Preferred Pronouns Research Articles

Transgender men's experiences of fertility preservation: a qualitative study.

How do transgender men experience fertility preservation (FP) by cryopreservation of oocytes? The procedures required prior to oocyte cryopreservation, such as hormonal ovarian stimulation and transvaginal ultrasound (TVS), have a negative impact on gender dysphoria as they are closely linked to the men's female assigned sex at birth, which is incompatible with their current status. Transgender persons often have high dissatisfaction with assigned sex-specific body features, such as the genital organs and androgen/oestrogen-responsive features. Thus, undergoing FP that requires genital-specific examinations, aimed at obtaining oocytes to cryopreserve, could be distressing. As no previous studies have investigated transgender men's experiences of FP involving cryopreservation of oocytes, little is known about their experience of the procedures. This is a prospective study among adult transgender men referred for FP between March 2014 and December 2015. Individual in-depth qualitative interviews were conducted shortly after FP treatment. The interviews lasted between 62 and 111 min (mean 81 min) and were digitally recorded and transcribed verbatim. Participants were recruited on their first visit to the assisted reproduction clinic for reproductive counseling. There were 15 men, scheduled for FP, who chose to participate in the study (age 19-35); none had given birth and eight had a partner. Data were analyzed by thematic content analysis. The analysis resulted in three main categories: the journey to FP, reactions to the FP proceedings and strategies for coping. The referral for FP was an important part of the assessment and diagnosis and sometimes lined with frustrating waits and doubts. The reaction to the FP proceedings revealed that the genital examinations and the physical changes associated with discontinuation of testosterone or hormonal stimulation treatment triggered gender incongruence and dysphoria. However, for some, the negative expectations were not met. The participants used several coping strategies in order to manage the procedure, such as focusing on their reasons for undergoing FP, reaching out to friends and family for support and the cognitive approaches of not hating their body or using non-gendered names for their body parts. The results demonstrate the importance of contextual sensitivity during FP procedures. The authors have strived to be reflective about their pre-understanding of the phenomenon. The majority of the participants resided in large urban areas; it is possible that transgender men living in rural areas have different experiences. As the results are based on qualitative data from 15 transgender men, the results cannot readily be generalized to larger populations. However, the results are suggested to be applicable to other transgender men who want to undergo FP by cryopreservation of oocytes. The results show that transgender men's experience of FP places may elicit gender incongruence and gender dysphoria. However, health care personnel can alleviate distress by using a gender-neutral language and the preferred pronoun. Also, reassuringly, the men also have coping strategies of how to handle the situation. This knowledge is important to ensure adequate professional support for patients with gender dysphoria during FP. Swedish Society of Medicine, Stockholm County Council and Karolinska Institutet (to K.A.R.-W.). N/A.

Transgender Women in Clinical Trials of Pre-Exposure Prophylaxis

:Lessons were learned with trans women who participated (as volunteers and investigators) in trials of HIV pre-exposure prophylaxis (PrEP). Trans women are not men. Compared with men who have sex with men, trans women trial participants were more likely to be involved with transactional sex, had more sexual partners, and were less likely to have PrEP medications detected in blood. Trans women define themselves differently in different cultures. One best practice is to ask at least 2 gender questions: sex assigned at birth and current gender. More information is needed to fully situate PrEP efficacy for trans women, including analysis of drug–drug interactions between PrEP medications and feminizing hormones and PrEP drug penetration into neovaginal tissues. Including trans women in studies is helpful only if their participation is specifically reported, as could occur in a table of baseline characteristics of the enrolled cohort. Gender-affirming care is important to foster appropriate uptake and use of PrEP. Such care includes use of preferred pronouns and names, safety to use the bathroom of choice, and access to gender-affirming hormone therapy and surgery. The consistent finding that PrEP works when taken across diverse populations having diverse practices related to gender, sexual intercourse, and hormone use provides a basis for offering PrEP to people at substantial risk of acquiring HIV although some subgroups may not have been fully represented in trials. Nonetheless, specific PrEP implementation science for trans women (and men) is essential to develop best practices for PrEP delivery and use.

