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Background: While there is widespread consensus that sex- and gender-related factors are important for how interventions are designed, implemented, and evaluated, it is not currently known how alcohol treatment research accounts for sex characteristics and/or gender identities and modalities. This methodological systematic review documents and assesses how sex characteristics, gender identities, and gender modalities are operationalized in alcohol treatment intervention research involving youth. Methods and findings: We searched MEDLINE, Embase, Cochrane Central Registry of Controlled Trials, PsycINFO, CINAHL, LGBT Life, Google Scholar, Web of Science, and grey literature from 2008 to 2023. We included articles that reported genders and/or sexes of participants 30 years of age and under and screened participants using AUDIT, AUDIT-C, or a structured interview using DSM-IV criteria. We limited the inclusion to studies that enrolled participants in alcohol treatment interventions and used a quantitative study design. We provide a narrative overview of the findings. Of 8,019 studies screened for inclusion, 86 articles were included in the review. None of the studies defined, measured, and reported both sex and gender variables accurately. Only 2 studies reported including trans participants. Most of the studies used gender or sex measures as a covariate to control for the effects of sex or gender on the intervention but did not discuss the rationale for or implications of this procedure. Conclusions: Our findings identify that the majority of alcohol treatment intervention research with youth conflate sex and gender factors, including terminologically, conceptually, and methodologically. Based on these findings, we recommend future research in this area define and account for a spectrum of gender modalities, identities, and/or sex characteristics throughout the research life cycle, including during study design, data collection, data analysis, and reporting. It is also imperative that sex and gender variables are used expansively to ensure that intersex and trans youth are meaningfully integrated. Trial registration: Registration: PROSPERO, registration number: CRD42019119408 A.J. Lowik systematically review the consideration and reporting of sex and gender variables in studies of alcohol treatment interventions involving young people. Author summary: Why was this study done?: Both sex and gender are important factors for intervention design, implementation, and evaluation, including with regards to alcohol treatment interventions for young people. However, little is known about how alcohol treatment research accounts for sex and gender factors. What did the researchers do and find?: We systematically searched the peer-reviewed literature to identify alcohol treatment intervention studies that reported genders and/or sexes of participants 30 years of age or younger. Of the 86 articles included in our review, we found that none of them defined, measured, and reported both sex and gender variables accurately. Approximately 37% (n = 32) of the studies defined, measured, and reported either sex or gender accurately. Only 2 studies reported including trans participants. Most of the studies (n = 54) used sex or gender measures to control for their effects on the intervention but did not discuss the implications of this procedure. What do these findings mean?: Our findings identify how the vast majority of alcohol treatment intervention research with youth conflates sex and gender factors, including terminologically, conceptually, and methodologically. To advance sex and gender science in alcohol treatment intervention research, it is essential that researchers clearly articulate why they are choosing to include measures related to sex, gender or both, and to advance study designs and procedures that can account for sex and gender. It is also imperative that sex and gender variables are used in a way that ensures that intersex and trans people are meaningfully integrated so that both research and intervention can address their alcohol-related needs. [ABSTRACT FROM AUTHOR]

Objectives: Critical menstruation studies is a field in its nascence, marginalized within the broader area of reproductive health research. Menstruation-related research is virtually absent from trans studies, itself a marginalized field of inquiry. This article focuses on the experiences of trans and non-binary menstruators, to contribute to this burgeoning area of study. Methods: This article involves secondary data analysis of a qualitative dissertation research study on trans people’s reproductive lives, health, and decision-making processes. Of the fourteen participants in the broader study, eleven discussed their perceptions of and experiences with menstruation and menstrual health. Those experiences where subjected to thematic narrative analysis, with a focus on themes that were substantively significant. Results: Participants describe experiences with amenorrhea associated with the use of testosterone, menstrual resumption following the cessation of testosterone and for other reasons, menstruation-related dysphoria management strategies beyond medical interventions, as well as barriers to menstruation-related health care. One participant describes bloodless periods as a trans woman, a phenomenon altogether absent from the clinical and experiential literature in this field. The article explores how cisnormativity, repronormativity and transnormativity informed the participants experiences of menstruation and reproductive health care. Conclusions: Contributing novel stories to the literature, this article illustrates how clinically focused research fails to attend to the experiential components of menstruation for trans and non-binary people. Expanded knowledge is beneficial to the development of genderinclusive menstruation research, clinical interventions, healthcare environments, and activist efforts. [ABSTRACT FROM AUTHOR]

