Search Results (5)

Gender-affirming hormone therapy (GAHT) plays a significant role in the medical care of transgender individuals, helping to align their physical characteristics with their gender identity. While numerous studies have investigated the impact of GAHT on adults, research focusing on its effects on the quality of life (QoL) of transgender youth is limited. In this opinion paper, we aim to address selected challenges associated with gender-affirming medical care, such as (1) the necessity for evidence-based youth gender-affirming medical care, (2) the urge to explore different approaches to gender-affirming medical care diversely in transgender youth research, and (3) understanding the challenges of the detransition process (which refers to stopping or reversing gender-affirming medical or surgical treatments), as well as suggest possible solutions for meaningful progress. Notably, the available evidence underlines a positive impact of GAHT on various aspects of QoL of transgender youth, such as mental health and social functioning, by alleviating gender dysphoria, improving body satisfaction, and facilitating appearance congruence (the degree to which an individual’s physical appearance represents their gender identity). However, challenges related to methodological limitations, as well as ethical considerations, and several sociocultural factors highlight the need for further research to better understand the long-term effects of GAHT on the QoL of transgender youth. Ethical considerations, such as ensuring informed consent and weighing potential benefits against risks, are pivotal in guiding healthcare decisions. Additionally, navigating these ethical responsibilities amid sociocultural contexts is crucial for providing inclusive and respectful care to transgender youth. Addressing these research gaps is, therefore, crucial to developing successful healthcare programmes, raising awareness, and promoting the holistic well-being of transgender youth through comprehensive and affirming care. Full article

Current urban mobility systems in Europe, characterized by high car mobility shares, have negative environmental and health impacts but struggle to mitigate these for fear of sacrificing accessibility. Ironically, before the car mobility transition (in the 1950s and 1960s in Western countries and the 1990s in Eastern Europe), most cities were accessible by walking, cycling, public transport, and by the few cars there were. Through a longitudinal case study of a medium-sized urban area in Clermont-Ferrand, France (1950–2022), this paper explores the potential to ‘de-transition’, i.e., to reverse the urban transition process towards ‘accessible, low-car cities’ by reshaping infrastructures to constrain car use whilst accommodating walking, cycling, and public transport. We answer the following questions: To what extent can cities reverse the urban car mobility transition? How could such a process be further encouraged? Our analysis adopts a social practices perspective and uses a mixed-methods approach by combining semi-structured interviews, a survey, and a document analysis. On the one hand, our findings highlight the difficulty of an urban modality shift to car alternatives: (1) the limited reach of public transformation networks (in Clermont-Ferrand, the tramline); (2) the fact that many feel unsafe or assume they need excellent health conditions to cycle, which is associated with leisure and sports; and (3) strong convictions concerning the usefulness of vehicle ownership, which is believed to maximise comfort. On the other hand, based on a historic analysis, we offer practical recommendations to de-transition to low-car urban areas: (1) the creation of an extensive regional tramway network; (2) the development of a full cycling network; and (3) the promotion of an extensive car-free city centre. Full article

Despite the increasing visibility of transgender and gender diverse (TGD) people in U.S. society, current linguistic practices within forensic anthropology and death investigation in general are not TGD-inclusive. This lack of consideration for TGD decedents can cause unnecessary delays in the identification and disposition of their remains; moreover, failing to recognize their true identities is a form of forced post-mortem detransition. Using De León’s concept of necroviolence as a framework, we argue that language can also harm the dead and that the (mis)use of language within medicolegal death investigation reflects and reinforces structural violence against TGD people. Examples drawn from a qualitative review of public details for 87 cases are used to demonstrate how language and language-enforced bureaucratic structures can harm TGD decedents, their loved ones, the broader TGD community, and the process of medicolegal death resolution itself. We then suggest steps that anthropologists, death investigators, and their affiliated partners can take to reduce the systemic necropolitical violence faced by the TGD community. While TGD-inclusive methods will take time to implement at the institutional level, individual practitioners can enact significant change within the system by upholding core standards that recognize and respect the personhood and lived experiences of TGD decedents. Full article

Identity formation, questions of identity, shifting identities, perceived deviant identities, and reactions (social, political, cultural, individual) to them are the stuff of Bildungsroman as well as more “experimental” subgenres of long-form fiction. For minority/minoritized subjects and authors, questions of identity take on a different pallor: their work is expected to engage with questions of identity according to either or both how their subject position confronts marginalization and otherness, and how their subject position conditions every experience they have in the world, both inside and outside community. This inquiry investigates how contemporary transgender minor literature constructs dis/identity through authenticity. Imogen Binnie speculates in her 2013 novel Nevada on the concept of “Really, Truly Trans”, a cipher for identity policing and presumptions of sex–gender authenticity, based on cisnormative characteristics and, occasionally, inter-community phobias and proscriptions. More recently, Torrey Peters challenges measures of trans authenticity through both her titular detransitioner and his former partner in Detransition, Baby. Trans minor literature is an ideal testing ground for phobic public presumptions around “authentic” sex–gender and anti-identitarian strategies of those who are forced to confront purity tests and exclusion or suppression on grounds of authenticity, and each novel presses at phobic majoritarian dictates of authenticity and its presupposed value. Full article

Primary care must ensure high quality lifelong care is offered to trans and gender minority patients who are known to have poor health and adverse healthcare experiences. This quality improvement project aimed to interrogate and audit the data of trans and gender minority patients in one primary care population in England. A new data collection instrument was created examining pathways of care, assessments and interventions undertaken, monitoring, and complications. General practitioners identified a sample from the patient population and then performed an audit to examine against an established standard of care. No appropriate primary care audit standard was found. There was inconsistency between multiple UK gender identity clinics’ (GIC) individual recommended schedules of care and between specialty guidelines. Using an international, secondary care, evidence-informed guideline, it appeared that up to two-thirds of patients did not receive all recommended monitoring standards, largely due to inconsistencies between GIC and international guidance. It is imperative that an evidence-based primary care guideline is devised alongside measurable standards. Given the findings of long waits, high rates of medical complexity, and some undesired treatment outcomes (including a fifth of patients stopping hormones of whom more than half cited regret or detransition experiences), this small but population-based quality improvement approach should be replicated and expanded upon at scale. Full article