Author Interviews, Education, Gender Differences / 20.03.2017 Interview with: Tasseli McKay, MPH Violence and Victimization Research Program Center for Justice, Safety and Resilience RTI International What is the background for this study? Response: Prompted by a mass murder of LGBTQ+ individuals in Orlando in 2016 and a range of pending legislation affecting LGBTQ+ communities, RTI researchers analyzed 20 years’ worth of published studies on violence and LGBTQ+ communities. The systematic review identified patterns of evidence across 102 peer-reviewed studies as well as a few unpublished analyses and non-peer-reviewed papers. With The Henne Group, RTI also carried out a series of focus-group discussions to elicit the perspectives of members of LGBTQ+ communities on the violence and victimization issues identified in the review. These were conducted with LGBTQ+ communities in San Francisco; New York City; Durham, North Carolina; and rural Wyoming. (more…)
Author Interviews, Diabetes, Gender Differences, Lipids / 16.03.2017 Interview with: Dr Mark Jones, Senior Lecturer Faculty of Medicine and Biomedical Sciences, School of Public Health The University of Queensland What is the background for this study? Response: Multiple clinical trials have shown statins reduce LDL cholesterol, cardiovascular events, and all-cause mortality. However statins are also associated with adverse events, including type 2 diabetes. There have been very few older women included in statin trials hence effects of the drug in this population are somewhat uncertain. Also, more generally, results from clinical trials may not translate well into clinical practice. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Gender Differences, Mental Health Research / 16.03.2017 Interview with: Wellington K. Hsu, MD Clifford C. Raisbeck, MD, Professor of Orthopaedic Surgery Associate Professor of Orthopaedic Surgery Northwestern University Chicago, IL What is the background for this study? What are the main findings? Response: Concussions remains a significant problem in youth sports. The recent enactment of Traumatic brain injury laws have certainly heightened awareness regarding this problem. Our study looked at publicly available data regarding diagnosis of concussion in high school athletes. We found that females are more likely to be diagnosed with a concussion than males. We also concluded that girl soccer players and boys football players are at highest risk for a diagnosis of concussion. Since the neck meant of the Traumatic brain injury state laws, the diagnosis of concussion in this patient group increased significantly past decade. (more…)
Author Interviews, Gender Differences, JAMA / 15.03.2017 Interview with: David A. Klein, MD, MPH Uniformed Services University of the Health Sciences (USUHS) Bethesda, Maryland Fort Belvoir Community Hospital (FBCH), Fort Belvoir, Virginia What is the background for this study? What are the main findings? Response: In June 2016, the ban was lifted on transgender personnel serving openly in the military. Research suggests approximately 200 active-duty service members may request a gender transition annually. The purpose of this study is to determine military family physician readiness to care for such patients. The majority (74 percent) of physicians have not received any formal education on the treatment of patients with gender dysphoria. Almost half of surveyed physicians are willing to prescribe cross-hormone therapy; of these, 99 percent report the need for additional training and/or assistance to do so. 53 report an unwillingness to prescribe even with additional education and assistance. (more…)
Author Interviews, Education, Gender Differences, JAMA, UCLA / 06.03.2017 Interview with: Julie R. Boiko, MD, MS Resident Physician, PGY1 Department of Pediatrics University of California, San Francisco What is the background for this study? What are the main findings? Response: Grand rounds is an over 100-year-old tradition in US medical school clinical departments of recurring, expert-delivered lectures to update physicians and physicians-in-training on recent advances in relevant medicine. We wanted to determine whether gender representation of speakers at grand rounds aligns with the gender distribution of people typically represented in grand rounds audiences -- faculty, residents, and medical students -- by clinical specialty according to national academic medical trainee and workforce statistics. We chose to focus on grand rounds speakers as visible representations of women in academic medicine. This is important because, despite women and men entering medicine at comparable rates, women are much more likely to depart academic medical careers. As current and recent medical students, we considered that consistent exposure to successful female role models in grand rounds speaking venues may positively reinforce women trainees’ desires to continue in academic medical careers. We found that the people at the podiums do not resemble the people in the audience. Only 26% of grand rounds speakers are women. Even accounting that some clinical specialties contain few women faculty and residents, grand rounds speakers in most specialties we studied were statistically less likely to be women as compared to faculty and residents. Across the specialties, grand rounds speakers are 44% less likely than medical students, 39% less likely than residents, and 21% less likely than faculty to be women. (more…)
