Cross-sectional study of psychosocial well-being among lesbian, gay, bisexual, and heterosexual gynecologic cancer survivors.

BACKGROUND: Delays in care and increased risk for mental health diagnoses put individuals identifying as a sexual minority with cancer at risk for decreased quality of life. AIM: To assess psychosocial health among sexual minority gynecologic cancer survivors, we compared self-reported quality of life and psychosocial measures between individuals diagnosed with gynecologic cancers identifying as lesbian/gay/bisexual (LGB) and heterosexual. METHODS AND RESULTS: English-speaking adults with gynecologic cancers were invited to participate in an ongoing cohort survey study. Quality of life and psychosocial measures included the Functional Assessment of Cancer Therapy-General, Distress Thermometer (distress), Patient Health Questionnaire-8 (depression), General Anxiety Disorder-7 (anxiety), and Post-traumatic Stress Disorder Checklist for DSM-5 (post-traumatic stress disorder; PTSD). Measures were compared by self-reported sexual orientation (heterosexual vs. LGB) using descriptive statistics (frequencies and means) and linear and logistic regression models, adjusting for college education. Of 814 patients invited, 457 enrolled (56.1%) and 401 (92.6%) completed the survey and provided information on their sexuality. All but one self-identified as cisgender women and 22 (5.5%) as LGB. LGB participants were more likely to have completed college (68.2% vs. 40.1%, p = .009) but were otherwise similar across demographic and clinical characteristics. Quality of life and distress scores were similar between groups. LGB participants, compared to heterosexual, reported higher rates of depression (31.8% vs. 10.6%, adjusted odds ratio [OR] = 4.1 [95% confidence interval [CI]: 1.6-11.0], p = .004), anxiety (25.0% vs. 7.1%, adjusted OR = 5.4 [95% CI: 1.7-16.7], p= .004), and PTSD (13.6% vs. 3.5%, adjusted OR = 4.2 [95% CI: 1.1-16.3], p = .04). CONCLUSION: LGB participants reported poorer emotional health following a gynecologic cancer diagnosis than heterosexual participants. Our data suggest this population may need additional resources and support during and after their cancer diagnosis. Future work is needed to identify additional risk factors and the underlying sources of these disparities in order to improve patient care and wellness in this population.

Violências nas trajetórias afetivo-sexuais de jovens gays: "novas" configurações e "velhos" desafios / Violence in the affective-sexual trajectories of young gay men: "new" settings and "old" challenges

Resumo Este artigo aborda o fenômeno da violência nas trajetórias afetivo-sexuais de jovens gays cisgênero, pertencentes a camadas populares da região metropolitana do Rio de Janeiro, Brasil. A literatura brasileira sobre violência contra homens gays, geralmente, tem como foco a discriminação sofrida por esta população, mas pouco se problematiza a violência que eles sofrem nas relações familiares devido à sua orientação sexual, ou ainda, em suas relações ditas como "namoro" ou "ficar". Com o objetivo de discutir a presença de violências durante a trajetória afetivo-sexual dos jovens, este estudo qualitativo realizou entrevistas em profundidade a partir de um roteiro semiestruturado. Os resultados mostraram que há múltiplas faces de violência que ocorrem durante a infância e adolescência nas relações familiares, perpassando nos seus relacionamentos afetivo-sexuais na adolescência e juventude, incluindo violências sexuais, físicas, psicológicas e institucionais. As redes de apoio dos jovens são limitadas, como exemplo, a poucos amigos e ao acesso de blogs na internet. Nenhum profissional de saúde foi citado pelos jovens como fonte de ajuda. Destaca-se também a necessidade de debater a prevenção da violência e promoção da saúde destes jovens, ampliando o olhar para as várias formas contemporâneas de se relacionar intimamente.

Abstract This paper discusses the phenomenon of violence in the affective-sexual trajectories of young, cisgender gay men, from popular strata, in the metropolitan region of Rio de Janeiro, Brazil. Brazilian literature on violence against gay men generally focuses on the discrimination suffered by this population. However, the violence they are submitted to among family relationships due to their sexual orientation, or even their relationships known as "dating" or "hookup", is hardly discussed. This qualitative study used in-depth interviews based on a semi-structured guide to discuss violence during the young gay men's affective-sexual trajectory. The results evidenced multiple faces of violence during childhood and adolescence in family relationships, spanning their affective-sexual relationships in adolescence and youth, including sexual, physical, psychological, and institutional violence. Support networks are limited, for example, to a few friends and access to blogs on the Internet. No health professional was cited as a helping source. There is a need to discuss the prevention of violence and discuss health promotion of this social group, expanding the perspective on the various contemporary ways of relating intimately.

