Transgender Persons Research Articles

Perceptions of Transgender and Nonbinary Persons Toward Breast and Cervical Cancer Development, Screening, and Potential Impact on Gender-Affirming Hormone Therapy.

Approximately 1.6% of adult Americans identify as transgender (TG) or nonbinary (NB) and many take gender-affirming hormone therapy (GAHT). Little data exist to inform breast and cervical cancer risks, gender-specific screening guidelines, and inclusive cancer treatment algorithms that consider GAHT. We aimed to assess TGNB persons' perceptions on breast and cervical cancer development, screening knowledge and practices, and attitude toward GAHT in the setting of a hormone receptor-positive breast cancer diagnosis. This single-institution survey study was conducted through an LGBTQ+ focused clinic from 2021 to 2022. Noncisgender patients age ≥ 18 years who were English speaking were eligible to participate. A 5-point Likert scale was used to assess concern of developing breast (all participants) and cervical cancer (those assigned female sex at birth). Demographic and quantitative variables were examined in comparison with responses via chi-squared tests. Eighty-six participants completed the survey: 43% TG men, 24% TG women, and 20% NB persons. Most (84.9%) were age < 40 years, and 86% were non-Hispanic White. The majority were unaware of breast (77%) or cervical (60%) cancer screening recommendations for their sex assigned at birth or their gender. Approximately 35% reported concern regarding breast cancer development and of those age > 40 years; only 50% had undergone screening mammography. Of those assigned female sex at birth with an intact cervix, 47% were concerned about cervical cancer development and 46.6% had a Papanicolaou smear within the past 5 years. Nearly all (87.2%) were on GAHT, and 35.1% reported they would not consider stopping GAHT if diagnosed with a hormone receptor-positive breast cancer. The findings support the need for patient and provider education on screening options and large prospective cohort data to elucidate optimal gender-specific screening guidelines and treatment algorithms.

Ethical Need for a Fertility Decision-Aid for Transgender Adults of Reproductive Age

Ethical Need for a Fertility Decision-Aid for Transgender Adults of Reproductive Age

Mediation of transgender impression management between transgender privacy paradox and Trans Facebook Persona: A trans perspective

This study builds and evaluates a transgender privacy paradox impression management (TPPIM)' model to examine the influence of social networking site impression management (IM) on transgender users' sustained SNS involvement, contributing a new view to the field of information systems research. The study finds no direct relationship between privacy paradox and transgender individuals' online social media persona. However, transgender individuals, to enjoy an uninterrupted social media presence and protect their privacies, employ various impression management strategies on social media, which fully mediate the relationship between the privacy paradox and their social media personas. Transgender individuals use their social media presence to find resources required for their day-to-day survival, indicating that an active social media presence is not optional but mandatory. Users value privacy, however, they consciously or unconsciously implement privacy averseness for an active social media presence. The authors use a mixed methodology where qualitative analysis findings informed hypotheses and model development of a structural model that used 299 useable responses and PLS/SEM to test and confirm that trans impression management mediates the relationship between the trans privacy paradox and transgender persons' Facebook behavior. This study enhances model complexity relative to earlier work, mediating the investigation's hypothesized behavioral correlations. Complementing current SNS research, it highlights the complexity of social networking behavior, the suitability of impression management theory to describe dynamically evolving social structures, and how social capital drives impression management.

Episode 86: Inside the Monitor – Pathways to Diversity

Central Line Podcast Series| February 2023 Episode 86: Inside the Monitor – Pathways to Diversity Lalitha Sundararaman, MBBS, MD; Lalitha Sundararaman, MBBS, MD Search for other works by this author on: This Site PubMed Google Scholar Adam Striker, MD, FASA Adam Striker, MD, FASA Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor February 2023, Vol. 87, 1. https://doi.org/10.1097/01.ASM.0000919620.39295.62 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation Lalitha Sundararaman, Adam Striker; Episode 86: Inside the Monitor – Pathways to Diversity. ASA Monitor 2023; 87:1 doi: https://doi.org/10.1097/01.ASM.0000919620.39295.62 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: gender disparities, languages, touch sensation, transgender persons Dr. Lalitha Sundararaman, guest editor of the February ASA Monitor, speaks with Dr. Adam Striker about patient and provider diversity. The wide-ranging discussion touches on what health care inequities look like, how to practice cultural humility, language discordance, caring for transgender patients, gender disparities, and more. Recorded January 2023. You do not currently have access to this content.

