Survey of Urogynecology Fellows on the Care of Patients with Differences in Sex Development/Intersex Traits.

Introduction And Hypothesis: Patients with differences in sex development or intersex traits (DSD/I) struggle to find clinically competent care in adulthood. We sought to describe the surgical exposure of Urogynecology and Reconstructive Pelvic Surgery (URPS) fellows who had previously trained in ObGyn (URPS-Gyn) to patients with DSD/I and their interest in performing 18 relevant procedures. We hypothesized that most graduating fellows would not have had exposure to many of the surgeries.

Qualitative assessment of provider approaches to dilation following vaginoplasty.

Study Objective: Most surgical vaginoplasties are followed post-operatively, when age appropriate, by patient-led dilation to maintain patency, but there is a lack of both standardized protocols and research comparing dilation practices within and across surgical routes. This study's objective is to determine surgeon attitudes about dilation and learn what protocols they use and endorse to take steps towards addressing the literature gap around dilation practices and outcomes.

Methods: We performed semi-structured interviews with ten providers (nine surgeons, one nurse) involved in vaginoplasty at a single tertiary care children's hospital about their dilation practices.

National Trends of Common Gynecologic Procedures Among Pediatric Hospitals: A National Surgical Quality Improvement Program Pediatric (NSQIP-P) Database Analysis.

Background: Gynecologic surgeries have in general been performed in pediatric hospitals by both gynecologists and other surgical specialists. This study assessed current practices and outcomes using a national database.

Methods: Procedures performed by gynecologists in the National Surgical Quality Improvement Program Pediatric database (NSQIP-P) from 2012 to 2021 were reviewed and used to identify a set of common gynecologic procedures for which outcomes could be compared across specialties.

Association Between Body Mass Index and Clinical Outcomes of Gender-Affirming Masculinizing Chest Reconstruction.

Introduction: Body mass index (BMI) is often used in surgical settings to determine patients' risk of complications. In the context of gender-affirming care, BMI requirements for surgery can limit access to necessary care for larger-bodied people. There is a critical need to understand the association between BMI and postoperative outcomes for this population.

Understanding Gaps of HIV Knowledge Among Transgender Young Adults: A Pilot Interview Study.

Many transgender young adults are unaware of the role of pre-exposure prophylaxis (PrEP) in HIV prevention. Our aim was to understand where transgender and gender-diverse young adults receive health information about HIV and PrEP and their preferences for future learning. Semistructured, qualitative individual and group interviews were done with 14 transgender and gender-diverse young adults.

Factors Affecting Willingness to Provide Medication Abortion Among North American Society for Pediatric and Adolescent Gynecology Members Caring for Adolescents and Young Adults Following the Dobbs Decision.

Study Objective: To assess willingness to provide medication abortion among North American Society for Pediatric and Adolescent Gynecology (NASPAG) clinicians caring for adolescents and young adults (AYA) following Dobbs v. Jackson Women's Health Organization.

Design: Cross-sectional online survey.

Adult endocrinologists' perspectives on transitioning adolescent patients with congenital adrenal hyperplasia.

Objectives: The study aimed to evaluate adult endocrinologists' perspectives on caring for patients with congenital adrenal hyperplasia (CAH) and views on their transition from pediatric to adult care.

Methods: An online survey was conducted among adult clinical endocrinologists at Harvard Medical School-affiliated hospitals from March to October 2022.

Results: Most participants (25/34, 73.

Management of breakthrough bleeding in transgender and gender diverse individuals on testosterone.

Background: While many transgender and gender diverse individuals rapidly achieve amenorrhea on testosterone, emerging data have identified that breakthrough bleeding can occur in up to one-third of individuals with long-term use. Breakthrough bleeding can worsen dysphoria and patients may seek management to reattain amenorrhea. Because of this, there is a need to assess efficacy of management approaches.

Understanding Family Support for Transgender Youth: Impact of Support on Psychosocial Functioning.

Purpose: This study investigated the association between positive and negative family support and psychosocial outcomes among transgender and gender diverse (TGD) youth.

