Gender Nonconforming Individuals Research Articles

Examining the Risks of Multiple Types of Interpersonal Victimization for Transgender and Gender Non-Conforming College Students.

Recent research has shown that transgender and gender non-conforming (TGNC) individuals are at risk of experiencing interpersonal violence, yet there may be differences within this group and across victimization types. The current study examined rates of seven types of interpersonal victimization based on six gender identities (cisgender women, cisgender men, trans women, trans men, nonbinary, and another identity) among a national study of college students. Data from the Spring 2021 American College Health Association's National College Health Assessment III (ACHA-NCHA III), a national-level study of U.S. college students, were used. We examined the association between gender identity and seven types of interpersonal violence victimization (violent victimization, sexual victimization, intimate partner violence victimization, stalking, bullying, microaggression, and discrimination) that occurred within the past 12 months. Logistic regression analyses were performed to examine if, when controlling for competing factors, gender identity was associated with an increase in the expected odds of victimization for each victimization type. Analyses revealed that TGNC college students reported experiencing a greater amount of all seven types of victimization compared to cisgender college students. These findings corroborate previous research indicating that rates of interpersonal violence are higher among TGNC college students compared to those who identify as cisgender, even after controlling for sexual orientation, related demographic factors, and substance use. Findings from the current study suggest that there are differences within individuals who identify as TGNC in terms of their risk for interpersonal victimization and that rates differ across victimization types. More work is needed to provide tailored prevention programming for TGNC college students.

Enhancing Workplace Inclusivity for TGNC (Transgender/Nonconforming) Communities: “A Path to Psychological-Safety”

Discrimination against transgender and gender nonconforming (TGNC) individuals remains apervasive issue, significantly impacting their psychological safety and overall well-being. This marginalisedcommunity faces an array of challenges, including experiencing homelessness, poverty, and harassment, whichare interconnected and, to a considerable extent, a consequence of systemic discrimination. Studies by Tebbeet al. (2019) reveal that the TGNC community grapples with disproportionately high rates of homelessness,poverty, and harassment, thus highlighting the systemic nature of the challenges they confront. Workplacediscrimination within the TGNC community extends across a spectrum, impacting individuals’ authenticity andpotential for forced engagement in underground economy work to offset poverty, including survival sex workand drug dealing (Par & Howe, 2020). Workplace discrimination is a pivotal determinant of psychological safety and well-being for TGNC individuals.Frazier et al. (2017) emphasise the critical importance of preventing discrimination and conflict in theworkplace, which contributes to negative mental health outcomes. The consequences of discrimination areprofound. A significant portion of the TGNC community reports a history of suicidal ideation, ranging from 45%to 77% (Testa et al., 2017). Promoting psychological safety and well-being for this marginalised community isnot only a moral imperative, but also a pathway to fostering more prosperous and inclusive societies. Thisresearch utilises a qualitative methodology, through semi-structured interviews among diverse genderidentities. By exploring the lived experiences of TGNC individuals in the workplace, this study uncovers theimpact of discrimination on psychological well-being. The results of the findings demonstrate how to improvethe psychological-safety of gender-diverse communities through

Childhood Adversity and Adolescent Smartphone Use Across Sexual Orientation and Gender Expression

