How gender-affirming care improves trans mental health
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In recent years, a growing number of states have passed laws restricting or banning gender-affirming care for transgender people, particularly minors. As conversations about gender-affirming care increase, so do false narratives about it, with some opponents falsely suggesting that it’s harmful to mental health.
Despite widespread attacks against gender-affirming care, research clearly shows that it improves mental health outcomes for transgender people.
Read on to learn more about what gender-affirming care is, how it benefits mental well-being, and how you can access it.
What is gender-affirming care?
Gender-affirming care describes a range of medical interventions that help align people’s bodies with their gender identities. While anyone can seek gender-affirming care in the form of laser hair removal, breast augmentation, erectile dysfunction medication, or hormone therapy, among other treatments, most conversations about gender-affirming care center around transgender people, whose gender identity or gender expression does not conform to their sex assigned at birth.
Gender-affirming care for trans people varies based on age. For example, some trans adults seek hormone replacement therapy (HRT) or gender-affirming surgeries that help their bodies match their internal sense of gender.
Trans kids entering adolescence might be prescribed puberty blockers, which temporarily delay the production of hormones that initiate puberty, to give them more time to figure out their gender identities before deciding on next steps. This is the same medication given to cisgender kids—whose gender identities match the sex they were assigned at birth—experiencing early puberty.
What is gender dysphoria?
Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity. This can lead to a range of mental health conditions that affect their quality of life
Some trans people may manage gender dysphoria by wearing gender-affirming clothing, opting for a gender-affirming hairstyle, or asking others to refer to them by a name and pronouns that authentically represent them. Others may need gender-affirming care to feel at home in their bodies.
Trans people who desire gender-affirming care and have not been able to access it experience psychological distress, including depression, anxiety, self-harm, and suicidal ideation. The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People found that roughly half of trans youth “seriously considered attempting suicide in the past year.”
How does gender-affirming care improve mental health?
For trans adults, gender-affirming care can alleviate gender dysphoria, which has been shown to improve both short-term and long-term mental health. A 2018 study found that trans adults who do not undergo HRT are four times more likely to experience depression than those who do, although not all trans people desire HRT.
Extensive research has shown that gender-affirming care also alleviates gender dysphoria and improves mental health outcomes in trans kids, teens, and young adults. A 2022 study found that access to HRT and puberty blockers lowered the odds of depression in trans people between the ages of 13 and 20 by 60 percent and reduced the risk of self-harm and suicidal thoughts by 73 percent.
Both the Endocrine Society—which aims to advance hormone research—and the American Academy of Pediatrics recommend that trans kids and teens have access to developmentally appropriate gender-affirming care.
How can I access gender-affirming care?
If you’re a trans adult seeking gender-affirming care or a guardian of a trans kid or teen who’s seeking gender-affirming care, talk to your health care provider about your options. You can find a trans-affirming provider by searching the World Professional Association for Transgender Health directory or visiting your local LGBTQ+ health center or Planned Parenthood.
Some gender-affirming care may not be covered by insurance. Learn how to make the most of your coverage from the National Center for Transgender Equality. Find insurance plans available through the Marketplace that cover gender-affirming care in some states through Out2Enroll.
Some states restrict or ban gender-affirming care. Learn about the laws in your state by visiting the Trans Legislation Tracker.
Where can trans people and their families find mental health support?
In addition to working with a trans-affirming therapist, trans people and their families can find mental health support through these free services:
- PFLAG offers resources for families and friends of LGBTQ+ people. Find a PFLAG chapter near you.
- The Trevor Project’s hotline has trained counselors who help LGBTQ+ youth in crisis. Call the TrevorLifeline 1-866-488-7386 or text START to 678-678.
- The Trans Lifeline was created by and for the trans community to support trans people in crisis. You can reach the Trans Lifeline hotline at 1-877-565-8860.
For more information, talk to your health care provider.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Winter Wellness – by Rachel de Thample
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Winter is often the season of comfort foods and, in much of the Western world, there’s a holiday season slide of forgotten diets and instead sugar, alcohol, pastry, and the like.
What de Thample does here is an antidote to all that, without sacrificing happiness and celebration.