Complications After Orchiectomy and Vaginoplasty for Gender Affirmation: An Analysis of Concurrent Versus Separate Procedures Using a National Database.

Gender-affirming orchiectomy may be performed in isolation, as a bridge to vaginoplasty, or concurrently with vaginoplasty for transgender and nonbinary persons, although there is a paucity of data on immediate postoperative outcomes on the various procedural approaches. The aim of the study is to compare 30-day surgical outcomes after gender-affirming orchiectomy and vaginoplasty as separate and isolated procedures. This was a retrospective cohort study of patients in the American College of Surgeons National Surgical Quality Improvement Program database to compare surgical outcomes of orchiectomy alone and vaginoplasty alone to concurrent orchiectomy with vaginoplasty using bivariate and adjusted multivariable regression statistics. Concurrent orchiectomy and vaginoplasty were associated with greater 30-day surgical complications compared with orchiectomy alone (15.4% vs 2.9%, P < 0.01) and similar odds of 30-day surgical complications compared with vaginoplasty alone (15.4% vs 11.1%, P = 0.15). On multivariable logistic regression analysis, compared with orchiectomy alone, concurrent orchiectomy and vaginoplasty were associated with higher increased odds of 30-day surgical complications (adjusted odds ratio, 6.48; 95% confidence interval, 2.83-14.86) as well as vaginoplasty alone (adjusted odds ratio 4.30; 95% confidence interval, 1.85-10.00). This study highlights the perioperative outcomes for isolated versus concurrent gender-affirming orchiectomy and vaginoplasty, demonstrating lower morbidity for orchiectomy alone and similar morbidity for vaginoplasty alone when compared with concurrent procedures. These data will aid health care providers in preoperative counseling and surgical planning for gender-affirming genital surgery, particularly for patients considering concurrent versus staged orchiectomy and vaginoplasty.

Caring for the Transgender Patient: It Is More Than Using the Right Pronouns!

Features| February 2023 Caring for the Transgender Patient: It Is More Than Using the Right Pronouns! Kara Segna, MD; Kara Segna, MD Search for other works by this author on: This Site PubMed Google Scholar Lalitha Sundararaman, MBBS, MD Lalitha Sundararaman, MBBS, MD Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor February 2023, Vol. 87, 19–20. https://doi.org/10.1097/01.ASM.0000919536.69245.89 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation Kara Segna, Lalitha Sundararaman; Caring for the Transgender Patient: It Is More Than Using the Right Pronouns!. ASA Monitor 2023; 87:19–20 doi: https://doi.org/10.1097/01.ASM.0000919536.69245.89 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: transgender persons Trans individuals often face stigma and discrimination in their daily lives. Ideally, the health care setting should be a safe haven wherein they can be who they are – but is it always so? Unfortunately, the answer is still not a clear and resounding yes! Why are transgender patients stigmatized by society? The answer resides in how people are socialized to understand and enact gender. According to the Harvard Business Review, gendered behavior is learned. From a young age, boys and girls are encouraged to display stereotypically gendered behaviors and discouraged from displaying non-normative ones. My (KS) kindergartener was amazed that her male classmate's favorite color was pink. There is no biological predilection toward color, yet there is a designation as to what is socially acceptable. Moreover, children pick up on subtle signals from their parents and others who enforce gender stereotypes. For example, when donning female garments during dress... You do not currently have access to this content.

Health care for trans people: a bioethical reflection

Health care for trans people has not been among the priorities of Bioethics, so that in most of the manuals of this discipline there is no reference to this issue, or it is covered in a rather simple or measured way. However, it is necessary to note that in the last decade the bioethical debate, on gender issues in general and on transsexualism in particular, has increased significantly. This work seeks to offer the transsexual person, the health professional or the student on the trans topic tools to articulate their particular bioethical reflection. It has two clearly differentiated parts. In the first, the aspects that are considered necessary to consider when assessing the ethics of a gender change intervention are presented. In the second part, a reflection is offered on the lines of argument that support the different bioethical currents..

