Comprehensive biopsychosocial care for people with gender incongruence (ICD 11) who are transgender (trans) or gender diverse is a complex process in which the quality of the medical transition can only be guaranteed after a multidisciplinary approach, through teams that integrate professionals with training and experience not only in medicine but also in diversity and gender identity. Based on this, the Gonad, Identity and Sexual Differentiation working group of the Spanish Society of Endocrinology and Nutrition (GT-GIDSEEN) has established minimum care requirements that aim to guarantee adequate health care for these people by professionals. A position paper has been produced and is available at https://www.seen.es/portal/documentos/estandares-calidad-gidseen-2024.

OBJECTIVE: Sex workers can be disadvantaged in terms of overall health due to challenging living and working conditions. This research aimed to evaluate the health status and experiences related to sexually transmitted infections (STDs) of unregistered transgender sex workers in Turkey.
METHODS: It employed a phenomenological qualitative research design. SITE: Data were collected in Istanbul between March 2021 and November 2021.
METHODS: Data were collected through in-depth interviews involving 24 people (19 sex workers and 5 physicians).
METHODS: Key statements were listed during data analysis, and clusters of meanings were formed based on these statements. The participants\' statements were used for contextual and structural descriptions.
RESULTS: Sex workers suffer from chronic illnesses such as asthma, chronic obstructive pulmonary disease (COPD), diabetes, allergic diseases, and neurological disorders. Among the health issues affecting them, the most notable ones are STDs, psychological problems, and the risk of suicide. Sex workers also face a dilemma between choosing public hospitals and private hospitals. Majority of sex workers undergo regular testing for STDs, with the frequency varying from person to person. Reasons for not undergoing regular testing include lack of social security coverage, financial constraints, lack of information, and feeling undervalued. Some individuals are being subjected to mandatory testing.
CONCLUSIONS: It is recommended that sex workers who seek and request healthcare services should be provided with detailed information and education, particularly regarding psychological problems and STDs.

The transgender and gender-diverse (TGD) population holds significant relevance concerning exercise and sports practices. Specific challenges are highlighted, such as physical inactivity driven by internal and external reasons, including discrimination in sports environments. Psychological aspects and hormonal therapy effects create implications for hindering participation in sports competitions. Disparities in cardiovascular risk factors are also mentioned, emphasizing the need for inclusive sports policies based on scientific evidence. The article underscores the importance of addressing social, psychological, and medical aspects to promote the physical and mental health of the TGD population, particularly in the professional sports area.
La población trans y de género diverso (TGD) tiene una gran relevancia en relación con la práctica de ejercicio y deporte. Se destacan desafíos específicos, como la inactividad física motivada por razones internas y externas, incluida la discriminación en entornos deportivos. Existen aspectos psicológicos y efectos de la terapia hormonal que generan implicaciones para la dificultar participación en competiciones deportivas. También se menciona la disparidad en los factores de riesgo cardiovascular y se plantea la necesidad de políticas deportivas inclusivas basadas en evidencia científica. El artículo enfatiza la importancia de abordar los aspectos sociales, psicológicos y médicos para promover la salud física y mental de la población TGD, especialmente en el ámbito deportivo profesional.

The relationship between cancer diagnosis and cardiovascular diseases is complex, with newly diagnosed patients facing a higher risk of coronary disease, heart failure, and atrial fibrillation. Compared to the general population, they have two to six times more risk of dying from cardiovascular causes. Cardiovascular complications arising from chemotherapy and radiotherapy, along with social and healthcare access disparities, complicate the collection of accurate data on the incidence of cancer and cardiotoxicity in marginalized populations. Among the LGBTQ community, certain types of cancer are more prevalent, and hormone administration for gender affirmation is also under study. The delay in cancer screening in the transgender population results in late detections and deaths from cancer. Research on cancer in the transgender population and cardiotoxicity is limited, but special attention is needed to develop detection and prevention strategies in specific situations, such as hormone-dependent tumors.
La relación entre el diagnóstico de cáncer y enfermedades cardiovasculares es compleja, con pacientes recién diagnosticados enfrentando un mayor riesgo de enfermedad coronaria, insuficiencia cardíaca y fibrilación auricular. Comparados con la población general, tienen de dos a seis veces más riesgo de morir por causas cardiovasculares. Las complicaciones cardiovasculares derivadas de la quimioterapia y la radioterapia, junto con disparidades sociales y de acceso a la salud, complican la recopilación de datos precisos sobre la incidencia de cáncer y cardiotoxicidad en poblaciones marginadas. Entre la comunidad LGTBQ, ciertos tipos de cáncer son más frecuentes, y la administración de hormonas para la reafirmación de género también está bajo estudio. El retraso en el cribado de cáncer en la población transgénero resulta en detecciones tardías y muertes por cáncer. La investigación sobre cáncer en la población transgénero y cardiotoxicidad es limitada, pero se requiere atención especial para desarrollar estrategias de detección y prevención en situaciones específicas, como tumores dependientes de hormonas.