Pharmacotherapy Considerations in the Management ofTransgender Patients: A Brief Review.

Transgender and transsexual individuals have unique health care needs and risks compared with the population at large. It is estimated that 1 in 100,000 individuals in the United States is a transgender woman and 1 in 400,000 is a transgender man, although these estimates of prevalence are likely conservative. Transgender individuals are at an increased risk of tobacco, alcohol, and substance abuse; they have an increased lifetime suicide attempt risk; and they are more likely to experience significant stressors in their lives. Transgender patients may elect to transition their appearance to the gender with which they identify. Hormone treatment (and possibly sex reassignment surgery) is a significant part of this transition, and pharmacists must understand the pharmacotherapeutic principles involved so they can better recommend therapeutic agents, provide dosing recommendations, and anticipate and manage adverse effects. It is critical to be culturally sensitive when providing care for transgender patients including using their preferred gender identity, preferred names, and preferred pronouns. It is also essential to be able to identify transgender and transsexual patients correctly within electronic health records to ensure that appropriate care and monitoring are provided. For pharmacists, this means they should know the biologic sex for performing calculations such as creatinine clearance and to prevent teratogenic agents from reaching a transgender or transsexual man who could be pregnant or is capable of becoming pregnant. Promoting knowledge of transgender health issues will enable pharmacists to provide better, more holistic care to their transgender patients.

Lessons in Drag: An Interview with LaWhore Vagistan

Lessons in Drag:An Interview with LaWhore Vagistan Kareem Khubchandani (bio) I recently sat down to high tea with drag artist LaWhore Vagistan to discuss performance and pedagogy. Over the course of an hour, we touched on gender identity in the classroom, race and representation in performance, and sexually active Disney characters. Below is the transcript from our conversation. Kareem Khubchandani: Welcome LaWhore, it’s a pleasure to be here with you talking about your experiences in the university classroom. You look great by the way. LaWhore Vagistan: [Sly smile] When do I not? It’s great to be here with you too, it’s been a while since we were in a room together. [Winks] So tell me, dear, what are we doing today? KK: On several occasions you’ve guest-lectured in my classes at Northwestern University and the University of Texas at Austin, in performance and dance studies classes, as well as gender and sexuality lectures, and even comparative literature seminars. I’m very interested to learn about your experiences in those environments. I’m curious to know what it’s like for a South Asian drag queen teaching and performing in the US academy. LV: Darling, it’s always a pleasure to take over your classes, even if it does mean waking up at seven in the morning to beat my face and look good for your god-awful morning sessions. You know drag queens live on a different clock. KK: Yes, you know I appreciate it. So, generally, what happens when you substitute teach for me? LV: Well, we know you’re terrible at giving directions, so I’m always running late. But when I do get there, I apologize for your absence and let them know you’ve had another herpes outbreak that’s keeping you at home— KK: LaWhore!!!! LV: [Ignoring him] —and that I will be the head of the class instead. [Laughs loudly at her own joke] I usually have to do a quick costume change out of my aunty drag: remove the cardigan from over my sari, take off the kitten heels and put on my teaching pumps. You can’t teach in less than six inches, but then again you can’t do a lot of things with less than six inches. [Cackles again] I introduce myself, and then I have them tell me their— KK: [Interrupting] How do you introduce yourself to them? What kind of information do you share with them? LV: Well, I start by writing my name on the board and explaining its very elaborate origins. [Stands up and pretends she is in front of a classroom] My name is LaWhore Vagistan, my preferred pronouns are “she” or “aunty.” I chose “LaWhore” because my family traces its origins to Pakistan: Lahore is an important city in Pakistan, and, well, I’m a bit of a whore. And Vagistan because I [End Page 285] see the subcontinent as one, big, beautiful Vag . . . istan. Close your eyes and visualize it: India is the uterus-vagina, Pakistan and Bangladesh are the ovaries, Afghanistan, Nepal, Burma, and Bhutan are the fallopian tubes, and Sri Lanka is a little floating labia. Click for larger view View full resolution Fig. 1. LaWhore Vagistan performing “A Whole New World” at the Jai Ho! party in Chicago. (Image courtesy of Michael Elyea.) KK: That’s quite an encompassing vision of the subcontinent. What about the Maldives? LV: [Breaking character] Girl, the Maldives are sinking into the ocean, so who cares? By putting it altogether as “Vagistan” I’m trying to suture together the subcontinent after the British, French, and Dutch committed their acts of female genital mutilation. I’m a subaltern drag queen, and not only can this queen speak, she’s actually quite loud.1 [Gestures to her neon polka-dot sari] I assure the students that I am an educated queen. [Returning to her teacher persona] I received my PhD in drag from the Lahore University of New Drag (LUND).2 I’m currently adjuncting at the Drag Institute of Calcutta—now Kolkata (DICK), in the Department of Lip-sync and Dance. My real aspiration...