Internalized transphobia predicts worse longitudinal trend of body uneasiness in transgender persons treated with gender affirming hormone therapy: a 1-year follow-up study.

Given the relationship between interiorized stigma and body image, it could be hypothesized that high levels of internalized transphobia (IT) might predict higher levels of body uneasiness in subjects with gender dysphoria (GD) and worse improvement of body image after gender affirming hormone therapy (GAHT). We sought to evaluate the relationship between IT and body uneasiness in subjects with GD and the role of IT in moderating the improvement of body image after GAHT. In total, 200 individuals with GD performed the baseline assessment; 99 were re-evaluated 12months after starting GAHT. At baseline participants were evaluated through a face-to-face interview and filled self-administered questionnaires to evaluate GD (Utrecht Gender Dysphoria Scale [UGDS]), IT attitudes (Attitudes Toward Transgendered Individuals [ATTI] Scale), body uneasiness (Body Uneasiness Test, part A [BUT-A]), and general psychopathology (Symptom Checklist 90-Revised [SCL 90-R]). The same questionnaires, except ATTI, were readministered at follow-ups. Outcomes were based on measures of the associations between IT and baseline characteristics of the sample, the longitudinal trends of GD, body uneasiness, and general psychopathology; and IT as a moderator of the longitudinal trend of body uneasiness. At baseline, IT correlated with lower level of education, higher GD, and more severe body uneasiness. Longitudinal analyses showed significant improvements in GD, body uneasiness, and general psychopathology during GAHT. Moderation analysis confirmed that participants with more transphobic attitudes showed less improvement after GAHT with regard to body uneasiness (bTime*ATTI = -.002, P = .040). The Johnson-Neyman technique revealed that no significant improvement in body uneasiness was found for participants with ATTI scores lower than 71.14. The presence of IT should be investigated in subjects with GD who require gender affirming treatments to provide specific interventions aimed at targeting this dimension. Strengths of this study include the mixed cross-sectional and longitudinal design and the dimensional evaluation of the investigated constructs. Limitations include the small sample size and the limited follow-up. Furthermore, the effects of gender affirming surgery were not evaluated. The association of IT with both baseline body uneasinessand the longitudinal course of this dimension highlighted the clinical significance of body uneasiness and the importance of making continuous efforts to improve education and information to fight societal stigmas.

Obstacles in the access to public health services by transvestites and transgender persons: an integrative review

Objective: to describe obstacles to the access to health services of the transvestite and transgender population. Methods: integrative review, conducted from July to August 2022, in the following databases: LILACS, MEDLINE, Web of Science and SCOPUS. Results: 472 primary studies were found; however, at the end of the analysis process, 14 productions were included in the study. Obstacles to access to health were observed, such as the invisibility of health specificities, the lack of information and preparation of professionals, the susceptibility, which appears in the juvenile stage, and the resistance to care for sexually transmitted infections, highlighting the need to invest in the production of policies that affirm the right to health for this segment of the population. Conclusion: there was a lack of studies on the access of transvestites and transgenders to health services. These difficulties are associated with conservatism, heteronormativity, lack of implementation and regulation of public policies for them. Contributions to practice: this article presents information about access to health care for the transvestite and transgender population, facilitating the view of the specific needs of this population.

