The Pyramid of Transgender Health Therapeutics

Transgender care needs a multidisciplinary team approach. The awareness about transgender health has increased over the past few years in India. The pyramid of transgender health helps to demystify the care of transgender individuals. The 7 S's of lifestyle modification need to be followed in the routine clinical care of transgender individuals. The individuals also need psychological care and support, metabolic and medical care, endocrine management, and later surgery in some cases. The policy makers can use the pyramid to decide about financial help to the community for their holistic care. The physicians involved in the care of transgender individuals can also take guidance about comprehensive care and management of transgender and gender diverse individuals.

12. Invitation for the journey to the world of togetherness / 医学教育

This article is an account of a trans individual to share with the audience that transgender people are not a myth but ordinary humans living in Japan. I illustrated the real emotions and challenges a transgender person faces in a society that lacks sufficient understanding and support, including adequate legal and healthcare systems. I also want to tell readers what "coming out" and "transitions" mean to those who have had to hide their sexuality from a very young age, even from their parents.　Our society has been changing. However, there is still a number of enormous barriers in healthcare for someone who underwent gender-affirming therapy and finally started to live as their true self. I sincerely hope medical educators training future health professionals will recognize the hardships to improve the situations.

Therapeutic Patient Education in Transgender Care

This communication visits the concept of therapeutic patient education (TPE), and explores its relevance to transgender health care. It suggests a novel term, therapeutic education (TE), and defines it as “educational activities essential to the optimization of health, offered by health care providers duly trained in the field of education, designed to help a transgender individual (or a group of individuals and their families) to manage their treatment and prevent avoidable complications, while maintaining or improving their quality of life. It describes the soft and hard skills required for TE, and suggests a classification that can help in structuring TE programs.

Collective References and Identity Threat among Lebanese and Lebanese-Armenians in the Context of Continuous Intergroup Conflict / Referencias Colectivas y Amenazas a la Identidad entre Libaneses y Libaneses-Armenios en el Contexto de Conflicto Intergrupal Continuo

Abstract How people deal with adversity, in terms of threats to their social or ethnic identity has been extensively investigated. However, most studies have focused on samples (e.g. minority groups) from prototypical Western contexts. It is unclear how individuals perceive and deal with identity threats within non-Western plural contexts characterized by intergroup conflict. We therefore assess whether self-affirmation by recalling a past success can buffer against identity threat in the plural, non-Western context of Lebanon. In two studies we investigate how threats are negotiated at a national (Lebanon) (Study 1) and ethnic minority (Armenian) level (Study 2). In Study 1, we show that in a context characterized by a history of intergroup conflict, a superordinate national identity is non-salient. When investigating the content of memories of a sectarian group in Study 2, we find a hypersalient and chronically accessible ethnic identity, a pattern specific to Armenian Lebanese. We suggest that this hyper-salience is employed as a spontaneous identity management strategy by a minority group coping with constant continuity threat. Our findings point to the importance of expanding the study of identity processes beyond the typically Western contexts and in turn, situating them within their larger socio-political and historical contexts.

Resumen Ha sido ampliamente investigado el cómo luchan las personas con la adversidad, en términos de amenazas a su identidad social o étnica. Sin embargo, muchos estudios se han enfocado en muestras prototípicas de contextos Occidentales (p.ej. grupos minoritarios). Es poco claro cómo los individuos perciben y luchan con amenazas a su identidad dentro de contextos plurales no-occidentales caracterizados por el conflicto intergrupal. Por ello, evaluamos si la auto-afirmación a través del recuerdo de un hecho pasado puede mediar en contra de la amenaza a la identidad en el contexto plural, no-occidental de Líbano. A través de dos estudios investigamos cómo las amenazas son negociadas a nivel nacional (Líbano) (Estudio 1) y a nivel de una minoría étnica (Armenia) (Estudio 2). En el estudio 1 se muestra que, en un contexto caracterizado por la historia de conflicto intergrupal, una identidad nacional superordinada es no-saliente. Cuando se investigó el contenido de las memorias de un sector del grupo en el estudio 2, se encontraron identidades étnicas híper-salientes y crónicamente accesibles, un patrón específico a los Libaneses-Armenios. Se sugiere que esta híper-saliencia sea empleada como una estrategia de manejo de identidad espontánea por un grupo minoritario que se enfrenta a una amenaza continua y constante. Los hallazgos señalan la importancia de ampliar el estudio de los procesos de identidad más allá de los contextos típicos Occidentales, y a su vez, situarlos dentro de contextos sociopolíticos e históricos más grandes.

