Intimate Partnerships and Sexual Health in Gender-Dysphoric Individuals Before the Start of Medical Treatment

ABSTRACT

Objectives: This study focuses on sexual health aspects in partnered gender-dysphoric individuals at the start of medical treatment by examining their partnership constellations, sexual experiences, and reports of psychological problems. Methods: As part of the cross-national European Network for the Investigation of Gender Incongruence Study, 168 adult male-to-females (MFs) and female-to-males (FMs; MF:FM sex ratio = 1:1.2) were surveyed by means of self-administered questionnaires prior to any gender-confirming hormonal and surgical interventions. Results: MFs were often found to have androphilic (female) partners (sexually oriented toward males), noncomplementary with their female gender identity. In contrast, FMs frequently had androphilic (female) partners, complementary with their male gender identity and sexual orientations toward females. Conclusions: In both genders, complementary partnership constellations were associated with more avoidance of sexual experiences and more negative sexual experiences.     

Can Cultural Beliefs Cause a Gender Identity Disorder?

Abstract

Gender identity disorder (GID) is a relatively rare disorder with an unclear etiology. This case report involves a boy from Thailand who was thought by his parents at birth, on the basis of a birthmark, to be the reincarnation of his maternal grandmother. He subsequently demonstrated cross-gender behavior. A link between his parents' cultural beliefs and the boy's cross-gender behavior is explored. Implications for the causes of other cases of GID are explored, and in particular, the question of whether parental expectations, as exemplified by these parents' cultural beliefs, can be a contributor to the formation of GID is considered.     

Post-Traumatic Stress Disorder,Dissociation, and Neuropsychological Performance in Latina Victims of Childhood Sexual Abuse

This study compared the memory, attention/concentration, and executive functioning of 12 women with histories of child sexual abuse with a control group of 12 women without childhood abuse. Participants completed a neuropsychological test battery and various instruments assessing post-traumatic stress disorder and dissociation. The child sexual abuse group had lower performance than the control group on long- and short-term visual and verbal memory and presented more limited performance on executive functioning tasks. Functioning in these areas showed a negative correlation with post-traumatic stress disorder and dissociative symptoms. These findings suggest that child sexual abuse is associated with memory and executive functioning deficits and supports the idea that people with trauma histories and increased post-traumatic stress disorder and dissociation symptoms may have alterations in neuropsychological functioning.     

Suicidal Ideation and Comorbid Disorders in Adolescents and Young Adults Diagnosed with Asperger's Syndrome: A Population at Risk

ABSTRACT

The purpose of this study was to examine the level of suicidal ideation and comorbid disorders (major depressive disorder, generalized anxiety disorder) among adolescents and young adults with diagnosed Asperger's syndrome (AS). A cross-sectional study using a self-administrated mail questionnaire and a Web-based questionnaire were used. Two samples were selected for this study. The first sample used snowball sampling, starting with parents of adolescents and young adults with diagnosed AS who participated in a qualitative study conducted in 2002. The second sample consisted of a volunteer sample of parents who visited Web sites for parents and individuals with diagnosed autism spectrum disorder. The sample included 10 adolescents and young adults with diagnosed AS. Fifty percent of the sample had a clinically significant level of suicidal ideation, 20% met criteria for a diagnosis of major depressive disorder, and 30% met criteria for generalized anxiety disorder.     

Understanding Responses to Foster Care: Theoretical Approaches

Foster children making the transition from birth to foster homes or from foster homes to foster homes often present problematic behaviors. Limitations of attachment theory and reactive attachment disorder are presented, and three alternative approaches for understanding behaviors exhibited in foster settings are presented: conservation of resources, child alienation model, and developmental trauma disorder.     

Post-finasteride syndrome – does it really exist?

Abstract

Inhibitors of 5α-steroid reductase are drugs used to treat androgen-dependent conditions including prostate diseases and androgenic alopecia. Finasteride was the first on the market and is currently the most widely used inhibitor. Dutasteride was the second inhibitor to be approved and has a similar safety profile. Common adverse events of treatment consist of sexual disorders and a negative affect balance. It was described that the prolonged use of 5α-steroid reductase inhibitors in patients with alopecia can cause persistent side effects called a post-finasteride syndrome (PFS), that is not just a simple coexistence of events, but rather a definite syndrome with an iatrogenic background. PFS occurs in susceptible individuals even after small doses of the drug and can last for a long time after the discontinuation of treatment. A deterioration in the quality of life in affected individuals does not justify use of the drug. Wider recognition of PFS symptoms, its incidence, course, prevention, and treatment possibilities will allow the indications for drug use to be reconsidered and treatment to be more personalized. Knowledge about PFS will also help to provide the best treatment for affected individuals and to properly educate patients before obtaining an informed consent for therapy with 5α-steroid reductase inhibitors.     

