Treatment for gender dysphoria in children : the new legal, ethical and clinical landscape

- Gender dysphoria is a condition in which a child's subjectively felt identity and gender are not congruent with her or his biological sex. Because of this, the child suffers clinically significant distress or impairment in social functioning. - The Family Court of Australia has recently received an increasing number of applications seeking authorisation for the provision of hormones to treat gender dysphoria in children. - Some medical procedures and interventions performed on children are of such a grave nature that court authorisation must be obtained to render them lawful. These procedures are referred to as special medical procedures. - Hormonal therapy for the treatment of gender dysphoria in children is provided in two stages occurring years apart. Until recently, both stages of treatment were regarded by courts as special medical treatments, meaning court authorisation had to be provided for both stages. - In a significant recent development, courts have drawn a distinction between the two stages of treatment, permitting parents to consent to the first stage. In addition, it has been held that a child who is determined by a court to be Gillick competent can consent to stage 2 treatment. - The new legal developments concerning treatment for gender dysphoria are of ethical, clinical and practical importance to children and their families, and to medical practitioners treating children with gender dysphoria. Medical practitioners should benefit from an understanding of the recent developments in legal principles. This will ensure that they have up-to-date information about the circumstances under which treatment may be conducted with parental consent, and those in which they must seek court authorisation.

Book Review: "Gender and Global Justice edited by Alison M. Jaggar, Cambridge: Polity Press, 2014"

Hidden aspects of assumed gender-neutral global policies and transnational institutions that have “systematically disparate and often burdensome consequences for specific groups of women in both the global North and the global South” (10) are the focus of Gender and Global Justice edited by Alison M Jagger. In response to the frequent neglect of gender in considerations of moral philosophy in global issues, the chapters assembled in this edited collection highlight the manifold ways in which our attention to a broad range of questions of justice at a global level is enhanced by close attention to the gendered dimensions of injustice and inequality.

Take me seriously. Now laugh at me! How gender influences the creation of contemporary physical comedy

This paper unpacks some of the complexities of the female comic project, focussing on the creation of physical comedy, via multiple readings of the term “serious”. Does female desire to be taken seriously in the public realm compromise female-driven comedy? Historically, female seriousness has been a weapon in the hands of such female-funniness sceptics as the late Christopher Hitchens (2007), who (in)famously declared that women are too concerned with the grave importance of their reproductive responsibility to make good comedy. The dilemma is clear: for the woman attempting to elicit laughs, she’s not serious enough outside the home, and far too serious inside it.

Children with gender dysphoria deserve better from the law

An increasing number of Australian children are accessing specialist health services for gender dysphoria treatment, largely because of a growing awareness among doctors about available specialist health services. But the law is not in step with the needs of these children...

Bits and bumps: Understanding gender in contemporary physical comedy

This study investigates how the gender of a performer affects the way they produce physical comedy in a theatrical context, framed through Kristeva's theory of abjection and Butler's notion of gender as performance. As a thesis by creative work, it produced an original piece of theatre, The Furze Family Variety Hour, which featured a male/ female comic duo, where the female performer enjoyed an equal share of the punch lines. The study generates a new understanding of how the body operates in physical comedy, namely, a system of bodily registers, as well as a new understanding of the female grotesque comic body.

Retaining a diverse workforce: The impact of gender-focused human resource management

Demography theory suggests that high gender diversity leads to high turnover. As turnover is costly, we tested the following: a main effect prediction derived from demography theory, and a moderating effect prediction derived from the relational framework. Data on 198 publicly listed organizations were collected through a human resources decision maker survey and archival databases. The results indicate that higher gender diversity leads to lower turnover in organizations with many gender-focused policies and practices. Findings suggest that organizations can lower their turnover rates by increasing their gender diversity and by implementing gender-focused policies and practices.

Gendering occupations: Persistence and resistance of gender presumptions about members of particular healthcare professions

In spite of increasing gender diversity in employment roles, presumptions persist about the gender of people employed in particular occupations. Focusing on healthcare data collected in Australia and the United Kingdom within the past decade, we use Conversation Analysis (CA) to identify how presumptions about gender are displayed within social interaction through the use of gender-specific pronouns. We show how gender-specific pronouns are asymmetrically selected on the basis of a referent’s occupations, with gender-unspecified members of traditionally male occupations (e.g. doctors) referred to with masculine pronouns and gender-unspecified members of traditionally female occupations (e.g. nurses) referred to with feminine pronouns. We also explore ways people avoid making such presumptions. Our analysis therefore reveals a state of flux in contemporary social life, with instances in which gender presumptions persist as well as attempts to employ person references that reflect contemporary social dynamics.

Gender-specific differences of interaction between obesity and air pollution on stroke and cardiovascular diseases in Chinese adults from a high pollution range area: A large population based cross sectional study

