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In most societies, many groups and individuals rely on places beyond the scope of the household to live and enjoy their rights, including their rights to water and sanitation. These groups include persons in penal institutions and detention centres, health care professionals and patients who spend long periods in hospitals and health centres, students in boarding schools and workers who are required to spend considerable lengths of time in open workplaces. They also include people who reside in those spheres because of homelessness, people living in poverty who may lack access to water and sanitation in or near their homes and people who work formally or informally in the public spaces of urban areas. More broadly, they include the general public who commute daily.
Inequalities based on gender exist basically in every country and in all aspects of social life, and are echoed in the vast divides between men and women in their ability to access, manage and benefit from water, sanitation and hygiene. A large and growing body of studies suggests that women and men often have differentiated access, use, experiences and knowledge of water, sanitation and hygiene. Cultural, social, economic and biological differences between women and men consistently lead to unequal opportunities for women in the enjoyment of the HRtWS, with devastating consequences for the enjoyment of other human rights and gender equality more generally.
Owing to multiple, complex and intersecting health inequities, systemic oppression and violence and discrimination in their home countries, some transgender people are forced to migrate to countries that offer them better legal protection and wider social acceptance.
This review sought to explore and understand the multiple factors that shape the mental health outcomes of transgender forced migrants (TFMs).
We systematically searched nine electronic databases for multidisciplinary literature (PROSPERO ID: CRD42020183062). We used a meta-ethnographic approach to synthesise data. We completed a quality appraisal and developed a socio-ecological model to draw together our findings.
We retrieved 3399 records and screened titles, abstracts and full text to include 24 qualitative studies in this review. The synthesis identified individual survival strategies and factors in interpersonal, organisational and societal environments that contributed to profound deprivation and mental distress in TFMs. Pervasive and persistent violence and discrimination, economic exclusion, barriers to healthcare and a dependency on legal documentation were identified as key factors leading to poor mental health outcomes. Sources of resilience included community acceptance and support, being granted asylum, societal affirmation of gender, fulfilment of basic rights and healthcare access. Individual strategies for survival, such as hope and having purpose in life, were important in bringing relief from distress.
Improved communication and knowledge about the unique needs and concerns of TFMs through interventions at the individual, interpersonal, organisational and societal levels are necessary to improve mental health outcomes.
During the nineteenth century, words like 'intersex' and 'trans' had not yet been invented to describe individuals whose bodies, or senses of self, conflicted with binary sex. But that does not mean that such people did not exist. In nineteenth-century France, case studies filled medical journals, high-profile trials captured headlines, and doctors staked their reputations on sex determinations only to have them later reversed by colleagues. While medical experts fought over what separated a man from a woman, novelists began to explore debates about binary sex and describe the experiences of gender-ambiguous characters. Anne Linton discusses over 200 newly-uncovered case studies while offering fresh readings of literature by several famous writers of the period, as well as long-overlooked popular fiction. This landmark contribution to the history of sexuality is the first book to examine intersex in both medicine and literature, sensitively relating historical 'hermaphrodism' to contemporary intersex activism and scholarship.
The development of gender identity in children from around the age of 3 years is described. Wishes for transgender identity are distinguished from gender-atypical behaviour. Reasons for the recent rise in transgender referrals in the early teen years are discussed. The now widely used protocol developed by the Amsterdam group for assessing transgender children and young people and, where appropriate, offering them puberty blockers, cross-sex hormones and sex reassignment surgery is described. Evidence for the effectiveness of this approach is considered. The competence of young people to give consent to these procedures is discussed. Finally, proposals are made for topics urgently requiring further research.
UK adult gender identity clinics (GICs) are implementing a new streamlined service model. However, there is minimal evidence from these services underpinning this. It is also unknown how many service users subsequently ‘detransition’.
To describe service users’ access to care and patterns of service use, specifically, interventions accessed, reasons for discharge and re-referrals; to identify factors associated with access; and to quantify ‘detransitioning’.
A retrospective case-note review was performed as a service evaluation for 175 service users consecutively discharged by a tertiary National Health Service adult GIC between 1 September 2017 and 31 August 2018. Descriptive statistics were used for rates of accessing interventions sought, reasons for discharge, re-referral and frequency of detransitioning. Using multivariate analysis, we sought associations between several variables and ‘accessing care’ or ‘other outcome’.
