatric disorders, and that gender perception and sexual myths may also be influential. The fact that all individuals had full criminal responsibility emphasizes the need for more research on the social and cultural origins of sexual violence.

Online Group Psychotherapy to Increase Self-acceptance and Reduce Shame Among Transgender Migrants: An Observational Report. / Transgender Göçmenler Arasinda Öz Kabulü Arttirmak ve Çekimserligi Azaltmak için Çevrimiçi Grup Psikoterapisi: Bir Gözlemsel Rapor.

OBJECTIVE: Transgender and gender diverse (TGD) people experience higher levels of stigma, discrimination, and interpersonal violence due to their gender identity and/or expression, particularly TGD people with a migration background. This study aimed to conduct and evaluate group psychotherapy for TGD migrants to provide opportunities for exploring and developing interpersonal skills and relationships. METHOD: The group therapy included five individuals who identified as TGD and originated from the Middle East. The TGD group therapy consisted of 12 weekly sessions of 90 minutes each and was facilitated by a psychiatrist. All sessions were conducted online and in Turkish. The sessions were guided by the group process and discussions. RESULTS: After completing 12 group therapy sessions, members of the group reported benefiting from observing and emulating others who shared their problem constellation. Through the interpersonal skills that they built up throughout the sessions, they became more open to share their feelings experiencing fewer social barriers, and reduced anxiety. CONCLUSION: This observational study indicates the significance of offering group-based psychotherapy to enhance affirmation and social connection within gender minority groups and emphasizes the need to empirically evaluate the effectiveness of group psychotherapy with TGD individuals, with special attention to the unique needs of TGD migrants.

Does Pollyanna hypothesis hold true in death narratives? A sentiment analysis approach.

Pollyanna hypothesis claims that human beings have a universal tendency to use positive words more frequently and broadly than negative words. The present study aims to test Pollyanna hypothesis in medical death narratives at both lexical and text levels by using sentiment analysis and emotion detection methods, and to qualitatively analyze the contextual use of emotion words to deepen the understanding of doctors' emotions. Sentiment analysis showed a strong token-based linguistic positivity and a weak type-based negativity bias at the lexical level, and a general positivity bias at the text level, despite the gender of the doctors. Emotion detection discovered three prominent emotions of "joy", "sadness", and "anger", and a greater diversity of negative emotions in contrast to positive emotions in medical death narratives. Contextual analysis revealed that emotion words associated with joy were primarily observed in contexts related to doctors' actions and behaviors aiming to benefit others and promote social wellbeing. Emotion words associated with sadness and anger were chiefly employed to describe situations involving patients' death and doctors' attitudes towards death. The results confirm Pollyanna hypothesis at both token-based lexical level and text level and falsify the hypothesis at type-based lexical level. Possible explanations are explored by contextual analysis, and theoretical analysis from the perspectives of cognitive linguistics and social psychology. The findings are expected to enrich the understanding of Pollyanna hypothesis as well as the junior doctors' emotional responses to clinical deaths.