The wellbeing and health needs of a cohort of transgender young people accessing specialist medical gender-affirming healthcare in Auckland

INTRODUCTION: Increasing numbers of young people are seeking gender-affirming healthcare in Aotearoa New Zealand, and although international studies report health and wellbeing benefits of early medical intervention, we have no published reports on the impact of health services in this country. METHODS: Transgender young people accessing a specialist service providing medical gender-affirming healthcare were invited to take part in a survey about their health and wellbeing. RESULTS: High or very high psychological distress levels were reported by 74% of respondents, with 39% being unable to access mental health support when needed. DISCUSSION: Although the proportion of transgender young people with high or very high levels of psychological distress was five times greater (74%) than for the general population of young people (14.5%) in Aotearoa New Zealand, it was not as large as the proportion found for transgender young people in a community study (86%) in which an unmet need for hormones was reported by 29%. This highlights the need for clear referral pathways to access specialist gender-affirming healthcare services in order to reduce disparities in mental health outcomes

Wellbeing and healthcare access for sexuality and gender minority secondary school students with long-term health conditions

Peer reviewedPublisher PD

Wellbeing and healthcare access for sexuality and gender minority secondary school students with long-term conditions

Objective: To explore the prevalence of long-term health conditions (which includes disorders such as asthma and diabetes, lasting six months or more) among sexuality and gender minority youth (SGMY) within Aotearoa New Zealand, and report on SGMY access to health care services. Method: We used data from a population-based survey (Youth’19) of 7,059 secondary school students in Aotearoa New Zealand. Multivariable logistic regression models were used to investigate the associations of five sex, gender and sexuality groups: heterosexual cisgender females (n=3,127, 44.30%); heterosexual cisgender males (n=2,934, 41.64%); sexuality minority cisgender females (n=659, 9.34%); sexuality minority cisgender males (n=216, 3.06%); and gender minority adolescents (n=123, 1.74%), and the selected outcome variables (i.e., general health, long-term health conditions, difficulties accessing healthcare and talked to a health provider privately). Results: Gender minority adolescents reported the highest odds of having a long-term health condition (adjusted Odds Ratio/aOR=6.69, 95% Confidence Intervals/CI 3.89-11.42) compared to heterosexual cisgender males. Sexuality minority cisgender females and males also had significantly higher odds of having a long-term health condition compared to heterosexual cisgender males. Gender minority youth also reported the highest odds of experiencing difficulties accessing health care (aOR=3.99, 95% CI 2.50-6.36) compared to heterosexual cisgender males. Sexuality minority cisgender females and males were also significantly more likely to experience difficulties accessing healthcare than heterosexual cisgender males. Conclusion: SGMY are more likely to report a long-term health condition compared to their peers and access to health care for SGMY is constrained. Health and social care service providers need to ensure their provisions are safe, accessible, inclusive, and appropriate for SGMY

Multi-proxy evidence for sea level fall at the onset of the Eocene-Oligocene transition

Continental-scale expansion of the East Antarctic Ice Sheet during the Eocene-Oligocene Transition (EOT) is one of the largest non-linear events in Earth's climate history. Declining atmospheric carbon dioxide concentrations and orbital variability triggered glacial expansion and strong feedbacks in the climate system. Prominent among these feedbacks was the repartitioning of biogeochemical cycles between the continental shelves and the deep ocean with falling sea level. Here we present multiple proxies from a shallow shelf location that identify a marked regression and an elevated flux of continental-derived organic matter at the earliest stage of the EOT, a time of deep ocean carbonate dissolution and the extinction of oligotrophic phytoplankton groups. We link these observations using an Earth System model, whereby this first regression delivers a pulse of organic carbon to the oceans that could drive the observed patterns of deep ocean dissolution and acts as a transient negative feedback to climate cooling

Micropaleontological and geochemical dataset of shallow-marine deposits in central Mississippi, US Gulf Coastal Plain

Here we provide extensive micropaleontological and geochemical dataset of shallow-marine deposits that includes palynology and palynomorph component, carbonate fine-fraction stable-isotope, benthic foraminiferal stable-isotope, X-ray fluorescence (XRF), and glycerol dialkyl glycerol tetraether (GDGT) data. Samples were originally collected from the Mossy Grove core, nearby Jackson, central Mississippi, US Gulf Coastal Plain, between August 19, 1991 and September 5, 1991 (Dockery III et al., 1991). The dataset was generated between October 2015 and June 2019 and covers the latest Eocene and earliest Oligocene (~37.5-33.1 million years ago). These data were intended to yield unique multi-proxy records of the critical Eocene-Oligocene Transition, the most prominent climate event in the last 100 million years of Earth's history. Methods for age model, palynology and palynomorph component, carbonate fine-fraction stable-isotope, benthic foraminiferal stable-isotope, X-ray fluorescence (XRF), and glycerol dialkyl glycerol tetraether (GDGT) data follow De Lira Mota et al. (in review)