Across the globe, many countries publish low-risk alcohol guidelines which outline the recommended best practices for drinking limits to reduce the health risks and harms associated with excessive alcohol use. Frequently, low-risk drinking guidelines include different recommendations for cisgender men and women. As researchers working in the area of trans-inclusive substance use treatment and care, we are interested in the rationale for how gender-based low-risk drinking guidelines are determined, including the role of evidence and science. We argue that low-risk drinking guidelines based on sex and/or gender are highly insufficient and not engaging with a robust evidence base, and we further argue that it is important that we attend to these concepts correctly as we develop clinical and public health guidelines, which will undeniably have an impact on the individuals and societies who rely on them. [ABSTRACT FROM AUTHOR]

In many jurisdictions across the world, trans people are required to undergo genital surgeries that render them infertile for the state to legally recognize their genders. This article explores the rationalities used to justify mandating the sterilization of trans people, and names these eugenic logics. Much like the negative eugenics strategies directed at people of color, Indigenous people, those with a history of incarceration and people with disabilities (among others), trans people have had their reproduction restricted under the guise of doing what is in the best interest of children. This article demonstrates how historical eugenic logics concerned with normative notions of sex, gender and sexuality linger in the laws regarding trans people's legal gender recognition. This article calls for legal gender recognition based on self-determination, where giving up one's reproductive capacity is no longer a requirement all the while recognizing that trans people are parents, desire parenthood and are not inherently bad parents simply because of their non-normative gender identities or expressions. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Vulvar intraepithelial neoplasia is a chronic disorder caused by high-risk types of human papillomavirus (HPV), most commonly HPV type 16 (HPV-16). Spontaneous regression occurs in less than 1.5% of patients, and the rate of recurrence after treatment is high. Methods: We investigated the immunogenicity and efficacy of a synthetic long-peptide vaccine in women with HPV-16–positive, high-grade vulvar intraepithelial neoplasia. Twenty women with HPV-16–positive, grade 3 vulvar intraepithelial neoplasia were vaccinated three or four times with a mix of long peptides from the HPV-16 viral oncoproteins E6 and E7 in incomplete Freund's adjuvant. The end points were clinical and HPV-16–specific T-cell responses. Results: The most common adverse events were local swelling in 100% of the patients and fever in 64% of the patients; none of these events exceeded grade 2 of the Common Terminology Criteria for Adverse Events of the National Cancer Institute. At 3 months after the last vaccination, 12 of 20 patients (60%; 95% confidence interval [CI], 36 to 81) had clinical responses and reported relief of symptoms. Five women had complete regression of the lesions, and HPV-16 was no longer detectable in four of them. At 12 months of follow-up, 15 of 19 patients had clinical responses (79%; 95% CI, 54 to 94), with a complete response in 9 of 19 patients (47%; 95% CI, 24 to 71). The complete-response rate was maintained at 24 months of follow-up. All patients had vaccine-induced T-cell responses, and post hoc analyses suggested that patients with a complete response at 3 months had a significantly stronger interferon-γ–associated proliferative CD4+ T-cell response and a broad response of CD8+ interferon-γ T cells than did patients without a complete response. Conclusions: Clinical responses in women with HPV-16–positive, grade 3 vulvar intraepithelial neoplasia can be achieved by vaccination with a synthetic long-peptide vaccine against the HPV-16 oncoproteins E6 and E7. Complete responses appear to be correlated with induction of HPV-16–specific immunity. N Engl J Med 2009;361:1838-47. [ABSTRACT FROM AUTHOR]