Tales of Triumph: An Analysis of Famous Transgender Personalities from India

Purpose: The journey of travelling for authentication of one’s own sexual or gender identity is never a rose paved path before transgender persons, as their journey is beyond or away from established ideologies proposed about gender. Being born with a particular sexual identity but later realizing that the birth sex is not the actual essence of own self is a serious traumatic phase in any transgender life. It is never a pleasant reality for any of the believer of heterosexuality. They can never accept the existence of a varied gender or sexual category apart from one assigned at the time of birth. Thus, transgenders are forced to hide or suppress own identity to get acceptance in a gender binary led society like India. But there are many who were able to triumph in spite of sufferings from the shackles of gender inequality. Their tales are of courage, willpower, and self-reliance held firmly even before whips of harsh gender otherness. Thus, the article titled “Tales of Triumph: An Analysis of Famous Transgender Personalities from India” is an earnest attempt to draw mass attention to such excellent personalities from a suppressed gender group. Design: The article is prepared by collecting information from secondary sources such as peer-reviewed journals and National and International Publications. Internet sources, and research sources like Google Scholar, Research Gate, SSRN, Elsevier, Academia, and Shodhganga are used for identifying the research gap. To highlight the key aspects of the research ABCD analysis is used. Data is acquired from research journals, doctoral theses, scholarly articles, and websites to carry out the research that has been proposed. Concentrating on the keywords Transgender, Transgender in India, Famous Transgender, Excellent Trans Person, Gender Fluidity, Gender Binaries, of the chosen topic, the methodology used depends mostly on collecting, analyzing, and interpreting previous knowledge. The textual analysis and comparative method will be used in the methodology. There will be a close reading of the select works of Transgender writers followed by discussions on related issues. Writing research papers and participating in conferences on the subject are also aimed at. While conducting the analyses of the study, APA Manual has been followed to adhere to its requirements. Findings: It has been found out that limited study is available regarding great transgender personalities from India, thus a paper discussing the triumph or victories of such a repressed gender minority in India is very essential for educating public about their achievements. Originality: The proposed study focuses primarily on transgender community in India and their priceless achievements in various realms of human knowledge, thus attempting to create awareness about transgender persons and their victories through various time frames. An awareness created about such a category is highly essential for a heterosexual society to reform their perspectives about third gender in India. Paper Type: Research Article

Liver function in transgender persons: Challenges in the COVID-19 era.

Transgender persons constitute a non-negligible percentage of the general population. Physical gender-transitioning in trans persons is mainly achieved with hormonal cross-sex therapy and sex reassignment surgeries that aim to align bodily appearance with gender identity. Hormonal treatment acts via suppressing the secretion of the endogenous sex hormones and replacing them with the hormones of the desired sex. The administration of testosterone is the typical masculinizing treatment in trans men, whilst trans women are routinely treated with estradiol agents in combination with anti-androgens or gonadotrophin-releasing hormone agonists if testes are present. Exogenous androgenic steroids, estradiol agents, and anti-androgens have been implicated in a series of hepatotoxic effects. Thus, liver integrity is a major concern with the long-term administration of cross-sex therapy. Hepatic tissue is susceptible to coronavirus disease 19 (COVID-19) through various pathophysiological mechanisms. Special consideration should be paid to minimize the risk of hepatic damage from the potential cumulative effect of COVID-19 and gender-affirming treatment in transgender patients. Appropriate care is significant, with continuous laboratory monitoring, clinical observation and, if needed, specific treatment, especially in severe cases of infection and in persons with additional liver pathologies. The pandemic can be an opportunity to provide equal access to care for all and increase the resilience of the transgender population.

Emotional Distress, Suicidal Behavior, and Help-Seeking Among Transgender and Gender Diverse People in Israel.

The aim of this study was to evaluate emotional distress, suicidality, and help-seeking among Israeli transgender and gender diverse (TGD) persons. TGD (n=139) and cisgender (n=275) participants reported on suicidal thoughts and behavior (STB), help-seeking behavior, and emotional distress (General Health Questionnaire [GHQ-12]) in an online survey. GHQ-12 and STB were significantly higher among TGD compared with cisgender participants. More TGD participants reported seeking help. TGD persons reported high levels of emotional distress and STB, suggesting that their needs for mental health care are not met by the Israeli health services.

Stigma and Barriers in Health Care Among a Sample of Transgender and Gender-Diverse Active Duty Service Members.

