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Transgender People Pressured on ‘Conversion Therapy’

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, Aug. 28, 2019 (HealthDay News) — More than one in 10 transgender people say they’ve been pressured by a professional counselor to accept their birth sex.

So finds the largest survey to date on the issue.

Nearly 14% of transgender people say that some sort of professional — a psychologist, counselor or religious advisor — urged them to identify only with their sex assigned at birth, the survey revealed.

That amounts to more than 180,000 people across the United States who’ve been potentially subjected to a form of conversion therapy, said lead researcher Dr. Jack Turban. He is a child and adolescent psychiatrist at Harvard Medical School, in Boston.

Major medical organizations, including the American Medical Association, oppose such conversion efforts, deeming them ineffective and unethical, Turban said.

“State legislators have argued that these attempts to change gender identity don’t happen in their state, and they’ve used that as an argument against passing legislation that would make it illegal to try to change a person’s gender identity,” Turban said.

The percentage of transgender people who experienced conversion efforts ranged from a low of 9% in South Carolina to a high of 25% in Wyoming, the researchers found.

The survey “shows just how pervasive conversion therapy still is,” said Amy Green, director of research for The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for LGBTQ (lesbian, gay, bisexual, transgender, and queer or questioning) young people.

“Conversion therapy is dangerous, and The Trevor Project is proud to work with local coalitions and national organizations to end the discredited practice in all 50 states,” Green continued. “We know that with support, transgender and non-binary youth are resilient in the face of such harmful practices.”

Transgender conversion therapy was most commonly reported from a cluster of western states that include Montana, Idaho, Wyoming, Utah and South Dakota, the survey showed. These efforts also were common in Nevada, Oklahoma, West Virginia and Alaska.

The 2015 U.S. Transgender Survey involved more than 27,700 transgender people, with representation from all 50 states, the researchers said. As part of the survey, participants were asked if a professional had ever tried to make them stop being transgender.

Continued

Data have shown that conversion therapy can increase a person’s risk of suicide and psychological distress, Turban and Green said.

“In our latest survey, youth who reported having undergone conversion therapy attempted suicide at more than twice the rate as those who did not,” Green said. “In addition, more than half of transgender and non-binary youth surveyed seriously considered attempting suicide.”

Turban said, “We hope that these findings will provide inspiration for state legislators to outlaw gender identity change efforts. We also hope that parents and individuals will be less likely to seek out such modalities as we build public understanding that being transgender isn’t a disease that needs to be cured.”

The survey was published recently in the American Journal of Public Health.

These results are not surprising because there is not across-the-board agreement on how to deal with gender dysphoria in children, said Clinton Anderson, director of the American Psychological Association’s Sexual Orientation and Gender Diversity Office.

There’s widespread agreement that adults who declare themselves transsexual be assisted in making the transition to whatever extent they want, be it simple appearance or hormone therapy or surgery, Anderson said.

Adolescents who are transsexual also tend to be automatically accepted and assisted. “Increasingly, as they get older, it becomes clearer there is no likelihood that person will ever be able to accept their gender, except as a transgender person,” Anderson said.

But there’s ongoing debate over how to approach gender dysphoria in younger children, he added.

“Some people are hesitant about affirming completely a transition for that child, when you’re not sure if that transition is going to be what they will want when they are 15 or 25,” Anderson said.

On the other hand, such hesitancy is seen by some as being unsupportive or even opposed to a child’s exploration of their gender.

“Some people perceive that being anything less than affirming as being conversion therapy and, therefore, as being unethical and being bad,” Anderson said. “Sometimes that does get perceived by some people as being undermining to a child’s sense of themselves or of controlling their own destiny or autonomy.”

Continued

The term “conversion therapy” originally was coined to talk about efforts to change people’s sexual orientation, Anderson explained. But the term has been broadened in recent years to also refer to efforts to change a person’s gender identity.

