Individuals who identify themselves as transgender have gender identities that do not match their anatomical sex. Females who identify as male, also known as female-to-male transgender (FTM), may opt to undergo hormonal and surgical treatment in order to transition to the male phenotype, including high-dose testosterone treatment to develop male secondary sexual characteristics and surgical procedures. Currently, the recommendation is for the patient to have a hysterectomy within five years of initiating testosterone therapy to decrease the risk of developing endometrial cancer. However, long-term testosterone treatment has not been proven to cause an increased risk of endometrial cancer. With the use of gene expression and immunohistochemical studies, this study aimed to show no upregulation of genes associated with proliferation (Ki-67) and endometrial cancer (ZIC2) in endometrial tissue from FTM individuals treated with long-term testosterone compared to endometrial tissue from postmenopausal women, premenopausal women with benign endometrium, and women with endometrial cancer. Our findings showed that Ki-67 and ZIC2 expression in the FTM samples was significantly lower than in the endometrial cancer samples. Our findings call into question the concept that long-term testosterone treatment causes neoplastic changes in endometrial tissue and the need for routine hysterectomy in these patients. / 2018-07-11T00:00:00Z

Abstrakt (svenska) Titel: Infertilitet – vems rätt att bestämma? En kvalitativ intervjustudie kring barnmorskors erfarenheter av att arbeta med infertilitet. Författare: Rebecka Kristensen Berlin, Umeå Universitet -Institutionen för Omvårdnad   Syfte: Att undersöka hur barnmorskans erfarenheter av parens reaktioner uppfattas i samband med infertilitetsproblematik. Studiedesign: En kvalitativ intervjustudie innefattande fyra barnmorskor har genomförts på en barnmorskemottagning. Intervjumaterialet analyserades utifrån kvalitativ innehållsanalys, vilket i korthet innebar följande steg: Materialet transkriberades ordagrant och bröts därefter ned i meningsbärande enheter, för att kunna sortera data utifrån innehåll. Kondensering utfördes i syfte att lyfta fram kärninnehållet. Abstraktion utfördes för att få fram koder, i syfte att reducera mängden text men även för att därefter kunna sammanfoga snarlika ämnen till underkategorier, vilka sedan grupperades i huvudkategorier tillhörande ett gemensamt tema. Resultat: De fyra huvudkategorier som uppkom var känslor, kommunikation, rättighet och prevention. Känslor: Oro, stress samt nedstämdhet var vanligt förekommande. Mäns känslor var svårare att identifiera då kvinnor ibland kom ensamma till besöken, samt män ibland dolde känslor bakom aggressivitet. Kommunikation: God information skapade förtroende. Råd om livsstilsförändringar samt vidareremittering var en viktig form av stöd. Rättighet: Ingen har rätt till barn, men alla ansågs ha rätt att försöka få barn. Privatekonomi samt samhällets krav påverkar dock i stor utsträckning paren vid misslyckade försök eller önskan om ytterligare barn. Prevention: Vikten av information kring infertilitet vid undervisning i skolan, vid preventivmedelsamtal och vid cellprovtagning poängterades. Slutsats: Att vara väl införstådd med de känslor som kan uppstå i samband med infertilitet möjliggör att ge tillfredställande stöd. Särskilda ansträngningar behöver göras för att nå män, såväl emotionellt som preventivt. Stort utrymme för förbättring finns gällande preventiva åtgärder, i syfte att fördjupa allmänhetens kunskaper kring infertilitet. Nyckelord: kvinnlig infertilitet; manlig infertilitet; känslor; barnmorska; kvalitativ forskning / Abstract (English)     Title: Infertility. Who´s right to decide? A qualitative interview study regarding midwives experiences to work with infertility. Author: Rebecka Kristensen Berlin, Umeå University- Department of nursing   Objective: To investigate midwives thoughts and experiences regarding couples reactions in connection with infertility.  Study design: A qualitative interview study comprising four midwives have been conducted. The resulting data was analyzed using qualitative content analysis, consisting of the following steps: The material was transcribed verbatim and then broken down into sentences, to aid in sorting the data based on content. Condensation was carried out in order to highlight the core content. Abstraction was performed to obtain codes, in order to reduce the amount of text , but also to subsequently merge similar content into subcategories , which were then grouped into categories. Results: Four main categories emerged. Feelings: anxiety, stress and depression were common. Men’s feelings were more difficult to identify since women sometimes came alone to appointments, and men sometimes concealed their feelings behind aggression. Communication: Good information created trust. Advice on lifestyle changes and referrals were important forms of support. Empowerment: No-one has the right to a child, but the right to try to have a child. Personal and societal demands, however, affect the couples at failure to conceive or desire for additional children. Prevention: The importance of information about fertility in school, at contraception counselling and routine smear exams was emphasized. Conclusion: Awareness of the feelings that infertility may give rise to, enables providing satisfactory support. Further efforts need to be made to reach males emotionally as well as preventatively. There is great possibility for improvement in regards to public awareness about infertility. Keywords: female infertility; male infertility; emotions; midwife; qualitative research

