Survey and clinical considerations of gender identity in lower primary school children

BACKGROUND Gender consciousness directly affects the development of gender identity,which is a continuous and lifelong process.Meanwhile,hospitalization is a part of many children's lives and has an impact on their gender development.AIM To investigate the current situation of gender identity in lower primary school children by conducting a survey of 202 hospitalized children in the lower grades and to provide a theoretical basis and foundation for the cultivation of gender identity and medical treatment of children based on the results.This study aims to inspire clinical medical staff to scientifically and reasonably arrange hospital wards for lower primary school children and pay attention to gender protection during the medical treatment process and to help children shape a unified and clear gender identity,which will enable them to better integrate into society and promote their personality development.METHODS The gender consciousness scale for elementary and middle school students was RESULTS Gender identity was already present in lower primary school children.The children's gender roles and gender equality consciousness were strong,exceeding the critical value,but their gender characteristics,gender identity,and gender ideal consciousness were weak.Children aged 6 had the weakest gender identity,and girls had significantly stronger gender identity than boys.CONCLUSION Gender identity is already present in lower primary school children,providing a basis and inspiration for the cultivation of gender identity and medical treatment of lower primary school children.Clinical medical staff should be aware of and understand these results and should scientifically and reasonably arrange hospital wards for lower primary school children.

Are gender inclusiveness and rural transformation interlinked?The case of Bangladesh

Gender inclusiveness is important in the rural transformation process of Bangladesh as rural women play key roles in both agricultural and non-agricultural sectors.Gender inclusiveness also leads to gender equity.We empirically evaluate relationships between rural transformation and gender inclusiveness in Bangladesh.We consider three rural transformation indicators:high-value commodities’share in agricultural output values,non-farm employment’s share in rural labor employment,and non-agricultural GDP’s share in total GDP.Indicators capturing gender inclusiveness include the per capita rural income of males and females,ratio of investments into gender programs,female access to education,access to healthcare,employment participation,land ownership,and asset ownership.We test the effect of the difference in per capita rural income of males and females and the ratio of their incomes and check for the robustness of the gender variables across different model specifications.Analyzing 128 district-level observations from 32 districts of Bangladesh across four time periods(2000,2005,2010 and 2016),we use both ordinary least squares and fixed effects panel regression models.We find that female land and asset ownership and access to education and healthcare are robust determinants of various stages of rural transformation.Thus,our results suggest that improving women’s ownership of land and assets and investing in women’s education and healthcare will likely contribute to a more inclusive rural transformation.

Interaction between adolescent sleep rhythms and gender in an obese population

BACKGROUND The obesity rate of adolescents is gradually increasing,which seriously affects their mental health,and sleep plays an important role in adolescent obesity.AIM To investigate the relationship between sleep rhythm and obesity among adolescents and further explores the interactive effect of sleep rhythm and gender on adolescent obesity,providing a theoretical basis for developing interventions for adolescent obesity.METHODS Research data source Tianjin Mental Health Promotion Program for Students.From April to June 2022,this study selected 14201 students from 13 middle schools in a certain district of Tianjin as the research subject using the convenient cluster sampling method.Among these students,13374 accepted and completed the survey,with an effective rate of 94.2%.The demographic data and basic information of adolescents,such as height and weight,were collected through a general situation questionnaire.The sleep rhythm of adolescents was evaluated using the reduced version of the morningness-eveningness questionnaire.RESULTS A total of 13374 participants(6629 females,accounting for 49.56%;the average age is 15.21±1.433 years)were analyzed.Among them,the survey showed that 2942 adolescent were obesity,accounting for 22%and 2104 adolescent were overweight,accounting for 15.7%.Among them,1692 male adolescents are obese,with an obesity rate of 25.1%,higher than 18.9%of female adolescents.There is a statistically significant difference between the three groups(χ2=231.522,P<0.000).The obesity group has the smallest age(14.94±1.442 years),and there is a statistical difference in age among the three groups(F=69.996,P<0.000).Obesity rates are higher among individuals who are not-only-child,have residential experience within six months,have family economic poverty,and have evening-type sleep(P<0.05).Logistic regression analysis shows a correlation between sleep rhythm and adolescent obesity.Evening-type sleep rhythm can increase the risk of obesity in male adolescents[1.250(1.067-1.468)],but the effect on female obesity is not remarkable.Further logistic regression analysis in the overall population demonstrates that the interaction between evening-type sleep rhythm and the male gender poses a risk of adolescent obesity[1.122(1.043-1.208)].CONCLUSION Among adolescents,the incidence of obesity in males is higher than in females.Evening-type sleep rhythm plays an important role in male obesity but has no significant effect on female obesity.Progressive analysis suggests an interactive effect of sleep rhythm and gender on adolescent obesity,and the combination of evening-type sleep and the male gender promotes the development of adolescent obesity.In formulating precautions against adolescent obesity,obesity in male adolescents with evening-type sleep should be a critical concern.