Nonheterosexual and gender-nonconforming (GNC) individuals tend to report adverse childhood experiences (ACEs) more frequently compared with heterosexual and gender-conforming individuals, and individuals who have experienced ACEs, identify as nonheterosexual, or exhibit moderate to high levels of GNC are more prone to engaging in problematic smartphone use (PSU). However, there is limited school-based data among adolescents regarding this matter. To explore the associations between ACEs and PSU among adolescents across different sexual orientation and gender expression groups. Using data from the 2021 School-Based Chinese Adolescents Health Survey, this cross-sectional study includes participants from 288 public high schools across 8 provinces in China. Statistical analysis was performed from October 2023 to February 2024. Data on ACEs, sexual orientations, and gender expressions (high, moderate, and low GNC) were collected. PSU was assessed using the 10-item Smartphone Addiction Scale-Short Version (SAS-SV). Weighted linear, logistic, or Poisson regression models were used. Among the 85 064 adolescents included (mean [SD] age, 14.92 [1.77] years), 42 632 (50.1%) were female, 70 157 (83.2%) identified as Han Chinese, and 14 208 (16.8) identified as other ethnicities (Miao, Hui, Yi, Dai, and other ethnic groups). The prevalence of PSU among participants was 35.4%. Weighted Poisson regression models indicated that the interaction between GNC and ACE was significant (adjusted prevalence ratio [APR], 0.98; 95% CI, 0.97-0.99). Further stratified analysis demonstrated homosexual adolescents who experienced 4 or more ACEs showed a significantly increased prevalence of PSU (APR, 1.79; 95% CI, 1.64-1.96). Similarly, a markedly higher prevalence of PSU was observed among bisexual individuals with 4 or more ACEs (APR, 1.60; 95% CI, 1.41-1.80). Regarding gender expression categories, a significantly higher prevalence of PSU was noted among high GNC adolescents with 4 or more ACEs (APR, 1.78; 95% CI, 1.60-1.98) compared with low GNC adolescents without ACEs. Furthermore, experiencing any 3 ACE categories (abuse, neglect, and household dysfunction) was associated with an increased prevalence of PSU across different sexual orientation and gender expression subgroups. In this cross-sectional study, the amalgamation of elevated ACE scores with nonheterosexual orientations or GNC identities was significantly associated with increased PSU prevalence. These findings underscore that preventing ACEs may be beneficial in mitigating PSU among adolescents, particularly for nonheterosexual adolescents and those with high levels of GNC.

Perceptions and Acceptance of a Prophylactic Vaccine for Human Immunodeficiency Virus (HIV): A Qualitative Study.

Despite advances in human immunodeficiency virus (HIV) prevention methods, such as the advent of pre-exposure prophylaxis (PrEP), the number of people with newly acquired HIV remains high, particularly in at-risk groups. A prophylactic HIV vaccine could contribute to reduced disease prevalence and future transmission and address limitations of existing options, such as suboptimal long-term adherence to PrEPs. This qualitative study aimed to capture perceptions towards and acceptance of prophylactic HIV vaccination in three adult populations in the United States: the general population, 'at-risk' individuals (e.g. men who have sex with men, transgender individuals, gender-nonconforming individuals, and individuals in a sexual relationship with a person living with HIV), and parents/caregivers of children aged 9-17years. Interviews were conducted with 55 participants to explore key drivers and barriers to HIV vaccine uptake, and a conceptual model was developed. The sample was diverse; participants were 51% female, aged 20-57 years (mean 37years), 33% with high school diploma as highest education level, and identified as White (42%), Black or African American (35%), of Hispanic, Latino, or Spanish origin (22%), or other races/ethnicities (8%) [groupings are not mutually exclusive]. Perceptions were influenced by individual, interpersonal, community, institutional, and structural factors. Overall, 98% of participants thought vaccination would be beneficial in preventing HIV. Key considerations/barriers included perceived susceptibility, i.e. whether participants felt there was a risk of contracting HIV (discussed by 90%); the clinical profile of the vaccine (e.g. the adverse effect profile [98%], and vaccine efficacy [85%], cost [73%] and administration schedule [88%]); and concerns around potential vaccine-induced seropositivity (VISP; 62%). Stigma was not found to be an important barrier, with a general view that vaccination status was personal. Participants in the 'at-risk' group were the most likely to accept an HIV vaccine (70%). Unique concerns in the subgroups included how a potential vaccine's clinical profile compared with PrEP, voiced by those receiving/considering PrEP, and considerations of children's views on the topic, voiced by parents/caregivers. Understanding these factors could help develop HIV vaccine research strategies and contribute toward public health messaging to support future HIV vaccination programs.

Using Simulation to Teach Gender-Affirming Care Concepts in Nursing Education.

