The transgender parent: Experiences and constructions of pregnancy and parenthood for transgender men in Australia

Background: Transgender (trans) men are commonly born with the reproductive anatomy that allows them to become pregnant and give birth and many wish to do so. However, little is known about Australian trans men's experiences of desiring parenthood and gestational pregnancy.

Aims: The present study aims to address this gap in the literature through addressing the following research questions: how do Australian trans men construct and experience their desire for parenthood? And, how do Australian trans men construct and experience gestational pregnancy?

Methods: This study aimed to explore these experiences, through a mixed-methods research design using online survey data and one-on-one interviews, with 25 trans men, aged 25–46 years old, who had experienced a gestational pregnancy. Data were analyzed using thematic analysis.

Results: For our participants, parenthood was initially described as alienating and complex, however transitioning enabled participants to negotiate and construct their own parenting identity. Pregnancy was positioned as a problematic but “functional sacrifice,” however formal assisted fertility experiences were rife with exclusion. At the same time dysphoria associated with withdrawing from testosterone and the growing fecund body were significantly troubling. Changes to the chest were of particular concern for participants. Exclusion, isolation, and loneliness were the predominant features of trans men's experiences of gestational pregnancies. Healthcare systems are not generally supportive of trans bodies and identities and trans men encounter significant issues when interacting with healthcare providers. As such, the results reinforce the importance of inclusive and specialized health services to support trans men through pregnancy.     

The Countertransference Experiences of Pregnant Counselors Working With Sex Offenders

Using a phenomenological approach, the authors explored the lived experiences of female counselors who were pregnant during the course of providing clinical services to sex offenders. Themes included awareness of countertransference, emotional distress, safety concerns, and clinical objectivity.     

妊娠合并结核临床诊治的决策

妊娠合并结核是一种对母婴健康危害极大的妊娠期疾病。在妊娠期结核病中,多数患者无明显症状,早期症状与妊娠期某些生理反应相似,加之妊娠与结核病的相互影响,x线、CT等重要的影像学检查受限,致使本病易被误诊或误治。某些抗结核药物对母婴的不良影响,使其治疗难以实施,由于结核病本身及治疗后可能对胎儿的影响,在临床上是否终止妊娠往往难以决策。本文就妊娠合并结核诊治过程中的相关问题进行综述,以期为临床诊治决策提供帮助。     

Condom Use and Contraception Non-Use Amongst 16-19 Year Olds: A Within Subjects Comparison

Abstract

The present study used a within subject design to examine which situation specific factors discriminated between the use of condoms and non-use of contraception in the context of preventing unwanted pregnancy. Adapting the methodology of Gold et al (1991, 1992), 215 16 to 19 year olds completed a questionnaire concerning the most recent time they had experienced sexual intercourse without using contraception (the “without contraception” encounter) and me most recent time they had experienced sexual intercourse using a condom (the “with a condom” encounter). The results showed that although past behaviour did not differentiate between the two encounters, situational factors relating to preparation for action, affect and interpersonal interaction were important. However, when analysed for men and women separately most of the differences were only found for women. In particular, the results suggest that women report non-contraception use as associated with feeling more guilty, having a partner who is less motivated to use contraception than they are, with neither themselves nor their partner raising the desire to use contraception, not expecting to have sex and not discussing contraception and not having contraception available. In contrast, for men, only the availability of contraception appeared to differentiate between the two encounters. The results are discussed in terms of the usefulness of the methodology and the associated shift in emphasis from users and non-users of contraception to use and non-use. The implications of the results in terms of health education interventions are also considered.     

Risk drinking and contraception effectiveness among college women

Risk drinking, especially binge drinking, and unprotected sex may co-occur in college women and increase the risks of STI exposure and pregnancy, but the relationships among these behaviors are incompletely understood. A survey was administered to 2012 women of ages 18–24 enrolled in a public urban university. One-quarter of the college women (23%) drank eight or more drinks per week on average, and 63% binged in the past 90 days, with 64% meeting criteria for risk drinking. Nearly all sexually active women used some form of contraception (94%), but 18% used their method ineffectively and were potentially at risk for pregnancy. Forty-four percent were potentially at risk for STIs due to ineffective or absent condom usage. Ineffective contraception odds were increased by the use of barrier methods of contraception, reliance on a partner's decision to use contraception, and risk drinking, but were decreased by the use of barrier with hormonal contraception, being White, and later age to initiate contraception. In contrast, ineffective condom use was increased by reliance on a partner's decision to use condoms, the use of condoms for STI prevention only, and by risk drinking. Thirteen percent of university women were risk drinkers and using ineffective contraception, and 31% were risk drinkers and failing to use condoms consistently. Risk drinking is related to ineffective contraception and condom use. Colleges should promote effective contraception and condom use for STI prevention and consider coordinating their programs to reduce drinking with programs for reproductive health. Emphasizing the use of condoms for both pregnancy prevention and STI prevention may maximize women's interest in using them.     

