Health Care

The dangers of family rejection

Augustus Klein and Sarit Golub are professors at the City University of New York (CUNY), Klein in the Department of Social Welfare at the Graduate Center and Golub in the Department of Psychology at Hunter.

They have recent had a paper published Family Rejection as a Predictor of Suicide Attempts and Substance Misuse Among Transgender and Gender Nonconforming Adults

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Meanwhile in Hawaii

It may seem like the country has become overrun with hate.

But there is still good news from time to time.

The Hawaii House of Representatives on Tuesday passed a bill which prohibits insurance companies from denying, canceling or limiting insurance coverage based on gender identity.

That's something that's really critical, especially now when you have states around the country moving the other direction, explicitly placing into law the ability to discriminate based on who people perceive themselves to be.

Here in Hawaii where we treat everyone with respect and aloha, we think everyone is created equal and ought to be treated the same.

--Rep. Chris Lee (D)

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JAMA on mental health of trans women

The Journal of the American Medical Association published a new study on Monday: Psychiatric Diagnoses and Comorbidities in a Diverse, Multicity Cohort of Young Transgender Women

I. e.-- Are transgender women just inherently nuts or we get help to be that way?

Objective: To report the prevalence of mental health, substance dependence, and comorbid psychiatric disorders assessed via clinical diagnostic interview in a high-risk community-recruited sample of young transgender women.

Results: Of the 298 transgender women, 41.5% of participants had 1 or more mental health or substance dependence diagnoses; 1 in 5 (20.1%) had 2 or more comorbid psychiatric diagnoses. Prevalence of specific disorders was as follows: lifetime and current major depressive episode, 35.4% and 14.7%, respectively; suicidality, 20.2%; generalized anxiety disorder, 7.9%; posttraumatic stress disorder, 9.8%; alcohol dependence, 11.2%; and nonalcohol psychoactive substance use dependence, 15.2%.

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Uterus transplants open new world of possibility for trans women

 photo bowick_zpsvcviuweo.jpgSurgeons at Cleveland Clinic transplanted a uterus into a woman identified only as Lindsey in late February. The clinic plans to perform ten such transplants in a clinical trial. Recipients at this time will be women who can't get pregnant because their uterus is damaged or missing.

But transgender women are watching.

I hope it becomes a reality. I absolutely would be willing to do it.

Ever since I was old enough to understand the concept of parenting, I wanted to be a mother. I didn’t know how that would ever happen, but that’s what I wanted.

--Chastity Bowick, 30, a medical case manager in Worcester, Mass

Bowick began her transition when she was 19.

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Pharmacological management of transgender patients

Meghan Ross, Senior Associate Editor of Pharmacy Times, has written a call for Pharmacists to educate themselves on the "unique needs" of transgender patients: 5 Ways Pharmacists Can Help Transgender Patients

Transgender patients have unique health needs, but few health care professionals have received adequate training on how to best care for these patients.

--Ross

Bryan Bishop, PharmD, BCPS, clinical assistant professor at the University of Toledo College of Pharmacy and Pharmaceutical Sciences, recently wrote about pharmacotherapy considerations in the management of transgender patients in Pharmacotherapy.

Not being a peruser of that no-doubt fine journal, I'm glad Ms. Ross is.

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Transgender youth 4 times as susceptible to eating disorders as cis youth

Eating disorders have historically been associated with young, white women of privilege. However, this is a myth—eating disorders do not discriminate. While more research is needed in this area, we do know that the prevalence of eating disorders is similar among Non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, with the exception that anorexia nervosa is more common among Non-Hispanic Whites.

--NEDA

TeenVogue Magazine has published an article investigating why trans kids are more susceptible to developing eating disorders than their cisgender, heterosexual, female peers (the latter being the poster version for eating disorders). The TeenVogue article, in a classic example of "better late than never" is based on a December essay from Broadly, which itself was based on a study published in Journal of Adolescent Health last summer.

It turns out eating disorders are most common among those who we have selectively ignored: A study published in the Journal of Adolescent Health earlier this year found that transgender youth were four times more likely to report an eating disorder diagnosis than their cisgender heterosexual female peers—the next leading eating disorder group. The study involved over 200,000 heterosexual students, 5,000 who are "unsure," 15,000 who are gay, lesbian, or bisexual, and 479 who are transgender.

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Research: Most Endocrinologists uncomfortable treating transgender patients

 photo Caduceus1.pngThe results of a survey administered at an American Association of Clinical Endocrinologists conference have now been published. Research was lead by Michael S. Irwig, MD, of George Washington University and was published in the journal Endocrine Practice.

While endocrinologists and other providers have received more education and training on transgender care within the past decade, self-rated comfort levels with discussing gender identity and/or sexual orientation and competency to provide transgender care is still rated relatively low.

The survey, which was conducted at a meeting for endocrinologists in the Mid-Atlantic region of the U.S. with 125 conference attendees, found that 63 percent of those surveyed were willing to provide transgender care, but the majority of providers had no current transgender patients under their care. Irwig also found that 50 percent of those surveyed had read the Endocrine Society's transgender clinical practice guidelines - with 70 percent of those under the age of 40.

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The positive mental health of trans children supported in their identities

A new study shows that trans Kids supported by their families are not destined to have mental health problems.

Studies of mental health among transgender people in the United States have been consistently grim, showing higher rates of depression, anxiety and suicide.

But almost nothing is known about the mental health of a new and growing generation of transgender Americans — prepubescent children who are living openly as transgender with the support of their families. How do those children fare in an environment of openness and family support? When their gender identity is affirmed, are they happy?

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DC to require medical providers have LGBTQ cultural competency

 photo Caduceus1.pngThis past Tuesday the Council of the District of Columbia unanimously and with little fanfare passed B21-168, the LGBTQ Cultural Competency Continuing Education Amendment Act. When signed by Mayor Muriel Bowser, he district will be the first jurisdiction in the nation to require LGBTQ cultural competency training for all health care providers.

The bill sets a modest but needed floor for such training by requiring any health care professional who is required to receive continuing education to include at least two credits of LGBTQ-related clinical or cultural competency training.

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