Impulsivity and pathological gambling across depressive versus bipolar disorders

Impulsivity has been implicated in the development of pathological gambling (PG); sensation seeking and urgency in particular have predicted gambling pathology in undergraduate and psychiatric samples. In light of the relevance of both depressed and elevated mood to impulsivity and gambling, the components of impulsivity associated with PG across mood disorders warrants investigation. The aim of the current investigation was to examine the association between impulsivity and gambling pathology severity across depressive versus bipolar disorders. A total of 275 participants with lifetime depressive or bipolar disorder completed measures of impulsivity and gambling. Urgency was consistently associated with gambling pathology indicators; lack of perseverance was specifically associated with gambling pathology within participants with depressive disorders. Reckless action during negative mood is associated with gambling pathology across mood disorders, whereas difficulty remaining focused is associated with PG solely within depressive disorders. Impulsivity and affective comorbidity may inform current understanding of PG.     

One of the Boys?

This article argues that American media reports of the Jessica Lynch case illustrate some of the ways in which gender has been reordered, policed and disciplined within the United States (and North America more broadly) in the wake of 9/11 and in the context of war. The study of a key gendered representation of the war – and of the way gender interlocks with race, class, nationality and sexuality in these representations – tells us not only about how the war was sold to the American public, but also about the degree to which normative and disciplinary gender roles can be stretched, or not, within domestic society and the ways in which contemporary media portrayals of foreign adventures serve to reinforce these gender norms. Ultimately we argue that media portraits of Jessica Lynch demonstrate how little the simple inclusion of women in the military acts to disrupt sexist systems of power and meaning.     

Protocol for student replication of published research

Subpart D of the Common Rule establishes 4 categories of research that may be conducted on children. One category, 45 CFR 46.406, permits research posing a minor increase over minimal risk and no prospect of direct benefit but expected to yield vital knowledge about the subjects' disorder or condition. To include other children in research posing a minor increase over minimal risk and no prospect of direct benefit requires federal review and approval of the Secretary of Health and Human Services under 45 CFR 46.407. It is widely held that children generally should not be exposed to more than minimal risk in research without the prospect of direct benefit. To justify deviating from this norm, as 406 allows, two claims must be true: (1) When there is vital knowledge to be gained from studying children, it is permissible to expose some children to a minor increase over minimal risk with no prospect of direct benefit; (2) It is permissible for locally reviewed and approved research to expose only children with the disorder or condition under investigation to greater risk with no prospect of direct benefit. The justification for (1) appears to be grounded in the magnitude of benefit to society combined with the need to study children. This article demonstrates that, even if the necessity and magnitude of benefit to society justify exposing children to increased risk, the decision to categorically restrict participation in such research to children with the disorder or condition under investigation (unless the study is federally reviewed and approved) is not justified. Subpart D should be revised.     

Hidden Eating Disorders: Attachment and Affect Regulation in the Therapeutic Relationship

From the time I began working at a clinic that specialized in therapy with individuals with eating disorders, I have repeatedly encountered cases of clients hiding these symptoms from their therapists. When they finally do reveal the disorder, their therapists often worry that their clients are more disturbed than they thought and that, they, the therapists, did something wrong in the therapy. Although some therapeutic rupture can be part of the picture, I have found that these disclosures often reflect a client’s growing trust in the therapist’s presence and ability to help with feelings that have been, until now, dealt with through the eating behaviors themselves. In my attempts to understand what happens before and after an individual shares a hidden eating disorder with a therapist, I have found ideas from attachment theory, in particular those that explore links between attachment, affect regulation, and self-reflection, to be very helpful. Many authors have noted that eating disorders are related to problems with attachment, loss and separation, and affect regulation. Difficulties in these areas make it hard for clients to be self-reflective or use insight productively. In this article, I discuss my experience with the integration of these dynamics, which I have found to be key to successful psychotherapy with clients who hide their eating disorders.