This study examined differences in alcohol use by sexual and gender identities during the COVID-19 pandemic, and assessed whether variation between groups was explained by pandemic-related stressors and minority stress. Data from 2,429 partnered adults in the National Couples\' Health and Time Use Study (n = 3,593) collected from September 2020 to April 2021 were used to model drinking patterns (frequency, amount, and drinking to cope) by sexual and gender identities, COVID-19 stress and disruption, microaggressions, and supportive climate. Regression models indicated differences in drinking by gender and sexual identities, even controlling for demographic and socioeconomic factors. Gay, lesbian, and bisexual people had higher odds of drinking to cope with the pandemic than did heterosexual people, and cisgender men had higher odds than did cisgender women. Gay and lesbian people drank more regularly than did heterosexual people, as did cisgender men in relation to cisgender women. Exclusively bisexual people drank significantly more drinks than exclusively heterosexual people, and cisgender men drank significantly more drinks than did cisgender women and those who identified as trans/another gender identity. COVID-19 stress and minority stress were associated with greater alcohol consumption, but they did not account for these differentials. Moving forward, researchers will need to continuously assess these associations, as sources of discrimination and stress will persist beyond the pandemic. Although LGBTQ+ people have disproportionate sources of stress, they varied in how they used alcohol to cope. Potential sources of resilience among sexual and gender diverse individuals should be explored.

UNASSIGNED: As transgender individuals age, they are at risk for neurocognitive disorders which pose not only medical but also bioethical questions. We present a case study of a transgender older adult with dementia who experienced changes in gender identity and explore the bioethical implications of identity over time, including end-of-life care.
UNASSIGNED: We reviewed clinical notes and relevant medical history to describe the transition and detransition process and examined ethical frameworks related to autonomy, psychological continuity, and transgender care.
UNASSIGNED: The individual transitioned as a transgender woman in mid-life but detransitioned shortly before being diagnosed with dementia. This case highlighted conflicts between precedent autonomy and current gender identity in the context of neurocognitive decline and end-of-life care.
UNASSIGNED: The case underscores the complexity of managing gender identity in transgender older adults with dementia, emphasizing the need for personalized and ethically sound care plans.
UNASSIGNED: Clinicians should be vigilant about the impact of neurocognitive disorders on gender identity, balancing respect for patients\' prior decisions with their current values, and develop personalized end-of-life care plans that honor the evolving identities and preferences of transgender individuals with dementia.

This editorial describes the Cass Review findings and the extraordinary challenge we all face in managing uncertainty amid a toxic and highly polarised debate. Children and young people will only get the best care if patients and professionals join forces to seek answers collaboratively and respectfully.

Inclusive measures of gender are critical for health equity research. This study compared the reliability and applications of two different approaches for measuring gender in response to emerging community concerns regarding the potential harms of asking about sex assigned at birth (SAAB) within transgender and gender diverse (TGD) populations. Using data from a 2021 survey of LGBTQ+ people in Washington state, we compared approaches for measuring gender via a two-step question that collected data on: (1) current gender and SAAB versus (2) current gender and transgender self-identification. Among 2,275 LGBTQ+ participants aged 9-81, 63% were cisgender, 35% TGD, and 2% were not categorized. There was near perfect agreement between the two methods in their ability to identify TGD participants (percent agreement=99.7%, unweighted Cohen\'s Kappa=0.99). Among gender diverse participants, stratification by SAAB revealed differences in sexual health outcomes, while stratification by transgender self-identification revealed differences in access to gender-affirming care and lifetime experiences of discrimination. Ascertaining SAAB may be most useful for identifying sexual health disparities while transgender self-identification may better illuminate healthcare needs and social determinants of health among TGD people. Researchers and public health practitioners should critically consider the acceptability and relevance of SAAB questions to their research goals.

Despite established associations between discrimination and mental health, little research has focused on gender expression discrimination and integrated individual strengths such as transgender and gender-expansive (TGE) identity pride. This study examined the roles of gender expression discrimination and pride in mental health among TGE adults across gender identity, race, and class. A national sample of TGE adults (N = 212) completed online measures assessing gender identity, race, income, gender expression-related discrimination, TGE identity pride, and depression and anxiety symptoms. Gender expression discrimination was positively associated with depressive and anxiety symptoms. Black, Indigenous, People of Color (BIPOC), higher income, transfeminine participants reported more gender expression discrimination. High TGE identity pride buffered the association between gender expression discrimination and depression-most robustly for BIPOC, lower income, transfeminine participants. TGE identity pride may buffer the effects of gender expression discrimination on depression. Intersectionality in case formulation and treatment planning with TGE individuals is vital.