Basic Research on the Burden of Dropping off and Picking up Children: Differences by Employment Type and Gender in the Tokyo Metropolitan Area

There is a need to reduce the burden of child drop-off and pick-up for child-rearing generations, but most studies on the actual situation in Japan are based on survey results. In this study, we analyzed differences in child drop-off and pick-up by employment type and gender, utilizing the “Metropolitan Area Person Trip Survey,” which is a statistical data set. The study targeted households in which both spouses were between 30 and 49 years old, had children under the age of 6, and included the following three groups. 1) Dual-income Group 1 (both spouses employed/on contract/temporary);2) Dual-income Group 2 (husband employed/on contract/temporary, wife part-time);3) Full-time housewife group (husband employed, wife unemployed). The analysis revealed that a) wives are almost always responsible for dropping off and picking up their children;b) husbands drop off and pick up their children less frequently in dual-income households;and c) households with children raising within 10 to 30 km of Tokyo Station have longer commuting times and need to reduce the burden of dropping off and picking up their children.

Comprehensive Analysis of Gender Classification Accuracy across Varied Geographic Regions through the Application of Deep Learning Algorithms to Speech Signals

This article presents an exhaustive comparative investigation into the accuracy of gender identification across diverse geographical regions,employing a deep learning classification algorithm for speech signal analysis.In this study,speech samples are categorized for both training and testing purposes based on their geographical origin.Category 1 comprises speech samples from speakers outside of India,whereas Category 2 comprises live-recorded speech samples from Indian speakers.Testing speech samples are likewise classified into four distinct sets,taking into consideration both geographical origin and the language spoken by the speakers.Significantly,the results indicate a noticeable difference in gender identification accuracy among speakers from different geographical areas.Indian speakers,utilizing 52 Hindi and 26 English phonemes in their speech,demonstrate a notably higher gender identification accuracy of 85.75%compared to those speakers who predominantly use 26 English phonemes in their conversations when the system is trained using speech samples from Indian speakers.The gender identification accuracy of the proposed model reaches 83.20%when the system is trained using speech samples from speakers outside of India.In the analysis of speech signals,Mel Frequency Cepstral Coefficients(MFCCs)serve as relevant features for the speech data.The deep learning classification algorithm utilized in this research is based on a Bidirectional Long Short-Term Memory(BiLSTM)architecture within a Recurrent Neural Network(RNN)model.

Gender disparities and woman-specific trends in Barrett’s esophagus in the United States:An 11-year nationwide populationbased study

BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not screened.Current practice guidelines include male gender as a predisposing factor for BE and EAC.The population-based clinical evidence regarding female gender remains limited.AIM To study comparative trends of gender disparities in patients with BE in the United States.METHODS A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)database.Patients with a primary or secondary diagnosis code of BE were identified.The major outcome of interest was determining the gender disparities in patients with BE.Trend analysis for respective outcomes for females was also reported to ascertain any time-based shifts.RESULTS We identified 1204190 patients with BE for the study period.Among the included patients,717439(59.6%)were men and 486751(40.4%)were women.The mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(H.pylori),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of H.pylori and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among women has steadily increased from 2009 to 2019.The existing knowledge concerning BE development has historically focused on men,but our findings show that the risk in women is not insignificant.

Beyond Gender Perspectives:A More Comprehensive Examination of Yang Yi’s Translation of Wuthering Heights

The renowned translator Yang Yi passed away in 2023.Many scholars argue that,influenced by their biological gender,female translators often employ translation methods in adherence to feminist translation or reflect characteristics typical of female translators.This study examines the translation of Wuthering Heights by Yang Yi,focusing on whether there is a definite influence of gender on translator behavior.While existing literature primarily analyzes Yang Yi’s work through a feminist lens,this research takes a broader approach.By considering the translator’s social background and translation practice,this paper challenges the assumption that her work strictly aligns with feminist translation theories.Instead,this study emphasizes the importance of considering diverse factors when interpreting translated works,moving beyond a singular gender-based standpoint.

