Sep 242013

This post is a legacy page, and was part of an on-going series, Trans 101 for Trans People. It covers questions about medical transition, hormones, surgeries, or seeking health care for transgender people.

For the material that once lived on this page, please see this page.

Please update your links to the full Trans 101.

Aug 062013

CC BY-NC 2.0 - flickr user springfieldhomerTime for the monthly summary of the latest gender and sexual minority, and sexuality, related news!

  • The American Heart Association released a consensus that physicians should counsel people about resuming sex after a heart-related illness (e.g., heart attack, stroke, pacemaker installation). Apparently physicians have not be doing that. Oops! More information here.
  • Risk factors for developing PTSD (post-traumatic stress disorder) after exposure to a traumatic event have been further explored in adolescents. 61% of teens in this study were exposed to a potentialy traumatic event, but only 4.7% of the teens in the study actually developed PTSD. Risk factors included: previous diagnosis of a mood or anxiety disorder, being female, and the type of event. Interpersonal traumatic events (e.g., being raped or assaulted by another person) were associated with a higher risk of PTSD. Why bring this study up? Because GSM youth are at high risk for traumatic events! More info.
  • Virginia Johnson passed away due to natural causes. She was one half of the Masters and Johnson team that did pioneering work on sexuality in the 1960s. Condolences to her friends, family and loved ones. More info.
  • The X chromosome may have a role in sperm production. Not at all surprised by this – after all, the idea of the X chromosome as the “female” chromosome and the Y chromosome as the “male” chromosome are based in human perception, not pure biology. More info.
  • Female survivors of childhood sexual abuse may benefit from writing about their experiences. A study found that female survivors who specifically wrote about how the abuse changed the way they thought about sex had improved sex lives. Abstract.
  • PSA, prostate-specific antigen, may be useful as an indicator of testosterone level. While PSA’s usefulness as a screening tool for prostate cancer is still under debate, this other use is an interesting idea. It’s not currently in use for detecting low levels of testosterone, but it might be in the future. Cool! Abstract.
  • The average penis size has been determined. Again. Sorta. This study was internet, self-report based. So who really knows? This study reports that the average erect penis is 14.15 cm (5.57 in) long with a 12.23 cm (4.81) circumference. The racial makeup and age of the sample was not reported in the abstract. Abstract.
  • Sex addiction does not appear to be an addiction, according to a study out of UCLA. Interesting and not altogether surprising. Press release.
Jul 172013

Gender Spectrum

Gender Spectrum has a yearly Family Conference and Professionals Workshop in Berkeley, California. This year was the 7th conference, and my 3rd time attending (2nd year as a volunteer). Gender Spectrum is an organization supporting, educating and advocating for transgender and gender non-conforming youth and their families.

I’ll start by talking about the Professional’s Workshop, which was Friday. It was roughly split into four tracks: medical, mental health, legal, and educational. There was a lot of overlap. One panel I particularly enjoyed was the “Working With Caregivers” panel. It was a series of cases and discussion of those cases between a family practice physician and a social worker. The varying concerns in each case , the individuality, and the back-and-forth between professional fields really helped bring the case reports to life. For someone like me with limited clinical experience it was a real treat. Another panel I really appreciated was on research relevant for trans youth. The summary? As usual, not much… but I do have a few more citations to track down and read.

I also want to give a shout out to Jeanne Nollman (and, by extension, the AIS-DSD Support Group) for coming and giving an Intersex 101 talk and sharing her story. This was the first year Gender Spectrum addressed intersex/DSD issues and it’s sorely needed. As much as trans issues are hidden from the public eye, intersex issues are even more hidden… often by medical professionals and families themselves. Thank you Jeanne for stepping into the light and talking with us. Let’s create some change there too!

The last panel I attended in the professionals workshop was on fertility. It was repeated for the family conference. Many many families are concerned that, by allowing their children to start hormone therapy or have surgery, that they will forever lose their ability to have biological children. I see two aspects to this: the (often complex) biology of fertility and fertility preservation, and the emotional aspects of family and family building. Before the conference began, I coordinated with several of the presenters to help make a flow chart to simplify explaining the fertility biology.

The family question is, in a way, a lot harder. What is family? Who is family? For many, biological grandparentage is important. For others, they simply don’t want to sterilize their child. I was more emotionally involved in the conversation than I expected to be. I believe very strongly that family is chosen, not just biological. I have more than two parents. I accept them all whole heartedly, and I don’t make a distinction based on genes. But I admit that the dominant culture I see in California doesn’t accept that… and we lack language that truly supports that. Worse, much of my family is not legally recognized. So it’s a bit of a tangle of an issue. As far as I know this was the first year fertility was addressed in a panel. It went very well, and I hope to see it repeated and expanded next year.

As for the family conference? I heard rumor that some 150-200 youths were there. It was huge this year! My volunteering this year was primarily focused on the medical consult sessions. Every year the conference offers one-on-one sessions with various professionals. This year it included medical, mental health, spiritual, and legal professionals. It was pretty busy. I didn’t get to as many panels as I might have liked, but that’s nothing strange. As always at a conference, one wants to be in five different places all at the same time. So unlike previous years, I didn’t come home with a folder full of notes and citations to look up. Instead, I sat and talked with people.