LGBTQIA+ (lesbian, gay, bisexual, trans-gender, queer or questioning, intersex, asexual), and gender-nonconforming (GNC) individuals have limited access to quality care, leading to health disparities. Lack of training and implicit bias are significant contributors to discrimination. Nursing schools must provide opportunities for student interaction with vulnerable populations, and interacting with transgender and GNC individuals during clinical experiences may be challenging. Simulated experiences offer opportunities for students to develop clinical competencies. Students participated in a simulation on caring for transgender and GNC populations. Students participated in a prebriefing session, viewed a simulation video, and engaged in a debriefing session. Participants completed a pre- and postsurvey to assess their knowledge and perceived confidence. Students' confidence in providing gender affirming care was improved by the activity. Students prioritize providing competent care to vulnerable populations. In-class simulation is an effective method for improving students' clinical competencies in a safe, nonjudgmental setting. [J Nurs Educ. 2024;63(4):241-246.].

Increased rate of pancreatitis in gender diverse and transgender patients on hormone therapy: a case series study.

There is limited data on the incidence of gastrointestinal-specific pathology in gender non-conforming (GNC) populations. Retrospective analysis of pancreatitis incidence rates in transgender and GNC persons exposed and not exposed to gender-affirming hormone therapy (GAHT). 7 of the 1333 patients on hormone therapy had an incidence of pancreatitis. 0 of the 615 patients with no history of GAHT use developed pancreatitis. Representing a 6.96 (95% CI 2.76 to 848.78) for the development of pancreatitis in patients with exposure to GAHT therapy. Clinicians working with GNC individuals should be aware of this possible association.

Fantasy Worlds, Real-Life Impact: The Benefits of RPGs for Transgender Identity Exploration

ABSTRACT The current research explored the influences of role-playing video games (RPGs) on the development of gender identity among transgender and gender non-conforming (TGNC) individuals. In Study 1 (N = 10), we used a Consensual Qualitative Research approach to interview TGNC individuals and identify common themes regarding the perceived impact of RPGs on gender identity development. TGNC individuals highlighted the influence of character customization, exploration, and the function of RPGs as safe spaces. In Study 2 (N = 100), we quantitatively explored the influence of RPG avatar customization on TGNC gender identity development. Although avatar customization was not associated with gender identity commitment, those playing RPGs with highly customizable avatars were more likely to report an impact of RPGs on their gender identity development. Content analyses reinforced Study 1 findings, indicating that RPGs, especially those with customizable avatars, can shape the gender identity journey for TGNC individuals.

Gender dysphoria and gender-affirming surgery: The New York state experience

Transgender and gender nonconforming (TGNC) individuals experience incongruence between their self-identified gender versus their birth-assigned sex. In some cases, TGNC patients undergo gender-affirming surgical (GAS) procedures. Although GAS is an evolving surgical field, there is currently limited literature documenting patient characteristics and procedures. Addressing this knowledge gap, this retrospective cohort analysis described the characteristics of New York State's TGNC residents with gender dysphoria (GD) diagnosis, including patients undergoing at least one gender-affirming surgical procedure. Using the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2002 to 2018, we identified patients' first-time TCNC records and their risk characteristics. Patients who received GAS procedures were sub-classified as top-only, bottom-only, or combined top/bottom procedures and were compared with TGNC patients who did not receive GAS. Of 24,615 records extracted from TGNC SPARCS database, 11,427 (46.4%) were transmasculine (female-to-male) and 13,188 (53.6%) were transfeminine (male-to-female). Overall, 2.73% of transgender patients received at least one GAS procedure. Of these patients, 78.2% had masculinizing and 21.8% had feminizing surgeries. After a diagnosis of GD, the positive predictors for a GAS-based procedure included female birth sex, pediatric age (<18 years) or older age (60+ years), commercial insurance coverage, and Hispanic race. In contrast, negative GAS predictors included male birth sex and government insurance coverage (i.e., Medicare and Medicaid). Compared with transgender women, transgender men were more likely to receive at least one GAS procedure. Because the race, ethnicity, and payor status of TGNC patients can impact GAS treatment rates, additional research is warranted to examine post-diagnosis GAS treatment disparities among TGNC patients.

