
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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CLA for Weight Loss?
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Conjugated Linoleic Acid for Weight Loss?
You asked us to evaluate the use of CLA for weight loss, so that’s today’s main feature!
First, what is CLA?
Conjugated Linoleic Acid (CLA) is a fatty acid made by grazing animals. Humans don’t make it ourselves, and it’s not an essential nutrient.
Nevertheless, it’s a popular supplement, mostly sold as a fat-burning helper, and thus enjoyed by slimmers and bodybuilders alike.
❝CLA reduces bodyfat❞—True or False?
True! Contingently. Specifically, it will definitely clearly help in some cases. For example:
- This study found it doubled fat loss in chickens
- It significantly increased delipidation of white adipose tissue in these mice
- The mice in this study enjoyed a 43–88% reduction in (fatty) weight gain
- Over the course of a six-week weight-loss program, these mice got 70% more weight loss on CLA, compared to placebo
- In this study, pigs that took CLA on a high-calorie diet gained 50% less weight than those not taking CLA
- On a heart-unhealthy diet, these hamsters taking CLA gained much less white adipose tissue than their comrades not taking CLA
- Another study with pigs found that again, CLA supplementation resulted in much less weight gained
- These hamsters being fed a high-cholesterol diet found that those taking CLA ended up with a leaner body mass than those not taking CLA
- This study with mice found that CLA supplementation promoted fat loss and lean muscle gain
Did you notice a theme? It’s Animal Farm out there!
❝CLA reduces bodyfat in humans❞—True or False?
False—practically. Technically it appears to give non-significantly better results than placebo.
A comprehensive meta-analysis of 18 different studies (in which CLA was provided to humans in randomized, double-blinded, placebo-controlled trials and in which body composition was assessed by using a validated technique) found that, on average, human CLA-takers lost…
Drumroll please…
00.00–00.05 kg per week. That’s between 0–50g per week. That’s less than two ounces. Put it this way: if you were to quickly drink an espresso before stepping on the scale, the weight of your very tiny coffee would cover your fat loss.
The reviewers concluded:
❝CLA produces a modest loss in body fat in humans❞
Modest indeed!
See for yourself: Efficacy of conjugated linoleic acid for reducing fat mass: a meta-analysis in humans
But what about long-term? Well, as it happens (and as did show up in the non-human animal studies too, by the way) CLA works best for the first four weeks or so, and then effects taper off.
Another review of longer-term randomized clinical trials (in humans) found that over the course of a year, CLA-takers enjoyed on average a 1.33kg total weight loss benefit over placebo—so that’s the equivalent of about 25g (0.8 oz) per week. We’re talking less than a shot glass now.
They concluded:
❝The evidence from RCTs does not convincingly show that CLA intake generates any clinically relevant effects on body composition on the long term❞
A couple of other studies we’ll quickly mention before closing this section:
- CLA supplementation does not affect waist circumference in humans (at all).
- Amongst obese women doing aerobic exercise, CLA supplementation has no effect (at all) on body fat reduction compared to placebo
What does work?
You may remember this headline from our “What’s happening in the health world” section a few days ago:
Research reveals self-monitoring behaviors and tracking tools key to long-term weight loss success
On which note, we’ve mentioned before, we’ll mention again, and maybe one of these days we’ll do a main feature on it, there’s a psychology-based app/service “Noom” that’s very personalizable and helps you reach your own health goals, whatever they might be, in a manner consistent with any lifestyle considerations you might want to give it.
Curious to give it a go? Check it out at Noom.com (you can get the app there too, if you want)
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Foods That Cause You to Lose Weight – by Dr. Neal Barnard
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We previously reviewed Dr. Barnard’s “The Power Foods Diet”, and this time his work is about weight loss.
This time there are more recipes (which take up most of the book, so this one could be reasonably described as a cookbook), but not until after nearly a hundred pages of concepts, principles, and tips.
The recipes themselves are again very respectable, even if some may be a little redundant (e.g. the double-page recipe for blueberry muffins is followed by a double-page recipe for banana and date muffins, instead of just saying “or substitute this”—things like that) and run the gamut from salad dressings to hearty main meals.
A strength of the book is that it’s about what you eat, not how much of it you eat, so if you love eating (which is a very healthy trait to have in general), then you’ll enjoy that aspect.
Bottom line: if you’d like to eat more and weigh less, then this is a top-tier book for you.
