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Assignment 2: whitepaper on food security

Uncategorized

 

Due Week 7 and worth 110 points

The members of the United Nations found great value in the whitepaper you provided on population growth. They are now asking you to expand the whitepaper to include global food security as it relates to population growth and poverty. Read the overview and provide an assessment based on the questions below.

I.  Overview           

We can define global food security as the effort to build food systems that can feed everyone, everywhere, and every day by improving its quality and promoting nutritional agriculture (1). That said, there are certain practices that can advance this project:

  1. Identifying the underlying causes of hunger and malnutrition
  2. Investing in country-specific recovery plans
  3. Strengthening strategic coordination with institutions like the UN and the World Bank
  4. Encouraging developed countries to make sustained financial commitments to its success

We must bear in mind that more than 3 billion people—nearly one-half of the world’s population—subsist on as little as $2.50 a day, with nearly 1.5 billion living in extreme poverty on less than $1.25 a day. According to the World Health Organization, the United Nations, and other relief agencies, about 20,000 people (mostly children) starve to death in the world every day, for a total of about 7 million people a year. In addition, about 750 million (twice the population of the United States) do not have access to clean drinking water, meaning that some one million people die every year from diarrhea caused by water-borne diseases.

The earth’s population has grown since it reached 7 billion in 2010. It is expected to reach 8 billion in 2025, 9 billion in 2040, and 11 billion by the end of the 21st century (2). If the demand for food is predicted to rise 50% by 2030 and 70% by 2050, the real problem is not necessarily growing enough food, but rather making that amount available to people. Moreover, food illnesses are prevalent, with nearly 600 million reported cases of foodborne diseases each year. These mainly affect children but can also negatively impact the livelihood of farmers, vendors, trade associations, and ultimately, can reduce the Gross Domestic Product (national income) of a country. These issues can impose tremendous human, economic, social, and fiscal costs on countries, so addressing them allows governments to devote more resources to making desperately needed infrastructure improvements that raise the quality of life for everyone.

It is not enough to have adequate supplies of food available. Policies that focus exclusively on food production can exacerbate the problem, particularly if, to satisfy the need for quantity, the quality of the food is left wanting.

Reasons for Food Insecurity

Certainly, poverty and the contributing systemic internal conditions are the driving factors behind keeping adequate food resources from reaching people, but it is only one of several. Others are discussed next.

Inadequate Food Distribution: The reality is that there is more than enough food in the world to feed its people, but the primary cause of famine is not poor weather conditions as much as it is getting the food to the people who need it most. Quite often, disruptions in food distribution result from political instability and poor infrastructure (such as poorly functioning port facilities, lack of transportation options, and inadequate road networks). Paradoxically, although the world’s population is increasing, the amount of potential food available will increase along with it, due mostly to advances in bio-agricultural engineering and seed immunity to molds.  

Writing in the late 18th century, Thomas Malthus warned that the global population would exceed the earth’s capacity to grow food, in that while the population would grow exponentially, food production would grow only arithmetically. Although this theory was proved invalid, its propagation has unfortunately resulted in some governments rationalizing political choices that avoid helping the poverty-ridden and starving.

Political-Agricultural Practices: The widespread use of microbiological, chemical, and other forms of pesticides in food continues to be a serious issue throughout the global food chain. Widespread use of fertilizers also causes illness in millions of people every year, not only from the food itself, but from run-off into streams and rivers, contaminating entire water supplies. The human, social, fiscal, and economic costs of such practices impede improvements not only in the raising of crops, but in their distribution. Added to this, the rising demand in developed countries for biofuels, refined mostly from corn and soybean, reduces the amount of arable land devoted to producing food.

The failure of many farmers in the developing world to rotate their crops harms the replenishing of nutrients necessary to continue growing crops. In addition, neglecting to allow land to remain fallow exhausts the soil, making it much more difficult to raise a decent amount of food per acre the following growing season.    

