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Referrals to child and adolescent gender identity services are rising steeply, especially for people assigned female at birth
Gender identity questions feature with increasing frequency in the scientific literature and media, but much of it is focused on adults. However, a retrospective analysis of referrals to the Gender Identity Development Service (GIDS), the largest service of its kind in the UK, between 2009 and 2016 has shown a steady increase in the overall number of referrals year on year. The proportion of referrals for those assigned female at birth (AFAB) increased at a greater rate than for those assigned male at birth (AMAB) and now accounts for more than two-thirds of referrals received. It is unknown whether this disparity reflects differences in experience of puberty or if social norms promote greater acceptability of AFAB gender variance than for AMAB.
Arch Sex Behav 2018; https://doi.org/10.1007/s10508-018-1204-9
A new, shorter Anti-Bisexual Experiences Scale may ease detection of stigma and discrimination in bisexual people
Anti-bisexual discrimination is linked to anxiety and depression. In research, a measure often used to quantify this is the Anti-Bisexual Experiences Scale (ABES) but the length of the scale makes it less practical for use in other settings. With this in mind, the authors developed a Brief-ABES and validated it across diverse gender and non-monosexual identities. They were able to reduce the original ABES from 17 to 8 items, while retaining its meaning, and found that it tested comparably across diverse identities.
Arch Sex Behav 2018; https://doi.org/10.1007/s10508-018-1157-z
Googling of syphilis symptoms precedes diagnosis in clinics
Google searches for syphilis symptoms are strongly associated with subsequent diagnosis of syphilis, according to a recently published study using linear mixed models. The study compared rates of primary and secondary syphilis diagnosis per US state as reported to the Centers for Disease Control and Prevention between 2012 and 2014, with the previous week’s Google Trends data. The model found that certain syphilis-related keyword combinations in Google searches spiked in the week preceding a spike in diagnoses in the corresponding state. Following the Cambridge Analytica scandal and with the new European Union General Data Protection Regulations coming into force, we should consider how this kind of epidemiological strategy could be used in the UK.
Epidemiology 2018; doi:10.1097/EDE.0000000000000836
An animal model vaginal implant aimed at inducing T-cell quiescence may protect against HIV transmission
A vaginal implant has been designed to reduce risks of HIV transmission. The study uses a hydroxycholoroquine vaginal implant in a rabbit model to induce T-lymphocyte quiescence and improve integrity of the vaginal epithelium. Whether this technology will come to benefit cis-women and trans-men in the future remains to be seen: further animal investigation is needed before trials can be carried out in human subjects, but it presents an interesting strategy.
J Control Release 2018; https://doi.org/10.1016/j.jconrel.2018.03.010
Young men can be engaged in preventing unintended pregnancy if they are provided with emergency contraception
One hundred and twenty-six young men aged 16–35 years attending a clinic in New York State were asked: “Along with a supply of condoms, would you like a pack of emergency contraception (EC) for your partner, in case the condom breaks?” The question was posed as part of an exploratory study investigating acceptability of advanced provision of progestogen-only emergency contraception (POEC) to young men. Some 76% of participants and 89% of those with three or more casual partners in the last 12 months accepted EC. However, only 32% of participants knew that POEC could prevent pregnancy if taken in a timely manner, and so advanced provision of EC must be accompanied with appropriate educational interventions, if it is to be used correctly.
Contraception 2018; doi:10.1016/j.contraception.2018.04.005
GyneFix can be used as transcaesarean intrauterine contraception
Insertion of intrauterine contraception at caesarean section is gaining popularity in the UK and is commonplace globally. The frameless intrauterine device (IUD) GyneFix has been modified for use at caesarean section (GyneFix-CS) and the randomised trial by Unal et al has shown comparable levels of acceptability and complications between GyneFix-CS and a T-frame IUD, with a lower level of expulsion of GyneFix-CS at 3 months. For both types of IUD, expulsion rates were low but the GyneFix-CS took on average 4 min to insert compared to seconds for the T-frame device, and this may restrict its uptake.
Contraception 2018; doi:10.1016/j.contraception.2018.03.034
Analgesia provision for early medical abortion varies widely, within and across countries
Abortion can be a painful experience and many women require analgesia. An international survey of abortion care providers has shown that while the majority of providers supply some analgesia for use in early medical abortion (EMA) (up to 9 weeks’ gestation) the regimes used and the point of initiation of analgesia varies widely between providers. Furthermore, the majority of providers are unlikely to use any kind of formal pain scoring or evaluation for women. This likely reflects the largely ‘at home’ setting for EMA. Further research is required in order to understand what works for pain management in EMA, and then the harder task of standardising practice across international providers.
Eur J Obstet Gynecol 2018; https://doi.org/10.1016/j.ejogrb.2018.04.030
Biomarker identified for placental dysfunction and miscarriage
Serum kisspeptin, a known regulator of puberty, and found in high levels in the placenta, appears to be a promising biomarker in the evaluation of placental dysfunction and miscarriage, and may be useful for identifying viable first-trimester pregnancies. A case-control study collected data about serum kisspeptin and beta-hCG levels in 20 women with intrauterine pregnancies, 20 women who had a confirmed miscarriage and 20 non-pregnant women. Kisspeptin levels differed between the pregnant and non-pregnant state and by viability. There was also a significant positive association with beta-hCG in the miscarriage group, but not in those with healthy pregnancies.
Fertil Steril 2018; doi: 10.1016/j.fertnstert.2017.09.029
Footnotes
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Commissioned; internally peer reviewed.
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