Click here to check out “Foods That Cause You To Lose Weight”, and enjoy eating!
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Delay Ageing – by Dr. Colin Rose
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Note: the title is spelled that way because it is British English. We generally write in US English here at 10almonds, but we’ll first quote directly from Dr. Rose as written:
❝I have written Delay Ageing because there is some very important recent University research on ageing and age related illness that deserves to be made accessible to a general audience.❞
What is this research? Well, there’s quite a lot over its 300-odd pages (exact number depends on the edition and whether we count end matter), and most of it is tweaks and refinements on things with which you’ll probably be at least brushingly familiar if you’re a regular 10almonds reader.
Dr. Rose addresses the nine hallmarks of aging, of which there are ten, ranging from such things as “telomeres get shorter” and “DNA accumulates damage”, to “stem cells become exhausted” and “cells fail to communicate properly”, and asks the question “what if we were to target all these things simultaneously?”.
Rather than going for drugs on drugs on drugs (half of them to deal with undesired side effects of the previous ones), Dr. Cole leaves no stone unturned to find lifestyle interventions that will improve each of these, even if just a little. Because, all those “little” improvements add up and even compound, and on the flipside, mean that factors of aging aren’t adding up and compounding so much or so quickly anymore.
The rather broad umbrella of “lifestyle interventions” obviously includes food under its auspices, and with it, nutraceuticals. So to give one example, if you’re taking a fisetin supplement (a natural senolytic agent), you’ll find science vindicating that here. And much more.
The style is… Less pop-science and more “textbook written for laypersons”, and you may be thinking “isn’t that the same?” and the difference is that the textbook has a lot less polish and finesse, but often more precise information.
Bottom line: if you’d like to combat aging on 10 different fronts with easily implementable lifestyle interventions, and know exactly what is doing what and how, then this is the book for you.
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The Age-Proof Brain – by Dr. Marc Milstein
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Biological aging is not truly just one thing, but rather the amalgam of many things intersecting—and most of them are modifiable. The cells of your body neither know nor care how many times you have flown around the sun; they just respond to the stimuli they’re given.
Which is what fuels this book. The idea is to have a brain that is less-assailed by the things that would make it age, and more rejuvenated by the things that can make it biologically younger.
Dr. Milstein doesn’t neglect the rest of the body, and indeed notes the brain’s connections with the immune system, the heart, the gut, and more. But everything in this book is done with the brain in mind and its good health as the top priority outcome of all the things he advises.
On which note, yes, there is plenty of practical, implementable advice here. For a book that is consistently full of study paper citations, he does take care to make everything useful to the reader, and makes everything as easy as possible for the layperson along the way.
Bottom line: if you would like your brain to age less, this is an excellent, very evidence-based, guidebook.
Click here to check out The Age-Proof Brain, and age-proof your brain!
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Chickpeas vs Pinto Beans – Which is Healthier?
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Our Verdict
When comparing chickpeas to pinto beans, we picked the pinto beans.
Why?
Both are great! And an argument could be made for either…
In terms of macros, pinto beans have slightly more fiber and slightly more protein, while chickpeas have slightly more carbs, and thus predictably higher net carbs. In the category of those proteins, they both have a comparable spread of amino acods, with pinto beans having very slightly more of each amino acid. All this adds up to a clear, but moderate, win for pinto beans.
When it comes to vitamins, technically chickpeas have more of vitamins A, B3, B5, C, K, and choline, but the margins are so small as to be almost meaningless. Meanwhile, pinto beans have more of vitamins B1, B6, and E, and/but the only one where the margin is enough to really care about is vitamin E (a little over 2x what chickpeas have). So, an argument could be made either way, but we’re going to call this category a tie.
The story with minerals is similar; chickpeas have more copper, iron, manganese, phosphorus, and zinc, all with small margins, while pinto beans have more potassium and selenium, and/but also less sodium. We’d call this either a tie, or a very slight win for chickpeas.
Adding up the sections gives for a very modest win for pinto beans, but as we say, an argument could be made for either.
Certainly, enjoy both!
Want to learn more?
You might like to read:
- Chickpeas vs Black Beans – Which is Healthier?
- Kidney Beans vs Fava Beans – Which is Healthier?
- What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
Take care!
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Why is pain so exhausting?