Relationship between negative life events and state-anxiety:Mediating role of rumination and moderating role of self-affirmation / 中国心理卫生杂志

Objective:To explore the effect of rumination and self-affirmation on the relations between negative life events and state-anxiety in college students.Methods:A total of 265 college students were assessed with the Adolescent Self-rating Life Events Checklist (ASLEC),State Anxiety subscale of Sate-Trait Anxiety Inventory (STAIA),Rumination Response Scale (RRS) and self-affirmation subscale of General Health Questionnaire (GHQ).The mediating effect was tested by multiple regression and bias-corrected percentile residual Bootstrap methods.The moderating effect was tested by multiple regression and simple slope analysis.Results:The state anxiety scores and self-affirmation scores were higher in students from cities than those from village(Ps ＜0.05).Negative life events negatively predicted state-anxiety directly(β =0.57,P ＜0.001).Rumination partly mediated the relationship between negative life events and state-anxiety,and the ratio of the mediating effect to the total effect was 29.7％.Self-affirmation was the moderator of the relationship between negative life events and state-anxiety(β =0.13,P ＜0.05).Conclusion:It suggests that negative life events could not only have a direct effect on state-anxiety,but also has an indirect effect through rumination.Self-affirmation could moderate the relations between negative life events and state anxiety.

O homem no entrevero do prazer e da realidade / El hombre en el enredo del placer y de la realidad / The man in the tangle of pleasure and reality

O autor procura, na obra de Freud, as origens de seu artigo fundamental de 1911: Os dois princípios do suceder psíquico. Percorre, para isso, os caminhos freudianos desde a Interpretação das afasias de 1891 até Esboço de psicanálise de 1938, visitando quase exaustivamente o Projeto, o Narcisismo, as Pulsões, o Luto e Melancolia, o Inconsciente e demais textos freudianos - acompanhando a evolução do pensamento do mestre. O texto estrutura-se com uma introdução, a construção teórica, a Metapsicologia, a clínica e finda com considerações sintéticas e reflexivas a título de conclusão. A dialética entre prazer e realidade atravessa todo o trabalho. Explora ao longo do texto os argumentos de Freud, entremeando-os com outros estudiosos como Lacan e Garcia-Roza. O trabalho promove uma reflexão profunda em torno da ênfase que Freud confere ao estudo sobre o principio de realidade e o lugar do prazer na dinâmica da vida. Finaliza destacando exemplos ilustrativos de sua prática clínica referentes ao conteúdo teórico apresentado. O autor observa que Freud não resolveu por completo a questão da realidade para a psicanálise. Essa questão, como outras, ficou para os seguidores. Segundo o artigo, dos seguidores de Freud, quem ofereceu uma solução à herança freudiana foi Lacan com sua metapsicologia do Simbólico, Imaginário e Real.

The author seeks in Freud's work the origins of his fundamental article of 1911: Formulations on the two principles of mental functioning. With this objective, he covers the Freudian paths from on aphasia of 1891 to An outline of psychoanalysis of 1938, thoroughly visiting the Project, the Narcissism, the Impulses, Grief and melancholy, the Unconscious and other Freudian texts, following the evolution of the master's thoughts. The text is structured as follows: introduction, theoretical construction, metapsychology, clinics, and ends with synthetic and reflexive considerations as conclusion. The dialectic between pleasure and reality is crosscutting throughout the whole work. It explores Freud's arguments along the text, intertwining them with other scholars' concepts, such as Lacan's and GarciaRoza's. The work brings up a deep reflection on the emphasis that Freud confers to the study about the principle of reality and the place of pleasure in the dynamics of life. It outlines illustrative examples of the author's clinicaI practice related to the theoretical content presented. The author observes that Freud has not completely resolved the issue of reality for psychoanalysis. This issue, as others, has remained for his followers. According to the article, the one who has offered a solution for Freud's heritage was Lacan with his metapsychology of the symbolic, the imaginary and the real.

