October is Breast Cancer Awareness Month in the United States. Breast cancer is a common, deadly, and aggressive disease that can develop in any individual regardless of sex or age, not just menopausal cisgender women.

According to the Mayo Clinic, breast cancer is the second most common cancer diagnosed in designated females in the US. Breastcancer.org reports that 1 in 8 designated females will develop invasive breast cancer in their lifetime, as opposed to approximately 1 in 1000 designated males.

While deaths from breast cancer have decreased in the last 50 years, around 42,000 designated females are expected to die as a result of breast cancer by the end of 2019. Breast cancer has the highest mortality rate of any cancer in the US for designated females aside from lung cancer.

The 15-40 Connection is an advocacy group for young people who are diagnosed with cancer and focuses on spreading information for early detection. They report that cancer survival rates for people aged 15 to 40 have lagged significantly behind those of older individuals, and state that this can be attributed to low rates of diagnosis.

The Young Survival Coalition reports that more than 250,000 designated females who are living with breast cancer were diagnosed before 40, but stresses that diagnoses before 40 are difficult as there are no effective diagnostic procedures for younger designated females due to the denser breast tissue.

Frustratingly, breast cancer in designated females below 40 tends to be more aggressive; this, coupled with difficulty producing accurate diagnoses, results in a drastically lower survival rate for young breast cancer patients and a higher rate of metastasis.

The youngest known case of breast cancer was 8-year-old Chrissy Turner, who underwent a full mastectomy in her undeveloped right breast in November 2015. Her only symptom was a painful lump on her chest.

Extensive research has not been done on the occurrence of breast cancer in transgender men and nonbinary designated femalaes. Aside from a Dutch study on trans men who elected hormone replacement therapy, the majority of data on transgender individuals is available is from case studies and reports of diagnoses and treatments, Laurie Ray at Clue reports. The Dutch study found breast cancer to present in trans men at roughly the same percentage as cis men, but retrospective studies of trans patients in the US suggest that artificial androgens used for transitioning might promote the development of breast cancer. Regardless of the effects of different transitional procedures, it is crucial to understand that gender identity does not play a role in the expression of breast cancer.

Every individual must be aware of their physical health regardless of age, sex, or gender. In Amarillo, breast diagnostic and treatment procedures are typically performed at the BSA Harrington Breast Center, which provides a program for individuals who are at a higher risk of developing cancer. Additionally, WT is host to a branch of Zeta Tau Alpha womens fraternity, which boasts a breast cancer foundation in addition to their fraternity philanthropy program being breast cancer awareness. Further information about treatment, testing, and risk factors can be found at either link.

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Breast cancer awareness is for everyone - The Prairie

When the doctor walked in and immediately asked me about my prostate during an appointment I'd made about an issue entirely unrelated to my gender, I knew things werent going to go well.

I dont have any reproductive organs, I answered.

He fumbled with his clipboard. Oh.

We tried to recover a neutral mood in the room, but the visit remained tense and awkward. I couldnt feel fully comfortable with him.

Trans patients face polar struggles in seeking medical treatment: We need doctors to diagnose us with gender dysphoria in order to receive trans-related treatments that align us with who we are, while general practitioners express total ignorance of our basic health needs and mishandle our gender identities and bodies instead. Close medical scrutiny, which is supremely important in making effective individualized care possible, is still taxing, complex, and draining to navigate.

I am a trans boy with chronic back and neck pain that has worsened over time. After my ability to drive to and stand at work deteriorated, I left my apartment, friends, and job to move across the country so my mom could help with my care as I sought a diagnosis. With so much lost and even more at stake, it was especially frustrating when doctors focused on the fact that I'm trans instead of my symptomslike in the visit where I had to explain my lack of reproductive organs.

By the time I turned to the healthcare abyss in search of answers, I was a veteran of the system, having undergone hormone replacement therapy and two surgeries over the prior four years. Navigating my medical transition was exhausting, expensive, and complicated, but the surgeons, therapists, and physicians I saw specialized in trans-related treatment. They gave me the nave belief that, with decent insurance, emotional support, and the willingness to complete a thousand forms, I could receive adequate care.

But needing non-trans-related care meant dealing with doctors who had little to no experience treating trans patients, who often conflated my gender with my wider health. Over the span of two years, many medical professionals immediately questioned if my gender-confirming surgeries were responsible for my pain. One doctor read my chart and cross-examined me about my genetic material. So, if we were to test your DNA and chromosomes, youd actually be a woman? she interrogated. A rheumatologist asked me if I believed in God, which apparently would give me the strength I needed toI dont knowsurvive this appointment? I was sometimes asked when I first felt I was trans, and whether I was considering further surgeries.

After ruling out these concerns, providers brushed me off with a painkiller prescription and the recommendation to see a psychiatrist. I did, and she helped me understand and handle the toxic cycle of pain and stress familiar to many chronically ill folks. But my pain never went away. I wondered if doctors suggestions for me to see a psychiatrist were informed not only by my symptoms or behavior, but by my previous medical record of gender-related therapy.

