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Taiwan shows LGBTQ-friendliness doesn’t mean equality for all

In Taiwan, public attitude towards LGBTQ citizens are non-violent, at best. The rate of hate crimes is relatively low compared to other countries. Be that as it may, there are still a lot of tweaking to do when it comes to having a truly respectful and empowering environment for LGBTQ citizens.

Photo courtesy of Ketty W. Chen

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Taiwanese society, in general, is pretty accepting of diversity. The country is known to have the largest Pride Parade in Asia and leads in LGBTQ rights in the region.  Some queer-centric hang-out spots can be seen around its capital, Taipei – from gay-friendly clubs and cafes, a weekly social activity for LGBTQ folks to the existence of a welcoming Christian church and, presently, being home to the only Taoist temple in the world that hears the prayers of LGBTQ individuals seeking romantic love.

Public attitude towards LGBTQ citizens are non-violent, at best. The rate of hate crimes is relatively low compared to other countries. Be that as it may, there are still a lot of tweaking to do when it comes to having a truly respectful and empowering environment for LGBTQ citizens.

Working on SOGIE (mis)education

At face value, the Taiwanese government endorses LGBTQ rights through its public announcements, bills and policies. But actual implementation is another story. In the same way that the Ministry of Interior fails for years to deliver on its promise to do away with discriminatory requirements on legal gender change, the Ministry of Education (MOE) also disappoints with its crude implementation of the Gender Equity Education Act, which supposedly should promote comprehensive SOGIE awareness and education in schools.

Wayne Lin, consultant for Taiwan Tongzhi (LGBT) Hotline Association, shared that, In year 2004, Taiwan passed a very advanced, pioneering Gender Equity Education Act. So conceptually, schools need to teach [gender equity education] 4 hours every semester, supposedly. But what’s ‘gender equity education’? That has been the battlefield for the past years… When the government or some professional teachers try to draft a guideline for the teachers… the opposition tries to manipulate fear with misleading information [about gender equity education], and the government doesn’t really take a strong and clear stance [on this policy]… But some teachers still want to do that [impart SOGIE education] so the hotline is [sometimes] invited to schools to talk about gender equity education.”

Wayne added, “I think the MOE doesn’t want to take any political risk… It’s always asking the two sides to fight each other, and the government doesn’t make any decision.”

Anti-LGBTQ groups continue to figure out ways to get into the school system in order to influence policies. For example, they run for the head positions in the parent groups/associations in schools while hiding their identity as anti-LGBTQ. There are organizations dubbed as “parent groups” but are actually an offshoot of conservative religious groups opposing LGBTQ equality. Moreover, anti-LGBTQ groups spread misinformation that schools are teaching students how to have sex and converting them into homosexuality. They would stop at nothing to get Gender Equity Education off of schools’ curricula.

“Several years ago, one Christian legislator asked MOE to let anti-LGBTQ people to get into the Gender Equity Education Committee. They said that anti-LGBTQ opinion is also part of the diversified opinion; therefore, they can get into the committee… So now the Gender Equity Education Committee has a few seats for anti-LGBTQ members, which is very ironic,” Wayne lamented.

Presbyterian Church in Taipei offering its support for LGBTQ+ rights
Photo courtesy of Ketty W. Chen

Establishing an LGBTQ-inclusive environment isn’t only needed in educational institutions. Aside from empowering queer youth, Taiwan Tongzhi Hotline Association works on providing support to the elderly demographic as well. Wayne shared, “The other thing we also pay quite a lot of attention to is the Long-Term Care Policy Taiwan is forming at this moment… For example, in Taiwan, some long-term care institutions actually are religious, like Muslim or Christian, so we already know some people are so afraid of going into that institution because they don’t know how they will be treated.”

The indifference towards LGBTQ issues, which is also why their rights are not taken seriously enough to be prioritized, can also be felt in the workplace. For example, even though there are work regulations against discrimination, in reality, a lot of queer employees are still not that comfortable to be open about their sexual orientation or gender identity for fear of it affecting their career development. Sexual harassment or discrimination cases are also not properly addressed. Basically, as Wayne put it, “You probably would not hear really harsh discrimination, but typically you are ignored. LGBTQ’s are kind of invisible.”

