Medical Complications of Female Genital Mutilation

Abstract

More than 130 million women are subjected to genital mutilation. Despite increasing efforts to reduce the practice, there are many obstacles to eliminating this 2,000-year-old practice, which is based on strong cultural traditions. As college health clinicians provide care to more international students from countries where female genital mutilation is performed, increased awareness and knowledge of the procedure will enable clinicians to understand and manage its complications. We report a case of obstructive uropathy resulting in hydronephrosis secondary to female genital mutilation and review the medical literature regarding this and other complications of genital mutilation “surgery.”     

Mutually Dependent Health Beliefs Associated With Breast Self-examination in British Female University Students

Abstract

Objective: Whereas research suggests young women's beliefs about breast cancer (susceptibility/severity) and its early detection (barriers/benefits) reliably distinguish breast self-examiners from nonexaminers, this study assessed whether these impressions are interreliant, especially in the context of familial risk. Participants: The sample comprised over 200 female undergraduates from a university in England, United Kingdom. Methods: Participants completed a self-administered survey on their attitudes concerning breast cancer and early detection. Data were analyzed using logistic regression analysis. Results: Nonexaminers were distinguished by a combination of greater perceived hindrances to self-examinations and stronger appraisals of breast cancer severity, and also by a permutation of fewer perceived benefits in self-examinations and lower perceived susceptibility to breast cancer. The latter interaction persisted after accounting for family history. Conclusions: Interwoven attitudes may depict sophisticated efforts on the part of nonexaminers to justify inaction. Clinical implications for college health providers are considered.     

Diagnosis of Pregnancy

Abstract

Contraceptive failure is a growing problem, especially on the college campus. Because of this, college health care providers are treating more and more college women not only for pregnancy-related problems, but women that present to the health center with other health complaints and are pregnant as well.

For these reasons, the diagnosis of pregnancy must always be entertained by all health care providers treating young women. Pregnancy must always be excluded before any tests or procedures are done that may be teratogenic. This is not only important for optimal health care, but also for medical-legal reasons.

This paper presents four unusual presentations of pregnancy and reviews the guidelines for diagnosis of pregnancy.     

What Pediatric Subspecialists Need to Know About Sexual and Reproductive Health: A Review of the American Board of Pediatrics Content Outlines for Subspecialty Certifying Examinations

ABSTRACT

Many adolescents with complex medical conditions regard their subspecialty providers as an important source of clinical information including sexual and reproductive health information related to their medical condition. Thus, training for pediatric subspecialty providers should include clinically relevant sexual and reproductive content. The purpose of this study is to understand what disease-relevant sexual and reproductive health information is currently included in content outlines for each of the available pediatric subspecialty certifying examinations. The American Board of Pediatrics (ABP) offers 17 subspecialty certifying examinations; 13 content outlines are available on the ABP website which defines the body of knowledge to be tested. Each available outline underwent content analysis for sexual and reproductive health information. A team of adolescent medicine physicians identified seven thematic areas including: 1) puberty; 2) sexual behavior and identity; 3) fertility; 4) contraception; 5) sexually transmitted infections; 6) other genital pathology; 7) pregnancy. Across disciplines, learning objectives related to sexual behavior, sexual identity, fertility, contraception and pregnancy were the most limited. However, content related to puberty, sexually transmitted infections and other genital pathology was better represented. Overall, disease-and treatment-specific sexual and reproductive health information was sparse. Most subspecialty content outlines contain very little disease-specific sexual and reproductive health information despite the growing adolescent and young adult population with complex medical conditions in the care of pediatric subspecialists. Further studies are needed to explore if lack of sexual and reproductive information on board exams relates to the knowledge base and skill set of pediatric subspecialists.     

When Sex is Hardly About Mutual Pleasure: Dominant and Resistant Discourses on Sexuality and its Consequences for Young People's Sexual Health

ABSTRACT

This study explores gendered discourses about sexuality in Ecuador, the consequences of these discourses for young people's sexual health, and the possibility of the emergence of resistance and challenge. We analyzed and compared individual interviews and focus-group discussions with: young women, youth service providers, ordinary young men, and activist young men. Five interpretative repertoires emerged: (1) becoming sexually respectable women, (2) policing young women's sexuality, (3) men threatening and protecting women, (4) sexual relations (abusing, fooling, or seducing?), and (5) emerging resistance. The repertoires constructed a hierarchy of sexualities in which heterosexual monogamous lifelong coupledom was normative and women's pleasure was absent, but resistance was emerging.     

