Jan 182016
 

There’s been a cluster of publications and news recently that I won’t be able to dig fully into and write a full article on, but still needs mentioned. So this week’s post is a quick summary of a bunch of them!

Several articles came out pointing out that various health care professionals have a role to play in gender/sexual minority health. Articles like this are important in helping the wider medical community understand why learning about gender and sexual minority health issues is important. The articles include…

  • Obstetricians can help screen fetuses for being intersex and help to manage the medical aspect of intersex medical conditions. Gynecologists can help adult intersex people with both medical and social issues associated with being intersex. See the article.
  • Pharmacists can help with the care of trans people above and beyond just filling a prescription. They can help make sure that certain laboratory calculations are done correctly, based on the hormonal status of the patient. They can counsel on the various forms of hormones (e.g., pill vs patch vs injection). See the article.
  • Dermatologists may be able to assist in medical transition by providing hair removal and other noninvasive, aesthetic procedures. See the article.

Asking about sexual orientation and gender identity and recording it in the electronic health record is now a required part of all electronic health records by Medicare/Medicaid. This is part of “meaningful use”, and is part of the larger goal of having electronic health records that actually cooperate with each other and record the same things. Here’s a quick abstract discussing this. This is really the beginning of a change in health care around the United States — there’s now a financial incentive to screen for sexual orientation and gender identity and to handle patients who aren’t cisgender and straight. It’s good stuff.

A study of examined the effectiveness of therapy intended to change same sex sexual attraction as performed within the Church of Jesus Christ of Latter-day Saints. Less than 4% of those surveyed experienced a change. 42% reported that it wasn’t effective, and 37% found it to be moderately to severely harmful. Those who seek to modify their sexual orientation should keep this in mind — therapy intended to change sexual orientation is far more likely to do harm than good. For context, if this therapy was a new drug the FDA would never allow it into the marketplace. It would never get past early clinical trials. In contrast, acceptance therapy (i.e., therapy meant to help one be accepting of one’s orientation) in this study was found not only to reduce depression and improve self esteem but also improved relationships with family. See the abstract.

It’s well known that lesbian, gay, and bisexual cisgender people are at higher risk of suicide than the general public. A study recently clarified some of that risk, finding that bisexual cis women are at nearly 6 times higher risk of suicide than straight cis women (roughly 4-9% of the women). Gay men were 7 times more likely to attempt than straight men (roughly 3.5-13% of gay men). Lesbian and bisexual women were also more likely to attempt suicide at a younger age than straight women — roughly 16 years old vs 19 years old. Sad news. See the abstract.

Gay and bisexual men may be more likely to rely on chosen family for social and economic support than lesbian and bisexual women and heterosexuals, who may rely more on blood relatives. See the abstract.

And very exciting — the FDA has changed their blood donation policy for men who have sex with men! Instead of an “indefinite deferral”, people who quality as “men who have had sex with men” need to wait 12 months after the last sexual encounter to donate. This brings the guidelines for sex who have sex with men roughly equivalent to the guidelines for others who are at higher risk for HIV.

If you are transgender, the guidelines are still unclear. Transgender women who had ever had sex with a man (unclear if cis or trans) used to count as “men who have sex with men” in the FDA’s eyes. Now the FDA advises that transgender people should self report their gender. What this seems to say is that trans women should be counted as women and trans men should be counted as men regardless of hormonal/surgical status. So according to the guidelines, this should be the logic…

  • If you are a cis/trans man who has had sex with another cis/trans man once since 1977, but over 12 months ago: You may donate blood.
  • If you are a cis/trans man who has had sex with another cis/trans man within the past 12 months: Wait until 12 months after that sexual encounter to donate, whether you used a condom/barrier or not.
  • If you are a cis/trans woman who has had sex with a cis/trans man in the past year, and that cis/trans man has had sex with a cis/trans man in the past year: Wait until 12 months after your sexual encounter to donate, whether you used a condom/barrier or not.
  • If you are a cis/trans woman who has not had sex with a cis/trans man in the past year: You may donate blood.
  • If you are a cis/trans woman who has had sex with a cis/trans man in the past year, but that cis/trans man has not had sex with a cis/trans man in the past year: You may donate blood.

