Increased resilience has been consistently linked to improved mental and physical health outcomes. Because individuals with HIV have a longer life expectancy than ever before, it is imperative to identify mechanisms to promote resilience in this population. Physical activity has significant potential to strengthen resilience and improve overall well-being in individuals with HIV. The goal of this study was to investigate whether increased physical activity is positively associated with increased individual-level psychosocial resilience, and whether this association varied by HIV status. Data for this analysis were obtained from the Multicenter AIDS Cohort Study (MACS), a longitudinal observational cohort study following men living with and without HIV in the United States. Specifically, cross-sectional data collected between October 2016 and March 2017 from 1118 MACS participants enrolled in the Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men sub-study were used. Odds ratios were determined using logistic regression to examine the association of physical activity with psychosocial resilience (measured using the 14-item Resilience Scale). Among all MACS participants enrolled in the sub-study, both sufficient physical activity and health-enhancing physical activity were positively associated with high resiliency (odds ratio, 2.20 [95% CI, 1.36-3.56] and odds ratio, 3.72 [95% CI, 2.30-6.03], respectively). Among the participants with HIV, only health-enhancing physical activity was positively associated with high resiliency (odds ratio, 3.07 [95% CI, 1.54-6.14]). At the level of individual patient care, physical activity has significant potential to improve health outcomes and strengthen resilience in individuals living with HIV.
{"title":"Association Between Physical Activity and Psychosocial Resilience Among Middle-Aged and Aging Men Living With or Without HIV in the Multicenter AIDS Cohort Study","authors":"Liddy Kasraian, Deanna Ware, M. Plankey","doi":"10.52504/001c.74744","DOIUrl":"https://doi.org/10.52504/001c.74744","url":null,"abstract":"Increased resilience has been consistently linked to improved mental and physical health outcomes. Because individuals with HIV have a longer life expectancy than ever before, it is imperative to identify mechanisms to promote resilience in this population. Physical activity has significant potential to strengthen resilience and improve overall well-being in individuals with HIV. The goal of this study was to investigate whether increased physical activity is positively associated with increased individual-level psychosocial resilience, and whether this association varied by HIV status. Data for this analysis were obtained from the Multicenter AIDS Cohort Study (MACS), a longitudinal observational cohort study following men living with and without HIV in the United States. Specifically, cross-sectional data collected between October 2016 and March 2017 from 1118 MACS participants enrolled in the Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men sub-study were used. Odds ratios were determined using logistic regression to examine the association of physical activity with psychosocial resilience (measured using the 14-item Resilience Scale). Among all MACS participants enrolled in the sub-study, both sufficient physical activity and health-enhancing physical activity were positively associated with high resiliency (odds ratio, 2.20 [95% CI, 1.36-3.56] and odds ratio, 3.72 [95% CI, 2.30-6.03], respectively). Among the participants with HIV, only health-enhancing physical activity was positively associated with high resiliency (odds ratio, 3.07 [95% CI, 1.54-6.14]). At the level of individual patient care, physical activity has significant potential to improve health outcomes and strengthen resilience in individuals living with HIV.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114690041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Negative aging perceptions have been shown to influence one’s health care–seeking behaviors; this relationship has not been studied among middle-aged and aging adults living with HIV. The current study uses data from the Multicenter AIDS Cohort Study (MACS) to investigate the association between subjective age and health care avoidance. To examine the hypothesis that adults living with HIV who perceive themselves as older, after adjustment for covariates, would be more likely to avoid care than their HIV-negative counterparts who perceive themselves as older. The MACS is a prospective study of more than 7000 sexual minority men living with and without HIV from 4 metropolitan US areas. The Understanding Patterns of Healthy Aging in Men Who Have Sex With Men sub-study of the MACS was conducted from April 2016 to March 2019. Current analyses use cross-sectional data on 1118 participants from this sub-study from October 2016 to March 2017. Logistic regression was used to produce odds ratios and 95% CIs examining the association between subjective age and health care avoidance. Covariates included age, HIV status, race and ethnicity, education, and comorbid conditions. Further analyses were conducted among persons living with HIV, which included CD4 counts and viral load detection as covariates. In the full sample and sample of people living with HIV, after adjustment for covariates, there was a positive association between older subjective age and health care avoidance and a negative association between younger subjective age and health care avoidance, albeit both not statistically significant. Living with HIV was positively associated with health care avoidance, but not statistically significant. Future studies with larger sample sizes are needed to elucidate the significance of subjective age and health care avoidance. Aside from the pivotal role of health care avoidance, the field of HIV and aging may benefit from identifying other psychological, physiological, and behavioral mechanisms by which perceptions of aging influence health.
