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Susie Lee D, Semenchenko H. Father absence and pubertal timing in Korean boys and girls. Evol Med Public Health 2023; 11:174-184. [PMID: 37325803 PMCID: PMC10266580 DOI: 10.1093/emph/eoad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/24/2023] [Indexed: 06/17/2023] Open
Abstract
Background and objectives Pubertal timing is a key life history trait with long-term health consequences in both sexes. Evolutionary theory has guided extensive research on developmental influences, in particular growing up without a father, on earlier menarche. Far less is known whether a similar relationship exists for boys, especially beyond western contexts. We used longitudinal data from the nationally representative sample of Korean adolescents, which provided us with a unique opportunity for studying male puberty using a hitherto underutilized biomarker: age at first nocturnal ejaculation. Methodology We pre-registered and tested a prediction that growing up in father-absent households is associated with earlier puberty in both sexes. Large sample size (>6000) allowed testing the effect of father absence, which remains relatively uncommon in Korea, while adjusting for potential confounders using Cox proportional-hazard models. Results Self-reported age at first nocturnal ejaculation was on average 13.8 years, falling within the range known from other societies. Unlike previous findings mostly for white girls, we did not find evidence that Korean girls in father-absent households had a younger age at menarche. Boys in father-absent households reported having their first nocturnal ejaculation 3 months earlier on average, and the difference was evident before age 14. Conclusion and implications The association between father absence and pubertal timing appears sex- and age-dependent, and these differences may further interact with cultural norms regarding gender roles. Our study also highlights the utility of the recalled age of first ejaculation for male puberty research, which has lagged in both evolutionary biology and medicine.
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Affiliation(s)
- D Susie Lee
- Corresponding author. Max Planck Institute for Demographic Research, Konrad-Zuse Strasse 1, 18057 Rostock, Germany. Tel: +49 381 2081-0; E-mail:
| | - Hanna Semenchenko
- Max Planck Institute for Demographic Research, Konrad-Zuse Strasse 1, 18057 Rostock, Germany
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2
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Prenatal Exposure to Parental Lifestyle Factors, Diseases, and Use of Medications and Male Pubertal Development: a Review of Epidemiological Studies Published 2017–2022. CURR EPIDEMIOL REP 2023. [DOI: 10.1007/s40471-023-00320-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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3
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Urological and Gynaecological Considerations for the Use of Gonadotropin-releasing Hormone Analogues in Transgender and Nonbinary Adolescents: A Narrative Review. Eur Urol Focus 2023; 9:35-41. [PMID: 36396559 DOI: 10.1016/j.euf.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/16/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022]
Abstract
CONTEXT Gonadotropin-releasing hormone analogues (GnRHAs) delay the progression of puberty in transgender and nonbinary (TGNB) adolescents and reduce the impact of dysphoria due to ongoing physical development. The intervention remains contentious despite growing evidence to support this practice. OBJECTIVE To stimulate discussion on this topical issue in the urological and gynaecological community given potential ramifications for future fertility, physical development, and options for gender affirmation surgery (GAS). EVIDENCE ACQUISITION We conducted searches of the MEDLINE (from 1946) and Embase (from 1974) databases for the benefits and potential challenges of hormone blockade in TGNB adolescents on February 1, 2022. Evidence with a primary focus on clinical issues of interest to urologists and gynaecologists was objectively synthesised and reported. EVIDENCE SYNTHESIS The onset of puberty represents a period of distress for TGNB adolescents as secondary sexual characteristics develop. GnRHAs are prescribed to inhibit sex hormone production, but the decision to treat should be balanced against the known (and unknown) adverse effects. Fertility preservation is more likely to be successful if GnRHA treatment is delayed for as long as possible. Some adolescents may decide to stop GnRHA use to harvest spermatozoa or oocytes before starting gender-affirming hormone treatment. Transfeminine individuals should consider that options for genital GAS may become more limited, as vaginoplasty with penile skin inversion requires an adequate stretched penile length. Transmasculine individuals may no longer require chest reconstruction for breast development. CONCLUSIONS Offers of GnRHA treatment to TGNB adolescents should be balanced by careful preparation and counselling. Urologists and gynaecologists can complement the expertise of specialist psychosocial and adolescent endocrinology teams, and should be involved early in and throughout the treatment pathway to maximise future functional and surgical outcomes. PATIENT SUMMARY Puberty blockers for transgender and nonbinary adolescents have benefits, but timing is important to preserve fertility and surgical options.
