Despite new advances in modern medicine, the cultural use of plant in traditional medicine continues from ancient time to this day all over the world. The present research seeks to explore ethnomedicinal plants used by the local people of Nawalparasi district for primary healthcare. Local healers were interviewed regarding the detail uses of plants. When convenient a jungle or forest walk was also conducted, accompanying local healers for plant collection and detailed information gathering. A rich and unique diversity of 94 ethnomedicinal plant species belonging to 49 families under 86 genera were documented. In Nawalparasi, the expense of modern medical treatment combined with the poor economic status of indigenous people and a strong belief in the traditional medicine and traditional medical practitioners are the main reasons for the persistence of the traditional healing system. In addition, we have also documented a lack of continuation and flow of indigenous knowledge from the elders to the younger generation. Youth tend to be attracted by the wave of modernization and do not appreciate the importance of conservation of traditional knowledge. The use of plants in Nawalparasi is an old tradition and the exploration of such unique cultures should be completed thoroughly so that the oral traditions are not lost forever. Immediate conservation and management approaches of valuable medicinal plants with the involvement of local indigenous people of Nawalparasi district will encourage the sustainable conservation of both biological and cultural diversity.Key words: Traditional medicine; Local healers; Healthcare; Conservation; NawalparasiDOI: 10.3126/on.v7i1.2555Our Nature (2009) 7:82-99

Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirmi...