Satisfaction with a gender realignment service

Many components make up a successful comprehensive gender realignment service. These components vary throughout the different UK-based services. We argue that it is essential to incorporate the views of patients using such services to ensure that these meet expectations and needs as well as eliminate post-operative regret where possible. Early age for surgery in accurately diagnosed patients with meaningful support, equality in access to services and reducing post-operative complications were all considered to be important factors by our patients. Incorporating these factors should contribute to improved services for this specialist group of patients.     

Pupil-size asymmetry is a physiologic trait related to gender,attentional function,and personality

A small difference in the size of the two pupils is common in healthy individuals, a condition termed benign or physiologic anisocoria (BA). Past research indicates that BA is probably caused by asymmetry in sympathetic nervous system (SNS) function [e.g., Rosenberg (2008). Physiologic anisocoria: A manifestation of a physiologic sympathetic asymmetry. Neuro-Ophthalmology, 32, 147–149]. This study is the first to show that BA varies with psychological factors linked to brain asymmetry and autonomic arousal, including gender, attention, and personality. Males exhibited a more directional BA than females, consistent with greater hemispheric lateralization in males. BA also varied with a self-report measure of attentional function, consistent with evidence of hemispheric asymmetry in visuospatial attention networks. Finally, BA varied with personality traits linked to autonomic arousal. Individuals exhibiting higher Meanness and Boldness, and lower Empathy scores tended to show more directional BA. This link between personality traits and BA may be related to brain asymmetries in autonomic arousal and emotion-related processing. If future studies employing direct measures of lateralized brain activity confirm the link between BA and SNS asymmetries, this new metric may prove useful in discovering new relationships between brain organization and psychological function, and how these relationships vary across individuals.     

Effects of sex and gender in ten types of psychotherapy

Objective: This paper addresses the results of two samples of a large naturalistic (effectiveness study) outpatient process-outcome study in Switzerland (Practice-Oriented Outpatient Psychotherapy Study). Ten different types of psychotherapy were investigated by looking at the role of the sex or gender of therapists and patients with regard to treatment outcome by including several nonspecific therapeutic factors. Method: Ten different types of psychotherapy, 237 patients, and 68 therapists were included in the study. A subsample of 116 cases was analyzed with regard to therapists' technical interventions. Results: Sex and gender issues of both therapists and patients did not play a crucial role in any type of psychotherapy investigated. Gender issues appeared to play an indirect role. Female therapists intervene more empathically, whereas male therapists tend to use more confrontational techniques. Conclusions: Since the results show that therapists differ substantially with regard to their intervention techniques due to their sex, they should become more conscious of their interventions by considering patients' severity of psychological problems and patients' level of psychological functioning so as to not over or underchallenge them.     

Birth order in girls with gender identity disorder

This study examined the birth order of girls with gender identity disorder (N=22). Each proband was matched to 3–7 clinical control girls for age at assessment and number of siblings (the mode number of controls per proband was 7) (total N=147). The number of older brothers, older sisters, younger brothers, and younger sisters was recorded. Slater’s birth order index showed that the probands were significantly more likely to be early born than were the controls. A modified Slater’s index also compared the birth order of the probands and the controls only to their brothers (when they had one or more) and only to their sisters (when they had one or more). Compared to the controls, the probands were born early compared to their sisters, but not to their brothers. These findings are the inverse of two previous studies of boys with gender identity disorder, who were later born relative to clinical control boys (11), an effect that appeared to be accounted for primarily by being born later relative to older brothers, but not to older sisters (46). Received: 14 October 1996 Accepted: 29 April 1997     

Long-term clinical outcome of schizophrenia with special reference to gender differences

A sample of 94 first-admitted schizophrenics and 47 patients with schizophreniform disorder (DSM-III) was personally re-examined after a mean of 10 years (by Retterstöl), and 110 of the patients after a mean of 31 years (by the author). Nearly half of the patients were admitted in 1946-1948 (long-term) and the remaining in 1958-1961 (short-term). Average outcome was significantly more favourable for short-term than for long-term patients. Single marital status and no, minimal or mild psychosocial stressor at onset (Axis IV) predicted poor long-term outcome. At 10-year follow-up there was no difference between men and women in clinical outcome. No substantial change was revealed in men at last follow-up, whereas on average women had clearly deteriorated.     

