Freedom to think: the need for thorough assessment and treatment of gender dysphoric children.
Ontology highlight
ABSTRACT: Summary
Referrals (particularly natal female) to gender identity clinics have increased significantly in recent years. Understanding the reasons for this increase, and how to respond, is hampered by a politically charged debate regarding gender identity. This article starts with a discussion of the so-called 'affirmative approach' to gender dysphoria and considers the implications of the Memorandum of Understanding on conversion therapy. I then say something about the relationship between gender dysphoria and the developmental problems that are characteristic of adolescence. Finally, I outline what changes to the current approach are needed to do our best to ensure these patients receive the appropriate treatment.
SUBMITTER: Evans M
PROVIDER: S-EPMC8596151 | biostudies-literature | 2021 Oct
REPOSITORIES: biostudies-literature
Publications
Freedom to think: the need for thorough assessment and treatment of gender dysphoric children.
BJPsych bulletin 20211001 5
<h4>Summary</h4>Referrals (particularly natal female) to gender identity clinics have increased significantly in recent years. Understanding the reasons for this increase, and how to respond, is hampered by a politically charged debate regarding gender identity. This article starts with a discussion of the so-called 'affirmative approach' to gender dysphoria and considers the implications of the Memorandum of Understanding on conversion therapy. I then say something about the relationship betwee ...[more]
Similar Datasets
Project description:We provide the first systematic research into the origins of subjective freedom of speech in Germany. Relying on the GLES 2021 Cross-Section Pre-Election Survey, which includes a newly designed survey item on subjective freedom of speech, we evaluate a whole range of plausible candidate hypotheses. First, we contribute to cumulative research by testing the explanatory factors in Gibson (1993)-citizens' social class, their political involvement and political preferences, and their personality dispositions-for the German case. Second, we move beyond the state of the art and test three new hypotheses that reflect more recent political developments and arguments in the free speech debate: the role of social media, increasing political and social polarization, and the rise of populism. Importantly, all hypothesis tests reported in this paper have been preregistered prior to data collection. Our results reveal that three explanatory factors are significantly, consistently, and substantively related to subjective free speech in Germany: political preferences, populist attitudes, and identification with the Alternative for Germany party.Supplementary informationThe online version of this article (10.1007/s11615-022-00414-6) contains supplementary material, which is available to authorized users.
| S-EPMC9368691 | biostudies-literature
Project description:Metabolomic analyses in epidemiological studies have demonstrated a strong sexual dimorphism for most metabolites. Cross-sex hormone treatment (CSH) in transgender individuals enables the study of metabolites in a cross-gender setting. Targeted metabolomic profiling of serum of fasting transmen and transwomen at baseline and following 12 months of CSH (N = 20/group) was performed. Changes in 186 serum metabolites and metabolite ratios were determined by targeted metabolomics analysis based on ESI-LC-MS/MS. RandomForest (RF) analysis was applied to detect metabolites of highest interest for grouping of transwomen and transmen before and after initiation of CSH. Principal component analysis (PCA) was performed to check whether group differentiation was achievable according to these variables and to see if changes in metabolite levels could be explained by a priori gender differences. PCA predicted grouping of individuals-determined by the citrulline/arginine-ratio and the amino acids lysine, alanine and asymmetric dimethylarginine - in addition to the expected grouping due to changes in sex steroids and body composition. The fact that most of the investigated metabolites did, however, not change, indicates that the majority of sex dependent differences in metabolites reported in the literature before may primarily not be attributable to sex hormones but to other gender-differences.