Much ado about marriage equality

Currently, Taiwan lets LGBTQ couples have civil unions, but which is evidenced only by a piece of paper that brings zero spousal protection or benefits. They are not granted medical visitation rights, joint property rights, parental rights, adoption rights or any of the hundred or so rights given to married couples under the law. Surprisingly, even their national ID cards would still state their status as being “single”, not married. However, according to Reese Li, Secretary of Taiwan LGBT Family Rights Advocacy, although such civil unions are only done symbolically without any substantial partnership rights, one goal of this is to let government realize that there is actually a mass of LGBTQ couples who yearn for the right to marry. Hence, they must be given this basic civil right as citizens of the country.

In the past year, Taiwan’s Constitutional Court has declared that banning same-sex marriage is unconstitutional. It was ruled that marriage equality would be implemented after 2 years from May 2017. The options involve amending the Civil Code or, the less appealing route, by crafting a separate law for same-sex marriage. Despite the past media hype, Taiwan’s road to marriage equality is still actually stagnating in legislation. Without a clearly defined law protecting LGBTQ couples’ right to marry, as well as guaranteeing all their rights and benefits in marriage, the future for same-sex matrimony remains vague.

Taiwan’s prominent gay civil rights activist, Chi Chia Wei (祁家威), waves a rainbow flag atop a building.
Photo courtesy of Ketty W. Chen

While the government is being lax on this issue, anti-LGBTQ groups are continuously devising ways to block the progress of marriage equality. Early this year, opposing groups have passed a referendum proposal diluting multifaceted LGBTQ issues into 3 questions: (1) Should homosexuality be taught to primary and high school students? (2) Should marriage be defined as solely between a man and a woman? (3) Should same-sex couples have a different kind of union from marriage?

“Same-sex marriage must be implemented since the Constitutional Court already proclaimed it. It should not be overruled by the referendum. But the main question is ‘How?’… The aim of the anti-gay groups is for legislation to make a ‘special’ law for same-sex marriage, instead of amending the Civil Code [for marriage] because they believe that the Civil Code is theirs”, said Reese Li. “Special laws are written for disadvantaged people in society- for example, indigenous people or children. The purpose is to provide special protection… But the purpose behind anti-gay groups wanting a special law [for same-sex marriage] is from blatant discrimination, not to protect a minority group.”

Anti-LGBTQ protestors in Taiwan join hands as they stand menacingly.
Photo courtesy of Ketty W. Chen

In response to this, a pro-LGBTQ referendum was initiated by Social Democratic Party member Miao Po Ya. They are fighting against well-funded, threatening attempts to trash both the Gender Equity Education Act and marriage equality ruling. Reese shared that the coalition of opposing groups are quite strong since, aside from getting financial and mobilization support from local political and religious organizations, they are also backed by conservative groups in the US and Hong Kong.

At the end of August, the opposing groups’ referendum proposals have been submitted to election authorities. The last stage would involve placing the referendum on ballot in the coming local elections in November 2018. If anti-LGBTQ sentiments were to succeed, government might take this as a sign that Taiwanese society is not yet ready for the progress of LGBTQ rights; and thus, such atmosphere of discrimination could lead to the continuation of curtailing their civil rights.

The sign reads, “In Canada, we are a married couple. Under Taiwanese law, we are mere strangers.”
Photo courtesy of Andrea Toerien

Indeed, same-sex marriage stirs a lot of discussions not just in Taiwan but also in different parts of the world, which can be a good thing for advocating less discrimination for a minority group. However, it’s also getting slammed as a bourgeoisie movement that has strayed away from its roots, furthers inequality and ignores the struggles in structural intersectionality (the same goes for exorbitant celebrations of Pride parades) especially when, at times, it takes a huge slice of attention and funding at the expense of other important socio-politico-economic struggles experienced by LGBTQ’s (e.g. poverty, disability issues, homelessness, HIV-related issues). All this mainstream focus on marriage rights as the helm of LGBTQ advocacy can be rather dismissive and shortsighted.