Author Interviews, Gender Differences, Heart Disease, JACC, Metabolic Syndrome / 01.03.2017 Interview with: Mark D. DeBoer, MD Associate Professor of Pediatrics Division of Pediatric Endocrinology University of Virginia Charlottesville, VA 22908 What is the background for this study? What are the main findings? Response: Worldwide there remains a need for accurate prediction of cardiovascular disease. One such predictor is the metabolic syndrome, a cluster of individual risk factors including central obesity, high blood pressure, high triglycerides, low HDL cholesterol, and high fasting glucose. Metabolic Syndrome is usually diagnosed using set criteria, where a person is diagnosed if he or she has abnormalities in at least 3 of the individual components. Using these criteria, someone with MetS (compared to without MetS) has a >50% greater chance of developing cardiovascular disease over the ensuing 10 years. The problem is that prior studies showed that having MetS did not increase risk above that seen for having the abnormalities in the individual risk factors themselves. Our study used a continuous MetS severity score that we derived previously and assessed this score as a predictor of future cardiovascular disease in two large cohorts. We found that even when analyzed with abnormalities in the individual Metabolic Syndrome components, higher levels of the MetS severity score conferred higher risk for cardiovascular disease. This suggests the potential for following this score in individuals over time to identify those at higher risk for future cardiovascular disease. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, Menopause, OBGYNE, PLoS / 28.02.2017 Interview with: Dr. Eija K. Laakkonen PhD Assistant professor Gerontology Research Center Faculty of Sport and Health Sciences University of Jyväskylä What is the background for this study? Response: Physical activity improves health and may delay the onset of chronic diseases. For women in particular, the rate of some chronic diseases accelerates at middle age around the time of menopause; therefore it is important to identify the determinants of health-enhancing physical activity during midlife in this population. The main aim of this study was to characterize the level of physical activity and to examine the association between different female reproductive factors and objectively-measured physical activity in middle-aged women. The reproductive factors included cumulative reproductive history index, and perceived menopausal and pelvic floor dysfunction symptoms. (more…)
Author Interviews, Gender Differences, Sleep Disorders / 27.02.2017 Interview with: Kelly L. Sullivan, PhD Assistant Professor Department of Epidemiology Jiann-Ping Hsu College of Public Health Georgia Southern University Statesboro, Georgia What is the background for this study? What are the main findings? Response: The original aim of this study was to determine which factors were associated with getting sufficient sleep in men and women. In this analysis, we considered many possible influences including BMI, age, race, education, marital status, exercise, employment status, and income in addition to having children in the household. The aim was to determine which factors were most strongly associated with insufficient sleep in men and women specifically in order to inform efforts to best address their sleep challenges. In this study, we found that younger women with insufficient sleep time were more likely to have children in the household compared with women who reported sufficient sleep. Each child in the household was associated with a nearly 50% increase in a woman’s odds of insufficient sleep. This finding held after controlling for the potential effects of age, exercise, employment status and marital status. Children in the household were also associated with the frequency of feeling unrested among younger women, but not among younger men. Women with children reported feeling tired about 25% more frequently compared to women without children in the household. (more…)
Author Interviews, Exercise - Fitness, Gender Differences / 27.02.2017 Interview with: Sean Notley, PhD. Postdoctoral Fellow School of Human Kinetics | École des sciences de l'activité physique University of Ottawa | Université d'Ottawa Ottawa ON What is the background for this study? What are the main findings? Response: Gender-differences in human heat loss (skin blood flow and sweating) have long been ascribed to innate differences between men and women. However, we believed that these were more related more to size than to gender, because most previous research compared average (larger) men with average (smaller) women. In our view, the size and shape (morphology) of an individual might be as important, if not more important, than gender in determining heat loss. When we matched men and women for body morphology, and when we studied those participants in tolerable conditions, we found that larger men and women were more dependent on sweating and less on skin blood flow, while smaller individuals were more reliant on skin blood flow and less on sweating. Moreover, as anticipated, gender differences in those heat-loss responses could be explained almost entirely by individual variations in morphology. (more…)
