Transgender Health

Access to trans-affirmative mental health care can contribute to the well-being of the trans community. Historically, the psychiatrization and pathologization of trans and non-binary people has led to interventions which have negatively affected the well-being of this population(Turban et al., 2020). In response, both the trans community and mental health professionals now identify trans-affirmative interventions as a way to enhance trans and non-binary people well-being (Pullen Sansfaçon et Medico, 2021).

The objective of this presentation is to point out which factors impact the access to trans-affirmative mental health care for trans and non-binary people. The results emerged from a qualitative research realized by Yannick Gaudette during his master’s degree, under the direction of Maria Nengeh Mensah, at Université du Québec à Montréal. 

This article discusses the acquisition of a physical impairment/disability through voluntary body modification, or transability. From the perspectives of critical genealogy and feminist intersectional analysis, the article considers the ability and cis*/trans* axes in order to question the boundaries between trans and transabled experience and examines two assumptions impeding the conceptualization of their placement on the same continuum: 1) trans studies assume an able-bodied trans identity and able-bodied trans subject of analysis; and 2) disability studies assume a cis* disabled identity. The perception of transsexuality and transability as mutually exclusive phenomena results from a non-intersectional analysis of transsexuality as an issue of sex/gender, but not ability, and of transability as an issue of ability, but not sex/gender. Difficulty recognizing continuities between these phenomena thus stems from an ableist interpretation of sex/gender and a cis(gender)normative* interpretation of ability. This article aims to: 1) enrich intersectional analysis in trans and disability studies and transability scholarship; 2) complicate disability studies, in which disabilities are often presumed “involuntary”, and encourage the decentering of a cis* subject; 3) encourage trans studies to decenter an able-bodied subject; and 4) advocate for increased dialogue and the creation of alliances between trans and disability studies and movements.

Link: https://onlinelibrary.wiley.com/doi/10.1111/hypa.12113/abstract

Les personnes trans et non-binaires accèdent aux services en santé mentale pour diverses raisons : questionnements identitaires, soutien au processus de transition, détresse psychologique (Gaudette, 2020). La littérature sur les expériences de cette communauté auprès des services en santé mentale demeure émergente, particulièrement en contexte québécois. Les objectifs de cette recherche, réalisée dans le cadre de la maîtrise en travail social à l’Université du Québec à Montréal, sont les suivants: 1- Identifier les facilitateurs, ainsi que les obstacles, à l’accès aux services trans-affirmatifs en santé mentale; 2- Connaître la perception et les expériences des personnes trans à propos des interventions qu’elles ont reçues et qu’elles souhaiteraient avoir en santé mentale; 3- Produire une réflexion sur le développement des services trans-affirmatifs en santé mentale.

ABSTRACT
This research, situated at the junction of feminist, trans and disability studies, examines the limits of intersectional feminist analyses and the difficulties faced in their consideration of gender identity and ability through an analysis of two types of body modification: transsexuality and transability (voluntary disability acquisition). In response to the question “what are the limits of intersectional analyses and how can they be addressed?”, three objectives are proposed: 1) participate in the critical examination of specific limits of intersectional feminist analyses in order to diversify their axes through the consideration of gender identity and ability; 2) question the conceptual assumptions and cisgenderist and (cis)ableist privileges informing negative discourses around these body modifications and highlight points of convergence among feminist, transactivist and anti-ableist movements in order to encourage dialogue and solidarities among them; 3) provide feminist, trans and disability studies with an enriched model of intersectionality capable of addressing new claims for justice from oppressed groups, such as those of transsexual and transabled individuals. The negative discourses of certain feminists and other scientists regarding these body modifications are mapped and critiqued through a methodology combining archeological, genealogical and critical discourse analysis. The reflections presented here, inspired by poststructuralist and queer approaches, explore neither the “origins” of transsexuality and transability nor their motivations; this is a study of the negative discourses about these phenomena and the normative systems from which they originate. The result is an important contribution to theoretical, normative and political fields of knowledge: the examination of two “extreme” cases of body modification reveals the bodily normativities of dominant regimes, specifically cisgenderism and (cis)ableism, that remain as unrecognized in our societies as in our social movements. 