Economic Issues: The fact is, government policies that focus on growing cash crops, for example, are designed solely to export them to earn foreign exchange. This may be fine for the government in its effort to earn money, but the result is that farmers end up growing for foreign markets and not domestic ones, leading to shortages of necessary staples. Consequently, the poorest of the population are frozen out of the local markets because they cannot afford the food that remains to be sold (3).

Civil Strife: Civil war can interrupt the flow of food from gathering depots, such as ports, to distribution centers where it can be handed out to people. During the 1990s, Somalia was particularly hard hit by their civil war, as clans fought for control of the main port at Mogadishu, which affected the flow of food to the rest of the population. In this case, as with many civil wars, whoever controls the supply of food controls the country. In failed and failing states like Zimbabwe, Congo, Haiti, South Sudan, Yemen, and Libya, food is very often another weapon used by one segment of the population against another.

Sources:

1.  Peter Timmer. 2015. Food Security and Scarcity: Why Ending Hunger Is So Hard. Foreign Affairs magazine.

2.  The United Nations Population Division. 2017. World Population Prospects: The 2017 Revision. https://www.un.org/development/desa/publications/world-population-prospects-the-2017-revision.html 

3.  Will Martin. November 2010. Food Security and Poverty: A Precarious Balance. Let’s Talk Development blog by The World Bank. http://blogs.worldbank.org/developmenttalk/food-security-and-poverty-a-precarious-balance  

II.  Assessment

The issue is not the lack of food in the world, but the access to food. In many developing countries, the food shortage is due to governmental control over food. These governments maintain control and preference by limiting access of nutritious food to certain groups, thereby weaponizing food.

In this second assignment, research the impact of poverty on global food security and the potential technological solutions. Write a minimum of four pages (not including the cover letter) assessing the impact of food insecurity. Select one country from the United Nations list of developing countries to use as an example throughout your assessment. The completed version of this assignment will include the following items:

  • Cover page: Include your name, title of course, name of the developing country you have chosen from the UN list, current date, and the name of your instructor.
  • Introduction: Introduce the topic of the whitepaper (half-page minimum).
  • One-page (minimum) answers to each of the following questions (for a total of three pages):
  • What is food insecurity, and what role does population growth play in it?
  • What specific factors interrupt the flow of food from the source to the people in the developing country you selected?
  • What forms of technology can be used to reduce hunger and improve food security? Explain how these technological solutions would work.

Note: Give examples in your responses to each of the above questions as it relates to the developing country you have chosen.

  • Conclusion: A one-half page (minimum) conclusion.

Cite at least five credible sources excluding Wikipedia, dictionaries, and encyclopedias for your assessment. A brief list of suggested resources has been provided at the end of the course guide.

This course requires use of Strayer Writing Standards (SWS). The format is different compared to other Strayer University courses. Please take a moment to review ​the SWS documentation for details. (Note: You’ll be prompted to enter your Blackboard login credentials to view these standards.)

The specific course learning outcomes associated with this assignment are:

  • Propose a plan to address the issue of global food security in underdeveloped countries that considers the impact of prior solutions.

Grading for this assignment will be based on answer quality, logic/organization of the paper, and language and writing skills, using the following rubric:

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July 1, 2023
    

7

Thesis Statement and Annotated Bibliography

Destiny Johnson

Chamberlain University College of Nursing

PHIL 347: Critical Reasoning

Todd Buck

December 1, 2024

Thesis Statement and Annotated Bibliography

Thesis Statement

The prospect of administering puberty blockers, hormone treatment, and surgery for sex reassignment for young minors presents a problem of ethics of gender-related discomfort and possible risks in a future perspective. While puberty blocking substances might have reversible effects, the irreversible effects from hormone treatment and/or surgeries involves risks, such as regret, medical repercussions, and trauma. Due to the lack of sufficient data about long-term effects, these therapies should be done with extreme care considering the importance of mental health and informed consent to deliver secure, ethical, and personalized care.