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Tang Y, Diao H, Jin F, Pu Y, Wang H. The effect of peer education based on adolescent health education on the resilience of children and adolescents: A cluster randomized controlled trial. PLoS One 2022; 17:e0263012. [PMID: 35108312 PMCID: PMC8809556 DOI: 10.1371/journal.pone.0263012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND An increasing number of children and adolescents have reported mental health problems, and resilience is a protective factor against these problems. Therefore, the aim of the study is to verify the effect of peer education based on adolescent health education on adolescent resilience. METHOD A cluster randomized controlled trial was conducted including 1,613 students who were divided into an intervention group (19 classes, 732 participants) and a control group (24 classes, 881 participants). One-year peer education was performed in the intervention group, and the control group had no interventions. The Resilience Scale for Chinese Adolescents by Yueqin Hu and a self-designed basic information questionnaire were used to collect data. Chi-square test and rank-sum test were used to compare the differences of demographic characteristics between the two groups. A linear mixed model was used to compare the changes of resilience between the two groups after intervention, and the intra-cluster correlation coefficient (ICC) was calculated. A generalized linear mixed model (GLMM) was used to verify the effect of peer education on adolescent resilience. The significance was set at P < 0.05. RESULTS After intervention, compared with the control group, the intervention group showed significant improvement in target focus, emotion adjustment, interpersonal assistance and total resilience (P < 0.05). The ICC range was 0.003 to 0.034. The GLMM results indicated that peer education based on adolescent health education had significant effects on adolescents' target focus (β = 0.893, P = 0.002), emotional adjustment (β = 1.766, P < 0.001), interpersonal assistance (β = 1.722, P = 0.016) and total mental resilience (β = 5.391, P < 0.001), and the effect was greater for boys than for girls. CONCLUSIONS Peer education based on adolescent health education is effective for improving adolescents' target focus, emotional adjustment, interpersonal assistance, and total resilience, especially for males. Future research should devote more attention to positive cognition and family support as well as gender differences.
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Affiliation(s)
- Yinshuang Tang
- School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Hua Diao
- School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Feng Jin
- School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Yang Pu
- School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Hong Wang
- School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- * E-mail:
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5
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Chad JA. The First Ejaculation: A Male Pubertal Milestone Comparable to Menarche? JOURNAL OF SEX RESEARCH 2020; 57:213-221. [PMID: 30500271 DOI: 10.1080/00224499.2018.1543643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Boys experience their first ejaculation (thorarche) during adolescence, but this event is often overlooked as a milestone in male adolescent development. The purpose of this article is to draw attention to thorarche and consider it in comparison with the female milestone of menarche. A critical analysis is provided of how thorarche has been interpreted to date and the complexities in construing thorarche from a biological perspective are outlined. Despite potential tenability of characterizing thorarche as a comparable milestone to menarche, two particular points challenge this notion: (a) While thorarche may befall the boy involuntarily, it may also be induced by the boy's own will; and (b) Thorarche occurs concomitantly with (pubertal) orgasmarche and has an innate connection with sexuality. The answer to the title question remains contentious, but open topics for future research are noted throughout the article as essential steps towards attaining a better understanding of thorarche.