KEYWORDS
Intersectionality; feminist theories; trans theories; queer theories; disability theories; social movements; body modifications; bodies; transsexuality; transability; voluntary amputation; BIID; disability; mutilation; pathologization; normality/abnormality; stigmatization; discourse; critical discourse analysis; norms; oppression; autonomy; bioethics.


RÉSUMÉ
Cette recherche se situe à la jonction des études féministes, trans et sur la production du handicap. Elle s’intéresse aux limites des analyses féministes intersectionnelles et leurs difficultés à considérer certains axes identitaires, telles l’identité de genre et les capacités, à travers l’analyse de deux cas de figure de modifications corporelles, soit la transsexualité et la transcapacité (transformation visant à acquérir un handicap). Cette thèse s’articule autour de la question suivante : quels sont les angles morts des analyses intersectionnelles et comment pouvons-nous y remédier? Pour répondre à cette question, cette thèse propose trois objectifs : 1) Participer aux questionnements critiques entourant certaines limites des analyses féministes intersectionnelles pour en diversifier les axes à partir de l’identité de genre et des capacités; 2) Remettre en question les présupposés conceptuels et les privilèges cisgenristes et (cis)capacitistes qui sous-tendent les discours négatifs entourant ces modifications corporelles et mettre en valeur les points de convergence entre les mouvements féministes, transactivistes et anticapacitistes pour instaurer des dialogues et des solidarités entre eux; 3) Fournir un modèle enrichi de l’intersectionnalité pouvant être déployé en études féministes, trans et sur la production du (trans)handicap, apte à répondre aux nouvelles revendications de justice de groupes opprimés, comme celles des personnes transsexuelles et transcapacitaires. À l’aide d’une méthodologie alliant l’analyse critique de discours, l’analyse archéologique et généalogique, les discours négatifs de certaines féministes et d’autres scientifiques sur ces transformations corporelles sont cartographiés et critiqués. Les réflexions présentées ici, s’inscrivant dans une approche poststructuraliste et queer, ne proposent pas une recherche des « origines » et des motivations de la transsexualité et de la transcapacité, mais plutôt une étude des discours négatifs vis-à-vis ces phénomènes et des systèmes normatifs qui sous-tendent ces discours. C’est sous cet angle que cette recherche constitue un apport important aux champs des savoirs, tant sur le plan théorique, normatif que politique : en se penchant sur deux cas de figure « extrêmes », elle met en lumière les normativités corporelles des régimes dominants, notamment cisgenriste et (cis)capacitiste, occultées tant dans nos sociétés que dans nos mouvements sociaux.


MOTS CLÉS
Intersectionnalité; théories féministes; théories trans; théories queers; théories sur le handicap; mouvements sociaux; modifications corporelles; corps; transsexualité; transcapacité; amputations volontaires; BIID; handicap; mutilations; pathologisation; normalité/anormalité; stigmatisation; discours; analyses critiques de discours; normes; oppressions; autonomie; bioéthique.

The health care needs of people who are lesbian, gay, bisexual, or transgender (LGBT) have received significant attention from policymakers in the last several years. Recent reports from the Institute of Medicine, Healthy People 2020, and the Agency for Healthcare Research and Quality have all highlighted the need for such long-overdue attention. The health care disparities that affect this population are closely tied to sexual and social stigma. Furthermore, LGBT people aren't all alike; an understanding of the various subgroups and demographic factors is vital to providing patient-centered care. This article explores LGBT health issues and health care disparities, and offers recommendations for best practices based on current evidence and standards of care.

This expert guide to working with transgender and gender variant youth offers ways to make positive change to service provision for practitioners working with this group. Based on the latest research, the recommendations made by the author are backed up by statistics and data, and refer to first-hand stories and experiences.

Exploring four key areas - mental health, physical health, sexual health and social health - the book sets out exactly what professionals need to know in relation to these areas and how to support trans youth in these circumstances. Providing clarity on a range of topics, this is the perfect overview for practitioners, as well as a useful text for students and researchers.