Chromosome Abnormalities Related to Reproductive and Sexual Development Disorders: A 5-Year Retrospective Study.

Chromosomal abnormalities are the main genetic risk factor associated with reproductive and sexual development disorders (DSD). The goal of this study is to retrospectively evaluate the frequency of chromosomal aberrations in Moroccan subjects with problems of procreation or sexual ambiguity. A total of 1005 individuals, including 170 infertile couples, underwent cytogenetic analysis in the Cytogenetic Laboratory of the Pasteur Institute of Morocco. Heparinized blood samples were processed according to the standard karyotype method. A total (81.5%) of the patients studied had a normal karyotype, while the remaining (18.5%) patients had an abnormal karyotype. Female patients had more chromosomal abnormalities (52%) than male patients (48%). These chromosomal aberrations included 154 cases (83%) of sex chromosomal abnormalities, the most common being Turner's syndrome and Klinefelter's syndrome, and 31 cases (17%) had autosomal aberrations, especially chromosome 9 reversal (inv(9)(p12;q13)). The present data shows that among 170 couples, 10.6% had chromosomal abnormalities mainly involved in the occurrence of recurrent miscarriages. Genotype-phenotype correlations could not be made, and therefore, studies using more resolutive molecular biology techniques would be desirable.

Disfunciones y trastornos sexuales en mujeres en climaterio: pacientes del Instituto Nacional de Perinatología / Sexual dysfunctions and disorders in climacteric women: patients from the national institute of perinatology"

La sexualidad es una de las áreas que sufre cambios importantes cuando la mujer se instala en el climaterio, estos cambios se conocen como trastornos y/o disfunciones sexuales. Material y método: en el Instituto Nacional de Perinatología se llevó a cabo un estudio con 139 mujeres en climaterio; se utilizó la encuesta de síntomas y la Historia Clínica Codificada de la Sexualidad Femenina (HCCSF) para conocer la presencia de las disfunciones y/o trastornos sexuales y los factores asociados a estos. Resultados: no se encontró relación alguna entre las variables sociodemográficas y la presencia de disfunciones sexuales; de la muestra, 124 mujeres presentaron al menos una disfunción sexual. Conclusión: aquellas mujeres que cuentan con información sexual a edades tempranas, que tienen deseo y cooperan durante la relación sexual y que además han explorado su sexualidad con más de una pareja, tienen un efecto protector para no presentar disfunciones sexuales. Por otra parte, la presencia de trastornos sexuales se asocia exclusivamente con padecimientos médicos y de salud en la mujer como en la pareja.

Sexuality is one of the areas that undergoes important changes when women settle in climacteric, these changes are known as sexual disorders and/or dysfunctions. Methods: A study was carried out at the National Institute of Perinatology with 139 women in climacteric. The survey of symptoms and the Codified Clinical History of Female Sexuality (HCCSF) were used to determine the presence of sexual dysfunctions and/or disorders and the factors associated with them. Results: No relationship was found between sociodemographic variables and the presence of sexual dysfunctions. Of the sample, 124 women presented at least one sexual dysfunction. Conclusion: Those women who have sexual information at an early age, who have desire and cooperate during sexual intercourse and who have explored their sexuality with more than one partner, have a protective effect for not presenting sexual dysfunctions. On the other hand, the presence of sexual disorders is associated exclusively with medical and health conditions in both the woman and the couple.

