Inversão Sexual (Portuguese Edition)

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Hamburg University, Hamburg, Germany. University of Wisconsin Press, Madison. Mitochondrial DNA 22 S1: University of Colorado Museum, p. White cross-dressers seemed to engage in very low-risk recreational sex work. Exploring the desires and sexual culture of men who have sex with male-to-female transgender women. Men who have sex with transgender women MSTW currently constitute a gap in the research community's understanding of male sexuality and sexual desire.

The specific objectives were to: In this analysis, we described the MSTW sex market landscape in New York and identified three major recurrent themes in the ways that MSTW organized their sexual desire for TW transitioning from sex marketplaces to social spaces in their lives: Although the findings from the study are not representative of the broader MSTW population, they represent an important step in amassing a body of knowledge about an understudied and underserved sex market upon which future research is needed. The study found that only half of the KSW participants reported having been tested for HIV, and that except for one participant, all others had not seen health care providers in the past 12 months.

About one third of the participants reported having engaged in unprotected anal sex with customers in the past 6 months.

Almost all participants reported al HIV-related risk behaviors among kathoey male-to-female transgender sex workers in Bangkok, Thailand. About one third of the participants reported having engaged in unprotected anal sex with customers in the past six months. Almost all participants reported alcohol use, as well as having had sex with customers under the influence of alcohol.

A multiple regression analysis showed that the participants who were post-operative status, had used illicit drugs, or had been abused by their father and brothers were less likely to use condoms for anal sex with customers. The qualitative interviews revealed that many identified as girl or kathoey in early age and had been exposed to transphobia and violence from father and brothers.

Some reported support for gender transition from their mothers. More than half of the participants currently had difficulties in living as kathoey, such as challenges in the job market and relationship with family members. Family obligation for sending money and the Buddhist concept of karma were discussed in relation to risk behaviors among KSWs. Sex -specific differences in hemodialysis prevalence and practices and the male-to-female mortality rate: Directory of Open Access Journals Sweden. A comprehensive analysis of sex -specific differences in the characteristics, treatment, and outcomes of individuals with end-stage renal disease undergoing dialysis might reveal treatment inequalities and targets to improve sex -specific patient care.

Here we describe hemodialysis prevalence and patient characteristics by sex , compare the adult male-to-female mortality rate with data from the general population, and evaluate sex interactions with mortality. Among 35, sampled DOPPS patients with full data collection, we studied patient characteristics descriptively and mortality via Cox regression by sex. The average estimated glomerular filtration rate at hemodialysis initiation was higher in men than women.

The male-to-female mortality rate ratio in the general population varied from 1. Facilitating access to sexual health services for men who have sex with men and male-to-female transgender persons in Guatemala City. The purpose of this study was to identify barriers to accessing sexual health services among gay, bisexual and heterosexual-identifying men who have sex with men and male-to-female transgender persons in Guatemala City, to inform the development of high quality and population-friendly services.

Topical codes were applied to the data using software Atlas. Analysis revealed that public clinics were most commonly used due to their lower cost and greater accessibility, but many participants experienced discrimination, violation of confidentiality and distrust of these services. The most prominent barriers to sexual health services included fear of discrimination, fear of having HIV, cost and lack of social support. Findings highlight the need to strengthen existing public sexually transmitted infection clinics so that they address the multiple layers of stigma and discrimination that men who have sex with men and transgender persons experience.

Social support, exposure to violence and transphobia, and correlates of depression among male-to-female transgender women with a history of sex work. A total of THSW who worked or resided in San Francisco or Oakland, California, were recruited through street outreach and referrals and completed individual interviews using a structured questionnaire.

White and African American participants reported transphobia experiences more frequently than did others. Social support, transphobia, suicidal ideation, and levels of income and education were significantly and independently correlated with depression. HIV Infection, risk factors and health services use among male-to-female transgender sex workers: A participatory cross-sectional survey was conducted with TSW recruited in locations and networks where sex workers congregate. HIV-risk behaviors were common among participants. Inconsistent condom use with clients in the previous month was reported by Ever use of psychoactive substances was reported by Also, ever use of psychoactive substances was negatively associated with older age and Portuguese nationality.

The socioeconomic, relational or partnering, and structural contexts conducive to increased risk are warranting further investigation. This knowledge would be valuable to inform prevention programs. Outreach initiatives aimed to reach TSW who are difficult to access can play a role in promoting access to health services and reducing HIV infection and transmission. Preparatory behaviours and condom use during receptive and insertive anal sex among male-to-female transgenders Waria in Jakarta, Indonesia. The male-to-female transgender waria is part of a key population at higher risk for HIV.

