BackgroundSince the beginning of the COVID-19 pandemic, access to medical care was restricted for nearly all non-acute medical conditions. Due to their status as a vulnerable social group and the inherent need for transition-related treatments (e.g., hormone treatment), transgender people are assumed to be affected particularly severely by the restrictions caused by the COVID-19 pandemic. This study aims to assess the impact of the COVID-19 pandemic on the health and health care of transgender people.Methods and findingsAs an ad hoc collaboration between researchers, clinicians, and 23 community organizations, we developed a web-based survey. The survey was translated into 26 languages, and participants were recruited via various social media and LGBTIQ-community sources. Recruitment started in May 2020. We assessed demographical data, physical and mental health problems (e.g., chronic physical conditions), risk factors (e.g., smoking), COVID-19 data (symptoms, contact history, knowledge and concerns about COVID-19), and the influence of the COVID-19 pandemic on access to transgender health care and health-related supplies. To identify factors associated with the experience of restrictions to transgender health care, we conducted multivariate logistic regression analysis.5267 transgender people from 63 higher-middle income and high-income countries participated in the study. Over 50% of the participants had risk factors for a severe course of a COVID-19 infection and were at a high risk of avoiding testing or treatment of a COVID-19 infection due to the fear of mistreatment or discrimination. Access to transgender health care services was restricted due to the COVID-19 pandemic for 50% of the participants. Male sex assigned at birth and a lower monthly income were significant predictors for the experience of restrictions to health care. 35.0% of the participants reported at least one mental health conditions. Every third participant had suicidal thoughts, and 3.2% have attempted suicide since the beginning of the COVID-19 pandemic. A limitation of the study is that we did not analyze data from low-income countries and access to the internet was necessary to participate.ConclusionsTransgender people are assumed to suffer under the severity of the pandemic even more than the general population due to the intersections between their status as a vulnerable social group, their high amount of medical risk factors, and their need for ongoing medical treatment. The COVID-19 pandemic can potentiate these vulnerabilities, add new challenges for transgender individuals, and, therefore, can lead to devastating consequences, like severe physical or mental health issues, self-harming behaviour, and suicidality.

Background Minority stress is an important risk factor for sexual problems in gay and bisexual men. It remains unclear whether and to what extent this stress is associated with the sexual quality of life in these groups. Aim To investigate the significance of minority stress as a factor explaining the sexual quality of life in gay and bisexual men. Methods The analysis is based on data collected in an Internet study on the sexuality of Polish gay, bisexual, and straight men. Multiple regression analysis was used to investigate the importance of minority stress in explaining the sexual quality of life in a group of 1,486 non-heterosexual men in the context of other predictors, including demographics, the level of current sexual function, sexual patterns and experiences, and mental and physical health. We used the Sexual Minority Stress Scale based on Ilan Meyer’s Minority Stress Model, with its subscales relating to internalized homophobia, expectation of rejection, concealment, and sexual minority negative events. The level of sexual functioning was evaluated using 2 scales, the International Index of Erectile Functioning and the Premature Ejaculation Diagnostic Tool. Data on the remaining predictors were obtained using a survey that we developed. Main Outcome Measures The men’s sexual quality of life as rated on the Sexual Quality of Life Scale for Men was a dependent variable. Results Internalized homophobia (β = −0.28; P < .001) and sexual minority negative events (β = −0.09; P < .001) were statistically significant predictors of sexual quality of life in non-heterosexual men. Internalized homophobia (β = −0.28; P < .001) and erectile function (β = 0.29, P < .001) turned out to be the strongest predictors. Sexual orientation (gay vs bisexual) and its interactions with individual processes of minority stress were statistically nonsignificant. Clinical Implications To evaluate and improve the sexual quality of life of non-heterosexual men, it is necessary to consider not only their sexual function, but also the minority stress they experience, particularly internalized homophobia. Strengths & Limitations The major strengths of the study include a large sample size, a comprehensive assessment of minority stress, and the previously understudied Central European cultural context. The major limitations are the nonrepresentative sampling, retrospective data collection, and cross-sectional design. Conclusion Internalized homophobia predicts poorer sexual quality of life in gay and bisexual men in Poland.

Women with PCOS have, depending on age and severity of disease, problems with psychological gender identification. Duration and severity of PCOS can negatively affect the self-image of patients, lead to a disturbed identification with the female-gender scheme and, associated with it, social roles.

Psychoeducation may exert a positive influence on virtually important cognitive variables, which seem to be clinically important. This influence may disappear with time, thus the interventions should either be repeated or the duration of intervention should be prolonged. The study shows new possible research directions in the field of searching for the mechanism of action of psychoeducation in bipolar disorder, as well as of its active components.

