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Psychiatric Aspects of Transgender Health

Psychiatric Aspects of Transgender Health

Over the past half century psychiatric views of Transsexualism have been shifting from pathologizing towards acceptance as a variant of the norm. The phrase Gender Identity Disorder now seems set to disappear from the DSM. A psychiatric opinion nonetheless is desirable to exclude other conditions presenting as Gender Dysphoria. These may include delusional disorders or the obsessions sometimes a feature of Asperger’s Syndrome. Discrimination and rejection by family and others can have disastrous effects. Assessment itself should explore this possibility. Ongoing counselling is a safeguard which may prove life saving.

Conference: AChSHM
Areas of Interest / Categories: RACP Sexual Health Medicine 2013

RACP Sexual Health Medicine 2013

Gay men prefer partner notification by short message service (SMS) rather than e-postcards: a web-based evaluation

In 2006 two new innovative features were added to the WhyTest website; the ‘Tell them’ service allowing visitors to forward anonymous e-postcard or short message services (SMS) to sexual partners who may have been exposed to an STI, and the ‘remind me’ service allowing visitors to register for a 3, 6 or 12 monthly SMS reminder for a sexual health check. We describe the usage of the new website functionality, and recognition of a health promotion campaign conducted in January-June 2007 to promote these new features.

SMS reminders increase re-testing for repeat chlamydial infection in heterosexuals at a sexual health clinic

Repeat infection with Chlamydia trachomatis is common. If left untreated it can lead to onward transmission and in females it increases the risk of pelvic inflammatory disease by four-fold. In late 2008, Sydney Sexual Health Centre implemented a reminder system using short message service (SMS) to improve re-testing rates following treatment of chlamydial infection. Clinicians were advised to set up SMS reminders to be sent out at 3 months after the visit. We compared the frequency of re-screening within 1-4 months of the initial infection in women and heterosexual men who received the SMS in the 12 month period of January-December 2009 (intervention group) to a 18-month period before the SMS was introduced (historical control group) using a Chi-square test, and multivariate regression.

Download to Diagnosis: Reinforcing the Net - Testing for Chlamydia one year on.

Western Australia’s (WA) Online Chlamydia Program was launched in February 2010 as a case-finding vehicle aimed to address increasing rates of genital Chlamydia trachomatis (CT). The free test can be accessed via two websites ( & http:// Participants must be 16 years or older, have a mobile telephone, access to a computer with printer and the ability to visit a PathWest specimen collection site. Specimens are tested for both chlamydia and gonorrhoea. All results are faxed to Fremantle’s B2 sexual Health Clinic. Positive results are actioned, negative results are available via a toll-free number.

Client feedback and satisfaction with an express STI screening service at an inner city sexual health centre

Sydney Sexual Health Centre (SSHC) commenced an express STI clinic (Xpress) for asymptomatic clients in March 2010, utilising CASI and self-collected samples. Client feedback and satisfaction was assessed over 6 months and comparisons made between priority groups. This was a cross sectional study questionnaire. Results were stratified by gender, MSM status, age (<25/>25) and sex work.

Epidemiological treatment of chlamydia co-infection in MSM with a presumptive diagnosis of urethral gonorrhea in South Australia - Should we or shouldn't we?

Recent studies have shown up to 30% Neisseria gonorrhea (NG) and Chlamydia trachomatis (CT) co-infection rates in men. Historically, Men who have Sex with Men (MSM) were generally considered to have a low incidence of Chlamydia. In Australia and overseas, there has been increasing prevalence of CT and NG in MSM, especially asymptomatic anorectal infection. Despite well-established guidelines providing presumptive co-treatment for Chlamydia to patients with treatment indications for N. Gonorrhea, various centers in Australia differ in their approach to management in MSM. At our Clinic, epidemiological treatment for Chlamydia is given to heterosexual males with a presumptive diagnosis of urethral gonorrhea. This is not the case for MSM. We wanted to determine if the local prevalence of co-infection in MSM is enough to justify epidemiological treatment when there is a presumptive diagnosis of urethral gonorrhea.

The CaddyShack Project: overcoming barriers in access to Chlamydia screening for young people

The concerning high prevalence of Chlamydia within the population of young people aged 16 – 25 in Australia has been well established. Creative strategies are required to overcome barriers to screening for this population, as improved screening rates will promote better understanding and management of this condition. Various initiatives have been designed to increase access to screening for young people, from awareness and education campaigns, to mail out home testing kits. Many initiatives have had limited success in overcoming inherent barriers to testing for this important population.

Improved partner notification through a web-based partner notification service: Let Them Know

Websites that assist individuals infected with an STI to contact their sexual partners using SMS and email have been established, but few have published data that demonstrate their effectiveness in enhancing notification of partners. In March 2010, the 'Let Them Know' website - was expanded to support individuals diagnosed with one of five STIs to notify their partners. We undertook an evaluation of the service including feedback received by users.