Diet and reproductive aspects of the exotic gecko gehyra mutilata (

This study aims to test whether psychosocial determinants as defined by the theory of planned behaviour TPB can explain behaviours related to condom use among waria. Posttest-only studies and studies that combined pre-post data were excluded. Interventions that targeted at general public but did not include MSM or transgender women as a segment or did not have outcome data for an MSM or transgender segment were excluded. Two authors independently extracted data from each included study and assessed study quality.

Meta-analyses were conducted to compare pre- and post-intervention and intervention and control group outcomes of HIV and STI testing uptake. Three serial, cross-sectional pretest-posttest study designs one with a control group and two without were included in the final analysis. Overall, risk of bias was high and quality of evidence was low.

None of the studies were conducted in developing countries or included male-to-female transgender women. This review provided limited evidence that multi-media social marketing campaigns can promote HIV testing among MSM in developed countries. Future evaluations of social marketing interventions for MSM should employ more rigorous study designs. Implementation research, including detailed process evaluation, is needed to identify elements of social marketing interventions that are most effective in reaching the target population and changing behaviours.

Lacking information on men who have sex with men MSM for most reported cases, sexually transmitted disease STD programs in the United States have used crude measures such as male-to-female case ratios MFCR as a rule of thumb to gauge MSM involvement at the local level, primarily with respect to syphilis cases in the past. Suitability of this measure for gonorrhea incidence has not previously been investigated. A random sample of gonorrhea cases reported from January through June were interviewed in selected counties participating in the STD Surveillance Network to obtain gender of sex partners and history of transactional sex.

Male-to-female case ratio ranged from 0. Sex reversal in vertebrates. This special topic issue of Sexual Development gives an overview of sex reversal in vertebrates, from fishes naturally changing their sex , to rodents escaping the mammalian SRY-determining system. It offers eight up-to-date reviews on specific subjects in sex reversal , considering fishes, amphibians, reptiles, birds, marsupials, and placental mammals, including humans. The broad scope of represented animals makes this ideal for students and researchers, especially those interested in the Sex Reversal in Birds. Sexual differentiation in birds is controlled genetically as in mammals, although the sex chromosomes are different.

Males have a ZZ sex chromosome constitution, while females are ZW. Gene s on the sex chromosomes must initiate gonadal sex differentiation during embryonic life, inducing paired testes in ZZ individuals and unilateral ovaries in ZW individuals. The traditional view of avian sexual differentiation aligns with that expounded for other vertebrates; upon sexual differentiation, the gonads secrete sex steroid hormones that masculinise or feminise the rest of the body.

However, recent studies on naturally occurring or experimentally induced avian sex reversal suggest a significant role for direct genetic factors, in addition to sex hormones, in regulating sexual differentiation of the soma in birds. This review will provide an overview of sex determination in birds and both naturally and experimentally induced sex reversal , with emphasis on the key role of oestrogen. We then consider how recent studies on sex reversal and gynandromorphic birds half male: Current evidence shows that sexual differentiation in birds is a mix of direct genetic and hormonal mechanisms.

Perturbation of either of these components may lead to sex reversal. Men who have sex with men MSM and male-to-female transgender women transwomen are disproportionately at risk of syphilis infection in Peru. At baseline, interviewers collected sociodemographic, behavioral, and medical characteristics from participants. Using cross-sectional analyses, bivariate and multivariate models were used to determine factors associated with recently acquired syphilis infection and calculate adjusted prevalence ratios.

We recruited participants, MSM and 89 transwomen, with median ages of The prevalence of recently acquired syphilis infection at baseline was Among MSM and transwomen, Co-infection rates among MSM with recently acquired syphilis infection included: Co-infection rates among transwomen with recently acquired syphilis infection included: After studying this article, the participant should be able to discuss: The terminology related to male-to-female gender dysphoria. The different theories regarding cause, epidemiology, and treatment of gender dysphoria. The surgical goals of sex reassignment surgery in male-to-female transsexualism.

The surgical techniques available for sex reassignment surgery in male-to-female transsexualism. Gender identity disorder previously "transsexualism" is the term used for individuals who show a strong and persistent cross-gender identification and a persistent discomfort with their anatomical sex , as manifested by a preoccupation with getting rid of one's sex characteristics, or the belief of being born in the wrong sex.

Harry Benjamin, one of the first physicians who made many clinicians aware of the potential benefits of sex reassignment surgery has played a major role in the research and treatment of gender identity disorder, publishing the Standards of Care for Gender Dysphoric Persons. The authors performed an overview of the terminology related to male-to-female gender identity disorder; the different theories regarding cause, epidemiology, and treatment; the goals expected; and the surgical technique available for sex reassignment surgery in male-to-female transsexualism.

Surgical techniques available for sex reassignment surgery in male-to-female transsexualism, with advantages and disadvantages offered by each technique, are reviewed. Other feminizing nongenital operative interventions are also examined. This review describes recent etiopathogenetic theories and actual guidelines on the treatment of the gender identity disorder in male-to-female transsexuals; the penile-scrotal skin flap technique is considered the state of the art for vaginoplasty in male-to-female transsexuals, whereas other techniques rectosigmoid flap, local flaps, and isolated skin.