{"title":"Subjective Age and Health Care Avoidance Among Aging Men Living With or Without HIV","authors":"Q. Seau, Deanna Ware, M. Plankey","doi":"10.52504/001c.74742","DOIUrl":"https://doi.org/10.52504/001c.74742","url":null,"abstract":"Negative aging perceptions have been shown to influence one’s health care–seeking behaviors; this relationship has not been studied among middle-aged and aging adults living with HIV. The current study uses data from the Multicenter AIDS Cohort Study (MACS) to investigate the association between subjective age and health care avoidance. To examine the hypothesis that adults living with HIV who perceive themselves as older, after adjustment for covariates, would be more likely to avoid care than their HIV-negative counterparts who perceive themselves as older. The MACS is a prospective study of more than 7000 sexual minority men living with and without HIV from 4 metropolitan US areas. The Understanding Patterns of Healthy Aging in Men Who Have Sex With Men sub-study of the MACS was conducted from April 2016 to March 2019. Current analyses use cross-sectional data on 1118 participants from this sub-study from October 2016 to March 2017. Logistic regression was used to produce odds ratios and 95% CIs examining the association between subjective age and health care avoidance. Covariates included age, HIV status, race and ethnicity, education, and comorbid conditions. Further analyses were conducted among persons living with HIV, which included CD4 counts and viral load detection as covariates. In the full sample and sample of people living with HIV, after adjustment for covariates, there was a positive association between older subjective age and health care avoidance and a negative association between younger subjective age and health care avoidance, albeit both not statistically significant. Living with HIV was positively associated with health care avoidance, but not statistically significant. Future studies with larger sample sizes are needed to elucidate the significance of subjective age and health care avoidance. Aside from the pivotal role of health care avoidance, the field of HIV and aging may benefit from identifying other psychological, physiological, and behavioral mechanisms by which perceptions of aging influence health.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121787625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Love Letter: A Case for Expanding Good Samaritan Laws","authors":"Lisa Gong","doi":"10.52504/001c.67865","DOIUrl":"https://doi.org/10.52504/001c.67865","url":null,"abstract":"","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115749075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"For the Physician, By the Physician: The Management of Addiction in Medicine","authors":"A. Prasad","doi":"10.52504/001c.67867","DOIUrl":"https://doi.org/10.52504/001c.67867","url":null,"abstract":"","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126501228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. L. Umstead, S. Woolford, Ellen F. Macnamara, T. Yanes, K. Brothers, P. Han, Julie C. Sapp, M. Crenshaw, Cristofer S. Price, B. Biesecker
Understanding perceptions of uncertainty among parents of children with chronic conditions—and health care providers’ opportunities to help parents effectively cope—is limited by existing measures. To develop a novel, outcomes-oriented scale to measure parental perceptions of uncertainties about the health of a child. Informed by existing literature and interviews with parents, items were generated to capture disease-centered uncertainties (about diagnosis, prognosis, treatment) and patient-centered uncertainties (about familial, reproductive, social, and existential implications). After pilot testing, the Parental Uncertainty About a Child’s Health Scale (PUCHS) was administered in 3 studies assessing parental uncertainty in the context of caring for a child with an undiagnosed medical condition. Data from 2 studies (n = 149) were used to refine the hypothesized measurement model, and data from a third study (n = 417) were used to conduct a confirmatory factor analysis to determine the fit of the resulting measurement model. A 4-factor model (diagnostic, therapeutic, familial, social) satisfied overall model fit statistics and structural validity as indicated by standardized loadings, reliability, and variance extracted for each of the constructs. Additionally, each of the constructs satisfied convergent and discriminant validity. These findings across multiple samples in varying contexts suggest that the model demonstrates configural invariance across applications. As a valid, reliable measure of parental uncertainties about children with chronic undiagnosed medical conditions, the PUCHS will advance understanding and thereby inform development of interventions to manage uncertainties. Communication of these uncertainties and their effective management are fundamental components of patient-centered care.
