The Gender Congruence and Life Satisfaction Scale (GCLS): Development and validation of a scale to measure outcomes from transgender health services

Background: It is vital that the treatment offered at transgender health services can be evaluated to ensure a high quality of care. However, the tools currently used to evaluate treatment at transgender health services are limited by mainly focusing on mental health or because they have been developed for binary transgender people only. This study therefore aimed to develop and validate a tool that addresses these limitations. The Gender Congruence and Life Satisfaction Scale (GCLS) was developed through reviewing the literature, conducting interviews with transgender people, and holding discussions with experts working in transgender healthcare. An initial pool of items was developed and feedback on these was obtained. The tool was then validated.

Method: For the validation of the tool, a total of 789 participants (451 transgender [171 transgender females, 147 transgender males, 133 people identifying as non-binary], and 338 cisgender [254 females, 84 males]) were recruited from the United Kingdom to test the factor structure and validity of the GCLS.

Results: Exploratory factor analysis retained 38 items which formed seven subscales (psychological functioning; genitalia; social gender role recognition; physical and emotional intimacy; chest; other secondary sex characteristics; and life satisfaction). These seven subscales were found to have good internal consistency and convergent validity. The GCLS was also found to be capable of discriminating between groups (e.g., people who have and have not undergone gender affirming medical interventions). Transgender and cisgender subscale norms are provided for the GCLS.

Conclusion: The GCLS is a suitable tool to use with the transgender population to measure health-related outcomes for both clinical and research purposes.     

Family Functioning and Attachment Among Young Adults in Western and Non-Western Societies

Abstract

Family functioning (FF) is associated with patterns of adults’ close relationship attachment, which works differently in western and non-western societies. In this study, the relationship between FF and attachment (A), as well as the difference in relationship between FF and A across western and non-western societies were examined. A total of 600 young adults (294 males, 306 females) were recruited from western and non-western societies through the SurveyCircle and social media and communication applications. The data was analyzed using PLS-SEM and multigroup analysis, and the results showed that in western and non-western societies, family adaptability and cohesion were significantly associated with anxiety, close, and depend attachments. Unexpectedly, higher family adaptability was associated with higher anxiety attachment. The associations among family adaptability and cohesion with anxiety, close, and depend attachments showed that the strengths of the relationships are significantly different in western and non-western societies, except for the association between family cohesion and anxiety. Based on these results, the cultural differences in terms of FF and young adults’ close relationship attachment were presented for future research, family therapy, and the society.     

Confirmatory reinforcement learning changes with age during adolescence

Understanding how learning changes during human development has been one of the long-standing objectives of developmental science. Recently, advances in computational biology have demonstrated that humans display a bias when learning to navigate novel environments through rewards and punishments: they learn more from outcomes that confirm their expectations than from outcomes that disconfirm them. Here, we ask whether confirmatory learning is stable across development, or whether it might be attenuated in developmental stages in which exploration is beneficial, such as in adolescence. In a reinforcement learning (RL) task, 77 participants aged 11–32 years (four men, mean age = 16.26) attempted to maximize monetary rewards by repeatedly sampling different pairs of novel options, which varied in their reward/punishment probabilities. Mixed-effect models showed an age-related increase in accuracy as long as learning contingencies remained stable across trials, but less so when they reversed halfway through the trials. Age was also associated with a greater tendency to stay with an option that had just delivered a reward, more than to switch away from an option that had just delivered a punishment. At the computational level, a confirmation model provided increasingly better fit with age. This model showed that age differences are captured by decreases in noise or exploration, rather than in the magnitude of the confirmation bias. These findings provide new insights into how learning changes during development and could help better tailor learning environments to people of different ages.

Research Highlights

• Reinforcement learning shows age-related improvement during adolescence, but more in stable learning environments compared with volatile learning environments.
• People tend to stay with an option after a win more than they shift from an option after a loss, and this asymmetry increases with age during adolescence.
• Computationally, these changes are captured by a developing confirmatory learning style, in which people learn more from outcomes that confirm rather than disconfirm their choices.
• Age-related differences in confirmatory learning are explained by decreases in stochasticity, rather than changes in the magnitude of the confirmation bias.

     

Does colour preference have a role in colour term acquisition?