The False Obvious:Gender Myth in Perfume Commercials

Perfume commercial,as a form of cultural text and practice,is relatively special in contemporary commercial advertising:The commodity qualities of perfume dictate that perfume advertisements must cater to the sexual fantasies of the audience,and therefore inevitably characterize the mainstream,dominant gender norms.At the same time,perfume commercial,as a unique marketing communication method,also unconsciously influences people’s values through sensory stimulation and emotional rendering.This article explores the connection between perfume and its commercials,sex,and gender,and discusses the generation of meaning in perfume commercials as texts and deconstructs the gender myth implied from the perspectives of representation and myth analysis,ultimately revealing that behind the gender myth of perfume commercials is but a false manifestation of the ideal self-image of the western white bourgeois heterosexuality.

Advancement Towards Spatial Justice:The Barrier-Free Environment Construction from a Gender Perspective

Space is both a product and a producer of social relations.In the spatial domain,gender blindness has long existed,limiting women’s rights of access to and use of space,leading to structural oppression of women’s rights,and giving rise to new gender inequalities.The barrier-free environment construction has the functions of eliminating physical barriers and generating societal norms,and when combined with social changes,can facilitate justice correction across multiple dimensions.However,barrier-free environment construction itself,as a means of justice correction,also suffers from gender blindness.There remains room for improvement in the areas of facility construction,information exchange,and social services within the realm of barrier-free environments.In response to this phenomenon,gender equality offers a new critical perspective.Therefore,integrating a gender perspective into the barrier-free environment construction,focusing on the spatial rights of women,especially groups with multiple vulnerabilities,such as disabled women and elderly women,can contribute to the advancement towards spatial justice.

A Comprehensive Study on Gender Language and Its Differences in China

The study of language and gender,especially the study of gender language differences involves many fields such as psychology,sociology,anthropology,language and literature,news media,education,and so on.Starting from the broad definition of gender language,this paper composes and reviews the research history of domestic gender language and its differences.Around the research history of domestic gender language,the research period is divided according to the timeline into germination,genesis,and growth.Divided by theme and content,the main content is the phenomenon of sexism in language;the second is the study of gender language style differences;the third is the root causes of sexism and verbal gender differences,i.e.,the construction of the corresponding theories;and the fourth is the discussion of the limitations of the study of gender language in foreign countries.

The Influence of Depression on Different Age and Gender Groups in Bahawalpur

In Bahawalpur,a cross-sectional study assessed depression prevalence across age and gender groups,involving 442 participants from diverse socioeconomic backgrounds and settings.Utilizing the PHQ9 questionnaire,84%were found to meet depression levels.The findings revealed a higher incidence in females(88%)than males(79%),with the greatest disparity among young adults,particularly young women,due to factors like academic pressure and financial stress.School children had the lowest depression rates(68%),possibly due to better immunity.Elderly individuals exhibited more severe depression,likely related to aging and domestic challenges.The study’s findings highlight a significant variation in depression severity across different demographic groups,with an overall higher incidence in women.The research underscores the necessity for targeted mental health resources and interventions tailored to the specific needs of each demographic group.It also points to the importance of addressing academic and socioeconomic stressors to mitigate depression,particularly among young women.While the study provides valuable insights,it relies on self-reported data,which may introduce bias.Therefore,future research should include clinical assessments to validate these findings and ensure a more accurate representation of depression within the community.

Analysis Of Urban Planning Instruments in Comala,Colima,Mexico(1997-2009)from a Gender Perspective-A Secondary Publication

This work is carried out based on the analysis of urban planning instruments,taking the gender perspective as a foundation.It arises from the inclusion of women in the participation of urban development,through an analysis of the gender gaps that have marked the history of women,the inequalities serve as a basis for carrying out this study.It highlights the challenges we face today as a society in the process of building citizen participation,where we must all be recognized and have equal opportunities within the territory in which we live.This article analyzes the extent to which the Municipal Urban Development Programs of the Mexican municipality of Comala,Colima,Mexico,consider the recommendations on gender and urbanism,established since the 1990s by international entities and applied transversally to urban planning policies.Considerable differences are found between women and men in terms of empowerment and participation in urban territorial planning instruments,mainly in the oldest instrument(1997).Significant progress is observed in the most recent document and is currently in force in the municipality of Comala(2009).

