Acceptance is protection:
New approach supports families dealing with 'normal diversity' of gender identity and expression
How should parents respond when their four years old son insists on wearing girls' clothes, or their daughter switches to using a male version of their name? These are the questions increasingly being asked of family therapist Jean Malpas who writes in Family Process about a new approach to support parents with gender nonconforming and transgender children.
Jean Malpas, the Director of the Gender and Family Project at the Ackerman Institute for the Family, explains how families of gender nonconforming and transgender children can benefit from a multi-dimensional approach to negotiating two understandings of gender: One being a traditional system of male or female which dominates mainstream society, which contrasts with a more flexible and fluid spectrum of gender being expressed by their children.
"Parents of gender nonconforming children often struggle with how to best protect their child from bullying and ostracism, while accepting and nurturing their child's identity and expression." said Jean Malpas. "This research shows how coaching, education, parent support group and family therapy can support everyone in the family in negotiating this dilemma."
Jean Malpas' clinical findings confirm that a normal diversity of gender expression exists among children and uses anonymous case studies to demonstrate the varied paths children take when developing their identity. Some nonconforming children will grow up to be transgender, others will eventually feel comfortable identifying with their biological sex, while others will continue to display gender nonconforming traits without requesting social or medical transition.
"Research on gender nonconformity also has implications for education policy," said Malpas. "It is important that schools are aware and sensitive to the non-binary and non-biological aspects of gender, as it means gendered activities and segregation of students based on gender lines may no longer be appropriate if our children's understanding of gender is expressed in more complex ways."
Clinical approaches based on the non-pathologisation of gender diversity contrast with traditional psychiatric approaches, which have used cognitive-behavioral methods to extinguish atypical behaviours and reinforce traditional gender expression.
"Our clinical findings show that gender nonconformity in children is not a psychopathology but a normal display of diversity in gender expressions and identities," concluded Malpas. "Providing multi-dimensional support to parents of gender nonconforming and transgender children allows them to accept and affirm their child's identity while providing valuable protection at home, in school and out in the world."
06 December 2011
05 December 2011
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01 December 2011
29 November 2011
New study supports mammography screening at 40
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Women in their 40s with no family history of breast cancer are just as likely to develop invasive breast cancer as are women with a family history of the disease, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA). These findings indicate that women in this age group would benefit from annual screening mammography.
The breast cancer screening guidelines issued by the U.S. Preventive Services Task Force in November 2009 sparked a controversy among physicians, patient advocacy groups and the media. Much of the debate centered on the recommendation against routine annual mammography screening for women in their 40s.
"We believe this study demonstrates the importance of mammography screening for women in this age group, which is in opposition to the recommendations issued by the task force," said Stamatia V. Destounis, M.D., radiologist and managing partner of Elizabeth Wende Breast Care, LLC, in Rochester, N.Y.
For the study, Dr. Destounis and colleagues performed a retrospective review to identify the number and type of cancers diagnosed among women between the ages of 40 and 49—with and without a family history of breast cancer—who underwent screening mammography at Elizabeth Wende Breast Care from 2000 to 2010. The researchers then compared the number of cancers, incidence of invasive disease and lymph node metastases between the two groups.
Of the 1,071 patients in the 40 – 49 age group with breast cancer, 373 were diagnosed as a result of screening. Of that 373, 39 percent had a family history of breast cancer, and 61 percent had no family history of breast cancer. In the family history group, 63.2 percent of the patients had invasive disease, and 36.8 percent had noninvasive disease. In the no family history group, 64 percent of the patients had invasive disease, and 36 percent had noninvasive disease. The respective lymph node metastatic rates were 31 percent and 29 percent.
"In the 40 – 49 age group, we found a significant rate of breast cancer and similar rates of invasive disease in women with and without family history," Dr. Destounis said. "Additionally, we found the lymph node metastatic rate was similar."
According to Dr. Destounis, these results underscore the importance of early detection and annual screening mammography for women between the ages of 40 and 49 whether or not they have a family history of breast cancer.
Women in their 40s with no family history of breast cancer are just as likely to develop invasive breast cancer as are women with a family history of the disease, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA). These findings indicate that women in this age group would benefit from annual screening mammography.
The breast cancer screening guidelines issued by the U.S. Preventive Services Task Force in November 2009 sparked a controversy among physicians, patient advocacy groups and the media. Much of the debate centered on the recommendation against routine annual mammography screening for women in their 40s.
"We believe this study demonstrates the importance of mammography screening for women in this age group, which is in opposition to the recommendations issued by the task force," said Stamatia V. Destounis, M.D., radiologist and managing partner of Elizabeth Wende Breast Care, LLC, in Rochester, N.Y.