Annotated Bibliography

Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S. (2020). Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation. 
Pediatrics, 
145(2), e20191725. https://doi.org/10.1542/peds.2019-1725

The authors used data from a cross-sectional survey of 20, 619 transgender adults aged 18 to 36 years to test their hypothesis that there is an association between suppressing puberty during adolescence and mental health outcomes during adulthood. They used self-reported data on the history of use of puberty blockers during adolescence. Their hypothesis was not supported in transgender adults by finding a significant association between receiving pubertal suppression treatments during adolescence and lifetime suicidal ideation. The use of puberty suppressants for transgender adolescents desiring this treatments is linked to favorable mental health outcomes.

This source supports my thesis that puberty blocking substances might have reversible effects as they do not cause permanent changes, but hormone treatment and gender reassignment surgeries may have irreversible consequences, significantly, leading to lasting mental health impacts on minors, especially when they are adults. Although it reveals potential psychological benefits associated with these therapies, it raises concerns about long-term consequences.

Biggs, M. (2022). The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence. 
Journal of Sex & Marital Therapy, 
49(4), 348–368. https://doi.org/10.1080/0092623X.2022.2121238

The authors use data from Dutch Protocol for Juvenile Transsexuals comprising 70 adolescents who had been introduced to puberty suppression, followed by cross-sex hormones and surgery to review the history of this intervention and supporting evidence. They found positive outcomes immediately after the surgery except for the death of one patient. Puberty blockers may temporarily alleviate juvenile transsexuals’ distress, but may lock them into further medical interventions in the long-term. The therapies may result in lethal physical effects, such as accrual bone mass and unknown effects on the patient’s emotional and cognitive development.

This source strongly supports my thesis that the use of puberty suppression treatments and gender reassignment surgeries my present long-term implications on the client due to the irreversible effects associated. The irreversible therapeutic effects may require clinicians to do careful assessments based on individual cases.

de Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. 
Pediatrics, 
134(4), 696–704.
https://doi.org/10.1542/peds.2013-2958

The researchers used data from a longitudinal study of 55 young transgender adults with a history of receiving puberty suppression during teen years to evaluate the effectiveness of these interventions. They evaluated the outcomes of the adolescents before starting puberty suppression, when they received the cross-sex hormones and at least after one year of undergoing gender reassignment surgery. They found significant alleviation of gender dysphoria and steady improvement in psychological functioning. The well-being of this group was similar or better than their counterparts from the general population. They found a positive correlation between postsurgical subjective well-being and enhancements in psychological well-being.

This source supports the thesis that the puberty suppression and gender reassignment therapies may relieve gender dysphoria and improve psychological functioning in the short-term, but careful considerations should be made when administrating these therapies in the contexts of safety, ethics and personalized care. It supports cautious care by suggesting a clinical protocol comprising a multidisciplinary team of physicians, mental health professionals, and surgeons, including puberty suppression, followed by gender reassignment and cross-sex hormones, in supporting gender dysphoric youths seeking such interventions to develop into well-functioning young adults.

van Leerdam, T. R., Zajac, J. D., & Cheung, A. S. (2023). The Effect of Gender-Affirming Hormones on Gender Dysphoria, Quality of Life, and Psychological Functioning in Transgender Individuals: A Systematic Review. 
Transgender Health, 
8(1), 6–21. https://doi.org/10.1089/trgh.2020.0094

The researchers used data from a systematic review comprising observational studies (longitudinal and cross-sectional studies) published in English and in a peer-reviewed journal to assess the efficacy of gender-affirming hormone therapy (GAHT) in enhancing gender and body-related dysphoria, along with Quality of Life (QoL) and psychological well-being. They found that GAHT may body-related and subjective gender dysphoria, QoL and psychological well-being. However, they found most evidence, predominantly from cohort studies and cross-sectional studies to show low to moderate quality in body-related and subjective gender dysphoria improvements. The researchers reveal gaps in the quality measurement or assessment of gender dysphoria, as the primary goal of GAHT. They propose evaluation of the secondary outcomes, including QoL and mental health, as arguably the most critical outcomes of such treatments, providing accuracy of the efficacy of GAHT.

