this slide created to give knowledge about trans gender in india. it also covers the section of indian penal code and supreme court's decision ,related to them.
Transgender people are those who have a gender identity or gender expression that differs from their assigned sex.
Transgender people are sometimes called transsexual if they desire medical assistance to transition from one gender to another.
How And When To Tell Your Kids About Sex Reviseddfwilliams1162
A presentation built on the text, "How and When to Tell Your Kids about Sex," by Stanton Jones. For use by church leaders who are looking for ways to train parents in providing sound biblical and developmental education in human sexuality.
this slide created to give knowledge about trans gender in india. it also covers the section of indian penal code and supreme court's decision ,related to them.
Transgender people are those who have a gender identity or gender expression that differs from their assigned sex.
Transgender people are sometimes called transsexual if they desire medical assistance to transition from one gender to another.
How And When To Tell Your Kids About Sex Reviseddfwilliams1162
A presentation built on the text, "How and When to Tell Your Kids about Sex," by Stanton Jones. For use by church leaders who are looking for ways to train parents in providing sound biblical and developmental education in human sexuality.
Equality SW UK - Brenda Weston Presentation 2013 Note- equality SW is now closed: this file is made available as a legacy resource only, it will not be updated.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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3. “there is hope on the horizon that
young transpeople will not have to
tolerate what we have gone through;
but other areas of concern have not
changed and it is the job of this report
to highlight those areas.”
Krys Vere-Bujnowski
Former Co-chair, SWTEN
4. ‘Gender dysphoria’
Identification with or wish to be considered as
their true gender (not that assigned at birth)
A spectrum of identities – gender variance
Emerging evidence: brain anatomy and
physiology in transsexual people develops in
the womb. (Atypical Gender Development – A Review,
International Journal of Transgenderism)
Not a mental illness, but is often treated as
one by medical profession
5. Trans-lation
Transsexual - someone whose gender
dysphoria is such that they need to deal with it
through transitioning – usually with medical
assistance - to a gender role different from that
assigned to them at birth.
Transgender - a broader term that includes all
those who experience some degree of gender
variance, in most cases requiring no medical
intervention (GIRES 2009)
6. Trans people ...
Are all over the world – not just a Western thing
Have existed always - through recorded history
Cross all economic and social boundaries
Are part of a natural variation
Want no more than to be themselves, in peace
Are entitled to dignity, respect and
confidentiality
7. Current legislation
Human Rights Act 1998
Article 8: right to respect for private & family life
Article 12: right to marry and found a family
Gender Recognition Act 2004
• GR Certificate: able to change birth certificate
Equality Act 2010
• Protected characteristic ‘Gender reassignment’
• No need to be under medical supervision
8. UK Statistics
Are far from accurate - best estimate approx 21 in
every 100,000 people are transsexual (GIRES)
A school with 1,000 pupils will have 6 who experience
gender dysphoria during their lives.
Others likely to have transgender parent or relative
80% of trans people have encountered problems (The
Equalities Review 2007)
34.4% said they thought about or attempted suicide or
self harm (The Equalities Review 2007)
9. Early years
Children usually know how they fit within the
gender spectrum by about age 4 or 5. (GIRES)
When young the common experience (is) having
no-one to talk to, or no-one who could be trusted
to listen... (SWTEN report)
“I have felt like a gay boy trapped in a girl’s body
since I was five and don't understand why… My
head is messed up over this stuff and there doesn't
seem to be anybody who understands or who I can
talk to. It affects me everyday.” (young PP&T
contributor)
10. Early years
80% of those who go on to transition knew by the time
they were 8 years old that their gender identity was at
odds with society’s perception (Gender Identity Research &
Education Society)
“...the school environment and community (has a key
role) in securing or undermining the well-being of
Transgender children and young people”.
“Problems during school years create barriers for
individuals in fulfilling their academic, creative,
professional and economic potential”. (SWTEN report)
11. Puberty and the ‘pause
button’
Changes at puberty “can be terrifying and repulsive to a
transgendered person”.
International Endocrine Society (IES) – recommends
‘puberty blocking’ for some young trans people
"People are always afraid that (puberty blocking) will be
harmful for the children. But what they never take into account
is that it is also harmful to not give them this treatment.”
Clinics in Australia, Canada, Germany, the U.S. and
the UK have started to offer treatment to young trans
people to prevent the onset of puberty.
12. Transition
Process of moving towards living in true
identity
A fundamental, extremely stressful, life change
Typically Loss of friends, jobs, family, home - often all in one go
Male/female socialisation needs to be unlearned and new
behaviours acquired
Required to live in identity for 2 yrs prior to
medical treatment
Hormone therapy and surgery not widely
available in UK for under 18s
13. Vulnerability to
Social exclusion, bullying, abuse
Isolation
Loss of essential emotional support – family
Loss of security – home and employment
Loss of confidence and self-esteem
Risks to mental and physical health and wellbeing
Self-harm and suicide: overall attempted
suicide rate 34%; 50% for teenagers (SWTEN
report).