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Affiliation(s)
- Jordan A Chad
- Department of Medical Biophysics, University of Toronto
- Rotman Research Institute, Baycrest Health Sciences
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6
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Nicolson NA, Ponnamperuma T. Gender moderates diurnal cortisol in relation to trauma and PTSD symptoms: A study in Sri Lankan adolescents. Psychoneuroendocrinology 2019; 104:122-131. [PMID: 30844606 DOI: 10.1016/j.psyneuen.2019.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/09/2019] [Accepted: 02/13/2019] [Indexed: 01/03/2023]
Abstract
Trauma exposure and posttraumatic stress disorder (PTSD) have been linked to aspects of diurnal cortisol secretion in adolescents, but little is known about gender differences in these associations. A school-based sample of Sri Lankan adolescents aged 13-16 years took part in this study 4.5 years after the 2004 tsunami had impacted many of their lives to varying degrees. Saliva samples were obtained 4 times a day for 3 days in 84 participants, who also completed measures of lifetime trauma, current stressors, and posttraumatic stress symptoms (PTSS). We used multilevel regression to estimate effects of trauma exposure and symptoms on cortisol level, diurnal slope, and awakening response (CAR). Results indicated higher cortisol in girls and older adolescents. Although trauma, PTSS, and recent PTSD had non-significant main effects, these three variables interacted with gender, with higher cortisol in girls than in similarly traumatized or symptomatic boys. Co-occurrence of internalizing symptoms and PTSS was also associated with higher cortisol. The 28 adolescents with recent PTSD displayed flatter diurnal slopes, reflecting relatively low morning cortisol. Among the 56 trauma-exposed participants, negative trauma appraisals were associated with higher cortisol. Girls were more likely than boys to display elevated cortisol in relation to re-experiencing and hyperarousal symptoms. In contrast to significant findings for cortisol level and diurnal slope, the CAR showed no association with either trauma or PTSS, irrespective of gender. Findings, viewed in light of normative gender differences in HPA activity during adolescence, can contribute to understanding heightened female vulnerability to posttraumatic stress disorder.
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Affiliation(s)
- Nancy A Nicolson
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Thyagi Ponnamperuma
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
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7
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Young J, Xu C, Papadakis GE, Acierno JS, Maione L, Hietamäki J, Raivio T, Pitteloud N. Clinical Management of Congenital Hypogonadotropic Hypogonadism. Endocr Rev 2019; 40:669-710. [PMID: 30698671 DOI: 10.1210/er.2018-00116] [Citation(s) in RCA: 182] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 10/05/2018] [Indexed: 12/12/2022]
Abstract
The initiation and maintenance of reproductive capacity in humans is dependent on pulsatile secretion of the hypothalamic hormone GnRH. Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder that results from the failure of the normal episodic GnRH secretion, leading to delayed puberty and infertility. CHH can be associated with an absent sense of smell, also termed Kallmann syndrome, or with other anomalies. CHH is characterized by rich genetic heterogeneity, with mutations in >30 genes identified to date acting either alone or in combination. CHH can be challenging to diagnose, particularly in early adolescence where the clinical picture mirrors that of constitutional delay of growth and puberty. Timely diagnosis and treatment will induce puberty, leading to improved sexual, bone, metabolic, and psychological health. In most cases, patients require lifelong treatment, yet a notable portion of male patients (∼10% to 20%) exhibit a spontaneous recovery of their reproductive function. Finally, fertility can be induced with pulsatile GnRH treatment or gonadotropin regimens in most patients. In summary, this review is a comprehensive synthesis of the current literature available regarding the diagnosis, patient management, and genetic foundations of CHH relative to normal reproductive development.
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Affiliation(s)
- Jacques Young
- University of Paris-Sud, Paris-Sud Medical School, Le Kremlin-Bicêtre, France.,Department of Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Bicêtre Hôpital, Le Kremlin-Bicêtre, France.,INSERM Unité 1185, Le Kremlin-Bicêtre, France
| | - Cheng Xu
- Service of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Georgios E Papadakis
- Service of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - James S Acierno
- Service of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Luigi Maione
- University of Paris-Sud, Paris-Sud Medical School, Le Kremlin-Bicêtre, France.,Department of Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Bicêtre Hôpital, Le Kremlin-Bicêtre, France.,INSERM Unité 1185, Le Kremlin-Bicêtre, France
| | - Johanna Hietamäki
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Translational Stem Cell Biology and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Taneli Raivio
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Translational Stem Cell Biology and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Nelly Pitteloud
- Service of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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8
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Worthman CM, Trang K. Dynamics of body time, social time and life history at adolescence. Nature 2018; 554:451-457. [PMID: 29469099 DOI: 10.1038/nature25750] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/15/2018] [Indexed: 12/16/2022]
Abstract
Recent opposing trends towards earlier physical maturation and later social maturation present a conundrum of apparent biological-social mismatch. Here we use life history analysis from evolutionary ecology to identify forces that drive these shifts. Together with findings in developmental science, our life history analysis indicates that adolescence is a distinctive period for biological embedding of culture. Ethnographic evidence shows that mass education is a novel feature of the globalizing cultural configurations of adolescence, which are driven by transformations in labour, livelihood and lifestyle. Evaluation of the life history trade-offs and sociocultural ecologies that are experienced by adolescents may offer a practical basis for enhancing their development.