Prevalence of Gender-Based Violence among Sex Workers in Bangui, Central African Republic (CAR)

Background: Violence against women has become an international public health and human rights issue in recent decades. The violence suffered by sex workers is of little interest for research, yet it constitutes a major health and safety problem. We propose to assess the extent of the phenomenon of gender-based violence (GBV) among sex workers (SWs) in the city of Bangui in the CAR. Methodology: This is a descriptive cross-sectional epidemiological study covering the period from July to October 2021 carried out among SWs in Bangui, the capital of the CAR. Given that the SWs association had only 159 members in Bangui, an exhaustive sampling was retained. Were included in the study, any SW present during the data collection period and having given their written consent. The parameters studied were socio-demographic characteristics: age, sex, residence, level of education, marital status, and characteristics linked to violence: the notion of violence during their professional activity, the type of violence, the declaration and the declaration if necessary, the response and management of this violence. The data collected was analyzed using Epi info version 7 software. Results: Of the 159 SWs that counted the association, 108 had been included. The average age was 27.0 years with extremes of 14 and 46 years. The age groups of 25 to 34 years were the most represented (43.5%). Fifty-six SWs (51.9%) had reached the secondary level. Unemployed SWs were in the majority at 74.1%;Sixty-six (66) SWs in our sample (61.1%) had already been victims of violence during the exercise of their activity Sexual violence was the most represented (28.5%) followed by verbal violence (22.4%). Sixty-eight (62.9%) wanted to stop the professional activity of SWs and 93.1% would accept another income-generating activity in place of sex work. Conclusion: It is necessary to supervise SWs and protect them within the framework of respect for human rights, rather than criminalizing them and the exploiters flouting their human dignity and putting their lives in danger. .

Frequency and Factors Associated with Gender-Based Violence in the Northern Region of Benin from 2016 to 2022

Introduction: Gender-based violence constitutes a public health problem. The objective of this study is to determine the frequency and factors associated with gender-based violence. Study Framework and Method: This was a retrospective, descriptive, cross-sectional study with an analytical aim over the period from January 2016 to December 2022. The study took place in the Integrated Support Center for Victims and Survivors of Gender-Based Violence located in the Departmental University Hospital Center of Borgou and Alibori. The study population consisted of people who were victims of gender-based violence in the northern region of Benin, regardless of their age and gender. Results: The study population consisted of 1198 subjects. The average age of the victims was 21.76 ± 10.02;female victims represented 96.4%, with a sex ratio equal to 0.037 (43/1155). Sexual violence was the most represented (50.25%), followed by psychological (29.30%), physical (24.37%), economic (13.77%) and property (2%). The factors associated with violence were married people and monthly income (physical violence), minors, female gender and single people (sexual violence), polygamous households and monthly income (economic violence), the absence of children burden, married people and monthly income (psychological violence), married people (property violence). Conclusion: Gender-based violence is frequent in the North of Benin and is dominated by sexual violence. The victims are mainly female.

Caloric restriction-mimetics for the reduction of heart failure risk in aging heart: with consideration of gender-related differences

The literature is full of claims regarding the consumption of polyphenol or polyamine-rich foods that offer some protection from developing cardiovascular disease(CVD). This is achieved by preventing cardiac hypertrophy and protecting blood vessels through improving the function of endothelium. However, do these interventions work in the aged human hearts? Cardiac aging is accompanied by an increase in left ventricular hypertrophy, along with diastolic and systolic dysfunction. It also confers significant cardiovascular risks for both sexes. The incidence and prevalence of CVD increase sharply at an earlier age in men than women. Furthermore, the patterns of heart failure differ between sexes, as do the lifetime risk factors. Do caloric restriction(CR)-mimetics, rich in polyphenol or polyamine, delay or reverse cardiac aging equally in both men and women? This review will discuss three areas:(1) mechanisms underlying age-related cardiac remodeling;(2) gender-related differences and potential mechanisms underlying diminished cardiac response in older men and women;(3) we select a few polyphenol or polyamine rich compounds as the CRmimetics, such as resveratrol, quercetin, curcumin, epigallocatechin gallate and spermidine, due to their capability to extend health-span and induce autophagy. We outline their abilities and issues on retarding aging in animal hearts and preventing CVD in humans. We discuss the confounding factors that should be considered for developing therapeutic strategies against cardiac aging in humans.