El autor examina, en la obra de Freud, los orígenes de su trabajo fundamental del 1911: Formulaciones sobre los dos principios del acaecer psíquico. Hace, para tal fin, un recorrido por los caminos freudianos desde la Interpretación de las afasias del 1891, hasta el Esquema del psicoanálisis deI 1938, adentrándose, casi al cansancio, en el Proyecto, Narcisismo, las Pulsiones, Duelo y melancolía, el Inconsciente y otros textos freudianos, siguiendo la evolución del maestro. El texto se estructura con una introducción, la construcción teórica, la metapsicología, la clínica y se cierra con observaciones breves y reflexivas sobre el tema. La dialéctica entre el placer y la realidad abarca todo el trabajo. Explota, a lo largo del texto, los argumentos de Freud, mezclando con otros estudiosos como Lacan y Garcia-Roza. El trabajo lleva a cabo una honda reflexión alrededor del énfasis que Freud le da al estudio sobre el principio de realidad y el puesto y el placer en la dinámica de la vida. Pone ejemplos puntuales de su prâctica clínica sobre el contenido teórico desarrollado. El autor observa que Freud no pudo resolver de un todo la cuestión de la realidad para el psicoanálisis. Esta, como otros temas, quedó para los seguidores resolvieren. Según el artículo, de los pos-freudianos, quien ofrece una solución de la herencia freudiana es Lacan con su metapsicología deI simbólico, lo imaginaria y lo real.

A rima na escola, o verso na história / Rhyme at school, poetry in history / La rima en la escuela, la poesía en la historia

Este artigo aborda os estudos de uma pesquisa e intervenção realizada em uma sala de aula com alunos da 7ª série de uma escola pública de São Paulo. Estes jovens, amantes do ritmo e da poesia, são descendentes de famílias afro-brasileiras e indígenas Pankararu, oriundas do sertão de Pernambuco, que se alojaram em São Paulo, a partir da década de 50, período desenvolvimentista, servindo como mão-de-obra da construção civil paulistana. Apesar de conhecida, a história desta comunidade não se revelou integrada à cultura escolar - cuja tendência parecia ser a de negar a herança afro-indígena nordestina do corpo discente. Neste sentido, o objetivo do estudo foi investigar e propiciar, pela via poético-musical dos jovens, formas de interlocução com este passado recente.

This article is based in a research and intervention with seventh grade students in a classroom at a public school in Sao Paulo. These rhythm and poetry young lovers descend from Afro-Brazilian and Pankararu indian families who came from the countryside of Pernambuco and settled down in Sao Paulo after the 1950s (developmental phase) to work as civil construction workers. We observed that this history wasn't proven integrated to the school culture - the tendency of which seemed to deny the students are Northeastern Afro-Indian descendent. Therefore, the objective of this study was not only to investigate but also to provide the students with ways to dialogue with their recent past by means of their poetic-musical manners.

Este artículo aborda el estudio y la investigación de intervenciones realizadas en un aula con alumnos de séptimo grado en una escuela pública de São Paulo. Estos jóvenes amantes del ritmo y la poesía, son descendientes de familias afro-brasileñas y Pankararu indígenas, procedentes del interior de Pernambuco, que se quedó en São Paulo, a partir de los años 50, período de desarrollo, sirviendo como mano de obra São Paulo de obra civil de la construcción. Se observó que la historia no estaba integrados en la cultura escolar - la tendencia parecía ser a negar la herencia de los estudiantes del noreste de África y la India. En este sentido, el objetivo del estudio fue investigar y proporcionar, a través de político-musical para los jõvenes, las formas de diálogo con el pasado reciente.