We aimed to assess the Minority Stress Model which proposes that the stress of experiencing stigma leads to adverse mental health outcomes, but social supports (e.g., school and family connectedness) will reduce this negative effect.We measured stigma-related experiences, social supports, and mental health (self-injury, suicide, depression, and anxiety) among a sample of 923 Canadian transgender 14- to 25-year-old adolescents and young adults using a bilingual online survey. Logistic regression models were conducted to analyze the relationship between these risk and protective factors and dichotomous mental health outcomes among two separate age groups, 14- to 18-year-old and 19- to 25-year-old participants.Experiences of discrimination, harassment, and violence (enacted stigma) were positively related to mental health problems and social support was negatively associated with mental health problems in all models among both age groups. Among 14-18 year olds, we examined school conne...

This paper offers a discussion of the rationale for the creation of sports categorization criteria based on sporting genealogy and the gendered body, as proposed by Torres et al. in their article 'Beyond Physiology: Embodied Experience, Embodied Advantage, and the Inclusion of Transgender Athletes in Competitive Sport'. The strength of their 'phenomenological' account lies in its complex account of human experience; but this is also what makes it impractical and difficult to operationalize. Categorization rather requires simplicity and practicability, if it is to be applied to all athletes (and not exceptionally to transgender athletes). This discussion helps us to formulate three general principles for the process of categorization of athletes, relating to fairness, verifiability and practicability.

Using a narratological framework, we examined how gender roles and stereotypes affect experiences of transgender and gender-nonconforming college students. Six participants were interviewed about navigating their gender identity throughout college and adulthood. Four themes emerged: gendered attributes, within-group differences, identity development, and experiences in counseling. Themes are discussed in light of humanistic literature, and implications are discussed.

Quote from the review:
"As well as giving complex accounts of embodied subjectivity through emphasis on intersectional analysis, the second Reader makes evident how transgender studies has moved beyond poststructuralist perspectives on gendered embodiment, which is a shift that is in line with emerging themes and conceptual developments in feminist, queer and gender studies more generally. However, as the articles do not follow a specific theoretical shift, this move is not made normative. Instead the anthology as a whole oscillates between different perspectives and concepts. It should, moreover, be mentioned that the articles overall are written by authors who do remarkable, thorough and sound theoretical and empirical work. While most of the texts are new, there are also some classical texts that have been published previously. On the  whole, Transgender Studies Reader 2 demonstrates the maturation and expansion of the field, at the same time as it shows the importance of previous work."

This report provides the main analytical results of a survey distributed to gender minority students (i.e. transgender, non-binary, and gender non-conforming) in Irish higher education (Third-Level Programmes). The survey touched upon daily lived-experiences and issues of safety, the efficacy of administrative policies, obstacles (on- and off-campus), and sources of support. The aim of the report was to capture essential quantitative and qualitative information that could be used to better students' lives, increase the effectiveness of gender policies, and lobby for reform (regarding issues such as trans health care, third gender recognition, and hate crime laws).

I was given the assignment to write a paper connecting Jay Prosser's 1998 "Second Skins: The Body Narratives of Transsexuality," specifically the chapter titled A Skin of One's Own: Toward a Theory of Transsexual Embodiment, and a more contemporary photo series by Zackary Drucker and Rhys Ernst, a couple in the earlier stages of their "opposite" physical and medical transitions. Additionally, I delve into an analysis of one particular photo in juxtaposition to a famous but widely criticized 19th c. painting.

Participants needed! I am conducting a study of attitudes toward transgender individuals, an important area of research to understand how to improve transgender healthcare. ¨ Please consider participating if you are a licensed and practicing Registered Nurse or Nurse Practitioner over the age of 18 ¨ Interested participants are willing to take an anonymous, brief online assessment of attitudes and answer questions regarding feelings toward transgender individuals and clinical experiences ¨ The total time needed is ~15 minutes ¨ Participation can occur by following this link: https://mili2nd.co/fgib If there are any questions about this study, please contact: Kathlyn Khoukaz | (925) 331-0716 | [email protected] You may contact the IRB with questions or concerns at (856) 612-8384 | [email protected]