Before the recipes get started, she has a chapter on “food as medicine“, and to our immense surprise, proceeds to detail, accurately, many categories such as
- Foods for immune health
- Foods against inflammation
- Foods for gut health
- Foods against aging
- Foods for energy levels
- Foods against anxiety
- Foods for hormonal balance
…and so forth, with lists of ingredients that fit into each category.
Then in the rest of the book, she lays out beautiful recipes for wonderful dishes (and drinks) that use those ingredients, without unhealthy additions.
The recipes are, by the way, what could best be categorized as “fancy”. However, they are fancy in the sense that they will be impressive for entertaining, and (again, to our great surprise) they don’t actually call for particularly expensive/rare ingredients, nor for arcane methods and special equipment.Instead, everything’s astonishingly accessible to put together and easy to execute.
Bottom line: if you’d like to indulge this winter, but would like to do so healthily, this is an excellent way to do so.
Click here to check out Winter Wellness, and level-up your seasonal health and happiness!
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Some women’s breasts can’t make enough milk, and the effects can be devastating
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Many new mothers worry about their milk supply. For some, support from a breastfeeding counsellor or lactation consultant helps.
Others cannot make enough milk no matter how hard they try. These are women whose breasts are not physically capable of producing enough milk.
Our recently published research gives us clues about breast features that might make it difficult for some women to produce enough milk. Another of our studies shows the devastating consequences for women who dream of breastfeeding but find they cannot.
Some breasts just don’t develop
Unlike other organs, breasts are not fully developed at birth. There are key developmental stages as an embryo, then again during puberty and pregnancy.
At birth, the breast consists of a simple network of ducts. Usually during puberty, the glandular (milk-making) tissue part of the breast begins to develop and the ductal network expands. Then typically, further growth of the ductal network and glandular tissue during pregnancy prepares the breast for lactation.
But our online survey of women who report low milk supply gives us clues to anomalies in how some women’s breasts develop.
We’re not talking about women with small breasts, but women whose glandular tissue (shown in this diagram as “lobules”) is underdeveloped and have a condition called breast hypoplasia.
Sometimes not enough glandular tissue, shown here as lobules, develop.
Tsuyna/ShutterstockWe don’t know how common this is. But it has been linked with lower rates of exclusive breastfeeding.
We also don’t know what causes it, with much of the research conducted in animals and not humans.
However, certain health conditions have been associated with it, including polycystic ovary syndrome and other endocrine (hormonal) conditions. A high body-mass index around the time of puberty may be another indicator.
Could I have breast hypoplasia?
Our survey and other research give clues about who may have breast hypoplasia.
But it’s important to note these characteristics are indicators and do not mean women exhibiting them will definitely be unable to exclusively breastfeed.
Indicators include:
- a wider than usual gap between the breasts
- tubular-shaped (rather than round) breasts
- asymmetric breasts (where the breasts are different sizes or shapes)
- lack of breast growth in pregnancy
- a delay in or absence of breast fullness in the days after giving birth
In our survey, 72% of women with low milk supply had breasts that did not change appearance during pregnancy, and about 70% reported at least one irregular-shaped breast.
The effects
Mothers with low milk supply – whether or not they have breast hyoplasia or some other condition that limits their ability to produce enough milk – report a range of emotions.
Research, including our own, shows this ranges from frustration, confusion and surprise to intense or profound feelings of failure, guilt, grief and despair.
Some mothers describe “breastfeeding grief” – a prolonged sense of loss or failure, due to being unable to connect with and nourish their baby through breastfeeding in the way they had hoped.
These feelings of failure, guilt, grief and despair can trigger symptoms of anxiety and depression for some women.
Feelings of failure, guilt, grief and despair were common.
Bricolage/ShutterstockOne woman told us:
[I became] so angry and upset with my body for not being able to produce enough milk.
Many women’s emotions intensified when they discovered that despite all their hard work, they were still unable to breastfeed their babies as planned. A few women described reaching their “breaking point”, and their experience felt “like death”, “the worst day of [my] life” or “hell”.
One participant told us:
I finally learned that ‘all women make enough milk’ was a lie. No amount of education or determination would make my breasts work. I felt deceived and let down by all my medical providers. How dare they have no answers for me when I desperately just wanted to feed my child naturally.
Others told us how they learned to accept their situation. Some women said they were relieved their infant was “finally satisfied” when they began supplementing with formula. One resolved to:
prioritise time with [my] baby over pumping for such little amounts.