Author Interviews, Gender Differences, JAMA, Johns Hopkins, Mental Health Research, Pediatrics / 21.02.2017 Interview with: Julia R.G. Raifman, ScD Post-doctoral fellow Johns Hopkins Bloomberg School of Public Health What is the background for this study? Response: Suicide is the second leading cause of death among adolescents between the ages of 15 and 24 years old in the United States. Gay, lesbian, and bisexual adolescents have elevated rates of suicide attempts. In our study, we found that 29% of gay, lesbian, and bisexual adolescents reported attempting suicide in the past year relative to 6% of heterosexual adolescents. (more…)
Accidents & Violence, Author Interviews, Gender Differences / 20.02.2017 Interview with: Jeanne Mager Stellman, PhD Professor Emerita & Special Lecturer Department of Health Policy & Management Mailman School of Public Health Columbia University York NY 10032 What is the background for this study? Response: We examined the experiences of 1285 American women, military and civilian, who served in Vietnam during the war and responded to a mail survey conducted approximately 25 years later in which they were asked to report and reflect upon their experiences and social and health histories. The data were collected as part of a much larger study that centered about methodological approaches to studying health effects of the military herbicides used in Vietnam. To our knowledge, this is the first study (a) to describe the experiences of civilian women deployed to a war zone and to compare them to those of military women; (b) to differentiate the experiences and outcomes among military women by the length of their military career service; (c) to contextualize the general health and happiness, marital characteristics, and childbearing patterns of women deployed to Vietnam and those of their peers by comparing them to a contemporaneous nationally representative age-matched cohort, the General Social Survey (GSS). Overall, this paper provides insight into the experiences of the understudied women who served in Vietnam, and sheds light on subgroup differences within the sample. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, Rheumatology / 14.02.2017 Interview with: Adam Culvenor, PT, PhD Research Fellow,Institute of Anatomy Paracelsus Medizinische Privatuniversität Strubergasse Salzburg, Austria What is the background for this study? What are the main findings? Response: Thigh muscle weakness, particularly of the knee extensors (quadriceps), is a common feature of people with knee osteoarthritis. Thigh muscle weakness could be a consequence of knee osteoarthritis, or precede knee osteoarthritis development. There is conflicting evidence regarding the role of thigh muscle weakness as a risk factor for incident knee osteoarthritis in both men and women. Thigh muscle specific strength is a measure of muscle quality incorporating both the capacity of the muscle to produce force as well as muscle structure (ie. size, cross-sectional area), and preliminary data suggests this may be a more relevant measure of strength in relation to knee osteoarthritis development. (more…)
Author Interviews, Environmental Risks, Gender Differences, Heart Disease / 14.02.2017 Interview with: Nathalie Auger MD MSc FRCPC Montréal, Québec What is the background for this study? Response: Snow shoveling is a challenging cardiovascular activity. Some studies suggest a link between snowfall and myocardial infarction, but use aggregate data which are limited. We used health data for individuals in the province of Quebec, Canada to analyze the association between snowfall and likelihood of hospital admission or death due to myocardial infarction. (more…)
Author Interviews, CDC, Gender Differences, HIV, Race/Ethnic Diversity / 09.02.2017 Interview with: Donna Hubbard McCree, PhD MPH, RPh Association Director for Health Equity/Division of HIV/AIDS Prevention Centers for Disease Control and Prevention What is the background for this study? What are the main findings? Response: HIV diagnosis rates among women declined 40% between 2005 and 2014 with the largest decline, 42%, occurring in black women. However, in 2015 black women represented 61% of HIV diagnoses among women. Our goal in this analysis was to determine whether the decline resulted in a decrease in the disparities among African American, Hispanic and white women between 2010 and 2014. There is currently not a standard method for measuring HIV-related disparity. However, for this analysis we used three different measures – the absolute rate difference (the difference between the group with the lowest rate and the group with the highest rate); 2) the diagnosis disparity ratio (the ratio of the difference between the group rate and the overall population rate to the overall rate); and 3) the Index of Disparity (the average of the differences between rates for specific groups and the total rate divided by the total rate, expressed as a percentage). The absolute rate difference between black women and white women decreased annually, from 36.9 in 2010 to 28.3 in 2014. The diagnosis disparity ratio for black women compared to the total population decreased from 1.7 in 2010 to 1.2 in 2014. The Index of Disparity increased during 2010–2011, and then decreased each year during 2012–2014. Although disparities still exist, these findings indicate improvement. (more…)