Minha vontade aqui, neste texto, é, primeiramente, trazer um brevíssimo histórico sobre teorias escritas por homens cisgêneros das ciências sobre a transexualidade e, então, constranger suas perspectivas patologizadoras com as narrativas e mobilizações realizadas pelas próprias pessoas trans, na atualidade. Busco demonstrar, portanto, como os discursos feitos referentes à transexualidade são elementos muito importantes na constituição de um imaginário social sobre o que é ser um sujeito trans. Assim, considero que é a partir do embate entre diferentes vozes ─ entre aquelas da autoridade médica, institucionalizada, e aquelas marginais, provenientes de nossos gritos ─ que o entendimento sobre as possibilidades de ser travesti, mulher trans, homem trans e não binário é construído. Entendo que traçar uma rápida reflexão sobre os argumentos patologizantes de nossa identidade é uma tarefa necessária, embora dolorida. Pois, tais narrativas que nos foram impostas sob um olhar cisgênero-masculino ─ em termos de " transexualismo " ─ ainda são potentes e capazes de perturbar e restringir a autodeterminação pelo nosso corpo e pelo nosso subjetivo. É importante compreendermos, por meio da história, os desvios e embates que realizamos para consagrar nossa pluralidade frente aos laudos e receitas que teimam em julgar e aferir legitimidade a nossa realidade no gênero. Assim, aqui neste texto, decidi dar atenção a três escritos dos seguintes autores: Richard von Krafft-Ebing, David O. Cauldwell e Robert J. Stoller, os quais publicaram obras em 1886, 1949 e 1975, respectivamente, sobre experiências diagnosticadas como transexuais. Escolhi falar sobre esses pesquisadores, em específico, deixando muitos outros para trás, porque, além de serem reconhecidos nesse campo, é possível compreender uma ordem cronológica de suas obras e, também, porque é possível acompanhar através de seus relatos a evolução de uma sistematização sobre o que é o " transexualismo ". Esses homens, imbuídos em um sistema simbólico de conhecimento do mundo pautado pela dominação binarista e cis-heteronormativa, realizaram seus escritos promovendo descrições de subjetividades desviantes da norma por meio de uma análise ditada pelo estigma da anormalidade. A partir disso, observaremos como que o status de linguagem científica possui o poderio de estabelecer imaginários e, também, concepções materiais sobre sujeitos marginais. O primeiro autor, Krafft-Ebing, no livro " Psycopathia Sexualis: as histórias de caso " , lança mão de suas interpretações provenientes de narrativas pessoais para estabelecer diagnósticos e anomalias. Esse livro é caracterizado pelo seu linguajar de difícil acesso, pois escrito em latim, e é criado exclusivamente para servir como manual para o trabalho de uma classe de cientistas. A obra não poderia ser disseminada, de forma

Collective memory work allows participants to recall, examine, and analyze their memories and experiences within a broader cultural context to see how their individual experiences link to collective, shared experiences of similar and/or diff erent groups. Th is study utilized collective memory work to engage six trans participants in an examination of their individual experiences with health care. During a four-hour focus group, participants engaged in this process of discourse analysis and came to collective agreements about the meaning of their stories, the intentions of the author, and the intentions of others in their shared lived experience. In this paper, we will provide a thorough and rich description of the participants' memories and their collective analysis, which highlights the interconnection between perceptions of oneself and their experiences with the health-care system. Our analysis revealed participants felt they had a toxic relationship with the health-care system. In particular, they discussed how health-care professionals left trans people tremulously asking for services, uncertain if they would receive care, what the quality of the care would be, and whether they would be treated respectfully. When discussing positive health-care experiences, participants highlighted when fears and anxieties were not realized, but all instances refl ected some inappropriate actions. Th e results from this study will contribute to research on trans health care by providing a nuanced understanding of how health-care experiences impact trans communities collectively, as well as the ways in which health practices can be improved.

This work identifies transgender oriented image memes as a dataset that reflects transgender lived experience, minority stress, and resilience. In this analysis of transgender memes, four themes were identified: Community, Bodies, Transgender Experience, and The Broken System of Gender. Memes about bodies dealt not only with medical transition, but discussed the distinction between euphoria and dysphoria, as well as cisgender expectations of transgender bodies and bodily narratives. Memes about community included depictions and acts of validation, discussions of reclamations of power, and the queering of media to form senses of community representation. Transgender experience memes discussed the ways being transgender tints otherwise common experiences, such as interfacing with family, or coming into one’s identity. Finally, the ways gender, as a social system, limit people and reinforce harmful hegemonic tendencies are discussed. Importantly, these memes demonstrated each element o...

