We would like to show you a description here but the site won’t allow us. Baixar filme download avi. A Lista de Schindler Dublado Download Mega, Baixar Filme A Lista de Schindler Dublado Download Mega. Titanic Dublado AVI Download Mega, A Lista de Schindler o A Lista de Schindler Dublado Download Mega, Baixar Halloween Macabro Dublado Servidor Mega, A Lista de Schindler Dublado Download Mega. Baixar Filmes Dublados, Gratis, Avi, Rmvb, Legendado, Download Filmes, Dublados, Filmes Dublados Baixar, Download Filmes Gratis, Baixar Filmes Completos, Filmes Gratis.

Danksagung

1. Allgemeine Depressionsskala Ads Pdf Converter Free
2. Gulf Times Classified Ads Pdf
3. Facebook Ads Pdf
4. Price Chopper Weekly Sale Ads Pdf

Für die Unterstützung der Studie danken wir Herrn Dr. S. Rovati, Frau Dr. S. Kussmann und Herrn Dr. G. Mautone (IBSA, Pambio-Noranco, Schweiz). Weiterhin danken wir den Schwestern der Schmerzambulanz der Universitätsklinik Schleswig-Holstein, Campus Lübeck, und den Kollegen Dr. M. Lindig (Leiter der Schmerzambulanz des Universitätsklinikums Schleswig-Holstein, Klinik für Anästhesiologie, Campus Lübeck), Frau Dr. A. Schmitz (Ostseeklinik Neustadt) sowie Frau S. Preuss und Herrn Dr. D. Kissinger (Schmerztherapeutische Gemeinschaftspraxis Lübeck).

• About this Journal ·
• Abstracting and Indexing ·
• Aims and Scope ·
• Article Processing Charges ·
• Bibliographic Information ·
• Editorial Board ·
• Editorial Workflow ·
• Publication Ethics ·
• Reviewer Resources ·
• Submit a Manuscript ·
• Subscription Information ·

May 04, 2005  Hautzinger M, Bailer M. Allgemeine Depressionsskala (ADS): Die deutsche Version des CES-D. Download PDF; Twitter Facebook More. Email LinkedIn. Acupuncture for Patients With Migraine: A Randomized Controlled Trial. Klaus Linde, MD. Fast downloads of the latest free software!*** CubexSoft MBOX Merger is a useful conversion tool that can combine multiple MBOX files into a single MBOX. Blog About Contact I'm James. This is my year of travel. Dosch 3D Food Printers. Allgemeine Depressionsskala (ADS). Zovirax Inyectable Herpes Labial vicodin principio activo jun sertralin fluoxetine que espa. Editors note This is a review of the trial version of JPG to PDF Converter 1.

• Annual Issues ·
• Open Special Issues ·
• Published Special Issues ·

Quality of Life in Transitioned Trans Persons: A Retrospective Cross-Sectional Cohort Study

¹Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
²Department of Psychology, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland
³Division of Clinical Psychology and Psychiatry, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
⁴Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, Basel University Hospital, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland
⁵Psychiatric Services Graubünden, Loëstrasse 220, 7000 Chur, Switzerland
⁶Department of Obstetrics and Gynecology, University Hospital Bern, Effingerstrasse 102, 3010 Bern, Switzerland
⁷Center for Gender Variance, Basel University Hospital, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland

Correspondence should be addressed to ; hc.zsu@datsellej.anel

Received 16 December 2017; Revised 26 February 2018; Accepted 7 March 2018; Published 12 April 2018

Academic Editor: Miroslav Djordjevic

Copyright © 2018 Lena Jellestad et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Medical gender-affirming interventions (GAI) are important in the transition process of many trans persons. The aim of this study was to examine the associations between GAI and quality of life (QoL) of transitioned trans individuals. Methods. 143 trans persons were recruited from a multicenter outpatient Swiss population as well as a web-based survey. The QoL was assessed using the Short Form (36) Health Survey questionnaire (SF-36). Depressive symptoms were examined using the Short Form of the Center for Epidemiologic Studies-Depression Scale (ADS-K). Multiple interferential analyses and a regression analysis were performed. Results. Both transfeminine and transmasculine individuals reported a lower QoL compared to the general population. Within the trans group, nonbinary individuals showed the lowest QoL scores and significantly more depressive symptoms. A detailed analysis identified sociodemographic and transition-specific influencing factors. Conclusions. Medical GAI are associated with better mental wellbeing but even after successful medical transition, trans people remain a population at risk for low QoL and mental health, and the nonbinary group shows the greatest vulnerability.