| S-EPMC5105120 | biostudies-literature
Project description:Two popular models of trustworthiness have garnered support over the years. One has postulated three aspects of trustworthiness as state-based antecedents to trust. Another has been interpreted to comprise two aspects of trustworthiness. Empirical data shows support for both models, and debate remains as to the theoretical and practical reasons researchers may adopt one model over the other. The present research aimed to consider this debate by investigating the factor structure of trustworthiness. Taking items from two scales commonly employed to assess trustworthiness, we leveraged structural equation modeling to explore which theoretical model is supported by the data in an organizational trust context. We considered an array of first-order, second-order, and bifactor models. The best-fitting model was a bifactor model comprising one general trustworthiness factor and ability, benevolence, and integrity grouping factors. This model was determined to be essentially unidimensional, though this is qualified by the finding that the grouping variables accounted for significant variance with for several organizational outcome criteria. These results suggest that respondents typically employ a general factor when responding to items assessing trustworthiness, and researchers may be better served treating the construct as unidimensional or engaging in scale parceling of their models to reflect this response tendency more accurately. However, the substantial variance accounted by the grouping variables in hierarchical regression suggest there may be contexts in which it would be acceptable to consider the theoretical factors of ability, benevolence, and integrity independent of general trustworthiness.
| S-EPMC9012151 | biostudies-literature
Project description:ObjectiveTo investigate the view of clinicians on diagnostic radiology and its future.MethodsCorresponding authors who published in the New England Journal of Medicine and the Lancet between 2010 and 2022 were asked to participate in a survey about diagnostic radiology and its future.ResultsThe 331 participating clinicians gave a median score of 9 on a 0-10 point scale to the value of medical imaging in improving patient-relevant outcomes. 40.6%, 15.1%, 18.9%, and 9.5% of clinicians indicated to interpret more than half of radiography, ultrasonography, CT, and MRI examinations completely by themselves, without consulting a radiologist or reading the radiology report. Two hundred eighty-nine clinicians (87.3%) expected an increase in medical imaging utilization in the coming 10 years, whereas 9 clinicians (2.7%) expected a decrease. The need for diagnostic radiologists in the coming 10 years was expected to increase by 162 clinicians (48.9%), to remain stable by 85 clinicians (25.7%), and to decrease by 47 clinicians (14.2%). Two hundred clinicians (60.4%) expected that artificial intelligence (AI) will not make diagnostic radiologists redundant in the coming 10 years, whereas 54 clinicians (16.3%) thought the opposite.ConclusionClinicians who published in the New England Journal of Medicine or the Lancet attribute high value to medical imaging. They generally need radiologists for cross-sectional imaging interpretation, but for a considerable proportion of radiographs, their service is not required. Most expect medical imaging utilization and the need for diagnostic radiologists to increase in the foreseeable future, and do not expect AI to make radiologists redundant.Clinical relevance statementThe views of clinicians on radiology and its future may be used to determine how radiology should be practiced and be further developed.Key points• Clinicians generally regard medical imaging as high-value care and expect to use more medical imaging in the future. • Clinicians mainly need radiologists for cross-sectional imaging interpretation while they interpret a substantial proportion of radiographs completely by themselves. • The majority of clinicians expects that the need for diagnostic radiologists will not decrease (half of them even expect that we need more) and does not believe that AI will replace radiologists.
| S-EPMC10667510 | biostudies-literature
Project description:BackgroundThe planning of orthodontic treatment within a public health system requires information on the orthodontic treatment needs of the population. It is important to have epidemiological data to estimate the total need for orthodontic care in any region. The present study aimed to determine the orthodontic treatment need in 12 years old Southwestern Ethiopian children.MethodsThe institution-based cross-sectional study was conducted which involved 347 twelve years old school children randomly selected from seven different public schools in Jimma Town, Southwestern Ethiopia. A structured interview and clinical examination were used to assess the subjects. One examiner used Dental Health Component (DHC) and Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) to estimate the treatment need. Descriptive statistics and chi-square tests were used for data analysis with statistical significance set at P < 0.05.ResultsAccording to the DHC of IOTN, almost half of the subjects in the sample were in moderate to the great need for orthodontic treatment. About 15% of the children had a great need for orthodontic treatment based on IOTN-AC. The most prevalent occlusal traits for defining the DHC categorization include increased Overjet (30.8%) and Crowding (23.3%). There was no statistical difference in the distribution of DHC grades and AC scored based on gender.ConclusionThis study revealed that the need for orthodontic treatment was high. The percentage of the need for orthodontic treatment is higher in comparison to most of the studies conducted in African regions. Therefore, publicly subsidized orthodontic treatment should be planned and provided to those who are in great need for orthodontic treatment. Besides, awareness about orthodontic treatment should also be considered.