This source supports my thesis by highlighting gaps in evaluating the outcomes of gender-affirming therapies, including mental health and QoL due to low to moderate quality evidence existing to support gender dysphoria improvements. It makes it challenging to draw clear inferences and fails to mirror the external social factors, which have substantial impacts on dysphoria.

Ludvigsson, J. F., Adolfsson, J., Höistad, M., Rydelius, P. A., Kriström, B., & Landén, M. (2023). A systematic review of hormone treatment for children with gender dysphoria and recommendations for research. 
Acta Paediatrica (Oslo, Norway: 1992), 
112(11), 2279–2292. https://doi.org/10.1111/apa.16791

The researchers employed data from a systematic review comprising studies published in English focused on hormone therapy in children with gender dysphoria to evaluate the effects on psychosocial and mental health, body composition, cognition, and metabolic markers of hormone treatment in such children They found that in the few longitudinal studies included, the outcomes were hindered by small numbers and high attrition rates. As a result, it was difficult to evaluate the long-term effects of hormone therapy on the child’s psychosocial health. They also found that gonadotropin-releasing hormone analogues (GnRHa) treatment leads to delayed bone maturity and gaining bone density, which, however, they found to partially recover during cross-sex hormone treatment (CSHT) when studied when patients reached 22 years.

This source supports my thesis by emphasizing the cautious approach to the use of puberty suppression and gender-reaffirming treatments by revealing that the long-term effects of hormone therapy on somatic and psychosocial are largely unknown based on existing literature. The only evidence revealed are the effects of GnRHa, including delayed bone maturity and bone mineral density gain, hence, the need to ensure the safety of such treatments before administering them.

Overall, the existing evidence on the use of puberty suppressants and gender-reassignment surgeries appears to be limited on the long-term impacts of such treatments on patients’ psychosocial well-being, mental health and QoL The reviewed studies suggest the need for cautious, individualized approach to the administration of such therapies, stressing informed consent, mental evaluation and the need for more robust longitudinal studies.

References

Biggs, M. (2022). The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence. 
Journal of Sex & Marital Therapy, 
49(4), 348–368. https://doi.org/10.1080/0092623X.2022.2121238

de Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. 
Pediatrics, 
134(4), 696–704.
https://doi.org/10.1542/peds.2013-2958

Ludvigsson, J. F., Adolfsson, J., Höistad, M., Rydelius, P. A., Kriström, B., & Landén, M. (2023). A systematic review of hormone treatment for children with gender dysphoria and recommendations for research. 
Acta Paediatrica (Oslo, Norway: 1992), 
112(11), 2279–2292. https://doi.org/10.1111/apa.16791

Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S. (2020). Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation. 
Pediatrics, 
145(2), e20191725. https://doi.org/10.1542/peds.2019-1725

van Leerdam, T. R., Zajac, J. D., & Cheung, A. S. (2023). The Effect of Gender-Affirming Hormones on Gender Dysphoria, Quality of Life, and Psychological Functioning in Transgender Individuals: A Systematic Review. 
Transgender Health, 
8(1), 6–21. https://doi.org/10.1089/trgh.2020.0094

default image
July 1, 2023
    

7

Thesis Statement and Annotated Bibliography

Destiny Johnson

Chamberlain University College of Nursing

PHIL 347: Critical Reasoning

Todd Buck

December 1, 2024

Thesis Statement and Annotated Bibliography

Thesis Statement

The prospect of administering puberty blockers, hormone treatment, and surgery for sex reassignment for young minors presents a problem of ethics of gender-related discomfort and possible risks in a future perspective. While puberty blocking substances might have reversible effects, the irreversible effects from hormone treatment and/or surgeries involves risks, such as regret, medical repercussions, and trauma. Due to the lack of sufficient data about long-term effects, these therapies should be done with extreme care considering the importance of mental health and informed consent to deliver secure, ethical, and personalized care.