Regional gray matter variation in male-to-female transsexualism. Gender identity—one's sense of being a man or a woman—is a fundamental perception experienced by all individuals that extends beyond biological sex. Yet, what contributes to our sense of gender remains uncertain. Since individuals who identify as transsexual report strong feelings of being the opposite sex and a belief that their sexual characteristics do not reflect their true gender, they constitute an invaluable model to understand the biological underpinnings of gender identity.

We analyzed MRI data of 24 male-to-female MTF transsexuals not yet treated with cross- sex hormones in order to determine whether gray matter volumes in MTF transsexuals more closely resemble people who share their biological sex 30 control men , or people who share their gender identity 30 control women. Results revealed that regional gray matter variation in MTF transsexuals is more similar to the pattern found in men than in women.

However, MTF transsexuals show a significantly larger volume of regional gray matter in the right putamen compared to men. These findings provide new evidence that transsexualism is associated with distinct cerebral pattern, which supports the assumption that brain anatomy plays a role in gender identity.

Current research to describe and evaluate effectiveness of voice and communication therapy for male-to-female transgender people is limited to adults. This paper provides rationale, procedures, and outcomes from voice and communication therapy for a male-to-female transgender adolescent 15 years of age.

Treatment addressed vocal hygiene, breath…. Male-to-female transsexuals have female neuron numbers in a limbic nucleus. Transsexuals experience themselves as being of the opposite sex , despite having the biological characteristics of one sex. A crucial question resulting from a previous brain study in male-to-female transsexuals was whether the reported difference according to gender identity in the central part of. The degree to which one identifies as male or female has a profound impact on one's life. Yet, there is a limited understanding of what contributes to this important characteristic termed gender identity.

In order to reveal factors influencing gender identity, studies have focused on people who report strong feelings of being the opposite sex , such as male-to-female MTF transsexuals. To investigate potential neuroanatomical variations associated with transsexualism, we compared the regional thickness of the cerebral cortex between 24 MTF transsexuals who had not yet been treated with cross- sex hormones and 24 age-matched control males. Results revealed thicker cortices in MTF transsexuals, both within regions of the left hemisphere i. These findings provide further evidence that brain anatomy is associated with gender identity, where measures in MTF transsexuals appear to be shifted away from gender-congruent men.

Sex Reversal in Amphibians. Amphibians have been widely used to study developmental biology due to the fact that embryo development takes place independently of the maternal organism and that observations and experimental approaches are easy. Some amphibians like Xenopus became model organisms in this field. In the first part of this article, the differentiation of the gonads in amphibians and the mechanisms governing this process are reviewed. In the second part, the state of the art about sex reversal , which can be induced by steroid hormones in general and by temperature in some species, is presented.

Also information about pollutants found in the environment that could interfere with the development of the amphibian reproductive apparatus or with their reproductive physiology is given. Such compounds could play a part in the amphibian decline, since in the wild, many amphibians are endangered species. Gender alignment surgery was introduced into German law in Judicial guidelines for the change of first names and gender were established and transsexuality was labelled as a psychosomatic and somatopsychic syndrome and disorder, thus opening the way for treatment to the social health-care under well-defined conditions requesting cross-dressing and hormone therapy as well as psychological counselling by 2 independent psychologists or psychiatrists.

In a retrospective, chart-related survey of questionnaires on male to female transsexuals it was found that patients start to suspect being born into the wrong gender at the onset of puberty, it takes them however approximately 20 years to have gender alignment surgery. More than half the patients are single at this time, while the remaining group is married or divorced with equal rates.

About half the patients experienced support by their families for their decision. Despite numerous secondary corrections of the surgical alignment, patients were content with the result, although emotional acceptance of the desired result took about one year. In general plastic surgical gender alignment treatment was perceived as the major contribution to harmonise their phenotype with their identity.

Perforation of the neovagina in a male-to-female transsexual: There are several techniques for creation of a neovagina in male-to-female reassignment surgery. Although vaginoplasty with the sigmoid colon is not a common procedure, it is becoming more common. Perforation of the recto-sigmoid neovagina after sex reassignment surgery is very rare. We hereby report a case of perforation of the neovagina that presented as acute peritonitis, with a massive abscess in the intra-abdominal cavity. This case report describes a year-old Asian woman presenting with mild persistent abdominal pain, nausea, and vomiting who had undergone male-to-female sex reassignment surgery four years prior.

Physical examination revealed mild abdominal pain without rebound tenderness. An abdominal computed tomography scan showed a massive abscess that occupied a significant portion of the intra-abdominal cavity. Perforation of the neovagina was confirmed by exploratory laparotomy and surgical drainage with primary closure was performed without any complications. This is a rare case involving perforation of the neovagina that was successfully treated with surgical intervention.

