Facial gender confirmation surgery—review of the literature and recommendations for Version 8 of the WPATH Standards of Care

Facial gender confirmation surgery (FGCS), also popularly known and referred to in the scientific literature as facial feminization surgery (FFS), was previously treated as a collection of aesthetic procedures complementing other aspects of gender-confirming surgery. Recent literature on quality-of-life outcomes following FGCS has supported the substantial impact these procedures have on overall well-being and reduction of psychosocial sequelae in patients. The World Professional Association for Transgender Health Standards of Care, Version 7 (WPATH SOC 7), did not deem FGCS a medical necessity. Based on these new studies, increasing evidence points to the need to include FGCS among medically necessary gender-confirming surgeries, though more-prospective studies are needed. Updates to the WPATH SOC 8 are proposed based on available quality of life studies.     

A comparison of health disparities among transgender adults in Colorado (USA) by race and income

Transgender individuals face heightened risks for discrimination, harassment, and violence that impact their psychosocial well-being and physical health. However, few studies have thoroughly examined the general physical and mental health of transgender adults or within-group health differences by race/ethnicity and income. To that end, after controlling for health insurance status, age, and engagement in exercise, this study asks: (a) Are transgender people of color more likely than White transgender individuals to experience poor health outcomes? and (b) Is lower annual household income among transgender adults associated with poorer health outcomes? The study analyzes secondary data from a survey of transgender adults (N = 417) in one state in the western United States using multiple linear regression and logistic regression models. Results showed that transgender people of color had significantly greater odds than their White counterparts of having arthritis/rheumatoid arthritis/gout/lupus/fibromyalgia, or asthma but lower odds of being told by a provider that they had depression. Having a lower income was significantly associated with worse general health as well as multiple indicators of poor physical and mental health, including depression, anxiety, and suicidal ideation. We discuss implications for health care delivery for transgender people and for future research.     

Iteration of Partially Specified Target Matrices: Application to the Bi-Factor Case

The current study proposes a new bi-factor rotation method, Schmid-Leiman with iterative target rotation (SLi), based on the iteration of partially specified target matrices and an initial target constructed from a Schmid-Leiman (SL) orthogonalization. SLi was expected to ameliorate some of the limitations of the previously presented SL bi-factor rotations, SL and SL with target rotation (SLt), when the factor structure either includes cross-loadings, near-zero loadings, or both. A Monte Carlo simulation was carried out to test the performance of SLi, SL, SLt, and the two analytic bi-factor rotations, bi-quartimin and bi-geomin. The results revealed that SLi accurately recovered the bi-factor structures across the majority of the conditions, and generally outperformed the other rotation methods. SLi provided the biggest improvements over SL and SLt when the bi-factor structures contained cross-loadings and pure indicators of the general factor. Additionally, SLi was superior to bi-quartimin and bi-geomin, which performed inconsistently across the types of factor structures evaluated. No method produced a good recovery of the bi-factor structures when small samples (N = 200) were combined with low factor loadings (0.30–0.50) in the specific factors. Thus, it is recommended that larger samples of at least 500 observations be obtained.     

Motor Imagery Shapes Abstract Concepts

The concepts of “good” and “bad” are associated with right and left space. Individuals tend to associate good things with the side of their dominant hand, where they experience greater motor fluency, and bad things with their nondominant side. This mapping has been shown to be flexible: Changing the relative fluency of the hands, or even observing a change in someone else's motor fluency, results in a reversal of the conceptual mapping, such that good things become associated with the side of the nondominant hand. Yet, based on prior studies, it is unclear whether space–valence associations were determined by the experience of fluent versus disfluent actions, or by the mere expectation of fluency. Here, we tested the role of expected fluency by removing motor execution and perceptual feedback altogether. Participants were asked to imagine themselves performing a psychomotor task with one of their hands impaired, after which their implicit space–valence mapping was measured. After imagining that their right hand was impaired, right‐handed participants showed the “good is left” association typical of left‐handers. Motor imagery can change people's implicit associations between space and emotional valence. Although asymmetric motor experience may be necessary to establish body‐specific associations between space and valence initially, neither motoric nor perceptual experience is needed to change these associations subsequently. The mere expectation of fluent versus disfluenct actions can drive fluency‐based effects on people's implicit spatialization of “good” and “bad.” These results suggest a reconsideration of the mechanisms and boundary conditions of fluency effects.     

