Medical students who are specifically trained in clinical transgender medicine are better prepared to treat transgender patients, a new study from Boston University School of Medicine suggests. The study results will be presented in a poster Saturday, March 17 at ENDO 2018, the 100th annual meeting of the Endocrine Society in Chicago, Ill.

"The number one barrier to quality transgender medical care is the lack of trained clinicians," study co-authors Jason Andrew Park, a medical , and Joshua David Safer, M.D., the medical director of the Center for Transgender Medicine and Surgery, said in a joint statement.

"Boston University School of Medicine introduced a clinical elective where students can participate in direct medical care for . The students who participated in the elective reported greater confidence in providing care to transgender individuals than the same students had reported from classroom instruction alone," they noted.

To augment the school's mandatory training of medical students in gender identity and transgender medicine, the authors implemented a pilot Transgender Medicine elective that enabled fourth-year  to rotate on services that provided direct transgender-specific clinical care for transgender . The 20 students in the program had already taken part in an elective in which they learned methods of providing transgender medical care.

In a survey at the beginning of the pilot elective, all the students expressed the opinion that medical schools and residency programs need to provide training in transgender health. In a survey after completing the elective, the students reported significantly improved confidence in their ability to provide care to transgender patients. Students rating their comfort as "high" increased from 45 percent (9 students) at baseline to 80 percent (16 students), and those rating their knowledge of the management of transgender patients as "high" rose from zero to 85 percent (17 students).

The percentage of students rating their skills for providing general care to transgender patients as "low" decreased from 35 percent (7 students) at baseline to zero, and the number rating their skills for providing hormone treatment to transgender patients as "low" dropped from 10 students to 1.

"Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. Clinical exposure to transgender  during clinical years can contribute to closing the gap between  and LGB care and to improving access to care," the authors wrote in their abstract.

The male to female can give a better life to the majority of patients, revealed a study.

Scientists have developed a transgender-specific questionnaire, which confirms for the first time that significantly improves for the majority of patient.


The study shows that 80 percent of male-to-female patients perceived themselves as women post- However, the of individuals is still significantly lower than the general population.

Many individuals request reassignment surgery, but until now there only existed information on general aspects of health-related (QoL) and non-validated questionnaires about the improvement of QoL.

A team at the in Essen, Germany, led by Dr. Jochen Hess, followed 156 patients for a median of more than 6 years after  They developed and validated the new Essen Inventory, which is the first methodology to specifically consider 

They found that there was a high overall level of satisfaction with the outcomes of When comparing the QoL of the last four weeks with the QoL during the time of publicly identifying as transgendered there was a highly significant increase on all subscales of the ETL as well as for the global score indicating a large improvement of QoL in the course of the transitioning process.

Dr Hess commented, "The good news is that we found that around three-quarters of patients showed a better after  80 percent perceived themselves to be women, and another 16 percent felt that they were 'rather female'. 3 women in 4 were able to have orgasms after reassignment surgery".

"It's very important that we have good data on in people. They generally suffer from a worse QoL than non-population, with higher rates of stress and mental illness, so it's good that can change this, but also that we can now show that it has a positive effect. Until now we have been using general methods to understand the in individuals, but this new method means that we can address well-being in greater depth", continued Dr Hess.

Recent data1 estimates that 1.4 million adults in the USA identify as transgender, which is about 0.6 percent of the population. Comparable European figures are not available, but there is wide variation between reported prevalence in individual European countries.

"Nevertheless, we now have the first specific validated tool for measuring QoL in patients, we hope that this means that we can go forward to gather better information to help us improve treatment", said Dr Hess.

Commenting, Prof Piet Hoebeke, Ghent University Hospital, Belgium, who was not a part of the study, said, "As patients develop a better understanding and higher acceptance of surgery, more will seek gender-confirming  Despite this observation, many doctors are still not convinced that this is a medical condition for which can be offered as a valuable treatment. We need studies like this one to convince the medical world that these patients can get a better QOL with treatment".