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Affiliation(s)
- Carol M Worthman
- 1Department of Anthropology, Emory University, Atlanta, Georgia 30322, USA
| | - Kathy Trang
- 1Department of Anthropology, Emory University, Atlanta, Georgia 30322, USA
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9
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Gooding DC, Chambers BH. Age of pubertal onset and 2nd to 4th digit ratios: Preliminary findings. Early Hum Dev 2018; 116:28-32. [PMID: 29112888 DOI: 10.1016/j.earlhumdev.2017.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/23/2017] [Accepted: 10/30/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND The second to fourth digit ratio (2D:4D) is used as a marker of prenatal sex hormone exposure. The aim of this study was to evaluate the possible relation between digit ratio and age of pubertal onset. METHODS Participants were 321 men and 202 women aged between 18 and 28 at the time of assessment who self-reported their onset of puberty (i.e., age at first conscious ejaculation or menarche). Participants' right and left digit lengths were measured from hand scans. RESULTS All groups of males, i.e., early, average, and late pubertal onset, had lower mean 2D:4D than the comparable female groups, regardless of the relative timing of their pubertal onset. Among the males, there was a significant difference in digit ratios between individuals who experienced early, average, and late onset of puberty. In the males, we observed a positive relationship between 2D:4D and age of pubertal onset for both right and left hands. There were no significant differences in 2D:4D among the three groups of female maturers. We observed no significant association between digit ratios and age at menarche. CONCLUSIONS These data lend further support for using 2D:4D as a measure of prenatal androgen exposure.
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Affiliation(s)
- Diane C Gooding
- Department of Psychology, University of Wisconsin, Madison WI, USA.
| | - Blake H Chambers
- Department of Psychology, University of Wisconsin, Madison WI, USA
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10
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Skakkebaek NE, Rajpert-De Meyts E, Buck Louis GM, Toppari J, Andersson AM, Eisenberg ML, Jensen TK, Jørgensen N, Swan SH, Sapra KJ, Ziebe S, Priskorn L, Juul A. Male Reproductive Disorders and Fertility Trends: Influences of Environment and Genetic Susceptibility. Physiol Rev 2016; 96:55-97. [PMID: 26582516 DOI: 10.1152/physrev.00017.2015] [Citation(s) in RCA: 576] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
It is predicted that Japan and European Union will soon experience appreciable decreases in their populations due to persistently low total fertility rates (TFR) below replacement level (2.1 child per woman). In the United States, where TFR has also declined, there are ethnic differences. Caucasians have rates below replacement, while TFRs among African-Americans and Hispanics are higher. We review possible links between TFR and trends in a range of male reproductive problems, including testicular cancer, disorders of sex development, cryptorchidism, hypospadias, low testosterone levels, poor semen quality, childlessness, changed sex ratio, and increasing demand for assisted reproductive techniques. We present evidence that several adult male reproductive problems arise in utero and are signs of testicular dysgenesis syndrome (TDS). Although TDS might result from genetic mutations, recent evidence suggests that it most often is related to environmental exposures of the fetal testis. However, environmental factors can also affect the adult endocrine system. Based on our review of genetic and environmental factors, we conclude that environmental exposures arising from modern lifestyle, rather than genetics, are the most important factors in the observed trends. These environmental factors might act either directly or via epigenetic mechanisms. In the latter case, the effects of exposures might have an impact for several generations post-exposure. In conclusion, there is an urgent need to prioritize research in reproductive physiology and pathophysiology, particularly in highly industrialized countries facing decreasing populations. We highlight a number of topics that need attention by researchers in human physiology, pathophysiology, environmental health sciences, and demography.