Understanding Gender as a Fundamental Cause of Health: Simultaneous Linear Relationships between Gender,Mental Health,and Physical Health Over Time

Abstract

Responding to calls to move beyond mental or physical health examinations of gender and health, and to systemically understand the relationships between mental health, physical health, and social identity locations, we explored the extent to which gender is a fundamental cause of health by estimating the relationships between gender, mental health, and physical health simultaneously. We analyzed nationally representative longitudinal data from Waves I and III of the American Changing Lives Survey, and estimated general and gender-specific structural equation models to better understand direct and indirect effects of the structural relationships between gender, mental health, and physical health over time. Our findings suggest mental health outcomes drive the likelihood of physical health outcomes in the case of women only, whereas for men, there is no direct nor significant relationship. However, we find persistent effects of anxiety on limited daily activities for men, but not for women. In conclusion, we discuss potential lessons learned from using such analytic methods and the implications of our findings as they relate to gender and health.     

Lesbian Health

ABSTRACT

Health care research suggests that lesbians may face unique physical and mental health risks, yet few studies make use of gender and sexuality theories to explain lesbian health. In this study, a social constructionist view of sexuality is used to examine the impact of lesbian identity on well-being. Drawing from nineteen intensive interviews with women who self-identify as lesbians, the results show that individuals' sexual identities change over time and are affected by their social environments. The data also demonstrate that sexual identity and social context have implications for well-being. Specifically, hostile environments, which are characterized by animosity toward gay men, lesbians, and others who do not conform to heteronormative gender expectations, are associated with distress over lesbian identity and with physical and mental health problems. By contrast, supportive environments, which many women report finding through feminism, facilitate the construction of a positive lesbian identity and enhance well-being.     

HIV Prevention,Gender and Sexual Health

Abstract

Drawing on a review of relevant literature as well as global experience, this paper focuses on aspects of the growing feminisation of the HIV epidemic, especially the combination of age and gender which makes young women particularly vulnerable to HIV. It also briefly touches upon the gender-constructed vulnerability of young men. The linkages between gender, sexual health and HIV-and what works to forge these linkages-have now been well established. Not acting on the basis of this knowledge in order to avert millions of infections and deaths due to HIV, is no longer an option.     

Uptake of HPV vaccine in traditional-age undergraduate students: Knowledge,behaviors, and barriers

Abstract

Objective: This study investigated potential factors associated with HPV vaccine uptake in a diverse population of traditional-age undergraduate students. Participants: One hundred and twenty-nine undergraduate students aged 18–24 attending a small southeastern university completed surveys in January to March of 2013. Methods: Questionnaires included demographic information, basic HPV knowledge, HPV vaccine uptake, and factors influencing uptake decision. Survey results were analyzed with chi-square and t-test analyses. Results: Vaccine uptake was significantly higher in students who reported that health care provider, public health information, parents, and access to vaccine were important factors in their decision to get vaccinated. Female students had a significantly higher vaccine uptake in comparison to males and the HPV knowledge scores differed significantly by race but not gender. Conclusions: It is especially important to consider how public health campaigns and communication with parents and health care providers help promote HPV vaccine uptake in this high-risk group.     

Sexual Body Image and Its Correlates: A Population-Based Study of Finnish Women and Men

ABSTRACT

Sexual body image was examined in a population-based sample of 9,532 Finnish men and women, age 18 to 49 years. More than one half of women and men were satisfied with their genitals, one half of the women were satisfied with their breasts. Higher levels of genital satisfaction were related to higher frequencies of sexual behavior and better sexual function for both genders. For men, penis size satisfaction was associated with lower levels of premature ejaculation and better erectile function. Sexual body image was related to overall perceived attractiveness, for women a higher body mass index was related to satisfaction with breast size. Having children was negatively related to women's sexual body image, abortions and miscarriages likewise. Limitations of the study and clinical implications of the findings are discussed.     