Pronoun Discomfort: A Situational Analysis

Pronoun Discomfort:A Situational Analysis Claire Harlan Orsi (bio) “We suffer from the condition of being addressable.” --Judith Butler, as quoted in Citizen, by Claudia Rankine SITUATION: About two years go, I make two general announcements. 1) I am getting an elective surgery to remove my breasts. 2) I have decided I would like to be addressed with the pronoun “they.” These two announcements are part of a larger project, a project of being honest with the world about how I feel. For a long time I have known that when people say “she,” they are not describing the person who is me. I considered the alternatives. Gender is a two-party system, and I didn’t feel like the other platform fit me, either, though it was closer than the one I’d been born into. I picked “they” because I’d heard people were using it, mostly people a little younger than I. It seemed like the best compromise. I might say it felt right, but it is more accurate to say that it did not feel at all. “They” seemed a blank space, a cipher into which I could store myself. I make my announcement on Facebook. SITUATION: “It seems impersonal,” my mother says, when I first make the request. But she adjusts, heroically. For a year she corrects herself every time she says “she.” She says it’s one of the hardest changes she’s had to make. I feel guilty, always guilty. Who am I to make my mother, who has been nothing but supportive—emotionally and, let’s face it, financially—contort her language? Now she’s pretty good at it. But I wonder how she talks about me to her friends, to her mother, to people who don’t know me. In some ways this is not my problem, because I am not the one who speaks about myself. I don’t suffer the consequences, and yet I have brought them into being. SITUATION: A literary magazine asks for a bio. Usually I can avoid the problem of pronouns by making the bio only one sentence, but this journal wants a longer one. I’d rather forget neutrality altogether, go back to “she,” blend into the page. But I’ve yoked myself to this albatross and there’s no going back. I write the bio with a bracketed explanation that the pronoun is there intentionally, in case they think it’s a mistake. The brackets are meant to signal that the text within them should not appear in the bio, but it ends up [End Page 139] in the journal anyway when my copies come in the mail. I am embarrassed by this—at least they could have hidden my request! And I am embarrassed by the pronoun, which, when I read it again in the bio, looks wrong. Is there a difference between looking and feeling, because being a woman feels wrong, but this pronoun looks wrong, so what am I supposed to do? SITUATION: Facebook, in addition to a range of 51 gender options, allows users to change their preferred pronoun to “they.” I’ve tried to do this before, messing with my profile’s code, but I’ve never gotten it to stick. I shouldn’t need one of the major structures of the techno world order to validate my gender, but I’m surprised by how good it feels. “Capitalism knows me too well,” I write on my Facebook wall, because there is nothing good that doesn’t also make me feel guilty. SITUATION: A friend introduces me at a campus reading. For months I have been agonizing about this introduction; I know it will involve someone talking about me at some length in the third person, a situation I have grown to dread. (Fortunately, I am not a famous writer—I get introduced maybe once a year.) I remind my friend about the pronoun, and she is gracious. My friend is visually impaired, and regularly struggles to get her own accommodations met. She sees parallels between our situations, but I’m not sure if I do. Because I have chosen this, and she has not. During her introduction...

