An Argument for Separate Analyses of Attitudes Toward Lesbian, Gay, Bisexual Men, Bisexual Women, MtF and FtM Transgender Individuals

While past research has certainly investigated a variety of correlates of U.S. attitudes toward lesbians, gays, bisexual men, bisexual women, male-to-female (MtF) and female-to-male (FtM) transgender (LGBT) individuals, there are no U.S. quantitative studies that could be located that examined attitudes toward each of these groups separately. This is especially important because efforts to combat prejudices are likely to be most successful if they are based in research that explores how attitudes are both similar and different across specified targets of prejudice. Toward that goal, this essay underscores the significance of examining U.S. attitudes toward LGBT individuals as separate constructs. Both the gender and sexual orientation of the target of prejudice and the gender and sexual orientation of the respondent are highlighted as important constructs that should be considered when investigating U.S. attitudes toward LGBT individuals. First, I review previous U.S. studies that have examined attitudes toward LGBT individuals. Second, I offer arguments for how the intersections of gender and sexual orientation may affect attitudes toward LGBT individuals. Third, I discuss future considerations in studies of attitudes toward LGBT individuals in the context of multiple intersectionalities. I suggest that U.S. initiatives to reduce sexual stigma, gender nonconformity stigma, and transgender stigma should be grounded in research that highlights prejudicial attitudes as they vary by the target of prejudice and the respondents’ characteristics.     

Client Aggression Towards Therapists: Is It More or Less Likely with Transgendered Clients?

ABSTRACT

It is well known that clients occasionally threaten or assault their therapists. No studies to date have attempted to systematically measure client aggression by transgender patients towards clinicians. One of the major questions of this study was to determine if clients with gender dysphoria have greater levels of aggression towards therapists than non-gender dysphoric clients. One hundred and fourteen professional therapists who are members of the Harry Benjamin International Gender Dysphoria Association responded to a questionnaire that addressed aggression by both transgender and non-transgender clients. Transgender clients were shown to commit significantly less acts of aggression than did non-transgendered clients (p = 0.0094). Within the relatively small subgroup of transgender clients that did commit acts of aggression, male-to-female transgender clients were significantly more likely to do so than female-to-male clients (p = 0.002). While the transgendered client undergoes significant suffering in violating inviolable gender boundaries, this suffering, in general, does not translate into acting out behaviors directed towards their therapists.     

Evolution of Gonadal Axis After Sex Reassignment Surgery in Transsexual Patients in the Spanish Public Health System

ABSTRACT

Although the effects of hormone therapy on cardiovascular risk factors and bone metabolism have been studied, data are lacking on the gonadotropin profile after gonadectomy in the sex reassignment process (SRP). Accordingly, whether measurement of the gonadotropin profile is useful in order to adjust the postsurgical dose of gonadal hormones is unknown. We studied the evolution of LH, FSH, prolactin, testosterone, and estradiol in 50 transsexual persons, 41 male-to-female transsexuals (MtF) and 9 female-to-male transsexuals (FtM), following a proto-colized regimen of hormone therapy for 12–24 months before and after genitoplasty. The increase in gonadotropins after surgery was greater in the FtM than in the MtF (66% vs. 50%), with the increase continuing more than one year after surgery. No variable was significantly associated with this different level of gonadotropins.     

Clinical Aspects of Transgender Speech Feminization and Masculinization

SUMMARY

Societal norms of speech, voice, and non-verbal communication are often strongly gendered. For transgender individuals who experience a mismatch between existing communication behaviours and felt sense of self, changes to the gendered aspects of communication can help reduce gender dysphoria, improving mental health and quality of life. While peer resources are often beneficial in changing overall appearance and presentation, speech and voice modification is best facilitated by a trans-competent speech professional. In this article we review clinical research relating to transgender speech and voice change and discuss clinical protocols for trans-specific assessment, treatment, and outcome evaluation.     