This review summarizes the impact of gender affirming hormone therapy used in the transgendered population and the classic and emerging risk factors on cardiovascular outcomes and surrogate markers of cardiovascular health. There is a growing body of evidence that people who are transgender and gender diverse are impacted by disparities across a variety of cardiovascular risk factors compared with their peers who are cisgender. Previously, disparities have been reported in cardiovascular morbidity and mortality across this group as a result of a higher prevalence of non-healthy life style. However, recent research suggests that there are additional factors playing a role in this differences: there is the hypothesis that the excess of cardiovascular morbility and mortality has been driven by psychosocial stressors across the lifespan at multiple levels, as structural violence (e.g., discrimination, lack of affordable housing, lack of access to health care, etc.). Lack of information and research in this population is an important limitation; therefore, a multifaceted approach that integrates best practice into research, health promotion and cardiovascular care for this understudied and growing population is clearly needed.
Este artículo resume la literatura existente hasta este momento sobre el impacto de la terapia hormonal para la asignación de género utilizada en la población transgénero, y de los factores de riesgo tradicionales y emergentes, en los desenlaces cardiovasculares o los marcadores subrogados de enfermedad cardiovascular. Actualmente se reconoce la evidencia creciente de que las personas transgénero o con género diverso son víctimas de disparidades en una gran variedad de factores de riesgo cardiovascular comparadas con sus pares cisgénero. Se ha reportado disparidad en morbilidad y mortalidad como resultado de una alta prevalencia en estilos de vida no saludables. Sin embargo, recientemente se ha incorporado la interpretación de que no solo la disparidad en factores de riesgo cardiovascular es lo que incrementa el riesgo en la salud cardiovascular de la población transgénero. Existe la hipótesis de que el exceso en morbilidad y mortalidad cardiovascular está relacionado con estresores psicosociales a lo largo de la vida de este grupo en múltiples niveles, incluyendo violencia estructurada (p. ej., discriminación, falta de acceso a los servicios de salud, falta de vivienda digna, etc.). La falta de información y de investigación en este grupo son limitantes importantes que requieren un abordaje multifacético para mejorar aspectos como la promoción de la salud y el mejor cuidado cardiovascular.

The Gender-Diverse (TGD) population in Mexico faces significant health challenges, such as limited access to healthcare and a prevalence of adverse conditions. Cardiology is crucial for this population due to a high prevalence of risk factors and cardiovascular diseases. Despite a lack of precise data, it is estimated that 0.5-1.5% of the population identifies as TGD. They encounter sociocultural challenges, including discrimination and stigma, contributing to health issues and a lack of treatment access. Cardiovascular risk factors, hormone self-administration, and barriers to healthcare access are prominent concerns. Opportunities for improvement involve strengthening medical education, implementing inclusive policies, and promoting research and data collection. The development of specific clinical guidelines and inclusive health programs is suggested. The theory of minority stress emphasizes addressing chronic psychosocial stressors and recognizing the influence of stress factors on health. Integrating healthcare services for all populations in cardiology and fostering resilience are key strategies. In summary, a comprehensive approach is needed to reduce disparities in cardiac care and enhance the health of all populations in Mexico.
La población de diferentes géneros en México se enfrenta a desafíos significativos en salud, cómo el acceso limitado a la atención médica y la prevalencia de malas condiciones. La cardiología es crucial para esta población debido a la alta prevalencia de factores de riesgo y enfermedades cardiovasculares. A pesar de la falta de datos precisos, se estima que el 0.5-1.5% de la población se identifica como transgénero. Enfrentan desafíos socioculturales, como discriminación y estigmatización que contribuyen a problemas de salud y falta de acceso a tratamientos. Los factores de riesgo cardiovascular, la autoadministración de hormonas, y las barreras en el acceso a la atención médica son preocupaciones destacadas. Las oportunidades para mejorar incluyen fortalecer la educación médica, implementar políticas inclusivas, y promover la investigación y recopilación de datos. Se sugiere el desarrollo de guías clínicas específicas y programas de salud inclusivos. La teoría de la minorización destaca la importancia de abordar tensiones psicosociales crónicas y reconocer la influencia de factores estresantes en la salud. Integrar servicios de salud para todas las poblaciones en cardiología y fomentar la resiliencia son estrategias clave. En resumen, se necesita un enfoque integral para reducir las disparidades en la atención cardíaca y mejorar la salud de todas las poblaciones en México.

In the past five years, healthcare organisation for trans people in Spain has changed as laws intended to protect sexual and gender diversity have been put in place. As a result, endocrinologists are not only on the front lines (understood as prescribing and following up gender-affirming hormone therapy) but also coordinating multidisciplinary healthcare for these individuals. Advances in transgender medicine, the complexity of diverse trans identities and the impact of hormone therapy on quality of life and risk of middle- and long-term complications call for in-depth examination of a personalised biopsychosocial approach to trans people that requires specific training in this field of knowledge as well as updates on the concepts, terminology and drug treatments used.