I underwent countless appointments, misdiagnoses, and stressful tests in search of a cause: MRIs, CT scans, X-Rays, corticosteroid shots, antibiotics, four rounds of physical therapy. Nearly a year after the onset of my pain, I remarked to one physicians assistant that doctors didnt seem to believe I had a legitimate health problem and asked inappropriate questions about my gender. The PA told me straight out, firmly but sympathetically: Youre young, transgender, and have a mental health diagnosis," he said, referring to the gender dysphoria diagnosis I'd needed in order to transition. "Most doctors will think you just want drugs or have psychological problems.

His candor was shocking. Throughout six years of working with doctors during my transition, I jumped through hoops to prove my mental stability in order to access the gender-confirming procedures I needed. Yet, regarding my chronic pain, the body I'd worked so hard to align with was used against meevidence that I was prone to psychological problems.

Doctors have always been trans peoples biggest allies and biggest antagonists. Doctors made it possible for trans people to access new levels of harmony in their own bodies, and doctors helped dispel the stigma that trans people are inherently mentally disturbed. But doctors were also the very people who determined that being trans was a mental illness in the first place.

In the 1940s and 50s, during the early years of trans medicine in the U.S., doctors instituted a system of gatekeeping to sort the real trans people from the rest. They prized trans folks' ability to pass"to move through society undetected as transand patients needed to play the game if they wanted approval for treatment. In Julia Seranos queer classic Whipping Girl, she describes how trans women learned to show up for their psychotherapy appointments wearing dresses and makeup, stick to a narrative about being trapped in a mans body, and deny being sexually active.

The functions and language of this system of control linger: When I had top surgery in 2012, my insurance listed my diagnosis as true transsexual, a term from endocrinologist Harry Benjamins 1966 Sexual Orientation Scale. Just this May, the worlds two gold-standard diagnostic tools, the World Health Organizations International Classification of Diseases (ICD) and the American Psychiatric Associations Diagnostic and Statistical Manual (DSM), de-categorized transness as a mental illness. Until then, trans patients were labeled as suffering from gender identity disorder (GID). The new ICD terminology is gender incongruence, and the DSM replaced GID with gender dysphoria.

Susan Stryker highlighted medical sciences power to regulate society in Transgender History , writing , Medical practitioners and institutions have the social power to determine what is considered sick or healthy, normal or pathological... to transform potentially neutral forms of human difference into unjust and oppressive social hierarchies. Still today, doctors play god with trans bodies, deciding who does and doesn't deserve access to careas I found out, this time around, in my experiences with general practitioners.

The doctor who cluelessly asked about my prostate was, ironically, the doctor who gave me the best advice about subjecting myself to doctor after doctor: You have to prepare yourself to go through this for a long time. By this, I think he meant not only physical discomfort, but the very process of seeking care itself, of dealing with the unpleasant assumptions, of being profoundly disappointed and dismissed.

I finally received a diagnosis when a friend recommended a rheumatologist close to home. His office didnt take insurance, but I was desperate. The doctor himself actually received me on time from the waiting rooma first. He went over my trans-related treatment briefly, but spent nearly all of the appointment directly addressing the actual symptoms I was there to discuss. He determined I have undifferentiated spondyloarthritis, an auto-inflammatory disease that affects the spine, joints, and where tendons and ligaments attach to bone. I will most likely struggle with pain for my entire life, although medications and physical therapy can help. I felt dejected, but grateful to regain a modicum of understanding and control. And I'd found a doctor who made me feel believed.

This should not have taken as long as it did, especially given the amount of specialists I saw. 2016 data suggests around 1.4 million people in the U.S. identify as trans, which means we can bust once and for all the myth that the average American (and doctor) has not met a transgender person. Trans healthcare is no longer a niche business, and with unprecedented media visibility for trans folks this decade, a lack of basic knowledge about trans identities and healthcare needs is more inexcusable than ever.

My doctor didnt specialize in trans healthcare, but he could provide tailored care for my specific body with kindness and respect. Im certain my positive experience at this practice was directly correlated to the fact that I paid out of pocket for the care, a more-lucrative exchange for doctors which subsequently incentivizes a more hands-on approach, but there are things all medical care providers can do to educate themselves and make trans patients feel more welcome.

We cant fix the outdated, for-profit healthcare system overnight, but we can start by advocating for the humanization of disenfranchised patient populations. Practices should prioritize having at least one doctor with some experience treating trans people and have all of their staff take full advantage of free resources about how to offer respectful and effective care, like the University of San Franciscos "Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People." Healthcare professionals with an online presence can openly list their trans-friendliness in order to help clients find them (and avoid doctors who aren't aware or respectful of trans health). Even seemingly small things, like safe space stickers and LGBTQ health brochures are always appreciated. It is an anomaly for anyone to have reliable access to good healthcare in America, but for trans patients like me, especially ones seeking care for chronic issues, it's, devastatingly, even rarer.

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For Trans People, Doctors Are Both Allies and Antagonists - Tonic

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You have to surrender to it, British comedian Dawn French proclaimed last year of menopause. "I promise that, afterwards, theres life."

Disturbed sleep. Thinning hair. Anxiety. Mood swings. Memory loss. Weight gain. Or, for some women, nothing much at all.

Despite being a fundamental biological transition affecting half the world's population, the symptoms of menopause have been deemed, traditionally, "secret" women's business. Now it's starting to become more a part of the conversation.