Health and Social Services for Male-to-Female Transgender Persons of Color in San Francisco

SUMMARY

This article presents findings from an investigation of health needs, service utilization, and perceived barriers to services among male-to-female (MtF) transgender persons of color in San Francisco. Focus groups (n = 48) and survey interviews (n = 332) were conducted with convenience samples recruited from the community. Participants reported a range of health and social services needed during the previous year, with African-Americans and Latinas showing particularly strong service needs. Rates of utilizing services were high for basic health care but lower for social services, substance abuse treatment, psychological counseling, and gender transition-related medical services. No significant ethnic group differences in health service utilization were found. Qualitative findings evinced the call for transgender-specific programs and advanced provider training on transgender issues such as hormone use, gender transition, HIV/ AIDS care and prevention, substance abuse, and mental health problems.     

Orchiectomy in transgender individuals: A motivation analysis and report of surgical outcomes

Abstract

Background: Different surgical procedures are available for transgender women wishing to undergo genital gender-affirming surgery.

Aim: To assess preoperative motivations, the frequency of orchiectomy procedures, and postoperative outcomes of orchiectomy in transgender individuals.

Methods: All transgender individuals who underwent orchiectomy in the period between January 2012 and January 2020 at our institution were retrospectively identified. A chart study was conducted, recording motivations, demographics, perioperative characteristics and surgical outcomes. The frequency of orchiectomy and vaginoplasty procedures during the study period were determined and compared.

Results: During the study period, an increase of performed orchiectomy procedures was observed. The orchiectomy/vaginoplasty ratio was 0.01–0.07 in the period 2012–2018 and 0.24 in 2019. A total of 43 transgender individuals were retrospectively identified. Sixteen (37%) initially wished to undergo a vaginoplasty, but did not meet institutional requirements (nonsmoker, BMI < 30kg/m²) or were not eligible for vaginoplasty surgery because of interfering somatic or mental health issues. Fourteen (33%) individuals who underwent orchiectomy regarded it as a preceding step to a future vaginoplasty procedure. Out of these fourteen, one person is now on the waiting list for vaginoplasty surgery. Thirteen (30%) others did not report a desire to pursue vaginoplasty in the future. This was mostly motivated by the absence of genital dysphoria or motivations related to their gender identity, with a desire to discontinue anti-testosterone treatment. The postoperative course was uncomplicated in 39 (91%) individuals.

Conclusion: In the Netherlands, especially in the last year, the frequency of orchiectomy procedures has increased. Reasons that people chose to undergo this procedure include: not being eligible for a vaginoplasty procedure, seeing it as a preceding step to a possible future vaginoplasty or other identity-related motivations (i.e., non-binary gender identification or absence of genital dysphoria).     

Thai Transgenders in Focus: Their Beliefs About Attitudes Towards and Origins of Transgender

ABSTRACT

One hundred and ninety-five transgendered females (i.e., male-to-female trans-genders (or MtF TGs)), with a mean age of 25.4 years, completed a questionnaire examining, inter alia, their beliefs about (a) attitudes (of parents and society) towards them (and to MtF TGs in general); and (b) origins of their own MTF TG status.

According to our participants, 62.9% of mothers and 40.6% of fathers accepted or encouraged their child's transgender from its first expression. Many with misgivings became more positive as time went on. According to 40.7% of our participants, Thai people overall held similarly favourable attitudes towards MtF TGs.

Many of our participants cited multiple origins for their transgender. Nearly 84% believed inborn biology had played a role. Friends and karma were also commonly endorsed as explanatory factors (50% and 48.4% respectively). Parents, siblings, and other relatives were less commonly cited (30.3%, 24.1%, and 22.2%, respectively). Cluster analysis revealed that, based on their beliefs, 97.1% of the sample could be divided into three groups. Most (61.2%) fell into a ‘biogenic’group, emphasising the role played by inborn biology, while 29.4% believed took a ‘peer psychogenic’ view, emphasising the role played by friends in the development of their transgender. A small ‘eclectic’ group (6.5%) believed that biology, karma, and parents combined to account for their transgender.     