História das abordagens científicas, médicas e psicológicas sobre as transexualidades e suas aproximações críticas / A history of scientific, medical and psychological approaches to transsexualities and their critical approach

Resumo Neste artigo, apresenta-se um breve enquadramento histórico das abordagens científicas, médicas e psicológicas sobre as transexualidades, tecendo um conjunto de considerações sobre a forma como tal enquadramento foi fundacional da noção de patologia associada às pessoas trans e como tem sido responsável pela manutenção da patologização destes indivíduos no imaginário coletivo. Para atingir tal objetivo, é desenhado um mapa cronológico dos acontecimentos que têm vindo a marcar, ao longo da história, o estudo e a intervenção com as pessoas trans a partir do modelo biomédico, referenciando algumas das personalidades que, no contexto ocidental, tiveram responsabilidade nesta visão biomédica das pessoas trans. No final deste trabalho, apresenta-se a discussão em torno da (des)patologização das transexualidades a partir do surgimento do paradigma centrado nos direitos humanos das pessoas trans e em propostas de autodeterminação dos seus corpos e identidades.

Abstract This study provides a brief historical background of scientific, medical and psychological approaches to transsexualities. It also makes considerations on how such approaches based the concept of pathology that is associated with trans people and how it has been responsible for maintaining the pathologization in the collective imaginary. More specifically, we will establish a chronology of events that, throughout history, have affected the study on and the intervention with trans people, based on the biomedical model. We will also refer to some Western figures responsible for creating this biomedical vision of trans people. Finally, the discussion about the (de)pathologization of transsexualities is presented, based on the emergence of the paradigm centered on the human rights of trans people and proposals for self-determination of their bodies and identities.

Replacement Hormone Therapy for Gender Dysphoria and Congenital Sexual Anomalies.

What is it about sexuality that makes it such a burning matter since the dawn of mankind? Much was lost of humankind heritage because of society's attitude toward sex and gender, but we've made progress. Medical knowledge progressed incredibly and so did social and cultural norms. In these days, on most places on the planet, there is acceptance. Still, gender issues take a center stage, often inflaming the social and political milieu everywhere. So how informed and prepared is the medical community to deal with these issues? Aside from medical treatments, gender dysphoric patients need mental health and social support throughout life. Do we have enough guidelines for treatments that have life-long effects? Do we actually know all of those effects? There are many issues to consider, like fertility preservation, puberty suppression with its adverse effects, and not in the least, the effects of the hormonal therapy on the target tissues.

[Transgender in Adolescence: State of the Art and Future Research Needs]. / Transgender im Jugendalter: Forschungsstand und zukünftiger Forschungsbedarf.

Transgender in adolescence is currently a widely discussed topic, additionally reflected by an increasing prevalence in clinical practice. The present review of the available literature on transgender, trans* , gender dysphoria or gender incongruence in youth reports results on the long-term results of medical interventions for the psychological well-being, prevalence, referral rates and sex ratio, developmental pathways, current developments and the role of the social environment. Finally, implications for clinical care and future research will be discussed.

What urologists need to know about male to female genital confirmation surgery (vaginoplasty): techniques, complications and how to deal with them.

Vaginoplasty is the most commonly performed genital surgery for gender affirmation. Male-to-female (MTF) patients are roughly four times more likely to undergo genital surgery than female-to-male (FTM) patients. Penile inversion vaginoplasty is the most common technique used today, although there are also lesser used alternative methods including visceral interposition and pelvic peritoneal vaginoplasty. In general, outcomes are excellent, and many of the complications are self-limited. Most surgeons performing genital surgery for gender dysphoria adhere to the World Professional Association for Transgender Health (WPATH) guidelines for determining who is a candidate for surgery. Currently, there are no absolute contraindications to vaginoplasty in a patient who is of the age of majority in their country, only relative contraindications which include active smoking and morbid obesity. Important complications include flap necrosis, rectal and urethral injuries, rectal fistula, vaginal stenosis, and urethral fistula. When performed correctly in excellent surgical candidates by skilled surgeons, vaginoplasty can be a rewarding surgical endeavor for the patient and surgeon.

What urologists need to know about female-to-male genital confirmation surgery (phalloplasty and metoidioplasty): techniques, complications, and how to deal with them.

Transmasculine gender-affirming surgery (GAS) is technically challenging, and in the past associated with a high but improving complication rate. Few surgical centers are performing this surgery, which can include metoidioplasty and phalloplasty, and patients often travel great distances for their surgery. While many will continue care with their original surgeons, others cannot due to social/geographic factors, or because emergencies arise. Thus, patients may seek care with their local urologist for relief of delayed complications, the most common of which include urethral stricture, penile prosthesis issues and urethrocutaneous fistula. This review will discuss the surgical elements behind metoidioplasty and phalloplasty, and the diagnosis and treatment for the most common postoperative issues.

Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study.

OBJECTIVE: Despite professional recommendations to consider gender-affirming hormone and surgical interventions for transgender individuals experiencing gender incongruence, the long-term effect of such interventions on mental health is largely unknown. The aim of this study was to ascertain the prevalence of mood and anxiety disorder health care visits and antidepressant and anxiolytic prescriptions in 2015 as a function of gender incongruence diagnosis and gender-affirming hormone and surgical treatment in the entire Swedish population. METHODS: This study used the Swedish Total Population Register (N=9,747,324), linked to the National Patient Register and the Prescribed Drug Register. Among individuals who received a diagnosis of gender incongruence (i.e., transsexualism or gender identity disorder) between 2005 and 2015 (N=2,679), mental health treatment in 2015 was examined as a function of length of time since gender-affirming hormone and surgical treatment. Outcome measures were mood and anxiety disorder health care visits, antidepressant and anxiolytic prescriptions, and hospitalization after a suicide attempt. RESULTS: Compared with the general population, individuals with a gender incongruence diagnosis were about six times as likely to have had a mood and anxiety disorder health care visit, more than three times as likely to have received prescriptions for antidepressants and anxiolytics, and more than six times as likely to have been hospitalized after a suicide attempt. Years since initiating hormone treatment was not significantly related to likelihood of mental health treatment (adjusted odds ratio=1.01, 95% CI=0.98, 1.03). However, increased time since last gender-affirming surgery was associated with reduced mental health treatment (adjusted odds ratio=0.92, 95% CI=0.87, 0.98). CONCLUSIONS: In this first total population study of transgender individuals with a gender incongruence diagnosis, the longitudinal association between gender-affirming surgery and reduced likelihood of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them.

CIE-11 y la despatologización de la condición transgénero / CIE-11 and the depathologisation of the transgender condition

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Centro de cidadania LGBT: memórias e experiências no campo das práticas psi em prol da defesa dos direitos humanos / LGBT citizenship center: memories and experiences in the field of psi practices for the defense of human rights / Centro de ciudadanía LGBT: memorias y experiencias en el campo de las prácticas psi en defensa de los derechos humanos

O presente artigo constitui-se num relato de experiências de profissionais da Psicologia vivenciadas nos Centros de Cidadania LGBT do Programa Rio sem Homofobia, no período em que este programa e seus Centros de Cidadania estiveram plenamente ativos e presentes em diferentes pontos do estado do Rio de Janeiro. Este programa é vinculado à Superintendência de Direitos Individuais, Coletivos e Difusos da então Secretaria de Assistência Social e Direitos Humanos do estado do Rio de Janeiro (SUPERDir/SEASDH) e tem como objetivos gerais o combate às homo, lesbo, bi e transfobias, bem como a promoção da cidadania LGBT. A partir de alguns casos por nós acompanhados, discutimos possibilidades de intervenção que se colocassem ao lado do movimento de ampliação da potência de vida dos(as) usuários(as) do serviço, principalmente pela proposta de intervenções interdisciplinares e articuladas com o contexto da demanda e/ou violação. Desta forma, reiteramos a importância de construirmos o campo das práticas psi atravessado por um trabalho em rede pautado por questões relacionadas aos Direitos Humanos, movimento social e políticas públicas.(AU)

This article is a narrative of the experiences of psychology professionals working in the LGBT Citizenship Centers of the Rio without Homophobia Programme, in the period in which this program and its Citizenship Centers were fully active and present in different parts of the state of Rio de Janeiro. This program is linked to the Superintendence of Individual, Collective and Diffuse Rights of the Department of Social Assistance and Human Rights of the state of Rio de Janeiro (SUPERDir/SEASDH) and has as general objectives the combat against homo, lesbo, bi and transphobia, as well as the promotion of LGBT citizenship. From a few cases we monitored, we discussed possibilities for intervention that were placed alongside the movement to increase the potency of life of the users of the service, mainly by the proposal of interdisciplinary interventions and articulations with the context of demand and/or violation. In this way, we reiterate the importance of constructing the field of psi practices through a networked work based on issues related to Human Rights, social movement and public policies.(AU)