Annotated Bibliography

Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S. (2020). Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation. 
Pediatrics, 
145(2), e20191725. https://doi.org/10.1542/peds.2019-1725

The authors used data from a cross-sectional survey of 20, 619 transgender adults aged 18 to 36 years to test their hypothesis that there is an association between suppressing puberty during adolescence and mental health outcomes during adulthood. They used self-reported data on the history of use of puberty blockers during adolescence. Their hypothesis was not supported in transgender adults by finding a significant association between receiving pubertal suppression treatments during adolescence and lifetime suicidal ideation. The use of puberty suppressants for transgender adolescents desiring this treatments is linked to favorable mental health outcomes.

This source supports my thesis that puberty blocking substances might have reversible effects as they do not cause permanent changes, but hormone treatment and gender reassignment surgeries may have irreversible consequences, significantly, leading to lasting mental health impacts on minors, especially when they are adults. Although it reveals potential psychological benefits associated with these therapies, it raises concerns about long-term consequences.

Biggs, M. (2022). The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence. 
Journal of Sex & Marital Therapy, 
49(4), 348–368. https://doi.org/10.1080/0092623X.2022.2121238

The authors use data from Dutch Protocol for Juvenile Transsexuals comprising 70 adolescents who had been introduced to puberty suppression, followed by cross-sex hormones and surgery to review the history of this intervention and supporting evidence. They found positive outcomes immediately after the surgery except for the death of one patient. Puberty blockers may temporarily alleviate juvenile transsexuals’ distress, but may lock them into further medical interventions in the long-term. The therapies may result in lethal physical effects, such as accrual bone mass and unknown effects on the patient’s emotional and cognitive development.

This source strongly supports my thesis that the use of puberty suppression treatments and gender reassignment surgeries my present long-term implications on the client due to the irreversible effects associated. The irreversible therapeutic effects may require clinicians to do careful assessments based on individual cases.

de Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. 
Pediatrics, 
134(4), 696–704.
https://doi.org/10.1542/peds.2013-2958

The researchers used data from a longitudinal study of 55 young transgender adults with a history of receiving puberty suppression during teen years to evaluate the effectiveness of these interventions. They evaluated the outcomes of the adolescents before starting puberty suppression, when they received the cross-sex hormones and at least after one year of undergoing gender reassignment surgery. They found significant alleviation of gender dysphoria and steady improvement in psychological functioning. The well-being of this group was similar or better than their counterparts from the general population. They found a positive correlation between postsurgical subjective well-being and enhancements in psychological well-being.

This source supports the thesis that the puberty suppression and gender reassignment therapies may relieve gender dysphoria and improve psychological functioning in the short-term, but careful considerations should be made when administrating these therapies in the contexts of safety, ethics and personalized care. It supports cautious care by suggesting a clinical protocol comprising a multidisciplinary team of physicians, mental health professionals, and surgeons, including puberty suppression, followed by gender reassignment and cross-sex hormones, in supporting gender dysphoric youths seeking such interventions to develop into well-functioning young adults.

van Leerdam, T. R., Zajac, J. D., & Cheung, A. S. (2023). The Effect of Gender-Affirming Hormones on Gender Dysphoria, Quality of Life, and Psychological Functioning in Transgender Individuals: A Systematic Review. 
Transgender Health, 
8(1), 6–21. https://doi.org/10.1089/trgh.2020.0094

The researchers used data from a systematic review comprising observational studies (longitudinal and cross-sectional studies) published in English and in a peer-reviewed journal to assess the efficacy of gender-affirming hormone therapy (GAHT) in enhancing gender and body-related dysphoria, along with Quality of Life (QoL) and psychological well-being. They found that GAHT may body-related and subjective gender dysphoria, QoL and psychological well-being. However, they found most evidence, predominantly from cohort studies and cross-sectional studies to show low to moderate quality in body-related and subjective gender dysphoria improvements. The researchers reveal gaps in the quality measurement or assessment of gender dysphoria, as the primary goal of GAHT. They propose evaluation of the secondary outcomes, including QoL and mental health, as arguably the most critical outcomes of such treatments, providing accuracy of the efficacy of GAHT.

