Connect with us

Health & Wellness

Access to identification documents reflecting gender identity may improve trans mental health

A study finds that possessing gender-concordant IDs is associated with reduced psychological distress, and a lower prevalence of suicidal thoughts and suicide planning.

Published

on

Photo by Cecilie Johnsen from Unsplash.com

A study finds that possessing gender-concordant IDs is associated with reduced psychological distress, and a lower prevalence of suicidal thoughts and suicide planning. And the authors suggest policy changes to increase access to gender-concordant IDs. For example, by reducing fees, administrative hurdles and eligibility requirements, and also by either expanding gender options beyond male or female, or by removing gender markers entirely.

Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The authors note that the survey only questioned respondents at one time point, making it difficult to confirm whether lack of gender-affirming IDs caused psychological distress or the other way around. It is possible that trans people suffering from psychological distress might find it harder to obtain IDs. However, a previous Canadian study found that having at least one document showing a trans person’s preferred gender marker was associated with fewer suicidal thoughts and suicide attempts, and previous research has found that mental health risks in transgender adolescents are reduced when their preferred name is used socially.

“Our results suggest that governments and administrative bodies can play an important role in helping to reduce psychological distress for trans people, simply by making it easier to access identity documents that reflect their identity,” says Dr Ayden Scheim from Drexel University, USA.

Of the 1.4 million Americans who identify as transgender, over half are estimated to have clinical depression, compared to around 30% over a lifetime in the general US population, while 31% to 41% attempt suicide at some point during their lives, compared to less than 9% generally in the US. These mental health disparities can be attributed in part to a lack of recognition and acceptance of trans people’s identified gender. Lack of gender-concordant official documents can prevent access to services such as healthcare, education, and employment, and increase exposure to verbal harassment and violence.

The authors suggest that at the moment, the ID change process can be difficult to impossible. For example, in most US states updating a name on government-issued ID first requires a court-ordered name change, which can cost several hundred dollars. Most states require medical letters or affidavits to validate reclassification requests, and some may require gender transition surgery. In most jurisdictions, gender markers reflecting non-binary gender identity (such as an ‘X’ marker) are not yet available.

To explore the impact of access to IDs on psychological distress, suicidal thoughts and suicide attempts, researchers analysed data from 22,286 trans people, who were surveyed in 2015. Respondents were asked whether all, some or none of their IDs – including birth certificates, passports and driving licences – listed their preferred name and gender marker. Psychological distress was measured using a validated scale with a score between 0 and 24, with 13 or greater indicating serious psychological distress. To assess respondents’ suicide risk, they were asked whether they had seriously considered suicide in the previous 12 months, whether they had made any plans to kill themselves and whether they had attempted suicide.

To ensure that the analysis was able to pick up any association between mental health and access to updated IDs, the authors of the current study adjusted the results to account for other variables that could contribute to psychological distress and suicidal thoughts – such as age, ethnicity, medical transition status and years living full-time in the identified gender.

The results found that 45.1% of respondents (10,288 out of 22,286) had no IDs with their preferred name and gender marker, 44.2% (9,666/22,286) had some ID that matched their name and/or gender, and only 10.7% (2,332/22,286) had their preferred name and gender on all their documents. The authors weighted the sample to reflect the age and ethnicity of the US population, although they note that trans demographics may not mirror broader US population demographics.

The reasons for not changing gender markers included a lack of suitable gender options (in the group with no concordant ID, people with non-binary identities were over-represented), cost, and perceived ineligibility (for example, believing that additional medical treatment was required). The authors also identified geographic variation in the results, with participants in western states more likely to have gender-concordant ID, while those in the Midwest were less likely.

Those with all gender-concordant IDs had a 32% lower prevalence of serious psychological distress than those with no updated documents. They were also 22% less likely to have had suicidal thoughts in the past year and 25% less likely to have made plans to kill themselves. Those with some updated IDs had smaller reductions in distress and suicidal thoughts (e.g., 12% reduction in distress). The results did not indicate an association between access to IDs and suicide attempts, once the authors had adjusted for other influences on mental health.

“When a trans person changes their gender on their official documents, it can be a critical step towards gaining social acceptance and legal recognition, and our findings suggest that policy changes to support trans people with taking this step should be considered, in order to help improve their wellbeing, reduce their exposure to discrimination and reduce suicidal thoughts,” says Professor Greta Bauer from Western University, Canada.

The authors note that other variables not covered in the study may mediate psychological distress, for example access to social support.