Este artículo es un informe de las experiencias de los profesionales de psicología que vivieron en los Centros de Ciudadanía LGBT de Río sin el Programa de Homofobia, durante el período en que este programa y sus Centros de Ciudadanía estuvieron completamente activos y presentes en diferentes partes del estado de Río de Janeiro. Este programa está vinculado a la Superintendencia de Individuos, Colectivos y Difusos de la entonces Secretaría de Asistencia Social y Derechos Humanos del estado de Río de Janeiro (SUPERDir/SEASDH) y tiene como objetivos generales la lucha contra el homo, lesbo, bi y transfobías, así como la promoción de la ciudadanía LGBT. Con base en algunos casos que hemos seguido, discutimos las posibilidades de intervención que se colocarían junto con el movimiento para aumentar el poder de servicio de los usuarios del servicio, principalmente debido a la propuesta de intervenciones interdisciplinarias y articuladas con el contexto de demanda y / o violación Por lo tanto, reiteramos la importancia de construir el campo de las prácticas psi atravesadas por una red basada en temas relacionados con los Derechos Humanos, el movimiento social y las políticas públicas.(AU)

[THE MEDICAL CARE OF TRANSGENDER PEOPLE].

INTRODUCTION: The phenomenon of the discrepancy between a person's sexual self-perception and his/her genetic sex has been known to medicine since the mid-19th century. Initially, this discrepancy was considered to be a mental disorder. Over time, advances in medical abilities in surgery, hormonal treatment and infertility, have enabled physicians to help those who are affected to fulfill their wish. The present notion is that transsexualism is a solvable problem (whether the desired wish is for a man to become a woman or vice versa). Treatment is both complicated (surgery) as well as chronic (hormones). In this review the various medical aspects of the different possible treatments are discussed, excluding the psychological part of this intriguing condition.

Clínica nodal y transexualismo a partir de una ficción cinematográfica / Nodal Clinic and Transsexualism from a Cinematographic Fiction

En el presente escrito abordaremos la temática del transexualismo a través del film The Danish Girl (Hooper, 2015). En él se narra la vida Einar Wegener, destacado artista plástico que sería conocido luego como Lili Elbe, la primera persona en someterse a una cirugía de reasignación de sexo. Para analizar el caso recurriremos a la clínica nodal propuesta Jacques Lacan en su Seminario El Sinthome, proponiendo una lectura novedosa a través de la trenza, y en articulación con algunos aportes de las fórmulas de la sexuación. Por último, enmarcaremos esta cuestión en el escenario del derecho a la identidad de género, como contribución a una tesis de maestría en curso.

In the present paper we will approach the subject of transsexualism through the film The Danish Girl (Hooper, 2015). It tells the story of Einar Wegener, a prominent plastic artist who would later be known as Lili Elbe, the first person to undergo sex reassignment surgery. To analyze the case we will resort to the nodal clinic created by Jacques Lacan in his El Sinthome Seminar, proposing a novel reading through the braid, and in articulation with some contributions of sexuation formulas. Finally, we will frame this issue in the context of the right to gender identity, as a contribution to an ongoing master's thesis.

Sexual preferences and associated disorders: toward an extended model for description. / Preferencje seksualne i zwiazane z nimi zaburzenia: w strone rozszerzonego modelu opisu.

The notion of human sexual preferences relates to relatively stable patterns of sexual response and to directing sexual behaviors toward specific arousing stimuli, which are also important for sexual satisfaction. The preferences may pertain to the properties of the object or the sexual activity itself. Diagnosing sexual preferences, in its basic form, is conducted with the use of disorder criteria defined in diagnostic classifications (ICD-10, DSM-5). However, while employing these criteria enables the categorization of the patient's sexual preferences as normal or pathological, they seem clearly insufficient for describing complex sexual interest patterns in a comprehensive manner. The goal of this article is to present a detailed dimensional model for describing sexual preferences. This proposal assumes the description of two aspects of preference: a contentual aspect, defining the individual hierarchy of sexually attractive and aversive stimuli, and a formal aspect. The latter involves four dimensions: the diversity of stimuli falling within the pattern of the patient's sexual interest, preference changeability in time, the coherence between individual components of responding to sexual stimuli, and insight into one's own preferences. The proposed model supplements the basic description of sexual preferences conducted on the basis of diagnostic criteria. The model can be a tool useful for diagnostic practice, particularly in precise characterization of various difficulties experienced by patients in relation to the properties of their sexual interests. It can also inspire new research on features of human sexual response patterns which have been neglected in previous analyses.

