Evolution of Gonadal Axis After Sex Reassignment Surgery in Transsexual Patients in the Spanish Public Health System

ABSTRACT

Although the effects of hormone therapy on cardiovascular risk factors and bone metabolism have been studied, data are lacking on the gonadotropin profile after gonadectomy in the sex reassignment process (SRP). Accordingly, whether measurement of the gonadotropin profile is useful in order to adjust the postsurgical dose of gonadal hormones is unknown. We studied the evolution of LH, FSH, prolactin, testosterone, and estradiol in 50 transsexual persons, 41 male-to-female transsexuals (MtF) and 9 female-to-male transsexuals (FtM), following a proto-colized regimen of hormone therapy for 12–24 months before and after genitoplasty. The increase in gonadotropins after surgery was greater in the FtM than in the MtF (66% vs. 50%), with the increase continuing more than one year after surgery. No variable was significantly associated with this different level of gonadotropins.     

EDITORS' INTRODUCTION

ABSTRACT

Transsexualism implies that an anatomically normal individual feels that he or she is actually a member of the opposite sex. Treatment usually includes real-life experience along with hormone therapy and sex reassignment surgery. Voice modification surgery may be necessary, as pass ability in general is still in a large extent dependent on the aspects of voice in transsexual people. Often male-to-female patients report being addressed in telephone conversations as their genetic gender, which is experienced as a disability. The purpose of this study was to evaluate the impact of voice on the quality of life in transsexuals.

In order to detect the disability caused by a voice disorder, the validated assessment method the Voice Handicap Inventory (VHI) was used. An additional question about the way patients were addressed in a telephone conversation was added.

As part of a study describing general health in transsexual persons, done at the Ghent University Hospital Belgium, a total of 48 patients were evaluated. In female-to-male transsexuals the median scores were very low, suggesting testosterone treatment led to an acceptable voice alteration. A higher serum LH level was significantly correlated with higher total, functional and emotional VHI scores. In male-to-female transsexuals the scores were significantly higher than those of the female-to-male transsexuals, but still there was no indication of a real disability/handicap. The extra telephone question was scored higher suggesting male-to-female transsexuals did experience a disability caused by their voice. From this study it is concluded that the VHI values did not demonstrate a handicapping effect.     

Assessing the Relationship Between Cold Pressor Pain Responses and Dimensions of the Anxiety Sensitivity Profile in Healthy Men and Women

Anxiety sensitivity (AS) has been shown previously to be an important factor in the perception and experience of experimentally induced pain within healthy adults. The aim of the current study was to extend this research by: (i) using the Anxiety Sensitivity Profile (ASP) as an alternative measure of AS; (ii) examining whether different coping instructions affect pain reports; and (iii) investigating potential differences between men and women. Participants were 50 healthy adults (23 males, 27 females) who were required to complete 2 versions of the cold pressor pain task; one version required the use of control instructions, whereas the other made use of acceptance‐based instructions. Although the coping instructions were found to affect pain thresholds (acceptance resulted in lower thresholds), a similar pattern of correlations were found between the pain indexes and AS under both conditions. Of the ASP subscales, the gastrointestinal and cognitive concerns components were found to be the most strongly related to pain experiences. When the analysis was conducted separately for each sex, the ASP scales were related to the self‐report measures of pain in women, whereas they were related to the behavioural measures of pain in men. These results not only confirm that AS is associated with experimental pain, but that there may be sex differences in this relationship.     

Exploring the personal and social context of female youth sex offenders

This study explored the personal and social context of young female sex offenders, probing their risk profiles for prospective treatment interventions. A convenience sample of eight young South African female sexual offenders participated in the study (black = 88%, Indian = 12%, age range = 14–20 years). They completed semi-structured interviews on their perceptions of the influences to commit a sexual offence. The data were thematically analysed. Emergent themes on factors associated with sexual offending included: peer influence, poor child monitoring, parental neglect, unproductive sexual health education, as well as insight into the participants’ maladaptive beliefs and distorted thinking.     

Pathways in the offending process of sex offenders who target marginalised victims

Prior literature shows that although marginalised populations are at a high risk of severe violence and homicide, research has focused on their offenders as if they constituted a homogeneous group. On the basis of a sample of 213 sex offenders who targeted marginalised individuals (i.e., sex trade worker, homeless individual, and severe drug user), we investigate the different pathways that these offenders take both prior to and during the commission of their crimes. Results of 2‐step cluster analysis regarding the offender's development, criminal history, crime context, and modus operandi revealed 3 distinct pathways of the offending process. The coercive pathway was characterised by the amount of violence used against the victim. The explosive pathway was defined by offenders who were in a state of rage at the time of the offence. Finally, offenders in the situational pathway committed their crimes out of opportunity and used very little violence. Differences between pathways were investigated with regard to characteristics of the index offence.     