Writing in a linked comment, lead author Dr Monica Malta (who was not involved in the study) from the University of Toronto says: “The cross-sectional study design prohibits causal interpretation of the identified relationships, and reverse causation is plausible–those with better mental health might be better able to navigate the difficult bureaucratic requirements to obtain gender congruent IDs. Even with those limitations, the large dataset and careful inclusion of potential confounders strengthen the study design. Thus, the authors’ findings support the need to increase the availability of and streamline the processes to obtain gender congruent IDs. Gaining gender-congruent IDs should be easy, affordable, and quickly completed by adequately trained officials at TGD-friendly environments.”

Health & Wellness

Trans women can safely maintain estrogen treatments during gender affirming surgery

The practice of withholding estrogen prior to gender affirming surgery was not necessary. Most transgender women can now safely remain on their estrogen therapy throughout surgery.

Published

on

Photo by @kylewilliamurban from Unsplash.com

There was no difference in blood clots when estrogen hormone therapy was maintained during gender affirming surgery.

This is according to a study (titled, “No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender Affirming Surgery”) helmed by John Henry Pang with Aki Kozato from Mount Sinai, and was published in the Journal of Clinical Endocrinology & Metabolism.

Historically, the lack of published data contributed to heterogeneity in the practice of whether doctors and surgeons advised transgender women to withhold their estrogen therapy before surgery. The sudden loss of estrogen in the blood was sometimes very uncomfortable with symptoms that amounted to a sudden, severe menopause.

So the researchers tapped 919 transgender patients who underwent gender affirming surgery at Mount Sinai’s Center for Transgender Medicine and Surgery between November 2015 and August 2019. Notably, including 407 cases of transgender women who underwent primary vaginoplasty surgery.

This study found that the practice of withholding estrogen prior to gender affirming surgery was not necessary. Most transgender women can now safely remain on their estrogen therapy throughout surgery.

The bottom line: This study found that most transgender women can  safely maintain their estrogen hormone treatments during gender affirming surgery.

Continue Reading

Health & Wellness

Facebook posts help facilitate belief that HPV vaccine is dangerous to health

Nearly 40% of Facebook posts about the HPV vaccine amplified a perceived risk, and the data suggests these posts had momentum over time.

Published

on

Photo by @nordwood from Unsplash.com

The human papillomavirus infection, or HPV, is one of the most common sexually transmitted infections, according to the Centers for Disease Control and Prevention (CDC). HPV is associated with health problems including genital warts and cancers, but a vaccine has been available since 2006 to help stop the virus. The CDC reports more than 12 years of data supports the HPV vaccine is safe and effective, yet HPV vaccination rates still remain low.

Social media has a history of being a popular place for sexual health discussions, and the HPV vaccine is one of the most discussed vaccines on the internet. Monique Luisi, an assistant professor in the University of Missouri School of Journalism, has studied more than 6,500 public HPV vaccine-related posts on Facebook from 2006 to 2016. In a previous study, Luisi used these Facebook posts to identify a negative trend on Facebook related to how people perceive the HPV vaccine.

Now, she suggests this negative trend on Facebook may also cause people to develop a false perception of the health risk of the vaccine. After looking at the percentage of posts that made the vaccine seem more dangerous, less dangerous or neither, Luisi found nearly 40% of Facebook posts about the HPV vaccine amplified a perceived risk, and the data suggests these posts had momentum over time.

“We should not assume that only the disease is perceived as a risk, but when research supports it, that medical treatments and interventions might unfortunately also be perceived as risks,” she said. “It’s more likely that people are going to see things on social media, particularly on Facebook, that are not only negative about the HPV vaccine, but will also suggest the HPV vaccine could be harmful. It amplifies the fear that people may have about the vaccine, and we see that posts that amplify fear are more likely to trend than those that don’t.”

Luisi suggests the spread of this negative information may lead people to have a false perception of the vaccine, so people should consult their doctor or health care provider before making an informed decision.

“Facebook remains a very popular social media platform for adult audiences, which necessitates action to address HPV vaccine risk messages,” she said. “People are going to see what they are going to see on social media, so it’s important to not only take what you see on social media, but also talk to a doctor or health care provider. Just because it’s trending doesn’t mean it’s true.”

Luisi notes research must continue to address the perception of vaccine safety where the vaccine is perceived as a greater health threat than the virus or disease it prevents, and her study could also inform officials for the ongoing COVID-19 vaccine roll out and distribution.

“As the COVID-19 vaccine is being rolled out, people are likely going to see a lot of negative information, and that negative information will be what trends on social media,” she said. “But, if the public can anticipate this negative information, it will be interesting to see if that will that make them less sensitive to the perceived risk of the vaccine.”

Continue Reading

Health & Wellness

Depression and stress could dampen efficacy of COVID-19 vaccines

Even though rigorous testing has shown that the COVID-19 vaccines approved for distribution are highly effective at producing a robust immune response, not everyone will immediately gain their full benefit. Environmental factors, as well as an individual’s genetics and physical and mental health, can weaken the body’s immune system, slowing the response to a vaccine.