In Britain, women are gathering at pop-up "menopause cafes" to swap notes on their experiences. Workplace policies to cater for menopausal employees are up for discussion too: Britain's Labour Party wants to mandate them for large organisations, and a major media company introduced one in October.

What is menopause and what is it with a "peri" in front? What happens to women experiencing it? What happens afterwards? And is there a male equivalent?

On average, a woman in Australia will have 400 to 500 periods in her lifetime. Menopause is when the periods stop. The word itself stems from the Greek pausis ("pause") and men ("month"), meaning the "end of monthly cycles".

Women are on a path to menopause from birth. A baby girl has more than a million eggs in her ovaries. Steadily, as she ages, they deplete. By the time puberty hits, only about 300,000 remain, and so it goes, through her adult life.

[Menopause] represents the end of a womans reproductive life, says Martha Hickey, professor of obstetrics and gynaecology at the University of Melbourne. Specifically, menopause is the final menstrual period a woman experiences it is a one-off event. All women will go through menopause. It is inevitable."

(In a reproductive life spanning decades, the average Australian woman will have two or fewer babies.)

Menopause is considered a normal part of ageing when it happens after the age of 40. But some women can go through menopause early, either as a result of surgery such as hysterectomy, or damage to the ovaries such as from chemotherapy. When menopause happens before 40, regardless of the cause, it is called premature menopause.

The average age of menopause is about 51 but it can happen sooner, with most women experiencing symptoms in the lead-up which brings us to perimenopause.

Comparing notes on perimenopause: there's a lot to talk about. Credit:Illustration: Dionne Gain

Technically speaking, the symptoms women experience in the lead-up to menopause are actually perimenopausal. Peri, a Greek word for "around" or "near" menopause refers to this transitional state.

Perimenopause is when a woman's ovaries begin to make less oestrogen and the body responds. It's a phase that lasts until menopause and, on average, begins when a woman is 47, although it can last from a year to a decade.

As the body makes less oestrogen, the pituitary gland produces higher levels of signalling hormones follicle-stimulating and luteinising hormones in an effort to keep the ovaries producing eggs and to make oestrogen and progesterone levels "normal".

This can lead to ovulation occurring twice in a cycle, the second time during a period, which can lead to high hormone levels. In other cycles, ovulation might not occur at all.

Some women describe perimenopause as a time of hormonal chaos akin to a second-wave puberty. Symptoms also include hot flushes, changes in libido, mood swings, memory problems, vaginal dryness and a higher risk of osteoporosis. Periods can be less regular, lighter or heavier, last longer or be briefer.Womens' experiences vary greatly some barely register anything.

"It's what's called the menopause transition when those symptoms start," Professor Hickey says. "That can go on for a number of years and the end of that transitional period is a year after the final menstrual period."

Genetic factors play some role in timing. If your mother and other close female relatives had an early or late perimenopause, it's likely you will too. But various studies also point to lifestyle factors, such as smoking, being linked to early onset while other studies have pointed to alcohol consumption delaying perimenopause.

Credit:IStock

After a woman has had 12 consecutive months of amenorrhea (lack of menstruation) she is said to be postmenopausal.

Perimenopausal symptoms ease but health risks related to the loss of oestrogen rise. This includes a decrease in bone density, which can lead to osteoporosis, where bones become thin and fragile. It also includes weight gain, which can increase the risk of obesity, diabetes and cardiovascular disease. Women are advised to keep active, which also releases endorphins that improve mood, and to do strength training to increase blood flow and strengthen the heart.

Hormone replacement therapy (HRT), or menopausal hormone therapy (MHT) as it's now known, is currently the most effective type of treatment available for perimenopause symptoms; more than 300,000 Australian women and about 12 million women in Western countries are using it. But it has been linked with breast and ovarian cancers.

"All medications carry risk and benefits," Professor Hickey says. "A benefit of HRT is that it's really good for symptoms. A risk is that it does increase the risk of cancer. I don't think we should beat around the bush about that. But it varies by the type of hormone therapy you take and it might vary depending on how long you take it for."

The risks are greater, for example, for users of oestrogen-progestagen hormone therapy than for oestrogen-only therapy. A large study by the Institute of Cancer Research in London found that women who took hormone therapy for five years were 2.7 times more likely to develop breast cancer than those who did not. Recent research also suggests that, in some cases, the danger can persist for more than a decade after treatment stops.

Another study found that women using hormone therapy for between one and four years have a 60 per cent higher chance of developing breast cancer compared with those who have never used it.

The report's authors, who examined 58 studies across the world, found that of 108,647 women who developed breast cancer at an average age of 65, almost half had used hormone therapy.

When asked if women should avoid hormone therapy due to the increased risk of cancer, Professor Kelly-Anne Phillips, the founder of the Peter MacCallum Breast and Ovarian Cancer Risk Management Clinic, has said the decision should be made on a case-by-case basis.

"Some women will find, short-term, it can help relieve their symptoms," she saidearlier this year.

Professor Phillips warned, however, that women who had been on hormone therapy for a year should have their treatment reviewed, adding there were alternatives for treating symptoms including weight loss, moisturisers for vaginal dryness and avoiding caffeine or alcohol.