Identidad, género y confusión / Identity, gender and confusion

El objetivo del presente trabajo es presentar el caso de una (¿o un? Como veremos...) adolescente que resulta muy ilustrativo respecto a la difusión de la identidad propia de las organizaciones limítrofes de la personalidad, poniendo el foco, entre otros, en las manifestaciones de dicha organización en el plano de la construcción de la identidad de género.Así mismo, al hilo del caso expuesto, se aprovechará para reflexionar en torno a desarrollos teóricos de interés dentro del marco psicoanalítico, como el 'síndrome de difusión de identidad' de los Kernberg o 'el complejo de la madre muerta' de André Green

The aim of this work is to present the case of an adolescent that is very illustrative of the diffusion of the own identity in the borderline organizations of personality, putting the focus, among others, in the manifestations of this organization in the construction of gender identity. Likewise, this case will be used to reflect on interesting theoretical developments within the psychoanalytic framework, such as Kenberg’s 'identity diffusion syndrome' or André Green’s 'the complex of the dead mother'

Nociones de prestigio y producción del cuerpo temeroso: Reflexiones en torno a la normalización de cuerpos intersexuales / Noções de prestígio e produção do corpo temeroso: Reflexões sobre a normalização dos corpos intersexuais / Prestige notions and production of the fearful body: Reflections about intersexual body's normalization

Resumen El activismo y literatura académica en torno a la intersexualidad, como lugar de problematización política de la identidad, parecen sugerir la necesidad de una labor doble. Por un lado, desplazar la comprensión del cuerpo intersexual a un campo en el que no sea un saber biomédico (fundamentado en la norma heterosexual) el que defina el proceder. Por otro, denunciar la manera en que tecnologías abusivas se instalan sobre el cuerpo intersexual para normalizarlo a través de mutilaciones quirúrgicas y procedimientos hormonales, con tono de obligatoriedad de adecuación a los binarios del sexo. Haciendo eco de estas labores, este artículo sugiere, desde una experiencia de trabajo etnográfico con un grupo de personas intersexuales en Colombia, algunas líneas de problematización sobre la experiencia de normalización del cuerpo intersexual, para reconocer el papel del deseo y la agencia de la persona diagnosticada en la reiteración de órdenes binarios. A partir de la experiencia compartida de personas que han sido nombradas como intersexuales, se problematiza la afirmación de que la normalización sea un ejercicio en el que no estén involucradas múltiples voluntades -incluso la de la persona intervenida-; y se invita a comprender cómo otras técnicas de captura están operando, en un contexto mucho más amplio que, bajo el temor, produce sujetos que pueden disponerse a la normalización. Dichas tecnologías se ubican en el campo abstracto del prestigio social, fuerza integradora que potencia ciertos discursos médicos, que instauran sus arbitrariedades en la producción del cuerpo, todo dentro de una matriz binaria heterosexual.

Resumo O ativismo e a literatura acadêmica em torno da intersexualidade, como um lugar de problematização política da identidade parecem sugerir a necessidade de uma dupla tarefa: por um lado, mudar a compreensão do corpo intersexual para um campo no qual não é um conhecimento biomédico (com base na norma heterossexual) que define o procedimento. Por outro lado, denunciar a forma como as tecnologias abusivas são instaladas no corpo intersexual para normalizá-lo através de mutilações cirúrgicas e procedimentos hormonais, com um tom compulsivo de adaptação aos binários sexuais. Fazendo eco dessas tarefas, este artigo sugere, a partir de uma experiência de trabalho etnográfica com um grupo de pessoas intersexuais na Colômbia, algumas linhas de problematização sobre a experiência de normalização do corpo intersexual, para reconhecer o papel do desejo e da agência da pessoa diagnosticada na repetição de ordens binárias. Com base na experiência compartilhada de pessoas que foram nomeadas como intersex, a afirmação de que a normalização é um exercício no qual múltiplos testamentos estão envolvidos não é problematizada, inclusive a da pessoa interposta, e nos convida a entender como outras técnicas de captura estão operando, em um contexto muito mais amplo do que sob medo, produzindo assuntos que podem ser descartados para a normalização. Essas tecnologias estão localizadas no campo abstrato do prestígio social, uma força integradora que alimenta certos discursos médicos que estabelecem sua arbitrariedade na produção do corpo, tudo dentro de uma matriz binária heterossexual.

