Experiences of surgery readiness assessments in British Columbia

Abstract

Background: A surgical readiness assessment is a major step in the medical journey of trans people seeking gender-affirming surgery. Much of the peer-reviewed literature surrounding surgical readiness assessments emphasizes the perspectives of academics and clinicians, leaving the voices of trans and gender diverse patients largely unheard.

Aims: This paper foregrounds patient experiences with surgery readiness assessments to discuss the tensions, challenges and opportunities they generate.

Methods: We conducted a thematic analysis of 35 in-depth interviews with trans people who accessed or were seeking to access gender-affirming surgery in British Columbia.

Results: We developed three main themes to capture participants’ narratives of their surgical assessment experiences. The first, assessments as gatekeeping, explores the stories of people who described their assessments as outdated and even discriminatory processes. The second, assessments as a barrier to care, discusses the informational missteps, bureaucratic regulations, economic issues, and geographic concerns that made assessments difficult to access. The third, assessments as useful, includes positive stories about assessments that often involved feeling supported by an assessor and feeling prepared for the next steps.

Discussion: These narratives demonstrate how much variation exists among people’s experiences of readiness assessments for gender-affirming surgery. No matter how their actual assessment turned out, many participants approached their appointments with a great deal of anxiety and trepidation. We attributed this stress was to challenges ranging from lengthy wait times, arbitrary medical gatekeeping, a lack of access to knowledgeable and supportive providers, unclear or changing administrative processes, and insufficient communication. To address these challenges, it is crucial for the medical system to create more accessible pathways with centralized, up-to-date information for people trying to access assessments. Patients are best served by multi-disciplinary gender-affirming teams that provide individualized care.     

Fromm’s understanding of the Buddhist philosophical theory and psychoanalysis: From the phenomenal ego to the authentic being1

Abstract

Erich Fromm was one of the first psychoanalytic thinkers who was genuinely interested in Asian philosophies. In the first part of this article, I will show Fromm’s imago of Buddhism as a radical, nontheistic, and ethical philosophy “without God.” I will argue that Fromm made an important difference between the phenomenal ego and being that proves crucial for his understanding of psychoanalysis and his critique of modern society. I will also explore Fromm’s synthesis of Buddhist philosophy and psychoanalysis, and show the similarities and differences between them.     

Preventing extremism through education: exploring impacts and implications of counter-radicalisation efforts

ABSTRACT

The counter-radicalisation efforts that have swept through much of the world seem to have placed schools and universities at the forefront of global counterterrorism. In this article, we review research to explore the impacts and implications of preventing radicalisation and violent extremism through education. We synthesised themes from the literature in relation to intervention models that differentiate between primary, secondary and tertiary prevention levels, in order to embrace the heterogeneity and complexity of radicalisation issues. Research is at an early stage in trying to make sense of the ‘causes and cures’ of radicalisation in the context of young people and education; yet our review suggests that educators should approach prevention through humanistic, relational and inclusive pedagogics. However, counter-radicalisation efforts tend to result in the use of ‘harder’ prevention strategies, which can have quite negative impacts on education. Although scholarly output is growing, effectiveness evidence on these issues remains weak. More consideration should be given to study how the counter-radicalisation discourse is merged with education, and with what consequences.     

Newborns modulate their crawling in response to their native language but not another language

Human newborns can propel themselves to their mother's breast when positioned skin to skin on her abdomen just after birth. For decades, researchers have considered this primitive crawling behavior a spinal reflex, immune to supra spinal control. However, recent research suggests that neonatal crawling is already responsive to visual and olfactory stimuli processed at a supra spinal level. Here we report that a few hours post birth, French newborns can also modulate their crawling in response to their native language – a source of information that is processed supra-spinally. The crawling patterns of 23 French-born newborns were recorded on video and via an infrared motion capture system during two randomly ordered 2-min trials. The newborns were secured on a mini skateboard to facilitate arm and leg movements during their crawling propulsion. They heard a repetitive sequence of the same sentences either in French, their native language, or in English, a rhythmically different and hence discriminable unfamiliar language, on each trial. In French, compared to English, crawling was enhanced, with significantly more arm and leg steps and significantly more and larger trunk rotations in the cephalo-caudal axis. Moreover, newborns rotated their heads and trunk toward the appropriate loud speaker when hearing French but not English. These preliminary findings suggest that newborn crawling is not a simple stereotyped reflex under spinal control, but a complex pattern that can be modulated in response to higher-order, supra-spinally processed stimuli. The findings open fascinating questions about the range of stimuli to which newborn crawling is responsive.