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Contraception and Pregnancy Prevention for Transgender And
Contraception and pregnancy prevention for transgender and gender nonbinary individuals across the gender spectrum Chance Krempasky, FNP, WHNP (he/him) Callen-Lorde Community Health Center New York, NY USA Intros/Who's in the room? A Little About Callen-Lorde... Introduction • Transmasculine persons (TMGNB=transgender men and gender nonbinary persons who are assigned female at birth), may utilize testosterone as part of gender affirming therapy • They may have a uterus + ovaries and be capable of achieving pregnancy • They also may engage in sexual activity which can achieve pregnancy TMGNB people can still get pregnant, even if they are on testosterone and haven’t had a recent period. Pregnancy in TMGNB persons • 31% trans masculine persons, 67% trans feminine persons believed or were unsure if gender affirming hormone therapy (GAHT) prevents pregnancy • 6% trans feminine, 9% trans masculine reported that a provider stated that GAHT prevents pregnancy • 3% TMGNB/trans masculine had unplanned pregnancies Contraception Knowledge in TMGNB Persons • Many believed testosterone functioned as a contraceptive • Respondents reported receiving unclear or confusing information from clinicians on need for contraception while on GAHT • Concerned contraception would interfere with masculinizing effects of GAHT Pregnancy in TMGNB Persons • 16.4% of TMGNB persons believed that GAHT is a contraceptive • 5.5% reported a provider stated that GAHT prevents pregnancy • 17% had been or were currently pregnant (11/60 pregnancies with current or past GAHT use) • 60 pregnancies reported, 10 (17%) pregnancies occurred after stopping testosterone, 1 (1.6%) while taking testosterone irregularly Clinical Barriers to Transmasculine Contraception • Unger, AJOG 2015: • Less than one third of OBGYN clinicians surveyed recently stated that they were comfortable providing care for TM individuals • NCTE U.S. -
NVA Research Update E- Newsletter September – October – November 2016
NVA Research Update E- Newsletter September – October – November 2016 www.nva.org __________________________ Vulvodynia The Vulvar Pain Assessment Questionnaire inventory. Dargie E, Holden RR, Pukall CF. Pain. 2016 Aug 1. https://www.ncbi.nlm.nih.gov/pubmed/27780177 Millions suffer from chronic vulvar pain (ie, vulvodynia). Vulvodynia represents the intersection of 2 difficult subjects for health care professionals to tackle: sexuality and chronic pain. Those with chronic vulvar pain are often uncomfortable seeking help, and many who do so fail to receive proper diagnoses. The current research developed a multidimensional assessment questionnaire, the Vulvar Pain Assessment Questionnaire (VPAQ) inventory, to assist in the assessment and diagnosis of those with vulvar pain. A large pool of items was created to capture pain characteristics, emotional/cognitive functioning, physical functioning, coping skills, and partner factors. The item pool was subsequently administered online to 288 participants with chronic vulvar pain. Of those, 248 participants also completed previously established questionnaires that were used to evaluate the convergent and discriminant validity of the VPAQ. Exploratory factor analyses of the item pool established 6 primary scales: Pain Severity, Emotional Response, Cognitive Response, and Interference with Life, Sexual Function, and Self-Stimulation/Penetration. A brief screening version accompanies a more detailed version. In addition, 3 supplementary scales address pain quality characteristics, coping skills, and the impact on one's romantic relationship. When relationships among VPAQ scales and previously researched scales were examined, evidence of convergent and discriminant validity was observed. These patterns of findings are consistent with the literature on the multidimensional nature of vulvodynia. The VPAQ can be used for assessment, diagnosis, treatment formulation, and treatment monitoring. -
Table of Contents
Society for Sex Therapy and Research SSTAR 2008: 33rd Annual Meeting Continuing Medical Education Credit is provided through joint sponsorship with The American College of Obstetricians and Gynecologists (ACOG). Intercontinental Hotel Chicago, Illinois USA March 13-15, 2008 TABLE OF CONTENTS President‘s Welcome ..........................................................................................................1 SSTAR 2009: 34th Annual Meeting – Arlington, Virginia, USA ........................................2 SSTAR 2008 Fall Clinical Meeting – New York, New York USA ....................................2 SSTAR Executive Council and Administrative Staff ..........................................................3 Continuing Education Accreditations & Approvals ............................................................5 Acknowledgements ..............................................................................................................6 Program Schedule ................................................................................................................7 2008 Award Recipients ....................................................................................................14 SSTAR Health Professional Book Award .............................................................14 Sex, Therapy, and Kids Recipient: Sharon Lamb, EdD SSTAR Service Award ..........................................................................................14 Recipient: Bill Maurice, MD SSTAR Student Research Award Abstract ............................................................15 -