A developmental association exists between colour preference and emerging colour term acquisition in young children. Colour preference might influence colour term acquisition by directing attention towards or away from a particular colour, making it more or less memorable. To investigate the role that colour preference may have in the acquisition of colour terms, experimental tasks of colour preference, discrimination, attention, memory, and new colour term learning, were given to three groups of participants (preschool children; primary school children; and adults). Each task utilized the same colour stimuli, which were four computer‐simulated colours, matched perceptually to four different Munsell chips, drawn from the same colour category. Three colours varied systematically from an anchor colour (10PB 4/8) only in saturation (10PB 4/4), luminance (10PB 6/8), or hue (5P 4/8). Results showed that within‐category colour preferences emerged with age, and that when established within individuals, most preferred colours were named significantly more accurately than least preferred colours, although this association did not appear to be mediated directly by attention or memory. Rather, perceptual saliency was shown to have a mediating role, to some extent, in determining the relationship between colour preference and the cognitive processing of colour.     

Complex Demonstratives

Philosophical Studies -     

UNDERSTANDING FEMALE SPORT ATTRITION IN A STEREOTYPICAL MALE SPORT WITHIN THE FRAMEWORK OF ECCLES'S EXPECTANCY–VALUE MODEL

An empirical research study based upon the expectancy–value model of Eccles and colleagues (1983) investigated the effect of gender-role orientations on psychological dimensions of female athletes' sport participation and the likelihood of their continued participation in a stereotypical masculine activity. The model ( Eccles et al., 1983 ) posits that gender-role orientation is linked to the intention to persist or discontinue sport participation, which is acted upon indirectly through mediation by two motivational variables: an individual's perceived competence and the perceived value of the activity. Three models were compared to test this mediation hypothesis with 333 female adolescent handball players in a prospective study. Results from structural equation modeling showed that a fully mediated model fit the data. The masculinity orientation positively predicted value for and perceived competence in handball, whereas the femininity orientation negatively predicted perceived competence. In addition, the two motivational variables negatively predicted intention to drop out. Finally, such intentions are the more proximal predictors of actual dropout.     

Manifestations of anxiety and coping strategies in patients with metastatic lung cancer and their family caregivers: a qualitative study

Objective: Advanced non-small cell lung cancer (NSCLC) is common, deadly, and associated with impairing anxiety for patients and caregivers who often co-experience similar symptoms that can vary together over time. We aimed to discover themes as to how NSCLC patients and caregivers express and cope with anxiety.

Design: Semi-structured interviews of patient-caregiver dyads (N?=?21), coded using NVivo Software.

Main Outcome Measures: Open-ended questions on anxiety mutuality, giving or receiving care, communication, and the most difficult aspects of having or caring for someone with Stage IV NSCLC.

Results: Analyses revealed that patients and caregivers were linked psychologically, co-experiencing symptoms of distress or coping, rising and falling together. Shared patient and caregiver themes emerged of cognitive, behavioural and physiological manifestations of anxiety and coping mechanisms.

Conclusions: Patient and caregiver expressions of anxiety and coping methods mapped onto the cognitive-behavioural model, implying potential use of cognitive behavioural therapy (CBT) to address these issues. This expands understanding of symptoms and coping strategies in NSCLC, explores patient-caregiver interaction, and confirms the need for future clinical intervention. Future research should focus on development and dissemination of CBT-based dyadic interventions addressing anxiety in NSCLC patients and caregivers.     

Mental health and quality of life in non-binary transgender adults: a case control study

Abstract

Background: The social challenges that non-binary people experience, due in part to social intolerance and the lack of validation of non-binary gender identities, may affect the mental health and quality of life of this population. However, studies that have distinguished between non-binary and binary transgender identities are lacking.

Aim: To compare the mental health and quality of life of a community sample of non-binary transgender adults with controls (binary transgender people and cisgender people) matched on sex assigned at birth.

Method: A total of 526 participants were included. Ninety-seven were classified as non-binary and were compared with two control groups: 91 people classified as binary and 338 cisgender people. Only transgender people not on gender affirming hormone treatment or who had not undergone gender affirming surgery were included. Participants were invited to complete an online survey that included mental health and quality of life measures.

Results: Non-binary people reported significantly better mental health than binary transgender people, but worse than cisgender people. Overall, there were no significant differences in quality of life between non-binary and binary transgender participants assigned male at birth and transgender females, but non-binary assigned males at birth had better scores on the psychological and social domains of quality of life than transgender males. Quality of life was better across all domains in cisgender people than transgender groups.

Conclusion: There is an inequality with regard to mental health and quality of life between non-binary (and binary) transgender people and the cisgender population that needs to be addressed. The better mental health scores in non-binary people may reflect lower levels of body dissatisfaction among the non-binary population. Mental health problems and poor quality of life are likely to have social causes and hence legislative measures and broader government-led inclusive directives should be put in place to recognize and to validate non-binary identifying people.