Interaction between age and gender on survival outcomes in extramedullary multiple myeloma over the past two decades

BACKGROUND Extramedullary multiple myeloma(MM)(EMM)is a rare and aggressive subentity of MM that can be present at diagnosis or develop anytime during the disease course.There is a paucity of data on the clinical characteristics and overall epidemiology of EMM.Furthermore,there is a scarcity of data on how the interaction of age and gender influences the survival of EMM.AIM To evaluate the clinical characteristics of patients with EMM over the past 2 decades and to identify epidemiologic characteristics that may impact overall prognosis.METHODS A total of 858 patients diagnosed with EMM,between 2000 and 2017,were ultimately enrolled in our study by retrieving the Surveillance,Epidemiology,and End Results database.We analyzed demographics,clinical characteristics,and overall mortality(OM)as well as cancer-specific mortality(CSM)of EMM.Variables with a P value<0.1 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors,with a hazard ratio(HR)of greater than 1 representing adverse prognostic factors.RESULTS From a sample of 858 EMM,the male gender(63.25%),age range 60-79 years(51.05%),and non-Hispanic whites(66.78%)were the most represented.Central Nervous System and the vertebral column was the most affected site(33.10%).Crude analysis revealed higher OM in the age group 80+[HR=6.951,95%confidence interval(95%CI):3.299-14.647,P=0],Non-Hispanic Black population(HR=1.339,95%CI:1.02-1.759,P=0.036),Bones not otherwise specified(NOS)(HR=1.74,95%CI:1.043-2.902,P=0.034),and widowed individuals(HR=2.107,95%CI:1.511-2.938,P=0).Skin involvement(HR=0.241,95%CI:0.06-0.974,P=0.046)and a yearly income of$75000+(HR=0.259,95%CI:0.125-0.538,P=0)had the lowest OM in the crude analysis.Crude analysis revealed higher CSM in the age group 80+,Non-Hispanic Black,Bones NOS,and widowed.Multivariate cox proportional hazard regression analyses only revealed higher OM in the age group 80+(HR=9.792,95%CI:4.403-21.774,P=0)and widowed individuals(HR=1.609,95%CI:1.101-2.35,P=0.014).Multivariate cox proportional hazard regression analyses of CSM also revealed higher mortality of the same groups.Eyes,mouth,and ENT involvement had the lowest CSM in the multivariate analysis.There was no interaction between age and gender in the adjusted analysis for OM and CSM.CONCLUSION EMM is a rare entity.To our knowledge,there is a scarcity of data on the clinical characteristics and prognosis factors of patients with extramedullary multiple myeloma.In this retrospective cohort,using a United States-based population,we found that age,marital status,and tumor site were independent prognostic factors.Furthermore,we found that age and gender did not interact to influence the mortality of patients with EMM.

Gender and rural transformation:A systematic literature review

Rural transformation can improve poverty reduction,living standards,and health outcomes in developing countries.However,impacts associated with rural transformation vary by region,household,and individual trait(including gender).While research on rural transformation has been increasing over the last decade,there has been no comprehensive review conducted on the relationships between gender and rural transformation.Here,we conduct a systematic literature review to investigate the impacts of rural transformation on gender and the influence of gender inclusiveness on rural transformation.We reviewed 82 studies from 1960-2021 that explore the relationships between rural transformation and gender.We then developed a framework that captures incidences and flow directions between indicators.Results show that most studies examined the impacts of rural transformation on women and between gender indicators.Few investigated the role of women and the influence of gender inclusiveness on rural transformation.Overall,studies showed that rural transformation typically leads to positive outcomes for women regarding employment,income,and empowerment.However,negative impacts on women’s control over income,stability of new income sources,and access to healthy food are also common.Tailoring future development policies and programs to explicitly account for gender inclusiveness can lead to more successful rural transformation.

Racial and gender-based disparities and trends in common psychiatric conditions in liver cirrhosis hospitalizations:A ten-year United States study