Methods: A retrospective analysis was performed using psychological data collected from 175 TGD youth (aged 13-18 years) at time of hormone readiness assessment within a multispecialty gender clinic between May 2021 and February 2023. As part of this assessment process, TGD youth provided responses to a variety of measures, including the Youth Self-Report and the Family Environment Scale.

A Multidisciplinary Approach Improves Sexual Health Care for Youth with Duchenne Muscular Dystrophy.

We sought to determine the prevalence of sexual health counseling in patients with Duchenne muscular dystrophy in a single-institution setting. Keywords related to sexual health and development concerns were documented at least once for 75% of patients across the duration of their care. Integration of sexual health discussions was facilitated by comprehensive multidisciplinary support, particularly with the inclusion of specialists in endocrinology and adolescent medicine.

Establishing a Pediatric Health Equity, Diversity, and Inclusion Research Review Process.

Equity, diversity, and inclusion (EDI) research is increasing, and there is a need for a more standardized approach for methodological and ethical review of this research. A supplemental review process for EDI-related human subject research protocols was developed and implemented at a pediatric academic medical center (AMC). The goal was to ensure that current EDI research principles are consistently used and that the research aligns with the AMC's declaration on EDI.

Use of the Drospirenone-Only Contraceptive Pill in Adolescents with Endometriosis.

Study Objective: To evaluate the efficacy and tolerability of a progestin-only pill containing 4 mg drospirenone (DRSP) as a hormonal therapy for the management of endometriosis-associated symptoms in adolescents and young adults.

Design: Retrospective cohort study.

Methods: A retrospective chart review was performed of all adolescents who were prescribed DRSP continuously (without placebo) for treatment of endometriosis at a single pediatric tertiary care center between 2019 and 2022.

Research in the Transformation Zone.

In this Patient Platform, Elizabeth Boskey, Ph.D., describes how her experiences as a clinical research participant have profoundly affected the ways that she does research.

Association of Pubertal Blockade at Tanner 2/3 With Psychosocial Benefits in Transgender and Gender Diverse Youth at Hormone Readiness Assessment.

Purpose: Compare psychosocial function at the time of hormone readiness assessment for transgender and gender diverse (TGD) youth who received pubertal blockade to prevent a nonaffirming puberty with those who did not.

Methods: Retrospective cohort study of psychological assessment data from hormone readiness evaluations conducted at a multispecialty gender clinic. Participants include all TGD youth between the ages of 13 and 17 assessed for hormone readiness between 2017 and 2021.

Preventive Practices and Knowledge of Human Papillomavirus in Mayer-Rokitansky-Küster-Hauser Syndrome Individuals.

Mayer-Rokitansky-Küster-Hauser syndrome is a congenital disorder typified by an underdeveloped female reproductive tract. An exploratory online survey of adults with Mayer-Rokitansky-Küster-Hauser syndrome found that many did not recall receiving the human papillomavirus vaccine, and answers to knowledge questions suggested inadequate human papillomavirus counseling. However, recalled vaccine counseling was associated with improved uptake.

Prevalence of pelvic pain in transgender individuals on testosterone.

Background: Pelvic pain has been reported in transmasculine individuals taking testosterone. There is a need for further investigation to increase understanding of the prevalence and risk factors of this pain.

Aim: We sought to determine the prevalence of pelvic pain reported by transmasculine individuals who had both a uterus and ovaries and were taking testosterone.

Understanding Their Experiences: Psychosocial Functioning of Nonbinary and Binary Youth at the Time of Hormone Readiness Assessment.

The unique psychosocial experiences of nonbinary individuals across the lifespan are understudied compared with those of binary transgender individuals. This study examined the psychosocial stressors faced by nonbinary youth compared with their binary transgender counterparts at the time of gender-affirming hormone (GAH) readiness assessment. This study compared the psychosocial functioning of nonbinary youth with their binary transgender peers, ages 14-18, utilizing the Youth Self Report (YSR) at the time of GAH readiness assessment.