The 'grandmother theory" is one explanation for menopause in humans.

Apart from humans, most mammals stay fertile until the ends of their lives. There are a few exceptions: killer whales, short-finned pilot whales, belugas and narwhals can live for decades beyond their reproductive years. Guppies also appear to go through a fish version of menopause.

But long postmenopausal lifespans are an aspect of biology that appears to be at odds with natural selection. Why do women suddenly stop having periods when they still have at least a third of their lives to live, during which they could be producing offspring?

Some experts, including Professor Hickey, believe high death rates of mothers during childbirth throughout history emphasised the importance of grandmothers in rearing future generations, unhindered by more children of their own. This is known as the grandmother theory.

Not really but andropause can affect men older than 40. Andropause is the gradual reduction of the male sex hormone (testosterone) with increasing age. Its symptoms include sexual dysfunction, weakness, fatigue, insomnia, loss of motivation, mood disorders and reduction of bone density. Though the symptoms aren't as severe as those of menopause, they can last for as long as 15 to 20 years.

An egg surrounded by sperm.Credit:Alamy

Although eggs succumb to menopause, pregnancy is still possible using a donor egg. During perimenopause, ovulation can occur, meaning a woman can conceive naturally, even if she is using hormone therapy.

When UK based former magazine editor Lynnette Peck and her friend Paula Fry first began to experience symptoms of perimenopause they found they had no safe space to share their feelings on the matter. In a bid to open up dialogue, they started a secret Facebook page in 2017.

Word got around quickly. Soon they had more than 700 members and then Feeling Flush was born; a public online community for women across the world to connect.

"We wanted women, including ourselves, to have places to share information and educate each other and have a moan," Ms Peck says.

"Women mostly ask us about hormone replacement therapy and the pros and cons. We are not medical experts so we point them to people who are. There is now a conversation. It was hidden before. Here in the UK, even political parties and huge brands are getting involved."

Professor Hickey notes that women make up almost half of the workforce in Australia and two-thirds of the voluntary sector. They continue to look after children across generations and are often the primary carer for parents.

Our society has a big a focus on youth and the preservation of youth and menopause is a maker of age in women and ageing in women is not a topic we still have very much discussion about," Professor Hickey says.

"It's quite likely that women who experience menopause may not have been informed fully about what to expect. It's quite possible a lot of men don't know very much about menopause at all."

Last week, British free-to-air television Channel 4 launched a menopause policy to support women experiencing perimenopausal symptoms such as hot flushes, anxiety and fatigue by giving them access to flexible working arrangements and paid leave if they feel unwell.

It's a shift Professor Hickey wants in Australia. She would like to see menopause treated as a "diversity issue" with workplaces actively supporting women experiencing it.

"Pregnancy would be a similar example: only women get pregnant, and we've learnt to adapt, and I think we need to take a similar perspective to menopause."

Melissa Cunningham is The Age's health reporter.

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What is menopause and perimenopause? - The Age

The Church of Jesus Christ of Latter-day Saints is pressuring state regulators to punt a proposed ban on conversion therapy for minors back to Utah lawmakers, or change it so that therapists can keep counseling young clients about putting religious convictions over sexual identity.

The church has a certain view about what is right and good with respect to gender and sexuality, and so its really hard for me to believe that amendments such as these would not be interpreted by some clinicians as license to continue pushing their particular version of health and well-being on vulnerable youth, said Lisa Diamond, a professor of psychology and gender studies at the University of Utah.

The Utah Psychological Association also opposes the churchs suggested rule alterations, saying that they are inconsistent with peer-reviewed science and in violation of the American Psychological Associations ethics code. The conversion therapy ban under consideration would not infringe on self-determination, parental rights or religious freedoms, wrote Nanci Klein, the associations director of professional affairs.

The rule would do nothing more than regulate the practice of mental health therapy by prohibiting licensed mental health professionals from subjecting minors to an unnecessary, ineffective, and life-threatening practice, Klein wrote in an email.

So Troy Williams, executive director of Equality Utah, said he hopes state regulators dont comply with the churchs request to kick the issue back to lawmakers.

I dont know whats going to happen," he said, but I hope science prevails over politics.

The church released its opposition to the rule, as written, in a short news release Tuesday. Its Family Services, which offers mental health and other counseling, submitted a more formal statement to state officials expounding on concerns that the rule as drafted is too broad and would fail to protect religious beliefs.

About 250 therapists with Family Services work with 28,000 clients in Utah each year, the networks letter states. Seeing one of these therapists requires a referral from a congregational leader (a bishop or branch president), a stake president (a regional leader) or a mission president, and the typical client is looking for counseling that respects and accounts for their religious identity and personal faith goals.

Family Services has prohibited therapies seeking to change sexual orientation and supports protecting children and youth from abusive conversion therapy practices," according to the correspondence. However, the lengthy letter enumerates a number of objections to the current proposals wording, including language crafted to protect transgender youths from conversion techniques.

The church expresses concern that the drafted rule would prevent therapists from encouraging young people to adopt a wait-and-see approach before pursuing gender transition. The letter also takes issue with proposed language restricting mental health professionals from trying to change presentation and behaviors" expressing aspects of gender.

