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Objectives: To describe the paediatric transgender population accessing health care through the Manitoba Gender Dysphoria Assessment and Action for Youth (GDAAY) program, and report youth's experiences accessing health care in Manitoba., Methods: Demographic, medical, surgical and mental health information was extracted from the medical records of youth referred to the GDAAY program (n=174). A 77-item online survey was conducted with a subset of those youth (n=25) to identify common health care experiences and perceptions of trans youth in Manitoba., Results: Chart review of 122 natal females and 52 natal males, ranging in age from 4.7 to 17.8 years (mean 13.9 years), found 66 patients (46.8%) with a pre-existing or current mental health diagnosis, of which anxiety and depression were the most common (n=43, 30.5%). Qualitative self-reports revealed all patients had negative interactions with health care providers at some point, many having experienced lack of engagement with the medical system due to reported lack of knowledge by the provider on trans-related health services., Conclusion: Transgender youth in Manitoba seeking GDAAY services have high rates of anxiety and depression. These youth face adversity in health care settings and are distressed over long wait times for mental health services. Recommendations to improve care include increasing general health care providers' education on gender affirmative care, providing gender sensitivity training for health care providers, gathering preferred names and pronouns during triage, increasing visibility of support for LGBT+ persons in clinics, increasing resource allocation to this field and creating policies so all health care settings are safe places for trans youth.

GLWamides are a recently described, novel family of neuropeptides in Cnidaria. Antibodies specific for the GLWamide terminus have been raised and used to evaluate the occurrence and localisation of immunopositive material in various Cnidaria in order to determine whether GLWamides are present and to obtain a first impression of the possible regulatory role of these neuropeptides. GLWamide immunoreactivity has been found in all species tested and is not confined to distinct life stages but is present during most of the life cycle of the Cnidaria. Additionally, GLWamides are expressed by different nerve cells at different life stages. GLWamide-immunoreactive cells constitute a subset of the neural equipment. Overall our data suggest that GLWamides generally occur in the nervous system of Cnidaria and that these peptides are multifunctional. Putative functions other than the control of development include the regulation of nematocyst discharge, muscle contraction and the regulation of gastric function.

The metamorphosis of many marine invertebrate larvae is induced by environmental signals. Upon reception of the cues, internal signals have to be set in motion to convey information to all cells of the larvae. For hydrozoan larvae it was hypothesised that ectodermal neurosensory cells at the anterior part are those cells receptive of the inducer. Recently, it was shown that novel peptides with a common GLWamide terminus are found in Cnidaria. These peptides are located in a specific subset of the anterior sensory cells. It was hypothesised that the neuropeptides represent an internal signal coordinating the metamorphic process. In the current study we present further evidence for this hypothesis. Induction of metamorphosis is very specific for the GLWamide terminus and amidation is essential. The potency to metamorphose is strongly correlated with the presence of GLWamide-immunoreactive cell bodies. Our data fit our hypothesis about a very important role of GLWamides in the initiation of the morphogenetic processes very well.