In a nutshell, critics assert that since the flawed neoliberal institution of marriage tends to emphasize the gap between the privileged and less privileged, between those with a family and those without a family, not to mention its historical subjugation of women, “marriage equality” then comes off as a misnomer that is not really pushing for equality in its truest sense.

Reese Li gave her two-cents on this particular critique.  “I think we have to look at the situation of each country. First, do the poor in Taiwan not think about marriage? Actually they still look for marriage, and this might be passed down from the conservative thinking in the past of need to marry to have children for manpower. I think many Asian country are like this… advancing marriage equality is not to oppress people or pressure gay people to marry. It only offer an option, a choice…When our organization supported marriage equality, it’s not because a lot of us want to have a wedding, but because a lot of same-sex couples already have kids…. A lot of protection, benefits, rights in society can be obtained through being registered as family. When it comes to single parent, there are less resources provided… Right now, we can only at least make baby steps to deal with the current situation. Personally, I, myself, don’t have any desire for marriage. But marriage can change our legal status and this can guarantee relevant rights and provide more resources. This is our reality now. We can’t just make a gigantic jump and demand government to provide subsidy on an individual citizen basis. That is impossible at this time.”

Wayne Lin is of the same tune with Reese. “Actually even within Hotline we have this kind of debate as well before we decide to work with other groups and the legislators to propose our bill. Yes, we all know that marriage cannot solve all the issues for LGBTQ. Of course, it’s better for everyone to enjoy the rights without getting married under certain circumstances… In the short-term, there’s no way for us to break the current marriage system in Taiwan… So for me it’s [marriage equality advocacy] more practical, just step-by-step… As long as this policy-making can benefit someone in our community, we should do that.”

According to Wayne, marriage equality can be a good talking point for society to start thinking about LGBTQ rights, as well as the concept of marriage and family. “I think majority of society probably doesn’t know LGBTQ that much, especially for the elder group. But this is an opportunity, you can talk to them, you can come out and showcase some story, so that they can better understand… I still believe the movement is really about how you make others understand our situation, and marriage equality is one easy way to open a dialogue. [If] They understand what’s the meaning, benefit or drawback of marriage,…as a beginning, then get a feeling of LGBTQ issues… it’s a methodology or way of doing public education… not everyone can still get married even if [same-sex marriage is] legalized due to economic status or not coming-out to family. So there are still so much work to be done.”

Anti-LGBTQ groups protest against amending Civil Code 972 on marriage.
Photo courtesy of Ketty W. Chen

What makes a family

Another human rights organization known as Taiwan Alliance to Promote Civil Partnership Rights (TAPCPR) is working on advocating a multi-family system that aims to provide, not only a legal option for marriage for the LGBTQ community, but also the proper rights and protections for different family structures in Taiwan.

TAPCPR has 3 different proposals which include marriage equality. The second proposal pertains to a partnership system whereby two individuals can enter into a civil contract that customizes the obligations and rights that they would mutually agree on, such as those relating to inheritance, property and so forth. The third one proposes a multi-member family system that allows individuals to have a contractual option to live and be registered as a family with friends.

However, opposing groups argue that the multi-family system proposal would be dangerous to society as it would destroy traditional relationships and families. It is too radical of an idea to be discussed as of now.

Photo courtesy of Ketty W. Chen

Just with same-sex marriage alone, the voice of opposition can be virulent. While marriage equality advocates are merely fighting for LGBTQ’s right to enter into a monogamous married life and to build a family, anti-LGBTQ groups stretch the imagination beyond ridiculousness. Now, rather than posturing as messengers of God and using battlecries based on subjective interpretations of Bible verses, opposing groups – in an attempt to extend their influence – have rebranded themselves to be ordinary parents or citizens concerned about the future of families in Taiwan.

Aside from the usual conservative religious rhetoric, opponents are also operating out of misguided fear that marriage equality’s agenda is to erode monogamous relationships and family values, as well as to cause people into marrying animals or inanimate objects. They also posit that marriage equality would only worsen the country’s declining birth rate. Another extremist view is that same-sex marriage will lead to the eventual extinction of the human race. Unfortunately, the power of fear-mongering and misinformation over human emotions can never be underestimated.