The treatment pathway was completed by 56.1%. All interventions initially sought were accessed by 58%; 94% accessed hormones but only 47.7% accessed gender reassignment surgery; 21.7% disengaged; and 19.4% were re-referred. Multivariate analysis identified coexisting neurodevelopmental disorders (odds ratio [OR] = 5.7, 95% CI = 1.7–19), previous adverse childhood experiences (ACEs) per reported ACE (OR = 1.5, 95% CI = 1.1–1.9), substance misuse during treatment (OR = 4.3, 95% CI = 1.1–17.6) and mental health concerns during treatment (OR = 2.2, 95% CI 1.1–4.4) as independently associated with accessing care. Twelve people (6.9%) met our case definition of detransitioning.
Service users may have unmet needs. Neurodevelopmental disorders or ACEs suggest complexity requiring consideration during the assessment process. Managing mental ill health and substance misuse during treatment needs optimising. Detransitioning might be more frequent than previously reported.
The prevalence rates of mental health issues, particularly anxiety and depression, is high among transgender people. However, the incidence of anxiety and depression in transgender people living in Russia is unclear until now.
To examine the frequency of anxiety and depression in transgender people living in Russia.
The Hospital Anxiety and Depression Scale (HADS) was used for online screening for symptoms of anxiety and depression in transgender people living in Russia throughout November 2019. 588 transgender adults living in all Federal Districts of Russia (mean age 24.0±6.7) were included in the final analysis. 69.6% (n=409) of the survey participants indicated the direction of transition as transmasculine (TM), 23.1% (n=136) – as transfeminine (TW), and 7.3% (n=43) – as other (TO).
It was found that 45.1% (n=265) and 24.0% (n=141) of transgender people had clinically significant levels of anxiety and depression, respectively (HADS score of 11 or higher). The rates of anxiety (TM=10.21±4.68; TW=8.72±3.91; TO=10.72±4.43) and depression (TM=7.53±4.09; TW=7.40±4.19; TO=7.74±4.33) did not have statistically significant differences within the direction of transition. The anxiety and depression mean scores in all subgroups were statistically significantly higher than in the general Russian population (p<0.001; one sample t-test).
Our findings suggest a high prevalence of depression and anxiety disorders in the transgender population as compared to the cisgender population in Russia. The identified frequency of anxiety and depression in transgender people in Russia is worrying and requires immediate action to improve the availability and quality of medical and psychological care for this group of people.
Prejudice, stigmatization and discrimination behaviors causes social stress and lead vulnerability to mental and physical health problems in Transgender and Gender Nonconforming (TGNC) individuals. The prevalence of mental disorders that can be associated with “minority group stress”, especially major depression and anxiety disorders, are known to be higher in the TGNC group in comparison to general population.
The aim of this study was to reveal the impact of minority stress on TGNC individuals’ mental health. Resilience factors like gender identity pride, social support, community connectedness expected to diminish the negative impact of stigmatization and discrimination.
The study sample consisted of 48 volunteered participants who consulted to Psychiatry Department for gender transition process. After semi-structured interview, applicants were given Gender Minority Stress and Resilience Scale-Turkish Form (GMSR-Tr), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Perceived Stress Scale (PSS), Multidimensional Scale of Perceived Social Support (MSPSS).
Analysis revealed a negative correlation between the stress subscales of GMSR-Tr scale and BDI (p< .001; rs= .727), BAI (p< .001; rs= .649), PSS (p< .001; rs= .671). For psychological resilience, the strongest positive relationship was found with the community connectedness subscale (p< .001; rs= .864); the strongest negative relationship was observed with the internalized transphobia subscale (p< .001; rs= .750).
Our study presented the importance of internalized transphobia and protective effect of resilience factors for mental health outcomes of TGNC individuals exposed to minority stress. The depression, anxiety and stress scores decreases with increasing psychological resilience.
Transsexuals are considered to be stable in their identity (White Hughto et al., 2016). Meanwhile, the stages of medical transition affect the mental state of transsexuals differently.
The aim was to reveal relationships between salience of self-identification in transsexual people being on different stages of medical transition.
151 transsexual people: 55 pre-operated Female-to-Male (FtM I), 25 FtM on a hormonal therapy (FtM II), 25 FtM after some surgical operations (FtM III); 12 pre-operated Male-to-Female-Transsexual (MtF I), 16 MtF on a hormonal therapy (MtF II), 18 MtF after some surgical operations (MtF III). The participants filled the modificated Kuhn’s test “Who am I?” (Tkhostov et al., 2014). The modification includes a Likert scale for evaluating one’s self-identifications in terms of salience: “How often do You think or remember this answer?” (Stryker, 2007).