Reimagining gender in psychology: What can critical psychology offer?

In this article, I argue that gender is a complex sociocultural construct, yet how gender is accounted for in psychological research is limited. Specifically, psychologists conflate sex with gender, rely on quantifying gender differences and, by implication, conceptualise gender as merely a participant characteristic. To illustrate, I apply this viewpoint to the topic of gender differences in tobacco use/cessation using on a feminist quality appraisal tool. I show how these three issues promote the narrow study of sex/gender differences, despite problems surrounding this inquiry, and reduce insights into the intersection of gender and behaviour. To offer a way forward for psychology, I describe how a critical psychology perspective attends to the complexities of gender and its influence on behaviour. I showcase diverse ways of attending to gender as a sociocultural construct, inviting psychologists to engage with, and reflect on, their gender analyses.     

Endocrine and emotional response to exclusion among women and men; cortisol,salivary alpha amylase,and mood

Background and Objectives: Social exclusion is ubiquitous and painful. Evolutionary models indicate sex differences in coping with social stress. Recent empirical data suggest different sex patterns in hypothalamic–pituitary–adrenal (HPA) and sympathetic–adrenal–medullary (SAM) reactivity. The present study sought to test this hypothesis.

Design: We examined differences in endocrine and emotional response to exclusion by using a virtual ball tossing paradigm (Cyberball). Saliva samples and mood ratings were collected to reflect levels before, and repeatedly following, exclusion.

Methods: The sample included 21 women and 23 men. Cortisol and salivary alpha amylase (sAA), biomarkers of the HPA and SAM systems, respectively, were used as indices of two arms of stress response.

Results: Following exclusion, all participants experienced mood worsening followed by mood improvement, with men reporting less distress than women. Women evinced decline in cortisol following the Cyberball task, whereas men’s cortisol levels showed a non-significant rise, and then decline, following exclusion.

Conclusions: Our results concur with previous findings showing SAM reactivity to be gender-neutral and HPA reactivity to be gender-divergent. Additional studies are needed to examine sex-specific response to social exclusion. Implications for individual differences in recovery from stress are discussed.     

The primal scene in cross-species and cross-cultural perspectives

A review of cross-species and cross-cultural research suggests that, throughout most of human behavioral evolution, children may have been enlightened as to the facts of life by observing parental intercourse and then imitating it in sexual rehearsal play in the context of a continuously rising curve of sexual desire and sexual knowledge throughout childhood. Concealment of the primal scene and prohibition of cross-generational, bisexual, and 'polymorphously perverse' childhood sex play may be of relatively recent origin in human cultural evolution, buttressed by the instillation of culturally acquired sexual disgust in sexually conservative cultures. Looking at the primal scene in cross-species and cross-cultural perspectives utilizing the adaptationist framework of contemporary evolutionary biology can challenge normative assumptions that may still be embedded in psychoanalytic theories of species-wide psychosexual development.     

Parental involvement, child temperament, and parents' work hours: Differential relations for mothers and fathers

This study examined how child temperament was related to parents' time spent accessible to and interacting with their 2-year-olds. Bivariate analyses indicated that both fathers and mothers spent more time with temperamentally challenging children than easier children on workdays, but fathers spent less time with challenging children than easier children on non-workdays. After accounting for work hours, some associations between temperament and fathers' workday involvement dropped to non-significance. For fathers, work hours also moderated the relation between irregular temperament and workday play. For mothers, work hours moderated the relation between both difficult and irregular temperament and workday interaction. Mothers also spent more time with girls (but not boys) who were temperamentally irregular. Results speak to the influence of child temperament on parenting behavior, and the differential construction of parenting roles as a function of child characteristics and patterns of work.     

Comparison of arousal and preference assessment outcomes for sex offenders with intellectual disabilities

We compared outcomes of arousal and preference assessments for five adult male alleged sexual offenders with intellectual disabilities. Arousal assessments involved the use of the penile plethysmograph to measure changes in penile circumference to both deviant (males and females under the age of 18) and nondeviant (males and females over the age of 18) video clips. Paired‐stimulus preference assessments were arranged to present still images from the video clips used in the arousal assessments. Results showed correspondence between the assessments for four out of the five participants. Implications are discussed for the use of preference assessment methodology as a less intrusive assessment approach for sexual offender assessments.