O transexualismo é caracterizado pelo desejo irreversível de viver e ser aceito como pertencente ao sexo oposto ao seu sexo biológico. Os transexuais masculinos (feminino para masculino) utilizam cronicamente hormônios androgênicos para promover alterações nas características sexuais secundárias compatíveis com o sexo de identidade, correspondendo à terapia hormonal cruzada.A testosterona é o principal hormônio usado na terapia hormonal cruzada desta população. Embora seja considerada segura, quando utilizada em doses adequadas, poucos estudos estão disponíveis na literatura a respeito dos efeitos da testosterona nessa população específica, além de incluir tamanhos amostrais pequenos. Assim, os objetivos desta dissertação foram os de revisar de forma sistemática a literatura a respeito dos efeitos do tratamento comtestosterona sobre o perfil clínico, metabólico, hematológico, lipídico e hepático de indivíduos transexuais masculinos.Nesta revisão sistemática e meta-análise, buscaram-se estudos publicados até maio de 2016 nas bases de dados Medline (PUBMED) and EMBASE. Foram incluídos estudos que relatassem intervenções com qualquer dose de testosterona e que apresentassem dados comparando variáveis clínicase metabólicas antes e depois do tratamento Para a meta-análise, somente artigos que tivessem analisado os efeitos do tratamento com undecanoato de testosterona por 12 meses foram incluídos. Desta forma, o tamanho do efeito foi calculado como alteração em 12 meses em relação ao valor médio basal. A busca resultou em 391 artigos potencialmente elegíveis. Destes, 13 alcançaram os critérios de eligibilidade e foram incluídos na revisão sistemática. Três foram elegíveis para a meta-análise. A qualidade destes estudos de acordo com a escala de Newcastle-Ottawa Scale foi boa. O tratamento com undecanoato de testosterona promoveu um significativo aumento nos níveis séricos de testosterona (tamanho do efeito 6.18, IC 95%: 4.59 à 7.76), hematócrito(4.80, IC95%: 4.06 à 5.54), hemoglobina(1.54, IC95%: 1.10 à 1.98), e pressão sistólica (4.74, IC 95%: 2.15 à7.33). Em conclusão, os resultados deste trabalho sugerem que o tratamento comundecanoato de testosteronaé efetivo e embora aumente significativamente hematócrito, hemoglobina e pressão sistólica no primeiroano de tratamento de homens transgêneros, estes achados são clinicamente aceitáveis evidenciando segurança deste tratamento. / Transsexualism is characterized by the irreversible desire to live and be accepted as belonging to the opposite sex to its biological sex. Male transsexuals (female to male) chronically use androgenic hormones to promote changes in secondary sexual characteristics compatible with gender identity, corresponding to cross-sex hormone therapy. Testosterone is the main hormone used in cross-hormone therapy in this population. Although it is considered safe, when used in adequate doses, few studies are available in the literature regarding the effects of testosterone in this specific population, in addition to including small sample sizes. Thus, the objectives of this dissertation were to systematically review the literature regarding the effects of testosterone treatment on the clinical, metabolic, hematological, lipid and hepatic profile of male transsexual individuals. In this systematic review and meta-analysis, studies were published until May 2016 in the Medline (PUBMED) and EMBASE databases. We included studies that reported interventions with any dose of testosterone and that presented data comparing clinical and metabolic variables before and after treatment For the meta-analysis, only articles that had analyzed the effects of treatment with testosterone undecanoate for 12 months were included. In this way, the effect size was calculated as change in 12 months in relation to the baseline mean value. Search resulted in 391 potentially eligible articles. Of these, 13 met the eligibility criteria and were included in the systematic review. Three were eligible for the meta-analysis. The quality of these studies according to the Newcastle-Ottawa Scale scale was good. Treatment with testosterone undecanoate promoted a significant increase in serum testosterone levels (effect size 6.18, 95% CI: 4.59 to 7.76), hematocrit (4.80, 95% CI: 4.06 to 5.54), hemoglobin (1.54, 95%: 1.10 to 1.98), and systolic pressure (4.74, 95% CI: 2.15 to 7.33). In conclusion, the results of this work suggest that testosterone undecanoate treatment is effective and although it significantly increases hematocrit, hemoglobin and systolic pressure in the first year of treatment of transgender men, these findings are clinically acceptable, evidencing the safety of this treatment.