{"title":"Parental Uncertainty About a Child’s Health Scale (PUCHS): Development and Validation of a Novel Measure","authors":"K. L. Umstead, S. Woolford, Ellen F. Macnamara, T. Yanes, K. Brothers, P. Han, Julie C. Sapp, M. Crenshaw, Cristofer S. Price, B. Biesecker","doi":"10.52504/001c.68103","DOIUrl":"https://doi.org/10.52504/001c.68103","url":null,"abstract":"Understanding perceptions of uncertainty among parents of children with chronic conditions—and health care providers’ opportunities to help parents effectively cope—is limited by existing measures. To develop a novel, outcomes-oriented scale to measure parental perceptions of uncertainties about the health of a child. Informed by existing literature and interviews with parents, items were generated to capture disease-centered uncertainties (about diagnosis, prognosis, treatment) and patient-centered uncertainties (about familial, reproductive, social, and existential implications). After pilot testing, the Parental Uncertainty About a Child’s Health Scale (PUCHS) was administered in 3 studies assessing parental uncertainty in the context of caring for a child with an undiagnosed medical condition. Data from 2 studies (n = 149) were used to refine the hypothesized measurement model, and data from a third study (n = 417) were used to conduct a confirmatory factor analysis to determine the fit of the resulting measurement model. A 4-factor model (diagnostic, therapeutic, familial, social) satisfied overall model fit statistics and structural validity as indicated by standardized loadings, reliability, and variance extracted for each of the constructs. Additionally, each of the constructs satisfied convergent and discriminant validity. These findings across multiple samples in varying contexts suggest that the model demonstrates configural invariance across applications. As a valid, reliable measure of parental uncertainties about children with chronic undiagnosed medical conditions, the PUCHS will advance understanding and thereby inform development of interventions to manage uncertainties. Communication of these uncertainties and their effective management are fundamental components of patient-centered care.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134496005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use Your Brain! Help Change the Narrative Surrounding Concussions in the Media","authors":"Zack Backstrom","doi":"10.52504/001c.68101","DOIUrl":"https://doi.org/10.52504/001c.68101","url":null,"abstract":"","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126331352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Breast cancer is one of the leading causes of cancer-related mortality among women. Multiple subtypes exist for tumor biology, but triple-negative breast cancer (TNBC) lacks expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor. TNBC accounts for 20% of breast cancers and is one of the most aggressive subtypes associated with an earlier age susceptibility, racial and ethnic differences, and limited targeted therapies. African American women bear a disproportionate burden in oncology-related health disparities. This population of women is diagnosed at later stages often with regional to distant metastases, high tumor grades, aberrant sequence mutations, treatment delays, and decreased disease-free survival. This review explores the multifactorial nature of this health disparity by addressing the physiological mechanisms, socioeconomic factors, ancestral differences, and challenges associated with diagnosis and treatment methods in the era of precision medicine.