Co™™I™™Ee Opinion
The American College of Obstetricians and Gynecologists WOMEN’S HEALTH CARE PHYSICIANS COMMITTEE OPINION Number 673 • September 2016 (Replaces Committee Opinion No. 345, October 2006) Committee on Gynecologic Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice and the American Society for Colposcopy and Cervical Pathology (ASCCP) in collaboration with committee member Ngozi Wexler, MD, MPH, and ASCCP members and experts Hope K. Haefner, MD, Herschel W. Lawson, MD, and Colleen K. Stockdale, MD, MS. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Persistent Vulvar Pain ABSTRACT: Persistent vulvar pain is a complex disorder that frequently is frustrating to the patient and the clinician. It can be difficult to treat and rapid resolution is unusual, even with appropriate therapy. Vulvar pain can be caused by a specific disorder or it can be idiopathic. Idiopathic vulvar pain is classified as vulvodynia. Although optimal treatment remains unclear, consider an individualized, multidisciplinary approach to address all physical and emotional aspects possibly attributable to vulvodynia. Specialists who may need to be involved include sexual counselors, clinical psychologists, physical therapists, and pain specialists. Patients may perceive this approach to mean the practitioner does not believe their pain is “real”; thus, it is important to begin any treatment approach with a detailed discussion, including an explanation of the diagnosis and determination of realistic treatment goals. Future research should aim at evaluating a multimodal approach in the treatment of vulvodynia, along with more research on the etiologies of vulvodynia. -
St. John's College Annapolis, Maryland
ST. JOHN'S COLLEGE ANNAPOLIS, MARYLAND 1696-1989 COMMENCEMENT EXERCISES SUNDAY, MAY TWENTY-FIRST NINETEEN HUNDRED EIGHTY-NINE PROGRAM FOR THE ONE HUNDRED NINETY-SEVENTH COMMENCEMENT IN THE TWO HUNDRED NINETY-THIRD YEAR OF THE COLLEGE ACADEMIC PROCESSION Brass Quintet WELCOME William M. Dyal, Jr. President of the College ANNOUNCEMENT OF PRIZES AND AWARDS President Dyal ADDRESS TO THE GRADUATING CLASS Thomas K. Simpson Tutor, St. John's College CONFERRING OF DEGREES President Dyal ACADEMIC RECESSION Brass Quintet BACHELOR OF ARTS DEGREE (with title of essay) HAROLD ATWOOD ANDERSON JR Cleveland, Ohio An Inquiry into the Nature of the Musical Object LINDA SUSANNA ATTAR Houston, Texas Emile, An Experiment in Nature DANIEL CHRIS AUKERMAN Union Bridge, Maryland Labor as a Basis for Value Labor Theory in Karl Marx's Capital BRIGHAM BLASE BECHTEL Millersville, Maryland A Christian in the Profession of Arms TIMOTHY JOHN BENJAMIN Clinton, New Jersey The Art of Virtue A Study of The Brothers Karamazov JOSEPH GEORGE BOUCHER Canandaigua, New York The Inheritance and Repudiation of a Legacy: The Heroism of Belief in Faulkner's The Bear JULIET HARWOOD BURCH Annapolis, Maryland Alienation and Social Recourse A Look at lonesco's Rhinoceros GROVER LAFAYETTE BYNUM, III Austin, Texas Born to Sue SARA ELLEN CATANIA Chicago, Illinois Working on the Soul in Tolstoy's Anna Karenina WILL NATHANIEL CLURMAN Newark, New Jersey Something on Learning SEAN ELENA COSTELLO Kansas City, Missouri Is He a Second Danton? A Study of Hypocrisy in Stendhal's Le Rouge et Le Noir -
FGM – Female Genital Mutilation Kvinnlig Könsstympning
Trollhättan, 17+18/11 2016 Senior FGM – Female Genital Mutilation Kvinnlig Könsstympning Dr. med. Johannes Leidinger, MD., MPH. Senior Consultant in Gynaecology and Obstetrics Överläkare på Kvinnokliniken Södersjukhuset Stockholm & Mälarsjukhuset Eskilstuna Lehrbeauftragter/Dozent der Ludwig-Maximilians-Universität München 16 days of activism 2016 From 25 November, the International Day for the Elimination of Violence against Women, to 10 December, Human Rights Day, the 16 Days of Activism against Gender-Based Violence Campaign is a time to galvanize action to end violence against women and girls around the world. http://www.unwomen.org/en/what-we-do/ending-violence-against-women/ take-action/16-days-of-activism#sthash.zXvSzU8E.dpuf Sexual Violence: ¨ Rape ¨ Indecent Assault ¨ Forced Marriage ¨ Sexual Slavery http://www.eldis.org ¨ FGM (Female Genital Mutilation) ¨ Forced Pregnancy ¨ Forced Abortion ¨ Sexual Harassment WHO: FGM ¨ „FGM comprises all procedures that involve altering or injuring the female genitalia for non medical reasons - , and is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women and girls.“ Program 18 Nov 2016, 9-12 am ¨ Nomenklatur ¨ Klassifikation ¨ Global Prevalens ¨ Förklaringsmodeller ¨ Medicinska komplikationer ¨ Nationell & internationell Lagstiftning ¨ Vård i Sverige – AMEL-mottagning – Operativa rekonstruktioner – Desert Flower Scandinavia ¨ Global perspektiv – Internationella strategier (WHO och NGOs) – Medicalization of FGM Terminology ¨ The expression ”Female Genital Mutilation" gained growing support from the late 1970s. The word ”mutilation” establishes a clear linguistic distinction from male circumcision, and emphasizes the gravity and harm of the act. ¨ In 1990, this term was adopted at the ”3rd Conference of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children”, in Addis Ababa, Ethiopia. -