[I]t is easy to imagine numerous dysfunctional presentations and behaviors that express aspects of gender, such as extremes in dress, grooming, language and sexuality, states the letter, addressed to a DOPL representative.

For instance, discussing a topic such as toxic masculinity might be off-limits for a therapist, the church posits.

To a lesser degree, the church outlined the same problem with the proposed wording on sexual orientation, arguing that it is overly broad and could mute conversations about pornography addiction, abstinence and integrating religious values with other aspects of life.

Major medical and mental health groups in the state spoke in favor of the proposed rule during a lengthy public hearing last month, saying restricting conversion therapy could save lives by protecting youths from a practice linked to suicide and depression.

Research shows more than 60% of LGBT youths who go through conversion therapy attempt suicide, Klein noted.

But some therapists say they can see where the church is coming from.

Julie de Azevedo Hanks, a therapist with Wasatch Family Therapy who is a Latter-day Saint, said she can appreciate the churchs concerns but does not share them herself. The rule language, in her view, would not stifle conversations with a teen whos addicted to gay pornography or other sex-related issues.

The problem isnt that hes looking at gay pornography. Its that he is looking at pornography many hours a day, said Hanks, whos also an assistant professor of social work at Utah Valley University. And you treat that behavior. It has nothing to do with whether its gay or straight.

David Matheson, a former conversion therapist who recently came out as gay, said he also has problems with the ban now under consideration. The current language fails to reflect the complexities of sexual fluidity and gender identity, he said, and would act as a blunt instrument where nuance is needed.

Theres a lawyer now sitting in the therapists office, and he doesnt belong there, said Matheson, who still works as a therapist but has disavowed his past conversion efforts.

He did, however, explain that he disagrees with the churchs doctrines and policies on LGBTQ people, which he called inhumane.

Diamond said these positions throw into question the churchs credibility on the topic of conversion therapy. And while the churchs letter condemns conversion tactics using electric shock and nausea, researchers have found the techniques that cause most harm to gay youths involve prayer, she said.

Because youre asking God to help you. And then nothing happens, and you feel like, Oh, God has forsaken me, she said. So when we think about the harm of conversion therapy, we have to remember that harm doesnt just come from having somebody shock you. Harm comes from receiving and internalizing the message that there is something fundamentally wrong about you.

Therapists who follow the ethical guidelines for their profession have no reason to fear that the proposed DOPL rule will curtail their freedom during counseling sessions, she said.

Gayle Ruzicka, president of the Utah Eagle Forum and an ardent opponent of the current proposal, disagrees and says the measure would infringe on both parental and personal rights. Teens who are questioning their sexual or gender identities should have access to therapy that conforms with their religious beliefs, she said.

Its a parents right for their children and our right as individuals," she said, to be able to express ourselves and get the therapy that we want.

Matheson argues that gender dysphoria extreme discomfort because of a discrepancy between peoples assigned gender and the one they identify with subsides for many people who experience it in childhood and that therapists should be allowed to proceed with caution with these clients.

Therapies that encourage transitioning may be enforcing a lifelong change on a childhood issue somewhat like forcing a child to grow up to be an astronaut because thats what they wanted to be when they were 7, Matheson wrote in an email.

Diamond, on the other hand, says this wait-and-see approach would not fall under the conversion therapy ban and is standard therapeutic practice.

Its not like the average therapist is encouraging children ... to identify as trans as early as possible, she said. This field is extraordinarily cautious, because were aware of how complicated development is.

Sue Robbins, board chairwoman for Transgender Advocates of Utah, said hormone replacement therapy and sex reassignment surgeries are typically done later in life, and minors more often use hormone blockers to put a pause on puberty. The blockers give young people time to work through their feelings on gender identity, she said.

While the churchs letter speaks about the likelihood that gender confusion or dysphoria in children will fade over time, Robbins said only a tiny percentage of people who transition pursue a reversal and those few often do so because of discrimination rather than a change of feeling.

"It's all about going back into the closet," Robbins said.

The proposed changes suggested by the church would leave children vulnerable to nonaffirming therapy based on junk science, Robbins said.

LGBTQ advocates had negotiated the legislation with the churchs attorneys and public affairs office and landed on language that representatives of the Utah-based faith agreed not to oppose, Williams said. He said the proposed rule would have the same effect as the legislation negotiated with the church, and hes not sure why Family Services now objects.

I was surprised and disappointed to see a 26-page rebuttal of what we had worked so hard on, he said.

DOPL denied a request for an interview, but officials have said the rule could take effect Tuesday at the earliest. However, the agency could also take the rule back to any of its licensing boards if it believes public input warrants further review, according to an agency spokeswoman. Public notice would be required if the agency changes the proposed language.

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LDS Church says proposed 'conversion' ban would silence therapists, but its motives are under fire - Salt Lake Tribune

by Sam Manzella 10/25/2019

Its impossible to imagine contemporary popular music without the synthesizer. The instrument, which generates audio signals that are then converted to sound, pervades almost every modern musical genre. Pop, dance pop, hip-hop, EDM, experimentalif its based in electronica, it can be traced back to the invention of the commercial synthesizer. And yes, that includes most of the LGBTQ artists who comprise your going-out (or broody staying-in) playlists (Kim Petras or Sophie, anyone?)