“They’re two distinct parts of a person’s sexuality,” Anderson said of sexual orientation and gender identity. “They’re not the same.”

Turban recommends that parents of a child questioning their gender identity “keep an open, supportive stance toward your child. Remind them that you love them no matter what. Let them explore their gender identity, and don’t try to force them one way or another.”

He added that “research continues to show that shame and rejection drive most of the mental health problems in this population.”

WebMD News from HealthDay

Sources

SOURCES: Jack Turban, M.D., M.H.S., child and adolescent psychiatrist, Harvard Medical School, Boston; Amy Green, Ph.D., director, research, The Trevor Project; Clinton Anderson, Ph.D., director, American Psychological Association’s Sexual Orientation and Gender Diversity Office; Aug. 15, 2019,American Journal of Public Health, online

Copyright © 2013-2018 HealthDay. All rights reserved.

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Transgender ‘Conversion Therapy’ Common, Potentially Harmful

WEDNESDAY, Aug. 28, 2019 — More than one in 10 transgender people say they’ve been pressured by a professional counselor to accept their birth sex.

So finds the largest survey to date on the issue.

Nearly 14% of transgender people say that some sort of professional — a psychologist, counselor or religious advisor — urged them to identify only with their sex assigned at birth, the survey revealed.

That amounts to more than 180,000 people across the United States who’ve been potentially subjected to a form of conversion therapy, said lead researcher Dr. Jack Turban. He is a child and adolescent psychiatrist at Harvard Medical School, in Boston.

Major medical organizations, including the American Medical Association, oppose such conversion efforts, deeming them ineffective and unethical, Turban said.

“State legislators have argued that these attempts to change gender identity don’t happen in their state, and they’ve used that as an argument against passing legislation that would make it illegal to try to change a person’s gender identity,” Turban said.

The percentage of transgender people who experienced conversion efforts ranged from a low of 9% in South Carolina to a high of 25% in Wyoming, the researchers found.

The survey “shows just how pervasive conversion therapy still is,” said Amy Green, director of research for The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for LGBTQ (lesbian, gay, bisexual, transgender, and queer or questioning) young people.

“Conversion therapy is dangerous, and The Trevor Project is proud to work with local coalitions and national organizations to end the discredited practice in all 50 states,” Green continued. “We know that with support, transgender and non-binary youth are resilient in the face of such harmful practices.”

Transgender conversion therapy was most commonly reported from a cluster of western states that include Montana, Idaho, Wyoming, Utah and South Dakota, the survey showed. These efforts also were common in Nevada, Oklahoma, West Virginia and Alaska.

The 2015 U.S. Transgender Survey involved more than 27,700 transgender people, with representation from all 50 states, the researchers said. As part of the survey, participants were asked if a professional had ever tried to make them stop being transgender.

Data have shown that conversion therapy can increase a person’s risk of suicide and psychological distress, Turban and Green said.

“In our latest survey, youth who reported having undergone conversion therapy attempted suicide at more than twice the rate as those who did not,” Green said. “In addition, more than half of transgender and non-binary youth surveyed seriously considered attempting suicide.”

Turban said, “We hope that these findings will provide inspiration for state legislators to outlaw gender identity change efforts. We also hope that parents and individuals will be less likely to seek out such modalities as we build public understanding that being transgender isn’t a disease that needs to be cured.”

The survey was published recently in the American Journal of Public Health.

These results are not surprising because there is not across-the-board agreement on how to deal with gender dysphoria in children, said Clinton Anderson, director of the American Psychological Association’s Sexual Orientation and Gender Diversity Office.

There’s widespread agreement that adults who declare themselves transsexual be assisted in making the transition to whatever extent they want, be it simple appearance or hormone therapy or surgery, Anderson said.

Adolescents who are transsexual also tend to be automatically accepted and assisted. “Increasingly, as they get older, it becomes clearer there is no likelihood that person will ever be able to accept their gender, except as a transgender person,” Anderson said.