Gender and Sexuality Disparities in Perception, Attitude and Social Intimacy Among Sinophone Youth Toward Transgender and Gender Non-Conforming Individuals: Based on an Internet Survey

ABSTRACT The study aims at assessing gender and sexuality characteristics (GSC) in perception, attitude, and social intimacy among Sinophone youth toward transgender and gender non-conforming (TGNC) people. Based on an internet survey with 3 825 valid questionnaires, we distinguished the general public into TGNC, cisgender heterosexual, and cisgender non-heterosexual individuals. Then we classified TGNC individuals into trans females, trans males, and non-binary/genderqueer people and cisgender individuals into cisgender females and cisgender males. The chi-square test, one-way analysis of variance (ANOVA), and multiple linear regression were used. We found that the evident gender and sexuality disparities in perception, attitude, and social intimacy toward TGNC individuals exist both in and out of TGNC individuals. Negative perceptions and attitudes as well as alienated social intimacy were most pronounced among cisgender heterosexual people (Chi-square test, one-way ANOVA, and multiple linear regression: all p < .001). Cisgender females exhibit higher levels of supportiveness compared to cisgender males. Trans females were the most positive while they also had more concerns regarding public space and gender expression-related issues. The findings are practical for community-based advocacy for raising public awareness of the presences and experiences of TGNC people in Sinophone societies.

Mental health changes in partners of transgender and gender nonconforming individuals as a result of partner gender transition: What about me?

Purpose Research on the psychosocial impact of gender transitioning on partners of transgender and gender nonconforming (TGNC) individuals is scarce in the literature. Here, we assessed mental health in partners of TGNC individuals. Methods Anonymous surveys were administered via Amazon Mturk. Eligible participants were ≥ 18 years with a partner who transitioned genders. Relationship satisfaction and mental health were assessed via perceived changes, Personal Health Questionnaire Depression Scale (PHQ-8), General Anxiety Disorder (GAD-7), Self-Esteem and Relationship Questionnaire (SEAR), Resilience Scale, and Difficulties in Emotion Regulation Scale (DERS-5). Multivariable linear regression assessed associations between relationship satisfaction and type of partner transitioning. Results Of the 337 study respondents, 42.4% were assigned male, 57.6% assigned female (43.9% identify as male; 55.8% as female) and 1.76% nonbinary, with a mean age of 35.8. 44.4% had partners who are transgender women, while a third (36.8%) had partners who are transgender men, 7.7% from assigned male to nonbinary, and 11.2% from assigned female to nonbinary. Most (72.4%) partners underwent surgical transitioning (15.1% top surgery; 5.6% bottom; 51.6% both) versus 27.6% non-surgical transitioning. PHQ-8, SEAR, confidence, self-esteem, relationship satisfaction, and resilience scores were higher among respondents whose partners underwent surgical transitioning (p < 0.001). SEAR scores differed significantly among participants whose partners underwent top only versus bottom only surgery (p = 0.004). Conclusion Partner mental health and relationship satisfaction were most impacted by surgical transitioning of their TGNC partner. Supportive services for partners of TGNC individuals during the transition process to protect these romantic relationships should be considered.

‘Readiness as opposed to eligibility’- preliminary consensus amongst professionals regarding gender identity assessments employing the DELPHI methodology

Purpose Gender identity assessments (GIAs) have been criticized by practitioners and trans and gender non-conforming (TGNC) individuals alike. With the practice of exploring individuals’ gender identity for treatment pathway purposes being potentially invasive and inappropriate, the current study aims to explore explicit standards. Design/methodology/approach The current study used the Delphi methodology to survey practitioners familiar with GIA. Over three rounds, 14 international participants rated their agreement about six areas relating to the assessment: purpose; content; approach; forensic application; psychometric instruments; and wider issues. Statements that reached an 80% cut-off among participants were viewed as a sufficient level of agreement, while the remaining items were fed back for repeated ratings. Furthermore, participants had the opportunity to suggest additional items that the group could rate. Findings Overall, a consensus across 23 items was achieved. The findings indicate a practice emphasizing collaboration between clinician and client to facilitate an informed decision. Furthermore, participants advocated for a non-pathologizing version of the GIA. This is a departure from diagnoses like gender dysphoria toward an approach which encapsulates also positive aspects of the trans experience, for example, resilience and future plans. Research limitations/implications Limitations include sampling biases due to participants’ high specialization and challenges in recruiting TGNC individuals. Furthermore, findings appear restricted to adult services. Originality/value To the best of the author’s knowledge, this pilot is a first step to making current practice transparent and comparable, with the hopes to improve trans care. Furthermore, it is contextualized with the previously suggested application of the power threat meaning framework to GIA.