Objective: Studies in the United States demonstrate a low proportion of cisgender women in medical leadership. No research exists about the prevalence of transgender people in medical leadership. The objective of this study was to evaluate gender representation within Canadian surgical training leadership., Design: This study represents a survey based exploratory analysis and literature review. Associations between gender and leadership position, surgical subspecialty, years in practice and leadership role, province of work, and age were calculated using Chi squared goodness of fit and independence tests., Setting: The study was based out of the University of British Columbia in Vancouver and included all Canadian surgical training programs., Participants: Participants were identified using the Canadian Resident Matching Service and program websites. All prospective respondents (359) were emailed an encrypted survey link., Results: The survey response rate was 65/359 responses (18%). The overall gender distribution was cis men (n = 36, 56.5%), cis women (n = 26, 40%), nonbinary (n = 1, 1.5%), agender (n = 1, 1.5%) and nonresponse (n = 1, 1.5%). Sixty-three percent of program directors were cis men, 33% were cis women and 4% were agender. Sixty-seven percent of associate program directors were cis women and 33% were cis men. Sixty-five percent of division leads were cis men, 29% were cis women, and 6% were nonbinary. There were more cis women in general surgery leadership than expected (df = 1, N = 20, x 2  = 11.05, p ≤ 0.001). No statistically significant associations between gender identity/modality, leadership role, province, or age were found using chi squared tests., Conclusions: Cis men continue to outnumber all others in surgical training leadership. More cis women than expected work in general surgery training leadership. However, these findings must be interpreted with caution considering the low survey response rate and the greater proportion of cis women respondents compared to cis women surgeons. There is a marked absence of binary-identified trans people in surgical training leadership in Canada, however a small number of nonbinary and agender people are present., (Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Phenomenon : Intersex, trans, and Two-Spirit people report overwhelmingly negative experiences with health care providers, including having to educate their providers, delaying, foregoing, and discontinuing care due to discrimination and being denied care. Medical education is a critical site of intervention for improving the health and health care experiences of these patients. Medical research studies, clinical guidelines, textbooks, and medical education generally, assumes that patients will be white, endosex, and cisgender; gender and sex concepts are also frequently misused. Approach : We developed and piloted an audit framework and associated tools to assess the quantity and quality of medical education related to gender and sex concepts, as well as physician training and preparedness to meet the needs of intersex, trans, and Two-Spirit patients. We piloted our framework and tools at a single Canadian medical school, the University of British Columbia, focused on their undergraduate MD program. We were interested in assessing the extent to which endosexnormativity, cisnormativity, transnormativity, and the coloniality of gender were informing the curriculum. In this paper, we detail our audit development process, including the role of advisory committees, student focus groups, and expert consultation interviews. We also detail the 3-pronged audit method, and include full-length versions of the student survey, faculty survey, and purpose-built audit question list. Findings : We reflect on the strengths, limits, and challenges of our audit, to inform the uptake and adaptation of this approach by other institutions. We detail our strategy for managing the volume of curricular content, discuss the role of expertise, identify a section of the student survey that needs to be reworked, and look ahead to the vital task of curricular reform and recommendations implementation. Insights : Our findings suggest that curricular audits focused on these populations are lacking but imperative for improving the health of all patients. We detail how enhancing curriculum in these areas, including by adding content about intersex, trans, and Two-Spirit people, and by using gender and sex concepts more accurately, precisely and inclusively, is in line with the CanMEDS competencies, the Medical Council of Canada's Objectives for the Qualifying Examinations, many institutions' stated values of equity, inclusion and diversity, and physicians' ethical, legal and professional obligations.

Drawing on data from focus groups with 152 trans youth aged 14-18 years in the United States, this article explores the factors that the participants understood as contributing to adolescent pregnancy among trans youth. Youth posited that unintended pregnancies occur due to barriers to contraceptives; a lack of gender-affirming sexual health education; sexual assault and dating violence; and mental health-influenced sexual risk-taking. Participants suggested that intended pregnancies may be a self-development strategy; a self-directed effort to repress/change gender modality or identity; and due to the perceived incompatibility between pregnancy and transition, where pregnancy must occur prior to transitioning.