This case emphasizes the importance of taking a detailed medical history and to make physicians and patients aware that bowel vaginoplasty can result in a weak vagina. Our aims were to estimate HIV prevalence and examine the behaviors and characteristics of the population. We conducted a cross-sectional study of MTF transgender persons recruited through time location sampling in Participants underwent interviewer-administered paper and pen surveys and rapid tests for HIV.

Descriptive univariate analyses were conducted on various factors, including sociodemographics, substance use, accessing social services requested vs. Social context of HIV risk behaviours among male-to-female transgenders of colour. Participants were likely to report having unprotected sex with primary partners to signify love and emotional connection, as well as to receive gender validation from their partners. In contrast, viewing sex work with customers as a business encouraged intentious to use condoms. Safer sex intentions with customers were frequently undermined by urgent financial needs, which stemmed from transphobia, employment discrimination and costly procedures associated with gender transition.

Participants reported using drugs as a way to cope with or escape life stresses associated with relationships, sex work, transphobia and financial hardship. Interventions with at-risk MTF transgenders should address the interpersonal and social context of unsafe sex and drug use, particularly the unique roles of relationship issues with male partners, stigma, discrimination and community norms regarding sex work and drug use. Data on HIV risk were collected with the Countywide Risk Assessment Survey from participants; 92 were male-to-female transgender persons i.

Transgender-identified individuals were more likely than the rest of the sample to have received hormone injections, offensive comments, and HIV testing; injected hormones with a used needle; been Asian or American Indian; been paid for sexual intercourse; and lived in unstable housing but less likely to have used heroin. Transgender-identified individuals are at high risk for HIV infection because of reuse of needles and being paid for sexual intercourse.

Cricothyroid approximation and subluxation in 21 male-to-female transsexuals. To evaluate the medium-term outcome of cricothyroid approximation and subluxation CTAS with postoperative speech therapy for pitch elevation in male-to-female transsexuals. Retrospective study of male-to-female transsexuals who underwent pitch-raising surgery between. HIV-related sexual risk behaviors among male-to-female transgender people in Nepal. Transgender women are a vulnerable and key risk group for HIV, and most research has shown an increased frequency of HIV infection among this minority population.

This study examined the prevalence of HIV-related sexual risk behaviors and the socio-demographic correlates with HIV-related sexual risk behaviors among male-to-female MtF transgender persons. Data were collected from a sample of individuals through venue-based and snowball sampling and face-to-face interviews. Statistically significant differences were found for age, income, education, alcohol habit, and sex with more than two partners per day for these three different HIV-related sexual risk behaviors.

MtF transgender persons with a secondary or higher level of education were three times OR 2. Age, education, income, frequency of daily sexual contact, and an alcohol habit remain significant with regard to HIV-related sexual risk behavior. There is an urgent need for programs and interventions to reduce risky sexual behaviors in this minority population. Published by Elsevier Ltd.. We clarify what gender dysphoria is, and we examine methods of intervention. We categorized the subjects'experiences regarding dysphoria into the 'Onset of gender dysphoria,' 'Experience of feeling gender dysphoria,' and 'Changes due to receiving medical care.

All subjects described their experiences of dysphoria as negative. Additionally, all said that the dysphoria was alleviated by a medical intervention such as visiting a gender clinic, receiving a diagnosis and treatment, and changing their physical sex to the sex congruent with their gender identity. The provision of information at the gender clinic and the physical changes achieved by medical intervention exerted a positive effect both mentally and socially on the subjects, who suffered various physical, mental and social problems.

Gender-specific differences in resting-state networks. Recent research found gender-related differences in resting-state functional connectivity rs-FC measured by functional magnetic resonance imaging fMRI. To the best of our knowledge, there are no studies examining the differences in rs-FC between men, women, and individuals who report a discrepancy between their anatomical sex and their gender identity, i.

To address this important issue, we present the first fMRI study systematically investigating the differences in typical resting-state networks RSNs and hormonal treatment effects in 26 male-to-female GD individuals MtFs compared with 19 men and 20 women. Differences between male and female control groups were found only in the auditory RSN, whereas differences between both control groups and MtFs were found in the auditory and fronto-parietal RSNs, including both primary sensory areas e.

Overall, differences in MtFs compared with men and women were more pronounced before cross- sex hormonal treatment. Interestingly, rs-FC between MtFs and women did not differ significantly after treatment. When comparing hormonally untreated and treated MtFs, we found differences in connectivity of the calcarine gyrus and thalamus in the context of the auditory network, as well as the inferior frontal gyrus in context of the fronto-parietal network.

