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Sex and gender blind spots and biases in health research
Published in Sridhar Venkatapuram, Alex Broadbent, The Routledge Handbook of Philosophy of Public Health, 2023
Avni Amin, Lavanya Vijayasingham, Jacqui Stevenson
There are big gaps when it comes to our knowledge of health issues affecting intersex and transgender persons. Transgender people face higher levels of adverse health outcomes compared to the general population (Reisner et al. 2016). For example, transgender people are approximately thirteen times more likely to be HIV-positive than other adults of reproductive age. Transgender populations also face higher risks of other sexually transmitted infections, poor mental health, and substance abuse. This evidence is limited to some geographic regions (mostly the United States and some from Canada, Europe, India, and Australia) (Reisner et al. 2016). Much less is known about other sexual and reproductive health needs and concerns, other health issues, as well as experiences of violence and access to and experiences of health services among transgender populations, particularly in low- and middle-income countries. Those who seek gender-affirming or transition-related healthcare face access barriers in many parts of the world. In the United States, many are denied gender-affirming surgery or hormonal treatment as part of normal health insurance coverage, despite the fact that gender-affirming care is found to be cost-effective in the long term (Learmonth et al. 2018).
The person
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
Sex reassignment surgery, or SRS (also known as gender reassignment surgery, gender confirmation surgery, genital reconstruction surgery, gender-affirming surgery or sex realignment surgery), is the surgical procedure (or procedures) by which a transsexual person’s physical appearance and function of their existing sexual characteristics are altered to resemble that is associated with that gender.
Routes to gender-affirming surgery
Published in Gabriele Griffin, Malin Jordal, Body, Migration, Re/Constructive Surgeries, 2018
Gender-affirming surgery changes gendersex bodily traits to affirm a person’s experience of their gendersex. Female-to-male (FtM) surgery changes the body of individuals assigned female at birth towards a more masculine/male appearance. Male-to-female (MtF) surgery changes the body of individuals assigned male at birth towards a more feminine/female appearance. Yet, FtM and MtF are partly misleading terms, as not everyone who desires gender-affirming surgery understands themselves as (trans) women and men, and because many align their body with the gendersex they already know themselves to be.
Non-typhoidal Salmonella soft-tissue infection after gender affirming subcutaneous mastectomy case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2023
Branden T. Barger, Mikhail Pakvasa, Melinda Lem, Aishu Ramamurthi, Shadi Lalezari, Cathy Tang
Gender affirming surgery is an essential procedure that plastic and other surgeons are providing in increasing numbers. This relatively new field has a rapidly enlarging literature base to draw from, but there remain gaps illustrating the vast diversity of this patient population. Gender affirming medical care, including hormone therapy and surgical intervention, has been shown to improve gender dysphoria and quality of life, and decrease rates of depression, anxiety, and other health comorbidities among transgender patients [2,3,6]. Transgender patients are a medically underserved population and experience higher rates of mental and physical illness attributed to excess minority stress, lack of access to medical care, and interpersonal and societal stigmatization [3,7]. Surgeons should be aware of the multiple social, medical, psychiatric, and surgical factors at play when performing surgery on and working with transgender patients. Our case highlights these interactions in a patient with a complex past medical and psychiatric history who developed a significant post-operative infection requiring multiple reoperations.
The impact of the first three months of the COVID-19 pandemic on the Australian trans community
Published in International Journal of Transgender Health, 2023
Sav Zwickl, Lachlan M. Angus, Alex Wong Fang Qi, Ariel Ginger, Kalen Eshin, Teddy Cook, Shalem Y. Leemaqz, Eden Dowers, Jeffrey D. Zajac, Ada S. Cheung
There were significantly greater odds of thoughts of self-harm or suicide in trans people experiencing cancelation or postponement of their gender-affirming surgery. Gender-affirming surgery can be a critical part of transition and affirmation for many trans people, with previous data demonstrating that access to gender-affirming surgery is protective against suicidal ideation and suicide risk (Bauer et al., 2015; Tucker et al., 2018). Despite the 95% confidence interval crossing 1 for reporting depression, the point estimate indicates an increased odds ratio of 1.35 for cancelation of surgery. Statistically, whilst the concordance rate between depression and suicide is high (76%), there is a group of individuals (18%) who met criteria for clinically significant depression but did not have thoughts of self-harm or suicide. Amongst those who had thoughts of self-harm or suicide and had surgery canceled, the majority (93%) also had depression. In contrast, amongst those who had surgery canceled and no thoughts of self-harm or suicide, only 29% had depression. This may suggest that cancelation of surgery may not be a primary risk factor for some individuals with depression but no thoughts of self-harm or suicide. This is likely contributing to the (relatively) smaller effect size between surgery canceled and depression, in contrast to the effect size for thoughts of self-harm or suicide. With resumption of elective surgery, prioritization of gender-affirming surgery may help alleviate symptoms of depression and thoughts of self-harm or suicide in the trans community which are clearly higher than the general population.
Sex work, gender transition, family rejection and depressive symptoms among transgender women in India
Published in International Journal of Transgender Health, 2023
Ankur Srivastava, Jordan P. Davis, Prachi Patel, Elkan E. Daniel, Shama Karkal, Eric Rice
In the bivariate analysis (see Table 1), participants who reported being in sex work were significantly more likely to endorse uptake of any form of transition: gender affirming surgery (77% vs 67%); hormonal therapy (37.5% vs 28.9%); and breast augmentation (36.3% vs 15.3%) compared to those who did not report being in sex work. Use of gender affirming surgery methods also differed significantly by sex work status (χ2 = 12.9(2), p < 0.05); with those in sex work endorsing more for sex reassignment surgery compared to other methods, nonprofessional surgery assisted by guru and emasculation. Additionally, participants who reported being in sex work were also significantly more likely to report probable depression diagnosis (clinical cutoff point of 10 or higher) compared to their counterparts (42.1% vs 28.9%).