Shifting Students’ Imaginings of Disability

Shifting Students’ Imaginings of Disability Kathryn Linn Geurts (bio) and Jessica Hansen (bio) The artwork in this essay was produced by members of a 2013 undergraduate course, Intergroup Dialogue on Disability, in which Kathryn Linn Geurts was an instructor and Jessica Hansen was a student. These visual responses, such as “Freakshow” (figure 1), reflect reactions to several readings and showcase the critical learning objectives and goals of the course. Inherently interdisciplinary, the class was offered through the Conflict Studies program and was cross-listed with Social Justice, Anthropology, and Public Health Sciences at Hamline University, in Saint Paul, Minnesota. Hamline is a private institution with a small but growing commuter population; it attracts students who grew up primarily in the Midwest, and is somewhat selective. With no Disability Studies program at Hamline, this mid-level course met Conflict Studies program requirements and also fulfilled “Cultural Breadth” requirements all students must meet to earn an undergraduate degree. The aim was to teach students to communicate through dialog across social, cultural, and power differences. Through sustained and meaningful cross-group contact and relations, the course encourages students to explore both conflict and common ground, particularly around issues related to ableism. It challenges students to examine their assumptions and their political and social understandings of disability as they engage in reflective conversations and inquiry. Click for larger view View full resolution Figure 1. In honor of Eli Clare’s chapter on the history of “freaks,” by an anonymous student. Early in the semester, Jessica Hansen created this assemblage and titled it “Power and Control” (figure 2). Her explanation of her work’s origin and meanings reflects the pedagogical approach of the class: This collage was a fairly spontaneous reaction to the massive amount of new concepts and questions that arose from our course discussions and readings (especially Eli Clare’s Exile and Pride). I sat down with a huge pile of magazines, and cut out every word or image which connected with the things we had been learning. I took note of the framing of people with disabilities as superheroes and success stories in the media, and remembered our discussions of how framing disability and difference as something to “overcome” takes society off the hook for making our world livable for everyone, regardless of differences in ability. I feel that I came away with a condensed experience of reading popular magazines—highlighting how many messages we receive (consciously or not) from these forms of media. After experiencing this course, I will always think twice about popular narratives of ability and difference. [End Page 183] To ensure that the group of students in the class would have diverse social identities, we required instructor permission to register. Sixteen individuals enrolled in the course. When people introduced themselves in the first class meeting, one individual requested that everyone note their preferred pronouns as well as their name. A few students displayed surprise and mild confusion at the request, which provided a hint of the level of students’ awareness (or lack thereof) of identity issues. Some individuals began the class not knowing the meaning of terms such as cisgender, transgender, or intersectionality. In addition to various prose writing assignments, we required poetry, skits, drawings, collages, paintings, and a video. We believed that this would democratize the classroom, allowing different skills and talents to emerge and enabling the group to see each individual’s strengths. Academic writing, we have found, is not always the best means for allowing our college students to demonstrate how their understandings have shifted or moved as a result of exposure to learning materials. During the tenth week of class students produced “testimonials” by explaining how they came to be the person they are today by taking into account their dis/ability identity along with one other identity (race, gender, religion, sexual orientation, social class, etc.). Students made private YouTube videos of their testimonials and we viewed them one after another during two separate three-hour class sessions. These powerful accounts represented a range of experiences. Not only did the group embody gender, sexual, racial, ethnic, and economic diversity, but dis/abilities also ran the gamut. The class included individuals and families dealing with...

The Development of NP Selection in School-Age Children: Reference and Spanish Subject Pronouns

To investigate the development of the NP selection process, preferences for overt or null Spanish subject pronouns were elicited from 139 children (5;09 to 15;08) and 30 adults in Mexico. Participants were told stories in which consecutive grammatical subjects shared the same referent (same-reference), or did not (switch-reference). In the stories, overt pronouns in same-reference were redundant, and null pronouns in switch-reference rendered reference ambiguous. Adult participants preferred null pronouns in same-reference contexts and overt pronouns in switch-reference contexts, demonstrating an avoidance of redundancy and ambiguity. Children demonstrated a tolerance for redundancy well into adolescence. A tolerance for ambiguous reference declined at age eight/nine and then progressively decreased with age. We interpret the tolerance for ambiguity as an indication that children have difficulty with perspective taking when faced with complex structures and tasks.