There were differences between identity salience and stages of medical transition (F = 7,177; P < 0,001; η2 = 0,108). Transsexuals before medical transition demonstrated higher levels of identity salience (average score is 7,62 in FtM I and 7,75 in MtF I). Transsexuals on a hormonal therapy demonstrated sharply decreased level of identity salience (6,97 in FtM II and 6,19 in MtF II). Transsexuals after surgical operations reported increased level of salience (7,81 in FtM III and 7,23 in MtF III). There were no statistically significant differences between the groups by gender assigned at birth.
Data suggest that medical transition could change the salience of self-identification. Hormone therapy is associated with a sharp revision of the salience of self-identifications for transsexuals.
“Super Fluid/Super Black: Translations and Teachings in Transembodied Metaphysics” was originally commissioned as a keynote lecture for the 2020 Collegium for African Diaspora Dance (CAAD) conference, Fluid Black::Dance Back. It is a hybrid text that centralizes Black Transgender and Nonbinary experiences in a conversation of futurity in African Diasporic spirituality, dance traditions, and performativities. Furthermore, “Super Fluid/Super Black” interrogates beingness through an exploration of astrophysics and global attempts at Black erasure in an attempt to uncover new strategies of collectivizing under dance that dismantle cisheteronormativity at their core.
The regulation of public space is generative of new approaches to gender nonconformity. In 1968 in Jakarta, the capital of Indonesia, a group of people who identified as wadam—a new term made by combining parts of Indonesian words denoting “femininity” and “masculinity”—made a claim to the city's governor that they had the right to appear in public space. This article illustrates the paradoxical achievement of obtaining recognition on terms constituted through public nuisance regulations governing access to and movement through space. The origins and diffuse effects of recognition achieved by those who identified as wadam and, a decade later, waria facilitated the partial recognition of a status that was legal but nonconforming. This possibility emerged out of city-level innovations and historical conceptualizations of the body in Indonesia. Attending to the way that gender nonconformity was folded into existing methods of codifying space at the scale of the city reflects a broader anxiety over who can enter public space and on what basis. Considering a concern for struggles to contend with nonconformity on spatial grounds at the level of the city encourages an alternative perspective on the emergence of gender and sexual morality as a definitive feature of national belonging in Indonesia and elsewhere.
In this chapter, we problematise the simplistic assumption that change in regard to gender is made more tenable or positive for humans as a result of the continuity that animal companionship offers. Instead, we argue that animals are not passive recipients of human change. Rather, we suggest that animals are closely attuned to human change. In the context of gender transition, continuity is rendered far more complex than might be suggested by cisgenderist narratives circulating about transgender and non-binary people. Liberal accounts of gender transition suggest that ‘the person doesn’t change’. Yet animal responses to gender transition suggest that the person does change, even if the nature of the human–animal relationship remains constant. By considering human accounts of how animals engage with change in their lives, this chapter suggests that animal companions are active agents in the context of human gender transition, speaking to their own awareness of, and contribution to, human–animal relationships.
Despite Pope John Paul II's call for “intense dialogue” between theology and science that excludes “unreasonable interpretations” of Scripture, ecclesial statements on gender and sexuality—including John Paul II's own works—deploy an interpretation of the literal meaning of Genesis to perpetuate a complementarian anthropology that contradicts scientific insights about the human body. After illustrating the implications of this hermeneutical inconsistency, this article presents Jesuit astronomer William Stoeger's theological method and hermeneutics of the full flourishing of life as an alternative approach, which fulfills John Paul II's vision for dialogue and paves a way toward reimagining church teachings on gender and sexuality.
Judith Butler's book Gender Trouble, published in 1990, enjoyed its thirtieth anniversary in 2020. To that end, the Association for Asian Studies, the United States’ largest association of academics working on Asia, invited scholars to consider the importance of her arguments and ideas for Asian studies and scholarship in Asia, including how scholars have diverged from and expanded their studies of gender and sexuality in ways not anticipated by Butler when she first published the book. In this essay, I examine the impact of Butler's book in Southeast Asia. Out of the abundance of scholarship stemming from and about the region's eleven diverse countries and their histories, I prioritize those works that explicitly engage the theoretical insights in Gender Trouble to elucidate the lives of gender-nonconforming communities in Southeast Asia. I include scholarship that allows me to explore the disjunction between categories of analysis that are foundational to Butler's theory and those at work in Southeast Asia. Far from rendering Butler's theory and methodological intervention inapposite, this mismatch has catalyzed productive rethinking of Gender Trouble and its implications for the region.