| S-EPMC7376854 | biostudies-literature
Project description:The glass cliff suggests that women are more likely to access leadership positions when organizations are facing a crisis. Although this phenomenon is well established, it is still largely unknown how variations in types of crises influence the strength of the think crisis-think female association, and whether female leaders and leaders with communal gendered traits are both affected by this association. We hypothesized that selection of stereotypically feminine traits (communal leaders) is specific to a relational crisis because of a fit between leader traits and traits required by the situation. We further expected that the selection of women also extends to other crisis situations because other factors such as their signaling change potential may play a role. We investigated the associations that participants made with candidates who varied across gendered traits and gender and between two crisis situations involving problems with either stereotypically feminine (e.g., an internal disharmony) or masculine (e.g., a financial problem) components, and a no crisis situation control. Results from three experimental studies (Ns = 319, 384, 385) supported our hypotheses by showing that communal leaders were most strongly associated with a relational crisis and least with a financial crisis, with the no crisis context situated in-between. This pattern was explained by higher relevance ratings for communal leadership behavior in the relational crisis versus financial crisis context, with the no crisis context situated in-between. In contrast, female leaders were most strongly associated with the relational crisis and least with the no crisis context, with the financial crisis situated in-between. Specific explanatory mechanisms related to the female-crisis association are explored and discussed. Our findings suggest that implicit motivations for valuing feminine/communal leadership and atypical leaders in crisis situations need further research.
| S-EPMC7924740 | biostudies-literature
Project description:Mutations in APP, PSEN1, MAPTand GRNare the most common genetic causes of dementia. The previous miss-assignment of pathogenicity to benign variants in these genes stresses the importance of discerning between disease causing mutations and benign variants with no pathogenic effect on the function of the respective protein. In this study we sequenced GRNand MAPTin 282 samples from the Centre d'Etude du Polymorphisme Humain - Human Genome Diversity Cell Line Panel, in order to identify benign variants that could otherwise be mistaken for pathogenic mutations. We found sixteen different non-synonymous changes, eleven of which are novel variants.
| S-EPMC2815037 | biostudies-literature
Project description:BackgroundMore than a billion people globally are living with disability and the prevalence is likely to increase rapidly in the coming years in low- and middle-income countries (LMICs). The vast majority of those living with disability are children residing in LMICs. There is very little reliable data on the epidemiology of musculoskeletal impairments (MSIs) in children and even less is available for Malawi. Previous studies in Malawi on childhood disability and the impact of musculoskeletal impairment (MSI) on the lives of children have been done but on a small scale and have not used disability measurement tools designed for children. Therefore in this study, we aimed to estimate the MSI prevalence, causes, and the treatment need among children aged 16 years or less in Malawi.MethodsThis study was carried out as a national cross sectional survey. Clusters were selected across the whole country through probability proportional to size sampling with an urban/rural and demographic split that matched the national distribution of the population. Clusters were distributed around all 27-mainland districts of Malawi. Population of Malawi was 18.3 million from 2018 estimates, based on age categories we estimated that about 8.9 million were 16 years and younger. MSI diagnosis from our randomized sample was extrapolated to the population of Malawi, confidence limits was calculated using normal approximation.ResultsOf 3792 children aged 16 or less who were enumerated, 3648 (96.2%) were examined and 236 were confirmed to have MSI, giving a prevalence of MSI of 6.5% (CI 5.7-7.3). Extrapolated to the Malawian population this means as many as 576,000 (95% CI 505,000-647,000) children could be living with MSI in Malawi. Overall, 46% of MSIs were due to congenital causes, 34% were neurological in origin, 8.4% were due to trauma, 7.8% were acquired non-traumatic non-infective causes, and 3.4% were due to infection. We estimated a total number of 112,000 (80,000-145,000) children in need of Prostheses and Orthoses (P&O), 42,000 (22,000-61,000) in need of mobility aids (including 37,000 wheel chairs), 73,000 (47,000-99,000) in need of medication, 59,000 (35,000-82,000) in need of physical therapy, and 20,000 (6000-33,000) children in need of orthopaedic surgery. Low parents' educational level was one factor associated with an increased risk of MSI.ConclusionThis survey has uncovered a large burden of MSI among children aged 16 and under in Malawi. The burden of musculoskeletal impairment in Malawi is mostly unattended, revealing a need to scale up both P&O services, physical & occupational therapy, and surgical services in the country.
