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Gay parenting: A guide to your options

There are still mixed messages in the mainstream media surrounding gay couples having children. Despite this, the fact remains that many gay couples do want children. Here, at least, there is good news. Gay couples who want to have children have many options available to them.

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There are still mixed messages in the mainstream media surrounding gay couples having children. Despite this, the fact remains that many gay couples do want children. Here, at least, there is good news. Gay couples who want to have children have many options available to them. Some of those options were not viable only a short time ago. So it is a wonderful thing indeed that homosexuals can now find ways of having children to raise.

Any gay couple starting to think about having a baby might well be overwhelmed with the choices available. When it comes to thinking about something as big as this, it can be difficult or stressful.

Nonetheless, there are many options available – and that can only be a good thing. If you are in the position of thinking about kids at the moment, and you’re wondering what to do, look no further. In this post, we will guide you through the most common options that gay couples have for having a baby.

We will also look briefly at the pros and cons of each, to help you make your decision.

Without further ado, let’s take a look now.

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ADOPTION

Adoption has much to be said for it for any couple, straight or gay. One thing is for sure: it is popular, just about the most popular choice for homosexual couples wanting babies in the last few years. The process for adoption can be a long and tiresome one – but at the end of it, you are likely to be very happy. One great thing about adoption is that, as a process, you know you are relying on something with a long and successful history. Adoption is one of the oldest methods, and one of the most successful. There is also the obvious, and huge, benefit of taking in a child and ensuring that they have a happy home. Truly, this is one of the greatest gifts that anyone can give to anyone else. This alone is often enough for many couples to go for adoption as their first choice.

However, it’s not for everyone, and it does have its downsides. It is a notoriously long and drawn-out process, and you might well be waiting for a long time. If you are the patient type, then that is probably no great deal. However, if you and your partner are keen to get going, then adoption might not be the best choice.

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Regardless, adoption is a viable option for any gay couple. What’s more, there is plenty of support available. If you are interested in adoption, seek that help out to give you a boost.

INSEMINATION

This is the next most popular option, and it is particularly popular among gay couples in recent times. Insemination is the use of a donor’s sperm to bring about the pregnancy. For this reason, it is particularly popular among lesbian couples who wish to conceive. There are, additionally, many different variations on this, and therefore many options available. A lesbian couple might choose for one (or both) partners to be inseminated with donor sperm. Alternatively, they might decide upon an IVF option. There are many different possibilities here. For example, you could use the eggs of one partner, along with donated sperm, and implant it into the other partner. Or vice versa, of course.

On the other hand, you could use the eggs of one partner, and donor sperm, and implant into a surrogate. Or donor eggs and sperm could be implanted into one of the partners. There are many different possibilities, and that is great news for the couple. It means that, regardless of their situation, it is likely that some form of IVF is available and possible to fulfill their wishes. This makes IVF a great boon to lesbian couples who want to have a baby everywhere.

With the likes of the lesbian IVF program at HRC Fertility, lesbian couples can be sure that there is an option to suit their needs and biologies.

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SURROGACY

Surrogacy is quite possibly one of the first that people tend to think of. While in the past it has been used successfully for couples with infertility problems, its use has now increased. Now, it is just as useful for gay couples who want to have a baby. Surrogacy is a vital and useful way for gay couples to fulfill their dreams of parenthood. One of the great things about it is that it is well-established as a method. This means that finding a surrogate should not be too much hassle for most couples. There are plenty of trustworthy professionals to help you along the entire process. This certainly helps with maintaining some peace of mind throughout the process. Like adoption, the surrogacy process can take a while. But the results are normally pretty positive.

Another great thing about surrogacy is that the medicine is so advanced that the pregnancy chances are now very high. What’s more, surrogate mothers are usually well-screened, so you can trust that everything is above board. Nonetheless, no method is perfect, and there are some potential downsides which you should consider well first.