Counting Ourselves is the first comprehensive national survey of the health and wellbeing of trans and non-binary people living in Aotearoa
New Zealand and was conducted from 21June till 30 September 2018. We worked with a diverse community advisory group to design the
questions. Our team is based at the University of Waikato and we also collaborated with other academics, health professionals, community
organisations and policymakers with an interest in the wellbeing of trans and non-binary people. We had 1,178 survey participants, with 99% of them completing the survey online.
The survey had participants from all regions in the country, who ranged in age from 14 to 83. Most were either youth aged 14–24 (46%) or adults aged 25–54 (47%). Almost half (45%) of participants were non-binary, and we had slightly more trans men (29%) than trans women (26%). The survey had a higher proportion of European participants and a lower proportion of Asian participants than the general population. A quarter of participants had a disability.

Migration studies in post-Apartheid South Africa have maintained a strong focus on cross-border mobility while often narrowing health-related research to HIV/AIDS concerns and framing gender in woman-oriented approach with a gradually emerging area of research on migrant sex workers. This article offers to bridge certain gaps in migration research on health, internal mobility, and gender. It revolves around experiences of black unprivileged transgender internal migrants accessing medical services in the public health sector in urban Gauteng, in particular, Johannesburg and Pretoria. The article explores their experiences of migration focusing on analysis of their “transition”—both “gendered transition” (different medical interventions that alter/modify gender-related attributes of the body) and “spatial transition” (diverse mobility patters, relocation, renegotiation of place of living and belonging)—and ways they negotiate belonging. The analysis outlines challenges that transgender individuals face in the public health sector and affects these challenges have on mobility of transgender South Africans. Further, the article delves into exploration of transgender internal migrants’ experiences and understanding of “migration” that arises from sense of (non)belonging and ways to negotiate dynamic subjective sense of being (or not) part of physical (and sometimes) imaginary social groups and places, such as family/home, local (“host”) community, lesbian, gay, bisexual and transgender (LGBT) community, and religion/spirituality.

In this brief, semi-scientific paper, the author describes and journals a short experiment upon himself involving the self-administration of female sex hormones with the purpose of observing their effects on his mind and body, with the intent to evaluate their fitness within his system, and thus indirectly, acquire further evidence in favor or against his theory that he is transsexual. [Spoiler: she is!]

Il testo vuole incarnare una possibile mediazione tra universi culturali lontani ed essere una lettura propedeutica per chi intenda addentrarsi nella tematica, lasciando che la fede cristiana s’interroghi liberamente sul ‘gender’. Un approccio sereno e critico sia alla cultura laica di genere – della quale si esaminano i nodi principali – sia a quella cattolica, con l’intento di superare le reciproche diffidenze e cercare insieme una verità umanizzante per tutti. L’obiettivo è gettare delle basi condivisibili su cui costruire una sintesi teologica più ampia. Un testo che, nell’esaminare i nodi teoretici, volge lo sguardo alla recente campagna ‘anti-gender’, cercando di fornire le coordinate utili a svelenire il clima e muoversi al suo interno con padronanza di lessico e concettualità. In questo senso, l’opera vuole essere uno strumento per formatori, pastori e attivisti che vogliano introdursi nella complessità senza scorciatoie, per cogliere la ricchezza del ‘pensiero di genere’: nell’orizzonte della promozione di un benessere comunitario e individuale.

SOURCE: Baril, A. (2021) “Detransition, Re-transition, Interrupted or Discontinued Transition: All the same thing? A critical and philosophical reflection on the notion of detransition,” Symposium: “Detrans” or the Phenomenon of Discontinuation of Gender Transition in Young People:
Preliminary Results, 25th Congress of the World Association for Sexual Health (WAS), Pre-recorded symposium, Virtual Congress, September 12.

"When a disaster occurs in a community, it does not selectively choose which population or group would incur the highest extent of devastation; it affects everyone in the community with variations based on the vulnerabilities and capacities of the people disturbed by it. Occurrences of disasters amplify daily living circumstances (Gaillard, 2010); as such, those who are marginalized members in normal conditions are also the ones who are subjugated and are more susceptible to the direct and indirect effects of disasters (Mallon, 2009).

