Objective
Perceived gender identity is correctly assigned when a combination of physical and vocal attributes become congruent. Several voice feminization procedures have gained popularity, but ...current evidence of their impact on vocal feminization is limited to case series. This study establishes an ex vivo porcine phonatory model to evaluate the ideal extent of anterior glottic web formation in relation to frequency elevation and airway patency.
Methods
Six fresh porcine larynges were obtained and fitted with arytenoid adduction sutures. Compressed air was passed through the larynges, and the vocal folds were adducted to induce phonation. Vocal fold length, posterior glottic width, fundamental frequency, and sound pressure intensity were measured as the vocal folds were progressively shortened as per the anterior glottic web surgical technique.
Results
The average fundamental frequency prior to web formation was 109.7 Hz. The maximum frequency achieved after web formation was 403.7 Hz, and the web proportions varied from 11.8% to 61.0% of the length of the membranous vocal folds. The glottic cross‐sectional area showed an expected inverse linear relationship to the length of the glottic web. Creation of an anterior glottic web caused consistent elevation of pitch, but there was a gradual plateau of effect with increased length of the web.
Conclusion
The ex vivo porcine larynx is demonstrated as an effective, available, and low‐cost model for further study of vocal pitch elevation surgical techniques. We demonstrate that in addition to progressively reducing the cross‐sectional area of the airway, additional benefit from increased web length is limited.
Level of Evidence
NA
Laryngoscope, 130:E206–E212, 2020
Sociology as a Female Preserve Bucior, Christine; Sica, Alan
The American sociologist,
03/2019, Volume:
50, Issue:
1
Journal Article
Peer reviewed
This article updates and expands upon Difuccia et al. (American Sociologist, 38(1), 3–22, DiFuccia et al. 2007), which asked whether, during the first decade of the twentyfirst century, sociology in ...the United States was shifting from a male-dominated discipline and educational enterprise to one controlled for the first time by the persons and interests of women. We expanded the parameters of the study and enriched the data in order to draw more exacting conclusions. Our analyses show that during the last dozen years, a very substantial shift has indeed occurred. Most graduate students and assistant and associate professors at the most prestigious doctoral-granting institutions are now female. With this switch has come a change in the substantive focus of sociology. Curricula at the graduate level are being modified to accommodate interests more typically female than male (as measured by the sex-composition of specialty sections of the American Sociological Association). We find that Bfemale interests” similarly predominate in current sociology dissertations, suggesting that the intellectual changes associated with sociology’s demographic shift are likely to persist. A correlated change is also apparent in ASA leadership.
Exogenous oestrogen 17β-oestradiol (E2) has been shown to effectively induce feminization in teleosts. However, the molecular mechanisms underlying the process remain unclear. Here, we determined ...global DNA methylation and gene expression profiles of channel catfish (Ictalurus punctatus) during early sex differentiation after E2 treatment. Overall, the levels of global DNA methylation after E2 treatment were not significantly different from those of controls. However, a specific set of genes were differentially methylated, which included many sex differentiation-related pathways, such as MARK signalling, adrenergic signalling, Wnt signalling, GnRH signalling, ErbB signalling, and ECM-receptor interactions. Many genes involved in these pathways were also differentially expressed after E2 treatment. Specifically, E2 treatments resulted in upregulation of female-related genes and downregulation of male-related genes in genetic males during sex reversal. However, E2-induced sex reversal did not cause sex-specific changes in methylation profiles or gene expression within the sex determination region (SDR) on chromosome 4, suggesting that E2-induced sex reversal was a downstream process independent of the sex determination process that was regulated by sex-specific methylation within the SDR.
Background
To date, 1‐year evaluation of pitch elevation in patients undergoing modified Wendler glottoplasty (WG) in combination with VT has not been assessed.
Objectives
To determine whether 1‐year ...pitch elevation is sustained in patients who undergo modified WG in combination with VT for voice feminization.
Methods
A retrospective review of patients who underwent WG in combination with voice therapy (VT) was performed from 2016 to 2020. Charts were reviewed for sustained vowel fundamental frequency (F0/a/), speaking fundamental frequency (SF0), and Trans Woman Voice Questionnaire (TWVQ) at preoperative, initial postoperative (3–6 months after surgery), and 12‐month postoperative visits.
Results
Change in average F0/a/, SF0 and TWVQ was 50.25 Hz, 32.96 Hz, and 32.6 at 12‐months postoperatively compared to preoperative values. Initial and 12‐month postoperative SF0 were significantly higher than preoperative SF0 (Mann–Whitney U test p = 0.0042, p = 0.0010). There was no difference in initial postoperative and 12‐month postoperative SF0 (p = 0.50). TWVQ at 12 months was significantly lower than preoperative TWVQ (ANOVA p < 0.001, Tukey honestly significant difference HSD p < 0.05).
Conclusions
Pitch elevation remains sustained at one year in patients undergoing modified WG in combination with VT. Modified Wendler glottoplasty combined with VT results in relatively long‐term improvements in voice‐related quality of life and is possibly a beneficial addition in the long‐term management of patients who desire voice feminization.