Published

on

Photo by Nick Bolton from Unsplash.com

Decades of research show that depression, stress, loneliness, and poor health behaviors can weaken the body’s immune system and lower the effectiveness of certain vaccines.

A new report accepted for publication in Perspectives on Psychological Science suggests that the same may be true for the new COVID-19 vaccines that are in development and the early stages of global distribution. Fortunately, it may be possible to reduce these negative effects with simple steps like exercise and sleep.

Vaccines are among the safest and most effective advances in medical history, protecting society from a wide range of otherwise devastating diseases, including smallpox and polio. The key to their success, however, is ensuring that a critical percentage of the population is effectively vaccinated to achieve so-called herd immunity.

Even though rigorous testing has shown that the COVID-19 vaccines approved for distribution are highly effective at producing a robust immune response, not everyone will immediately gain their full benefit. Environmental factors, as well as an individual’s genetics and physical and mental health, can weaken the body’s immune system, slowing the response to a vaccine.

This is particularly troubling as the novel coronavirus continues to rage across the world, trigging a concurrent mental health crisis as people deal with isolation, economic stressors, and uncertainty about the future. These challenges are the same factors that have been previously shown to weaken vaccine efficacy, particularly among the elderly.

“In addition to the physical toll of COVID-19, the pandemic has an equally troubling mental health component, causing anxiety and depression, among many other related problems. Emotional stressors like these can affect a person’s immune system, impairing their ability to ward off infections,” said Annelise Madison, a researcher at The Ohio State University and lead author on the paper. “Our new study sheds light on vaccine efficacy and how health behaviors and emotional stressors can alter the body’s ability to develop an immune response. The trouble is that the pandemic in and of itself could be amplifying these risk factors.”

Vaccines work by challenging the immune system. Within hours of a vaccination, there is an innate, general immune response on the cellular level as the body begins to recognize a potential biological threat. This frontline response by the immune system is eventually aided by the production of antibodies, which target specific pathogens. It is the continued production of antibodies that helps to determine how effective a vaccine is at conferring long-term protection.

The good news, according to the researchers, is that the COVID-19 vaccines already in circulation are approximately 95% effective. Even so, these psychological and behavioral factors can lengthen the amount of time it takes to develop immunity and can shorten the duration of immunity.

“The thing that excites me is that some of these factors are modifiable,” said Janice Kiecolt-Glaser, director of the Institute for Behavioral Medicine Research at The Ohio State University and senior author on the paper. “It’s possible to do some simple things to maximize the vaccine’s initial effectiveness.”

Based on prior research, one strategy the researchers suggest is to engage in vigorous exercise and get a good night’s sleep in the 24 hours before vaccination so that your immune system is operating at peak performance. This may help ensure that the best and strongest immune response happens as quickly as possible.

“Prior research suggests that psychological and behavioral interventions can improve vaccine responsiveness. Even shorter-term interventions can be effective,” said Madison. “Therefore, now is the time to identify those at risk for a poor immune response and intervene on these risk factors.”

Continue Reading

Health & Wellness

Bisexual men more prone to eating disorders than gay or straight men – study

80% of bisexual men reported that they “felt fat”, and 77% had a strong desire to lose weight, both figures higher than the 79% and 75% for gay men, respectively.

Published

on

Photo by Nicholas Swatz from Pexels.com

Bisexual men are more likely to experience eating disorders than either heterosexual or gay men. This is according to a report from the University of California San Francisco, published in the journal Eating and Weight Disorders.

A handful of studies have actually indicated that gay men are at increased risk for disordered eating, including fasting, excessive exercise and preoccupation with weight and body shape. This newer study, however, suggest that bisexual men are even more susceptible to some unhealthy habits.

For this study, the researchers surveyed over 4,500 LGBTQ adults, and a quarter of the bisexual male participants reported having fasted for more than eight hours to influence their weight or appearance. This is higher when compared to 20% for gay men.

The research also found that 80% of bisexual men reported that they “felt fat”, and 77% had a strong desire to lose weight, both figures higher than the 79% and 75% for gay men, respectively.

Now this is worth stressing: According to study co-author Dr. Jason Nagata, not everyone who diets or feels fat has an eating disorder. “It’s a spectrum — from some amount of concern to a tipping point where it becomes a pathological obsession about body weight and appearance,”Nagata was quoted as saying by NBC News.

For Nagata, several factors may be at play here, including “minority stress” (the concept that the heightened anxiety faced by marginalized groups can manifest as poor mental and physical health outcomes).

“LGBTQ people experience stigma and discrimination, and stressors can definitely lead to disordered eating,” Nagata was also quoted as saying. “For bi men, they’re not just facing stigma from the straight community but from the gay community, as well.”