Our results provide first evidence that MtFs exhibit patterns of rs-FC which are different from both their assigned and their aspired gender, indicating an intermediate position between the two sexes. We suggest that the present study constitutes a starting point for future research designed to clarify whether the brains of individuals with GD are more similar to their assigned or their aspired gender. Reversed sex change by widowed males in polygynous and protogynous fishes: Sex change, either protogyny female to male or protandry male to female , is well known among fishes, but evidence of bidirectional sex change or reversed sex change in natural populations is still very limited.

This is the first report on female removal experiments for polygnous and protogynous fish species to induce reversed sex change in the widowed males in the field. We removed all of the females and juveniles from the territories of dominant males in the cleaner wrasse Labroides dimidiatus Labridae and the rusty angelfish Centropyge ferrugata Pomacanthidae on the coral reefs of Okinawa. In both species, if new females or juveniles did not immigrate into the territories of the widowed males, some of them emigrated to form male-male pairs.

Thus, the reversed sex change occurred in the widowed males according to the change of their social status. These results suggest that such female removal experiments will contribute to the discovery of reversed sex change in the field also in other polygnous and protogynous species. Outcome and preferences in male-to-female subjects with gender dysphoria: Experience from Eastern India. Gender dysphoria GD is an increasingly recognized medical condition in India, and little scientific data on treatment outcomes are available. Our objective is to study the therapeutic options including psychotherapy, hormone, and surgical treatments used for alleviating GD in male-to-female MTF transgender subjects in Eastern India.

This is a retrospective study of treatment preferences and outcome in 55 MTF transgender subjects who were presented to the endocrine clinic. Descriptive statistical analysis is carried out in the present study, and Microsoft Word and Excel are used to generate graphs and tables.

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The mean follow-up was 1. Rest 41 subjects Most of the subjects preferred estrogen therapy as it was most affordable and only a small number of subjects preferred drospirenone or GnRH agonist because of cost and availability. Three subjects presented with prior breast augmentation surgery and nine subjects presented with prior orchiectomy without vaginoplasty, depicting a high prevalence of poorly supervised surgeries. Standards of care documents provide clinical guidance for health professionals about the optimal management of transsexual people. The lack of information among health professionals about proper and protocolwise management leads to suboptimal physical, social, and sexual results.

Dimensional profiles of male to female gender identity disorder: To explore the aggregation of clinical manifestations of MtF GID in order to identify meaningful variables describing the heterogeneity of the disorder. Diagnosis was based on formal psychiatric classification criteria. Factor analysis was performed. Several socio-demographic and clinical parameters were investigated. Factor analysis identified two dimensional factors: Factor 1 was associated with sexual orientation, and Factor 2 related to behavioral and psychological correlates of early GID development.

No correlation was observed between the two factors. A variety of other socio-demographic parameters and clinical features were associated with both factors. Behavioral and psychological correlates of Factor 1 sexual orientation and Factor 2 gender identity do not constitute the framework of two separate clinical entities, but instead represent two dimensions of the complex MtF GID structure, which can be variably intertwined in the same subject.

By using factor analysis, we offer a new approach capable of delineating a psychopathological and clinical profile of MtF GID patients. We aim to describe the relationship between sexual orientation identity and medical morbidities in a large sample of male-to-female MTF transgender patients. We reviewed medical records of patients presenting for MTF sex reassignment surgery SRS by a single, high-volume surgeon from to Sexual attraction to men heterosexual , women lesbian , or both bisexual was asked of each patient.

We examined 16 medical morbidities for this analysis. The average age at the time of surgery was Sexual orientation identity in MTF transgender patients is variable. The majority of medical morbidities are not associated with sexual orientation identity. Although HIV and depression are common morbidities among MTF patients seeking SRS, the prevalence of these morbidities differs by sexual orientation identity, but these findings need replication. Counseling and future research initiatives in transgender care should incorporate sexual orientation identity and associated risk behavior.

Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques. Gender reassignment surgery is the keystone of the treatment of transgender patients. For male-to-female transgenders, this involves the creation of a neovagina. Many surgical methods for vaginoplasty have been opted. The penile skin inversion technique is the method of choice for most. The fear of experiencing discrimination often provokes symptoms of psychological distress.

Participants were recruited from transgender events held in Arizona and Californi Conservatively treated perforation of the neovagina in a male to female transsexual patient. An unknown number of patients have had male to female gender transformation. Various surgical techniques have been employed to construct the neovagina. The more traditional techniques include inverted penile grafts and vascular pedicle grafts, but also the small bowel and sigmoid colon have been The patient was treated conservatively with antibiotics and discharged after 7 days Campomelic dysplasia MIM is a severe malformation syndrome frequently accompanied by male-to-female sex reversal.

Causative are mutations within the SOX9 gene on 17q Studies generally focus on transcriptional profiling and specific genes related to sex determination and differentiation. We obtained unique peptides and 93, unigenes with good correlation between messenger RNA and protein levels. The downstream regulator may not be dimorphic expressed genes, but genes expressed in intersex individuals, males and females.