Sural nerve conduction parameters in normal subjects related to age, gender, temperature, and height: a reappraisal.

Failure to take body height into considerations in the evaluation of nerve conduction velocities (CV) has recently been deemed unacceptable. This statement prompted the present study. Besides height, the influence of age, gender, and temperature was studied in 92 normal subjects, half of whom were females. The CV decreased 0.9 m/s per 10 years increase in age, the same in women and men aged 15 to 44 years. Mean temperature between distal and proximal ends of the nerve segment examined increased 6.1 +/- 0.3 degree C after heating followed by a CV increase of 7.0 +/- 0.5 m/s. The CV decreased 0.15 m/s per 100-mm increase in heights. When considering 37 individuals aged 25 to 34 years only, the CV increased 0.34 m/s per 1-m increase in height. In both instances, the changes were within the experimental error (2.3%) of the method.     

Influence of age and gender on the occurrence and presentation of reflex syncope

BACKGROUND: The clinical history is the cornerstone of diagnosing patients with transient loss of consciousness (TLOC). Reflex syncope is the most common cause of TLOC in patients across all ages. Knowledge of the variation in incidence and clinical features of reflex syncope by age and gender provides important background information to acquire an accurate diagnosis. METHODS: In a cohort of 503 patients presenting with TLOC we established a final diagnosis after systematic evaluation and two years of follow-up. The occurrence of prodromal signs, symptoms, and triggers in patients with reflex syncope was analyzed by both age (< 40 yrs, 40-59 yrs and > or = 60 years) and gender. RESULTS: Reflex syncope was the most frequently obtained diagnosis (60.2%) in patients of all ages presenting with TLOC. Its occurrence was higher in patients under 40 years (73.4%), than above 60 years of age (45.3%). Pallor (79.9%), dizziness (73.4%), and diaphoresis (63.0%) were the most frequently reported prodromal signs and symptoms. Most triggers and prodromal signs and symptoms were more common in patients under 40 years of age and in women. CONCLUSIONS: Reflex syncope is nearly twice as common in patients under 40 years of age than in patients aged 60 years or above. Typical signs and symptoms of reflex syncope are more common in younger patients and in women. Therefore, age and gender provide important diagnostic information and can help to decide whether additional testing is necessary.     

Gender monitoring and gender reassignment of children and adolescents with a somatic disorder of sex development

Individuals born with a somatic disorder of sex development (DSD) have high rates of gender-atypical behavior, gender uncertainty, gender dysphoria, and patient-initiated gender change in childhood, adolescence,and adulthood. This article addresses the issues a mental health services provider has to consider in evaluating and assisting such patients and provides examples of assessment-method batteries. To date, the World Professional Association for Transgender Health's Standards of Care, 6th version, for non-DSD patients with gender dysphoria, may be cautiously used for guidance, taking into account the considerable differences in presentation and medical context between gender dysphoric patients with and without a DSD.     

Therapist gender and psychoanalytic couple psychotherapy

Sexuality is an integral part of human experience and pregnancy is a time for adjustment. Every couple will have a special need for information, guidance and education about risks to the foetus from coitus during pregnancy. Personnel attending to their antenatal care must be able to address these problems and give clear advice as to what is safe for the mother and baby.     

Thoughts on the nature of identity: disorders of sex development and gender identity

Children with disorders of sex development have similarities to, but also marked contrasts with, children with normal anatomy but who have gender dysphoria. Understanding gender identity development in children with sex disorders will probably help us understand typical gender identity development more than in understanding gender development in children with gender identity disorder.     