One of the most neglected sectors in a community when it comes to the aftermath of disasters are transgender individuals. Bariola and colleagues (2015) characterized transgenders as “individuals who have gender identities, expressions, or behaviors that are not typically associated with the sex they were assigned at birth”. Gender-related stigma associated with transgender individuals during their day-to-day conditions transcend even to disaster situations where they are discriminated against and socially excluded from the processes of risk assessment and disaster risk reduction (Dominey-Howes, Gorman-Murray, & McKinnon, 2013). Their needs tend to be overlooked—for instance, they are given lower priority during rescue efforts—and this results to some debilitating consequences for this marginalized population (Knight & Welton-Mitchell, 2013).

Studies touching on the experiences of transgender individuals during and post-disasters have been sparse, more so those examining the differential experiences of individuals from varying developmental stages. Thus, this study intends to focus its lens on transgender individuals, particularly transwomen; that is, individuals who are biologically male but who identify their gender as female. Moreover, it aims to narrow down its focus on transwomen who are under the developmental stage of adolescence."

How have biomedical innovation, regulation, and distribution of pharmaceutical testosterone prescribed to trans men created new forms of medical, community, and individual surveillance of masculinity and masculinization? Our systematic analysis of more than one hundred trans men's testosterone vlogs provides evidence for the production (and consumption) and reproduction of a very narrow set of hegemonic scripts about what a male body is, how it is achieved, and what it means to become a man. We find in this medium, multiple overlapping agents of surveillance: the state, the medical-industrial complex, the interactive loop between ourselves and our screens, the videographer and the trans man, the viewer and watched, hegemonic masculinity and its internalizations. We offer a critical feminist reading of the way that surveillance technologies produce a particular type of transmasculine subject with consequences for cultural understandings of gender nonconformity.

Source: Baril, A. (2020). “La Condizione Trans Come Debilità: Ripensare le intersezioni tra le incarnazioni disabili e quelle trans” (“Transness as Debility: Rethinking intersections between trans and disabled embodiments”), KABUL Magazine (Torino), 5, 3: 1-23. URL: https://www.kabulmagazine.com/la-condizione-trans-come-debilita/

Original publication: Baril, A. (2015). “Transness as Debility: Rethinking intersections between trans and disabled embodiments,” Feminist Review, 111: 59-74.

Se trata del Relevamiento de Infancias y Adolescencias trans de Río Negro y Neuquén, realizado durante el año 2020 y parte del 2021, y coordinado por el Observatorio de DDHH de Neuquén, dependiente de la Subsecretaría de DDHH de la provincia.

Parent support is considered crucial for the health of transgender and gender-nonconforming (trans/ GNC) children, yet little research has focused on how to support parents and caregivers. This study considered the experience of participation in a support group for parents of transgender children on families. Methods: Online surveys were conducted with parents whose children were receiving clinical care at a gender specialty clinic and who participated at least once in a monthly support group. Close-ended questions addressed the importance of participation and open-ended questions addressed the specific ways it was helpful, how it impacted them and their trans/GNC child, and if they faced barriers to participating. Results: The majority of the 48 participants (77.1%) identified as female. The mean age of their trans/GNC child was 13.9 years (standard deviation 5.1, range 5-22 years); just over half (n = 25) of their trans/GNC children identified as male. Participants overwhelmingly reported positive experiences with the support group, with 72.9% reporting that the group was either important or critically important to them and 66.7% reporting that it was important or critically important to their trans/GNC child. Perceived benefits included the opportunity to learn about legal, medical, and school issues and receive emotional support. Conclusion: Support groups provide an important complement to specialized clinical care for families with trans/GNC children. Logistical challenges, lack of age peers, and lack of people of color all served as limitations of the group. Further research is needed to understand the experiences of fathers and to determine if the support group model would be effective with racially/ethnically and economically diverse populations.