For example, many couples find that the whole process can put a little bit of strain on things. This is simply because of the huge amount of emotions involved in a process such as this. This is something to be on guard for. What’s more, surrogacy is often quite expensive, so you might need to take that into consideration beforehand. There is also the issue of a lack of control. As you are not carrying the baby, you might feel that things are beyond you a little. This is a common feeling, and it should pass. But it can be quite a strong feeling to start with, so prepare yourself for it.

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Regardless of what method you decide to go for, here’s hoping that the process is as smooth and painless as possible. One thing is for sure: it will be worth it all at the end.

"If someone asked you about me, about what I do for a living, it's to 'weave words'," says Kiki Tan, who has been a writer "for as long as I care to remember." With this, this one writes about... anything and everything.

Health & Wellness

Loneliness in youth could impact mental health over the long term

Loneliness is associated with mental health problems, including depression and anxiety-potentially affecting them years later.

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The COVID-19 pandemic has necessitated widespread social isolation, affecting all ages of global society. A new rapid review in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports on the available evidence about children and young people specifically, stating that loneliness is associated with mental health problems, including depression and anxiety-potentially affecting them years later.

The review, which synthesizes over 60 pre-existing, peer-reviewed studies on topics spanning isolation, loneliness and mental health for young people aged between 4 and 21 years of age, found extensive evidence of an association between loneliness and an increased risk of mental health problems for children and young people.

“As school closures continue, indoor play facilities remain closed and at best, young people can meet outdoors in small groups only, chances are that many are lonely (and continue to be so over time),” said lead author, Maria Loades, DClinPsy, Senior Lecturer in Clinical Psychology at the University of Bath, UK.

“This rapid review of what is known about loneliness and its impact on mental health in children and young people found that loneliness is associated with both depression and anxiety. This occurs when studies measured both loneliness and mental health at the same point in time; when loneliness was measured separately; and when depression and anxiety were measured subsequently, up to 9 years later,” Dr. Loades added. “Of relevance to the COVID-19 context, we found some evidence that it is the duration of loneliness that is more strongly associated with later mental health problems.”

From the selected studies there was evidence that children and young people who are lonely might be as much as three times more likely to develop depression in the future, and that the impact of loneliness on mental health outcomes like depressive symptoms could last for years. There was also evidence that the duration of loneliness may be more important, than the intensity of loneliness, in increasing the risk of future depression among young people.

For many young people, loneliness will decrease as they re-establish social contacts and connections as lockdown eases (e.g., as they return to school or college). For some a sense of loneliness may persist as they struggle to resume social life, particularly for those who were more vulnerable to being socially isolated before lockdown.

“It’s key that children and young people are allowed to return to activities such as playing together, even if outdoors, as soon as possible, and that they are able to resume attending school, which gives them a structure for their day, and provides them with opportunities to see peers and to get support from adults outside of the nuclear family,” said Dr. Loades. Furthermore, she added “children need more in their strategy for easing lockdown. Alongside this, the government could target children’s wellbeing in public health messaging. And meanwhile, we should also continue to embrace technology as a way to keep in touch.”

So whilst we do what we can to mitigate the effects of loneliness and re-establish social connections, we also need to prepare for an increase in mental health problems, in part due to loneliness, and also due to the other unintended consequences of lockdown, such as a lack of structure, physical inactivity and social and/separation anxiety that might be triggered when resuming social interactions outside of the home.

There are several levels at which we can prepare for the heightened demand:

  • Take a universal approach to promoting wellbeing through public messaging, and by schools doing activities to promote wellbeing in children and young people as they resume normal activities.
  • Seek to identify those who are struggling with loneliness as early as possible and do so by targeted interventions to help them overcome their struggles. This may be through the provision of extra support in schools, helping them overcome anxieties about returning to school, or giving them an extra hand with reconnecting socially with peers.

For those who continue to struggle over time, and can’t get back to doing the things they normally do as a result of their struggles, we need to ensure that they are made aware that services are open, and can provide specialist help, and to make sure that they know how to access this help and are supported to do so.