Such antagonistic perspectives against same-sex marriage cannot be further from the truth. On the contrary, Reese explained that one crucial aspect of the legalization of same-sex marriage is for the protection of children under the care of same-sex parents.

“In legal papers, a kid raised by same-sex couples is indicated as being raised by a single parent only even though the kid is raised by a couple. This can lead to a lot of issues and insecurity when it comes to raising the child as a couple because the other ‘parent’ is considered a stranger under the eyes of law… Even with artificial reproduction done in other countries, when the gay couple comes back to Taiwan, they are not recognized as both parents.”, said Reese.

There are already a huge number of same-sex couples in Taiwan who encounter several issues when it comes to raising their child. A task as simple as taking their children to the doctor or fetching them from school already proves to be such a hassle if the not-legally-recognized parent is the one doing the job. How much more when heavier parental responsibilities must be done for the children’s well-being?

Reese continued on to explain, “Worse comes to worst, if the legally recognized parent dies, the surviving partner can’t continue to take care of the kid. The kid will be separated from the surviving parent because s/he is not recognized by law as parent. By law, the child has to go with blood-related relatives of the deceased parent. But we have to consider that not everyone can still be in good terms with relatives… It will be a bigger problem for the child.”

Photo courtesy of Ketty W. Chen

LGBTQ rights are universal rights 

While Taiwan is an LGBTQ-friendly destination, there are still undoubtedly a lot of obstacles to hurdle through and conflicts to sort out on the ground. Neighboring and distant countries need to keep a close watch and offer an intimate support to the Taiwanese LGBTQ+ community’s clamor for widespread equality – not just for the sake of marrying the person they love, but also to advance SOGIE awareness and education, to foster legal protection for diverse families that exist beyond the outdated concept of a traditional family, as well as to address the myriad of less talked about yet similarly important issues that affect LGBTQ+ folks. After all, their fight is also the fight of every LGBTQ+ and human rights movement around the globe. Even as a small Asian island, its wins could still pack a punch and contribute to putting an end to discrimination and hate crimes against people of different SOGIE.

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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.

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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.

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Love Affairs

Dating apps don’t destroy love

Contrary to earlier concerns, a UNIGE study has shown that people who met their partners on dating applications have often stronger long-term relationship goals, and that these new ways of meeting people encourage socio-educational and geographical mixing.

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As dating apps escalated in popularity, so has criticism about them encouraging casual dating only, threatening the existence of long-term commitment, and possibly damaging the quality of intimacy. There is no scientific evidence, however, to validate these claims.

Now a study by the University of Geneva (UNIGE), Switzerland – and which was published in the journal PLOS ONE – indicate that app-formed couples have stronger cohabitation intentions than couples who meet in a non-digital environment.

What is more, women who found their partner through a dating app have stronger desires and intentions to have children than those who found their partner offline. Despite fears concerning a deterioration in the quality of relationships, partners who met on dating apps express the same level of satisfaction about their relationship as others.

Last but not least, the study shows that these apps play an important role in modifying the composition of couples by allowing for more educationally diverse and geographically distant couples.

“The Internet is profoundly transforming the dynamics of how people meet,” confirms Gina Potarca, a researcher at the Institute of Demography and Socioeconomics in UNIGE’s Faculty of Social Sciences. “It provides an unprecedented abundance of meeting opportunities, and involves minimal effort and no third-party intervention.”

These new dating technologies include the smartphone apps like Tinder or Grindr, where users select partners by browsing and swiping on pictures. These apps, however, have raised fears: “Large parts of the media claim they have a negative impact on the quality of relationships since they render people incapable of investing in an exclusive or long-term relationship. Up to now, though, there has been no evidence to prove this is the case,” continues Dr. Potarca.

Facilitated encounters

The Geneva-based researcher decided to investigate couples’ intentions to start a family, their relationship satisfaction and individual well-being, as well as to assess couple composition. Dr. Potarca used a 2018 family survey by the Swiss Federal Statistical Office. The analysis presented in this study looks at a sub-sample of 3,235 people over the age of 18 who were in a relationship and who had met their partner in the last decade.