But there’s ongoing debate over how to approach gender dysphoria in younger children, he added.

“Some people are hesitant about affirming completely a transition for that child, when you’re not sure if that transition is going to be what they will want when they are 15 or 25,” Anderson said.

On the other hand, such hesitancy is seen by some as being unsupportive or even opposed to a child’s exploration of their gender.

“Some people perceive that being anything less than affirming as being conversion therapy and, therefore, as being unethical and being bad,” Anderson said. “Sometimes that does get perceived by some people as being undermining to a child’s sense of themselves or of controlling their own destiny or autonomy.”

The term “conversion therapy” originally was coined to talk about efforts to change people’s sexual orientation, Anderson explained. But the term has been broadened in recent years to also refer to efforts to change a person’s gender identity.

“They’re two distinct parts of a person’s sexuality,” Anderson said of sexual orientation and gender identity. “They’re not the same.”

Turban recommends that parents of a child questioning their gender identity “keep an open, supportive stance toward your child. Remind them that you love them no matter what. Let them explore their gender identity, and don’t try to force them one way or another.”

He added that “research continues to show that shame and rejection drive most of the mental health problems in this population.”

More information

GLAAD has more about being transgender.

© 2019 HealthDay. All rights reserved.

Posted: August 2019

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Medicare to Cover Breakthrough Cancer Gene Therapy

Aug. 8, 2019 — A breakthrough gene therapy will be covered for certain types of lymphoma and leukemia, Medicare says.

The therapy, called CAR-T, boosts a patient’s own immune cells to fight cancer and can cost hundreds of thousands of dollars, the Associated Press reported.

Studies have shown that CAR-T is effective against certain types of cancers, but can cause severe side effects. The use of the gene therapy to treat certain types of leukemia and lymphoma is approved by the U.S. Food and Drug Administration.

Medicare considered the matter for months before it announced its decision on Wednesday. The agency’s policies on coverage can influence private insurance, the AP reported.

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Does Hormone Therapy for Prostate Cancer Raise Dementia Risk?

SUNDAY, May 5, 2019 — When men with prostate cancer have to take drugs that block the testosterone fueling their tumors, they can suffer a host of side effects that include impotence, bone loss, heart trouble and obesity.

But new research uncovers yet another possible downside to the treatment: These men may be at greater risk for dementia.

For any type of dementia, that risk increased 17%; for Alzheimer’s disease, it increased 23%, the researchers said.

Common side effects of so-called androgen-deprivation therapy include hot flashes, unstable mood, trouble sleeping, headaches, high blood sugar, allergic reactions and impotence.

“Androgen-deprivation therapy may not only cause physical changes — such as osteoporosis, cardiovascular disease or obesity — but may also cause changes in cognition,” said researcher Dr. Karl Tully, a research fellow at Brigham and Women’s Hospital in Boston.

But Tully cautioned that this study cannot prove that such hormone therapy caused dementia, only that the two are associated.

The investigators also found that men on this type of therapy had a 10% greater risk of seeking psychiatric services.

The risk for dementia increased as the length of therapy increased, the researchers noted. Men on androgen-deprivation therapy for six months had a 25% increased risk for any kind of dementia and a 37% increased risk for Alzheimer’s, the findings showed.

Being on hormone therapy longer than six months increased the risk for dementia and using mental health services even more, Tully said.

For the study, Tully and his colleagues collected data on more than 100,400 men enrolled in Medicare. The men were diagnosed with prostate cancer between January 1992 and December 2009.

Given these findings, “physicians should be telling their patients about that risk and should probably perform regular screening,” Tully said.

One urologist, however, doesn’t think patients need to be told about this tenuous association.

“I don’t think it’s a fair discussion to have,” said Dr. Elizabeth Kavaler, a urology specialist at Lenox Hill Hospital in New York City.

In this population, the increase in dementia may not be from hormone therapy at all, Kavaler said. As people live longer, the odds of developing dementia naturally increase.