Transgender and/or gender-diverse (TGD) persons are vulnerable to stigma and health care inequities; however, data are particularly limited among TGD active duty military service members despite ongoing changes to service policies. TGD-related stressors may impede access to and utilization of health care due to fear of potential discrimination and distress, thereby adversely impacting military readiness. We examined stigma and barriers in health care and associations with physical and mental health in an online sample of 177 active duty service members who self-identified as TGD. To assess associations between stigma and barriers in health care with mental and physical health, linear regressions were conducted adjusting for age, gender identity, race, and rank. Over half (65%) of the participants reported at least 1 instance of stigma and/or barrier in health care. Stigma and barriers to health care were significantly associated with greater self-reported depressive symptoms (β=0.20, P =0.03), anxiety (β=0.21, P =0.03), stress (β=0.30, P =0.001), and poorer overall mental health (β=-0.23, P =0.007), after adjusting for covariates. Nearly one-quarter of participants had not disclosed their gender identity to their primary care clinician. Findings suggested that stigma and barriers to affirming health care were prevalent among active duty service members identifying as TGD, specifically, difficulty accessing gender-affirming care and negative assumptions from clinicians. These experiences may adversely affect mental health and impede the quality of health care received by a population already vulnerable to health inequities. Given recent changes to military policy, efforts may be warranted to improve access to timely, affirming care and clinician training.

Support Saves Lives: Exploring the Relationship Between Age of Transition, Family Support, and Retrospective K-12 Educational Experiences in Transgender Suicidality.

The purpose of this study is to test the association between protective and risk factors, including age of transition, K-12 experiences, and family support, on suicidality among transgender and gender nonbinary/gender queer (TNB) adults. Our analysis relies on data from the 2015 United States Transgender Survey. We used separate logistic regression models to predict lifetime suicidal ideation and suicide attempt among 19,121 survey respondents. Negative K-12 experiences significantly predict higher likelihood of both suicidal ideation and suicide attempt for transgender people, regardless of age of transition, and after controlling for a host of covariates. The age a transgender person begins to live full time in a gender different from the one assigned at birth has little association with suicidality. However, supportive families act as a buffer against suicidal ideation, and unsupportive families significantly predict higher likelihood of suicide attempt for transgender people when controlling for numerous covariates. Our findings underscore the importance of supportive environments for TNB adolescents. Interventions that strengthen interpersonal relationships and local environments will reduce suicidality among TNB youth. Importantly, recent anti-trans legislation may interfere with the ability of teachers and families to provide needed supports and will likely have deleterious effects on the mental health of TNB individuals.

Mpox vaccination willingness, determinants, and communication needs in gay, bisexual, and other men who have sex with men, in the context of limited vaccine availability in the Netherlands (Dutch Mpox-survey).

In the 2022 multicountry mpox (formerly named monkeypox) outbreak, several countries offered primary preventive vaccination (PPV) to people at higher risk for infection. We study vaccine acceptance and its determinants, to target and tailor public health (communication-) strategies in the context of limited vaccine supply in the Netherlands. Online survey in a convenience sample of gay, bisexual and other men who have sex with men, including transgender persons (22/07-05/09/2022, the Netherlands). We assessed determinants for being (un)willing to accept vaccination. We used multivariable multinominal regression and logistic regression analyses, calculating adjusted odds ratios (aOR) and 95 percent confidence-intervals. An open question asked for campaigning and procedural recommendations. Of respondents, 81.5% (n = 1,512/1,856) were willing to accept vaccination; this was 85.2% (799/938) in vaccination-eligible people and 77.7% (713/918) in those non-eligible. Determinants for non-acceptance included: urbanization (rural: aOR:2.2;1.2-3.7; low-urban: aOR:2.4;1.4-3.9; vs. high-urban), not knowing mpox-vaccinated persons (aOR:2.4;1.6-3.4), and lack of connection to gay/queer-community (aOR:2.0;1.5-2.7). Beliefs associated with acceptance were: perception of higher risk/severity of mpox, higher protection motivation, positive outcome expectations post vaccination, and perceived positive social norms regarding vaccination. Respondents recommended better accessible communication, delivered regularly and stigma-free, with facts on mpox, vaccination and procedures, and other preventive options. Also, they recommended, "vaccine provision also at non-clinic settings, discrete/anonymous options, self-registration" to be vaccinated and other inclusive vaccine-offers (e.g., also accessible to people not in existing patient-registries). In the public health response to the mpox outbreak, key is a broad and equitable access to information, and to low-threshold vaccination options for those at highest risk. Communication should be uniform and transparent and tailored to beliefs, and include other preventive options. Mpox vaccine willingness was high. Public health efforts may be strengthened in less urbanized areas and reach out to those who lack relevant (community) social network influences.