Different expression patterns of sex -related genes and gonadal histological characteristics suggested that C. Monoamines stimulate sex reversal in the saddleback wrasse. Monoamine neurotransmitters norepinephrine, dopamine, and serotonin play an important role in reproduction and sexual behavior throughout the vertebrates. They are the first endogenous chemical signals in the regulation of the hypothalamo-pituitary-gonadal HPG axis. In teleosts with behavioral sex determination, much is known about behavioral cues that induce sex reversal. The cues are social, processed via the visual system and depend on the ratio of females to males in the population.

The mechanisms by which these external behavioral cues are converted to an internal chemical regulatory process are largely unknown. The protogynous Hawaiian saddleback wrasse, Thalassoma duperrey, was used to investigate the biological pathway mediating the conversion of a social cue into neuroendocrine events regulating sex reversal. Because monoamines play an important role in the regulation of the HPG axis, they were selected as likely candidates for such a conversion.

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To determine if monoamines could affect sex reversal , drugs affecting monoamines were used in an attempt to either induce sex reversal under non-permissive conditions, or prevent sex reversal under permissive conditions. Increasing norepinephrine or blocking dopamine or serotonin lead to sex reversal in experimental animals under non-permissive conditions. Increasing serotonin blocked sex reversal under permissive conditions, while blocking dopamine or norepinephrine retarded the process.

The results presented here demonstrate that monoamines contribute significantly to the control sex reversal. Norepinephrine stimulates initiation and completion of gonadal sex of reversal as well as color change perhaps directly via its effects on the HPG axis. Dopamine exercises inhibitory action on the initiation of sex reversal while 5-HT inhibits both initiation and completion of sex reversal.

The serotonergic system appears to be an integral part of the pathway mediating the conversion of a social cue into a. The penile skin inversion technique is the method of choice for most gender surgeons. However, the optimal surgical technique for vaginoplasty in transgender women has not yet been identified, as outcomes of the different techniques have never been compared. With this systematic review, we aim to give a detailed overview of the published outcomes of all currently available techniques for vaginoplasty in male-to-female transgenders. A PubMed and EMBASE search for relevant publications present , which provided data on the outcome of techniques for vaginoplasty in male-to-female transgender patients.

Main outcome measures are complications, neovaginal depth and width, sexual function, patient satisfaction, and improvement in quality of life QoL. Twenty-six studies satisfied the inclusion criteria. The majority of these studies were retrospective case series of low to intermediate quality. Outcome of the penile skin inversion technique was reported in 1, patients, bowel vaginoplasty in patients.

Neovaginal stenosis was the most frequent complication in both techniques. Sexual function and patient satisfaction were overall acceptable, but many different outcome measures were used. QoL was only reported in one study. Comparison between techniques was difficult due to the lack of standardization. The penile skin inversion technique is the most researched surgical procedure.

Outcome of bowel vaginoplasty has been reported less frequently but does not seem to be inferior. The available literature is heterogeneous in patient groups, surgical procedure, outcome measurement tools, and follow-up. Standardized protocols and prospective study designs are mandatory for correct interpretation and comparability of data. Previous research has indicated that biological older brothers increase the odds of androphilia in males. This finding has been termed the fraternal birth order effect.

The maternal immune hypothesis suggests that this effect reflects the progressive immunization of some mothers to male-specific antigens involved in fetal male brain masculinization. Exposure to these antigens, as a result of carrying earlier-born sons, is hypothesized to produce maternal immune responses towards later-born sons, thus leading to female-typical neural development of brain regions underlying sexual orientation.

Because this hypothesis posits mechanisms that have the potential to be active in any situation where a mother gestates repeated male fetuses, a key prediction is that the fraternal birth order effect should be observable in diverse populations. The present study assessed the association between sexual orientation and birth order in androphilic male-to-female transsexuals in Brazil, a previously unexamined population.

Logistic regression showed that the transsexual group had significantly more older brothers and other siblings. These effects were independent of one another and consistent with previous studies of birth order and male sexual orientation. The presence of the fraternal birth order effect in the present sample provides further evidence of the ubiquity of this effect and, therefore, lends support to the maternal immune hypothesis as an explanation of androphilic sexual orientation in some male-to-female transsexuals. Hypogonadism in a male-to-female transsexual with super obesity. The global obesity epidemic is having a profound impact on the health of populations.

From a reproductive standpoint, obesity has been associated with infertility and hypogonadism. There is virtually no literature on the hormonal sequelae of obesity in transsexual people. The patient was prescribed an aromatase inhibitor, letrozole 2. The aromatase inhibitor reduced the serum oestradiol concentration from to 6. There were dramatic corresponding rises in total testosterone 2.

