Biotechnologies that empower transgender persons to self-actualize as individuals,partners, spouses,and parents are defining new ways to conceive a child: psychological considerations and ethical issues

Today, thanks to biomedical technologies advances, some persons with fertility issues can conceive. Transgender persons benefit also from these advances and can not only actualize their self-identified sexual identities but also experience parenthood. Based on clinical multidisciplinary seminars that gathered child psychiatrists and psychoanalysts interested in the fields of assisted reproduction technology (ART) and gender dysphoria, philosophers interested in bioethics, biologists interested in ART, and endocrinologists interested in pubertal suppression, we explore how new biotechnical advances, whether in gender transition or procreation, could create new ways to conceive a child possible. After reviewing the various medical/surgical techniques for physical gender transition and the current ART options, we discuss how these new ways for persons to self-actualize and to experience parenthood can not only improve the condition of transgender persons (and the human condition as a whole through greater equity) but also introduce some elements of change in the habitual patterns of thinking especially in France. Finally, we discuss the ethical issues that accompany the arrival of these children and provide creative solutions to help society handle, accept, and support the advances made in this area.     

Family Cohesion and Adaptation in Pediatric Chronic Conditions: The Missing Link of the Family’s Condition Management

The quality of family functioning has been considered an important predictor of adaptation in children with chronic conditions and their parents. Previous research suggests that beyond general family functioning, the specific experience of the family’s condition management is paramount for understanding family members’ adaptation. This study’s first goal was to compare family functioning and parents’ and children’s adaptation outcomes across four chronic conditions: asthma, diabetes, epilepsy, and obesity. Secondly, we explored the mediating role of family life difficulties and parental mutuality, as two potential paths through which family cohesion is linked to family members’ adaptation. A total of 263 parents of children (3–19 years old) with asthma (n = 77), obesity (n = 79), epilepsy (n = 52) and diabetes (n = 55) completed self-report measures of family cohesion, family life difficulty, parental mutuality, anxiety and depressive symptoms, and their children’s health-related quality of life (HrQoL). The results showed that families of children with diabetes, obesity, and epilepsy were at higher risk of experiencing family difficulties and children’s deteriorated HrQoL when compared to families of children with asthma. With regard to the links among study variables, although family cohesion had both a direct and indirect relationship with parental depressive symptoms, its links with parental anxiety symptoms and children’s HrQoL were only indirect, through family life difficulty. These associations were consistent across the four clinical groups. These findings emphasize the relevance of family-centered interventions aimed at promoting family cohesion, parents’ mutuality, and effective coping with the demands of pediatric chronic conditions.     

Communication of Information about Genetic Risks: Putting Families at the Center

Genetic information is a family affair. With the expansion of genomic technologies, many new causal genes and variants have been established and the potential for molecular diagnoses increased, with implications not only for patients but also their relatives. The need for genetic counseling and intrafamilial circulation of information on genetic risks grew accordingly. Also, the amount and, particularly, the complexity of the information to convey multiplied. Sharing information about genetic risks with family members, however, has never been an easy matter and often becomes a source of personal and familial conflicts and distress. Ethical requisites generally prevent healthcare professionals from directly contacting their consultands' relatives (affected or still at risk), who often feel unsupported throughout that process. We discuss here the communication of genetic risks to family members. We first consider genomic testing as a basis for family‐centered health care, as opposed to a predominant focus on the individual. We reviewed the literature on sharing genetic risk information with family members, and the associated ethical issues for professionals. Some clinical cases are presented and discussed, and key issues for meeting the needs of individuals and families are addressed. We argue that genetic information is inextricably linked to the family and that communicating about genetic risks is a process grounded within the broader milieu of family relationships and functioning. We conclude for the need for a more family‐centered approach and interventions that can promote sensitive attitudes to the provision of genetic information to and within the family, as well as its inclusion in educational and training programmes for genetic healthcare professionals.     

Using Force: Australian Newspaper Depictions of Contacts Between the Police and Persons Experiencing Mental Illness

The media creates and sustains knowledge about socially relevant issues such as crime, mental illness, and policing. Past research suggests that while the media portrayal of the police is undoubtedly complex, their portrayal of people experiencing mental illness remains mainly negative. The depiction of their encounters in the mass media is of considerable interest because of the influential role the media has on public opinion and debate; however, there is a lack of current research in this area. This study aimed to examine media items in the major newspapers across Australia between January 2006 and December 2007 (n = 77) to investigate their portrayal of this interface. The dominant themes encountered in the initial analysis depicted people experiencing mental illness as dangerous and a threat to the public, where the mental health system has failed to manage them adequately. Further analyses found that people experiencing mental illness were stigmatised in a third of the media items reviewed and were represented significantly more negatively in these encounters than the police. Implications of these findings and some suggestions regarding possible strategies that could improve socially responsible media reporting and public discourse on mental illness are proposed.     

Simulating murder: the aversion to harmful action

Diverse lines of evidence point to a basic human aversion to physically harming others. First, we demonstrate that unwillingness to endorse harm in a moral dilemma is predicted by individual differences in aversive reactivity, as indexed by peripheral vasoconstriction. Next, we tested the specific factors that elicit the aversive response to harm. Participants performed actions such as discharging a fake gun into the face of the experimenter, fully informed that the actions were pretend and harmless. These simulated harmful actions increased peripheral vasoconstriction significantly more than did witnessing pretend harmful actions or to performing metabolically matched nonharmful actions. This suggests that the aversion to harmful actions extends beyond empathic concern for victim harm. Together, these studies demonstrate a link between the body and moral decision-making processes.     