Invisibility and Stigma: Experiences of Transgender and Gender Non-Conforming Individuals in South Korea.

In this qualitative study, we explored the challenges that transgender and gender non-confirming (TGNC) individuals face in South Korea. For this, we conducted in-depth interviews with 14 South Korean TGNC younger adults attending colleges or graduate schools and analyzed their data through consensus qualitative research. Analyses revealed that issues related to interpersonal relationships and medical transiting were major challenges perceived by participants. Four categories emerged in the domain of challenges in interpersonal relationships, including issues associated with family, romantic partner, coming out and outing, and transphobia and cisnormativity. In addition, two categories (i.e., medical difficulties and physical appearance-related distress) were included in the domain of challenges related to medical transition. Unique sources of stress for South Korean TGNC younger adults included high risk of being outed due to Korean resident registration numbers, dissatisfaction with bodily changes when transitioning, and misgendering caused by Korean's different honorific titles depending on gender.

Negotiating Non-normative Identities: Gender Nonconforming Malaysian Muslims on Instagram

This paper delves into the utilisation of Instagram as a platform for self-expression and the establishment of non-normative identities among gender nonconforming Malaysian Muslims. Specifically, the research focuses on Malaysian Muslim males who identify as gender nonconforming and analyse their video posts on Instagram. These individuals construct and manifest their nonconforming identities while navigating the complexities of Malaysian Muslim identity, cultural norms, and religious influences. The deeply rooted Malay identity, combined with the adherence to Islamic principles, presents a challenging conflict for gender nonconforming Malaysians seeking to establish their identities. To address this, many gender nonconforming Malay males adopt the “femeskulin” mode of micro-celebrities on Instagram, blending gender nonconformity with religious values. The findings highlight the potential for coexistence and the significant role played by gender nonconforming individuals in shaping “femeskulin” identity and expression among Malaysian Muslims within the social media platform.

Migration, Exploitation, and Human Trafficking Among High-Risk Transgender and Gender Non-Conforming Individuals in Cape Town: A Case Study

ABSTRACT Transgender and gender non-conforming (TGNC) individuals and migrants are at risk for human trafficking, yet patterns of migration and exploitation among TGNC individuals are not well documented. This case study examined the experiences of migration and exploitation in a subsample of 27 TGNC individuals from a larger study of 665 high-risk adults in Cape Town, South Africa. The main variables of analysis are derived from a version of the Trafficking Victim Identification Tool, which includes quantitative and qualitative responses. Twenty-six participants (96%) reported at least one potential indicator of exploitation in their lifetime. In the past 12 months, ten participants indicated that someone had withheld payments from them or taken the payment they should have been paid. Half (n=13) of the South African born participants discussed internal migration in their qualitative responses without migration specific prompting. Participants described difficult lives that included childhood abuse, unstable housing, economic marginalization, internal migration, and elements of labor and sexual exploitation – much of which was driven by transphobic and intersectional discrimination and stigma. Our findings shed light on the vulnerability of TGNC individuals and emphasize the need to include TGNC voices in all research and interventions addressing human trafficking.

Association Between Perceived Stress and Salivary Biomarkers of Allostatic Load Among Gender Minorities in Chennai: An Observational Cross-Sectional Study.

Background Transgender individuals in India experience immense psychosocial stressors, stigma, and violence. In response to stress, the body exhibits adaptive responses that necessitate the production of organic chemicals ensuing in the detection of blood serum and saliva.There are currently no laboratory tests that are confirmatory for the diagnosis of stress and facilitate necessary treatment to be carried out in a timely manner. Thus, potential salivary biomarkers could be a helpful tool in overseeing the efficacy of pharmacological treatment prescribed by a psychiatrist. Aim This study aimed to assess the correlation between perceived stress and salivary stress biomarker levels in transgender and gender nonconforming (TGNC) individuals in Chennai, India. Methodology Twenty-two TGNC individuals and 22 age-matched controls in Chennai were administered the Perceived Stress Scale-10 questionnaire. Following this, their saliva samples were collected using the passive drool technique and subjected to sandwich enzyme-linked immunosorbent assay (ELISA) technique for measuring salivary cortisol, salivary tumor necrosis factor-alpha (TNF-alpha), and salivary C-reactive protein (CRP). Independent t-test was used to compare salivary stress biomarker levels between the TGNC and age-matched control groups. Pearson's correlation test was done to correlate perceived stress and salivary stress biomarker levels in the TGNC group. Results Significant difference was seen between the TGNC and control groups with respect to salivary cortisol and salivary TNF-alpha levels, with the levels being higher in the TGNC group. A significant positive correlation was seen between perceived stress and salivary cortisol and between perceived stress and salivary TNF-alpha levels. Conclusion There is a significant correlation between perceived stress and salivary biomarkers of stress among TGNC people in Chennai.