1. Introduction

Gender incongruence (GI) is a condition in which the gender identity or gender expression of a person is discordant with their assigned sex characteristics. GI is often accompanied by clinically relevant psychological distress, then called gender dysphoria (GD) [1]. Individuals with a GI are usually referred to as trans persons. This umbrella term covers persons whose gender identity is the opposite of their assigned sex (transmen and transwomen). It also includes persons who place themselves between or outside the binary gender categories (nonbinary persons).

GD can present with a strong rejection of the anatomical characteristics—primarily the sexual features [1]. Furthermore, because of the ubiquitous social stigma that trans persons experience [2], GD can lead to negative self-image and mental health problems [3–5]. In particular, many trans individuals experience depressive episodes during their lifetime, which in the worst case are associated with suicidal behavior [3]. To overcome this feeling of GD, many trans persons seek medical help and undergo gender-affirming interventions (GAI) (e.g., sex hormonal treatment or gender-affirming surgery). Nowadays, it is generally accepted that both hormonal and surgical interventions can alleviate GD [6–8].

Previous evidence on the negative psychological and QoL effects of GAI is rare and is based on older studies [9, 10]. In contrast, the positive effects on psychological wellbeing and QoL in trans persons have been reported more frequently [7, 8, 11–17]. Several studies have shown that a medical transition can positively impact the social status of treated trans persons [18]. However, it is also known that various psychosocial factors such as old age [7], unemployment [7, 19], being single [7, 20], having a low level of education [7], and depressive disorders [12] can negatively influence QoL. Many GAI require long-term care and follow-up, which can have a negative impact on wellbeing [21]. Consequently, the QoL of transitioned trans persons remains low compared to the general population [16, 22].

The literature is unclear regarding potential gender differences within the trans population. While some authors found no considerable differences in QoL scores between transwomen and transmen [12, 23], others noted significant divergences. For example, Parola et al. reported that transwomen have a better QoL in different mental and physical domains than transmen [14]. In contrast, Motmans et al. [7] found lower QoL scores in transwomen compared to transmen. Similar conflicting evidence is found in studies on mental health comparisons between trans persons. While some studies demonstrated worse mental health in transwomen [24], others found no gender-related differences [25].

Furthermore, this previous outcome research mainly used binary assumptions about gender identities and focused on either transfeminine or transmasculine individuals. There is little research on gender nonbinary persons [26]. This situation is caused by many factors but is particularly related to the theoretical and methodological issues of earlier study designs [27]. However, this unique subpopulation of trans persons seems to be especially prone to stigmatization [2], poor self-rated health [28], and high rates of affective disorders [29].

Therefore, the aim of this present study was to examine the associations between GAI and QoL in transitioned trans individuals. In particular, we investigated potential psychological and social factors that could influence the wellbeing of trans persons. We emphasized a broader gender spectrum by including gender nonbinary persons. For the first time, this provides a simultaneous comparison between different transitioned trans subgroups in terms of QoL.

2. Methods

We performed a retrospective cross-sectional multicenter study on persons self-identified as being trans. The study was performed in collaboration with the Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery at Basel University Hospital, the Department of Psychiatry and Psychotherapy of the University Hospital Zurich, the Department of Psychiatry and Psychotherapy of the University Hospital Bern, and the Psychiatric Services Hospitals of the Canton of Solothurn.

2.1. Sample

We applied two ways of recruitment. Trans persons who had formerly presented to the outpatient clinic of the collaborating hospitals were invited by post to participate in the study and could choose between a paper-based form and a web-based survey. To maximize the number of participants, recruiting was expanded to the larger Swiss trans community via advocacy groups. These participants could only use the web-based survey. Data was collected anonymously in both ways of recruitment. The inclusion criteria included a minimum age of 18 years, a good command of the German language, and self-identification of being transitioned, that is, participants defining their medical transition to be completed independent of the extent of medical affirming interventions performed. Here, we defined the latter by the absence of psychiatric treatment associated with gender dysphoria, a minimum of one year of hormonal treatment, and no planned surgical intervention for the upcoming year. The exclusion criterion was an unfinished medical transitioning process. The study was approved by the Ethics Committee of Basel.