Perversion and infancy and adolescence

Abstract

Studying the works of Freud and Lacan, the authors carried out research on perversion in childhood. Their work covered the perverse polymorphism of infantile sexuality and the perception of the anatomic difference between the sexes that leads the child to create sexual theories and fantasies. The phallic mother and the fetish are viewed as imaginary solutions directly related to the Oedipus and castration complexes. In perversion, a particular position is taken in relation to the Oedipus complex: a serious flaw occurs in the symbolization of the law, and the mechanisms of denial and disavowal take form. Sexuality requires a second “logical time,” separated from infancy by the latency period, in order to confirm (in action) that a fixed position of jouissance (enjoyment) has actually been established. This can only happen in a period after adolescent enhancement. The distinction between perverse traces and a perverse structure is made, taking into account the fact that, in the case of child analysis, the analyst should free the child from the family fantasy and help him/her to build his/her own fantasy.

Campos Santoro V. et al. Perversion und Kindheit und Adoleszenz.

Im Studium der Arbeiten von Freud und Lacan haben die Autoren Forschung über Perversion in der Kindheit gemacht. Die Studien behandeln den perversen Polymorphismus der infantilen Sexualität und die Wahrnehmung des anatomischen Unterschiedes zwischen den Geschlechtern, welche das Kind dazu führt, Sexual-Theorien und Phatasien zu schaffen.

Die phallische Mutter und der Fetisch werden als imaginäre Lösungen angesehen, die sich direkt auf den Ödipus- und Kastrations-Komplex beziehen. Bei der Perversion wird eine besondere Position in Bezug auf den Ödipus angenommen; ein ernsthafter Mangel tritt bei der Symbolisierung des Rechts auf; die Mechanismen der Verneinung und der Verleugnung bilden sich. Sexualität erfordert eine zweite “logische Zeit”, von der Kindheit durch die Latenz Periode getrennt, um (in der Handlung) zu bestätigen, daß eine fixierte Position der jouissance (Vergnügung) sich tatsächlich etabliert hat. Das kann sich nur in einer Periode nach der adoleszenten Verstärkung ereignen.

Es wird die Unterscheidung zwischen perversen Spuren und einer perversen Struktur gemacht, in Rechnung stellend, daß im Fall der Kinder-Analyse der Analytiker das Kind von der Familien-Phantasie befreien sollte und ihm/ihr helfen sollte, seine/ihre Phantasie auszubilden.

Campos Santoro V. Perversión e infancia y adolescencia.

Estudiando los trabajos de Freud y Lacan, los autores han investigado la perversión en la niñez. Los estudios cubren la sexualidad infantil perversa polimorfa y la percepción de la diferencia anatómica entre los sexos, que llevan al niño a crear teorías sexuales y fantasías.

La madre fálica y el fetiche son vistos como soluciones imaginarias relacionadas directamente con el complejo de Edipo y de castración. La perversión, toma una posición particular en relación al Edipo; un fallo importante tiene lugar en la simbolización de la ley; los mecanismos de negación y repudio toman forma. La sexualidad requiere un segundo “tiempo lógico” separado de la infancia por el periodo de latencia, para confirmar (en acto) que una posición fija de jouissance (goce) se ha establecido. Esto solo puede ocurrir en un periodo posterior a la intensificación adolescente.

La distinción entre las huellas perversas y la estructura perversa se ha hecho, teniendo en cuenta que, en el caso del análisis de niños, el analista debe librar al niño de la fantasía familiar y ayudar a el/ella a construir su propia fantasía.     

Social "facilitation" as challenge and threat.

The authors conducted an experiment to test a theoretical explanation of social facilitation based on the biopsychosocial model of challenge and threat. Participants mastered 1 of 2 tasks and subsequently performed either the mastered (i.e., well-learned) or the unlearned task either alone or with an audience while cardiovascular responses were recorded. Cardiovascular responses of participants performing a well-learned task in the presence of others fit the challenge pattern (i.e., increased cardiac response and decreased vascular resistance), whereas cardiovascular responses of participants performing an unlearned task in the presence of others fit the threat pattern (i.e., increased cardiac response and increased vascular resistance), confirming the authors' hypotheses and the applicability of the biopsychosocial model of challenge and threat to explain these results.     

Who gets mad,sad, scared or happy at discipline? Emotion attributions explain child externalizing behaviour

Few studies have linked parental discipline with children's emotional experiences, and not much data explore children's emotional attributions to discipline linked to externalizing behaviour. With a sample from Brazil, this study examines which emotions children most aptly attribute to a protagonist facing spanking, time-out or inductive discipline for norm violations. We hypothesized that anger, sadness, and fear would have higher attribution rates at spanking or time-out, relative to inductive discipline and that happiness would have higher attribution rates at induction relative to the other discipline modalities. We expected these findings to be more pronounced in older children. Based on emotional functions, we also tested the role of neutrality and happiness attributions to discipline in children's externalizing behaviour. A two-way MANOVA, with discipline and child age as explanatory variables, showed that children attributed more anger at time-out or spanking than at induction, and more happiness and neutrality at induction than at either time-out or spanking. Older children attributed significantly more sadness and less fear or neutrality. Hierarchical regressions showed that child externalizing behaviour was negatively related to happy attributions in discipline independently of child emotion situation knowledge or demographics. The results are interpreted in light of a functional view of emotions.