Uptake and impact of COVID-19 vaccination among HIV key populations: a cohort study from Tamil Nadu, India.

Human Immunodeficiency Virus (HIV) Key Populations (KPs) include Female Sex Workers (FSWs), men who have sex with men (MSM), transgender (TG), and transsexual (TS) persons. This study assessed coronavirus disease 2019 (COVID-19) vaccine uptake among KPs for HIV in India, adverse events following immunization (AEFI), and breakthrough infections among the vaccinated. This retrospective cohort study was conducted among 421 KPs enrolled in 41 Targeted Intervention (TI) clusters in 31 districts of the Tamil Nadu State Acquired Immunodeficiency Syndrome (AIDS) Control Society (TANSACS), India, from June to September 2022. A semi-structured, bilingual (English and Tamil), interviewer-administered questionnaire was used to collect data on socio-demographic characteristics, vaccination status, AEFIs, and breakthrough infections among the KPs under the TIs. Among the KPs, 45.4% were FSWs, 37.1% were MSM, 16.2% were TG, and 1.4% were TS persons. Among them, 4.3% had HIV, and 2.9% had syphilis or other sexually transmitted infections (STIs). The COVID-19 vaccine uptake rate was 96%. Among the KPs, TG/TS persons had the highest vaccine uptake (98.6%), followed by FSWs (96.3%) and MSM (94.2%). AEFIs were reported by 85.4% of the participants. HIV positive status was significantly associated with the incidence of AEFI. The breakthrough infection rate was 5.4% among the vaccinated participants. The COVID-19 vaccine uptake among HIV KPs was high in Tamil Nadu. AEFIs and breakthrough infections among COVID-19 vaccinated HIV KPs may be low, with mild AEFIs.

Transgender Persons and Affirmative Action: Answering the Why and the How

Justice Radhakrishnan began his judgement in the landmark Indian case of NALSA v Union of India, with an observation on the society’s moral failure being exhibited by its exclusion of the transgender community and its inability to understand their pain. The division bench judgement unanimously stated, inter alia that reservations be opened up for the transgender community by declaring them as socially and educationally backward. In the years since this judgement, however, there have barely been any State actions in India to implement the judgement in its spirit. The Transgender Persons (Protection of Rights) Act, 2019, a statute passed to further the ideals of protecting the interests of the transgender community was met with resistance and protests from the transgender community itself. The absence of reservation provisions in the Act was one of the many grievances raised by the activists. India’s Union cabinet has recently approved a cabinet note to include transgender persons within the ‘Other Backward Communities’, a move to open up the reservations in education and employment to transgender persons. Here, I look at the dichotomy between the acceptance of transgender persons in the early local Indian community practices and the discrimination that came with the colonisation and western mores. I attempt to understand the use of contemporary legal tools, like reservations as a compensatory and corrective measure for the aforementioned discrimination. While examining the adequacy of reservations as a measure, I look at the possibilities of potential Affirmative Action policies that go beyond the traditional state mandated reservation policies in India. I also intend to learn from existing Affirmative Action policies for the transgender community in the United States and the United Kingdom to provide suggestions that can benefit the community in India.

Gender Inequality and Biological Supremacy: A Sex Equality Analysis of Patrick Parkinson’s “Neutral” Proposal

AbstractIn this essay, a response to an article by Patrick Parkinson, Shannon Gilreath disputes Parkinson’s claim that religiously motivated discrimination against transgender people should be the subject of special exceptions to prevailing antidiscrimination law, especially where the transgender person does not seek to conform to the traditional male/female gender binary. Gilreath maps the ways in which Parkinson’s proposal is an argument for biological superiority, which has been the rationalization for systematic and systemic social inferiority throughout history, including most notably in the contexts of race, gender, and sexuality oppression. In concluding that Parkinson’s proposal is little more than a restatement of the faulty differences-based approach to equality through law, Gilreath ultimately concludes that its principles are wholly inconsistent with the legitimate purposes of antidiscrimination law.