Confusing enough? I hope that still helped. Keep in mind that all of the guidelines I attempted to simplify assumes that you’re not HIV+ (no one who is HIV+ may donate). If you’re confused still, take a look at the new guidelines or reach out to your local blood donation center.

And that’s it for this week! I hope this was fun, interesting, and helpful! Have a wonderful week.

Jun 032014
 

6763959_10420a4b6a_mThe biggest news for May of 2014 is really that Medicare lifted the blanket ban on covering genital surgeries for trans people. The National Center for Transgender Equality has a good summary (PDF) of what the decision actually means. If you’re trans and interested in surgery and are a Medicare recipient, I recommend calling the physician who’s prescribing your hormones and consulting with them about next steps. The news was covered in multiple outlets including the NY Times and CNN.

The other piece of news I spotted that is not getting as much traction as I’d like is this: Urine is NOT sterile! For a long time it’s been believed that urine produced by healthy people is sterile – at least until it passes through the urethra. Turns out not to be the case. Something to keep in mind if you have contact with urine. Source

Interested in the other news? Read on!

  • Work continues on the possibility of three-parent babies. While much of the research and reporting talks about preventing mitochondrial diseases, I still think it opens a wonderful door for three-parent poly households. The latest news is fairly political, but supportive.
  • Another study out of Europe indicates that transgender hormone therapy is safe. This was a 1-year study of both men and women, just over 100 people total No deaths or serious adverse reactions were reported. Highly recommend you skim the abstract for yourself! For US readers, please do note though that the hormones used in the study were different formulations than those used in the US. Source.
  • A published case study reminds us that not all “odd” physical things during medical transition are related to transition. This was a case of a trans man who had undiagnosed acromegaly from a benign brain tumor. Eek! He was correctly diagnosed and treated, thankfully. Source.
  • A Swedish review of transgender-related records found a transition regret rate of 2.2%. Other prevalence data, including the usual male:female ratios, are included. Source.
  • A study of gay men found that they have worse outcomes from prostate cancer treatments than straight men. Source.
May 082014
 

CC BY 2.0) - flickr user stevendepoloA little belated, but here’s the GSM health news that came out around April this year, in no particular order…

  • There was a new meta analysis of intestinal vaginoplasties published in April. This meta analysis overall found that rate and severity of complications was “low”, with stenosis the most common complication. There were no reports of cancer. Sexual satisfaction was high, but there were no quality of life measures reported. Quality of studies were reported to be low, though, and there was a distinct lack of use of standardized measures. Source.
  • Oncology Times released a review of cancer and cancer screenings in transgender people. Highly recommend you take a look at the source.
  • A study finds that trans men on testosterone have lower levels of anxiety, depression and anger than trans men not on testosterone. Source.
  • A review of current hormonal transition effects and aging determined that, based on current data, “Older [trans people] can commence cross-sex hormone treatment without disproportionate risks.” They note that monitoring for cardiovascular health is especially important for trans women, especially those who are on progesterones. Strength or type of hormones may need to be modified in order to minimize risk. Source.
  • As much of the sex positive community has known for a long time, the BMI of cis women is (in general) not correlated with sexual activity. Source.
  • In Croatian medical students knowledge about homosexuality was correlated with positive attitudes. Source.
  • Science is awesome! The Lancet reported success in engineering vaginas for 4 women with MRKHS. No complications over the 8 years of follow up, and satisfaction with sexual functioning. Fingers crossed that this technique can be used in the future for many more women! Source.
  • Remember that sexual orientation is not the same as behavior? In a recent analysis of previously collected data, 11.2% of heterosexual-identified sexually active (presumably cisgender) women reported ever having a same-sex partner. Another way of looking at it: 1 in 10 straight women have had sex with another woman. Source.
  • Don’t forget about aftercare and cuddling! Post-sex affection appears to be correlated with relationship satisfaction. Source.
  • Unsurprising but sad: Young LGB people are more likely to binge drink alcohol when they’ve been exposed to discrimination and homophobia. Source.