MSM's Versus Health Care Providers’ Perceptions of Barriers to Uptake of HIV/AIDS-Related Interventions: Systematic Review and Meta-Synthesis of Qualitative and Quantitative Evidence

ABSTRACT

To compare the perceptions of men who have sex with men (MSM) and health care providers (HCPs) on barriers to uptake of HIV/AIDS-related interventions using existing quantitative and qualitative data. Systematic review and meta-synthesis was employed to combine data from both groups. Based on studies focusing on MSM and HCPs, knowledge about the intervention and intervention's cost emerged as major barriers to uptake whereas HIV- or homosexuality-related stigma/discrimination was a barrier in studies focusing on MSM alone. Lack of practice guidelines was barrier among HCPs only. Few studies exist that focus on perceptions of barriers by HCPs.     

Observational Stance as a Predictor of Subjective and Genital Sexual Arousal in Men and Women

Observational stance refers to the perspective a person takes while viewing a sexual stimulus, either as a passive observer (observer stance) or an active participant (participant stance). The objective of the current study was to examine the relationship between observational stance and sexual arousal (subjective and genital) across a range of sexual stimuli that do or do not correspond with a participant's sexual attraction (preferred or nonpreferred stimuli, respectively). Regression analyses revealed that, for men (n = 44), participant stance significantly predicted subjective and genital arousal. Women's (n = 47) observer and participant stance predicted subjective arousal but not genital arousal. Analysis of variance showed that participant stance was greatest under preferred sexual stimuli conditions for all groups of participants, while observer stance scores revealed a less consistent pattern of response. This was particularly true for opposite-sex-attracted women, whose ratings of observer stance were lowest for preferred stimuli. Observational stance does not appear to account for gender differences in specificity of sexual arousal; for men, however, participant stance uniquely predicted genital response after controlling for sexual attractions. Similarities in the relationships between men's and women's observational stance and sexual responses challenge previous claims of gender differences in how men and women view erotica.     

Young,successful, precarious? Precariousness at the entry stage of employment careers in Germany

ABSTRACT

The article investigates entry-stage employment trajectories of young people in Germany, asking whether transitions into continuous employment indicate successful labour market integration. Applying a novel multidimensional approach to precariousness to individuals’ employment and household trajectories, we understand entry-stage employment trajectories holistically. The balanced-panel sample is drawn from the German Socio-Economic Panel, with a focus on young men and women between 15 and 25 years of age in the first year of the sample period who had been employed at least once (n?=?1360).

Dual-channel sequence-cluster analysis reveals considerable variation in the precariousness of young people’s entry-stage employment. While almost all young men and women experience periods of precariousness, the durations vary substantially. Precarious employment or precarious living conditions frequently occur during education. Our results confirm that individuals with disrupted employment trajectories are seldom successfully integrated into the labour market and frequently experience precarious employment. In previous research, transitions into continuous employment have been understood as the hallmark of successful labour market integration. This holds true for young women but not for young men, who experienced continuous and precarious entry-stage employment. To correctly identify young men’s successful labour market integration, additional information about their employment precariousness is required.     

American College Health Association

Abstract

Objective: The purpose of this cross-sectional investigation was to examine (1) gender differences in osteoporosis-related knowledge and beliefs and (2) if these beliefs could predict vigorous physical activity behavior in university students. Participants: Male (n = 176) and female (n = 351) university students participated in the study. Methods: Participants completed self-report measures of osteoporosis knowledge and health beliefs and vigorous physical activity. Results: Regardless of gender, osteoporosis knowledge was relatively poor. Women reported higher knowledge, perceived susceptibility, perceived severity, and calcium barriers, and lower exercise self-efficacy than men. Regression analyses showed that for women, perceived susceptibility, health motivation, and exercise self-efficacy predicted vigorous physical activity, whereas for men, exercise barriers was the only predictor. Conclusions: Gender differences in osteoporosis health beliefs appear to be greater in older adults than college-aged students. Interventions designed to increase vigorous physical activity may want to target different beliefs for men and women.     

Sources,Providers and Self-Reported Complications among Indian Women Seeking Induced Abortion: Evidence from the National Family Health Survey (2015–16)

Abstract

This article attempts to find types of sources and providers, and likelihood of self-reported complication among Indian women. Fifty-three percent of abortions are done at private health facilities. Only one in every 5 women went to public health facilities, and the rest did not go anywhere (27.5%). Doctors are the major abortion service providers (52.3%) in India. Eighteen percent of women who sought abortion reported some complication. Logit regression shows that complications were 1.8 times higher in the second-trimester than the first-trimester abortion. This study suggests for addressing the demand of abortion by accessing and improving services in public health system.     