情感障碍患者服药依从性及相关因素分析

目的探讨情感障碍服药依从性的现状及影响因素。方法采用依从性调查问卷分别对患者、家属和医生进行调查。结果患者、家属和医生认为患者能按医嘱服药的比例分别是53．5％、44．2％、61．59／5。患者能否按医嘱服药与患者对药物的态度、对疾病的认识、依从性环境、药物类别有关（P〈0．05）。结论情感障碍患者的药物治疗依从性不容乐观，影响因素包括患者服药态度、对疾病认识、药物类别等。     

Interhemispheric asymmetry of the human motor cortex related to handedness and gender

Most people are right-handed, preferring the right hand for skilled as well as unskilled activities, but a notable proportion are mixed-handed, preferring to use the right hand for some actions and the left hand for others. Assuming a structural/functional correlation in the motor system we tested whether asymmetries in hand performance in consistent right and left handers as well as in mixed handers are associated with anatomical asymmetries in the motor cortex. In vivo MR morphometry was used for analyzing interhemispheric asymmetry in the depth of the central sulcus in the region of cortical hand representation of 103 healthy subjects. Subjects were tested both for hand preference and hand performance. As expected, left-right differences in hand performance differed significantly between consistent right, consistent left and mixed handers and were independent on gender. Male consistent right handers showed a significant deeper central sulcus on the left hemisphere than on the right. Anatomical asymmetries decreased significantly from male consistent right over mixed to consistent left handers. Sixty two per cent of consistent left handers revealed a deeper central sulcus on the right than on the left hemisphere, but for the group as a whole this rightward asymmetry was not significant. No interhemispheric asymmetry was found in females. Thus, anatomical asymmetry was associated with handedness only in males, but not in females, suggesting sex differences in the cortical organization of hand movements.     

Rape Myth Scale: factor structure and relationship with gender egalitarianism among Japanese professionals

Services provided to rape victims by human service professionals are usually helpful but are occasionally very harmful in that the victim ends up feeling 're-victimized'. This may be caused by the attitudes of the professionals towards the victims based on beliefs regarding rape and gender roles. Japanese human service professionals were solicited for responses to the Rape Myth Scale (RMS) and the short form of the Scale of Egalitarian Sex Role Attitudes (SESRA-S). One interpretable factor was extracted according to an exploratory factor analysis. Impact of the participants' age, sex, residential area, and type of profession on rape myth acceptance were examined by four-way layout ANOVA. Nurses had significantly higher rape myth acceptance than any other professional group. Furthermore, a structural equation model showing the contribution of sex role egalitarian attitude to rape myth acceptance was established.     

Is interhemispheric transfer related to handedness and gender?

Interhemispheric transfer was assessed by five motor, tactile and visual tasks which required the 48 subjects to compare stimuli presented simultaneously on both sides of the body midline. Non-right-handers performed significantly better than consistent right-handers on one motor and one tactile task. Females out-performed males on the visual task and on one tactile task. Better interhemispheric transfer performance by non-right-handers and by females may be related to the reportedly larger corpus callosum regions in these groups and also to the reportedly less strong lateralization of function.     

Serotonergic interhemispheric asymmetry: gender difference in the orbital cortex

The asymmetry of tritiated imipramine (IMI) binding sites (which are associated with serotonergic mechanisms) were investigated in the orbital frontal cortex in 6 women and men who died of natural causes, and who did not have a history of mental disorders. There was significant interhemispheric asymmetry in both sexes, higher Bmax on the right side compared with the left. The Bmax values of IMI binding in the right orbital cortex in women were significantly higher than in men. Our preliminary findings--gender difference of serotonergic mechanisms in some area of the human brain--are in accordance with the observed gender differences in a variety of serotonin-regulated behaviors (sexual behavior, aggression and impulse control), and serotonergic mental disorders (eating disorders, suicidal behavior, anxiety disorders and depression).     

Schizophrenia: age at onset, gender and familial risk

In a family history study of 366 schizophrenic probands and their 1851 first-degree relatives, we found a relationship between age at onset of psychosis in the male probands and the risk for schizophrenia in their relatives. The relatives of male schizophrenic probands whose onset of psychosis occurred when they were younger than 17 years of age had an increased risk of schizophrenia when compared with the relatives of male probands with an age at onset greater than 17. We did not find an association between age at onset of psychosis in the female probands and familial risk. Cox proportional hazards models permitted us to examine the relationship between age at onset of psychosis in the probands and familial risk while controlling for possible confounding effects.     

