Cosmetic Surgery: Feminist Perspectives

Cosmetic surgery is gaining popularity not only in the U.S., but worldwide. The sheer number of procedures being performed makes it seem “normal,” and in the statistical sense it is. Feminist therapists are likely to have clients who are contemplating undergoing one or more of these procedures. Therapists ought to help their clients to understand the motivations underlying a decision to undergo surgery for the sake of improving on nature. In the final analysis, the decision belongs to the woman who may be placing her life at risk to achieve some desired end. The therapist can play a role in helping her to weigh the risks and what will be accomplished in the end.     

Atypical Gender Development: Why I Did Not Sign the GIRES-Review

ABSTRACT

This article discusses the review on Atypical Gender Development, published by the Gender Identity Research and Education Society (GIRES) in the International Journal of Transgenderism 9(1), 2006, pp. 29–44. Although appreciating the initiative of GIRES, the author, who was invited to join the signatories of the review chose to not do so for five major reasons: (1) The phenomenology of transgenderism displays such a great variety that it can not be explained by any individual factor, be it constitution, morphology, hormones or psychology. (2) The role of the Bed nucleus of the area striata of the hypothalamus is overemphasized in the review. (3) Regrets after SRS challenge biological explanations of transsexualism. (4) Dwelling on biological explanations may, as the history of sexology shows, be used in favor as well as against subject. (5) Striving for legal and social acknowledgement of transgendered persons and improvement of treatment conditions does not need biology as an argument.     

Presurgical MMPI-2 Cluster Profiles Predict 1-Year Low-Back Surgery Outcomes

The primary purpose of this study was to examine whether empirically derived cluster profiles based on scores from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) predicted outcomes of surgery at 1 year for patients with low-back pain. On the basis of hierarchical cluster analysis of presurgery MMPI-2 scores for 60 patients, three interpretable and significant subgroups were formed. These consisted of a pathological/neurotic type, a double V-code type, and a normal type. The patents in the normal type were significantly more likely to report beneficial outcomes of surgery in terms of disability and pain than those in the other 2 types. These findings extend previous research and suggest (1) low-back surgery candidates are heterogeneous in their psychological profiles, and (2) MMPI-2 profiles are predictive of low-back surgery outcome. Future research should focus on identifying physiological substrates for these distinct profiles and investigating the effectiveness of presurgical psychological interventions based on profile type.     

Self-determination and motivation for bariatric surgery: a qualitative study

This study examined how obese individuals acquire their motivation to undergo weight loss surgery and characterized the motivations within the framework of the self-determination theory (SDT). Participants expecting to have bariatric surgery were recruited and participated in semi-structured interviews. Interview accounts characterized different types of motivation for individuals seeking surgical weight loss treatments on the SDT continuum of relative autonomy. This study demonstrated that the more one’s motivation was internally regulated, related to one’s personal life and supported for competency, the more personal and hopeful were the anecdotes participants mentioned in accounts, thus the more positive the surgical outcomes were anticipated. Study limitations and future research were discussed as was the need for a systematic scheme to categorize types of motivation within the SDT, a longitudinal approach to measure actual weight loss outcomes based on the patient’s pre-surgical motivation, and a further investigation with a larger sample size and balanced gender ratio. Practical implications of the study findings were also discussed as a novel strategy to internalize bariatric patients’ motivation, further helping to improve their long-term quality of life post-surgery.     

心脏病外科治疗之趋势——微创

在近20年间,伴随着科学技术的发展以及医疗水平的提高,微创已经成为了外科医生行使手术的重要选择之一;由于国家生活水平的提高,患者不但追求高生存率,同时提出了更高的要求——低病痛,快恢复期,伤口美观等,微创外科得到了越来越多的人的青睐。本文主要探讨了微创心脏外科的分类(小切口技术,电视胸腔镜辅助心脏外科技术,机器人辅助心脏外科技术)以及各种新技术在心脏外科领域所存在的优势和不足,同时辩证地指出了心脏外科的未来发展趋势以及在发展过程中可能存在的一系列矛盾,同时指出了医疗为患者个体服务的观点。     

Complexity of online gender confirmation resources surpass patient literacy

Background: Increasing transgender health care coverage has resulted in easier access to gender confirmation surgery. Patients considering surgery consistently access medical information online to improve knowledge regarding surgical options, complications, recovery, and life after transitioning. As a result, national health institutes recommend that patient educational materials be written at a sixth-grade–reading level. The purpose of this study is to assess the complexity of online gender confirmation surgery information.

Methods: An Internet search was performed using the key phrase “transgender surgery”. Health care and non–health care websites were evaluated for pertinent articles regarding gender confirmation surgery. Readability analyses were conducted using Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, Simple Measure of Gobbledygook Index, and Automated Readability Index. A two-tailed z test was used to compare means; significance was set at p ≤ 0.05.

Results: A total of 108 articles from 87 websites were analyzed. The average readability for all online gender confirmation-surgery information was at an 11th-grade reading level. Materials written by health care entities were written at a 12th-grade–reading level compared to non–health care articles, which were written at a 10th-grade level (p < 0.001). Male-to-female surgery materials were written at a 12th-grade level, significantly higher than the 11th-grade reading level of female-to-male surgery materials (p = 0.04).

Conclusion: Online information regarding gender confirmation surgery is written at a level that is too complex for patients to understand. Informational materials should be written at lower grade levels to improve patient education, informed consent, and outcomes.     

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.     

外科手术抗生素的预防性应用探讨

手术野感染(surgical site infection,SSI)是外科手术的并发症之一,预防性抗生素使用可减少SSI发生率,但使用的目的与作用仅仅是在手术过程中,一旦手术结束这一作用也就结束。对于创伤较小清洁手术可以不用预防性抗生素;轻度污染手术创伤不大,也可以不使用预防性抗生素;只有患者存在高危因素时才考虑应用。麻醉诱导期使用最为合理的。对不同的手术部位和不同的创伤程度,应选择不同的抗生素即个体化给药原则。     

胸外科器械吻合与手工吻合的利弊权衡

胸外科器械吻合技术在临床应用日益广泛,已经影响了传统的手工吻合技术。器械吻合和传统外科在有效治疗病人的同时,面临着复杂的技术和经济问题。外科医生如何面对和选择,已成为临床决策过程中亟待解决的问题。     

"人工美女"意味着什么--浅析"人工美女"效应

"人工美女"的产生是社会进步、思想开放的结果,也是市场经济发展结果.一方面,社会进步、思想开放,给予美容受术者以足够的尊重和理解,使他们有了选择不同生活方式的自由,敢于公开"露脸";另一方面,市场经济的发展使她们愿意公开"露脸".而商家为谋取经济利益,打着"人工美女"的旗号,刻意进行商业炒作,将伤及广大消费者,危及美容外科行业.我们应以科学的态度、实事求是的精神予以坚决抵制,倡导在追求形体美和容貌美的同时,注重心灵美的培养,营造出一种真、善、美的社会环境.