But behind its familiar (though still seemingly out-of-this-world) sounds is a name you may not recognize: Wendy Carlos, an accomplished musician, recording engineer, and transgender woman whose forward-thinking use of synths helped make them ubiquitous.

Carlos, now almost 80 years old, has two Ivy League degrees, three Grammy Awards (all for her 1968 classic Switched-On Bach), and a handful of critically acclaimed film scores (for 1971s A Clockwork Orange and 1980s The Shining, among others) under her belt. Her rise to fame in the music industry began in New York City. After graduating from Columbia University with a masters degree in music composition in the 1960s, a 20-something Carlos worked alongside electronic music innovators and Columbia professors like Vladimir Ussachevsky and Otto Luening.

Leonard M. DeLessio/Corbis via Getty Images

There, she also met Robert Bob Moog, a fellow audio engineer and the namesake of the Moog synthesizer, a classic analog version of the instrument. The two became fast friends, and their working relationship spanned some 40 years.

It was a perfect fit, Carlos recalled in a blog post dedicated to Moog in 2005, after the 71-year-old synth pioneer died of cancer. He was a creative engineer who spoke music; I was a musician who spoke science. It felt like a meeting of simpatico minds, like he were my older brother, perhaps.

In 1964, Moog debuted his bespoke synthesizera smaller, more portable version of the hulking wall-to-wall synths that most audio technicians and recording engineers usedat NYCs annual Audio Engineering Society (AES) convention. It would graduate to become the worlds first commercial synthesizer, and Carlos would use it to record Switched-On Bach, an electronic reimagining of Johann Sebastian Bachs classical compositions. The triple-Grammy-winning classical music recordwhich sold a record-breaking 1,000,000 copiesis widely credited with meshing popular music and synths together. (Before Switched-On Bach, the instruments were mostly relegated to more experimental, less commercially successful music.)

SSPL/Getty Images

Her prestigious honors aside, Carlos was struggling. In fact, shed been struggling with gender dysphoria since childhood, and she began to feel hopeless and suicidal in college.

It wasnt until 197910 years after shed swept the Classical Musical categories at the 1969 Grammysthat she came out publicly as transgender in a Playboy magazine interview. Carlos recalled how shed felt too anxious to perform live once she began hormone replacement therapy (HRT) and had initiated her physical transition in secret. But she could no longer deny who she was. When Playboy asked if she had any idea what wouldve happened if she hadnt begun to live her life as a woman, Carlos was frank: Yes. Id be dead.

The magnitude of her announcement then is difficult to overstate. In 2019, in an era when trans issues are addressed explicitly by presidential hopefuls on the Democratic Party debate stage, an industry pioneer coming out in a mainstream magazine is cause for celebration. In 1970s America, it was not only unheard-of, but a potentially career-ending move (not to mention dangerous). The cultural conversation around transgender acceptance, much less transgender equality, was still burgeoning in LGBTQ spaces; it barely existed in cisgender, heterosexual circles.

Since her initial coming out, Carlos has rarely addressed her gender identity in interviews. (She declined to be interviewed for this story.) That may have something to do with the way her story has been told. In 1979, Playboy asked her some pretty invasive, if not genuinely curious, questions. Even after she discussed her transition in great detail, reporters and editors continued to print her deadname. But in one 1985 article in People, Carlos said she hit her stride in composing new music after opening up publicly about who she really was. The burden had been lifted; it was time to create.

The public turned out to be amazingly tolerant or, if you wish, indifferent, she told the magazine. There had never been any need of this charade to have taken place. It had proven a monstrous waste of years of my life.

Leonard M. DeLessio/Corbis via Getty Images

Carlos candor at a time when transness or gender nonconformity wasnt even on most Americans radars paved the way for a generation of LGBTQ electronic artists to come. Decades after Switched-On Bach, the Tron soundtrack, and her other contributions to 70s and 80s synth music, a new wave of queer musicians can make the kind of songs and albums they envision and love without their identities holding them back.

One of those artists is Kiran Gandhi, a.k.a. Madame Gandhi, a Los Angelesbased electronic music artist and activist who credits Carlos with changing the game for marginalized people in electronic music.

Usually, we imagine the analog synth community as a very homogenous community, she tells NewNowNext. But for Gandhia queer woman of color whose songs like The Future is Female and Top Knot Turn Up are meant to empower marginalized peoplediscovering Carlos pivotal role in the popularization of synth music was so inspiring, and such a relief. It made her want to pick up the instrument that much more.In 2018, Gandhi performed at Moogfest, an annual gathering for synth enthusiasts and music industry professionals that takes place in North Carolina, where Bob Moog spent the last 30 years of his life. She was joined onstage by a lineup of other electronic musiciansall women or gender-nonconforming peoplein honor of Carlos and Switched-On Bachs 50th anniversary.

Gandhi was thrilled that Moogfests organizers hosted a tribute to Carlos, but she was especially grateful that they paid homage to her transnessa fact she was unaware of before the event.