Family-of-origin aggression (FOOA) is an established risk factor for adult partner aggression. The research presented in this thesis tested a model proposing that (FOOA) is mediated through attachment and attributions to influence male and female partner aggression and withdrawal in early stage couple relationships. Study 1 tested the influence of FOOA, attachment, and attributions on partner aggression in a sample of 73 newlywed couples. FOOA was associated with male-to-female aggression, but not female-to-male aggression. Therefore the hypothesis that the influence of FOOA on partner aggression was mediated through attachment and attributions was tested only for men. Attachment was significantly associated with attributions, but there was no association between FOOA and attachment or between attributions and male partner aggression. Study 2 tested the influence of FOOA, attachment, and attributions on partner aggression and withdrawal in a sample of 101 dating couples. Structural equation model analyses found different results for men and women. For male partner aggression, the influence of FOOA was partially mediated through attachment and attributions. For male withdrawal, the influence of FOOA on withdrawal was fully mediated through attachment and attributions. The association between FOOA and withdrawal was also mediated through attachment independent of attributions, and through attributions independent of attachment. For female partner aggression and female withdrawal, the predicted associations were found for the attachment anxiety models but not for the attachment avoidance models. The current findings suggest that attachment and attributions should be intervention targets for improving relationship outcomes. The gender differences in model fit emphasise the importance of investigating risk factors for partner aggression and withdrawal separately for men and women.

Purpose: The purposes of the present study consisted of primary, secondary, and tertiary purposes: 1) to determine what factors that can be addressed in speech therapy are the most important for female-to-male (FtM) transgender individuals in passing as their true gender, 2) to determine what factors may contribute to these individuals seeking speech therapy services and to the importance that they assign to speech therapy as part of the transition process, and 3) to determine awareness of this population in regards to the availability and scope of speech therapy services relative to transitioning or passing as their true gender. Method: A 38-item survey was developed to address these research questions and a link to the online survey was distributed via email to various listservs, organizations, and personal contacts to assist in the electronic distribution of the survey link. The responses of the final participant pool of 63 respondents were evaluated. Results: Overall, the participants ranked voice characteristics as the most important for passing followed by nonverbal communication and social language use. These broad categories rankings are generally supported by the existing literature. Within category rankings revealed rankings that are in accord with the existing literature, others that oppose the existing literature, and others that have not been explored in the literature. The following factors stood out as possibly contributing to how important FtMs find speech therapy as facilitating their ability to live as their true gender: desire to pass, satisfaction with hormone related pitch changes, current overall presentation, and whether speech/language contribute to instances of not passing. Factors that appear to possibly contribute to how likely FtMs are to have sought speech therapy include: satisfaction with hormone related pitch changes, voice prior to transition, and if aspects of speech and language contribute to instances of not passing. Overall, FtMs have little awareness regarding speech therapy as part of the transition process, particularly for FtMs. / text

Thesis (M.A.), Psychology (Experimental)--University of Central Oklahoma, 2008. / Includes bibliographical references (leaves 64-68).

