Health Care

NEJM addresses bathroom issue and transgender equality

The New England Journal of Medicine has weighed in on how the bathroom issue affects the health of transgender people in an article entitled Beyond Bathrooms — Meeting the Health Needs of Transgender People by Mark A Schuster, Sari L. Reisner and Sarah E. Onorato which appeared in the July 14, issue.



Lancet tackles worldwide lack of transgender healthcare

Despite the recent flurry of media attention that has been directed toward transgender people, they and their health needs remain poorly understood, experts say.

Yesterday The Lancet published a series of articles on the health, social and legal conditions in which transgender people live.

Many of the health challenges faced by transgender people are exacerbated by laws and policies that deny them gender recognition.

In no other community is the link between rights and health so clearly visible as in the transgender community. Faced with stigma, discrimination and abuse, transgender people are pushed to the margins of society, excluded from the workplace, their families and health care. Many are drawn into risky situations or behaviors, such as unsafe sex or substance abuse, which leave them at risk of further ill health.

--Dr. Sam Winter

The majority of countries worldwide do not offer legal or administrative measures enabling gender recognition for transgender people. In Europe, eight countries fail to offer legal recognition to transgender people, and 17 countries still impose sterilization on people who seek gender recognition.

As of June 2016, Argentina, Denmark, Malta, Ireland, and Norway had laws that allow transgender people to determine their gender through an administrative process. Furthermore, Argentina and Malta affirm the right of transgender people to appropriate healthcare.

New Zealand, Australia, Nepal, Pakistan, and India are beginning to recognize gender diversity beyond the binary.

A comprehensive public health approach to address the health of transgender people requires access to gender affirmation services, evidence-based health-care delivery systems, and effective partnerships with local transgender communities.

Although there are substantial gaps in empirical research on transgender issues, there are sufficient actionable data highlighting unique biological, behavioural, social, and structural contextual factors surrounding health risks and resiliencies for transgender people that need interventions.

--Dr. Sari L. Reisner



Health news for LGBT people

In the wake of the Orlando massacre, Jane Sarasohn-Kahn writes at Health IT News about health disparities faced by the LGBT community in America.

The U.S. Centers for Disease Control, has an over-arching goal to improve the health, safety, and well-being of lesbian, gay, bisexual, and transgender individuals. The CDC points out that LGBT individuals face health disparities linked to societal stigma, discrimination, and denial of civil and human rights. These challenges have been associated, in clinical peer-reviewed literature, with higher rates of psychiatric disorders, substance abuse, and suicide.

Experiences of violence are frequent for LGBT individuals





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



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)



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%.



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.



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.


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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