Moreover, many of these patients probably had other medical conditions that might increase their risk for dementia and Alzheimer’s, Kavaler added.

“Earlier generations were all worried about cancer — we’re worried about dementia,” she said.

In addition, patients with prostate cancer may not have a good option whether to start hormone therapy or not, she noted.

“We really don’t have a choice. Androgen-deprivation therapy is what can be offered to men with recurring or advanced prostate cancer. It’s a matter of treating a deadly disease versus the risk of developing a non-life-threatening condition,” Kavaler said.

“How do you ask somebody to choose between losing your mind or not treating their high-risk disease,” she said. “It’s a hard position to put a patient in. I wouldn’t even bring it up.”

The findings were scheduled to be presented Sunday at the American Urological Association annual meeting, in Chicago. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

Visit the American Cancer Society for more on prostate cancer.

© 2019 HealthDay. All rights reserved.

Posted: May 2019

Drugs.com – Daily MedNews

‘Exposure Therapy’ Best Against PTSD Plus Drinking

By Robert Preidt

HealthDay Reporter

FRIDAY, April 26, 2019 (HealthDay News) — For veterans with post-traumatic stress disorder (PTSD) combined with a drinking problem, the type of psychotherapy prescribed can make a difference in recovery rates, a new study finds.

So-called prolonged exposure therapy is more effective than coping skills therapy in helping these patients, according to researchers at the VA San Diego Healthcare System.

“The main takeaway of the study for me is that we may be doing a disservice to veterans if we don’t offer them the best treatments we have available for PTSD, such as prolonged exposure,” said study leader Sonya Norman.

The findings could help guide care for many veterans who have both PTSD and an alcohol use disorder, which often occur together, Norman and her colleagues said. Alcohol use disorder does not always rise to the level of alcoholism, which is a term used to describe someone with a severe form of alcohol dependence.

The study included 119 patients with PTSD and alcohol use disorder. Some received prolonged exposure therapy while others received a coping skills therapy called Seeking Safety.

In prolonged exposure therapy, patients gradually confront memories, feelings and situations related to their PTSD-causing trauma. The objective is to face them without feeling anxiety and stress. It’s considered the gold standard for PTSD treatment.

Seeking Safety is a widely accepted therapy for patients with both PTSD and alcohol use disorder, and focuses on coping skills rather than exposure.

Both therapies led to fewer days of heavy drinking and a decrease in PTSD symptoms, but study participants in the prolonged exposure therapy group had significantly lower PTSD symptom scores and higher rates of PTSD remission.

Immediately after treatment, PTSD remission was achieved in 22% of prolonged exposure patients and 7% of those in the coping skills group, the study authors said in a VA news release. At a 3-month follow-up, the rates were 25% versus 6%, respectively. After six months, the rates were 33% versus 15%, respectively, the findings showed.

Patients in both groups had similar reductions in heavy drinking days after treatment, according to the report published April 24 in JAMA Psychiatry.

Continued

Some experts had questioned use of exposure therapy for these patients. However, “the research is not showing concerns that PTSD patients with alcohol use disorder can’t handle exposure to be true,” said Norman, a VA researcher and psychiatry professor at the University of California, San Diego.

“The next stage of this research is to learn how to make prolonged exposure even more effective for patients with PTSD and alcohol use disorder. We are now conducting a study where we are combining medication to help reduce drinking with prolonged exposure to see if the combination helps patients complete prolonged exposure and benefit even more from the treatment,” Norman said in the news release.