O transexualismo é caracterizado pelo desejo irreversível de viver e ser aceito como pertencente ao sexo oposto ao seu sexo biológico. Os transexuais masculinos (feminino para masculino) utilizam cronicamente hormônios androgênicos para promover alterações nas características sexuais secundárias compatíveis com o sexo de identidade, correspondendo à terapia hormonal cruzada.A testosterona é o principal hormônio usado na terapia hormonal cruzada desta população. Embora seja considerada segura, quando utilizada em doses adequadas, poucos estudos estão disponíveis na literatura a respeito dos efeitos da testosterona nessa população específica, além de incluir tamanhos amostrais pequenos. Assim, os objetivos desta dissertação foram os de revisar de forma sistemática a literatura a respeito dos efeitos do tratamento comtestosterona sobre o perfil clínico, metabólico, hematológico, lipídico e hepático de indivíduos transexuais masculinos.Nesta revisão sistemática e meta-análise, buscaram-se estudos publicados até maio de 2016 nas bases de dados Medline (PUBMED) and EMBASE. Foram incluídos estudos que relatassem intervenções com qualquer dose de testosterona e que apresentassem dados comparando variáveis clínicase metabólicas antes e depois do tratamento Para a meta-análise, somente artigos que tivessem analisado os efeitos do tratamento com undecanoato de testosterona por 12 meses foram incluídos. Desta forma, o tamanho do efeito foi calculado como alteração em 12 meses em relação ao valor médio basal. A busca resultou em 391 artigos potencialmente elegíveis. Destes, 13 alcançaram os critérios de eligibilidade e foram incluídos na revisão sistemática. Três foram elegíveis para a meta-análise. A qualidade destes estudos de acordo com a escala de Newcastle-Ottawa Scale foi boa. O tratamento com undecanoato de testosterona promoveu um significativo aumento nos níveis séricos de testosterona (tamanho do efeito 6.18, IC 95%: 4.59 à 7.76), hematócrito(4.80, IC95%: 4.06 à 5.54), hemoglobina(1.54, IC95%: 1.10 à 1.98), e pressão sistólica (4.74, IC 95%: 2.15 à7.33). Em conclusão, os resultados deste trabalho sugerem que o tratamento comundecanoato de testosteronaé efetivo e embora aumente significativamente hematócrito, hemoglobina e pressão sistólica no primeiroano de tratamento de homens transgêneros, estes achados são clinicamente aceitáveis evidenciando segurança deste tratamento. / Transsexualism is characterized by the irreversible desire to live and be accepted as belonging to the opposite sex to its biological sex. Male transsexuals (female to male) chronically use androgenic hormones to promote changes in secondary sexual characteristics compatible with gender identity, corresponding to cross-sex hormone therapy. Testosterone is the main hormone used in cross-hormone therapy in this population. Although it is considered safe, when used in adequate doses, few studies are available in the literature regarding the effects of testosterone in this specific population, in addition to including small sample sizes. Thus, the objectives of this dissertation were to systematically review the literature regarding the effects of testosterone treatment on the clinical, metabolic, hematological, lipid and hepatic profile of male transsexual individuals. In this systematic review and meta-analysis, studies were published until May 2016 in the Medline (PUBMED) and EMBASE databases. We included studies that reported interventions with any dose of testosterone and that presented data comparing clinical and metabolic variables before and after treatment For the meta-analysis, only articles that had analyzed the effects of treatment with testosterone undecanoate for 12 months were included. In this way, the effect size was calculated as change in 12 months in relation to the baseline mean value. Search resulted in 391 potentially eligible articles. Of these, 13 met the eligibility criteria and were included in the systematic review. Three were eligible for the meta-analysis. The quality of these studies according to the Newcastle-Ottawa Scale scale was good. Treatment with testosterone undecanoate promoted a significant increase in serum testosterone levels (effect size 6.18, 95% CI: 4.59 to 7.76), hematocrit (4.80, 95% CI: 4.06 to 5.54), hemoglobin (1.54, 95%: 1.10 to 1.98), and systolic pressure (4.74, 95% CI: 2.15 to 7.33). In conclusion, the results of this work suggest that testosterone undecanoate treatment is effective and although it significantly increases hematocrit, hemoglobin and systolic pressure in the first year of treatment of transgender men, these findings are clinically acceptable, evidencing the safety of this treatment.

abstract: The number of interracial marriages and multiracial individuals continues to increase rapidly in the United States (U.S. Census Bureau, 2010). Black Female (BF) /White Male (WM) marriages are increasing, but not as quickly as other interracial marriages (Wang, 2012) leaving this population void in social science literature available to social workers. Consequently, there is a lack of information available to understand factors that contribute to these couple identities and how they navigate in the monoracialized systems they encounter. This qualitative study explored how BF/WM partners married in different generational cohorts experience and navigate race and identity as a couple through video recorded interviews where couples shared their narrative as a dyad. The secondary data analyzed was originally collected through snowball and convenient sampling to find BF/WM married couples that were married different generational cohorts living in the Phoenix area. Couples were asked to respond to starter questions (Linhorst, 2002) that encouraged them to share experiences as a couple interacting with community, social, and family systems. Ecological systems framework and social construction were used to guide analysis. Results from the multimodal transcript analysis and detailed review of the video data found themes of invisibility of the couples' relationships from community and family. Differences between cohorts were identified with movement from separation of racial identities within the couple identity to an infusion of both identities represented within the couple. Additionally, insights into the benefits of videography as a data collection method and its usefulness in to connecting social work research to practice were identified and align with the NASW Cultural Competence standards (NASW, 2001). / Dissertation/Thesis / Doctoral Dissertation Social Work 2014