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One of the most common feelings associated with persisting pain is fatigue and this fatigue can become overwhelming. People with chronic pain can report being drained of energy and motivation to engage with others or the world around them.
In fact, a study from the United Kingdom on people with long-term health conditions found pain and fatigue are the two biggest barriers to an active and meaningful life.
But why is long-term pain so exhausting? One clue is the nature of pain and its powerful effect on our thoughts and behaviours.
simona pilolla 2/Shutterstock Short-term pain can protect you
Modern ways of thinking about pain emphasise its protective effect – the way it grabs your attention and compels you to change your behaviour to keep a body part safe.
Try this. Slowly pinch your skin. As you increase the pressure, you’ll notice the feeling changes until, at some point, it becomes painful. It is the pain that stops you squeezing harder, right? In this way, pain protects us.
When we are injured, tissue damage or inflammation makes our pain system become more sensitive. This pain stops us from mechanically loading the damaged tissue while it heals. For instance, the pain of a broken leg or a cut under our foot means we avoid walking on it.
The concept that “pain protects us and promotes healing” is one of the most important things people who were in chronic pain tell us they learned that helped them recover.
But long-term pain can overprotect you
In the short term, pain does a terrific job of protecting us and the longer our pain system is active, the more protective it becomes.
But persistent pain can overprotect us and prevent recovery. People in pain have called this “pain system hypersensitivity”. Think of this as your pain system being on red alert. And this is where exhaustion comes in.
When pain becomes a daily experience, triggered or amplified by a widening range of activities, contexts and cues, it becomes a constant drain on one’s resources. Going about life with pain requires substantial and constant effort, and this makes us fatigued.
About 80% of us are lucky enough to not know what it is like to have pain, day in day out, for months or years. But take a moment to imagine what it would be like.
Imagine having to concentrate hard, to muster energy and use distraction techniques, just to go about your everyday tasks, let alone to complete work, caring or other duties.
Whenever you are in pain, you are faced with a choice of whether, and how, to act on it. Constantly making this choice requires thought, effort and strategy.
Mentioning your pain, or explaining its impact on each moment, task or activity, is also tiring and difficult to get across when no-one else can see or feel your pain. For those who do listen, it can become tedious, draining or worrying.
Concentrating hard, mustering energy and using distraction techniques can make everyday life exhausting. PRPicturesProduction/Shutterstock No wonder pain is exhausting
In chronic pain, it’s not just the pain system on red alert. Increased inflammation throughout the body (the immune system on red alert), disrupted output of the hormone cortisol (the endocrine system on red alert), and stiff and guarded movements (the motor system on red alert) also go hand in hand with chronic pain.
Each of these adds to fatigue and exhaustion. So learning how to manage and resolve chronic pain often includes learning how to best manage the over-activation of these systems.
Loss of sleep is also a factor in both fatigue and pain. Pain causes disruptions to sleep, and loss of sleep contributes to pain.
In other words, chronic pain is seldom “just” pain. No wonder being in long-term pain can become all-consuming and exhausting.
What actually works?
People with chronic pain are stigmatised, dismissed and misunderstood, which can lead to them not getting the care they need. Ongoing pain may prevent people working, limit their socialising and impact their relationships. This can lead to a descending spiral of social, personal and economic disadvantage.
So we need better access to evidence-based care, with high-quality education for people with chronic pain.
There is good news here though. Modern care for chronic pain, which is grounded in first gaining a modern understanding of the underlying biology of chronic pain, helps.
The key seems to be recognising, and accepting, that a hypersensitive pain system is a key player in chronic pain. This makes a quick fix highly unlikely but a program of gradual change – perhaps over months or even years – promising.
Understanding how pain works, how persisting pain becomes overprotective, how our brains and bodies adapt to training, and then learning new skills and strategies to gradually retrain both brain and body, offers scientifically based hope; there’s strong supportive evidence from clinical trials.
Every bit of support helps
The best treatments we have for chronic pain take effort, patience, persistence, courage and often a good coach. All that is a pretty overwhelming proposition for someone already exhausted.
So, if you are in the 80% of the population without chronic pain, spare a thought for what’s required and support your colleague, friend, partner, child or parent as they take on the journey.
More information about chronic pain is available from Pain Revolution.
Michael Henry, Physiotherapist and PhD candidate, Body in Mind Research Group, University of South Australia and Lorimer Moseley, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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