This diagnostic test demonstrated the important role of oestrogen in mediating the hypogonadism. After the testing, the patient was started on oestrogen therapy after a careful discussion of the benefits versus risks of oestrogen therapy. We anticipate that similar cases of hypogonadism in male-to-female transsexuals will likely become more common in an era of increased obesity rates.

Cortical activation during mental rotation in male-to-female and female-to-male transsexuals under hormonal treatment. There is strong evidence of sex differences in mental rotation tasks. Transsexualism is an extreme gender identity disorder in which individuals seek cross-gender treatment to change their sex. The aim of our study was to investigate if male-to-female MF and female-to-male FM transsexuals receiving cross- sex hormonal treatment have different patterns of cortical activation during a three-dimensional 3D mental rotation task.

Twenty-three males and 19 females served as controls. The general pattern of cerebral activation seen while visualizing the rotated and non-rotated figures was similar for all four groups showing strong occipito-parieto-frontal brain activation. However, compared to control males, the activation of MF transsexuals during the task was lower in the superior parietal lobe. Compared to control females, MF transsexuals showed higher activation in orbital and right dorsolateral prefrontal regions and lower activation in the left prefrontal gyrus.

FM transsexuals did not differ from either the MF transsexual or control groups. Regression analyses between cerebral activation and the number of months of hormonal treatment showed a significant negative correlation in parietal, occipital and temporal regions in the MF transsexuals. No significant correlations with time were seen in the FM transsexuals. In conclusion, although we did not find a specific pattern of cerebral activation in the FM transsexuals, we have identified a specific pattern of cerebral activation during a mental 3D rotation task in MF transsexuals under cross- sex hormonal treatment that differed from control males in the parietal region and from control females in the orbital prefrontal region.

The hypoactivation in MF transsexuals in the parietal region could be due to the hormonal treatment or could reflect a priori cerebral differences between MF transsexual. Societal individualism predicts prevalence of nonhomosexual orientation in male-to-female transsexualism. There are two distinct subtypes of male-to-female MtF transsexuals: The relative prevalence of these two subtypes varies dramatically between countries, but no explanation of this variability has yet been proposed.

This study examined the hypothesis that the prevalence of nonhomosexual MtF transsexualism, relative to homosexual MtF transsexualism, would be higher in individualistic countries than in collectivistic countries. I analyzed data from 22 studies of MtF transsexualism, conducted in 16 countries, examining the association between percentage of nonhomosexual participants and Hofstede's Culture's consequences: Comparing values, behaviors, institutions, and organizations across nations, Individualism Index IDV.

Inherited XX sex reversal originating from wild medaka populations. Here, we performed genetic analyses of nine spontaneous XX sex-reversed males to elucidate its genetic basis. In all cases, the F 1 progeny were all females, whereas XX males reappeared in the backcross BC progeny, suggesting that XX sex reversal is a recessive trait. We performed linkage analysis using 55 BC males and located a single major factor, sda-1 sex -determining autosomal factor-1 , controlling sex reversal in an autosomal linkage group.

Thus, genes involved in the sex -determining pathway can be isolated from spontaneous mutants in wild populations. The behavioural consequences of sex reversal in dragons. Sex differences in morphology, physiology, and behaviour are caused by sex -linked genes, as well as by circulating sex -steroid levels. Thus, a shift from genotypic to environmental sex determination may create an organism that exhibits a mixture of male-like and female-like traits. We studied a lizard species Central Bearded Dragon, Pogona vitticeps , in which the high-temperature incubation of eggs transforms genetically male individuals into functional females.

Although they are reproductively female, sex-reversed dragons individuals with ZZ genotype reversed to female phenotype resemble genetic males rather than females in morphology relative tail length , general behaviour boldness and activity level , and thermoregulatory tactics. This novel phenotype may impose strong selection on the frequency of sex reversal within natural populations, facilitating rapid shifts in sex -determining systems. A single period of high incubation temperatures generating thermally induced sex reversal can produce functionally female individuals with male-like or novel traits that enhance individual fitness, allowing the new temperature-dependent sex -determining system to rapidly replace the previous genetically based one.

Perceived discrimination and depression among low-income Latina male-to-female transgender women. This study examines exposure to perceived discrimination and its association with depression among low-income, Latina male-to-female transgender women as well as evaluates the impact of sexual partner violence and mistreatment on depression. A total of Latina male-to-female transgender women who resided in Los Angeles, California, were recruited through community based organizations and referrals. Participants completed individual interviews using a structured questionnaire.

Perceived discrimination was assessed using a fifteen-item measure that was designed to assess the experiences of maltreatment of transgender individuals. Multinomial logistic regression was used to examine the association between perceived discrimination and depression after controlling for the presence of other variables. Additionally, one-third of the participants indicated that in the two weeks prior to the interviews they had thought either of hurting themselves or that they would be better off dead.

