title: Standards of care for the health of Transgender and Gender Diverse People, Version 8

authors: Coleman, E

abstract: Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8.
Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment.
Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings.
Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health.
Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.

text: Standards of care for the health of Transgender and Gender Diverse People, Version 8 Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8.
Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment.
Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings.
Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health.
Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.

year: 2022-08-19

title: Lexical attraction for text compression

authors: Bach, Joscha

subjects: computer science

abstract: New methods of acquiring structural information in text documents may support better compression by identifying an appropriate prediction context for each symbol. The method of “lexical attraction” infers syntactic dependency structures from statistical analysis of large corpora. We describe the generation of a lexical attraction model, discuss its application to text compression, and explore its potential to outperform fixed-context models such as word-level PPM. Perhaps the most exciting aspect of this work is the prospect of using compression as a metric for structure discovery in text.

text: Lexical attraction for text compression New methods of acquiring structural information in text documents may support better compression by identifying an appropriate prediction context for each symbol. The method of “lexical attraction” infers syntactic dependency structures from statistical analysis of large corpora. We describe the generation of a lexical attraction model, discuss its application to text compression, and explore its potential to outperform fixed-context models such as word-level PPM. Perhaps the most exciting aspect of this work is the prospect of using compression as a metric for structure discovery in text.

year: 1999-01

title: Māori cultural concepts and service provision for homeless Māori men

authors: Ellis, Kenneth Desmond

subjects: Maori cultural concepts

abstract: Homelessness is a pressing issue for indigenous minorities such as homeless Māori men. Their circumstances are more vulnerable in ways, than other homeless groups given that their lives are impacted upon by ongoing colonisation. Homeless Māori men, like other ‘indigenous homeless groups’, often find themselves homeless because of social/cultural dislocation where, they are disconnected from their culture and closest forms of support. This study set out to explore how homeless Māori men’s circumstances could be improved through administering interventions in the form of Māori cultural concepts like: manaakitanga, wairuatanga, whanaungatanga and whānau. The overall approach used to gather the research was based on hybridisation, where several different approaches were used simultaneously to generate research data. These were participant observation: a kaupapa Māori approach, semi structured interviewing, thematic analysis and the use of a socio-historical context to underpin the entire research process. Two groups of Māori participants were interviewed for this study, one group comprising staff members, and one made of homeless Māori men. Each group had a number of unique characteristics. For example, the entire staff group comprised skilled and qualified professionals, while the men’s group was made up of individuals with severely impoverished backgrounds. The study produced several conclusive findings to show how Māori cultural concepts were used successfully as forms of social interventions. Concepts like whanaungatanga, manaakitanga, wairuatanga and whānau, were shown to produce positive social outcomes for homeless Māori men. These outcomes helped the men to stabilise their lives, as they attempted reintegration.

text: Māori cultural concepts and service provision for homeless Māori men Homelessness is a pressing issue for indigenous minorities such as homeless Māori men. Their circumstances are more vulnerable in ways, than other homeless groups given that their lives are impacted upon by ongoing colonisation. Homeless Māori men, like other ‘indigenous homeless groups’, often find themselves homeless because of social/cultural dislocation where, they are disconnected from their culture and closest forms of support. This study set out to explore how homeless Māori men’s circumstances could be improved through administering interventions in the form of Māori cultural concepts like: manaakitanga, wairuatanga, whanaungatanga and whānau. The overall approach used to gather the research was based on hybridisation, where several different approaches were used simultaneously to generate research data. These were participant observation: a kaupapa Māori approach, semi structured interviewing, thematic analysis and the use of a socio-historical context to underpin the entire research process. Two groups of Māori participants were interviewed for this study, one group comprising staff members, and one made of homeless Māori men. Each group had a number of unique characteristics. For example, the entire staff group comprised skilled and qualified professionals, while the men’s group was made up of individuals with severely impoverished backgrounds. The study produced several conclusive findings to show how Māori cultural concepts were used successfully as forms of social interventions. Concepts like whanaungatanga, manaakitanga, wairuatanga and whānau, were shown to produce positive social outcomes for homeless Māori men. These outcomes helped the men to stabilise their lives, as they attempted reintegration.

year: 2010