{"title":"The Physiological Mechanisms of Triple Negative Breast Cancer in African American Women","authors":"Tyra Albert","doi":"10.52504/001c.57753","DOIUrl":"https://doi.org/10.52504/001c.57753","url":null,"abstract":"Breast cancer is one of the leading causes of cancer-related mortality among women. Multiple subtypes exist for tumor biology, but triple-negative breast cancer (TNBC) lacks expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor. TNBC accounts for 20% of breast cancers and is one of the most aggressive subtypes associated with an earlier age susceptibility, racial and ethnic differences, and limited targeted therapies. African American women bear a disproportionate burden in oncology-related health disparities. This population of women is diagnosed at later stages often with regional to distant metastases, high tumor grades, aberrant sequence mutations, treatment delays, and decreased disease-free survival. This review explores the multifactorial nature of this health disparity by addressing the physiological mechanisms, socioeconomic factors, ancestral differences, and challenges associated with diagnosis and treatment methods in the era of precision medicine.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124910849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Myocardial infarction (MI) poses a significant burden to both patients and the health care system. The irreversible loss of functional cardiomyocytes due to ischemia threatens both patients’ immediate survival and quality of life over their lifespan. Stem cell therapy has been proposed as a solution to salvage cardiac contractility through the regeneration of cardiomyocytes, and bone marrow–derived stem cells (BMSc) are among the category of stem cells most extensively studied. Despite the promising theoretical potential of BMSc in tissue regeneration, several key aspects remain to be better understood to enable large-scale clinical application, including safety and efficacy. Our current work in synthesizing and evaluating both preclinical and clinical studies using stem cell applications in acute MI has demonstrated that BMSc transplantation is a safe therapy for MI. Although this therapy’s efficacy is not consistently proven, we have significantly improved our understanding of factors contributing to its success, such as the stem cell type, patients’ baseline left ventricular ejection fraction, individual hemodynamic factors, and differential expressions of specific genes. In future investigations, researchers should focus on the cellular and individual attributes of BMSc treatment to achieve maximal efficacy and outcomes for patients receiving this therapy after acute MI.
{"title":"Factors Affecting Outcomes of Bone Marrow Stem Cell Therapy for Acute Myocardial Infarction","authors":"Evan Czulada, Tianzhi Tang, Quinn Seau, Nithin Lankipelle","doi":"10.52504/001c.57047","DOIUrl":"https://doi.org/10.52504/001c.57047","url":null,"abstract":"Myocardial infarction (MI) poses a significant burden to both patients and the health care system. The irreversible loss of functional cardiomyocytes due to ischemia threatens both patients’ immediate survival and quality of life over their lifespan. Stem cell therapy has been proposed as a solution to salvage cardiac contractility through the regeneration of cardiomyocytes, and bone marrow–derived stem cells (BMSc) are among the category of stem cells most extensively studied. Despite the promising theoretical potential of BMSc in tissue regeneration, several key aspects remain to be better understood to enable large-scale clinical application, including safety and efficacy. Our current work in synthesizing and evaluating both preclinical and clinical studies using stem cell applications in acute MI has demonstrated that BMSc transplantation is a safe therapy for MI. Although this therapy’s efficacy is not consistently proven, we have significantly improved our understanding of factors contributing to its success, such as the stem cell type, patients’ baseline left ventricular ejection fraction, individual hemodynamic factors, and differential expressions of specific genes. In future investigations, researchers should focus on the cellular and individual attributes of BMSc treatment to achieve maximal efficacy and outcomes for patients receiving this therapy after acute MI.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127714019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over the past century, global disaster deaths have averaged approximately 45,000 people annually. Vector-borne pathogens are susceptible to climatic conditions influencing vector survival, gonotrophic cycle, and transmission efficiency in human hosts. However, the literature has not collectively analyzed the relationship between natural disasters and vector-borne disease (VBD) outbreaks over decades. This literature review identifies and examines published papers documenting VBD outbreaks associated with natural disasters. Additionally, information was gathered about the kinds of natural disasters commonly associated with VBD outbreaks and which diseases typically occur post- disasters. A literature review was performed using two search strategies with terms for natural disasters and vector-borne infectious diseases as identified in the title, keywords, or abstract. Observational studies and systematic review papers were screened on the occurrence of a VBD post-disaster. A total of 30 studies were captured. Eight disaster types were captured: flood, hurricane, tropical cyclone, typhoon, tsunami, drought, monsoon, and earthquake. Floods (n=21), hurricanes (n=20), tsunamis (n=8), and drought (n=8) account for the top four disaster events commonly associated with VBDs. Of the VBDs identified, malaria outbreaks were identified in 16 papers, while dengue outbreaks were captured in 11. The literature reveals a predominance of floods, malaria and dengue. While there is increasing acknowledgment that disasters can lead to outbreaks of VBDs, there is limited research and consistent data available. Future research should rely on well-defined, consistent case detection and enrollment procedures, preferably at various lag periods following a disaster event.