Molecular mechanisms of hormones implicated in migraine and the translational implication for transgender patients.

Migraine is a primary headache disorder recognized by the World Health Organization as one of the most poorly understood and debilitating neurological conditions impacting global disability. Chronic pain disorders are more frequently diagnosed among cisgender women than men, suggesting that female sex hormones could be responsible for mediating chronic pain, including migraine and/or that androgens can be protective. This review discusses the major gonadal hormones, estrogens, progesterone, and testosterone in the context of molecular mechanisms by which they play a role in migraine pathophysiology. In addition, the literature to date describing roles of minor sex hormones including prolactin, luteinizing hormone, follicular stimulating hormone, and gonadotropin releasing hormone in migraine are presented. Because transgender and gender non-conforming (trans*) individuals are an underserved patient population in which gender-affirming sex hormone replacement therapy (HRT) is often medically necessary to align biological sex with gender identity, results from cisgender patient populations are discussed in the context of these major and minor sex hormones on migraine incidence and management in trans* patients.

Examining the Second-Order Factor Structure of the Gender Minority Stress and Resilience Scale.

The gender minority stress and resilience (GMSR) theory and associated measure are widely utilized in research investigating the stress, resilience, and psychological health experiences of gender nonconforming (GNC) individuals. GMSR theory specifies that distal stress and proximal stress experiences adversely affect the psychological health of GNC individuals, while resilience factors help buffer against these deleterious impacts. Moreover, GMSR theory clearly specifies a second-order factor structure such that distal stress experiences are comprised of gender-based victimization, rejection, discrimination, and non-affirmation; proximal stress experiences are comprised of internalized transphobia, negative expectations for the future, and gender identity nondisclosure; and pride and community connectedness constitute resilience factors. However, despite widespread use of the GMSR measure, including validating its use among Italian, Spanish, and adolescent GNC individuals, all research to date has only queried the first-order factor structure of the measure. The present study therefore evaluated the second-order factor structure of the GMSR measure among a sample of 234 GNC college students. Results suggested that the second-order factor structure provided a reasonable fit to the data but did not fit the data exceptionally well. Moreover, results suggested that the first-order factor structure with correlated factors provided a better fit to the data than did the second-order model. Thus, while this study found support for the second-order factor structure, it appears that the first-order structure may be better suited for research use. Secondarily, the GMSR measure appears valid for use among GNC undergraduates. Additional research is needed to further validate the measure's second-order factor structure, and future research should consider trimming redundant items from the GMSR to address known fit issues.

Cisnormative symbolic colonization and transgender and gender nonconforming individuals in the workplace

AbstractCisnormativity assumes individual traits and social roles that correspond to one's gender assigned at birth. Cisnormativity in workplace culture sustains the discrimination of transgender and gender nonconforming (TGNC) individuals. Research in the workplace has yet to evaluate strategies that TGNC employees use to attain personal or social goals. In the present study, the term cisnormative symbolic colonization (CSC) incorporates Habermas' theory of communicative action with symbolic interactionism to demonstrate the permeation of cisnormative dominance in workplace culture through symbolic social practices. Interviews with 15 transgender women and gender nonconforming individuals illustrated four strategies used to mitigate CSC in the workplace: bargaining, validating, symbolic‐aligning, and value‐endorsing. The findings demonstrated the dominant impact of CSC in workplace culture and revealed the employment of trans‐symbolism to integrate trans‐inclusive values in the workplace.