Author Interviews, Cognitive Issues, Gender Differences, Hip Fractures, Orthopedics / 09.02.2017 Interview with: Ann L. Gruber-Baldini, Ph.D. Professor, Division of Gerontology Director, Program in Epidemiology and Human Genetics Department of Epidemiology & Public Health University of Maryland School of Medicine What is the background for this study? Response: While men make up only about 25% of all hip fractures, the number of men who fracture their hip is increasing and we know men are more likely to die than women after a hip fracture. It is also known that those with cognitive impairments, typically due to delirium and Alzheimer's disease and related dementia, are more likely to do more poorly after the fracture. The impact of both sex and cognition on outcomes after hip fracture has not been fully explored. (more…)
Author Interviews, Cancer Research, Gender Differences, Race/Ethnic Diversity / 01.02.2017 Interview with: Sheila F. Dunn, MD, MSc Scientist, Women's College Research Institute Director, Family Practice Health Centre Staff Physician, Department of Family and Community Medicine Women's College Hospital Associate Professor, Department of Family and Community Medicine University of Toronto What is the background for this study? Response: Despite organized cervical and breast cancer screening programs, inequities in screening remain. In Ontario, women who are newcomers, especially those of South Asian and East Asian origin, have much lower screening rates than Canadian-born women. In order to address these inequities the CARES program used a multi-faceted community-based intervention to increase knowledge and promote cervical and breast cancer screening among newcomer and otherwise marginalized women in Toronto, Ontario, Canada. We reached out to women in the target groups through a network of community agencies. Women attended group educational sessions co-led by peers who spoke their language. Access to screening was facilitated through group screening visits, a visit health bus and on-site Pap smears. Administrative data were used to compare screening after the education date for CARES participants with a control group matched for age, screening status and area of residence. (more…)
Author Interviews, BMJ, Gender Differences, Heart Disease, Social Issues / 20.01.2017 Interview with: Sanne Peters, PhD Research Fellow in Epidemiology The George Institute for Global Health University of Oxford Oxford United Kingdom What is the background for this study? Response: People from disadvantaged backgrounds are, on average, at greater risk of cardiovascular diseases than people with more affluent backgrounds. Some studies have suggested that these socioeconomic inequalities in cardiovascular disease are more consistent and stronger in women than in men. However, the literature is inconsistent. (more…)
Author Interviews, Gender Differences, Neurological Disorders, Psychological Science / 20.01.2017 Interview with: Lise Eliot PhD Associate Professor of Neuroscience Chicago Medical School Rosalind Franklin University North Chicago, IL 60064 What is the background for this study? What are the main findings? Response: Studies in rats indicate that the amygdala, which is important for many social behaviors including aggression and rough-and-tumble play, is larger in male animals.  Early MRI studies also reported that the human amygdala is larger in men, even after correcting for males' larger overall brain size.  Because so many MRI studies are now imaging amygdala volume in matched groups of healthy males and females, we realized that there is a lot of published data that could settle whether the human amygdala is indeed proportionally larger in men.  Another rationale for the study is that many psychiatric disorders that involve the amygdala (e.g., depression, anxiety, substance abuse) differ in prevalence between men and women. (more…)
Author Interviews, Endocrinology, Gender Differences, JCEM / 13.01.2017 Interview with: Caroline J. Davidge-Pitts, M.B., Ch.B Mayo Clinic Rochester, Minn. What is the background for this study? Response: The awareness of transgender healthcare issues has increased, leading to improved coverage of both hormonal and non-hormonal therapies. In endocrinology practices, there is an increased demand for providers who are competent in these areas. We wanted to assess the current status of knowledge and practice in transgender health amongst our current and future endocrinologists. (more…)