| S-EPMC8796456 | biostudies-literature
Project description:PurposeTo characterize, by specific biomarkers and nucleic acid sequencing, the structural and genomic sperm characteristics of partial (PG) and complete globozoospermic (CG) men in order to identify the best reproductive treatment.MethodsWe assessed spermatozoa from 14 consenting men ultrastructurally, as well as for histone content, sperm chromatin integrity, and sperm aneuploidy. Additional genomic, transcriptomic, and proteomic evaluations were carried out to further characterize the CG cohort. The presence of oocyte-activating sperm cytosolic factor (OASCF) was measured by a phospholipase C zeta (PLCζ) immunofluorescence assay. Couples were treated in subsequent cycles either by conventional ICSI or by ICSI with assisted gamete treatment (AGT) using calcium ionophore (Ionomycin, 19657, Sigma-Aldrich, Saint Louis, MO, USA).ResultsUltrastructural assessment confirmed complete acrosome deficiency in all spermatozoa from CG men. Histone content, sperm chromatin integrity, and sperm aneuploidy did not differ significantly between the PG (n = 4) and CG (n = 10) cohorts. PLCζ assessment indicated a positive presence of OASCF in 4 PG couples, who underwent subsequent ICSI cycles that yielded a 36.1% (43/119) fertilization with a 50% (2/4) clinical pregnancy and delivery rate. PLCζ assessment failed to detect OASCF for 8 CG patients who underwent 9 subsequent ICSI cycles with AGT, yielding a remarkable improvement of fertilization (39/97; 40.2%) (P = 0.00001). Embryo implantation (6/21; 28.6%) and clinical pregnancies (5/7; 71.4%) were also enhanced, resulting in 4 deliveries. Gene mutations (DPY19L2, SPATA16, PICK1) were identified in spermatozoa from CG patients. Additionally, CG patients unable to sustain a term pregnancy had gene mutations involved in zygote development (NLRP5) and postnatal development (BSX). CG patients who successfully sustained a pregnancy had a mutation (PIWIL1) related to sperm phenotype. PLCZ1 was both mutated and underexpressed in these CG patients, regardless of reproductive outcome.ConclusionsSperm bioassays and genomic studies can be used to characterize this gamete's capacity to support embryonic development and to tailor treatments maximizing reproductive outcome.
| S-EPMC8417186 | biostudies-literature
Project description:Undertreatment of osteoporosis has been recognized as a common problem in selected patient subgroups. However, primary prevention has been hampered by limited risk assessment tools that can be applied to large populations.Using clinical risk factors with a new tool from the World Health Organization (FRAX) and recommendations from the National Osteoporosis Foundation (NOF), we evaluated fracture risk and osteoporosis treatment in a US cohort.African Americans and Caucasians recruited from 2003-7 across the US as part of a longitudinal study.Cross-sectional.The number of persons receiving prescription osteoporosis medications was assessed by race, sex, and fracture risk. Multivariable logistic regression evaluated the association between receipt of osteoporosis medications and fracture risk after controlling for potential confounders.Among 24,783 participants, estimated fracture risk was highest for Caucasian women. After multivariable adjustment for fracture-related risk factors, the likelihood of receipt of osteoporosis medications among African Americans was lower than among Caucasians [odds ratio (OR) = 0.44, 95% confidence interval (CI) 0.37, 0.53] and for men compared to women (OR = 0.08, 95% CI 0.06-0.10). Even for the highest risk group, Caucasian women with 10-year hip fracture risk > or = 3% (n = 3,025, 39.7%), only 26% were receiving treatment.A substantial gap exists between 2008 NOF treatment guidelines based on fracture risk and the receipt of prescription osteoporosis medications. This gap was particularly notable for African Americans and men. FRAX is likely to be useful to assess risk at a population level and identify high-risk persons in need of additional evaluation.
| S-EPMC2710475 | biostudies-other