Background: While scarce, literature suggests that women at the intersection of HIV status and gender and/or sexual minority identities experience heightened social and health disparities within health care systems., Objectives: This study examines the association between sexual and/or gender minority identities and: (1) experiences of poor treatment by health professionals and (2) being unable to access health services among a cohort of women living with HIV in Metro Vancouver, Canada., Design: Data were drawn from a longitudinal community-based cohort of women living with HIV (Sexual Health and HIV/AIDS Women's Longitudinal Needs Assessment)., Methods: We examined associations between sexual and/or gender minority identities and the two outcomes. We drew on explanatory variables to measure sexual minority and gender minority identities independently and a combined variable measuring sexual and/or gender minority identities. The associations between each of these three variables and each outcome were analysed using bivariate and multivariable logistic regression models with generalized estimating equations for repeated measures over time. Adjusted odds ratios and 95% confidence intervals are reported., Results: The study sample included 1460 observations on 315 participants over 4.5 years (September 2014 to February 2019). Overall, 125 (39.7%) reported poor treatment by health professionals and 102 (32.4%) reported being unable to access health care services when needed at least once over the study period. A total of 110 (34.9%) of participants reported sexual and/or gender minority identities, 106 (33.7%) reporting sexual minority identities, with 29 (9.2%) reporting gender minority identities. In multivariable analysis, adjusting for confounders, sexual minority identities, and combined sexual and/or gender minority identities were significantly associated with increased odds of experiencing poor treatment by health professionals (sexual minority adjusted odds ratio = 1.39 (0.94-2.05); sexual and/or gender minority adjusted odds ratio = 1.48 (1.00-2.18)) and being unable to access health services (sexual minority adjusted odds ratio = 1.89 (1.20-2.97); sexual and/or gender minority adjusted odds ratio = 1.91 (1.23-2.98)). In multivariable analysis, gender minority identities were not significantly associated with increased odds of experiencing poor treatment by health professionals (gender minority adjusted odds ratio = 1.38; 95% CI = 0.76-2.52) and being unable to access health services (gender minority adjusted odds ratio = 1.72; 95% CI = 0.89-3.31) possibly due to low sample size among women with gender minority identities., Conclusion: Our findings suggest the need for access to inclusive, affirming, trauma-informed health care services tailored specifically for and by women living with HIV with sexual and/or gender minority identities.

Abstract: Individuals unaware of their HIV seropositive status continue to represent a key "driver" of the HIV epidemic. Strategies to improve initiation into the HIV treatment cascade, including among young men, are required. This study assesses the acceptability of three HIV testing options among young cisgender men living in Vancouver, British Columbia. Using a modified grounded theory approach, we conducted semi-structured interviews with 45 young cisgender men ages 18-30 years to identify the factors influencing the acceptability of diverse HIV testing approaches. Participants ascribed value to non-nominal testing as a means of providing a secure pathway to HIV-related care for those who test positive while also safeguarding privacy. Anonymous HIV testing was problematized by participants as potentially creating difficulty in accessing ongoing HIV-related care. Most participants preferred non-nominal testing. Nevertheless, based on principles of equity, we argue that anonymous access to one's serostatus should be available, especially within a criminalized context., (Copyright © 2022 Association of Nurses in AIDS Care.)

The objectives of this article are two-fold. First, it is a personal reflection on the need for reproductive health-care spaces and services where sex and gender binaries are challenged and room for non-binary people is made. Second, it is a critical commentary on why and how cis- and trans-normative understandings of sex and gender form the foundation of reproductive health care as it is currently delivered. Taken together, this article is a call to action for nurses to be creative in challenging sex and gender binaries in their provision of reproductive health care., (© Copyright 2020 Creative Health Care Management.)

: Epidemiological and clinical evidence clearly indicates that binge and/or heavy alcohol use while pregnant can be dangerous for the fetus. As such, there is a large body of research evaluating interventions to address harms associated with alcohol use during pregnancy. Unfortunately, based on our assessment of the scientific literature in this area, including a reading of three high-impact systematic reviews, there are several key areas where the language being used is hindering efforts to address alcohol harms during pregnancy in nonjudgmental and gender-inclusive ways. In this commentary, we describe four areas where intervention research in this area can benefit from a thoughtful refinement of the use of gender-inclusive and nonjudgmental language. We also describe how, in failing to do so, interventions to address alcohol use during pregnancy will continue to be evaluated and designed without a sufficient understanding of how gender and reproduction are diverse, including among people who are experiencing wanted and/or planned pregnancies, unwanted and/or unplanned pregnancies, and among those who are surrogates.