Background Little information exists regarding the interaction effects of obesity with long-term air pollution exposure on cardiovascular diseases (CVDs) and stroke in areas of high pollution. The aim of the present study is to examine whether obesity modifies CVD-related associations among people living in an industrial province of northeast China. Methods We studied 24,845 Chinese adults, aged 18 to 74 years old, from three Northeastern Chinese cities in 2009 utilizing a cross-sectional study design. Body weight and height were measured by trained observers. Overweight and obesity were defined as a body mass index (BMI) between 25–29.9 and ≥ 30 kg/m2, respectively. Prevalence rate and related risk factors of cardiovascular and cerebrovascular diseases were investigated by a questionnaire. Three-year (2006–2008) average concentrations of particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxides (NO2), and ozone (O3) were measured by fixed monitoring stations. All the participants lived within 1 km of air monitoring sites. Two-level logistic regression (personal level and district-specific pollutant level) was used to examine these effects, controlling for covariates. Results We observed significant interactions between exposure and obesity on CVDs and stroke. The associations between annual pollutant concentrations and CVDs and stroke were strongest in obese subjects (OR 1.15–1.47 for stroke, 1.33–1.59 for CVDs), less strong in overweight subjects (OR 1.22–1.35 for stroke, 1.07–1.13 for CVDs), and weakest in normal weight subjects (OR ranged from 0.98–1.01 for stroke, 0.93–1.15 for CVDs). When stratified by gender, these interactions were significant only in women. Conclusions Study findings indicate that being overweight and obese may enhance the effects of air pollution on the prevalence of CVDs and stroke in Northeastern metropolitan China. Further studies will be needed to investigate the temporality of BMI relative to exposure and onset of disease.

Is being #instagay different from an #lgbttakeover? A cross-platform investigation of sexual and gender identity performances

This paper introduces research in progress that examines how queer women perform sexual identity across social media platforms. Applying a lens of queer theory and Actor Network Theory, it discusses women’s embodied self-representations as taking on forms that both conform to and elaborate upon the selfie genre of digital representation. Acknowledging similarities and differences across platforms, specifically between Instagram and Vine, a novel walkthrough method is introduced to identify platform characteristics that shape identity performances. This method provides insights into the role of platforms in identity performances, which can be combined with analysis of user-generated content and interviews to better understand digital media’s constraints and affordances for queer representation.

The 'gender gap' in authorship in nursing literature

OBJECTIVES: Gender bias has been found in medical literature, with more men than women as first or senior authors of papers, despite about half of doctors being women. Nursing is about 90% female, so we aimed to determine if similar biases exist in nursing literature. DESIGN: Taking the eight non-specialist nursing journals with the highest impact factors for that profession, we counted the numbers of men and women first authors over 30 years. SETTING: We used nursing journals from around the world which attract the highest impact factors for nursing publication. PARTICIPANTS: Eight journals qualified for entry, three from the United Kingdom, four from the United States of America, and one from Australia. MAIN OUTCOME MEASURES Using Chi-square and Fisher exact tests, we determined differences between the numbers of men and women across all the journals, between countries (USA, UK and Australia), changes over the 30 years, and changes within journals over time. RESULTS Despite the small proportion of men in the nursing workforce, up to 30% of first authors were men. UK journals were more likely to have male authors than USA journals, and this increased over time. USA journals had proportions of male first authors consistent with the male proportion of its nursing workforce. CONCLUSIONS In the UK (though not in the USA) gender bias in nursing publishing exists, even though the nursing workforce is strongly feminized. This warrants further research, but is likely to be due to the same reasons for the gender gap in medical publishing; that is, female nurses take time out to have families, and social and family responsibilities prevent them taking opportunities for career progression, whereas men's careers often are not affected in such ways.

Sexual harassment in the medical profession: Legal and ethical responsibilities

Sexual harassment of women in medicine in the Australian medical profession is a serious problem which presents substantial legal, ethical and cultural questions for the medical profession. Women have enforceable legal rights to gender equality and freedom from sexual harassment in the workplace. Both individual offenders and their employers face significant legal consequences for sexual harassment. Individual medical practitioners and employers need to understand their legal and ethical responsibilities in this context. This article analyses four areas of legal liability in every State and Territory which apply to individual offenders and employers: criminal law, discrimination law, civil law, and contract law. It also analyses ethical duties owed by doctors towards their colleagues under professional regulatory schemes. The analysis shows that individual doctors and their employers have clear legal and ethical obligations to prevent sexual harassment. On legal and ethical grounds, medical employers, professional colleges and associations, and regulators need to improve gender equality and professional culture in medicine. A five-step model for cultural change is proposed.

Developments of the total entropy utility function for the dual purpose of model discrimination and parameter estimation in Bayesian design

The total entropy utility function is considered for the dual purpose of Bayesian design for model discrimination and parameter estimation. A sequential design setting is proposed where it is shown how to efficiently estimate the total entropy utility for a wide variety of data types. Utility estimation relies on forming particle approximations to a number of intractable integrals which is afforded by the use of the sequential Monte Carlo algorithm for Bayesian inference. A number of motivating examples are considered for demonstrating the performance of total entropy in comparison to utilities for model discrimination and parameter estimation. The results suggest that the total entropy utility selects designs which are efficient under both experimental goals with little compromise in achieving either goal. As such, the total entropy utility is advocated as a general utility for Bayesian design in the presence of model uncertainty.

Integrating LGBTIQ health personnel in the workplace: A literature review

Aim Lesbian, Gay, Bisexual, Transgender (LGBTIQ) issues have attracted attention in the popular media. The purpose of this study was to explore the workplace acceptance and experiences of LGBTIQ health and medical practitioners. Methods A systematic search of academic databases and reference lists from selected papers were the sources of the data. Inclusion criteria were research papers published in English, which focused on workplace acceptance and experiences of LGBTIQ health personnel. Both authors abstracted data from all eligible papers. Results Thirty-three papers were included in this review. Evidence indicated that LGBTIQ health personnel experienced discrimination from their patients, heterosexual colleagues and within the LGBTIQ community. Positive contribution of LGBTIQ health personnel include improved patient care and role models for LGBTIQ peers. Inclusive policy is required for LGBTIQ health personnel workforce retention. Conclusions There has been improvement in the acceptance and experiences of LGBTIQ health personnel in recent times. An inclusive workplace policy of LGBTIQ embraces and celebrates the value of diversity.