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Affiliation(s)
- Niels E Skakkebaek
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Ewa Rajpert-De Meyts
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Germaine M Buck Louis
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Jorma Toppari
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Michael L Eisenberg
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Tina Kold Jensen
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Shanna H Swan
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Katherine J Sapra
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Søren Ziebe
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Lærke Priskorn
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth & Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Physiology & Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Male Reproductive Medicine & Surgery Program, Stanford University, Stanford, California; Icahn School of Medicine at Mount Sinai, New York, New York; and The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark
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11
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Beier KM, Oezdemir UC, Schlinzig E, Groll A, Hupp E, Hellenschmidt T. "Just dreaming of them": The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ). CHILD ABUSE & NEGLECT 2016; 52:1-10. [PMID: 26773897 DOI: 10.1016/j.chiabu.2015.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/14/2015] [Accepted: 12/16/2015] [Indexed: 06/05/2023]
Abstract
The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ) offers diagnostic and therapeutic help to 12-to-18-year-old juveniles with a sexual preference for the prepubescent and/or early pubescent body of children and who apply for treatment on a voluntary basis. The project goal is to prevent primary or recurrent child sexual abuse as well as primary or recurrent use of child abuse images. Treatment aims to enable affected juveniles to obtain control over their conflictual sexual behaviors. In the present article, the origin of the PPJ; its main approach, including the conception of a media campaign; as well as results from the first year of a three-year study are presented. Further, initial characterizations of juveniles taking part in the project for the first 12 months are provided. The results confirmed that the group of 12-to-18-year-old juveniles with a sexual preference for prepubescent and/or early pubescent minors exists as a target group for primary preventive measures and that they can be assessed for their sexual preferences.
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Affiliation(s)
- Klaus M Beier
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Umut C Oezdemir
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Eliza Schlinzig
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Groll
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Elena Hupp
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Hellenschmidt
- Department of Child and Adolescent Psychiatry at Vivantes Hospital in Friedrichshain, Berlin, Germany
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12
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Ashoor I, Aviles D, Pasternak R, Vehaskari VM. Sexually transmitted infections in pediatric renal transplant recipients: Time to take notice! Pediatr Transplant 2015; 19:584-7. [PMID: 26108149 DOI: 10.1111/petr.12554] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2015] [Indexed: 01/22/2023]
Abstract
We sought to assess the prevalence of STIs, contraception use, and unintentional pregnancy in our pediatric renal transplant recipients. We performed a retrospective chart review. Forty-nine of 65 patients in our program are currently in the high-risk age window of 13 yr or older (34 men, 15 women; mean age 17 yr old, range 13-23 yr old). There was a disproportionate difference in sexual behavior among the men and women, such that while only 15% of the men reported being sexually active, 53% of the women were sexually active. Among high-risk age-group women, 40% were on hormonal contraception. This increased to 75% in sexually active women. There were no cases of unintentional pregnancy. Thirty percent of sexually active recipients had at least one STI. This was higher among sexually active women (37.5%) compared to men (20%). STIs identified included gonococcal and chlamydial urethritis/cervicitis, Trichomonas vaginitis, HSV-2 genital sores, pelvic inflammatory disease, and HIV. In conclusion, STIs are a realistic public health concern in our pediatric renal transplant recipients. Consensus guidelines on STI screening and reproductive health counseling are needed to address this understudied problem.