 

Mar 062014
 

A little late, but here’s some GSM health news from February 2014!

CC BY 2.0 - UCL Mathematical and Physical SciencesTransgender

  • A literature review found that “There is a notable lack of published research regarding hormone therapy in the transgender population” and came to the very reasonable conclusion that “Although there is currently considerable focus on sexually transmitted infections in the MTF transgender population, a more comprehensive approach to health care is required, including education for transgender people and the health professionals who attend to them regarding appropriate hormone therapy.” Ayup.  Source.
  • A study found that European pre-transition trans people, both men and women, were likely to have androphilic (attracted to men) partners. I admit I’m a bit baffled by the abstract on this paper – what about bisexuals? If anyone could find and grab a copy of the full paper I’d be grateful. Source.
  • For binary-identified trans people, connection to a trans community appears to be correlated with less suicidality, lower feelings of fearfulness and higher feelings of comfort. No effect was detected for non-binary identified trans people in this study. Source.

Gay, Lesbian, Bisexual

  • The greater the anti-gay sentiment, the less long the non-heterosexuals in a community seem to live. Source.
  • Gay youths are more likely than straight youths to have factors which increase their cancer risks, such as: low rates of exercise, smoking tobacco, and drinking alcohol at a young age. Source.
  • A study found that mood and safe sex behaviors were correlated for gay men in New York – the more depressed they were, the less likely they were to use safe sex techniques. Source.
  • Gay and bisexual male adolescents are more likely to use anabolic steroids than their heterosexual peers. Source.

Other

  • Two studies indicate that BDSM activities are associated with changes of consciousness. But why didn’t the researchers compare their results with other intense activities? Source.
  • A case report of a rectovaginal fistula showed up in my feeds this month. In this case it was in a cis woman. A fistula is a hole – in this case, it was a hole between her vagina and rectum, and was caused by penile intercourse. It’s fairly rare, but can and does happen. In the case, the woman was lucky enough that some stitches were all she needed. She fully recovered and was able to resume vaginal intercourse. Source.
  • Just like cis men, cis women can also experience priapism: prolonged, unwanted erection. A case study of a cis woman with painful priapism lasting 5 days showed up in the emergency room and was reported as a case study. Surprisingly enough, she was successfully treated with pseudoephedrine – aka SudaFed. Go figure. Source.

As always…  Stay healthy, stay safe, and have fun!

Feb 012014
 

CC BY 2.0 - Mauro CatebJanuary was a fairly quiet month for gender and sexual minority health news. Naturally there was also a lot of political news, but that’s not our focus here. A few interesting tidbits include…

  • A new analysis of transgender suicide data was released by the American Foundation for Suicide Prevention and The Williams Institute. No new data in this report, but it’s broken down differently. Suicide attempt rates were as high as 56% in some demographic subgroups, with higher rates among the poor, racial minorities, unemployed, and young. Suicide rates were also higher among those who had hormone therapy alone than for those who had had surgery. Read the report for yourself!
  • A study examined the use of color-coded wristbands at sex parties for men who have sex with men. Like a smaller version of the hanky code, the wristbands indicated top/bottom status, HIV status, and condom preferences. Most men were neutral or positive about the use of wristbands…the exception being wristband identification of HIV status, where there was fear of prejudice. Source.
  • A Spanish study finds that socioeconomic status is positively correlated with sexual satisfaction. Source.
  • Trans men are 10 times more likely to have an inadequate pap test than cis women. Testosterone use is one possible explanation – it does cause changes in the cervical cells and pathologists do need to be informed that the person in question is using T. Discomfort with exam itself may also be a factor. Insurance coverage for paps may (IMO) be yet another. No matter the barriers though, cervical cancer screenings for all who have cervixes are very very important. Please, get your bits checked! Source.

Did I miss something? Let me know in the comments!

Instead of flowers this year we’re doing gemstones! Because… why not? Even the New England Journal of Medicine breaks up its walls o’ text with pretty non-medical pictures, why not us?