War on rights, new research findings

  • Several states have adopted policies that restrict access to gender-affirming care.
  • At the same time, doctors and scientists are working on new technologies for trans patients.
  • Strong research has shown that gender-affirming care is good for mental health.

In 2022, a growing number of states have taken action to prevent young LBGTQ+ people from accessing gender-affirming health care.

Several studies have shown that access to supportive health care – which can include medical, surgical and mental health services – improves the mental health and general well-being of people of diverse gender identities, including transgender youth.

Yet lawmakers in 20 states have passed or introduced policies restricting young people’s access to gender-affirming care and, in some cases, penalizing adults who help children access such care. While legal challenges have prevented these policies from taking effect, other states have meanwhile adopted policies intended to protect people of diverse gender identities.

The political climate has not slowed the pace of research in transgender medicine; in fact, doctors and scientists have popularized new surgical techniques aimed at bringing “gender euphoria” to trans patients. Here are some of the biggest developments in transgender healthcare to come out of 2022.

Gender-affirming care supports youth mental health

Several studies have investigated how gender-affirming care can impact mental health outcomes for transgender and non-binary children and adolescents.

Gender-affirming care is “patient-centered and treats individuals holistically, aligning their outward physical traits with their gender identity,” according to the U.S. Department of Health and Human Services’ Office of Population Affairs. . This may include medical, surgical, mental health and non-medical services for transgender and non-binary people.

Previous research has highlighted the importance of gender-affirming care, particularly surgery, for transgender adults. The same is true for non-surgical interventions among transgender youth, according to a landmark JAMA study published in February.

The study found that access to gender-affirming care, including puberty blockers and gender-affirming hormones, was associated with alleviating mental health disparities among transgender children and adolescents and non-binary.

Researchers have established hormonal reference ranges for trans people

An underappreciated aspect of gender-affirming care is hormonal reference ranges, which are used to determine whether individual lab results are normal or cause for concern.

Reference intervals are important for medical testing because inaccurate reading of lab results could lead to misdiagnosis or mistreatment. However, existing reference intervals are based on the cisgender population, excluding transgender people who may be on hormone therapy.

Clinicians who treat transgender people have had to guess this information until recently. A study published in The Journal of Applied Laboratory Medicine in May finally established hormonal reference ranges for transgender people, based on data from healthy individuals who took estradiol or testosterone to affirm their sex.

This research could lead to significant improvements in health care for a vulnerable patient population, the authors concluded.

Genital anatomy studies have led to innovations in gender-affirming surgery

Doctors and researchers have made some exciting discoveries about sexual anatomy this year. For example, a gender-affirming surgeon became the first to count more than 10,000 nerve fibers in the human clitoris.

Dr. Blair Peters performs phalloplasties, or the surgical creation of a penis, on transmale patients at Oregon Health and Science University. Seven of his patients allowed him to study their clitoral tissue under the microscope, which led Peters to a wealth of nerve fibers.

Armed with new knowledge about clitoral anatomy, Peters told Insider he hopes to apply his research to preserve feelings of sexual pleasure in future phalloplasties.

Those looking for vaginas may also have access to cutting-edge surgical options, such as peritoneal traction vaginoplasty (PPT).

While standard vaginoplasty involves inversion of the penis, PPT uses pieces of abdominal mucosa to line the surgically expanded vaginal walls. The technique was originally developed to construct vaginas for birth defects, but is now gaining popularity in the field of gender affirmation surgery.

Compared to penile inversion, PPT may offer less scarring, more natural lubrication, and greater vaginal canal depth, according to Dr. Shubham Gupta. He is one of the few surgeons in Cleveland, Ohio to offer this procedure (which is becoming increasingly common in trans medicine).

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