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Affiliation(s)
- Isa Ashoor
- Nephrology, Children's Hospital of New Orleans, New Orleans, LA, USA
| | - Diego Aviles
- Nephrology, Children's Hospital of New Orleans, New Orleans, LA, USA
| | - Ryan Pasternak
- Adolescent Medicine, Children's Hospital of New Orleans, New Orleans, LA, USA
| | - Vesa M Vehaskari
- Nephrology, Children's Hospital of New Orleans, New Orleans, LA, USA
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13
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Cantor JM, McPhail IV. Sensitivity and Specificity of the Phallometric Test for Hebephilia. J Sex Med 2015; 12:1940-50. [DOI: 10.1111/jsm.12970] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Håkonsen LB, Olsen J, Støvring H, Ernst A, Thulstrup AM, Zhu JL, Shrestha A, Ramlau-Hansen CH. Maternal cigarette smoking during pregnancy and pubertal development in sons. A follow-up study of a birth cohort. Andrology 2013; 1:348-55. [PMID: 23335592 DOI: 10.1111/j.2047-2927.2012.00038.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Revised: 08/30/2012] [Accepted: 10/09/2012] [Indexed: 11/28/2022]
Abstract
Epidemiological studies have raised concern about the reproductive consequences of prenatal cigarette smoking exposure, possibly affecting semen quality and onset of pubertal development of the offspring. The aim of this study was to further investigate pubertal development in young men exposed to cigarette smoking in foetal life. In a Danish pregnancy cohort, information on maternal smoking during pregnancy was available from questionnaires administered in 1984-1987, and information on pubertal development, assessed by age at first nocturnal emission, acne, voice break and regular shaving, was obtained from a follow-up questionnaire administered in 2005 to the young men (age: 18-21). We found no significant association between prenatal cigarette smoking exposure and earlier onset of puberty, but we did observe a tendency towards earlier age of first nocturnal emission, acne and voice break, indicating an accelerated age of pubertal development. Men exposed to ≥15 cigarettes/day had 3.1 months (95% CI: -6.4; 0.2) earlier age at acne and 2.2 months (95% CI: -7.3; 3.0) earlier age at first nocturnal emission, 1.2 months (95% CI: -4.6; 2.2) earlier age at voice break, however, 1.3 months (95% CI: -1.6; 4.3) later age at regular shaving, compared with unexposed men. Prenatal cigarette smoking exposure may induce an earlier age at onset of puberty in young men, but larger studies with prospectively collected data on pubertal development are needed to explore this hypothesis further.
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Affiliation(s)
- L B Håkonsen
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus C, Denmark.
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15
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Tinggaard J, Mieritz MG, Sørensen K, Mouritsen A, Hagen CP, Aksglaede L, Wohlfahrt-Veje C, Juul A. The physiology and timing of male puberty. Curr Opin Endocrinol Diabetes Obes 2012; 19:197-203. [PMID: 22499221 DOI: 10.1097/med.0b013e3283535614] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE OF REVIEW To describe available markers of male puberty, discuss associations between adiposity and pubertal timing and to review recent evidence of a possible secular trend in male pubertal timing. RECENT FINDINGS An expert panel reviewing existing American pubertal data from boys in 2005 could not confirm a secular trend in male pubertal timing. National Health and Nutrition Examination Survey III findings have been confirmed by the National Institute of Child Health and Human Development study reporting a mean age of 10.4 years for Caucasian boys entering Tanner stage G2. Furthermore, the Copenhagen Puberty Study reported a 3 months decline in pubertal onset during a 15-year period (from 11.92 years in 1991 to 11.66 years in 2008).A negative association between obesity and early puberty was found in the National Institute of Child Health and Human Development study, in contrast to the positive association found in a Danish study. Other studies have not been able to document an association between prepubertal BMI and age at pubertal onset. SUMMARY Evaluation of Tanner stage and especially assessment of testicular volume should both be used in epidemiological studies. We speculate that the association between fat mass and pubertal timing may be nonlinear and recent studies may indicate a small decline in age at pubertal onset in boys.
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Affiliation(s)
- Jeanette Tinggaard
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark.
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Cantor JM. The Errors of Karen Franklin's Pretextuality. INTERNATIONAL JOURNAL OF FORENSIC MENTAL HEALTH 2012; 11:59-62. [PMID: 22745581 PMCID: PMC3382737 DOI: 10.1080/14999013.2012.672945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In her recent article, Hebephilia: Quintessence of Diagnostic Pretextuality (published in Behavioral Sciences and the Law, 2010), Karen Franklin expands on her previous argument that psychologists and psychiatrists should not diagnose as abnormal hebephilia, the sexual preference for early pubescent children. She supports her argument with a series of claims about the contents of the empirical literature and the scientists who produced it. The present document provides fact-checking of those claims, revealing that Franklin's conclusions are based largely on demonstrable falsehoods.
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Affiliation(s)
- James M. Cantor
- Law & Mental Health Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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