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Health & Wellness

Lesbian, gay, bisexual communities more at-risk for dementia – study

Social inequality makes less privileged groups, including sexual minorities, more prone to develop cognitive impairment. So making the society more just and more accepting of diverse sexuality may help prevent dementia and reduce related health care burden on society.

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Lesbian, gay and bisexual — or LGB — people are more vulnerable to one of the fastest-growing health concerns in the country: dementia, according to research from Michigan State University.

“Our study speaks to the unaddressed questions about whether members the LGB community are more likely to develop cognitive impairment at older ages and, if so, what factors contribute to their poorer cognitive health, ” said Ning Hsieh, an assistant professor of sociology at MSU and lead author of the study published in the journal, The Gerontologist.

“We knew that stress and depression are risk factors for many chronic health problems, including cognitive impairment, in later life. LGB people experience more stressful events and have higher rates of depression compared to their heterosexual counterparts,” she said.

Analyzing the elevated cognitive health risks among older members of the LGB community, the study was the first to use a national sample and screening tool to gauge cognitive health disparities between LGB and heterosexual older adults.

Hsieh and MSU colleagues Hui Liu, professor of sociology, and Wen-Hua Lai, a Ph.D. student of sociology — compared cognitive skills of 3,500 LGB and heterosexual adults using a screening tool and questionnaire that tests for six domains. Those areas included temporal orientation; language; visuospatial skills; executive function; attention, concentration and working memory; and short-term memory.

Social inequality makes less privileged groups, including sexual minorities, more prone to develop cognitive impairment. So making the society more just and more accepting of diverse sexuality may help prevent dementia and reduce related health care burden on society.

The researchers found that on average, older LGB adults were more likely to fall into categories for mild cognitive impairment or early dementia compared to heterosexual older adults. The team also tested for specific health and social factors — such as physical conditions, mental health conditions, living a healthy lifestyle and social connections — and the only factor related to cognitive differences for sexual minorities was depression.

“Our findings suggest that depression may be one of the important underlying factors leading to cognitive disadvantages for LGB people,” Hsieh said. “They may experience higher rates of depression than their heterosexual peers for many reasons, including not being accepted by parts of society, feeling ashamed of their sexual orientation or trying to hide their romantic relationships and being treated unfairly in school or at work.”

The researchers felt surprised that other factors — such as fewer social connections, drinking or smoking — didn’t have as great of an effect on LGB people’s cognitive function later in life. But, they also recognized the need for additional research to understand how the stressors sexual minorities experience earlier in life can lead to cognitive impairments as they age. Additionally, Hsieh said, they hope that the study’s findings shed light on the need for greater inclusivity for sexual minorities, as it can have an influence on their mental and cognitive well-being.

“Social inequality makes less privileged groups, including sexual minorities, more prone to develop cognitive impairment,” Hsieh said. “Making the society more just and more accepting of diverse sexuality may help prevent dementia and reduce related health care burden on society.”

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Health & Wellness

Many transgender people who receive hormone therapy have unaddressed heart disease risks

The researchers found that more than half of the study participants (56.5%) had been previously diagnosed with a mental health disorder such as anxiety or depression, which is also associated with increased risk of heart disease.

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Many transgender people who receive gender-affirming hormone therapy already have unaddressed heart disease risk factors such as high blood pressure and high cholesterol, even during young adulthood, according to new research presented via the American Heart Association.

“Previous research has shown that transgender individuals are less likely to have access to health care or to utilize health care for a variety of reasons, including stigma and fear of mistreatment,” said Kara J. Denby, M.D., lead study author and a clinical fellow in cardiovascular medicine at the Cleveland Clinic Foundation in Cleveland, Ohio. “Since transgender individuals have frequent physician visits while taking hormone therapy, this seems an opportune time to screen for cardiovascular risk factors and treat previously undiagnosed cardiovascular disease that can lead to poor health outcomes in the future.”