2.2. Measurements

2.2.1. Quality of Life

The Short Form (36) Health Survey questionnaire (SF-36) is a widely used self-reported questionnaire on QoL and health status which assesses four mental domains of health (vitality, social functioning, emotional role functioning, and mental wellbeing) and four physical domains of health (physical functioning, physical role functioning, bodily pain, and general health). The two global measures can be derived from all physical and all mental domains, respectively, and are referred to as the physical component summary (PCS) and the mental component summary (MCS). Answers were transformed via a standardized measure according to the predefined scoring algorithm to yield a total score ranging from zero to 100; higher values indicate a higher subjective quality of life. Cronbach’s alpha is an indicator of internal consistency and yielded a high score of .87.

In addition to group comparisons, we performed a -test group comparison of the mean scores of transfeminine and transmasculine individuals with mean scores of men and women in the German general population. The SF-36 German general population data were taken from the 1995 German population survey [30]. No standard values exist for nonbinary individuals.

2.2.2. Depressive Symptoms

The Allgemeine Depressionsskala (ADS-K) is a validated German short form adaptation of the Center for Epidemiologic Studies Depressions Scale (CES-D), a screening instrument for depressive symptoms [31, 32]. It covers 15 items on affective, motivational, psychosocial, somatic, and cognitive symptoms. The total score ranges from zero to 45, with higher values indicating more severe depressive symptoms. A score ≥ 18 is the cut-off for clinically relevant depressive disorders [33]. For reliability analysis, Cronbach’s alpha was calculated to assess the internal consistency of the ADS-K questionnaire in our sample. With a Cronbach’s alpha value of .85, the internal consistency of the questionnaire is high and comparable with the reported value of α = .88–.95 in the ADS-K manual [31].

Allgemeine Depressionsskala Ads Pdf Converter Free

2.2.3. Sociodemographic Characteristics

The sociodemographic survey was thematically divided into three categories: general, trans-specific, and transition-specific. In the general part, participants self-reported their age, current housing situation, relationship status, level of education, and current work situation. The trans-specific variables included gender assigned at birth and preferred gender label. The transition-specific variables included prior hormonal and surgical affirming interventions.

2.3. Data Analysis

We used SPSS version 22.0 for all statistical analysis. Frequency distributions were analyzed using chi-square tests. A set of -tests and one-way ANOVA tests were calculated to compare the mean scores between gender groups. We performed multiple multivariate regression analyses to identify predictor variables to QoL. We considered two-tailed values < 0.05 to be significant.

3. Results

Gulf Times Classified Ads Pdf

3.1. Sample

Facebook Ads Pdf

We contacted 373 individuals from outpatient clinics via a written form and asked them to participate in the study; 66 completed questionnaires were returned (response rate of 18.0%). There were 201 web participants, of whom 77 individuals completed it. There was an inclusion rate of 38%. In total, 143 individuals completed the questionnaire and were included. In this study, we defined a transfeminine person as an individual self-identified as female with a male sex assigned at birth and a transmasculine person as an individual self-identified as male with a female sex assigned at birth; a gender nonbinary person is an individual self-identified in-between male and female gender or self-identified as no gender, independent of the assigned sex at birth. The majority of our sample was transfeminine (; 53.8%) followed by transmasculine (; 28.7%) and nonbinary gender (; 17.5%). Within the group of nonbinary individuals, 7 persons (28%) had a male sex assigned at birth and 17 persons (68%) had a female sex assigned at birth. One person stated to have an “other” sex assigned at birth.

3.2. Sociodemographic Characteristics

Price Chopper Weekly Sale Ads Pdf

Participants’ age ranged from 18 to 75 years (Table 1). Transfeminine individuals were older than transmasculine individuals and nonbinary individuals; the difference between transfeminine and transmasculine individuals was significant (). There was no significant difference in the level of education, relationship status, work, and housing situation between groups. Post hoc test of the variable relationship status provided no significant differences between groups (data not shown).

Accident, improper installation or unauthorized alteration or repairs. Thank you for purchasing the Dynon Avionics EMS-D120. This section provides some important cautionary information and general usage instructions for this manual. Before You Fly. Transducer Installation 3-10 EMS-D120 Installation Guide. Transducer Installation Fuel Level Sensor Dynon Avionics does not sell fuel level sensors. The EMS-D120 supports both resistive type sensors as well as capacitive sensors which output a voltage (e.g., Princeton). 1-2 EMS-D120 Installation Guide. About this Guide. In the electronic (.PDF) version of this manual, page and section references in the Table of Contents and elsewhere act as hyperlinks taking you to the relevant location in the manual. The latest version of this manual is available on the Dynon Avionics website at. Installation. Dynon Avionics EMS-D120 Installation Guide User Manual Ems-d120.