In “The Context, Science and Practice of Gender-Affirming Care,” commentary authors Alex S. Keuroghlian, JoAnne Keatley, Simran Shaikh and Asa E. Radix, posit that gender-affirming care for transgender and gender diverse (TGD) people should be inclusive, community led and evidence informed to support mental health and wellbeing. This article outlines the evolution of gender-affirming care since the 1930s and emphasizes psychological, social, legal, medical and surgical affirmation within the contexts of culturally responsive healthcare environments, as well as broader policies and laws that support and protect gender diversity locally, nationally and globally.
New Article: Moving Beyond Psychiatric Gatekeeping for Gender-Affirming Surgery
In “Moving Beyond Psychiatric Gatekeeping for Gender-Affirming Surgery,” commentary authors Drs. Alex S. Keuroghlian and Catherine A. Wu offer a discussion of the phenomenon of clinical gatekeeping in the context of accessing gender-affirming hormone therapy (GAHT) or gender-affirming surgery (GAS), in contrast to what might be considered reasonable precautions to ensure candidacy. The article details the recent changes in requirement guidance issued by the World Professional Association for Transgender Health (WPATH) “Standards of Care for the Health of Transgender and Gender Diverse People, Version 8” (SOC8), and the way in which this shift reflects a move towards an informed consent model for gender-affirming care. The article authors offer their recommendations for an optimized informed consent approach to GAS to further mitigate the harms of psychiatric gatekeeping.
New Article: We Must Set A High Bar For Attributing Psychopathology To Sexual And Gender Minority People
A commentary published July 18, 2022 in the Journal of Clinical Psychiatry cautions clinicians, scientists, and researchers against making assumptions that sexually and gender diverse people have a greater predisposition to psychiatric illness. The commentary was written in response to a newly published study by Oka et al showing that there were no differences in clinical responsiveness to electroconvulsive therapy (ECT) for treatment-resistant psychiatric illness between LGBTQ and non-LGBTQ patients. The authors of the study had hypothesized that LGBTQ patients would be less favorable to ECT because they would be more likely to have clinical conditions less favorable to ECT, such as posttraumatic stress disorder, personality disorders, or substance use disorders.
- Filed under
- Behavioral Health
New Journal Article: Association Between Gender-Affirming Hair Removal and Mental Health Outcomes
This new article titled "Association Between Gender-Affirming Hair Removal and Mental Health Outcomes," was recently published in JAMA Dermatology. Authors Michelle Lee, Anthony Almazan, Dr. Vinod Nambudiri and Dr. Alex Keuroghlian discuss how gender-affirming medical care is essential for addressing the mental health burdens of transgender and gender-diverse (TGD) populations and how gender-affirming hair removal (GAHR) procedures, including electrolysis and laser hair removal, are desired by nearly 90% of TGD people. However, such services are covered by only 4.6% of insurance plans, possibly owing in part to limited evidence of their mental health benefits. In this study, they investigate the association between GAHR and mental health outcomes.
- Filed under
- Behavioral Health
In the News: Gender-affirming surgery linked to better mental health
Transgender people who have access to gender-affirming surgery report better mental health outcomes, according to a new study. The report, published Wednesday in JAMA Surgery, compared the psychological distress levels, suicide risk and substance use in transgender and gender diverse people who had undergone gender-affirming surgery with those who wanted such procedures but had not yet had them. “This study adds to a growing body of evidence showing affirmation in all forms can be life-saving for trans and gender-diverse people,” said lead author Anthony Almazan, a fourth-year medical student at Harvard Medical School. “Policies that limit access to care can put lives at risk. Our evidence shows we should be expanding gender-affirming care, not limiting it.” You can read the NBC story here.
Paper calls for new psychiatric practices that affirm transgender and gender-diverse patients without pathologizing diagnoses
An editorial published in The British Journal of Psychiatry calls for the development of alternative psychiatric care frameworks that affirm transgender and gender-diverse (TGD) people without pathologizing them through clinical diagnoses. The editorial was authored by researchers at The Fenway Institute and Dartmouth-Hitchcock Medical Center and adds to a growing body of literature demonstrating the need to uncouple gender diversity from the stigma of diagnostic classification.
Upcoming Webinars in April
The National LGBT Health Education Center is excited to announce the following upcoming live webinars in April.
Details and registration information are provided by clicking "Read More." CMEs are available.
In the News: Pubertal Suppression and Decreased Lifetime Suicidal Ideation
A new study by The Fenway Institute entitled, "Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation," examines associations between access to pubertal suppression and suicidality. The study demonstrates a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment. It suggests that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes. This research was recently published in Pediatrics, the official journal of the American Academy of Pediatrics. The online version of this article is available here.
Register for Advancing Excellence in Sexual and Gender Minority Health Conference
Advancing Excellence in Sexual and Gender Minority Health is a national CME course developed in response to a high volume of queries from clinicians and health care staff seeking to learn about providing high-quality care for patients who identify as a sexual or gender minority.
In the News: Study shows link between conversion efforts and suicidality
This new study was published in JAMA Psychiatry: Association Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults. You can find the original journal article here (JAMA requires either a subscription or a one-time payment to view the full text).