The researchers examined risk factors and medical history for more than 400 adults (56% assigned male sex at birth, mostly in their 20s and 30s) when they first sought care at the multidisciplinary transgender program at the Cleveland Clinic Foundation.

The researchers found that more than half of the study participants (56.5%) had been previously diagnosed with a mental health disorder such as anxiety or depression, which is also associated with increased risk of heart disease.

For participants without current heart disease, two scoring systems were used to estimate their risk of developing heart disease. The researchers found: 6.8% had undiagnosed high blood pressure; and 11.3% had undiagnosed high cholesterol.

Of those already diagnosed with high blood pressure, more than one-third had not been receiving recommended treatment. And, of those already diagnosed with high cholesterol, more than three-quarters had not been receiving recommended treatment.

“When we calculated the risk for developing a heart attack or stroke over 10 years, the risk for transgender men and women was higher than that reported for the average (person) of their age and gender. We also found that, even in the highest risk individuals, many were not receiving recommended treatment,” said Denby.

In addition, the researchers found that more than half of the study participants (56.5%) had been previously diagnosed with a mental health disorder such as anxiety or depression, which is also associated with increased risk of heart disease.

“Transgender individuals face numerous barriers and biases to access the health care they need. We owe it to them to improve access and care so they can improve their CVD health and overall well-being. Policies and health care structures that are safe and supportive are critical for the transgender population to achieve health equity,” Denby said.

The study, however, is limited by being a retrospective review of medical records. The results cannot be used to prove a cause-and-effect relationship between being transgender and the presence of heart disease risk factors.

Co-authors include Meghana Patil, M.D.; Karlo Toljan, M.D.; Leslie Cho, M.D.; and Cecile A. Ferrando, M.D., M.P.H. Author disclosures are in the abstract. The researchers reported no external funding sources.

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Health & Wellness

Underinsured transgender people more likely to turn to riskier sources for hormones

About 9% of transgender people – in the US alone, translating to nearly 170,000 individuals – access hormones from non-licensed sources like friends or online.

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People who are transgender continue to face insurance barriers in accessing the health care services they need. And those who lack access to insurance coverage for gender-affirming hormone therapy are more likely to turn to sources other than a licensed health care provider, compared to those with insurance coverage.

This is according to a Michigan Medicine-led study, “Insurance Coverage and Use of Hormones Among Transgender Respondents to a National Survey”, which found that about 9% of transgender people – in the US alone, translating to nearly 170,000 individuals – access hormones from non-licensed sources like friends or online. The study was published in the Annals of Family Medicine.

“Transgender and nonbinary people face major barriers to insurance coverage for their needed care, with many people still lacking or being denied coverage for gender-affirming care,” says lead author Daphna Stroumsa, M.D., M.P.H., an obstetrician gynecologist at Michigan Medicine Von Voigtlander Women’s Hospital and researcher with the U-M Institute for Healthcare Policy and Innovation.

“Those barriers affect transgender people’s ability to receive the care they need. Those who can’t, may seek alternative ways to get their medications, which can increase their risks for negative health outcomes.”

Transgender people face a host of structural barriers combined with barriers to insurance coverage that limit access to gender-affirming hormones. These limitations may have broad implications for the health and safety of transgender people.

Not only may medications be unchecked for content, quality, formulation and dosing, but the use of non-prescription hormones likely means providers aren’t as involved in monitoring hormone levels and mitigating potential harm, Stroumsa says.

Researchers evaluated national data and found that 84% of the 27,715 respondents were interested in using hormones, while only 55 % were using hormones. Overall, 3,362 (15%) of respondents were uninsured, compared with about 13 % of all Americans at the time of the survey in 2015.

Among insured respondents, 21% reported that their claims for gender affirming hormones were denied.

Nonprescription hormone use was most common among respondents assigned male at birth, and differed by race.

Among all who had interest in taking hormones, those who were uninsured were less likely to use hormones in general compared with insured counterparts, which experts say could negatively impact mental and emotional health.