Abstract Activism and academic literature about intersexuality as a political subject seems to suggest a double task: On one hand, understanding of the intersexual body that is not defined by a biomedical knowledge based on the heterosexual norm. On the other hand, to report the way in which abusive technologies are settled in the intersexual body to normalize it through surgical mutilations and hormonal procedures, characterized by the obligatory adaptation to the sex binaries. Emphasizing these tasks, this article suggests, from an ethnographic work experience with an intersexual group of people in Colombia, ways to problematize the intersexual body's normalization experience, and to recognize the role of desire and self agency of the diagnosed person in the reiteration of binary orders. Based on the shared experience of people labeled as intersexual, this article problematizes the statement that normalization is an action that doesn't involve multiple agencies, even the one of the diagnosed person, and appeals to comprehend how other capture techniques are working, in a bigger context that, using fear, produces subjects who are able to be normalized. Those technologies are placed in the abstract field of the social prestige, a unifying force that strengthens the arbitrary functioning of some medical discourses over bodies, all under a heterosexual matrix.

Role of Sexuality in Body Integrity Identity Disorder (BIID): A Cross-Sectional Internet-Based Survey Study.

BACKGROUND: Body integrity identity disorder (BIID)-a strong desire for amputation or paralysis-is often accompanied by feelings and cognitions of sexual arousal, although this sexual component has been largely neglected in the recent literature. AIM: To examine the presence of BIID-related sexual arousal in subjects with BIID and explore clinical and demographic variables of subjects with BIID who do and do not possess this sexual arousal. METHODS: Eighty individuals with BIID responded to an internet-based survey we created. For all subjects, restoring identity was the primary motivation for preferred body modification. We collected data about respondents' demographic, clinical, and sexual characteristics. Based on responses to questions about BIID-specific sexual desires, subjects were assigned to the group with BIID-related sexual feelings (S-BIID; n = 57) or the group without such feelings (NS-BIID; n = 23). OUTCOMES: Differences in clinical, demographic, and sexual characteristics between S-BIID and NS-BIID groups. RESULTS: Of the respondents, 71.3% endorsed S-BIID. Subjects with S-BIID were significantly more often men, religious, and of a homosexual identity compared with the NS-BIID group. Subjects with S-BIID also significantly more often reported a change in localization and/or intensity of their BIID feelings over time. Furthermore, 66.7% of subjects with S-BIID reported S-BIID as an additional motivation for body modification. Seven of the 57 subjects with S-BIID achieved their preferred body modification through (self)-amputation, whereas none of the subjects with NS-BIID did. CLINICAL IMPLICATIONS: BIID is a heterogeneous disorder in which subjects who self-reported comorbid sexual arousal more often resorted to (self-induced) amputation. STRENGTHS AND LIMITATIONS: This study contains the largest BIID cohort presented in the literature and is the first to genuinely research sexuality in BIID. The first limitation is the lack of face-to-face interviews with the subjects, so no clinical diagnoses could be made. Moreover, there is an ascertainment bias because subjects were collected through the internet and in English, which excluded those who spoke other languages or subjects without an internet connection. CONCLUSION: The present study provides preliminary evidence for a subpopulation or distinct group of individuals with BIID based on the presence of S-BIID. Blom RM, van der Wal SJ, Vulink NC, Denys D. Role of Sexuality in Body Integrity Identity Disorder (BIID): A Cross-Sectional Internet-Based Survey Study. J Sex Med 2017;14:1028-1035.

Intervenções na área da saúde frente à disfunção sexual feminina no Brasil: uma revisão sistemática

O termo sexualidade ainda é considerado um assunto complexo, controverso e de conceituação difícil, tornando ainda mais complicado a compreensão das disfunções relacionadas a essa temática. Quando o público-alvo envolvido é o gênero feminino, torna-se um assunto desafiador para os profissionais da saúde, pois as disfunções sexuais femininas não podem ser medidas com dados concretos...