The Year in Review

The Year in Review offers a synoptic review of notable new literature in various sub-specialties of transgender care. Confirmed speakers are:

Dr. David Garcia Nuñez

Mental health (adults)
Bio

Dr. Anna van der Miesen

Mental health (children & adolescents)

Background: There is an ongoing increase in the number of children and adolescents seeking care at gender identity specialty services. The evidence-base surrounding transgender/ gender diverse children and adolescents is also increasing, with a substantial number of scientific publications focusing on the mental health of these populations.

Aim(s): To present an overview of the published studies on mental health of transgender/ gender diverse children and adolescents.

Methods: A systematic search of published articles between August 2021 and April 2023 in Pubmed/Medline and Psycinfo was carried out. The following inclusion criteria were used: 1) study included participants aged 18 years or younger; 2) one or more study variables were related to mental health; and 3) articles were available in the English language. Review articles meeting these criteria were also included. All found articles were initially screened by their title and abstract, followed by the full review for the articles meeting the initial inclusion criteria. Two researchers independently performed the initial screening of records, and in case of a discrepancy, a third researcher decided whether or not to include the article.

Results: The presentation will include both a quantitative and thematic summary of the content of the included articles. In addition, the impact of the findings on the daily lives of transgender/ gender diverse children and adolescents and on gender-affirming care will be discussed.

Bio

Dr. Anna van der Miesen (she/her/they/them) is a medical doctor in child and adolescent psychiatry and a post-doctoral researcher at the Center of Expertise on Gender Dysphoria of the Amsterdam UMC, location VUmc. Anna combines clinical work with gender diverse and neurodiverse/autistic children, adolescents, and young adults with research on the intersections of gender diversity, neurodiversity, and mental health. Their research focusses on follow-up studies of gender diverse populations and community-based participatory approaches, partnering with gender-diverse and neurodiverse stakeholders to set research priorities and interpret study findings. In addition, Anna is building cross-cultural and cross-nation study initiatives to help gender diverse youth around the world. As part of the WPATH Global Education Initiative and other teaching programs, Anna is advocating for more awareness of the intersection of gender diversity and autism.

Dr. Dorte Glintborg

Endocrinology

Background:  Gender affirming hormone therapy is considered an important part of gender affirming health care. The goal of gender affirming hormone treatment is serum levels of sex hormones that match the individual’s gender identity. Gender affirming hormone treatment is generally considered safe, but individual tailoring of treatment regimens and long-term risk of side effects are still discussed.

Aim(s): To identify and present results from studies on endocrine aspects of transgender health with primary focus on gender affirming hormone therapy for adult study populations.

Methods: A search in PubMed and clinical trials on papers and ongoing studies between August 2021 and April 2023 on gender affirming hormone therapy and endocrine aspects of transgender care.

Main Outcome Measures: Publications included in the presentation are selected based on their novelty, importance and potential impact on gender affirming endocrine care.

Results: The presentation will include a discussion on recent and ongoing studies regarding cardiovascular and metabolic outcomes and risk of cancer during gender affirming hormone treatment and studies on kidney, liver and brain function. Evidence on progesterone, 5 alfa reductase, selective estrogen receptor modulators and upcoming gender affirming hormone treatments will also be presented.

Bio

Dr. Dorte Glintborg is associate professor and senior consultant at Odense University Hospital, Department of Endocrinology. She is a responsible senior consultant at Center for transgender care Odense University Hospital. Her areas of clinical work involve transgender care, pituitary, adrenal and gonadal diseases, PCOS, and bariatric surgery.

Scientific focus areas include endocrine aspects of transgender care and gender affirming hormone treatment and she is active part of the ENIGI initiative. Other research initiatives involve hirsutism and PCOS, pituitary and adrenal diseases, hypogonadism, Odense Child Cohort and active membership of the Nordic PCOS awareness Group.

Prof. dr. Jochen Heß

Surgery

Background: The number of people seeking gender-affirmation surgery has steadily increased in recent years. This is reflected in a seemingly exponential increase in scientific literature in recent years.

Aims: To provide a synoptic review of notable new literature in the field of surgical transgender care.

Methods: Pubmed data base was used to identify relevant articles published between 2021 and 2023. Initially the two search terms “transgender” and “surgery” were combined. In further searches, the terms “non-binary” and “surgery”, “detransition” and “surgery” as well as “transgender” and “uterine transplant” were used.  After removing duplicates in Endnote, title and abstract screening was performed. All publications were written in English, peer-reviewed and understood by the reviewer to be research that makes an important contribution to the field of surgery. Only full publications were considered.