O transexualismo é caracterizado pelo desejo irreversível de viver e ser aceito como pertencente ao sexo oposto ao seu sexo biológico. Os transexuais masculinos (feminino para masculino) utilizam cronicamente hormônios androgênicos para promover alterações nas características sexuais secundárias compatíveis com o sexo de identidade, correspondendo à terapia hormonal cruzada.A testosterona é o principal hormônio usado na terapia hormonal cruzada desta população. Embora seja considerada segura, quando utilizada em doses adequadas, poucos estudos estão disponíveis na literatura a respeito dos efeitos da testosterona nessa população específica, além de incluir tamanhos amostrais pequenos. Assim, os objetivos desta dissertação foram os de revisar de forma sistemática a literatura a respeito dos efeitos do tratamento comtestosterona sobre o perfil clínico, metabólico, hematológico, lipídico e hepático de indivíduos transexuais masculinos.Nesta revisão sistemática e meta-análise, buscaram-se estudos publicados até maio de 2016 nas bases de dados Medline (PUBMED) and EMBASE. Foram incluídos estudos que relatassem intervenções com qualquer dose de testosterona e que apresentassem dados comparando variáveis clínicase metabólicas antes e depois do tratamento Para a meta-análise, somente artigos que tivessem analisado os efeitos do tratamento com undecanoato de testosterona por 12 meses foram incluídos. Desta forma, o tamanho do efeito foi calculado como alteração em 12 meses em relação ao valor médio basal. A busca resultou em 391 artigos potencialmente elegíveis. Destes, 13 alcançaram os critérios de eligibilidade e foram incluídos na revisão sistemática. Três foram elegíveis para a meta-análise. A qualidade destes estudos de acordo com a escala de Newcastle-Ottawa Scale foi boa. O tratamento com undecanoato de testosterona promoveu um significativo aumento nos níveis séricos de testosterona (tamanho do efeito 6.18, IC 95%: 4.59 à 7.76), hematócrito(4.80, IC95%: 4.06 à 5.54), hemoglobina(1.54, IC95%: 1.10 à 1.98), e pressão sistólica (4.74, IC 95%: 2.15 à7.33). Em conclusão, os resultados deste trabalho sugerem que o tratamento comundecanoato de testosteronaé efetivo e embora aumente significativamente hematócrito, hemoglobina e pressão sistólica no primeiroano de tratamento de homens transgêneros, estes achados são clinicamente aceitáveis evidenciando segurança deste tratamento. / Transsexualism is characterized by the irreversible desire to live and be accepted as belonging to the opposite sex to its biological sex. Male transsexuals (female to male) chronically use androgenic hormones to promote changes in secondary sexual characteristics compatible with gender identity, corresponding to cross-sex hormone therapy. Testosterone is the main hormone used in cross-hormone therapy in this population. Although it is considered safe, when used in adequate doses, few studies are available in the literature regarding the effects of testosterone in this specific population, in addition to including small sample sizes. Thus, the objectives of this dissertation were to systematically review the literature regarding the effects of testosterone treatment on the clinical, metabolic, hematological, lipid and hepatic profile of male transsexual individuals. In this systematic review and meta-analysis, studies were published until May 2016 in the Medline (PUBMED) and EMBASE databases. We included studies that reported interventions with any dose of testosterone and that presented data comparing clinical and metabolic variables before and after treatment For the meta-analysis, only articles that had analyzed the effects of treatment with testosterone undecanoate for 12 months were included. In this way, the effect size was calculated as change in 12 months in relation to the baseline mean value. Search resulted in 391 potentially eligible articles. Of these, 13 met the eligibility criteria and were included in the systematic review. Three were eligible for the meta-analysis. The quality of these studies according to the Newcastle-Ottawa Scale scale was good. Treatment with testosterone undecanoate promoted a significant increase in serum testosterone levels (effect size 6.18, 95% CI: 4.59 to 7.76), hematocrit (4.80, 95% CI: 4.06 to 5.54), hemoglobin (1.54, 95%: 1.10 to 1.98), and systolic pressure (4.74, 95% CI: 2.15 to 7.33). In conclusion, the results of this work suggest that testosterone undecanoate treatment is effective and although it significantly increases hematocrit, hemoglobin and systolic pressure in the first year of treatment of transgender men, these findings are clinically acceptable, evidencing the safety of this treatment.

This work in the theoretical part focuses on the role of men in a society and on the position of a woman. It also describes differences between men and women, differences in communication between a man and a woman and differences in a general perspective. It gives an insight in the process and phases of men being in love. It also gives an outlook on a man and a woman and their equal chances.