Sex,Drugs, Violence,and HIV Status Among Male-to-Female Transgender Persons in Houston,Texas

SUMMARY

To inform the Community Planning Group (Houston, Texas) in setting HIV-prevention priorities, risk behavior surveys were completed by 67 male-to-female (MtF) transgender persons. By self-identification, 58% were preoperative and 48% were self-described heterosexual women. We found this small sample of male-to-female transgender individuals to have high rates of HIV infection, and high prevalence of risky behaviors, intimate partner violence, and suicidal ideation. Twenty-seven percent were infected with HIV. Barriers were seldom used during oral sex and used less than half the time for anal sex with either primary or casual partners. Nearly one-third of the sample reported use of methamphetamines, amyl nitrite or LSD and 40% reported crack or cocaine use. Intimate partner violence and forced sex were reported by 50% and 25%, respectively. Suicidal ideation was reported by 16% in the last 30 days; lifetime suicidal ideation was 60%.     

Gender traits and identities in a "masculine" organization: the Israeli police force

Gender and occupational identities were examined within the Israeli police force, a stereotypically masculine organization. The principal hypothesis was that women in this organizational setting did not reject their gender identity. Rather, they self-attributed more traditionally masculine traits in addition to their feminine traits. This was especially so among women going through particularly intense occupational and organizational socialization needed for field jobs. The findings only partially confirmed the hypothesis. Most women in the sample considered themselves to be highly feminine, even though they self-attributed masculine traits. Although the women, like their male colleagues, ranked occupational identity higher than gender identity, their feminine identity (usually in contrast with the masculine organizational context) was not repressed and their gender identity was as strong as that of the men.     

Are Female Stalkers More Violent Than Male Stalkers? Understanding Gender Differences in Stalking Violence Using Contemporary Sociocultural Beliefs

This study investigated gender differences in the perpetration of stalking violence and how sociocultural beliefs may account for these differences/similarities. A sample of 293 Australian undergraduate and postgraduate students classified as relational stalkers completed a self-report questionnaire assessing violence perpetration (no/moderate/severe violence) and sociocultural beliefs (justifications for relational violence; assessments of target fear). Female relational stalkers perpetrated elevated rates of moderate violence; however, there were no gender differences for severe violence. Both male and female relational stalkers were more supportive of justifications for female-perpetrated relational violence than male-perpetrated relational violence. Violent male relational stalkers were more likely to believe they caused fear/harm than their female counterparts. These findings are interpreted in the context of sociocultural beliefs that view male-to-female violence as more unacceptable and harmful than female-to-male violence.     

Eudaimonic Well-Being in Transsexual People,Before and After Gender Confirming Surgery

Gender confirming surgery (GCS) and cross-sex hormones (CSH) are crucial steps in the self-realization of a transsexual individual. However, no study has analyzed the outcome of GCS in a eudaimonic perspective, nor explored eudaimonic well-being before GCS. The study compares the eudaimonic well-being of trans men (N = 56) and women (N = 89) before and after GCS; in the MtF sample, a further comparison was carried out between those who never started any medical intervention and those who were already taking CSH. Finally, the impact of experiences of harassment, discrimination and violence on eudaimonic well-being in the post-surgery sample was explored. All participants completed the Psychological Well-being Scales (Ryff in J Pers Soc Psychol 57:1069–1081, 1989) and, only the post-surgery sample, a questionnaire to assess previous experiences of harassment, discrimination and violence. Both in MtF and FtM participants, those who already received GCS showed higher scores on self-acceptance; in the MtF sample, higher scores were also found on environmental mastery and lower scores on personal growth. The association between experiences of discrimination on well-being was limited and positive, with higher scores in personal growth only in FtM participants who reported being victims of such experiences. Our results suggest that both MtF and FtM transsexuals show higher levels of eudaimonic well-being after GCS.     

