"I Am Chelsea Manning": Comparison of Gendered Representation of Private Manning in U.S. and International News Media

Hormonal Gender Reassignment Treatment for Gender Dysphoria

BACKGROUND

No data are available at present on the prevalence of gender dysphoria (trans-identity) in Germany. On the basis of estimates from the Netherlands, it can be calculated that approximately 15 000 to 25 000 persons in Germany are affected. Persons suffering from gender dysphoria often experience significant distress and have a strong desire for gender reassignment treatment.

METHODS

This review is based on pertinent publications retrieved by a selective search in the PubMed database employing the searching terms "transsexualism," "transgender," "gender incongruence," "gender identity disorder," "gender-affirming hormone therapy," and "gender dysphoria."

RESULTS

In view of its far-reaching consequences, some of which are irreversible, hormonal gender reassignment treatment should only be initiated after meticulous individual consideration, with the approval of the treating psychiatrist/psychotherapist and after extensive information of the patient by an experienced endo - crinologist. Before the treatment is begun, the patient must be extensively screened for risk factors. The contraindications include severe preexisting thromboembolic diseases (mainly if untreated), hormone-sensitive tumors, and uncontrolled pre - existing chronic diseases such as arterial hypertension and epilepsy. Finding an appropriate individual solution is the main objective even if contraindications are present. Male-to-female treatment is carried out with 17β-estradiol or 17β-estradiol valerate in combination with cyproterone acetate or spironolactone as an antiandrogen, female-to-male treatment with transdermal or intramuscular testosterone preparations. The treatment must be monitored permanently with clinical and laboratory follow-up as well as with gynecological and urological early-detection screening studies. Prospective studies and a meta-analysis (based on low-level evidence) have documented an improvement in the quality of life after gender reassignment treatment. Female-to-male gender-incongruent persons often have difficulty being accepted in a gynecological practice as a male patient.

CONCLUZION

Further prospective studies for the quantification of the risks and benefits of hormonal treatment would be desirable. Potential interactions of the hormone preparations with other medications must always be considered.

Watching the Evolution of the American Family? Amazon's Transparent, Ecological Systems Theory, and the Changing Dynamics of Public Opinion

Using Bronfenbrenner's (1979) ecological systems theory as an organizing framework, the research closely examines the text of the Amazon Studios hit show Transparent and, by extension, the evolution of public opinion toward transgender individuals. By examining the Pfefferman family in detail and their related microsystem and macrosystem, we are able to closely unpack the transition of Jeffrey Tambor's character from Mort to Maura and the show's connections with broader developments in the Los Angeles LGBT community and the Jewish diaspora in postwar and contemporary Los Angeles. In addition, by focusing on the influence of the chronosystem, we are able to examine how both opinions toward Maura and public opinion toward transgender issues more generally have evolved within the family system and the larger American community over time.