Another Prof Jens Sønksen, University of Copenhagen, commented independently, "This study suffered from a high drop-out rate, which needs to be considered alongside the main data. Nevertheless, this is a large important study, one of the largest clinical transsexual surveys ever attempted, and the fact that has been performed using a specific validated questionnaire is significant. This is probably the best view of the in after sex-reassignment that we have".

SWAMPSCOTT — The principal of Stanley Elementary School has been let go after coming out as transgender last month.

Superintendent Pamela Angelakis has opted to keep Principal Shannon Daniels, formerly Tom, on paid administrative leave for the remainder of the school year and not renew Daniels’ contract with Swampscott Public Schools, which expires on June 30.

“In accordance with the terms of the contract, I notified Principal Daniels of that earlier this week,” Angelakis wrote in a letter to Stanley families. “As this is a personnel matter, and out of respect for Principal Daniels’ privacy, I will not be commenting on the reasons for this decision. Swampscott Public Schools wishes Principal Daniels the best moving forward.”

Daniels, who became the school’s principal in 2012, said they couldn’t comment.

Stanley families were told two weeks ago that Daniels was on a temporary leave of absence and early last week Angelakis said she was extending Daniels’ leave of absence indefinitely.

No reason was given for extending the leave, but initially Angelakis said the temporary leave was a mutual decision with Daniels, which came after several conversations with Daniels, “in which she reported receiving messages that she considered hurtful relative to her recent announcement.”

The decision to not renew the contract comes in the wake of a parents petition that was submitted to the School Committee earlier this month, which declared a lack of confidence in the Stanley principal, with parents saying the dissatisfaction in Daniels’ performance came before, and was not related to Daniels’ recent transgender announcement.

Amy O’Connor, school committee chairwoman, said in a previous interview with The Item that the committee had received a petition on Friday, March 2, which represented a large number of Stanley parents. She said the school committee met in executive session on March 2 to discuss complaints regarding a school employee.

O’Connor said she called the executive session two days before the meeting in response to a large quantity of emails that she had received from parents regarding the school employee, but clarified that the school committee does not make any decisions about personnel matters. The only personnel decision the school committee is involved with is the superintendent position.

“I can’t add any color to it because in the end this is in the superintendent’s purview since it’s a personnel issue,” O’Connor reiterated on Thursday regarding the superintendent’s decision not to renew the contract.

Daniels, 52, a Swampscott resident, announced early last month that they’re transgender and would be presenting as female going forward. Daniels identifies as both male and female and prefers they/them pronouns for a gender-fluid identity, but plans to become fully transitioned to female.

The superintendent’s decision to part ways with Daniels comes after a tumultuous period at Stanley Elementary School following Daniels’ announcement. There was a police presence at the school two weeks ago, and also the week before February vacation.

Angelakis said previously that she and Police Chief Ronald Madigan agreed there would be a police presence at the school to ensure a smooth return for students and parents, which officials hoped would reduce some of the anxiety that parents may be feeling as a result of the heightened media attention.

Madigan previously said that there have been phone calls, voicemails and emails at the school since the principal’s earlier announcement, but nothing that police felt rose to the level of constituting a threat.

Lois Longin, former principal at Hadley and Clarke Schools and director of curriculum and instruction for the district, will serve as acting principal at Stanley School starting March 20 and will remain in that position through the end of the school year, Angelakis said.

Longin retired in 2016 after a 31-year career with Swampscott Public Schools that included teaching K-2, serving as principal of Hadley for nine years and Clarke for seven years, and as district wide administrator until she retired in June 2016.

“A Swampscott native and product of Swampscott Schools, she has a passion for education and a familiarity with our district that will allow her to hit the ground running,” Angelakis wrote. “I know she looks forward to meeting you and your children.”

A transgender boy's lawsuit over a policy barring him from using the male locker room at his Maryland high school is moving forward.