Level of Evidence
4 Laryngoscope, 133:615–620, 2023
There is a literature gap regarding facial feminization surgery (FFS) access and coverage. Our goal is to compile information from previous studies and assess the current policy landscape for these ...surgeries in the US. We also explored why some policies do not cover them, identify states with better coverage, and determine the most covered procedures. PubMed, Medline, Embase, and Scopus were searched for studies that reviewed policies on FFS coverage. Studies on surgical techniques or other gender-affirming surgeries (GASs) that did not involve FFS were excluded. Seven studies were included for analysis. In 2014, the Department of Human Health Services (HHS) lifted the transgender exclusion policy, leading to an increase in policies regarding GASs for both private and state insurance. However, there are differences in medical necessity requirements among policies, which may not align with the World Professional Association for Transgender Health (WPATH) criteria. States that prohibit exclusion tend to offer better coverage for FFS. These states are mainly located in the western and northeast regions, whereas states in the southern and middle east regions have less coverage. Among the procedures, chondrolaryngoplasty is the most covered, while facial and cervical rhytidectomy are the least covered. To enhance transgender care, it is crucial to reach a consensus on how to offer coverage for facial feminization surgery. However, there is a lack of adequate research on this topic, and there is a need for resources and tools to assess the results of FFS procedures. One significant constraint of this study is that it does not provide a systematic review of the literature.
Structural change has long been at the core of economic development debates. However, the gender implications of structural change are still largely unexplored. This paper helps to fill this gap by ...analysing the role of structural change in the gender distribution of sectoral employment in sub‐Saharan African countries. I employ aggregate and disaggregate measures of gender sectoral segregation in employment, which measure the difference between the gender distribution across sectors with respect to the overall participation of women and men in the labour market. I build a panel database consisting of 10 sectors and 11 countries during 1960–2010. Fixed effects and instrumental variables' regression models show a significant, nonlinear link between labour productivity and gender segregation. Increasing labour productivity depresses gender segregation at initial phases of structural change. However, further productivity gains beyond a certain threshold of sectoral development increases gender segregation. Country‐industry panel data models complement the analysis showing that relative labour productivity has a nonlinear impact in gender segregation: Initial increases in relative productivity increases feminization but further relative productivity gains foster the masculinization of sectors. The estimates suggest that manufacturing, utilities, construction, business, and government services are key to correct gender biases in employment along the process of structural change.
Calorie restriction (CR) is one of the most effective anti-aging interventions in mammals. A modern theory suggests that aging results from a decline in detoxification capabilities and thus ...accumulation of damaged macromolecules. The present study aimed to determine how short-term CR alters mRNA profiles of genes that encode metabolism and detoxification machinery in the liver. Male C57BL/6 mice were fed CR (0, 15, 30, or 40%) diets for one month, followed by mRNA quantification of 98 xenobiotic processing genes (XPGs) in the liver, including 7 uptake transporters, 39 phase-I enzymes, 37 phase-II enzymes, 10 efflux transporters, and 5 transcription factors. In general, 15% CR did not alter mRNAs of most XPGs, whereas 30 and 40% CR altered over half of the XPGs (32 increased and 29 decreased). CR up-regulated some phase-I enzymes (fold increase), such as Cyp4a14 (12), Por (2.3), Nqo1 (1.4), Fmo2 (5.4), and Fmo3 (346), and numerous number of phase-II enzymes, such as Sult1a1 (1.2), Sult1d1 (2.0), Sult1e1 (33), Sult3a1 (2.2), Gsta4 (1.3), Gstm2 (1.3), Gstm3 (1.7), and Mgst3 (2.2). CR feminized the mRNA profiles of 32 XPGs in livers of male mice. For instance, CR decreased the male-predominantly expressed Oatp1a1 (97%) and increased the female-predominantly expressed Oatp1a4 (11). In conclusion, short-term CR alters the mRNA levels of over half of the 98 XPGs quantified in livers of male mice, and over half of these alterations appear to be due to feminization of the liver.
•Utilized a graded CR model in male mice•The mRNA profiles of xenobiotic processing genes (XPGs) in liver were investigated.•CR up-regulates many phase-II enzymes.•CR tends to feminize the mRNA profiles of XPGs.
Little research has explored the gender dimension of political actors who have emerged in response to the erosion of Western mainstream parties after the Great Recession. This article analyzes the ...case of Podemos, a party inspired by the protest movement Indignados, which has disrupted the Spanish two-party system in only two years. Through the analysis of its leadership’s discourse, I expose the constitutive friction between Podemos’ commitment to “new” alternative practices and the “feminization of politics,” and the reproduction of “old” and “masculinized” politics through a competitive rationale. I characterize this rationale with four features that underlie a dominant masculine party culture: (1) emphasis on winning and aggressive strategy, (2) adversarial style and internal confrontation, (3) hierarchy based on intellectual authority, and (4) charismatic masculine leadership. I suggest that this originates from a populist notion of empowerment and political power that relies on a patriarchal and dominant understanding of successful politics.
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