14. Health and well-being:
Messages from PP&T
• Local support services/groups are important
• All service providers/all sectors - publicise and
practise trans inclusiveness
• All staff (and volunteers) need awareness
training, and to practice respect
• GPs: attitudes and clinical knowledge key surgery-based trans specialists
• Mental health services: more counselling, more
timely, more Trans aware
15. Health and well-being:
Messages from SWTEN
Early intervention in schools to create a specific,
proactive, committed response to the needs of
Transgender young people, including
• active anti-bullying policies
• police working with schools to address trans issues of
safety
• awareness training for staff and governors
• trans issues described and introduced into PHSE and
other (e.g. Science) parts of the curriculum
16. How you can help
Visibly embrace diversity as an individual and/or
organisation (e.g. E&D posters)
Have up to date anti-discriminatory and antibullying policies that are publicised and enforced
Make it easy to report Transphobic incidents
Spread awareness and understanding – training
for staff and service users
Provide a mentor who can help trans people –
good pastoral care
17. “It takes so much
to
strength and courage
s
keep going as a Tran
tle
person that there’s lit
e.”
room for anything els
(SWTEN report)
judice
rst pre gious
wo
“...The e from reli
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a
friends
PP&T
“... those closest to trans
people often have the most
difficulty accepting gender
transition...” PP&T
Support from
education bodies is
vital in meeting the
needs and
promoting the wellbeing of
Transgender
children and young
people. (SWTEN
report)
The exp
eri
years ha ences of early
ve
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18. Ruth’s Story
Ruth was born in a male body but knew from
the age of 16 that she wanted to be a woman.
Learn about her hormone treatment and
surgery, and how she feels now:
http://www.nhs.uk/Conditions/Genderdysphoria/Pages/Introduction.aspx?r=1&rtitle=Gender+dysphoria++Introduction
20. Some useful links
The Beaumont trust:
http://www.beaumontsociety.org.uk/help_and_advice.html
GIRES - Information for trans people, their families and the
professionals who care for them: http://www.gires.org.uk/
Press for Change: http://www.pfc.org.uk/
NHS website: An Introduction to working with Transgender people:
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@d
h/@en/documents/digitalasset/dh_074254.pdf
SW Transgender Equality Network – to get involved and find out
more, including local groups, research and general information:
http://www.equalitysouthwest.org.uk/transgender
Transgender Information: transgender.information@yahoo.co.uk
Text: 0781 609 3291
Editor's Notes
Transgender contributors to Pride Progress and Transformation
Fore word to “Transgender: Dimensions of Inequality in the South West”
Transgender is an umbrella term, that is meant to be all encompassing.
Some people start their journey living as a transvestite or in certain situations in a gender role, some feel they need to go further and take hormones and have surgery.
To be covered by Equality Law there is no legal requirement for you to be under any form of medical supervision.
Trans people may be aware of “being different” from peers from a very early age. And if there is an intention to reassign then they may start to be come cross gender behaviour i.e. cross-dressing.
GIRES – Gender Variance in the UK: Prevalence, Incidence, Growth, and Geographic distribution 2009
We need to be very clear that this is not a mental illness. Because of the stress that people experience, both with physical changes, drugs, rejection by friends and family, and the loss of their support system, it does mean that Trans people often experience mental health issues, but these are not the root cause. We will come back to this later.
Article 8: the right to respect for your private and family life, your home and correspondence
Article 12: the right marry and found a family
Illegal to ask someone whether they have a Gender recognition certificate. This allows you to change your birth certificate, however, not all members of Trans community want to get one –divorce partner if you do get one.
You can acquire a valid UK passport in your acquired gender
In any school with 1,000 pupils, 6 will experience transgenderism during their lives. There are likely to be others who have a transgender parent or relative.
It is VERY difficult to collect data amongst the Trans community as they are fiercely protective of their confidentiality – particularly the transgender/cross-dressing community.
Engendered Penalties – Whittle, Turner and Al-Alami – The Equalities Review, Feb 2007
Our LGB Network and Transgender Network were involved in a regional piece of work, called pride, progress and transformation which looked examined the peoples experiences in the SW and what the issues are here.
.
The International Endocrine Society (IES) 1 issued a draft set of guidelines in early 2008-DEC. 2 They are co-sponsored by the European Society of Endocrinology (ESE), The World Professional Association for Transgender Health (WPATH), and Lawson Wilkins Pediatric Endocrine Society (LWPES).
The guidelines recommend that some transgendered children as young as 12 years-of-age should be given medication to avoid puberty. This would greatly simplify sex reassignment surgery if they decide to undergo it later in adulthood.
The main benefit from puberty blockers would be to avoid the inevitable body changes caused by puberty. For example, a male-to-female (MTF) transexual could avoid having her voice deepen, a masculine bone structure appear, her Adam's Apple enlarge, and hair growth on her face. A female-to-male (FTM) could avoid developing breasts, feminine shaped hips, and female bone structure elsewhere. Without these bodily changes, there would be less to correct during sex reassignment surgery.
Another benefit of putting off puberty would be that the individual would be more mature and capable of making a settled decision in their mid-teens rather than their pre-teens. If, at the age of 16 or so, they decide to not proceed with sex reassignment surgery when they are adults, they can stop the puberty blocker medication and go through puberty.
Blockers are now offered, but only after very extensive counselling, in the UK.
Peggy Cohen-Kettenis of the Free University of Amsterdam Medical Center
http://www.religioustolerance.org/transsexu17.htm
Male / Female socialisation - One of the things Network members often comment on is how you have to get used to people speaking to you differently, for example the way men speak to men is very different to the ways men speak to women.
Often you have to live for 2 years before they will prescribe you hormone therapy – this also presents people with difficulties as some people feel they need to have the hormones to have the confidence to live in their desired gender.
Blockers are available earlier than this, and many transpeople who wish to permanently reassign may take hormones they have acquired off the internet – they are that desperate.
Before and during transition many people feel very vulnerable which can be increased depending on a number of factors.
NB – Have a genuine understanding of, and a commitment to Trans inclusiveness. I.e. not just ticking boxes!