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Men\'s health has often been overlooked in health care, with traditional gender norms and societal expectations significantly shaping men\'s health behaviors and attitudes. The MANifest Health Theory (MHT) offers a comprehensive framework to address cis-gender men\'s unique health needs by considering the complex interplay of biological, psychological, and social factors. Rooted in four interconnected core concepts-Biopsychosocial Model, Health Optimization, Health Synchronicity, and Ethnocultural Expression-MHT provides a holistic understanding of men\'s health. This article explores how MHT integrates inductive and deductive reasoning, describing, explaining, predicting, and controlling aspects of men\'s health. Key components such as Gender-Sensitive Care, Health Empowerment, Supportive Environments, and Interdisciplinary Collaboration are discussed in relation to practical strategies for health care delivery. The limitations of MHT, including its developmental status, cultural applicability, and inclusivity of diverse gender identities, are acknowledged. Future steps for validating and refining the theory through empirical research, cultural adaptation, and inclusion of diverse gender experiences are outlined. By applying MHT, health care professionals can deliver more holistic and culturally competent care, promoting healthier lifestyles and reducing health care disparities among men.

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Integrating a social identity approach with Cortina\'s (2008) theorizing about selective incivility as modern discrimination, we examine how identification-with an organization, with one\'s gender, and as a feminist-shapes bystanders\' interpretations and responses to witnessed incivility (i.e., interpersonal acts of disrespect) and selective incivility (i.e., incivility motivated by targets\' social group membership) toward women at work. We propose that bystanders with stronger organizational identification are less likely to perceive incivility toward female colleagues as discrimination and intervene, but female bystanders with stronger gender identification are more likely to do so. Results from two-wave field data in a cross-lagged panel design (Study 1, N = 336) showed that organizational identification negatively predicted observed selective incivility 1 year later but revealed no evidence of an effect of female bystanders\' gender identification. We replicated and extended these results with a vignette experiment (Study 2, N = 410) and an experimental recall study (Study 3, N = 504). Findings revealed a \"dark side\" of organizational identification: strongly identified bystanders were less likely to perceive incivility as discrimination, but there were again no effects of women\'s gender identification. Study 3 also showed that bystander feminist identification increased intervention via perceived discrimination. These results raise doubts that female bystanders are more sensitive to recognizing other women\'s mistreatment as discrimination, but more strongly identified feminists (male or female) were more likely to intervene. Although strongly organizationally identified bystanders were more likely to overlook women\'s mistreatment, they were also more likely to intervene once discrimination was apparent.

OBJECTIVE: Weight bias internalization (WBI) is a robust, positive correlate of negative health outcomes; however, this evidence base primarily reflects cisgender individuals from Western cultural contexts. Gender-diverse individuals from non-Western cultural contexts (e.g., China) are at potentially high risk for WBI. Yet, no research has examined WBI and associated negative health consequences in this historically underrepresented population.
METHODS: A cross-sectional, online survey sampled Chinese gender-diverse individuals (N = 410, Mage = 22.33 years). Variables were self-reported, including demographics, WBI, body shame, body dissatisfaction, disordered eating, physical and mental health status, and gender minority stress (e.g., internalized cisgenderism). Analyses included correlations and multiple hierarchical regressions.
RESULTS: Pearson bivariate correlations demonstrated associations between higher WBI and more eating and body image disturbances and poor physical and mental health. After adjusting for age, BMI, gender identity, and gender minority stress, higher WBI was uniquely and positively associated with higher body shame, higher body dissatisfaction, higher disordered eating, and poor physical and mental health. Notably, WBI accounted for more unique variance in eating and body image disturbances (13%-25% explained by WBI) than physical and mental health (1%-4% explained by WBI).
CONCLUSIONS: While replication with longitudinal and experimental designs is needed to speak to the temporal dynamics and causality, our findings identify WBI as a unique, meaningful correlate of eating and body image disturbances in Chinese gender-diverse adults.