Effects of gender,age and diagnosis on perceived parental care and protection in adolescents

To assess whether perceived parental care and protection varied according to age and gender of the child and whether they were associated with psychiatric diagnoses, these constructs were measured with the Parental Bonding Instrument in a cohort of non-referred adolescents (n= 762), in a clinically referred cohort (n= 1299), and in a group of adolescents from the referred cohort (n= 365) for whom DSM-III diagnoses were available. Significant differences in parental care and protection according to clinical status, age, gender and diagnosis were found. However, perceived parental affectionless control was not associated with emotional disorders in adolescents, contrary to reports in adult subjects, but with clinical status.     

Metabolic and neural activity in the song system nucleus robustus archistriatalis: effect of age and gender

The sexually dimorphic robust archistriatal nucleus (RA) represents the telencephalic output of the bird song system. Here, we document sex-dependent changes in both the metabolic and neuronal activity of RA during the sensory and sensorimotor phases of song learning. From posthatching day (PHD) 20-63 in males but not females, RA and its input nucleus HVc showed sharp increases in cytochrome oxidase (CO) activity relative to surrounding archistriatum and the underlying shelf, respectively. In urethane-anesthetized birds, during the same period, the spontaneous activity of male RA neurons underwent dramatic changes in firing rate, distribution of interspike intervals, and bursting frequency, compared with other archistriatal cells. At PHD 20-21, RA neurons had extremely slow, irregular firing rates in birds of both sexes. In males, from PHD 30-36, RA neurons increased their firing rates and spiking activity became more regular, and at approximately PHD 38, strong bursts followed by inhibition (which in awake animals is associated with singing) began to be observed. Dual recordings from RA and HVc revealed synchronous bursting, with RA spikes lagging approximately 10 msec behind HVc. We conclude that changes in relative CO activity correlate with changes in spontaneous firing rates within RA and that patterns of RA spontaneous activity exhibit gradual change as birds enter early song and then again for plastic song. The emergence of strong burst patterns in RA occurs later in life than does input from HVc as established by tracer studies or based on observed HVc bursting in young animals.     

Association of gender disadvantage factors and gender preference with antenatal depression in women: a cross-sectional study from rural Maharashtra

Purpose

Maternal depression is a major public health problem in low- and middle-income countries including India. Very few studies have assessed association of various risk factors with antenatal depression in rural Indian women, especially the effect of marital conflict, gender disadvantage and gender preference on antenatal depression. This paper describes the prevalence of probable antenatal depression in rural Maharashtra, a state in the western part of India and specifically assesses the association of marital and gender disadvantage factors and gender preference for a male child with antenatal depression.

Methods

Primary Health Centre-based cross-sectional survey of antenatal women in rural Maharashtra was carried out. The outcome of interest was a probable diagnosis of depression in antenatal women which was measured using the Edinburgh postnatal depression scale (EPDS). Data were analyzed using simple and multiple logistic regression.

Results

302 women in their antenatal period were included in this study. The outcome of antenatal depression (EPDS?>?12) was found in 51 women (16.9%, 95% CI 12.6–21.1%). Feeling pressurized to deliver a male child was strongly associated with the outcome of antenatal depression (adjusted odds ratio (OR): 3.0; 95% CI 1.4–6.5). Unsatisfactory reaction of in-laws to dowry (adjusted OR 11.2; 95% CI 2.4–52.9) and difficult relationship with in-laws (adjusted OR 5.3; 95% CI 2.4–11.6) were also significantly associated with antenatal depression.

Conclusions

Our findings demonstrate that antenatal depression in rural women of Western Maharashtra is associated with gender disadvantage factors, especially related to preference for a male child. The agenda to improve maternal mental health should be ultimately linked to address the broader social development goals and gender empowerment.