REFERENCE: Baril, A., M. Silverman, M.-C. Gauthier and M. Lévesque (2020). “Forgotten Wishes: End-of-life documents for trans people with dementia at the margins of legal change,” Special Issue: On the Margins of Trans Legal Changes, Canadian Journal of Law & Society, p. 1-24, doi:10.1017/cls.2020.13
ABSTRACT: Literature on the topic of trans older adults has documented a few anecdotal cases in which some trans people living with dementia forgot they transitioned and reidentified with their sex assigned at birth ("detransition"). Trans communities and their allies have encouraged trans people to engage in end-of-life planning, including the preparation of legal documents that state their wishes regarding gender identity and expression in the event of "incapacity" caused by dementia. While useful, we contend that end-of-life planning is often implicitly based on cisnormative and cognonormative (normative system based on cognitive abilities) assumptions. Such planning is founded on a stable notion of gender identity throughout the life course ("post-transition") and assumes that the pre-dementia self is better equipped to make decisions than the "demented" self. We conclude by encouraging, based on an intersectional, trans-affirmative, crip-positive, and age-positive approach, respect for the agency of trans people with dementia.
KEYWORDS: Trans and nonbinary people, end-of-life planning and documents, cisgenderism/transphobia, ableism/cogniticism, ageism, epistemic injustices.
RÉSUMÉ: Les écrits portant sur les personnes âgées trans ont documenté quelques cas anecdotiques dans lesquels des personnes trans vivant avec une démence ont oublié leur transition et se sont réidentifiées avec leur sexe assigné à la naissance (« détransition »). Les communautés trans et leurs alliés encouragent ainsi les personnes trans à s'engager dans la planification de leur fin de vie, notamment à travers la préparation de documents juridiques qui énoncent leurs souhaits relativement à leur identité et à leur expression de genre en cas « d'incapacité » causée par la démence. Bien que de tels documents s'avèrent utiles, nous soutenons que la planification de la fin de vie est souvent implicitement basée sur des hypothèses cisnormatives et cognonormatives (système normatif basé sur les capacités cognitives). Une telle planification repose sur une conception de l’identité de genre comme étant stable tout au long de la vie (« post-transition ») et suppose que le soi « pré-démence » est mieux équipé pour prendre des décisions que le soi « dément ». Nous concluons en encourageant, sur la base d’une approche intersectionnelle, trans-affirmative, crip-positive et âge-positive, le respect de l’agentivité des per- sonnes trans vivant avec une démence.
MOTS CLÉS: Personnes trans et non binaires, démence, planification de fin de vie, cisgenrisme/transphobie, capacitisme/cogniticisme, âgisme, injustices épistémiques.

Purpose
The purpose of this research project was to obtain a global picture of osteopathic dysfunctions found in transmen who have undergone surgical gender reassignment, by studying more specifically the repercussions of mastectomy, genital reconstruction and testosterone.

Methodology
Thirty-seven participants were recruited, aged 21 to 54 years old, then divided in three groups of 12 transgender men, 12 cisgender women and 13 cisgender men. Data collection was done through a one-on-one interview with each participant, using a general health survey, as well as questions regarding the medical aspects of transition for the trans* participants. A series of 43 osteopathic tests and evaluations were performed on each of the 37 participants.

Results
Our study shows a significant number of repercussions on the superior cervical spine, cervicothoracic area, soft tissue of the neck and thorax. The pelvic mobility is also affected, whether through the bone structure or musculotendinuous elements. Visceral testing revealed changes in the mobility and motility of organs, and cranial tests showed a disturbance felt throughout the entire craniosacral axis.

Conclusion
Mastectomy, hysterectomy, testosterone and high levels of stress bring a tremendous amount of disruption in trans* subject’s homeostasis. With its holistic approach, osteopathy allows the practitioner to bring harmony between the body and soul, to care for the person while respecting their authenticity, and accompany them toward global wellness, and is therefore a treatment of choice to support trans* folks in their transition process.

Documento guía de práctica clínica, destinada a médicxs y otrxs integrantes de los equipos de salud, que tiene como objeto sistematizar una serie de recomendaciones, con la mejor
evidencia disponible, sobre tratamientos de modificación corporal hormonal, así como
aspectos de la atención integral de la salud de las personas trans*. Esta guía apunta a facilitar la toma
de decisiones de lxs médicxs y mejorar la calidad de los procesos de atención clínica, promoviendo la autonomía y las decisiones plenamente informadas en salud de las personas trans*.
Además, cuenta con recomendaciones vinculadas a atención y de la salud integral y, más específicamente, rastreos y atención de la salud sexual integral.

WPATH Board confirming that sex (gender) reassignment, properly indicated and performed as provided by the Standards of Care, has proven to be beneficial and effective in the treatment of individuals with transsexualism, gender identity disorder, and/or gender dysphoria.