WebMD News from HealthDay

Sources

SOURCE: Veterans Affairs, news release, April 24, 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

‘); } else { // If we match both our test Topic Ids and Buisness Ref we want to place the ad in the middle of page 1 if($ .inArray(window.s_topic, moveAdTopicIds) > -1 && $ .inArray(window.s_business_reference, moveAdBuisRef) > -1){ // The logic below reads count all nodes in page 1. Exclude the footer,ol,ul and table elements. Use the varible // moveAdAfter to know which node to place the Ad container after. window.placeAd = function(pn) { var nodeTags = [‘p’, ‘h3′,’aside’, ‘ul’], nodes, target; nodes = $ (‘.article-page:nth-child(‘ + pn + ‘)’).find(nodeTags.join()).not(‘p:empty’).not(‘footer *’).not(‘ol *, ul *, table *’); //target = nodes.eq(Math.floor(nodes.length / 2)); target = nodes.eq(moveAdAfter); $ (”).insertAfter(target); } // Currently passing in 1 to move the Ad in to page 1 window.placeAd(1); } else { // This is the default location on the bottom of page 1 $ (‘.article-page:nth-child(1)’).append(”); } } })(); $ (function(){ // Create a new conatiner where we will make our lazy load Ad call if the reach the footer section of the article $ (‘.main-container-3’).prepend(”); });

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‘Exposure Therapy’ May Work Best for PTSD Plus Drinking Problems

FRIDAY, April 26, 2019 — For veterans with post-traumatic stress disorder (PTSD) combined with a drinking problem, the type of psychotherapy prescribed can make a difference in recovery rates, a new study finds.

So-called prolonged exposure therapy is more effective than coping skills therapy in helping these patients, according to researchers at the VA San Diego Healthcare System.

“The main takeaway of the study for me is that we may be doing a disservice to veterans if we don’t offer them the best treatments we have available for PTSD, such as prolonged exposure,” said study leader Sonya Norman.

The findings could help guide care for many veterans who have both PTSD and an alcohol use disorder, which often occur together, Norman and her colleagues said. Alcohol use disorder does not always rise to the level of alcoholism, which is a term used to describe someone with a severe form of alcohol dependence.

The study included 119 patients with PTSD and alcohol use disorder. Some received prolonged exposure therapy while others received a coping skills therapy called Seeking Safety.

In prolonged exposure therapy, patients gradually confront memories, feelings and situations related to their PTSD-causing trauma. The objective is to face them without feeling anxiety and stress. It’s considered the gold standard for PTSD treatment.

Seeking Safety is a widely accepted therapy for patients with both PTSD and alcohol use disorder, and focuses on coping skills rather than exposure.

Both therapies led to fewer days of heavy drinking and a decrease in PTSD symptoms, but study participants in the prolonged exposure therapy group had significantly lower PTSD symptom scores and higher rates of PTSD remission.

Immediately after treatment, PTSD remission was achieved in 22% of prolonged exposure patients and 7% of those in the coping skills group, the study authors said in a VA news release. At a 3-month follow-up, the rates were 25% versus 6%, respectively. After six months, the rates were 33% versus 15%, respectively, the findings showed.

Patients in both groups had similar reductions in heavy drinking days after treatment, according to the report published April 24 in JAMA Psychiatry.

Some experts had questioned use of exposure therapy for these patients. However, “the research is not showing concerns that PTSD patients with alcohol use disorder can’t handle exposure to be true,” said Norman, a VA researcher and psychiatry professor at the University of California, San Diego.

“The next stage of this research is to learn how to make prolonged exposure even more effective for patients with PTSD and alcohol use disorder. We are now conducting a study where we are combining medication to help reduce drinking with prolonged exposure to see if the combination helps patients complete prolonged exposure and benefit even more from the treatment,” Norman said in the news release.

More information

The U.S. National Institute of Mental Health has more on PTSD.

© 2019 HealthDay. All rights reserved.

Posted: April 2019

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AHA News: How Can Therapy for Heart Attack Patients Help Cancer Survivors?

MONDAY, April 8, 2019 (American Heart Association News) — Heart disease and cancer — ruthless conditions that are the nation’s leading causes of death — can sometimes intertwine. Certain cancer treatments can directly damage the heart, while others leave survivors dealing with weight gain or loss of fitness.