Results and Conclusion: As of January 8th 2023 a total of 829 full publications were found for the combination “transgender” and “surgery” since 2021. This corresponded to about 40 % of the total literature listed in Pubmed for this search combination since 1992. 55, 6 and 11 full publications were found for the search combinations “non-binary” and “surgery”, “detransition” and “surgery” as well as “transgender” and “uterine transplant”. This corresponded to approximately 65%, 75% and 39% of the literature since the first listing on Pubmed. This review will highlight the main findings from key surgical publications since the last EPATH conference.

Bio

Jochen Heß (he/his) is a professor at the Department of Urology at the University Hospital Essen, Germany and has been involved in gender medicine since 2007. He has been a founding member of the European Association for Gender Surgeons since 2013 and a member of WPATH / EPATH since 2016. He is also a founding member of the working group “Gender Incongruence” of the German Society of Urology and a member of the corresponding working group of the German Society for Plastic, Reconstructive and Aesthetic Surgery. Jochen Heß is one of two coordinators of the German surgical guideline (S2K level), which is about to be adopted.

Dr. Amets Suess Schwend

Social & Political Sciences

Background: Social and political sciences are developing reflections on the human rights of trans people, their social situation, health, access to healthcare and healthcare decision-making, within an increasing field of trans studies. They contribute relevant perspectives and strategies for professionals working in the area of trans healthcare, aimed at approaching complex intersectional situations of discrimination, transphobia and social inequities.

Methods: A scoping review was conducted in Scopus, with the following eligibility criteria: articles published from September 2021 – December 2022 in the subject area Social Sciences (SOCI) in English, Spanish, French, Portuguese and German. The keywords transgender or trans in title and abstract were combined with keywords related to specific topics that are relevant in the current discussion in the field, focusing on intersections between social aspects, health, access to healthcare and healthcare decision-making. Furthermore, trans-related books and edited books were reviewed that were published in the established timespan in high ranking social and political sciences editorials.

Results and conclusions: The review provides an overview on trans-related scientific knowledge production in the field of social and political sciences published after the last EPATH conference, identifying recent developments in relevant topics, as well as emerging priorities and frameworks.

Bio

Dr. Amets Suess Schwend holds a PhD in Social Anthropology, MA in Arts Therapies and BA/MA in Sociology. They work in research and training at the Andalusian School of Public Health, Granada, Spain, and supervise PhD theses at the University of Granada. Since 2009, they have participated in international and regional networks, professional associations and projects related to trans and intersex human rights, health and healthcare, among them the EPATH Scientific Committee. Currently, they are consortium team member of the INIA: Intersex – New Interdisciplinary Approaches project, European Commission’s Marie Skłodowska- Curie Actions programme. Their PhD and recent publications focus on trans and intersex studies, human rights, depathologisation, intersectionality, health and healthcare, as well as research epistemologies, methodologies and ethics. In the artistic field, they use performance and other artistic languages to work on gender and bodily diversity, depathologisation and human rights.

Prof. dr. Maria Cristina Meriggiola

Reproductive health

Background: Gender affirming hormonal and surgical treatments may negatively impair fertility of transgender (TG) people. Considering a trend toward a decrease of age at the time of initial presentation, best practice guidelines recommend discussing future fertility desires, known and unknown infertility risk, options and outcomes of fertility preservation both before gender affirming medical treatments and across treatments. Such counseling is more often not performed or inadequate, especially in younger TG. Data on outcomes of fertility preservation in transgender population remain scarce, and evidence-based strategies are still needed to inform the counseling and the decision of TG people on their future fertility options.

Aims: to select most relevant studies on fertility issues in transgender population.

Methods: A literature search of major databases (Pubmed, Medline, Google Scholar, Web of Science) was completed using the search terms pertaining to reproductive health topics such as fertility counseling, fertility preservation, fertility treatments in gender diverse and nonbinary population from August 2021 and April 2023.

Results and Conclusions: An overview on the most relevant advancement in this field will be discussed with a highlight to the need for more research to overcome barriers to reproductive care for this vulnerable population.

Bio

Dr Maria Cristina Meriggiola is associate professor at University of Bologna and senior consultant at IRCCS Azienda Ospedaliero Universitaria di Bologna, Clinic of Gynecology and Physiopathology of Reproduction. She is responsible of the Center for Transgender Health at the Hospital and has an active collaboration with MIT (Movimento Identità Trans).
Her scientific as well as clinical work include transgender care, contraception, intersex conditions, and menopause.
She is one of the funding member of SIGIS (Italian Society Gender Identity Health) and she is in the Board of Directors of this society.

Prof. dr. Matthew Mills

Voice and communication
Bio

Lenny Emson

Law, politics, and ethics
Bio