Of all the respondents, 3.2% of bisexual males were clinically diagnosed with eating disorders (compared to 2.9% of gay men). For heterosexual men, it’s only 0.6%.

For the researchers, there is a need to conduct eating disorder research on various sexual identities independently. This is also to raise awareness on this issue (and how it affects different people of various SOGIESCs).

Continue Reading

Health & Wellness

Timing and intensity of oral sex may affect risk of oropharyngeal cancer

Love giving head? Consider this: Having more than 10 prior oral sex partners was associated with a 4.3-times greater likelihood of having HPV-related oropharyngeal cancer.

Published

on

Photo by Dainis Graveris from Unsplash.com

Human papillomavirus (HPV) can infect the mouth and throat to cause cancers of the oropharynx.

This is according to a study published in CANCER, a peer-reviewed journal of the American Cancer Society, which has found that having more than 10 prior oral sex partners was associated with a 4.3-times greater likelihood of having HPV-related oropharyngeal cancer. The study also shows that having oral sex at a younger age and more partners in a shorter time period (oral sex intensity) were associated with higher likelihoods of having HPV-related cancer of the mouth and throat.

Previous studies have shown that performing oral sex is a strong risk factor for HPV-related oropharyngeal cancer. To examine how behavior related to oral sex may affect risk, Virginia Drake, MD, of Johns Hopkins University, and her colleagues asked 163 individuals with and 345 without HPV-related oropharyngeal cancer to complete a behavioral survey.

In addition to timing and intensity of oral sex, individuals who had older sexual partners when they were young, and those with partners who had extramarital sex were more likely to have HPV-related oropharyngeal cancer.

“Our study builds on previous research to demonstrate that it is not only the number of oral sexual partners, but also other factors not previously appreciated that contribute to the risk of exposure to HPV orally and subsequent HPV-related oropharyngeal cancer,” said Dr. Drake. “As the incidence of HPV-related oropharyngeal cancer continues to rise… our study offers a contemporary evaluation of risk factors for this disease. We have uncovered additional nuances of how and why some people may develop this cancer, which may help identify those at greater risk.”

Continue Reading

Health & Wellness

Sexual, gender minority youths more likely to have obesity, binge eating disorder

Findings suggest that weight and eating disorder disparities observed in SGM adolescents/adults may emerge in childhood. As such, “clinicians should consider assessing eating- and health-related behaviors among SGM youths.”

Published

on

Photo by Rosemary Ketchum from Pexels.com

Sexual and gender minorities (SGM) youths were more likely to have obesity and full-threshold or subthreshold binge eating disorder. This is according to research – “Obesity and Eating Disorder Disparities Among Sexual and Gender Minority Youth” by Natasha A. Schvey, PhD; Arielle T. Pearlman, BA; David A. Klein, MD, MPH; et al -published in JAMA Pediatrics.

SGM are those who identify as lesbian, gay, bisexual and/or transgender, or whose sexual orientation and/or gender identity/expression do not conform to societal conventions.

For this study, the researchers noted that as it is, “obesity and eating disorders in youth are prevalent, are associated with medical and psychosocial consequences, and may persist into adulthood. Therefore, identifying subgroups of youth vulnerable to one or both conditions is critical.”

For them, one group that may be at risk for obesity and disordered eating is SGM.

In total, 11,852 participants were considered (aged 9-10 years), derived from the Adolescent Brain Cognitive Development Study. The mean age was 9.91, and 5,672 (47.9%) of the total number were female. The sample comprised 1.6% (n = 190) probable sexual (n = 151) and/or gender minority (n = 58) youths, of whom 24.7% (n = 47) responded yes and 75.3% (n = 143) responded maybe to the SGM queries.

The researchers found that one in six youths (1,987 [16.8%]) had obesity and 10.2% (n = 1,188) had a full-threshold (86 [0.7%]) and/or subthreshold (1103 [9.4%]) eating disorder.

They also reported that adjusting for covariates, SGM youths were more likely to have obesity (odds ratio, 1.64; 95% CI, 1.09-2.48) and full-threshold or subthreshold binge eating disorder (odds ratio, 3.49; 95% CI, 1.39-8.76).

SGM and non-SGM youths did not differ in the likelihood of full-threshold or subthreshold anorexia nervosa or bulimia nervosa. The same pattern of results remained when limiting SGM youths to those responding yes to the SGM items, although significance for the likelihood of obesity was attenuated.

For the researchers, the findings suggest that weight and eating disorder disparities observed in SGM adolescents/adults may emerge in childhood. As such, “clinicians should consider assessing eating- and health-related behaviors among SGM youths.”

Continue Reading
Advertisement
Advertisement

LIKE US ON FACEBOOK

Most Popular