Effectiveness of testosterone therapy for masculinizing voice in transgender patients: A meta-analytic review

Background: Testosterone therapy is the predominant treatment for voice masculinization in transgender patients. Although lowering of voice fundamental frequency (f₀) occurs with testosterone therapy, evidence suggests voice and gender identity may not fully align—i.e., voice-gender congruence may not be achieved—with its use.

Aim: This meta-analytic review evaluates the effectiveness of testosterone therapy to masculinize voice in transgender patients.

Methods: Multiple electronic databases were queried (inclusion dates: from database inception up to October 27, 2017) to identify original research on voice masculinization using testosterone therapy. Nineteen articles were included in this meta-analytic review, which followed PRISMA guidelines. In addition to qualitative analyses, random effects proportion meta-analyses were performed on data related to f₀, voice-gender congruence, voice problems, and satisfaction with voice.

Results: A meta-analysis on f₀ data showed after 1 year of testosterone therapy a combined estimate of 21% of participants (95% confidence interval [CI]: 5%–43%; I²: 59.9%) did not achieve cisgender male normative frequencies (f₀ ≤ 131 Hz). Meta-analyses on incomplete voice-gender congruence and voice problems indicated combined estimates of 21% (95% CI: 10%–34%; I²: 0.0%) and 46% (95% CI: 14%–79%; I²: 90.2%), respectively. Regarding incomplete satisfaction with voice, a meta-analysis showed a combined estimate of 16% (95% CI: 7%–28%; I²: 0.0%).

Discussion: We found that not all transgender patients using testosterone therapy to masculinize voice should expect f₀ lowering to cisgender male normative frequencies after 1 year. The vocal transition may involve voice problems for many patients, and some might not achieve voice-gender congruence without additional, voice-specific intervention. Given these findings, a voice evaluation should occur prior to initiating testosterone therapy and involve counseling on expectations for voice. Transgender patients who pursue voice masculinization may need management from laryngology and speech and language therapy to improve voice-gender congruence, mitigate voice problems, and increase satisfaction with voice.     

A Descriptive Examination of Prisonization through the Lens of Post-Exoneration Offending

Prisonization, which seeks to explain criminal behavior as a function of past prison experiences, has been examined through many lenses; however, more novel approaches to exploring prisonization have been lacking. This study uniquely explores the concept of prisonization by describing the post-release behavior of 118 wrongfully convicted individuals, known as exonerees.

Conclusions were drawn from a dataset of exonerees and criminal history background searches. Comparative analyses show that exonerees without priors serve longer sentences and demonstrate a shorter time to failure (as measured by post-release offending). Offending among this cohort may suggest that otherwise law-abiding citizens were negatively affected by their experience in prison and, furthermore, may indirectly support the notion that being imprisoned fosters criminality in individuals. These results can support conceptual and practical advancements.     

UNDERSTANDING PARENTING STRESS AND CHILDREN'S BEHAVIOR PROBLEMS AMONG HOMELESS,SUBSTANCE‐ABUSING MOTHERS

This article tested a model of parenting stress as a mediator between maternal depressive symptoms, emotion regulation, and child behavior problems using a sample of homeless, substance‐abusing mothers. Participants were 119 homeless mothers (ages 18–24 years) and their young children (ages 0–6 years). Mothers responded to questions about their depressive symptoms, emotion regulation, parenting stress, and child behavior problems. A path analysis showed that maternal depressive symptoms were positively associated with child behavior problems through increased parenting stress whereas maternal cognitive reappraisal was negatively associated with child behavior problems through decreased parenting stress. Moreover, maternal expressive suppression was negatively related to child externalizing problems. Findings support the parenting stress theory and highlight maternal parenting stress as a mechanism associated with homeless children's mental health risk. This study has significant implications for understanding the parenting processes underlying child's resilience in the context of homelessness and maternal substance use.     

The Flipped Curriculum: Dewey’s Pragmatic University

Recently Graham Badley (Stud High Educ 41(4):631–641, 2016) made the case that the "pragmatic university” represents a viable future for the post-modern institution. In his construction of the pragmatic university, Badley largely draws upon the vision laid out by Richard Rorty (Philosophy and social hope. Penguin Books, London, 1999). While Rorty’s neopragmatism offers an important perspective on the pragmatic institution, I believe that John Dewey’s classical pragmatism offers a richer and more capable vision of the university. The aim of this paper is to develop a view of the pragmatic university drawn from Dewey’s philosophy. His writings on the university offer a unique and viable path forward because he directly engages a reconstruction of the relationship between knowledge and experience in the context of post-secondary education.     

Wealth inequality and activism: Perceiving injustice galvanizes social change but perceptions depend on political ideologies

What motivates people to engage in activism against wealth inequality? The simple answer is perceiving injustice. However, the current work demonstrates that these perceptions depend on political ideologies. More specifically, for political liberals who frequently question the fairness of the economic system, messages simply describing the extent of the inequality (distributive injustice) are enough to motivate activism (Study 1). For political conservatives, who are inclined to believe that inequality results from fair procedures, messages must also detail how the system of economic forces is unjust (procedural injustice; Studies 2 and 3). Together, these studies suggest perceiving injustice can galvanize social change, but for conservatives, this means more than simply outlining the extent of the inequality.     

Increased parasympathetic activity and ability to generate positive emotion: The influence of the BDNF Val66Met polymorphism on emotion flexibility

Cross-species behavioral research suggests that a single nucleotide polymorphism (SNP) in the brain-derived neurotrophic factor (BDNF) gene (rs6265, Val66Met), influences behavioral inflexibility. This SNP has not yet been linked to variability in emotion-related behaviors, despite broader evidence suggesting an association may be present. This investigation explored the role of the BDNF Val66Met polymorphism in emotion response behaviors measured during a lab-based emotional provocation. Specifically, the influence of BDNF Val66Met in emotion flexibility was explored in a sample of healthy adults (N?=?120), emotion responses were recorded during the emotional provocation on multiple dimensions, in response to emotionally-evocative videos of negative then positive valence. These results suggest that Met carriers exhibit decreased parasympathetic responding, and reduced ability to generate positive emotion, relative to Val homozygotes. These findings are the first to suggest an association between the Met allele and a pattern of responding indicative of emotion inflexibility that might afford greater risk for psychopathology.