The extent of perceived discrimination in this population was extensive. Almost six out of ten participants admitted that they had been victims of sexual partner violence. Those who reported more frequent discrimination were more likely to be identified with severe depression. There was also a notable association between self-reported history of sexual partner violence and depression severity. A significant association between depression severity and perceived discrimination was identified.

How exposure to discrimination leads to increased risk of mental health problems needs additional investigation. Full Text Available Abstract Background This study examines exposure to perceived discrimination and its association with depression among low-income, Latina male-to-female transgender women as well as evaluates the impact of sexual partner violence and mistreatment on depression.

Methods A total of Latina male-to-female transgender women who resided in Los Angeles, California, were recruited through community based organizations and referrals. Conclusions A significant association between depression severity and perceived discrimination was identified.

How exposure to discrimination leads to increased risk of. Sex determinations are diverse in vertebrates. Although many sex -determining genes and pathways are conserved, the mechanistic roles of these genes and pathways in the genetic sex determination are not well understood.

DAX1 encoded by the NR0B1 gene is a vertebrate specific orphan nuclear receptor that regulates gonadal development and sexual determination. In human, duplication of the NR0B1 gene leads to male-to-female sex reversal. In mice, Nr0b1 shows both pro-testis and anti-testis functions. We generated inheritable nr0b1 mutation in the zebrafish and found the nr0b1 mutation caused homozygous mutants to develop as fertile males due to female-to-male sex reversal. The nr0b1 mutation did not increase Caspase-3 labeling nor tp53 expression in the developing gonads.

Introduction of a tp53 mutation into the nr0b1 mutant did not rescue the sex-reversal phenotype. Further examination revealed reduction in cell proliferation and abnormal somatic cell differentiation in the nr0b1 mutant gonads at the undifferentiated and bi-potential ovary stages. Together, our results suggest nr0b1 regulates somatic cell differentiation and cell proliferation to ensure normal sex development in the zebrafish. Neuroimaging differences in spatial cognition between men and male-to-female transsexuals before and during hormone therapy.

Neuropsychological abnormalities in transsexual patients have been reported in comparison with subjects without gender identity disorder GID , suggesting differences in underlying neurobiological processes. However, these results have not consistently been confirmed. Furthermore, studies on cognitive effects of cross- sex hormone therapy also yield heterogeneous results. We hypothesized that untreated transsexual patients differ from men without GID in activation pattern associated with a mental rotation task and that these differences may further increase after commencing of hormonal treatment.

Using functional magnetic resonance imaging at 3-Tesla, a mental rotation paradigm with proven sexual dimorphism was applied to all subjects. Data were analyzed with SPM5. Patterns of brain activation associated with a mental rotation task. The classical mental rotation network was activated in all three groups, but significant differences within this network were observed. Men without GID exhibited significantly greater activation of the left parietal cortex BA 40 , a key region for mental rotation processes. Both transsexual groups revealed stronger activation of temporo-occipital regions in comparison with men without GID.

Our results confirmed previously reported deviances of brain activation patterns in transsexual men from men without GID and also corroborated these findings in a group of transsexual patients receiving cross- sex hormone therapy. The present study indicates that there are a priori differences between men and transsexual patients caused by different neurobiological processes or task-solving strategies and that these differences remain stable over the course of hormonal treatment. A report from a single institute's year experience in treatment of male-to-female transsexuals.

Gender identity disorder or transsexualism is a complex clinical condition, and prevailing social context strongly impacts the form of its manifestations. Sex reassignment surgery SRS is the crucial step of a long and complex therapeutic process starting with preliminary psychiatric evaluation and culminating in definitive gender identity conversion. The aim of our study is to arrive at a clinical and psychosocial profile of male-to-female transsexuals in Italy through analysis of their personal and clinical experience and evaluation of their postsurgical satisfaction levels SRS.

From January to September , male patients who had undergone gender-transforming surgery at our institution were requested to complete a patient satisfaction questionnaire. The questionnaire consisted of 38 questions covering nine main topics: Average age was 31 years old. Family and colleague emotional support levels were satisfactory. All patients had been adequately informed of surgical procedure beforehand. Eighty-nine percent engaged in postsurgical sexual activities.

Seventy-five percent had a more satisfactory sex life after SRS, with main complications being pain during intercourse and lack of lubrication. Almost all of the patients were satisfied with their new sexual status and expressed no regrets. Our patients' high level of satisfaction was due to a combination of a well-conducted preoperative preparation program, competent surgical skills. Environmental sex reversal ESR , which results in a mismatch between genotypic and phenotypic sex , is well documented in numerous fish species and may be induced by chemical exposure.

Historically, research involving piscine ESR has been carried out with a view to improving profitability in aquaculture or to elucidate the processes governing sex determination and sexual differentiation.