Vulvar Pain Syndromes a Bounty of Treatments— but Not All of Them Are Proven
second of 3 parTs VulVar paIn syndroMes a bounty of treatments— but not all of them are proven Treatments for vulvodynia and vestibulodynia range from lifestyle adjustments and application of topical agents to tricyclic antidepressants and nerve blocks— but the data on their efficacy are not as bountiful neal M. lonky, Md, MpH, moderator; libby edwards, Md, Jennifer Gunter, Md, and Hope K. Haefner, Md, panelists s we discussed in the first installment vulva. Cool gel packs are sometimes helpful. of this three-part series in the Sep- In thIs When it comes to intercourse, I recom- Article A tember issue of OBG Management, mend adequate lubrication using any of a the causes of vulvar pain are many, and the number of effective products, such as olive Therapies discussed diagnosis of this common complaint can be oil, vitamin E oil, Replens, Slippery Stuff, As- by the panel difficult. Once the diagnosis of vulvodynia troglide, KY Liquid, and others. page 34 has been made, however, the challenge shifts There is an extensive list of lubricants at to finding an effective treatment. Here, our http://www.med.umich.edu/sexualhealth/ How to determine expert panel discusses the many options resources/guide.htm which treatments available, the data (or lack of it) behind each are best therapy, and what to do in refractory cases. In Part 3 of this series, in the November Topical agents might offer relief page 35 issue, the focus will be vestibulodynia. —but so might placebo Dr. Lonky: What is the role of topical medi- Is physical therapy cations, including anesthetics, for treating underrated? Management of vulvar pain vulvar pain syndromes? page 38 begins with simple measures Dr. -
Surgical and Functional Outcome of Sigmoid Colon-Vaginoplasty in Mayer-Rokitansky-Kuster-Hauser Syndrome
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Pan P. Int J Reprod Contracept Obstet Gynecol. 2017 Oct;6(10):4441-4446 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174421 Original Research Article Surgical and functional outcome of sigmoid colon-vaginoplasty in Mayer-Rokitansky-Kuster-Hauser syndrome Pradyumna Pan* Department of Pediatric and Reconstructive Surgery Unit, Ashish Hospital and Research Centre, Jabalpur, Madhya Pradesh, India Received: 22 July 2017 Accepted: 22 August 2017 *Correspondence: Dr. Pradyumna Pan, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: The objective of this study is to report our experience with sigmoid vaginoplasty in adolescent female patients of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome with emphasis on the effectiveness of surgery, complications, sexual and functional outcomes. Methods: A retrospective study of adolescent females with vaginal atresia and Mayer-Rokitansky-Kuster-Hauser syndrome. The sigmoid segment was used for vaginoplasty in all the case. Results: Eleven females were studied over a period of 15 years. Postoperative complications were perineal rash in 3, ileus in 3, and minor wound infection in 1 patient and urinary tract infection in one patient. Nine patients were on regular follow-up. All the neovaginas were patent and functional. The postoperative mean vaginal length was 12.1 cm (range 11 cm to 14 cm). -
Gender Dysphoria Treatment – Commercial Medical Policy
UnitedHealthcare® Commercial Medical Policy Gender Dysphoria Treatment Policy Number: 2021T0580J Effective Date: April 1, 2021 Instructions for Use Table of Contents Page Related Commercial Policies Coverage Rationale ....................................................................... 1 • Blepharoplasty, Blepharoptosis and Brow Ptosis Documentation Requirements ...................................................... 3 Repair Definitions ...................................................................................... 4 • Botulinum Toxins A and B Applicable Codes .......................................................................... 5 • Cosmetic and Reconstructive Procedures Description of Services ................................................................. 9 • Gonadotropin Releasing Hormone Analogs Benefit Considerations .................................................................. 9 Clinical Evidence ......................................................................... 10 • Habilitative Services and Outpatient Rehabilitation U.S. Food and Drug Administration ........................................... 15 Therapy References ................................................................................... 15 • Panniculectomy and Body Contouring Procedures Policy History/Revision Information ........................................... 16 • Rhinoplasty and Other Nasal Surgeries Instructions for Use ..................................................................... 17 Community Plan Policy • Gender Dysphoria -