The Washington Post reports U.S. District Judge George L. Russell III became the first judge in a Maryland case to rule transgender students' right to use facilities matching their gender identities is protected by federal and state law.

Russell's opinion this week says St. Michaels Middle High School's policy is discriminatory, forcing the 15-year-old to use a separate gender-neutral restroom to dress for gym class. The teen is identified as "M.A.B." in the suit against the Talbot County Board of Education.

Russell noted courts have stopped enforcement of federal policies violating transgender rights under the Trump administration.

Talbot schools spokeswoman Debbie Gardner declined comment, citing pending litigation.

On Dec. 28, 2014, Leelah Alcorn died after walking into traffic on a highway near her hometown of Kings Mills, Ohio. The 17-year-old identified as transgender, and in a suicide note published online, which became national news, Alcorn wrote:

"The only way I will rest in peace is if one day transgender people aren't treated the way I was, they're treated like humans, with valid feelings and human rights. Gender needs to be taught about in schools, the earlier the better. My death needs to mean something."

Devon Shanley read in those words a personal call to action. He is a transgender man teaching seventh-grade English in New York City. He resolved to become more vocal as a teacher and activist. While realizing that some trans people do not want to be out, and for others being out may threaten their safety, he believes, "this is what is killing us, this silencing."

Awareness of gender diversity has been growing. And schools in particular have been a battleground for gender rights. In interviews with 15 individuals, and in an NPR Ed survey of dozens more trans and gender-nonconforming educators around the country, teachers like Shanley told us they are becoming more visible, more active, more organized.

They are marching, writing lesson plans, changing the signs on bathroom doors and, alongside their students, pushing colleagues and school administrators and elected officials to improve awareness of gender issues.

Rates of suicide, homelessness and bullying are all higher among transgender, queer and gender-nonconforming youth. The current administration has formally stated that it won't consider discrimination complaints from these youth based on access to facilities like bathrooms.

Many trans teachers NPR spoke to for this article told us they were bullied as students, and they feel that their work in the classroom can be, quite literally, a matter of life and death.

A quick note on the terms we're using here. Gender nonconforming is an umbrella term that can refer to anyone whose appearance or behavior doesn't fit stereotypes of the sex they were assigned at birth. Transgender and gender nonconforming people may identify as men or women. Or they may use terms like nonbinary, genderqueer, genderfluid, transmasculine or transfeminine, or simply trans. They may use a variety of pronouns: he, she, they, ze. They may identify as straight, gay, lesbian, queer or any other possibility. Cisgender, meanwhile, refers to those whose gender identity does match their sex assigned at birth.

Forming a Network

Across the country in San Francisco, around the same time that Shanley felt his call to action, a former teacher named Harper Keenan, also a transgender man and an education Ph.D. candidate at Stanford, experienced the losses of some trans people he knew personally to suicide.

He realized, "We have to do a better job of making sure that transgender people aren't isolated. And I thought about my own work as an educator. Teaching is a pretty isolating job." And, he says, it complicates matters that teaching is one of the most gendered professions.

Teachers of younger students in particular are overwhelmingly women. Schools, meanwhile, Keenan points out, often sort students into boys and girls — when lining up, in the bathroom and locker rooms, in sports and phys ed. These are all points of friction for those who don't conform.

He posted on Facebook to start a professional and social network for anyone who worked with students in K-12 and whose identity did not "easily fit" into the gender binary. They became known as the Transgender Educators Network. Before they knew it, they had around 200 members and chapters that now meet in five places: the Bay Area, New York, Baltimore/Washington area, the Pacific Northwest and Minneapolis.

Chris Smith, a high school teacher and member of the New York chapter of TEN, says they come together to discuss issues like: "how to have conversations with your students. A little bit of safety. What school districts to avoid, what states to avoid. Some emotional support. The best time to come out."

As a group, TEN members have marched in rallies, written op-eds and submitted a "friend of the court" brief in support of Gavin Grimm, the Virginia high school student who sued for the right to use the bathroom that conformed with his gender identity.

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