In this book, Adrian Thatcher offers fresh theological arguments for expanding our understanding of gender. He begins by describing the various meanings of gender and depicts the relations between women and men as a pervasive human and global problem. Thatcher then critiques naive and harmful theological accounts of sexuality and gender as binary opposites or mistaken identities. Demonstrating that the gendered theologies of Hans Urs von Balthasar and Karl Barth, as well as the Vatican's “war on gender” rest on questionable binary models, he replaces these models with a human continuum that allows for sexual difference without assuming “opposite sexes” and normative sexualities. Grounded in core Christian doctrines, this continuum enables a full theological affirmation of LGBTIQ people. Thatcher also addresses the excesses of the male/female binary in secular culture and outlines a hermeneutic that delivers justice and acceptance instead of sexism and discrimination.
This chapter describes psychological science’s contributions to the global rights agenda on sexual orientation and gender identity (SOGI). First, we trace the historical stance taken in psychology on same-sex sexualities and on gender diversity, and how this positioning shaped how psychologists addressed (or did not address) SOGI concerns. Second, we examine how global rights entities such as the United Nations have engaged SOGI concerns. Third, we review four continuing challenges for SOGI-related human rights: (1) the persistent problem of LGBT pathologisation (including its manifestation in the form of so-called conversion therapy, or sexual orientation change efforts), (2) the increasing gap in the enjoyment of equal human rights for LGBT (lesbian, gay, bisexual, transgender, and other gender and sexual minority) individuals among people in different parts of the world, (3) the mobilization of human rights language against LGBT equality and diversity of gender identities and expressions, and (4) previously unrecognized concerns related to LGBT migrants, asylum-seekers, and refugees. Finally, we analyze how psychology as an academic discipline, as a profession, and as an organized network of professional associations has contributed to and could help in furthering the protection and promotion of rights across the spectrum of human sexual and gender diversity.
Chapter 6 concludes that discrimination based on sexual orientation, gender identity, or gender expression is sex discrimination under Title VII. In Etsitty v. Utah Transit Authority, the Tenth Circuit held that a bus company did not violate Title VII when it fired a transgender driver for using women’s restrooms along her route. The court concluded that discrimination based on transgender status does not violate Title VII’s prohibition of discrimination “because of sex,” and that the plaintiff was fired because of bathroom use, not discrimination. The rewritten opinion reverses course: the employer’s behavior violated both Title VII and the Equal Protection Clause. Hively v. Ivy Tech Community College held that discrimination based on sexual orientation is illegal sex discrimination. The rewritten opinion arrives at the same conclusion, but offers a more humanistic lens through which to view the legal question posed. The rewritten opinion relies on several legal theories to support its conclusion, including but-for causation, sex stereotyping, sex-plus, associational (or relationship) discrimination, and a unique use of the motivating factor provision in Title VII.
This chapter looks at discriminatory language related to sex and gender, in the past and present. We treat the “waves of feminism” and discuss how sexism is embedded in our language and society. We discuss sexist language in politics, the workplace, and such phrases as, locker room talk, Boys will be boys, That’s just how men speak, Not all men, and the Me Too movement. The concept of gender is explained, and transgender issues are discussed, including restroom rules, dead-naming, and misgendering, i.e., the incorrect use of pronouns as an insult. We consider contemporary cases and examples of sexism in pop culture and the media.
Identifying and quantifying sex differences and similarities has been a central research question and fascinated scientists for centuries. A large body of work has been accumulated on this topic; however, conclusions are often drawn as if they are applicable across cultures even though studies have predominantly relied on Western samples. This chapter reviews cross-cultural literature on several early childhood sex differences in domains of development that have caught attention in the literature recently: gender-typed play, gender identity, and gender expression. We also offer an overview of possible influences on sex differences, including evolutionary, biodevelopmental (genetics, sex hormones, and immune factors), and sociocultural mechanisms (socialization and macro-cultural factors). Given that a cross-cultural perspective has often been lacking in this literature, this chapter reviews research on early gender development in males and females from Western populations as well as the non-Western populations wherever possible to highlight important cultural (in)consistencies.
This article draws on our qualitative study of trans unemployment to introduce considerations of the relationship between trans unemployment and the demands for workers across economic sectors to perform affective labour as integral to industrial service relations. Affective dimensions of labour are often unspoken and unconscious, rendering it challenging for anti-discrimination laws to accommodate. We demonstrate the ways that recent cases grounded on unconscious bias open spaces for further consideration of the ways that trans employment discrimination rooted in demands for affective labour can be dealt with by anti-discrimination law.