{"title":"Outbreaks of Vector-borne Infectious Disease Following a Natural Disaster","authors":"Norma Quintanilla","doi":"10.52504/001c.38768","DOIUrl":"https://doi.org/10.52504/001c.38768","url":null,"abstract":"Over the past century, global disaster deaths have averaged approximately 45,000 people annually. Vector-borne pathogens are susceptible to climatic conditions influencing vector survival, gonotrophic cycle, and transmission efficiency in human hosts. However, the literature has not collectively analyzed the relationship between natural disasters and vector-borne disease (VBD) outbreaks over decades. This literature review identifies and examines published papers documenting VBD outbreaks associated with natural disasters. Additionally, information was gathered about the kinds of natural disasters commonly associated with VBD outbreaks and which diseases typically occur post- disasters. A literature review was performed using two search strategies with terms for natural disasters and vector-borne infectious diseases as identified in the title, keywords, or abstract. Observational studies and systematic review papers were screened on the occurrence of a VBD post-disaster. A total of 30 studies were captured. Eight disaster types were captured: flood, hurricane, tropical cyclone, typhoon, tsunami, drought, monsoon, and earthquake. Floods (n=21), hurricanes (n=20), tsunamis (n=8), and drought (n=8) account for the top four disaster events commonly associated with VBDs. Of the VBDs identified, malaria outbreaks were identified in 16 papers, while dengue outbreaks were captured in 11. The literature reveals a predominance of floods, malaria and dengue. While there is increasing acknowledgment that disasters can lead to outbreaks of VBDs, there is limited research and consistent data available. Future research should rely on well-defined, consistent case detection and enrollment procedures, preferably at various lag periods following a disaster event.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132265630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julian K. Marable, M. Etchéverry, Bailey Liter, Melissa Wu
Family planning is critical to the sexual and reproductive health of all patients. For transgender individuals, using gender-preferred modalities for conception and prevention can minimize gender incongruence and dysphoria. Currently, the literature describes several pregnancy options including natural conception, gamete cryopreservation, in vitro fertilization, and uterine transplantation. Prevention methods remain similar to those for cisgender patients such as oral contraception, intrauterine devices, condoms, and various surgical procedures. However, great emphasis lies on choosing a method that best supports the chosen gender identity of the patient. This review supports oocyte and sperm cryopreservation as the preferred method for pregnancy and finds consensus with the literature that there is no best method for prevention. As such, physicians should prioritize early discussions with patients and work closely to use modalities that fit each patient’s needs and expectations. As the body of literature on LGBTQ+ health continues to grow, this review will help to expand the knowledge around family planning for transgender patients.
{"title":"Fertility Options for Transgender Patients: How Can Physicians Provide More Inclusive Care?","authors":"Julian K. Marable, M. Etchéverry, Bailey Liter, Melissa Wu","doi":"10.52504/001c.57049","DOIUrl":"https://doi.org/10.52504/001c.57049","url":null,"abstract":"Family planning is critical to the sexual and reproductive health of all patients. For transgender individuals, using gender-preferred modalities for conception and prevention can minimize gender incongruence and dysphoria. Currently, the literature describes several pregnancy options including natural conception, gamete cryopreservation, in vitro fertilization, and uterine transplantation. Prevention methods remain similar to those for cisgender patients such as oral contraception, intrauterine devices, condoms, and various surgical procedures. However, great emphasis lies on choosing a method that best supports the chosen gender identity of the patient. This review supports oocyte and sperm cryopreservation as the preferred method for pregnancy and finds consensus with the literature that there is no best method for prevention. As such, physicians should prioritize early discussions with patients and work closely to use modalities that fit each patient’s needs and expectations. As the body of literature on LGBTQ+ health continues to grow, this review will help to expand the knowledge around family planning for transgender patients.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124323128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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