Dr. Potarca found that dating websites – the digital tools for meeting partners that preceded apps – mainly attracted people over the age of 40 and / or divorcees who are looking for romance.

“By eliminating lengthy questionnaires, self-descriptions, and personality tests that users of dating websites typically need to fill in to create a profile, dating apps are much easier to use. This normalized the act of dating online, and opened up use among younger categories of the population.”

Searching for a lasting relationship

Dr. Potarca sought to find out whether couples who met on dating apps had different intentions to form a family. The results show that couples that formed after meeting on an app were more motivated by the idea of cohabiting than others.

“The study doesn’t say whether their final intention was to live together for the long- or short-term, but given that there’s no difference in the intention to marry, and that marriage is still a central institution in Switzerland, some of these couples likely see cohabitation as a trial period prior to marriage. It’s a pragmatic approach in a country where the divorce rate is consistently around 40%.”

In addition, women in couples that formed through dating apps mentioned wanting and planning to have a child in the near future, more so than with any other way of meeting.

But what do couples who met in this way think about the quality of their relationship? The study shows that, regardless of meeting context, couples are equally satisfied with their lives and the quality of their relationship.

Couples with a diverse socio-educational profile

The study highlights a final aspect. Dating apps encourage a mixing of different levels of education, especially between high-educated women and lower educated men. Partners having more diversified socio-educational profiles “may have to do with selection methods that focus mainly on the visual,” says the researcher. Since users can easily connect with partners in their immediate region (but also in other spaces as they move around), the apps make it easier to meet people more than 30 minutes away – leading to an increase in long-distance relationships.

“Knowing that dating apps have likely become even more popular during this year’s periods of lockdown and social distancing, it is reassuring to dismiss alarming concerns about the long-term effects of using these tools,” concludes Dr. Potarca.

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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.

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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).

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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.

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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.”

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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.”

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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.”

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Health & Wellness

Sexual dysfunction hits some women harder than others as they age

Factors other than use of hormone therapy, such as higher importance of sex, positive attitudes toward sex, satisfaction with one’s partner, and fewer genitourinary symptoms associated with menopause appear to be protective and are linked to better sexual function across the menopause transition.

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Sexual dysfunction often accompanies the menopause transition. Yet, not all women experience it the same. A study identified the determinants that affect a woman’s risk of sexual dysfunction and sought to determine the effectiveness of hormone therapy in decreasing that risk and modifying sexual behavior.

The study – “Sexual behaviors and function during menopausal transition–does menopausal hormone therapy play a role?” – was published in Menopause, the journal of The North American Menopause Society (NAMS).

Although hot flashes easily rank as the most common symptom of menopause, the transition is often accompanied by other issues, including changes that affect a woman’s libido, sexual satisfaction, and overall sexual behavior. Because hormone therapy is the most-effective treatment option to help women manage menopause symptoms, it was the focus of a new study designed to determine why some women experience greater sexual dysfunction than others.

The study involving more than 200 women aged 45 to 55 years found that women with secondary and higher education and a greater number of lifetime sexual partners were less likely to experience sexual dysfunction. In contrast, women with more anxious behaviors during sexual activity and those with more severe menopause symptoms were more at risk for sexual dysfunction.

Hormone therapy was not found to mitigate the risk for sexual dysfunction, nor did it play a major role in determining sexual behaviors. However, women using hormone therapy typically had higher body esteem during sexual activities; better sexual function in all domains, except for desire/interest; better quality of relationships; and fewer sexual complaints (other than arousal problems) than those women who do not. Of importance to helping maintain a woman’s sexual function were positive sexual experiences, attitudes about sex, body image, and relationship intimacy.

“These results are consistent with the findings of prior studies and emphasize that factors other than use of hormone therapy, such as higher importance of sex, positive attitudes toward sex, satisfaction with one’s partner, and fewer genitourinary symptoms associated with menopause appear to be protective and are linked to better sexual function across the menopause transition,” says Dr. Stephanie Faubion, NAMS medical director.

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