(043) Genital Tucking Practices in Trans Individuals and Anogenital Implications

Abstract Introduction Genital tucking is a practice performed by some transgender women and gender nonconforming individuals to reduce or conceal the contour of the penis and testicles. A variety of genital tucking techniques exist that are used to achieve an individual’s desired appearance. The penis and scrotum may be moved into the perineal area or between the buttocks. Some individuals may additionally reposition the testicles upward into the inguinal canals. Typically, these techniques are reinforced through the use of compression underwear, a specialized supportive undergarment termed a gaff, or adhesive tape. Despite the important role genital tucking plays in gender expression and affirmation, little, if any, research currently exists on the prevalence of tucking practices, the techniques employed, and its effects on anogenital health. Dermatological injury due to genital tucking encompasses a broad range of complications and may be largely avoidable if correct anogenital care and tucking methods are implemented. Objectives The purpose of this study is to present key findings generated from a review of available literature on anogenital dermatological conditions and their association with genital tucking. Data are presented on genital tucking techniques, associated health risks with emphasis on dermatological considerations, as well as suggested physician preventative counseling. Methods PubMed was searched for publications corresponding to the areas of interest (moisture-associated skin damage, medical adhesive-related skin injury, anogenital care techniques). Research from primary publications, consensus statements, and literature reviews were included. Findings were synthesized and applied to the context of genital tucking practices. Results As certain tucking practices expose the anogenital skin to excessive moisture, friction, and adhesive products, dermatological complications are a significant concern. Individuals who tuck may experience medical adhesive-related skin injury which includes mechanical injury (e.g., skin tears, blistering), dermatitis (e.g., hypersensitivity reactions), and other injuries such as maceration and folliculitis. Moreover, genital tucking may predispose individuals to intertriginous dermatitis, an inflammatory skin condition that occurs due to friction and trapped moisture within skin folds. Predisposing risk factors to skin injury that may disproportionately affect transgender individuals who tuck include dehydration, exposure to estrogen hormone therapy, and immunodeficiency. Prevention of adverse outcomes related to tucking should include counseling and regular surveillance of the anogenital area. Patients should be counseled on the selection and use of absorbent, natural fabrics as well as the safest and most effective adhesive tapes. Applying barrier and drying agents before tucking and employing proper adhesive removal techniques should be recommended to further reduce risk of anogenital skin injury and infection. Conclusions This review was the first of our knowledge to discuss the practice of genital tucking, the associated dermatological risk factors, and the critical role physicians play in caring for and counseling patients on tucking practices. Genital tucking preventative counseling and routine examination of the affected area may improve anogenital health of individuals who engage in this practice. Disclosure No.

Experiences of the Transgender and Gender Non-Conforming Community in the University Setting

Background: Transgender and gender non-conforming individuals face daily challenges in higher education due to a lack of gender-inclusive resources. This shortcoming is rooted in the minimal knowledge about what barriers affect this population. Aims: The aims of this study were to identify fitness-related barriers faced by the transgender community in higher education and emphasize the need to develop fitness standards for the transgender population to reduce those barriers in higher education. Methods: Participants completed one or both aspects of this study. A survey was sent to students to gather information about experiences in fitness at a university and how it relates to their gender. Several of the survey respondents then agreed to participate in a series of fitness assessments to evaluate muscular strength, endurance, and body composition. Results: Seventy-nine students responded to the survey (n = 68 cisgender females, n = 5 cisgender males, n = 2, non-binary, n = 4 transgender males). Proportionally, more transgender and non-binary people (84%) felt that gendered fitness standards did not apply to them when compared to cisgender people (31%). Further, more transgender and non-binary respondents (50%) reported that they were not comfortable working out in all areas of their gym when compared to the cisgender respondents (37%). Twenty-eight students participated in the fitness assessment. The BOD POD assessment of body composition utilizes gender to calculate body fat percentage. When using both male and female classifications, results were not different, meaning the estimated body fat percentage was calculated as the same despite a different gender in the calculation. Conclusions: This study begins to identify fitness-related barriers faced by the transgender community in higher education. Additionally, these small-scale results provide a starting point for future research on developing gender-neutral fitness standards.