A 9-YEAR-OLD WITH CONVERSION DISORDER, SUCCESSFULLY TREATED WITH PSYCHOANALYSIS

This paper outlines the successful psychoanalytic treatment of a latency-aged boy with severe conversion disorder. Details of clinical treatment are presented. As no tested treatment has yet been found that reliably treats chronic conversion in children, this case is of importance in demonstrating the usefulness of psychoanalysis as treatment for severe psychopathology. The patient's unconscious fantasy constellations that gave rise to this syndrome are highlighted.     

Community member perceptions of influences on teenage pregnancies

This exploratory qualitative study aimed to provide insight into the factors contributing to the high prevalence rate of teenage pregnancy in South African communities. Focus group were conducted with 193 community members (females = 44.6%; adults = 50.8%, teenagers/youth = 44.0%) and followed by thematic content analysis to interpret the data. Several overarching themes regarding the increasingly common occurrence of teenage pregnancy emerged from the data. These included: (1) the increased acceptability of teenage pregnancy to families and communities for economic and material gain; (2) the influence of social pressure; and (3) the lack of sexual knowledge and provision of sex education. Community members perceived teenage pregnancy as an increasingly common occurrence in their communities. Community members perceived teenage pregnancy to be driven by multiple factors and to require holistic interventions at the individual, family and community level.     

Fetal Risks,Relative Risks,and Relatives' Risks

Several factors related to fetal risk render it more or less acceptable in justifying constraints on the behavior of pregnant women. Risk is an unavoidable part of pregnancy and childbirth, one that women must balance against other vital personal and family interests. Two particular issues relate to the fairness of claims that pregnant women are never entitled to put their fetuses at risk: relative risks and relatives' risks. The former have been used—often spuriously—to advance arguments against activities, such as home birth, that may incur risk; the latter implicate the nature of relationships in determining the acceptability of coercing or precluding activities. Motivated reasoning by clinicians and judges leads to inaccurate risk assessments, and judgments based on false claims to objectivity. Such judgments undermine the moral and legal standing of pregnant women and do not advance the interests of fetuses, pregnant women, families, or states.     

孕期生活事件与妊娠压力：心理健康的中介效应和丈夫支持的调节作用

用问卷调查法对上海市403名单胎、孕周在24～33周的孕妇进行研究,探讨怀孕过程中孕妇经历的生活事件和妊娠压力的关系,以及孕妇的心理健康状况和丈夫支持在其中所起的作用。结果表明：（1）怀孕计划的主效应显著,孕龄的主效应不显著,怀孕计划和孕龄的交互作用显著;妊娠压力在怀孕计划上的主效应显著,意外怀孕的孕妇的妊娠压力显著高于计划怀孕的孕妇的妊娠压力;（2）怀孕过程中孕妇经历的生活事件与妊娠压力呈显著正相关,与孕妇的心理健康呈显著负相关;（3）孕妇的心理健康状况在生活事件和妊娠压力的关系中起部分中介效应,即生活事件部分通过孕妇的心理健康状况影响孕妇的妊娠压力;而丈夫支持则对孕妇心理健康的中介效应起调节作用,当丈夫支持高时,心理健康状况越好的孕妇,其妊娠压力越低,心理健康状况对孕妇妊娠压力预测显著;当丈夫支持低时,心理健康状况对妊娠压力的预测不显著。     

妊娠晚期亚临床甲状腺功能减退症对母婴合并症的影响

本研究旨在观察妊娠晚期亚临床甲状腺功能减退症对母婴合并症的影响。最终选择2010年1月～2010年11月期间共325例妊娠晚期孕妇分为病例组（A组,n＝65）和正常对照组（B组,n＝260）,观察两组之间母婴合并症的变化。结果显示,两组之间在年龄、住院日、血压、体质量指数（BM I）、心率、分娩时孕周、血糖以及血脂方面差异均无统计学意义（P＞0．05）。但与B组相比较,A组发生母亲合并症及胎儿合并症的发生率明显增加,差异有统计学意义（P＜0．05）。此研究提示妊娠晚期亚临床甲状腺功能减退症增加母婴合并症的风险。