The Clinical Role of LASER for Vulvar and Vaginal Treatments in Gynecology and Female Urology: an ICS/ISSVD Best Practice Consensus Document
Received: 30 November 2018 | Accepted: 3 January 2019 DOI: 10.1002/nau.23931 SOUNDING BOARD The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document Mario Preti MD1 | Pedro Vieira-Baptista MD2,3 | Giuseppe Alessandro Digesu PhD4 | Carol Emi Bretschneider MD5 | Margot Damaser PhD5,6,7 | Oktay Demirkesen MD8 | Debra S. Heller MD9 | Naside Mangir MD10,11 | Claudia Marchitelli MD12 | Sherif Mourad MD13 | Micheline Moyal-Barracco MD14 | Sol Peremateu MD12 | Visha Tailor MD4 | TufanTarcanMD15 | EliseJ.B.DeMD16 | Colleen K. Stockdale MD, MS17 1 Department of Obstetrics and Gynecology, University of Torino, Torino, Italy 2 Hospital Lusíadas Porto, Porto, Portugal 3 Lower Genital Tract Unit, Centro Hospitalar de São João, Porto, Portugal 4 Department of Urogynaecology, Imperial College Healthcare, London, UK 5 Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio 6 Glickman Urological and Kidney Institute and Department of Biomedical Engineering Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 7 Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio 8 Faculty of Medicine, Department of Urology, Istanbul University Cerrahpaşa, Istanbul, Turkey 9 Department of Pathology and Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, New Jersey 10 Kroto Research Institute, Department of Material Science and Engineering, -
Gender Dysphoria Treatment – Community Plan Medical Policy
UnitedHealthcare® Community Plan Medical Policy Gender Dysphoria Treatment Policy Number: CS145.I Effective Date: March 1, 2021 Instructions for Use Table of Contents Page Related Community Plan Policies Application ..................................................................................... 1 • Blepharoplasty, Blepharoptosis, and Brow Ptosis Coverage Rationale ....................................................................... 1 Repair Definitions ...................................................................................... 3 • Botulinum Toxins A and B Applicable Codes .......................................................................... 4 • Cosmetic and Reconstructive Procedures Description of Services ................................................................. 8 • Gonadotropin Releasing Hormone Analogs Benefit Considerations .................................................................. 9 Clinical Evidence ........................................................................... 9 • Panniculectomy and Body Contouring Procedures U.S. Food and Drug Administration ........................................... 14 • Rhinoplasty and Other Nasal Surgeries References ................................................................................... 14 • Speech Language Pathology Services Policy History/Revision Information ........................................... 16 Commercial Policy Instructions for Use ..................................................................... 16 • Gender Dysphoria Treatment -
Reproductive Experiences Among Women with Vulvodynia Nora S
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Springer - Publisher Connector Johnson et al. BMC Pregnancy and Childbirth (2015) 15:114 DOI 10.1186/s12884-015-0544-x RESEARCH ARTICLE Open Access “You have to go through it and have your children”: reproductive experiences among women with vulvodynia Nora S. Johnson, Eileen M. Harwood and Ruby H.N. Nguyen* Abstract Background: Vulvodynia is a potentially debilitating chronic pain condition affecting the vulva (external genitalia) in women, with typical age of onset during the early-to mid-reproductive years. Yet, virtually nothing is known about the thoughts, feelings and experience of vulvodynia patients regarding conception, pregnancy and delivery; including the effect that a hallmark symptom, dyspareunia (painful sex), can have on a couple’s physical and emotional ability to conceive. We sought to describe these experiences and beliefs among women with vulvodynia who were pregnant or who recently had delivered a child. Methods: The study used in-depth, qualitative exploratory interview methods to gain a deeper understanding of these experiences for 18 women with vulvar pain who were recruited from an existing, nationally-sampled prospective pregnancy cohort study. Results: Four major themes were reported by our participants. Women described their reaction to pain as volatile at first, and, over time, more self-controlled, regardless of medical treatment; once the volatility became more stable and overall severity lessened, many women began planning for pregnancy. Techniques described by women to cope with pain around pregnancy included pain minimization, planning pregnancy-safe treatment and timing intercourse around ovulation.