Cancer Knowledge and Examination Frequency in College Students

Abstract

College students are now being considered an appropriate target for cancer education programs. However, research has demonstrated that only a fraction of those individuals knowledgeable about the importance of cancer examinations actually practice these examinations. This study investigated whether the personality construct of repression-sensitization could identify which individuals would or would not practice regular examinations for breast, cervical, and testicular cancer. College students were identified as repressors, neutral, or sensitizers and tested as to their knowledge and examination frequency for breast, cervical, and testicular cancer. After a cancer lecture, this information was reasessed. No differences were found among repressors, neutrals, or sensitizers in cancer knowledge or examination frequency, either prelecture or postlecture. Cancer knowledge significantly increased after the lecture for both males and females. No change was found in the frequency of breast self-examination, while frequency of pap smears declined after the lecture. In contrast, testicular self-examination frequency increased. The implications of these results for future research are discussed.     

College students' acceptance of trans women and trans men in gendered spaces: The role of physical appearance

ABSTRACT

Transgender people often face prejudice and discrimination in school, employment, housing, and health care, and this can affect their psychological well-being. Although the literature on prejudice toward transgender people is growing, there is limited research that has examined differences in attitudes toward trans women and trans men separately. Specifically, the current study examined the role of physical appearance in the acceptance of transgender women and men in gendered spaces, including bathrooms, locker rooms, residence halls, and sorority and fraternity organizations. Participants viewed masculine-appearing and feminine-appearing images of a trans woman and trans man. Measurements of overall transacceptance and gendered-space acceptance were assessed. Results indicated that, in general, trans women were less accepted than trans men. The masculine-appearing trans woman was less accepted in the gendered spaces compared to the feminine-appearing trans woman and both images of the trans men. Also, female participants were generally more accepting of transgender people than male participants were. These findings suggest that, compared to trans men, discrimination of trans women is more likely, especially when the trans woman's physical appearance transgresses traditional gender expectations.     

An Experiment to Modify Self-Concept and School Performance

Abstract

The joint or combined effects of age level, sex differences, and social factors in fear of crime are systematically investigated using elaboration analysis with 1976 NORC data. Findings reveal that while the elderly are somewhat more likely to report fear of crime when compared with young and middle-aged groups, many more women express apprehension than men at each age level. Fear of being victimized is especially prevalent among those segments of the population that are the most isolated and vulnerable, notably elderly and middle-aged black women, unmarried older women living alone, elderly women in poor health, and women of all ages who had been burglarized.     

More Than Just Sex

Abstract

The purpose of this research was to identify behaviors in addition to those of an explicitly sexual or romantic nature that men and women define as unfaithful acts in the context of committed dating relationships. We also sought to identify possible gender differences in the proportions of men and women who have engaged in these unfaithful behaviors while in dating relationships. We examined 219 college men's and women's reported involvement in sexual behaviors, romantic attachments, sexual and nonsexual fantasies, sexual attraction, romantic attraction, flirting, and social participation in dyads and groups with someone other than their current or past dating partner. A sizable proportion of both men and women reported engaging in one or more of the behaviors at some point in their dating history. Proportionately more men than women indicated having engaged in sexual fantasies of various types about someone other than their primary partner and reported “hitting on” someone else while in a dating relationship. No other gender differences emerged. A unique aspect of this study is that we asked young men and women to determine what kinds of behaviors they considered to be unfaithful rather than only examining sexual and emotional behaviors as has been the case in past research. Further, the few significant gender differences we found indicates that the convergence of men's and women's attitudes about sexuality may now be show in their behavior.     

Screening for Sexually Transmitted Infections (STIs) Among a Heterogeneous Group of WSW(M)

ABSTRACT

Objectives: This study explored predictors of STI screening among a heterogeneous group of women who have sex with women and men. Methods: Following bivariate analyses, a multivariate logistic regression model was conducted to assess the relationship between testing and sociodemographic, relationship characteristics. Results: The majority of participants reported not receiving STI screening in the past year. Gender expression, and not sexual orientation, was a significant predictor of screening. For each increase in masculinity, participants had lower odds of receiving an STI test. Conclusions: More research is needed to understand how gender expression of WSW(M) relates to preventative health behaviors.