Development and Initial Psychometric Evaluation of the Transgender Adaptation and Integration Measure (TG AIM)

ABSTRACT

Transgender individuals have a gender identity or expression that is not congruent with their anatomy (Bullough, 2000). Limited empirical data are available regarding the mental health and general well-being of the transgender population. In addition, few standardized measures have been developed specifically for transgender individuals. The main purpose of this study was item and scale development of a measure of adjustment for transgender adults, as well as the assessment of the internal consistency and validity of the measure. Responses to the Transgender Adaptation and Integration Measure (TG AIM) were collected from a sample of 108 self-identified male-to-female transsexual adults. Standardized measures of quality of life and self-esteem were also administered to participants in order to assess construct-related validity. Factor analysis of the measure identified four factors: Gender-Related Fears, Psychosocial Impact of Gender Status, Coping and Gender Reorientation Efforts, and Gender Locus of Control. Internal consistency for each of the four factors ranged from r = .59 to r = .81. Psychosocial Impact of Gender Status and Gender-Related Fears were positively correlated with self-esteem and quality of life. Coping and Gender Reorientation Efforts were significantly correlated to both Psychosocial Impact of Gender Status and Gender-Related Fears. Preliminary psychometric analysis resulted in a 15 item, multidimensional measure with three reliable and valid subscales for use with male to female (MtF) transsexual adults. Further psychometric evaluation of the measure for use with other segments of the transgender population is needed.     

understanding and counseling transgender clients

Because transgender individuals experience widespread employment discrimination, counselors need to understand and be able to work with members of the gay, lesbian, bisexual, and transgender communities. The aim of this article is to help counselors become more transgender literate by (a) defining gender dysphoric disorder and related terms; (b) discussing the causes, diagnosis, and treatment of gender dysphoria; (c) highlighting career realities faced by transgender employees; (d) touching upon legal issues pertaining to transgender workers; and (e) offering a few suggestions to counselors working with transgender clients.     

Morphological and morphometric changes in the faces of female-to-male (FtM) transsexual people

Facial changes associated with the administration of exogenous testosterone and bilateral oophorectomy in female-to-male (FtM) transsexual people (trans men; trans males) has not been previously documented. This study aimed to describe the qualitative and quantitative transformation from a female to a male facial appearance and to identify predictable patterns of change. Twenty-five trans men were studied using morphological and morphometrical analysis of pre-transition 2-D images and post-transition 3-D scan models. The mean subject age was 39 years and all subjects had been taking testosterone for at least 3 years, with a mean duration of therapy of 8.6 years. While 32% of subjects were classified by a majority of observers as male appearing in pre-transition photographs, this rose to 95.5% in post-transition images. Eighty-six percent of subjects demonstrated an increase in male classification after transition. Morphometrically, 44% of subjects became wider in the face overall and 100% of subjects measured demonstrated a narrower nose after transition. Testosterone virilizes adult female faces and will cause widening of the face. The most consistent facial change was the production of a narrower nasal width at the alae, which may be a result of fat re-deposition not related to ageing effects or body mass index (BMI).     

‘BRITISH BY RIGHT,PUNJABI BY HEART’

Media serves as a medium for self-assertion and identity formation by identifying and distinguishing Punjabi identity from Indian identity. Punjabi films assert a separate identity from Hindi cinema. This distinct identity is also found in representations of Punjabis living abroad. Punjabi films portray a self-contained and insular Punjabi diaspora that is gendered. While more nuanced than the male chauvinism found in Punjabi films from the 1990s, current films still depict hyper masculine spaces within the Punjabi diasporic communities. I analyze three Punjabi films Munde UK De, Jee Ayaan Nu and Asa Nu Maan Watana Da to show how they reinforce hyper masculine and hyper nationalist Punjabi image through the diasporic characters.     

Foregrounding Masculinities in Psychoanalytic Psychotherapy

Against the backdrop of contemporary debates around constructions of masculinities, and explorations concerning how gender figures in psychotherapeutic process, personal reflections are presented by a male psychoanalytic therapist practicing in South Africa. A reflexive, contextual, and historicized conversation is offered, highlighting the precariousness of masculine identities, and their melancholic response to contextual dislocation within a society in transition and in relation to the decline of patriarchal authority. The observations offered emphasize the importance of maintaining a self-reflective stance in order to grapple with normative gender biases and stereotypic assumptions and to reduce the probability of gendered enactments in clinical practice.     