Where to go for help
If you are struggling with low milk supply, it can help to see a lactation consultant for support and to determine the possible cause.
This will involve helping you try different strategies, such as optimising positioning and attachment during breastfeeding, or breastfeeding/expressing more frequently. You may need to consider taking a medication, such as domperidone, to see if your supply increases.
If these strategies do not help, there may be an underlying reason why you can’t make enough milk, such as insufficient glandular tissue (a confirmed inability to make a full supply due to breast hypoplasia).
Even if you have breast hypoplasia, you can still breastfeed by giving your baby extra milk (donor milk or formula) via a bottle or using a supplementer (which involves delivering milk at the breast via a tube linked to a bottle).
More resources
The following websites offer further information and support:
- Australian Breastfeeding Association
- Lactation Consultants of Australia and New Zealand
- Royal Women’s Hospital, Melbourne
- Supply Line Breastfeeders Support Group of Australia Facebook support group
- IGT And Low Milk Supply Support Group Facebook support group
- Breastfeeding Medicine Network Australia/New Zealand
- Supporting breastfeeding grief (a collection of resources).
Shannon Bennetts, a research fellow at La Trobe University, contributed to this article.
Renee Kam, PhD candidate and research officer, La Trobe University and Lisa Amir, Professor in Breastfeeding Research, La Trobe University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Eat Better, Feel Better – by Giada de Laurentis
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In yesterday’s edition of 10almonds, we reviewed Dr. Aujla’s “The Doctor’s Kitchen“; today we’re reviewing a different book about healing through food—in this case, with a special focus on maintaining energy and good health as we get older.
De Laurentis may not be a medical doctor, but she is a TV chef, and not only holds a lot of influence, but also has access to a lot of celebrity doctors and such; that’s reflected a lot in her style and approach here.
The recipes are clear and easy to follow; well-illustrated and nicely laid-out.
This cookbook’s style is less “enjoy this hearty dish of rice and beans with these herbs and spices” and more “you can serve your steak salad with white beans and sweet shallot dressing on a bed of organic quinoa if you haven’t already had your day’s serving of grains, of course”.
It’s a little fancier, in short, and more focused on what to cut out, than what to include. On account of that, this could make it a good contrast to yesterday’s book, which had the opposite focus.
She also recommends assorted adjuvant practices; some that are evidence-based, like intermittent fasting and meditation, and some that are not, like extreme detox-dieting, and acupuncture (which has no bearing on gut health).
Bottom line: if you like the idea of eating for good health, and prefer a touch of celebrity lifestyle to your meals, this one’s a good book for you.
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The Bare-Bones Truth About Osteoporosis
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In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:
The Bare-bones Truth About Osteoporosis
In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:
At first glance it may seem shocking that a majority of respondents to a poll in a health-focused newsletter think it’ll never be an issue worth worrying about, but in fact this is partly a statistical quirk, because the vote of the strongest “early prevention” crowd was divided between “as a child” and “as a young adult”.
This poll also gave you the option to add a comment with your vote. Many subscribers chose to do so, explaining your choices… But, interestingly, not one single person who voted for “never” had any additional thoughts to add.
We loved reading your replies, by the way, and wish we had room to include them here, because they were very interesting and thought-provoking.
Let’s get to the myths and facts:
Top myth: “you will never need to worry about it; drink a glass of milk and you’ll be fine!”
The body is constantly repairing itself. Its ability to do that declines with age. Until about 35 on average, we can replace bone mineral as quickly as it is lost. After that, we lose it by up to 1% per year, and that rate climbs after 50, and climbs even more steeply for those who go through (untreated) menopause.
Losing 1% per year might not seem like a lot, but if you want to live to 100, there are some unfortunate implications!
About that menopause, by the way… Because declining estrogen levels late in life contribute significantly to osteoporosis, hormone replacement therapy (HRT) may be of value to many for the sake of bone health, never mind the more obvious and commonly-sought benefits.
On the topic of that glass of milk…
- Milk is a great source of calcium, which is useless to the body if you don’t also have good levels of vitamin D and magnesium.
- People’s vitamin D levels tend to directly correlate to the level of sun where they live, if supplementation isn’t undertaken.
- Plant-based milks are usually fortified with vitamin D (and calcium), by the way.
- Most people are deficient in magnesium, because green leafy things don’t form as big a part of most people’s diets as they should.