This source supports my thesis by highlighting gaps in evaluating the outcomes of gender-affirming therapies, including mental health and QoL due to low to moderate quality evidence existing to support gender dysphoria improvements. It makes it challenging to draw clear inferences and fails to mirror the external social factors, which have substantial impacts on dysphoria.

Ludvigsson, J. F., Adolfsson, J., Höistad, M., Rydelius, P. A., Kriström, B., & Landén, M. (2023). A systematic review of hormone treatment for children with gender dysphoria and recommendations for research. 
Acta Paediatrica (Oslo, Norway: 1992), 
112(11), 2279–2292. https://doi.org/10.1111/apa.16791

The researchers employed data from a systematic review comprising studies published in English focused on hormone therapy in children with gender dysphoria to evaluate the effects on psychosocial and mental health, body composition, cognition, and metabolic markers of hormone treatment in such children They found that in the few longitudinal studies included, the outcomes were hindered by small numbers and high attrition rates. As a result, it was difficult to evaluate the long-term effects of hormone therapy on the child’s psychosocial health. They also found that gonadotropin-releasing hormone analogues (GnRHa) treatment leads to delayed bone maturity and gaining bone density, which, however, they found to partially recover during cross-sex hormone treatment (CSHT) when studied when patients reached 22 years.

This source supports my thesis by emphasizing the cautious approach to the use of puberty suppression and gender-reaffirming treatments by revealing that the long-term effects of hormone therapy on somatic and psychosocial are largely unknown based on existing literature. The only evidence revealed are the effects of GnRHa, including delayed bone maturity and bone mineral density gain, hence, the need to ensure the safety of such treatments before administering them.

Overall, the existing evidence on the use of puberty suppressants and gender-reassignment surgeries appears to be limited on the long-term impacts of such treatments on patients’ psychosocial well-being, mental health and QoL The reviewed studies suggest the need for cautious, individualized approach to the administration of such therapies, stressing informed consent, mental evaluation and the need for more robust longitudinal studies.

References

Biggs, M. (2022). The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence. 
Journal of Sex & Marital Therapy, 
49(4), 348–368. https://doi.org/10.1080/0092623X.2022.2121238

de Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. 
Pediatrics, 
134(4), 696–704.
https://doi.org/10.1542/peds.2013-2958

Ludvigsson, J. F., Adolfsson, J., Höistad, M., Rydelius, P. A., Kriström, B., & Landén, M. (2023). A systematic review of hormone treatment for children with gender dysphoria and recommendations for research. 
Acta Paediatrica (Oslo, Norway: 1992), 
112(11), 2279–2292. https://doi.org/10.1111/apa.16791

Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S. (2020). Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation. 
Pediatrics, 
145(2), e20191725. https://doi.org/10.1542/peds.2019-1725

van Leerdam, T. R., Zajac, J. D., & Cheung, A. S. (2023). The Effect of Gender-Affirming Hormones on Gender Dysphoria, Quality of Life, and Psychological Functioning in Transgender Individuals: A Systematic Review. 
Transgender Health, 
8(1), 6–21. https://doi.org/10.1089/trgh.2020.0094

default image
July 1, 2023
    

7

Thesis Statement and Annotated Bibliography

Destiny Johnson

Chamberlain University College of Nursing

PHIL 347: Critical Reasoning

Todd Buck

December 1, 2024

Thesis Statement and Annotated Bibliography

Thesis Statement

The prospect of administering puberty blockers, hormone treatment, and surgery for sex reassignment for young minors presents a problem of ethics of gender-related discomfort and possible risks in a future perspective. While puberty blocking substances might have reversible effects, the irreversible effects from hormone treatment and/or surgeries involves risks, such as regret, medical repercussions, and trauma. Due to the lack of sufficient data about long-term effects, these therapies should be done with extreme care considering the importance of mental health and informed consent to deliver secure, ethical, and personalized care.