[Wendy Carlos] made folks who are booking festivals more intentional about reaching out to gender-nonconforming folks and queer folks and women in a way that I dont think would have happened had she not been one of the biggest contributors to electronic music, she says. So this shiftactually putting Wendy Carlos on the mapmade us musicians more open-minded to say, Oh, wow, this genre is actually not what we thought it was. Its something else. And thats really freaking cool.

Brooklyn-based writer and editor. Probably drinking iced coffee or getting tattooed.

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Love Synth Pop? Thank Wendy Carlos, the Trans Woman Who Invented It. - NewNowNext

This report on globalBio-identical Hormone Replacement Therapy marketis a detailed research study that helps provides answers and pertinent questions with respect to the emerging trends and growth opportunities in this particular industry. It helps identify each of the prominent barriers to growth, apart from identifying the trends within various application segments of the global market.

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Bio-identical Hormone Replacement Therapy Market Growing Trends and forecast 2019 to 2025 - The Chicago Sentinel

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Results demonstrated potential to reduce current dosing frequency from once-daily to a single weekly injection

MIAMI and NEW YORK, Oct. 21, 2019 (GLOBE NEWSWIRE) -- OPKO Health Inc. (OPK) and Pfizer Inc. (PFE) announced today that the global Phase 3 trial evaluating somatrogon dosed once-weekly in pre-pubertal children with growth hormone deficiency (GHD) met its primary endpoint of non-inferiority to daily GENOTROPIN (somatropin) for injection, as measured by annual height velocity at 12 months.

Top-line results from the study demonstrated that treatment with somatrogon dosed once-weekly in pre-pubertal children with GHD was non-inferior to somatropin dosed once-daily with respect to height velocity at 12 months of treatment (the primary endpoint); the least square mean was higher in the somatrogon group (10.12 cm/year) than in the somatropin group (9.78 cm/year); the treatment difference (somatrogon somatropin) in height velocity (cm/year) was 0.33 with a two-sided 95% confidence interval of the difference of (-0.39, 1.05). In addition, change in height standard deviation scores at six and 12 months, key secondary endpoints, were higher in the somatrogon dosed once-weekly cohort in comparison to the somatropin dosed once-daily cohort. Moreover, at six months, change in height velocity, another key secondary endpoint, was higher in the somatrogon dosed once-weekly cohort in comparison to the somatropin dosed once-daily cohort. These common measures of growth are employed in the clinical setting to measure the potential level of catch-up growth that subjects may experience relative to heights of age and gender matched peers.

Somatrogon was generally well tolerated in the study and comparable to that of somatropin dosed once-daily with respect to the types, numbers and severity of the adverse events observed between the treatment arms. Immunogenicity testing and analysis of additional data are ongoing, and full results of the study will be submitted for presentation at a future scientific meeting.

We are very pleased to announce these favorable top-line results demonstrating the efficacy of somatrogon dosed once-weekly in the pediatric patient population with GHD, said Phillip Frost, M.D., Chairman and Chief Executive Officer of OPKO. Somatrogon is a new molecular entity incorporating OPKOs proprietary long-acting technology. We believe somatrogon represents a significant advance in the treatment of children with GHD compared to the current standard of one injection per day that could enhance a patients adherence to treatment and quality of life.

Were encouraged by these data and look forward to the possibility of bringing this longer-acting therapy to children. If approved, somatrogon could reduce the daily disease burden on children and their caregivers, potentially increasing treatment adherence, said Brenda Cooperstone, M.D., Chief Development Officer, Rare Disease, Pfizer Global Product Development. At Pfizer, we strive each and every day to advance treatment options that better serve the needs of patients with rare diseases.

In 2014, Pfizer and OPKO entered into a worldwide agreement for the development and commercialization of somatrogon for the treatment of GHD. Under the agreement, OPKO is responsible for conducting the clinical program and Pfizer is responsible for registering and commercializing the product.

About the Study

The somatrogon Phase 3 trial is a randomized, open-label, active-controlled study conducted in over 20 countries. This study enrolled and treated 224 pre-pubertal, treatment-nave children with growth hormone deficiency who were randomized 1:1 into two arms: somatrogon dosed once-weekly vs daily GENOTROPIN (somatropin) for injection. The primary endpoint of the trial was height velocity at 12 months. Secondary endpoints included change in height standard deviation at six and 12 months, safety and pharmacodynamic measures. Children completing this study had the opportunity to enroll in a global, open-label, multicenter, long-term extension study, in which they were able to either continue receiving or switch to somatrogon. Approximately 95% of the patients switched into the open-label extension study and received somatrogon treatment.

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About Somatrogon

Somatrogon is a new molecular entity that contains the natural sequence of growth hormone and one copy of the C-terminal peptide (CTP) from the beta chain of human chorionic hCG at the N-terminus and two copies at the C-terminus. The CTPs extend the half-life of the molecule. Somatrogon received Orphan Drug designation in the U.S. and the EU for the treatment of children and adults with growth hormone deficiency.

About Growth Hormone Deficiency

Growth hormone deficiency is a rare disease characterized by the inadequate secretion of growth hormone from the pituitary gland and affects one in approximately 4,000 to 10,000 people. In children, this disease can be caused by genetic mutations or acquired after birth. Because the patient's pituitary gland secretes inadequate levels of somatropin, the hormone that causes growth, his or her height may be affected, and puberty may be delayed. Without treatment, he or she will have persistent growth attenuation, a very short height in adulthood, and may experience other health problems.