When respondents were asked to evaluate the most pressing issues affecting transgender people in the U.S., they listed insurance coverage as one of most important (among 44 % of respondents). It ranked second only to violence against people who are transgender.

Many major medical societies and associations, including the American Academy of Family Physicians, have issued statements in support of insurance coverage for gender-affirming care. Clear guidelines also support the provision of gender-affirming hormones for transgender people who seek them, which is associated with improved mental health outcomes.

But significant barriers to accessing these health services still exist, experts say.

For example, transgender people often face employment discrimination leading to un-insurance and those who are insured often encounter insurance policies with specific exclusions or barriers for coverage of gender-affirming therapy.

There are structural barriers too. These include high rates of homelessness secondary to stigma, rejection and discrimination, a lack of knowledgeable and supportive clinicians, and transphobia and direct discrimination in health care settings.

About 9% of transgender people – in the US alone, translating to nearly 170,000 individuals – access hormones from non-licensed sources like friends or online.

“Transgender people face a host of structural barriers combined with barriers to insurance coverage that limit access to gender-affirming hormones,” says senior author Caroline Richardson, M.D., family medicine physician at Michigan Medicine and IHPI researcher. “These limitations may have broad implications for the health and safety of transgender people.”

When people are unable to fill a prescription through a regulated process, Stroumsa notes, they are left with options that increase negative health risks.

“People who need hormones for gender affirmation may either turn to risker sources or forgo hormones altogether, which means losing the opportunity for affirmation and improvement in their mental health and well-being,” Stroumsa says. “Ensuring access to hormones can decrease the economic burden and greatly improve health and quality of life for people who are transgender.”

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Health & Wellness

Many college students aren’t tested for STIs despite high rates; self-tests offer promise

The study offers important takeaways not just regarding the use of self-testing services among asymptomatic students, but also for increasing STI testing in clinical settings more broadly. It suggests that college students may be more likely to pursue STI testing if their contact with clinical staff could be reduced.

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Sexually transmitted infections (STIs) are at record levels in various parts of the world, with the Centers for Disease Control and Prevention reporting recent “steep and sustained” increases in the US, for instance. STIs are particularly common among young adults (aged 18-24 years), yet most sexually active college students have never been tested. This presents an urgent challenge, as well as a unique opportunity, for universities to increase STI testing among their students.

New research led by George Mason University’s College of Health and Human Services found that the vast majority of sexually active students (88%) said they were “likely” or “extremely likely” to use STI self-testing services if they could take a test kit home and test themselves in the privacy of their own home/residence, while 59% said they would use STI self-testing services if they could test themselves in a private room at Student Health Services.

Dr. Lisa Lindley led the study published in the Journal of American College Health this week. This is the first study to explore college students’ comfort with and intention to use self-collection STI testing services on campus, and to identify students’ questions and concerns about the “self-testing” process before offering the service.

The researchers conducted an online survey of more than 400 students at a large mid-Atlantic university to assess their HIV/STI testing behaviors, comfort with self-collection procedures, and intention to use self-collection services for STI testing if offered on campus.

“We already know that in settings where self-collection options have been made available, there have been significant increases in testing and the detection of STIs,” explains Lindley. “This presents an opportunity to increase the detection of asymptomatic infections among sexually active students who traditionally don’t get tested, link these students to care, and prevent further transmission, as well as harmful health outcomes of untreated infections.”

Most sexually active college students have never been tested. This presents an urgent challenge, as well as a unique opportunity, for universities to increase STI testing among their students.

Students who were older (25+ years), lived off campus, and identified as “lesbian, gay, bisexual, or an identity other than heterosexual” were significantly more likely to have ever been tested for HIV and other STIs than students who were younger (18-24 years), lived on campus, and identified as heterosexual.