Annotated Bibliography

Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S. (2020). Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation. 
Pediatrics, 
145(2), e20191725. https://doi.org/10.1542/peds.2019-1725

The authors used data from a cross-sectional survey of 20, 619 transgender adults aged 18 to 36 years to test their hypothesis that there is an association between suppressing puberty during adolescence and mental health outcomes during adulthood. They used self-reported data on the history of use of puberty blockers during adolescence. Their hypothesis was not supported in transgender adults by finding a significant association between receiving pubertal suppression treatments during adolescence and lifetime suicidal ideation. The use of puberty suppressants for transgender adolescents desiring this treatments is linked to favorable mental health outcomes.

This source supports my thesis that puberty blocking substances might have reversible effects as they do not cause permanent changes, but hormone treatment and gender reassignment surgeries may have irreversible consequences, significantly, leading to lasting mental health impacts on minors, especially when they are adults. Although it reveals potential psychological benefits associated with these therapies, it raises concerns about long-term consequences.

Biggs, M. (2022). The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence. 
Journal of Sex & Marital Therapy, 
49(4), 348–368. https://doi.org/10.1080/0092623X.2022.2121238

The authors use data from Dutch Protocol for Juvenile Transsexuals comprising 70 adolescents who had been introduced to puberty suppression, followed by cross-sex hormones and surgery to review the history of this intervention and supporting evidence. They found positive outcomes immediately after the surgery except for the death of one patient. Puberty blockers may temporarily alleviate juvenile transsexuals’ distress, but may lock them into further medical interventions in the long-term. The therapies may result in lethal physical effects, such as accrual bone mass and unknown effects on the patient’s emotional and cognitive development.

This source strongly supports my thesis that the use of puberty suppression treatments and gender reassignment surgeries my present long-term implications on the client due to the irreversible effects associated. The irreversible therapeutic effects may require clinicians to do careful assessments based on individual cases.

de Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. 
Pediatrics, 
134(4), 696–704.
https://doi.org/10.1542/peds.2013-2958

The researchers used data from a longitudinal study of 55 young transgender adults with a history of receiving puberty suppression during teen years to evaluate the effectiveness of these interventions. They evaluated the outcomes of the adolescents before starting puberty suppression, when they received the cross-sex hormones and at least after one year of undergoing gender reassignment surgery. They found significant alleviation of gender dysphoria and steady improvement in psychological functioning. The well-being of this group was similar or better than their counterparts from the general population. They found a positive correlation between postsurgical subjective well-being and enhancements in psychological well-being.

This source supports the thesis that the puberty suppression and gender reassignment therapies may relieve gender dysphoria and improve psychological functioning in the short-term, but careful considerations should be made when administrating these therapies in the contexts of safety, ethics and personalized care. It supports cautious care by suggesting a clinical protocol comprising a multidisciplinary team of physicians, mental health professionals, and surgeons, including puberty suppression, followed by gender reassignment and cross-sex hormones, in supporting gender dysphoric youths seeking such interventions to develop into well-functioning young adults.

van Leerdam, T. R., Zajac, J. D., & Cheung, A. S. (2023). The Effect of Gender-Affirming Hormones on Gender Dysphoria, Quality of Life, and Psychological Functioning in Transgender Individuals: A Systematic Review. 
Transgender Health, 
8(1), 6–21. https://doi.org/10.1089/trgh.2020.0094