See also: An update on magnesium and bone health
Next most common myth: “bone health is all about calcium”
We spoke a little above about the importance of vitamin D and magnesium for being able to properly use that. But potassium is also critical:
Read more: The effects of potassium on bone health
While we’re on the topic…
People think of collagen as being for skin health. And it is important for that, but collagen’s benefits (and the negative effects of its absence) go much deeper, to include bone health. We’ve written about this before, so rather than take more space today, we’ll just drop the link:
We Are Such Stuff As Fish Are Made Of
Want to really maximize your bone health?
You might want to check out this well-sourced LiveStrong article:
Bone Health: Best and Worst Foods
(Teaser: leafy greens are in 2nd place, topped by sardines at #1—where do you think milk ranks?)
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Burn! How To Boost Your Metabolism
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Let’s burn! Metabolic tweaks and hacks
Our metabolism is, for as long as we live, a constantly moving thing. And it’s not a monolith either; there are parts of our metabolism that can speed up or slow down independently of others.
If we talk about metabolism without clarifying context, though, this is usually about one’s “basal metabolic rate”, that is, how many calories we burn just by being alive.
Why do we want to speed it up? Might we ever want to slow it down?
We might want to slow our metabolism down in survival circumstances, but generally speaking, a faster metabolism is a better one.
Yes, even when it comes to aging. Because although metabolism comes with metabolizing oxygen (which, ironically, tends to kill us eventually, since this is a key part of cellular aging), it is still beneficial to replace cells sooner rather than later. The later we replace a given cell (ie, the longer the cell lives), the more damaged it gets, and then the copy is damaged from the start, because the damage was copied along with it. So, best to have a fast metabolism to replace cells quickly when they are young and healthy.
A quick metabolism helps the body to do this.
Most people, of course, are interested in a fast metabolism to burn off fat, but beware: if you increase your metabolism without consideration to how and when you consume calories, you will simply end up eating more to compensate.
One final quick note before we begin:
Limitations
There’s a lot we can do to change our metabolism, but there are some things that may be outside of our control. They include:
- Age—we can influence our biological age, but we cannot (yet!) halt aging, so this will happen
- Body size—and yes we can change this a bit, but we all have our own “basic frame” to work with. Someone who is 6’6” is never going to be able to have the same lower-end-of-scale body mass of someone who is 5’0”, say.
- Sex—this is about hormones, and HRT is a thing, but for example, broadly speaking, men will have faster metabolisms than women, because of hormonal differences.
- Medical conditions—often also related to other hormones, but for example someone with Type 1 Diabetes is going to have a very different relationship with their metabolism than someone without, and someone with a hypo- or hyperactive thyroid will again have a very different metabolism in a way that that lifestyle factors can’t completely compensate for.
The tips and tricks
Intermittent fasting
Intermittent fasting has been found to, amongst other things, promote healthy apoptosis and autophagy (in other words: early programmed cell death and recycling—these are good things).
It also has anti-inflammatory benefits and decreases the risk of insulin resistance. In other words, intermittent fasting boosts the metabolism while simultaneously guarding against some of the dangers of a faster metabolism (harms you’d get if you instead increased your metabolism by doing intense exercise and then eating a mountain of convenience food to compensate)
Read the science: Intermittent Fasting: Is the Wait Worth the Weight?
Read our prior article: Fasting Without Crashing? We Sort The Science From The Hype
Enjoy plenty of protein
This one won’t speed your metabolism up, so much as help it avoid slowing down as a result of fat loss.
Because of our body’s marvelous homeostatic system trying to keep our body from changing status at any given time, often when we lose fat, our body drops our metabolism to compensate, thinking we are in an ongoing survival situation and food is scarce so we’d better conserve energy (as fat). That’s a pain for would-be weight-loss dieters!
Eating protein can let our body know that we’re perfectly safe and not starving, so it will keep the metabolism ticking over nicely, without putting on fat.
Read the science: The role of protein in weight loss and maintenance
Stay hydrated
People think of drinking water as part of a weight loss program being just about filling oneself up, and that is a thing, but it also has a role to play in our metabolism. Specifically, lipolysis (the process of removing fat).
Because, we are mostly water. Not only is it the main content of our various body tissue cells, but also, of particular note, our blood (the means by which everything is transported around our body) is mostly water, too.