Performance Involvement,Identity, and Emotion Among Cisgender Male Drag Queens

Quantitative research on levels of depression and gender dysphoria in drag populations is lacking. It is possible that this lack occurs because researchers tend to include drag queens within transgender samples. Such sampling practices may result in inaccurate assumptions about drag queen populations. This study established rates of depression and gender dysphoria in a sample of self-identified cisgender drag queens. Participants reported low levels of gender dysphoria and significantly lower levels of depression than have been found among trans women, however, these participants presented with higher rates of depression than have been found among gay men who do not perform drag. Higher rates of involvement in drag performance were positively correlated with depression and negatively correlated with gender dysphoria. Results indicate that self-identified cisgender drag queens are unlikely to experience gender dysphoria and are less depressed than samples of trans women. The researchers discuss implications and future directions for mental health practitioners.     

Consuming Male Identities: Masculinities,Gender Relations and Alcohol Consumption in Aotearoa New Zealand

The excessive and public consumption of alcohol with other men has been a traditional indication of manliness in Western cultures for many years. However, over the last two decades, this association has been eroded, in part through increased consumption by women. Within the gender‐relational context of this increase, we empirically explore ways in which particular (friendship) groups of young men and women (re)construct masculine identities. The male participants demonstrated greater discursive flexibility in enacting their gender identities through alcohol consumption compared with earlier NZ research although also greater constraints on change compared with more recent UK research. A minority of men constructed themselves as atypical in that they did not like rugby, beer or consuming vast quantities of alcohol. These men were all in professional occupations, and we speculate that their social class and financial status may enable them to negotiate alternative demonstrations of masculinity. We conclude that these findings could be explicated through an examination of national gendered identities that arose out of a pioneer culture, and the commodification of gender identities through alcohol consumption. Copyright © 2011 John Wiley & Sons, Ltd.     

Masculinity and Emotionality: An Investigation of Men's Primary and Secondary Emotional Responding

In this study, we investigated the role of masculinity in men's affect intensity and men's fear of emotions. Men's masculine ideology and self-reported masculine gender role stress were assessed as cognitive and experiential factors of adherence to traditional masculine gender norms. Masculine ideology was negatively related to men's global affect intensity. However, on a 3-factor model of affect intensity, only negative reactivity was significantly related to masculine ideology. Both masculine ideology and masculine gender role stress were positively related to men's fear of emotions. Results are discussed in the context of theories of gender differences in emotion.     

Utrecht Gender Dysphoria Scale - Gender Spectrum (UGDS-GS): Construct validity among transgender,nonbinary, and LGBQ samples

Abstract

Background: Researchers combined both versions of the original Utrecht Gender Dysphoria Scale (UGDS) to create a single gender spectrum version (UGDS-GS) which measures dissatisfaction with gender identity and expression over time as well as comfort with affirmed gender identity.

Aim: This study examined the construct validity of the newly revised, UGDS-GS.

Method: Tests of measurement invariance were conducted in stages to assess measurement invariance of the UGDS-GS across three groups: cisgender, binary transgender, and nonbinary/genderqueer.

Results: Findings indicate that the UGDS-GS functions acceptably in all three gender groups (configural and metric invariance). Also, across binary transgender and nonbinary/genderqueer groups, the measure functions very similarly with all four types of invariance. Item level findings highlight the specificity of the measure to distinguish experiences of binary transgender and nonbinary/genderqueer persons differently from cisgender LGBQ individuals.

Conclusions: The UGDS-GS demonstrates a large degree of invariance across binary transgender, nonbinary/genderqueer, and cisgender LGBQ subgroups; and therefore, findings indicate this revision to be a substantial improvement. This 18-item self-report, Likert-type scale measure is a) inclusive of all gender identities and expressions (e.g., transfeminine spectrum, transmasculine spectrum, genderqueer, nonbinary, cisgender); b) appropriate for use longitudinally from adolescence to adulthood; and c) administered at any point in the social or medical transition process, if applicable, or in community-based research focused on gender dysphoria that examines cisgender and transgender persons.