The Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People is a publication of the World Professional Association for Transgender Health (WPATH). The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming people with safe and effective pathways to achieving lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment. This assistance may include primary care, gynecologic and urologic care, reproductive options, voice and communication therapy, mental health services (e.g., assessment, counseling, psychotherapy), and hormonal and surgical treatments. The SOC are based on the best available science and expert professional consensus. Because most of the research and experience in this field comes from a North American and Western European perspective, adaptations of the SOC to other parts ...

Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

In 1993 Oliver and Hyde conducted a meta-analysis on gender differences in sexuality. The current study updated that analysis with current research and methods. Evolutionary psychology, cognitive social learning theory, social structural theory, and the gender similarities hypothesis provided predictions about gender differences in sexuality. We analyzed gender differences in 30 reported sexual behaviors and attitudes for 834 individual samples uncovered in literature searches and 7 large national data sets. In support of evolutionary psychology, results from both the individual studies and the large data sets indicated that men reported slightly more sexual experience and more permissive attitudes than women for most of the variables. However, as predicted by the gender similarities hypothesis, most gender differences in sexual attitudes and behaviors were small. Exceptions were masturbation incidence, pornography use, casual sex, and attitudes toward casual sex, which all yielded medium effect sizes in which male participants reported more sexual behavior or permissive attitudes than female participants. Most effect sizes reported in the current study were comparable to those reported in Oliver and Hyde's study. In support of cognitive social learning theory, year of publication moderated the magnitude of effect sizes, with gender differences for some aspects of sexuality increasing over time and others decreasing. As predicted by social structural theory, nations and ethnic groups with greater gender equity had smaller gender differences for some reported sexual behaviors than nations and ethnic groups with less gender equity. Gender differences decreased with age of the sample for some sexual behaviors and attitudes.

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A meta-analytic review of research on gender differences in sexuality, 1993–2007.

Background
The field of Internet-supported therapeutic interventions has suffered from a lack of clarity and consistency. The absence of professional leadership and of accepted governing approaches, terminology, professional standards, and methodologies has caused this field to be diffused and unstructured. Numerous terms have been used to label and describe the activities conducted over the Internet for mental and physical health purposes: web-based therapy, e-therapy, cybertherapy, eHealth, e-Interventions, computer-mediated interventions, and online therapy (or counseling), among others.

Defining Internet-Supported Therapeutic Interventions

The Health Insurance Portability and Accountability Act, also known as HIPAA, was first delivered to congress in 1996 and consisted of just two Titles. It was designed to protect health insurance coverage for workers and their families while between jobs. It establishes standards for electronic health care transactions and addresses the issues of privacy and security when dealing with Protected Health Information (PHI). HIPAA is applicable only in the United States of America.

The Health Insurance Portability and Accountability Act.

Literature regarding sexual use of the Internet has primarily focused on anecdotal data of clinical cases. This study empirically examines the characteristics and usage patterns of individuals who use the Internet for sexual purposes. The Kalichman Sexual Compulsivity Scale was the primary tool used to divide the sample (n = 9,265) into four groups: nonsexually compulsive (n = 7,738), moderately sexually compulsive (n = 1,007), sexually compulsive (n = 424), and cybersex compulsive (n = 96); 17% of the entire sample scored in the problematic range for sexual compulsivity. Data analysis of the four groups indicated statistically significant differences on descriptive characteristics such as gender, sexual orientation, relationship status, and occupation. In addition, patterns of use differed across groups including the primary method of pursuing sexual materials, primary location of accessing sexual material, and the extent to which cybersex has interfered with a respondent's life. This study is o...

Cybersex users, abusers, and compulsives: New findings and implications

A large study (N = 7,037) was conducted through the MSNBC website during June 2000 to explore the general profile of people who engage in online sexual activity (OSA) as well as gender differences in OSA. The study explored ways in which the Internet is used for sexual activities, reasons for engaging in OSA, and consequences of use. The study found a relationship between use of OSA and its consequences in users' lives as well as significant gender differences in user profiles. Significant gender differences were found in reasons respondents gave for engaging in OSA and OSA-related behaviors. Overall, these findings increase our understanding of the user profiles of people who engage in OSA and corroborate gender differences in offline research. Implications for further research are discussed.

Toward an increased understanding of user demographics in online sexual activities.

Counseling and therapy on the Internet.

Table of Contents PREAMBLE SCOPE INTRODUCTION Internet-Based Telemental Health Models of Care Today CLINICAL GUIDELINES A. Professional and Patient Identity and Location 1. Provider and Patient Identity Verification 2. Provider and Patient Location Documentation 3. Contact Information Verification for Professional and Patient 4. Verification of Expectations Regarding Contact Between Sessions B. Patient Appropriateness for Videoconferencing-Based Telemental Health 1. Appropriateness of Videoconferencing in Settings Where Professional Staff Are Not Immediately Available C. Informed Consent D. Physical Environment E. Communication and Collaboration with the Patient's Treatment Team F. Emergency Management 1. Education and Training 2. Jurisdictional Mental Health Involuntary Hospitalization Laws 3. Patient Safety When Providing Services in a Setting with Immediately Available Professionals 4. Patient Safety When Providing Services in a Setting Without Immediately Available Professional Staff 5. Patient Support Person and Uncooperative Patients 6. Transportation 7. Local Emergency Personnel G. Medical Issues H. Referral Resources I .Community and Cultural Competency TECHNICAL GUIDELINES A. Videoconferencing Applications B. Device Characteristics C. Connectivity D. Privacy ADMINISTRATIVE GUIDELINES A. Qualification and Training of Professionals B. Documentation and Record Keeping C. Payment and Billing REFERENCES.

ATA practice guidelines for video-based online mental health services.

As telecommunication technologies have become more widely available and affordable, opportunities for psychologists to engage in telebehavioral health (TBH) have expanded greatly. A national sample of 164 professional psychologists completed a 28-item survey focusing on (a) current and anticipated use of telecommunication technologies in delivering TBH services, (b) types of telecommunication modalities currently used in clinical practice, (c) ethical and legal/regulatory concerns related to delivery of TBH services, and (d) educational and training needs for TBH practice. Associations between demographic factors (i.e., age, gender, practice setting, practice region, and years since completion of highest academic degree) and responses on survey items were examined. In descending order, the technologies most commonly used by psychologists were: landline telephone, mobile telephone, e-mail, and videoconferencing. A lower proportion of psychologists working in public settings used landline telephones, mobile telephones, or e-mail to deliver TBH than that of psychologists engaged in independent practice. In regard to respondents’ age, the proportion of psychologists delivering TBH collapsed across technologies was substantially higher among respondents 37 years of age or older compared with that of 36-year-olds or younger. Respondents also noted several ethical/legal barriers in providing TBH services, particularly managing emergencies, licensure requirements, and uncertainties about security, as well as confidentiality, Health Insurance Portability and Account Act (HIPAA) compliance, and malpractice insurance coverage. Overall, a substantial discrepancy was noted between psychologists’ positive appraisals of TBH and actual implementation, underscoring the ongoing barriers in the adoption of telehealth technologies in practice. Future directions addressed the need for training and education in TBH best practices.

Marlene M. Maheu

Papers

Toward an increased understanding of user demographics in online sexual activities.

Counseling and therapy on the Internet.

ATA practice guidelines for video-based online mental health services.

Survey of psychologists’ telebehavioral health practices: Technology use, ethical issues, and training needs.

Sexuality and the Internet: The next sexual revolution.