It’s hard for the body to keep everything ticking over like a well-oiled machine if its means of transportation is sluggish!
Check it out: Increased Hydration Can Be Associated with Weight Loss
Take a stand
That basal metabolic rate we talked about?
- If you’re lying down at rest, that’s what your metabolism will be like.
- If you’re sitting up, it’ll be a little quicker, but not much.
- If you’re standing, suddenly half your body is doing things, and you don’t even notice them because they’re just stabilizing muscles and the like, but on a cellular level, your body gets very busy.
Read all about it: Cardiometabolic impact of changing sitting, standing, and stepping in the workplace
Time to invest in a standing desk? Or a treadmill in front of the TV?
The spice of life
Capsaicin, the compound in many kinds of pepper that give them their spicy flavor, boosts the metabolism. In the words of Tremblay et al for the International Journal of Obesity:
❝[Capsaicin] stimulates the sympathoadrenal system that mediates the thermogenic and anorexigenic effects of capsaicinoids.
Capsaicinoids have been found to accentuate the impact of caloric restriction on body weight loss.
Some studies have also shown that capsinoids increase energy expenditure.
Capsaicin supplementation attenuates or even prevents the increase in hunger and decrease in fullness as well as the decrease in energy expenditure and fat oxidation, which normally result from energy restriction❞
Read for yourself: Capsaicinoids: a spicy solution to the management of obesity?
You snooze, you lose (fat)
While exercising is generally touted as the road to weight loss, and certainly regular exercise does have a part to play, doing so without good rest will have bad results.
In fact, even if you’re not exercising, if you don’t get enough sleep your metabolism will get sluggish to try to slow you down and encourage you to sleep.
So, be proactive, and make getting enough good quality sleep a priority.
Eat for metabolic health
Aside from the chilli peppers we mentioned, there are other foods associated with good metabolic health. We don’t have room to go into the science of each of them here, but here’s a well-researched, well-sourced standalone article listing some top choices:
The 12 Best Foods to Boost Your Metabolism
Enjoy!
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Blood-Sugar Balancing Beetroot Cutlets
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These beetroot cutlets are meaty and proteinous and fibrous and even have a healthy collection of fats, making these much better for your heart and blood than an animal-based equivalent.
You will need
- 1 can kidney beans, drained and rinsed (or 1 cup same, cooked, drained, and rinsed)
- ½ cup chopped roasted or steamed beetroot, blotted dry
- ½ cup chopped walnuts (if allergic, substitute with ¼ cup pumpkin seeds)
- ½ cup cooked (ideally: mixed) grains of your choice (if you need gluten-free, there are plenty of gluten-free grains and pseudocereals)
- ¼ cup finely chopped onion
- ¼ bulb garlic, minced or crushed
- 2 tbsp nutritional yeast
- 2 tbsp ground flaxseeds
- 2 tbsp ground chia seeds
- 2 tsp tomato purée
- 1 tsp black pepper
- ½ tsp white miso paste
- ½ tsp smoked paprika
- ½ tsp cayenne pepper
- ¼ tsp MSG or ½ tsp low-sodium salt
Method
(we suggest you read everything at least once before doing anything)
1) Combine the beetroot, beans, walnuts, grains, and onion in a food processor, and process until a coarse even mixture.
2) Add the remaining ingredients and process to mix thoroughly.
3) Transfer the mixture to a clean work surface and divide into six balls. If the structural integrity is not good (i.e. too soft), add a little more of any or all of these ingredients: chopped walnuts, ground flax, ground chia, nutritional yeast.
4) Press the balls firmly into cutlets, and refrigerate for at least 1 hour, but longer is even better if you have the time. Alternatively, if you’d like to freeze them for later use, then this is the point at which to do that.
5) Preheat the oven to 375℉ / 190℃.
6) Roast the cutlets on a baking tray lined with baking paper, for about 30 minutes, turning over carefully with a spatula halfway through. They should be firm when done; if they’re not, give them a little longer.
7) Serve hot, for example on a bed of greens and with a drizzle of aged balsamic vinegar.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Beetroot’s Many Benefits
- Our Top 5 Spices: How Much Is Enough For Benefits?
- What Omega-3 Fatty Acids Really Do For Us
- Three Daily Servings of Beans?
- If You’re Not Taking Chia, You’re Missing Out
Take care!
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