Author Interviews, Gender Differences, Sexual Health, University of Michigan / 31.12.2016 Interview with: Halley Crissman, MD, MPH University of Michigan Resident Physician Department of Obstetrics and Gynecology University of Michigan Ann Arbor, Michigan What is the background for this study? What are the main findings? Response: There has been very little data on the epidemiology of the transgender population in the U.S., including basic information regarding the proportion of adults that identify as transgender. Transgender is an identity term for individuals whose gender expression and gender identity does not align with culture expectations and gender norms associated with sex assigned at birth. Our study used data from the Centers for Disease Control and Prevention 2014 Behavioral Risk Factor Surveillance System to estimate the demographic characteristics of the U.S. adult transgender population compared to the non-transgender population. We found that 0.53% of U.S. adults identified as transgender. Transgender individuals were more likely to be non-white and below the poverty line, were less likely to attend college, and were as likely to be married, living in a rural area, and employed, compared to non-transgender individuals. (more…)
Author Interviews, Gender Differences, Lancet, OBGYNE, Surgical Research / 21.12.2016 Interview with: Prof. Cathryn Glazener PhD Health Services Research Unit University of Aberdeen Aberdeen,UK What is the background for this study? What are the main findings? Response: Prolapse is a condition that affects up to half of all women after childbirth. Women notice a bulge or discomfort in their vaginas due to pressure from the bladder, bowel or womb moving downwards. Women who have surgery for their prolapse have a 3 in 10 chance of needing at least one more operation, so the success rate is not great. Gynaecologists hoped that by reinforcing their repairs the success rate would get better. PROSPECT was a pragmatic, multicentre randomised controlled trial conducted in 35 centres across the UK. Women undergoing their first operation for prolapse were randomised to having a standard repair of the front or back wall of the vagina, or a repair reinforced by synthetic non-absorbable mesh, or a biological graft. We found that, in contrast to previous research, women were just as likely to be cured after standard surgery rather than reinforced repairs. They were just as likely to have other symptoms such as bladder or sexual problems, and other adverse effects such as infection, bleeding or pain. However, about 1 in 10 of the women who had mesh did have mesh exposure when a small portion of the mesh becomes visible through the vaginal wall. Although many women did not have symptoms, about half of those women needed a small operation to remove or bury the exposed mesh. (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Hospital Readmissions, JAMA / 20.12.2016 Interview with: Yusuke Tsugawa, MD, MPH, PhD Department of Health Policy and Management Harvard T. H. Chan School of Public Health, Department of Medicine Brigham and Women’s Hospital and Harvard Medical School Boston, Massachusetts What is the background for this study? What are the main findings? Response: We analyzed a 20% sample of Medicare beneficiaries hospitalized with a medical condition in 2011-2014, and found that patients treated by female doctors have lower mortality and readmission rates than those cared for by male doctors. (more…)
Author Interviews, Gender Differences, Ophthalmology, Social Issues / 02.12.2016 Interview with: Antoine Coutrot PhD CoMPLEX University College London London, UK What is the background for this study? What are the main findings? Response: The human face is central to our everyday social interactions. Recent studies have shown that while gazing at faces, each one of us has a particular eye-scanning pattern, highly stable across time. Although variables such as culture or personality have been shown to modulate gaze behavior, we still don't know what shapes these idiosyncrasies. Moreover, most previous observations rely on analyses of small-sized eye-position datasets, often from the WEIRD (western, educated, industrialized, rich, and democratic) population. Here we use a very large and diverse dataset (400+ participants from 58 nationalities) and show that among many observer characteristics, gender is the one that best explains the differences in gaze behaviour. When looking at faces, women are more exploratory than men and more biased toward the left side. We even trained a classifier able to infer the gender of observers only based on their gaze. (more…)
AHA Journals, Author Interviews, Gender Differences, Heart Disease, Surgical Research / 27.11.2016 Interview with: Dr. Stefano Savonitto  Director, Division of Cardiology Manzoni Hospital What is the background for this study? What are the main findings? Response: Over the last 15 years, there has been a shift from fibrinolytic therapy for STEMI to primary angioplasty, which required a re-organization of the whole STEMI treatment network. Besides the higher reperfusion efficiency of primary angioplasty, as compared to lytic therapy, it has been a global upgrade of the STEMI care system that has reduced the rate of no reperfusion. Elderly patients and women (who are, on average, also older than men) had theoretically the most to gain from this shift, but little data were available to assess this benefit. In the present paper, we have shown that “lack of reperfusion” was reduced dramatically across all age groups and in both sexes, with a progressive and uniform increase in primary angioplasty, and a significant reduction in mortality. Almost as expected, elderly women were the category with the most relevant mortality benefit. Nevertheless, after adjustment for age and other confounders, women continue to experience a higher mortality as compared to men. In the discussion of the paper, we propose some hypotheses for this persistently higher mortality in women. (more…)