Moving from Fear to Freedom: A Quest for Love, Respect, Freedom and Acceptance by LGBTQ Community Through Indian Cinema

The LGBT community is subject to gender-based violence and other violations of human rights since these laws are invisible to the public. Film has unquestionably been important to the LGBT movement in India. Like many contemporary movements, the queer movement in India seeks to change ingrained social mores, notably the pervasive notion that sexual orientation is merely a phase. Film is viewed as a social cycle in which audience members interpret signs or messages that are broadcast to them using their aural and visual senses. The movies have become much too popular a tourist attraction. Dramatic cinematography and sound film in an exhibition of copying not only shocks us but also holds our attention. Film has the power to captivate audiences, educate viewers, and shift the collective conscience. This huge growth of Bollywood in India and overseas is described by “Jaikumar (2006)” in his book ‘Film Towards the End of Empires’. Bollywood, an Indian film industry powerhouse, mimics and analyzes the public's credit, complexity, genuine elements, and deceptions via a variety of narrative perspectives. As a result, our worldview and general awareness are shaped by Bollywood This Research paper sets out to examine the mainstream treatment of homosexuality in Hindi films, with a focus on how the LGBT community is depicted. And how they fight for their rights for freedom, love, respect and acceptance in the society. The arrival of cinema in India's LGBT community was unquestionably a game-changer. Gay, lesbian, bisexual, and transgender persons are all part of the sexual minority. Among the numerous nations where homosexuality is still frowned upon one is India. In colonial India, the British enacted Section 377 of the Indian Criminal Code, which still exists today and criminalises homosexuality. In this paper, we have shown Hindi cinema’s representation of the LGBTQ community in films like Badhaai Do, Kapoor &amp; Sons, Dear Dad, Ek Ladki ko Dekha to Aisa Laga, Shubh Mangal Zyada Saavdhan and their struggle and acceptance in the society in the 21st century.

Intonation Parameters in Gender Diverse People

Although intonation is often addressed in speech training for gender diverse individuals, the relationship between intonation and femininity/masculinity ratings remains unclear. The aim of this study was to examine differences in intonation parameters in gender diverse individuals. Moreover, the relationship between acoustic intonation parameters and femininity/masculinity ratings was investigated. Speech samples of semistructured speech were elicited from cisgender (cis) (107 ciswomen, 104 cis men), transgender (trans) (19 trans women, 10 trans men), and non-binary (n=11) individuals using a prosody protocol. An objective acoustic analysis was performed to compare intonation parameters (upward/downward/flat intonation shift, general and final intonation shift, general fundamental frequency range, fundamental frequency variation index) between groups. In addition, a listening experiment was conducted, consisting of a cis and gender diverse listening panel (n=41). The listeners were asked to rate the femininity/masculinity of speech samples (n=57) using a visual analogue scale. Correlational analyses were used to examine the relationship between intonation parameters and femininity/masculinity ratings. Similarity was found in the intonation parameters of participants with a similar gender identity. In non-binary speakers, no significant differences in acoustic intonation parameters were found between these speakers and the cisgender speakers. In addition, no significant correlations were found between the acoustic intonation parameters and the femininity/masculinity ratings in the groups with cis men, cis women, and non-binary participants. However, moderate to strong significant correlations were found between acoustic intonation parameters and femininity/masculinity ratings in the trans participants. Intonation is a "speech marker" that distinguishes between groups with a different gender identity. No relationship was observed between intonation and femininity/masculinity ratings for cisgender and non-binary speakers. However, the significant relationship between these parameters for transgender participants (trans men and trans women) provides evidence for intonation exercises in gender affirming voice, speech, and communication training, and therefore contribute to evidence-based intonation training in transgender persons.