For the study, Dr. Destounis and colleagues performed a retrospective review to identify the number and type of cancers diagnosed among women between the ages of 40 and 49—with and without a family history of breast cancer—who underwent screening mammography at Elizabeth Wende Breast Care from 2000 to 2010. The researchers then compared the number of cancers, incidence of invasive disease and lymph node metastases between the two groups.
Of the 1,071 patients in the 40 – 49 age group with breast cancer, 373 were diagnosed as a result of screening. Of that 373, 39 percent had a family history of breast cancer, and 61 percent had no family history of breast cancer. In the family history group, 63.2 percent of the patients had invasive disease, and 36.8 percent had noninvasive disease. In the no family history group, 64 percent of the patients had invasive disease, and 36 percent had noninvasive disease. The respective lymph node metastatic rates were 31 percent and 29 percent.
"In the 40 – 49 age group, we found a significant rate of breast cancer and similar rates of invasive disease in women with and without family history," Dr. Destounis said. "Additionally, we found the lymph node metastatic rate was similar."
According to Dr. Destounis, these results underscore the importance of early detection and annual screening mammography for women between the ages of 40 and 49 whether or not they have a family history of breast cancer.
Male circumcision cost-effective way to prevent HIV in S. and E. Africa
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A collection of nine new articles to be published in PLoS Medicine and PLoS ONE, in conjunction with the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United States President's Emergency Plan for AIDS Relief (PEPFAR), highlights how scaling up voluntary medical male circumcision (VMMC) for HIV prevention in eastern and southern Africa can help prevent HIV not only at individual but also at community and population level as well as lead to substantial cost savings for countries due to averted treatment and care costs.
The first article by Catherine Hankins of UNAIDS, Steven Forsythe of The Futures Institute, and Emmanuel Njeuhmeli of PEPFAR/USAID, offers an introduction to the cost, impact and challenges of accelerated scaling up and lays out the rationale for the series. This article, as well as the one to follow, signposts the way forward to accelerate the scaling up of VMMC service delivery safely and efficiently to reap individual-and population-level benefits.
The remaining 8 papers also focus on the various factors that go into effective program expansion of VMMC, including data for decision making, policy and programmatic frameworks, logistics, demand creation, human resources, and translating research into services.
The cost savings are clear: an initial investment of US$1.5 billion between 2011 and 2015 to achieve 80% coverage of VMMC services in 14 priority countries in southern and eastern Africa and thereafter US$0.5 billion between 2016 to 2025 to maintain that coverage of 80% would result in net savings of US$16.5 billion between 2011 and 2025. However, as the articles in the collection show, strong political leadership, country ownership, and stakeholder engagement, along with effective demand creation, community mobilisation, and human resource deployment, are essential in effectively expanding and maintaining VMMC programs.
A collection of nine new articles to be published in PLoS Medicine and PLoS ONE, in conjunction with the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United States President's Emergency Plan for AIDS Relief (PEPFAR), highlights how scaling up voluntary medical male circumcision (VMMC) for HIV prevention in eastern and southern Africa can help prevent HIV not only at individual but also at community and population level as well as lead to substantial cost savings for countries due to averted treatment and care costs.
The first article by Catherine Hankins of UNAIDS, Steven Forsythe of The Futures Institute, and Emmanuel Njeuhmeli of PEPFAR/USAID, offers an introduction to the cost, impact and challenges of accelerated scaling up and lays out the rationale for the series. This article, as well as the one to follow, signposts the way forward to accelerate the scaling up of VMMC service delivery safely and efficiently to reap individual-and population-level benefits.
The remaining 8 papers also focus on the various factors that go into effective program expansion of VMMC, including data for decision making, policy and programmatic frameworks, logistics, demand creation, human resources, and translating research into services.
The cost savings are clear: an initial investment of US$1.5 billion between 2011 and 2015 to achieve 80% coverage of VMMC services in 14 priority countries in southern and eastern Africa and thereafter US$0.5 billion between 2016 to 2025 to maintain that coverage of 80% would result in net savings of US$16.5 billion between 2011 and 2025. However, as the articles in the collection show, strong political leadership, country ownership, and stakeholder engagement, along with effective demand creation, community mobilisation, and human resource deployment, are essential in effectively expanding and maintaining VMMC programs.
20 November 2011
Transgender Day of Remembrance
Tell others: If you have questions, need advice, feel unsure or unsafe, there are good people who want to help you. First stop is here.
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