BACKGROUND Chronic liver disease is associated with various neuropsychiatric conditions.There are currently no large studies assessing and comparing the prevalence of psy-chiatric illnesses based on patient profiles and the etiology of cirrhosis.AIM To examine the trends of hospitalizations among psychiatric conditions in cirrhosis.METHODS We used the National Inpatient Sample database 2016-2019 for the primary diagnosis of liver cirrhosis.The outcomes included the prevalence,trends,and associations of psychiatric diagnoses in these hospitalizations.Chi-square for categorical variables and the Wilcoxon rank test for continuous variables were utilized.RESULTS The prevalence of generalized anxiety disorder(GAD)in liver cirrhosis hospitalizations increased from 0.17%in 2009 to 0.92%in 2019(P<0.001).The prevalence of depression increased from 7%in 2009 to 12%in 2019(P<0.001).Attention deficit hyperactivity disorder(ADHD)prevalence increased from 0.06%to 0.24%.The prevalence of schizophrenia increased from 0.59%to 0.87%(P<0.001).Schizoaffective disorder prevalence increased from 0.10%to 0.35%(P<0.001).Posttraumatic stress disorder(PTSD)prevalence displayed increasing trends from 0.36%in 2009 to 0.93%in 2019(P<0.001).The prevalence of suicidal ideation increased from 0.23%to 0.56%in 2019.Cirrhosis related to alcoholic liver disease[adjusted odds ratios(aOR)1.18,95%CI 1.08-1.29,P<0.001]and non-alcoholic fatty liver disease(NAFLD)(aOR 1.14,95%CI 1.01-1.28,P=0.025)was associated with depression more than other causes.Alcohol-and NAFLD-associated cirrhosis had a stronger link to psychiatric disorders.Females had a higher association with GAD(aOR 2.56,95%CI 2.14-3.06,P<0.001),depression(aOR 1.78,95%CI 1.71-1.84,P<0.001),bipolar disorder(aOR 1.64,95%CI 1.52-1.77,P<0.001]and chronic fatigue(aOR 2.31,95%CI 1.31-4.07,P<0.001)when compared to males.Blacks,Hispanics,and Asian/Native Americans had a significantly lower association with GAD,depression,bipolar disorder,PTSD,and ADHD when compared to the white race.CONCLUSION The prevalence of psychiatric comorbidities in liver cirrhosis hospitalizations has increased over the last decade.Females had a higher association with psychiatric disorders compared to males.Blacks,Hispanics,and Asian/Native Americans had lower associations with psychiatric comorbidities compared to the white race.

The mean age of gender dysphoria diagnosis is decreasing

INTRODUCTION Gender dysphoria(GD),or gender identity disorder,is defined as persistent distress stemming from the incongruence between one's assigned sex at birth and gender identity.'GD has traditionally been introduced as a rare condition predominant in assigned males at birth(AMABs).2 However,recent studies have shown an upward trend in assigned females at birth(AFABs)with a dramatic reversal of the AMAB:AFAB ratio-.5-The actual AMAB:AFAB ratio varies by age group and study population.4-Questions have been raised concerning the increasing number of youth who seek professional care for GD,especially adolescent AFABs.

Cancer screening and management in the transgender population:Review of literature and special considerations for gender affirmation surgery

BACKGROUND Literature focused on cancer screening and management is lacking in the transgender population.AIM To action to increase contributions to the scientific literature that drives the creation of cancer screening and management protocols for transgender and gender nonconforming(TGNC)patients.METHODS We performed a systematic search of PubMed on January 5th,2022,with the following terms:“TGNC”,OR“transgender”,OR“gender non-conforming”,OR“gender nonbinary”AND“cancer screening”,AND“breast cancer”,AND“cervical cancer”,AND“uterine cancer”,AND“ovarian cancer”,AND“prostate cancer”,AND“testicular cancer”,AND“surveillance”,AND“follow-up”,AND“management”.70 unique publications were used.The findings are discussed under“Screening”and“Management”categories.RESULTS Screening:Current cancer screening recommendations default to cis-gender protocols.However,long-term genderaffirming hormone therapy and loss to follow-up from the gender-specific specialties contribute to a higher risk for cancer development and possible delayed detection.The only known screening guidelines made specifically for this population are from the American College of Radiology for breast cancer.Management:Prior to undergoing Gender Affirmation Surgery(GAS),discussion should address cancer screening and management in the organs remaining in situ.Cancer treatment in this population requires consideration for chemotherapy,radiation,surgery and/or reconstruction.Modification of hormone therapy is decided on a case-by-case basis.The use of prophylactic vs aesthetic techniques in surgery is still debated.CONCLUSION When assessing transgender individuals for GAS,a discussion on the future oncologic risk of the sex-specific organs remaining in situ is essential.Cancer management in this population requires a multidisciplinary approach while the care should be highly individualized with considerations to social,medical,surgical and gender affirming surgery related specifications.Special considerations have to be made during planning for GAS as surgery will alter the anatomy and may render the organ difficult to sample for screening purposes.A discussion with the patient regarding the oncologic risk of remaining organs is imperative prior to GAS.Other special considerations to screening such as the conscious or unconscious will to unassociated with their remaining organs is also a key point to address.We currently lack high quality studies pertinent to the cancer topic in the gender affirmation literature.Further research is required to ensure more comprehensive and individualized care for this population.