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There are two sides to every story

In the Philippines, one in five people suffers from mental health problems. Between 17% and 20% of Filipino adults experience psychiatric disorders, while 10% to 15% of Filipino children suffer from mental health problems. But addressing mental health is not yet among the priorities in the country.

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It all happened one busy Monday, in between unfinished deadlines and piling up of workload. The conversation suddenly ended, and it left him dumfounded. He kept looking for answers why it happened. He questioned himself; reviewed all his replies. Everything seemed okay.

His name is Andy. He considers himself as an introvert. There may be times when he can be talkative, but “that is different; I am not face-to-face with the person.”

Sometimes, people call him a “player,” claiming that he just wants to hook them into his “game”.

What not everyone knows is that whenever he starts to be close to someone, he (un)consciously builds walls around him, preventing anyone to get through particularly when he feels there is an attempt to make a deeper connection.

Andy said his intentions are always good. But most of the time, “I am read wrong and taken negatively.”

And every time that kind of thing happens, it just contributes to the sound he has been hearing in his head.

Running away

Sometimes it takes on the form of fear… fear of the current situation or the unknown. There are times when it invades his dreams, waking him up in the middle of the night with either a bad headache or heavy breathing. It is usually mistaken as stress.

A glass of warm milk or chilled rosé, a dosage of paracetamol or Valium, counting backwards from 100 while listening to calming music – any of these usually help, but only temporary.

“I found out a few years back that I am dealing with emotional and psychological trauma. I never knew I had one,” Andy said.

A type of mental health condition, trauma is a response to a stressful event. This is usually triggered by a terrifying situation, either experiencing or witnessing it firsthand.

Edgewood Health Network Canada listed down some of the most common symptoms of psychological trauma, i.e.:

  1. Disruptive recollections of the trauma, including flashbacks
  2. Emotional and physical reactions in response to reminders
  3. Negative beliefs about oneself or others
  4. Inability to feel close to others
  5. Being easily startled
  6. Dissociation
  7. Emotional numbness
  8. Inability to remember aspects of, or all of the traumatic event
  9. Avoidance of anything that reminds one of the trauma
  10. Hypervigilance (Always being alert, scanning and assessing for threat)
  11. Difficulty concentrating and focusing on reality
  12. Inability to fall asleep or to remain asleep, frequent and frightening nightmares

“When I am interested with someone, to either date that person or befriend him, after a few days, all of a sudden I will shut down,” Andy said. “There are even times when I would literally run away towards the other direction.”

Studies show that trauma also causes anxiety. When there are frequent occurrence of situations related to what caused the trauma or constant exposure to trigger points – confusion and overwhelming emotional and psychological pain will set in – and these translate into anxiety.

In the Philippines, one in five people suffers from mental health problems. Between 17% and 20% of Filipino adults experience psychiatric disorders, while 10% to 15% of Filipino children suffer from mental health problems.

Dealing with trauma

“Sometimes it is better to be alone because you do not need to explain yourself or adjust to them,” Andy said.

According to the National Institute of Mental Health, there are three common ways to cope with trauma:

  1. Avoiding alcohol and other drugs
  2. Spending time with loved ones and trusted friends who are supportive
  3. Trying to maintain normal routines for meals, exercise and sleep

How long will it last? Unfortunately, there is no way to find out since it is not possible to expedite the healing process of trauma. But the intensity of emotional and psychological pain reduces with time.

“I create distractions whenever I feel I am placed inside a box,” Andy said. “Just recently, when I did something like that, the person suddenly disappeared. I was left hanging, I felt like I was all alone.”

Distractions are created by anyone to give themselves breathing space, a moment to take a step back and look at the big picture.

Knowing the other side of the story

Before dismissing someone who seems “different” in terms of how he/she deals with situations, it is better to look a little longer first.

Here are few ways you can help someone who has experienced trauma, as listed by HuffPost:

  1. Realize that trauma can resurface again and again
  2. Know that little gestures go a long way
  3. Reach out on social media
  4. Ask before you hug someone
  5. Do not blame the victim
  6. Help them relax
  7. Suggest a support group
  8. Give them space
  9. Educate yourself
  10. Do not force them to talk about it
  11. Be patient
  12. Accompany them to the scene of the “crime”
  13. Watch out for warning signs

Keep in mind that it is not your experience/story that you can freely make judgements on, else “attack” it after feeling sour.

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“Some five years ago everything fell apart with my life, in my career and health, my partner at that time chose to fool around and left me alone. It was shit. My friends told me that I was broken for four years,” Andy recalled.

That moment did not leave his mind until now. And it affected his trust issues with anything and everything.

A 2016 report by MIMS Today noted that in the Philippines, one in five people suffers from mental health problems. Between 17% and 20% of Filipino adults experience psychiatric disorders, while 10% to 15% of Filipino children suffer from mental health problems.

Unfortunately, it seems like addressing mental health is not yet among the priorities in the Philippines.

Living life a day at a time – and writing about it, is what Patrick King believes in. A media man, he does not only write (for print) and produce (for a credible show of a local giant network), but – on occasion – goes behind the camera for pride-worthy shots (hey, he helped make Bahaghari Center’s "I dare to care about equality" campaign happen!). He is the senior associate editor of OutrageMag, with his column, "Suspension of Disbelief", covering anything and everything. Whoever said business and pleasure couldn’t mix (that is, partying and working) has yet to meet Patrick King, that’s for sure! Patrick.King.Pascual@outragemag.com

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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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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Health & Wellness

LGB adults less likely to take cholesterol-lowering meds

Lesbian, gay and bisexual (LGB) adults who could benefit from cholesterol-lowering medicine to prevent heart disease are less likely than non-LGB adults to take them.

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Lesbian, gay and bisexual (LGB) adults who could benefit from cholesterol-lowering medicine to prevent heart disease are less likely than non-LGB adults to take them.

This is according to new research – “Statin Use for Atherosclerotic Cardiovascular Disease Prevention Among Sexual Minority Adults” – written by Yi Guo, Christopher W. Wheldon, Hui Shao, Carl J. Pepine, Eileen M. Handberg, Elizabeth A. Shenkman, and Jiang Bian, and which appeared in the Journal of the American Heart Association.

As it is, sexual minorities – including LGB individuals – are at increased risk for cardiovascular disease. This can be attributed to elevated rates of health risk factors, including smoking and having obesity.

For this study, the researchers conducted a cross‐sectional online survey about statin use in adults ≥40 years of age between September and December 2019 using Facebook advertising. In total, 1,531 people responded to targeted Facebook ads.

The researchers calculated the prevalence of statin use by age, sexual orientation, and statin benefit populations. They used multivariable logistic regression to examine whether statin use differed by sexual orientation, adjusting for covariates.

Analysis showed that less than 21% of LGB adults were taking statins, compared to 44% of their non-LGB peers.

“We observed a significantly lower rate of statin use in the LGB versus non‐LGB respondents (20.8% versus 43.8%; P<0.001) in the primary prevention population,” the researchers reported.

In a news release, study author Yi Guo – an assistant professor of health outcomes and biomedical informatics at the University of Florida College of Medicine in Gainesville – said that “there could be many reasons for the difference we observed… LGB individuals may not go to the doctor as often, which leads to lower chances of being recommended statins for cardiovascular disease prevention.”

But looking at the use of statins among people who already had cardiovascular disease, there was no disparity between LGB and non-LGB adults.

For Guo, members of the LGB population may be less aware of the protective effect of statins.

For the researchers, the “results emphasize the urgent need for tailored, evidence‐based cardiovascular disease prevention programs that aim to promote statin use, and thus healthy aging, in the LGB population.”

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