Social Job Resources as Sources of Meaningfulness and its Effects on Nurses’ Vigor and Emotional Exhaustion: A Cross-Sectional Study Among Spanish Nurses

This study investigates the mediating role of psychological meaningfulness among social job resources (i.e., coworkers and supervisor support), vigor, and emotional exhaustion in a nursing context. In spite of progress in understanding which organizational influence affects nurses’ vigor and emotional exhaustion, the psychological mechanisms assumed to underlie the associations have not been fully explored. The sample for this study consisted of 171 nurses from Spanish hospitals (54.4 %) and Primary Care Centers (45.6 %). The mediation model was tested using the bootstrapping procedure. Our findings confirmed that psychological meaningfulness fully mediates the impact of social job resources on vigor at work. Moreover, psychological meaningfulness partially mediated the impact of social job resources on emotional exhaustion. Results suggest that meaningfulness plays an important role in the connection between job resources, vigor, and emotional exhaustion. The findings contribute to our understanding of the psychological processes that can explain how job resources contribute to the energetic aspect of burnout and engagement among nurses. Providing nurses with more social job resources, such as coworker and supervisor support, could activate their levels of personal meaningfulness and thus enhance their levels of well-being at work.     

National identifications and attitudes to national ingroups and outgroups amongst children living in the Basque country

This study investigated the development of national identification in children growing up in the Basque Country. The sample consisted of 246 children aged 6, 9, 12 and 15 years old who belonged to three linguistic subgroups: children who spoke only Basque with their parents in their home, children who spoke only Spanish in their home, and children who spoke both Basque and Spanish in their home. It was found that national identifications differed in the three linguistic subgroups. Furthermore, the three subgroups exhibited different evaluations of, and feelings towards, the national ingroup and a number of national outgroups. The positive and affective distinctiveness ascribed to the Basque and Spanish national groups was correlated with the strength of identification with the Basque and Spanish groups, respectively. The attitudes towards national outgroups which were exhibited by these children did not show any changes as a function of age. It is argued that the cognitive‐developmental account of the development of national attitudes is unable to explain the patterns of findings which were obtained, but that social identity theory can explain the correlation between the strength of national identification and the positive and affective distinctiveness which was ascribed to the ingroup. Copyright © 2003 John Wiley & Sons, Ltd.     

Examining the Association Between Body Mass Index and Weight Related Quality of Life in Black and White Women

Obesity not only increases risk for morbidity/mortality, but also impacts the quality of life of obese individuals. In the United States, black women have the highest prevalence of obesity of any other group with approximately 80% of black women over age 20 having a body mass index (BMI)????25?kg/m². We aimed to examine the association between BMI and quality of life in this high risk population compared to this association in white women, using the Impact of Weight on Quality of Life (IWQOL)-Lite questionnaire. Data from 172 black women (mean BMI?=?35.7; age?=?40.5) and 171 white women (mean BMI?=?35.5; age?=?40.4) were collected between 2000 and 2010 analyzed in 2010. The mean IWQOL-Lite total score was 81.6 for black women compared to 66.9 for white women, a statistically significant difference. Hierarchical linear regression models revealed a significant BMI-by-race interaction indicating that the relationship between BMI and IWQOL-Lite score was moderated by race. Our findings suggest notable differences in weight-related quality of life in black and white women. At similar BMIs, black women consistently reported better quality of life than white women on all IWQOL-Lite subscales. The greatest difference in IWQOL-Lite scores between black and white women was seen in the self-esteem subscale. Additional research is needed to understand how to incorporate the weight perspectives of black women into weight management messages and interventions.     

Quality of Life in Mexico: A Formative Measurement Approach

Improving quality of life for community members has become increasingly important for policy makers and society in general. This article presents the results from a representative sample of citizens from south-western Mexico. Because it is argued that quality of life indexes are formative rather than reflective, an advanced statistical method (partial least square) is used to analyze the data. The quality of life index used in the study includes the domains of health, income, work, education, safety, public services, non-governmental community services, social contact, and happiness. The results suggest that monetary-oriented indicators such as income and work are less important for respondents than domains such as happiness, social contact, or community services. However, for some of the domains, age and gender inequalities are observed.     

Motor skill learning in the middle-aged: limited development of motor chunks and explicit sequence knowledge

The present study examined whether middle-aged participants, like young adults, learn movement patterns by preparing and executing integrated sequence representations (i.e., motor chunks) that eliminate the need for external guidance of individual movements. Twenty-four middle-aged participants (aged 55–62) practiced two fixed key press sequences, one including three and one including six key presses in the discrete sequence production task. Their performance was compared with that of 24 young adults (aged 18–28). In the middle-aged participants motor chunks as well as explicit sequence knowledge appeared to be less developed than in the young adults. This held especially with respect to the unstructured 6-key sequences in which most middle-aged did not develop independence of the key-specific stimuli and learning seems to have been based on associative learning. These results are in line with the notion that sequence learning involves several mechanisms and that aging affects the relative contribution of these mechanisms.