It was a surprisingly intense and emotional conference for me. I really came out of the world of statistics and risk factors and into the world of emotions and realities. It was… well, I’m still looking for the right words. I appreciate all the people who sat and talked with me. I hope you’re all well. Know that someone in the world is thinking of you and hoping everything’s going to come out OK in the end. Another shout-out, this time to Micah of Neutrois Nonsense. Good to see you again!

One theme stands out for me this year particularly strongly: self-determination. The goal of Gender Spectrum, and of the parents there raising trans and gender non-conforming youth, is to let their children be themselves. Whatever that is at that particular moment. Let them explore and play and decide what’s right for themselves in the end. It’s like Maslow’s Hierarchy of Needs: provide the safety, security and love and let the child self-actualize and be happy.

At the closing plenary for the conference, we were asked “What’s the one thing you’ll do with this experience when you leave here?” For me? I need to revise my Gender and Sexual Minorities 101 lecture. I may accept the gender binary for myself (I identify as a woman), but that doesn’t mean I should assume others do. I think I emphasized the binary too much in my previous lectures. So when I record those lectures, it’ll be a revised version that’s more open to gender fluidity, and that provides more information on trans and gender non-conforming youth.

…also, I so need to bring business cards next year! Augh! Oh well. Hope everyone I gave contact info to is able to find me. 🙂

In summary? Great experience, as it is every year. If you are a family with a trans/gender non-conforming youth, or work with those youths, or do trans care of any flavor, or are just curious…. please try to come for next year! I hope to see you all there again soon.

Jan 182013

Book Cover -

Gender Born, Gender Made: Raising Healthy Gender Non-Conforming Children was written by Dr. Diane Ehrensaft and published in 2011. Dr. Ehrensaft is a psychoanalytically trained developmental and clinical psychologist. Her practice includes transgender and gender non-conforming youth, and she works closely with Gender Spectrum, which also works with such youth.

How to summarize the book? It is an exploration. Dr. Ehrensaft pulls strands from her experiences working with children (including her own) to weave a tapestry of stories which she uses to address everything from the varying experiences of gender, psychological theories surrounding gender, to parental and sibling reactions and experiences. Some of the stories are heartwarming; some heartbreaking.

Underlying this is Dr. Ehrensaft’s refreshing philosophy: Let the children explore freely and guide. She also describes the psychoanalytic perspective and Zucker’s reparative perspective as contrast. In all, though, the book is very light on theory and rich with anecdotes, demonstrating helpful and harmful approaches and the varying ways children react to and explore their gender.

Who should read it? I think it was primarily intended for parents of gender non-conforming children. Therapists treating families with gender non-conforming children may find some of the terminology and ideas useful in their own practices. The language is accessible for a lay audience, and Dr. Ehrensaft uses pronouns with respectful grace and skill.

Overall, I recommend it. Besides, look at that adorable child on the cover. How can you resist?

Oct 252012

LGBT youth are at elevated risk for suicide. Researchers have been looking into the risk factors for suicide in LGBT youth. Most of the studies so far have been cross-sectional; that means they only studied how things are once, at one point in time. Longitudinal studies, in contrast, measure at multiple points in time. Longitudinal studies are expensive, and risk losing track of participants, but they provide more information.

This year, the first longitudinal study of LGBT youth suicide risk factors was published. The participants were interviewed twice, a year apart. Both times, they were psychiatrically evaluated and asked about suicide attempts. They filled out questionnaires evaluating hopelessness, impulsivity, social support, gender non-conformity, age of same-sex attraction, and LGBT-related victimization.

In this sample, roughly 31.6% of the participants had attempted suicide. This is far higher than the 8% rate reported by the CDC. Seven variables were associated with previous suicide attempts: hopelessness, impulsivity, LGBT-related victimization, low family support, being younger when first feeling same-sex attraction (for LGB youth), and symptoms of either depression or conduct disorder. That is, the more hopeless or impulsive the youth, the more likely it is that they have previously made a suicide attempt. Gender non-conforming behavior and peer support did not seem to affect suicide risk. When it came to predicting future suicide attempts, the best predictor was previous suicide attempts. Youth who had previously attempted suicide had a 10 times greater risk of another attempt compared to those who hadn’t attempted suicide.

As always, these results should be accepted with caution. For example, this study did not find that gender non-conforming behavior was associated with suicidality. This is in contrast to other studies which did find an association. This study’s participants may not be representative of the population. They also had a small (ish) sample: 237 participants; 21 were transgender, and 13 had attempted suicide. Small sample sizes can limit a study’s ability to detect statistical significance. Gender non-conforming behavior may actually be associated with suicidality, but this study may not have had a large enough sample to detect it.

For me, this study brings up the question: How do we prevent suicide attempts in our LGBT youth who have already attempted suicide? They’re the most at risk for future attempts, according to this study. I don’t have a solid answer; neither do the researchers. But they do say that “The current findings underscore the need for increased prevention efforts and specifically point to the value of targeting youth who have made a prior attempt and who acknowledge their same-sex attractions at younger ages.”

Study Abstract – Full Text – Archives of Sexual Behavior