“We hope to be able to offer STI self-testing options on campus in the near future and encourage other universities to consider the same, as we found that most students, regardless of age, sexual experience, and previous testing experience, were interested in self-testing,” explains Lindley. “These findings are especially timely during the COVID-19 pandemic, as access to HIV/STI testing in traditional settings has become more challenging and the CDC is recommending at-home HIV tests.”

Collection of specimens for some of the most common STIs (chlamydia and gonorrhea) as well as those for HIV can easily be collected by most people. Tests for others–such as syphilis, genital herpes, and human papilloma virus (HPV)–will continue to be conducted by clinicians due to the procedures required for sample collection.

The study offers important takeaways not just regarding the use of self-testing services among asymptomatic students, but also for increasing STI testing in clinical settings more broadly. It suggests that college students may be more likely to pursue STI testing if their contact with clinical staff could be reduced.

Lindley recommends using online registration and sexual risk assessments, where appropriate, to collect necessary information and reduce interactions students find particularly embarrassing.

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Health & Wellness

Depression and anxiety more frequently diagnosed in women

Gender is a significant determining factor in mental health and in how it is managed by the healthcare services.

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Gender is a significant determining factor in mental health and in how it is managed by the healthcare services.

This is according to recent studies conducted by UPV/EHU’s research group OPIK, Social Determinants of Health and Demographic Change, a multidisciplinary group comprising research personnel in the field of social and health sciences.

The group used health questionnaires completed in the Basque Autonomous Community (2018) and in Spain (2017), and on the Spanish sample corresponding to the European Health Survey (2014).

What stood out in the analysis of these three databases is the higher prevalence of poor mental health among women of all ages and across all social groups. In addition, there is a multiplier effect due to the accumulation of experiences of inequality. This reality also appears to be unequal in terms of the age and socioeconomic level of the patients.

According to Dr. Amaia Bacigalupe, one of the authors of the study: “Women are more frequently diagnosed with depression and anxiety and the taking of prescribed psychotropic drugs is also significantly higher, even if there is no difference with men with respect to mental health equality, diagnoses and frequency of visits to healthcare centers. All this could point to the existence of a medicalization process of mental health in women, but interpreting its origin is complex since the processes involving the high prevalence of diagnosis and overprescription undoubtedly play a role, but maybe also due to infra-diagnosis and lower prescription rates in men.”

There is a multiplier effect due to the accumulation of experiences of inequality. This reality also appears to be unequal in terms of the age and socioeconomic level of the patients.

Bacigalupe added that these aspects should be tackled in greater depth in future studies.

The research group also highlighted that reducing gender inequalities in mental health will need to be the result of policy intervention on various levels.

In the field of mental health in which the medicalization of malaise is especially common, far from addressing the cause of the problem, some problems of a social origin end up receiving psychiatric or psychological treatment.

“There is a clear relationship between the degree of gender inequality in society and gender inequalities in mental health,” said Bacigalupe, “so all those policies designed to combat the discrimination endured by women on the labour market, in the responsibility for domestic and care work, in the use of time and, generally, relating to those that empower women on the basis of their greater political representation and making them more socially visible, will exert a positive effect on the reduction in mental inequalities between men and women.”

Another aspect highlighted in the study is the need to make commitments starting from an institutional level and geared towards curbing the medicalization of everyday malaise from a clear gender perspective.

“In the field of mental health in which the medicalization of malaise is especially common, far from addressing the cause of the problem, some problems of a social origin end up receiving psychiatric or psychological treatment,” said the researcher in the Department of Sociology 2 at the UPV/EHU.

For this study, it would also be necessary to encourage spaces for reflection in the clinical setting designed to help to collectively deconstruct certain aspects that have become natural in gender binarism and which have underpinned the definitions of psychopathology and its current treatment.

Bacigalupe also stated that “the actual incorporation into clinical practice of the biopsychosocial model, as well as the implementing of strategies to promote health and emotional well-being from a community health approach based on assets, could prevent the over-pathologization and over-medicalization of everyday malaise once a global view of how the social context influences health is acquired.”

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