The researchers used data from a systematic review comprising observational studies (longitudinal and cross-sectional studies) published in English and in a peer-reviewed journal to assess the efficacy of gender-affirming hormone therapy (GAHT) in enhancing gender and body-related dysphoria, along with Quality of Life (QoL) and psychological well-being. They found that GAHT may body-related and subjective gender dysphoria, QoL and psychological well-being. However, they found most evidence, predominantly from cohort studies and cross-sectional studies to show low to moderate quality in body-related and subjective gender dysphoria improvements. The researchers reveal gaps in the quality measurement or assessment of gender dysphoria, as the primary goal of GAHT. They propose evaluation of the secondary outcomes, including QoL and mental health, as arguably the most critical outcomes of such treatments, providing accuracy of the efficacy of GAHT.

This source supports my thesis by highlighting gaps in evaluating the outcomes of gender-affirming therapies, including mental health and QoL due to low to moderate quality evidence existing to support gender dysphoria improvements. It makes it challenging to draw clear inferences and fails to mirror the external social factors, which have substantial impacts on dysphoria.

Ludvigsson, J. F., Adolfsson, J., Höistad, M., Rydelius, P. A., Kriström, B., & Landén, M. (2023). A systematic review of hormone treatment for children with gender dysphoria and recommendations for research. 
Acta Paediatrica (Oslo, Norway: 1992), 
112(11), 2279–2292. https://doi.org/10.1111/apa.16791

The researchers employed data from a systematic review comprising studies published in English focused on hormone therapy in children with gender dysphoria to evaluate the effects on psychosocial and mental health, body composition, cognition, and metabolic markers of hormone treatment in such children They found that in the few longitudinal studies included, the outcomes were hindered by small numbers and high attrition rates. As a result, it was difficult to evaluate the long-term effects of hormone therapy on the child’s psychosocial health. They also found that gonadotropin-releasing hormone analogues (GnRHa) treatment leads to delayed bone maturity and gaining bone density, which, however, they found to partially recover during cross-sex hormone treatment (CSHT) when studied when patients reached 22 years.

This source supports my thesis by emphasizing the cautious approach to the use of puberty suppression and gender-reaffirming treatments by revealing that the long-term effects of hormone therapy on somatic and psychosocial are largely unknown based on existing literature. The only evidence revealed are the effects of GnRHa, including delayed bone maturity and bone mineral density gain, hence, the need to ensure the safety of such treatments before administering them.

Overall, the existing evidence on the use of puberty suppressants and gender-reassignment surgeries appears to be limited on the long-term impacts of such treatments on patients’ psychosocial well-being, mental health and QoL The reviewed studies suggest the need for cautious, individualized approach to the administration of such therapies, stressing informed consent, mental evaluation and the need for more robust longitudinal studies.

References

Biggs, M. (2022). The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence. 
Journal of Sex & Marital Therapy, 
49(4), 348–368. https://doi.org/10.1080/0092623X.2022.2121238

de Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. 
Pediatrics, 
134(4), 696–704.
https://doi.org/10.1542/peds.2013-2958

Ludvigsson, J. F., Adolfsson, J., Höistad, M., Rydelius, P. A., Kriström, B., & Landén, M. (2023). A systematic review of hormone treatment for children with gender dysphoria and recommendations for research. 
Acta Paediatrica (Oslo, Norway: 1992), 
112(11), 2279–2292. https://doi.org/10.1111/apa.16791

Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S. (2020). Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation. 
Pediatrics, 
145(2), e20191725. https://doi.org/10.1542/peds.2019-1725

van Leerdam, T. R., Zajac, J. D., & Cheung, A. S. (2023). The Effect of Gender-Affirming Hormones on Gender Dysphoria, Quality of Life, and Psychological Functioning in Transgender Individuals: A Systematic Review. 
Transgender Health, 
8(1), 6–21. https://doi.org/10.1089/trgh.2020.0094

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