One way to potentially counteract these heart-related risks is to adopt a cardiac rehab plan like the one heart attack survivors follow.

That’s the strategy behind cardio-oncology rehabilitation, an emerging health care specialty that could be instrumental in treating the cardiovascular-related problems that arise in cancer survivors, according to a new scientific statement from the American Heart Association published Monday in the journal Circulation.

Thanks to advances in early detection and treatment, there are nearly 17 million cancer survivors in the United States. But many are 1.3 to 3.6 times more likely to die from a cardiovascular-related event compared to someone who has never had cancer. Cancer survivors also are 1.7 to 18.5 times more likely to develop diabetes, high blood pressure, high cholesterol or other heart disease risks.

“There are still cancer patients and health care providers who don’t understand the link between heart disease and cancer, so we’re trying to educate them,” said Dr. Susan Gilchrist, chair of the statement’s writing committee and a cardiologist at the University of Texas MD Anderson Cancer Center in Houston.

The new report explains how certain factors — such as a patient’s age, the type of cancer and whether chemotherapy was involved — can make a difference in a person’s risk for cardiovascular disease, she said.

“We need to do a better job of explaining the issue, and I think this document helps people understand who’s at higher risk and, if they are at higher risk, what can we do about it as both oncologists and cardiologists so we don’t keep separate silos,” Gilchrist said.

Cardiovascular risks go up for cancer survivors for various reasons. Some people already may have cardiovascular risk factors, but not know about them at the time of their cancer diagnosis or during treatment.

Other times, the heart muscle is weakened by the drugs, radiation or other treatments used to eliminate the cancer.

“Many patients, after they receive their cancer therapy, need help getting their heart back to a stronger and healthier functional status,” said Dr. Randal Thomas, a member of the statement’s writing committee.

That’s where cardiac rehabilitation comes into play.

Cardiac rehab is a medically supervised program for people who have had a heart attack or some type of heart surgery. It involves exercise training, education about lifestyle changes and counseling to help reduce stress and anxiety.

“Cardiac rehab is a great way to systematically alter the lifestyles, particularly exercise, and cardiovascular risk factors at play for a cancer patient,” Gilchrist said. “And cardiac rehab already exists — you don’t have to re-invent the wheel. It exists all across the United States, both in community and academic hospitals.”

But because cardio-oncology rehab is an evolving field that has only existed for a handful of years, getting insurance to pay for it has been a problem.

“This scientific statement is a first step to pave the way for reimbursement for patients with cancer within the (cardiac rehab) model,” its authors wrote.

The statement also calls for more research to show cardio-oncology rehabilitation works. Past studies have shown exercise may help people regain some of the cardiorespiratory fitness lost during cancer treatment. Research also suggests programs modeled after cardiac rehab can improve a survivor’s muscular strength and quality of life.

“There’s definitely a need for more studies to look at new populations and methods and when is the best time to initiate therapy,” said Thomas, medical director of the cardiac rehabilitation program at the Mayo Clinic in Rochester, Minnesota, where a cardio-oncology rehab program is currently available for breast cancer survivors.

“But at the same time, it’s a really good time for patients and health care providers to communicate with policymakers, including government leaders, about the importance of covering what we already know can be beneficial to patients recovering from cancer.”

Gilchrist, who heads up one of the nation’s few programs in this area, said there’s an overlap between cardiovascular disease and factors that drive cancer.

“Cardiac rehab is about getting people to exercise more. We know exercise helps people live longer. It keeps people out of the hospital. It lowers the risk of cancer mortality for several types of cancer. It also prevents cardiovascular disease,” she said. “So providing structured exercise to cancer patients, systematically across the U.S., would be a tremendous win for society in general.”

© 2019 HealthDay. All rights reserved.

Posted: April 2019

Drugs.com – Daily MedNews

Physical Therapy Can Keep Sports Injuries at Bay