Specjaliści z zakresu psychiatrii, psychoterapii i seksuologii zajmujący się leczeniem i wspieraniem pacjentów nastoletnich, w swojej praktyce mogą dostrzec znaczny wzrost zgłoszeń dotyczących nieakceptowania płci przypisanej przy urodzeniu, kwestionowania jej, odrzucania lub na różne sposoby przeżywania. Chociaż praca z osobami dorosłymi znajdującymi się w spektrum transpłciowości ma historię sięgającą lat 20-tych XX wieku, dysforia płciowa u młodzieży, zwłaszcza w ostatnich latach, jest zjawiskiem, które w swojej złożoności wymyka się próbom ujednolicenia podejść i działań. Wiążące się z tą tematyką kontrowersje często skutkują pochopnymi wnioskami i mylnymi - w ocenie Autorów niniejszego artykułu założeniami - że populacja młodzieży doświadczającej dysforii lub niezgodności płciowej, jest homogeniczna. Tekst porusza następujące aspekty: omówienie zmian w zakresie diagnoz związanych z tożsamością płciową, które zaszły w ostatnich dekadach w klasyfikacjach DSM oraz ICD; zdrowie psychiczne i neuroróżnorodność pacjentów zgłaszających dysforię, dominujące obecnie modele leczenia, wraz z ich zaletami i wadami oraz wyzwania diagnostyczne i terapeutyczne w pracy z tą populacją.

Background Sexual anal pain—or anodyspareunia—in gay and bisexual men is a scientifically and clinically neglected topic. More understanding of its origins and correlates is needed. Aim To search for correlates of painful anal intercourse with the inclusion of minority stress processes. Methods The analysis is based on data collected in an Internet study on the sexuality of Polish gay, bisexual, and straight men. Multiple ordinal regression analysis was used to search for the correlates of painful receptive anal intercourse in a group of 1,443 nonheterosexual men who declared practicing this type of intercourse within the last 12 months. The investigated correlates included demographics, sexual patterns and experiences, experiencing minority stress, sexual problems, and mental and physical health. To assess the level of minority stress, we used the Sexual Minority Stress Scale based on Ilan Meyer's Minority Stress Model, with its subscales relating to internalized homophobia, expectation of rejection, concealment, and sexual minority negative events. Sexual problems were measured with single-item questions adapted from the National Health and Social Life Survey. Data on the remaining correlates were obtained using a survey that we developed. Main Outcome Measures The intensity of pain during receptive anal sexual intercourse as rated on a 5-point Likert scale was a dependent variable. Results Age (odds ratio [OR]: 0.97; P < .001), performance anxiety (OR: 1.94; P < .001), and internalized homophobia (OR: 1.04; P < .001) were the only statistically significant predictors of the intensity of pain during receptive anal sexual intercourse. Clinical Implications Clinicians addressing sexual anal pain should consider performance anxiety, internalized homophobia, and younger age as possible operating factors. Strengths & Limitations The major strengths of the study include the provision of additional data on this neglected topic derived from a large sample of participants from the little recognized Central European cultural context and the major limitations are the nonrepresentative sampling, retrospective data collection, cross-sectional design, Internet methodology, and lack of information on the clinical relevance of experienced pain, that is, distress or help-seeking, as well as its recurrent or persistent character. Conclusion Painful sexual anal activity requires further investigation.

The aim of the paper is to present a specific context for the occurrence of sexual problems, i.e., sexual dysfunction in the population of homo - and bisexual men. Sexual problems and revealing them are usually a big challenge for men. In case of homo - and bisexual men additional psychological and social factors may contribute to the occurrence of these problems, as well as make experiencing them more painful, but also impede looking for and receiving an adequate help. These factors are connected to the specific features of gay men sexuality, such as: lack of obvious sexual scripts for homosexual men, full reversibility of all sexual roles and positions in contacts between two men or no fear of unwanted pregnancy, but also with the unique psychosocial context such as: minority stress and internalized homophobia. Clinicians - psychiatrists, sexologists and psychologists - should be aware of their existence to deliver a more effective professional and culturally competent care, which is free of prejudice, based on deepened reflection and void of automatic transference of experiences with work with heterosexual men.

Psychotherapists and LGB people basically agreed upon the therapeutic aims of psychotherapy. The adverse social situation of non-heterosexual people in Poland is a source of their concerns about the psychotherapeutic relations. On the other side the concerns of psychotherapists seem to correspond to some degree with the concerns of LGB people. They both reflect the society, which still struggles with heterosexism and homophobia.