About GENOTROPIN

GENOTROPIN is a man-made, prescription treatment option, approved in the United States for children who do not make enough growth hormone on their own, have the genetic condition called Prader-Willi syndrome (PWS), were born smaller than most other babies, have the genetic condition called Turner syndrome (TS) or have idiopathic short stature (ISS). GENOTROPIN is also approved to treat adults with growth hormone deficiency. GENOTROPIN is taken by injection just below the skin and is available in a wide range of devices to fit a range of individual dosing needs. GENOTROPIN is just like the natural growth hormone that our bodies make and has an established safety profile.

Important GENOTROPIN Safety Information

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.

For the full Prescribing Information for GENOTROPIN, please visit http://labeling.pfizer.com/ShowLabeling.aspx?id=577.

GENOTROPIN Indications and Usage in the U.S.

GENOTROPIN is a prescription product for the treatment of growth failure in children:

GENOTROPIN is a prescription product for the replacement of growth hormone in adults with growth hormone deficiency (GHD) that started either in childhood or as an adult. Your doctor should do tests to be sure you have GHD, as appropriate.

About OPKO Health, Inc.

OPKO is a multinational biopharmaceutical and diagnostics company that seeks to establish industry-leading positions in large, rapidly growing markets by leveraging its discovery, development, and commercialization expertise and novel and proprietary technologies. For more information, visit http://www.OPKO.com.Pfizer Rare Disease

Rare disease includes some of the most serious of all illnesses and impacts millions of patients worldwide, representing an opportunity to apply our knowledge and expertise to help make a significant impact on addressing unmet medical needs. The Pfizer focus on rare disease builds on more than two decades of experience, a dedicated research unit focusing on rare disease, and a global portfolio of multiple medicines within a number of disease areas of focus, including rare hematologic, neurologic, cardiac and inherited metabolic disorders.

Pfizer Rare Disease combines pioneering science and deep understanding of how diseases work with insights from innovative strategic collaborations with academic researchers, patients, and other companies to deliver transformative treatments and solutions. We innovate every day leveraging our global footprint to accelerate the development and delivery of groundbreaking medicines and the hope of cures.

Clickhereto learn more about our Rare Disease portfolio and how we empower patients, engage communities in our clinical development programs, and support programs that heighten disease awareness.

Pfizer Inc.: Breakthroughs that change patients lives

At Pfizer, we apply science and our global resources to bring therapies to people that extend and significantly improve their lives. We strive to set the standard for quality, safety and value in the discovery, development and manufacture of health care products, including innovative medicines and vaccines. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as one of the world's premier innovative biopharmaceutical companies, we collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For more than 150 years, we have worked to make a difference for all who rely on us. We routinely post information that may be important to investors on our website atwww.pfizer.com. In addition, to learn more, please visit us onwww.pfizer.comand follow us on Twitter at @Pfizer and @Pfizer_News, LinkedIn, YouTube and like us on Facebook at Facebook.com/Pfizer.

DISCLOSURE NOTICE: The information contained in this release is as of October 21, 2019. Pfizer and OPKO assume no obligation to update forward-looking statements contained in this release as the result of new information or future events or developments.

This release contains forward-looking information about a product candidate, somatrogon dosed once-weekly in pre-pubertal children with growth hormone deficiency (or GHD) and Pfizers rare disease portfolio, including their potential benefits, that involves substantial risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statements. Risks and uncertainties include, among other things, the uncertainties inherent in research and development, including the ability to meet anticipated clinical endpoints, commencement and/or completion dates for our clinical trials, regulatory submission dates, regulatory approval dates and/or launch dates, as well as the possibility of unfavorable new clinical data and further analyses of existing clinical data; the risk that clinical trial data are subject to differing interpretations and assessments by regulatory authorities; whether regulatory authorities will be satisfied with the design of and results from our clinical studies; whether and when drug applications may be filed in any jurisdictions for somatrogon; whether and when any such applications may be approved by regulatory authorities, which will depend on myriad factors, including making a determination as to whether the product's benefits outweigh its known risks and determination of the product's efficacy and, if approved, whether somatrogon will be commercially successful; decisions by regulatory authorities impacting labeling, manufacturing processes, safety and/or other matters that could affect the availability or commercial potential of somatrogon; and competitive developments.

A further description of risks and uncertainties can be found in Pfizers and OPKOs respective Annual Reports on Form 10-K for the fiscal year ended December 31, 2018 and in their respective subsequent reports on Form 10-Q, including in the sections thereof captioned Risk Factors, Forward-Looking Information and Factors That May Affect Future Results, Cautionary Statement Regarding Forward-Looking Statements, as well as in their respective subsequent reports on Form 8-K, all of which are filed with the U.S. Securities and Exchange Commission and available atwww.sec.govand, as applicable,www.pfizer.com and http://www.OPKO.com.

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OPKO and Pfizer Announce Positive Phase 3 Top-Line Results for Somatrogon, an Investigational Long-Acting Human Growth Hormone to Treat Children with...