Some people, including minors, have a gender identity that does not correspond to the sex assigned at birth. They are known as trans* people, which is an umbrella term that encompasses transgender, transsexual, and other identities not conforming to the assigned gender. Healthcare units for trans* minors require multidisciplinary working, undertaken by personnel expert in gender identity, enabling, when requested, interventions for the minor and their social-familial environment, in an individualized and flexible way during the gender affirmation path. This service model also includes hormonal treatments tailored as much as possible to the individual\'s needs, beyond the dichotomic goals of a traditional binary model. This guide addresses the general aspects of professional care of trans* minors and presents the current evidence-based protocol of hormonal treatments for trans* and non-binary adolescents. In addition, it details key aspects related to expected body changes and their possible side effects, as well as prior counselling about fertility preservation.

暂无摘要。

Within the last decade, there has been a sharp global rise in the number of young people identifying as transgender. More recently, there appears to be an increase in the numbers of young people detransitioning or returning to identifying with their natal sex after pursuing medical transition. A case is presented of a young woman who pursued a gender transition and returned to identifying as female after almost two years on testosterone. The author considers and critiques the affirmative model of care for gender dysphoric youth in light of this case.
Dans les dix dernières années, on a vu un accroissement considérable du nombre de jeunes personnes qui s’identifient transgenre. Plus récemment, il semble qu’il y ait un accroissement du nombre de jeunes personnes qui reviennent en arrière par une détransition, ou qui reviennent à s’identifier à leur sexe de naissance après avoir souhaité une transition médicale. L’article présente le cas d’une jeune femme qui est entrée dans le processus de transition de genre et qui est ensuite revenue à une identification en tant femme, après presque deux années sous testostérone. A la lumière de ce cas, l’auteur examine et critique le modèle de soin qui va dans le sens d’affirmer la dysphorie de genre chez de jeunes personnes.
Innerhalb des letzten Jahrzehnts hat die Zahl der jungen Menschen, die sich als transgender identifizieren, weltweit stark zugenommen. In jüngerer Zeit scheint es einen Anstieg der Zahl junger Menschen zu geben, die sich nach einer medizinischen Umwandlung wieder mit ihrem Geburtsgeschlecht identifizieren. Es wird ein Fall einer jungen Frau vorgestellt, die eine Geschlechtsumwandlung anstrebte und sich nach fast zwei Jahren mit Testosterongaben wieder als weiblich identifizierte. Der Autor betrachtet und kritisiert das affirmative Modell der Betreuung geschlechtsbezüglich dysphorischer Jugendlicher im Lichte dieses Falls.
Durante l\'ultima decade c’è stato un netto incremento del numero dei giovani che si sono identificati come transgender. Più recentemente, sembra ci sia un aumento nel numero dei giovani che de-transitano o ritornano ad identificarsi con il loro sesso originario dopo aver fatto una transizione medica. Viene presentato il caso di una giovane donna che si è sottoposta ad una transizione ed è poi tornata ad identificarsi come femmina dopo circa due anni di testosterone. L’Autrice considera e critica il modello di cura affermativo in relazione alla disforia di genere nel caso clinico di una giovane.
За последнее десятилетие мы стали свидетелями резкого увеличения числа молодых людей, которые идентифицируют себя как трансгендеров. Однако недавно наметилась обратная тенденция: де-переход или возвращение к идентификации cо cвоим биологическим полом после медицинского вмешательства. Представлен случай молодой женщины, которая предприняла попытку смены пола, а затем вернулась к идентификации себя как женщины после двух лет приема тестостерона. В свете этого случая автор критически рассматривает аффирмативную модель помощи гендерно-дисфоричным молодым людям.
En la última década, ha habido un crecimiento global agudo de jóvenes que se han identificado como transgénero. Más recientemente, pareciera haber un incremento en el número de jóvenes de-transicionando o retornando a la identificación con su género natal luego de haber realizado una transición médica. Se presenta el caso de una joven mujer quien prosiguió una transición de género y retornó a identificarse como de género femenino, casi dos años después de haber tomado testosterona. La autora considera y critica, a la luz de este caso, el modelo afirmativo de cuidado para la disforia de género en las y los jóvenes.
去跨性别化:个案研究 在过去十年间, 全球跨性别青年的数量剧增。近期, 去除跨性别或是在追逐医学跨性别的个体重返对自身生理性别的认同的年轻人数量也在增加。文章呈现了一个个案, 关于一位女性曾经追求性别转换, 但在使用睾丸酮差不多两年后, 又重返女性化性别的认同。作者透过这个案例论述了对性别焦虑的年轻人的性别平权护理模型。.