Author Interviews, Gender Differences, Heart Disease, Surgical Research / 21.11.2016 Interview with: Dr James Spratt Bsc, MD, FRCP, FESC, FACC Spire Edinburgh Hospitals and Spire Murrayfield Edinburgh Spire Shawfair Park Hospital What is the background for this study? Response: Gender differences exist between male and female patients following routine PCI but data regarding these differences in Chronic Total Occlusions (CTO) Percutaneous Coronary Intervention (PCI) is limited. We maintain a dedicated national (United Kingdom) prospective CTO database contributed to by dedicated CTO PCI operators (lifetime CTO PCI >300). We retrospectively analysed this database from 2011-2015 to compare outcomes and characteristics of male versus female patients undergoing CTO PCI. We attempted to limit the bias of this observational study by propensity matched analysis. (more…)
Author Interviews, Gender Differences, JAMA, Stroke / 19.11.2016 Interview with: Catharina J. M. Klijn, MD Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery University Medical Center Utrecht, Utrecht Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience Department of Neurology Radboud University Nijmegen Medical Centre Nijmegen, the Netherlands What is the background for this study? Response: The incidence of stroke is higher in men than in women. This difference attenuates with increasing age. Established risk factors for stroke, such as hypertension, cigarette smoking and ischemic heart disease are more prevalent in men but only partly explain the difference in stroke incidence. The contribution of oral contraceptive use and hormone therapy to stroke risk has been previously reviewed. We aimed to evaluate what is known on other female- and male specific risk factors for ischemic and hemorrhagic stroke incidence and stroke mortality through a systematic review and meta-analysis of 78 studies including over 10 million participants. (more…)
Author Interviews, Cannabis, Gender Differences, Heart Disease / 14.11.2016 Interview with: Amitoj Singh MD Chief Cardiology Fellow St. Luke’s University Health Bethlehem, Pennsylvania What is the background for this study? Response: Marijuana use in steadily increasing and it is the most commonly used illicit drug in the US and worldwide. There has been a recent increase in reports of heart and vascular complications associated with its use. These include Myocardial infarctions, stroke and takotsubo. We had two questions that we wanted to answer with our study: a) Is there an association between marijuana use and development of Transient Regional Ventricular Ballooning [TVRB] (aka Stress Cardiomyopathy /Broken Heart Syndrome/ Takotsubo)? b) If the above is true, what are the differences between Marijuana users (MU) and Non Marijuana Users (NMU) who developed Stress Cardiomyopathy. (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Memory, Menopause / 12.11.2016 Interview with: Jill M. Goldstein, Ph.D. Director of Research for the Connors Center for Women's Health and Gender Biology Brigham and Women's Hospital and Professor of Psychiatry and Medicine at Harvard Medical School What is the background for this study? Response: Maintaining intact memory function as we age is one of the primary public health challenges of our time. In fact, women are at almost twice the risk for Alzheimer's disease and it is not only because women live longer. Thus, it is incumbent upon us to understand this sex difference and incorporate the knowledge into the development of sex-dependent therapeutics. Our study focused on beginning this investigation by understanding how memory circuitry and memory function change over the menopausal transition, when we believe that sex differences in memory aging emerge. By understanding healthy aging, we will better understand how the brain goes awry with age differently in men and women and who might be at highest risk for Alzheimer's disease later in life. (more…)
Author Interviews, Autism, Gender Differences / 08.11.2016 Interview with: Dr. John Strang, PsyD Division of Pediatric Neuropsychology Children's National Health System. What is the background for this study? What are the main findings Response: Gender dysphoria or transgenderism (GD) and autism spectrum disorders (ASD) often co-occur. Between 9 and 25% of youth referred for gender dysphoria concerns have co-occurring ASD. Autistic transgender youth often require significant supports; their autism symptoms alone present challenges, but when combined with gender dysphoria, the clinical needs and complexities increase significantly. For example, an autism spectrum disorder, with its resulting social and communication challenges, can make it more difficult for a transgender teen to advocate for their needs around gender. Specialists from youth gender clinics from around the world have years of experience working with autistic transgender youth. This study used an international search process to identify experts in co-occurring ASD and GD. Twenty-two experts were identified and participated in this multi-stage consensus building study. A set of initial clinical guidelines for the evaluation and care of youth with co-occurring ASD and GD were produced. (more…)