Benthic foraminifera stable isotope data for the Mossy Grove sediment core

Sample preparation for benthic foraminiferal stable-isotope analyses: Sediment amples were prepared and analyzed at Kochi University. Samples were washed through a 63 μm screen with Calgon in tapwater, and the residue was dried at 50 °C. Specimens of U. jacksonensis were picked from the >150 µm fraction of the residues, and were found to be present in 38 sediment samples. The specimens are well-preserved appearing transparent to translucent in color under the light microscope (Figure S2). Using a Keyence VHX-2000 digital microscope and a JEOL JSM-6500F scanning electron microscope, the preservation of examined specimens was assessed. The light microscopic image is focus stacking. To extend this record down core, a further five samples were prepared at the University of Birmingham. These samples were dried in a low-temperature oven at 40°C for approximately one week in order to obtain a dry bulk sediment weight and then washed over a 63 µm sieve with de-ionised water. The coarse fraction (>63 µm) was dried in the oven and then dry sieved at 250-300 µm and individuals of the infaunal benthic foraminifera genus Uvigerina picked (wherever possible U. jacksonensis was selected). Any sample with more than two individuals was analyzed for stable isotopes (>10 µg). The stable carbon (δ13C) and oxygen (δ18O) isotope analysis of five benthic foraminiferal samples prepared at the University of Birmingham were performed at the British Geological Survey, Keyworth, UK on a dual inlet, gas source, isotope ratio mass spectrometer. The carbonate analysis method involves reacting the carbonate sample with anhydrous phosphoric acid to liberate CO2. All data are reported against Vienna Pee Dee Belemnite standard (VPDB). Calibration of the in-house standard with NBS-19 shows the analytical precision is < ±0.01‰ for both isotope ratios. For the 38 benthic foraminifera samples prepared at Kochi University, we used a Finnigan MAT253 mass-spectrometer system with a Kiel III carbonate device in the Center for Advanced Marine Core Research/Kochi Core Center (CMCR/KCC), Kochi University. Between 2–7 individuals were measured in each sample and were cleaned at least three times, using milli-Q and methanol in a sonic bath. NBS-19 and ANU-m2 were used as stable isotopes standards. The precisions of the measurements (1σ) were 0.18‰ and 0.08‰ for δ13C and δ18O respectively, calculated using 24 repeat measurements of the standard

Fine fraction (<20 µm) bulk stable isotope data for the Mossy Grove sediment core

Sample preparation for carbonate fine-fraction stable-isotope data: A total of 444 bulk sediment samples, taken at ~30 cm spacing from the Mossy Grove Core (MGC), were processed at the University of Birmingham. The sediment was sieved over a 20 µm stainless steel mesh, with the fine fraction passing through the sieve captured on ultra-fine-grade filter paper and air dried. The sediment residue (>20 µm) was then transferred to 50 ml centrifuge tubes and organic matter within this fine fraction removed by overnight reaction with 5% sodium hypochlorite (NaClO) solution. The sample was then spun down at 4,500 rpm (6,800 × g) and the supernatant discarded. The sample was then washed 2-3 times with de-ionized water – each wash consisting of resuspension, agitation and then centrifuging and discarding of the solution as above - until a neutral pH was established. Samples were then weighed to provide sufficient sample mass for sample analysis. The stable carbon (δ13C) and oxygen (δ18O) isotope analysis of 444 fine-fraction sediment samples prepared at the University of Birmingham were performed at the British Geological Survey, Keyworth, UK on a dual inlet, gas source, isotope ratio mass spectrometer. The carbonate analysis method involves reacting the carbonate sample with anhydrous phosphoric acid to liberate CO2. All data are reported against Vienna Pee Dee Belemnite standard (VPDB). Calibration of the in-house standard with NBS-19 shows the analytical precision is < ±0.01‰ for both isotope ratios

Selected palynomorph-based indicators for the Mossy Grove sediment core

Palynology: Altogether, 112 samples collected at ~1.2 m intervals from the Mossy Grove borehole between ~17.0 and 152.0 m were treated with 40% HCl for 30 minutes and 60% HF for 24 hours to dissolve carbonates and disaggregate the rock matrix, and sieved over a 10 µm nylon mesh to retain the HF effluent from the material. A second HCl treatment was applied to remove any precipitate, followed by a final sieving over a 10 µm mesh. The remaining sample material (>10 µm) was subjected to oxidation (70% HNO3 for exactly two minutes) to remove pyrite, debris and any unstructured organic material from the palynomorphs, followed by another sieving over a 10 µm mesh to remove any HNO3 effluent. A final cleaning treatment was undertaken with a combination of domestic and industrial detergents. Using swirling techniques, palynomorphs in each sample were then concentrated and Bismark brown was added to make them more visible with light microscopy. Finally, the samples were sieved into two size fractions, 10-30 μm (concentrating spores and pollen) and 30 μm+ (concentrating dinocysts), and then mounted on separate 22x22 mm coverslips, which were glued to a glass slide using Norland optical adhesive. In this work, only the coarse-fraction content of each slide was analyzed. A pilot survey of these slides revealed that the acid and oxidizing technique yielded higher diversity than their non-acid and non-oxidizing counterparts61. The coarse/fine-fraction sorting follows the premise that pollen and spores size mostly ranges between 11 and 44 µm, whereas dinocysts range between 20 and 150 µm62. All slides are stored in the collection of the School of Geography, Earth and Environmental Sciences, University of Birmingham, and are available upon request from Tom Dunkley Jones. Palynomorph components: In this work, the coarse-fraction content of each slide was analyzed with a Zeiss transmitted light microscope (400x magnification). Two hundred dinocyst specimens were counted in each sample, along with any spores, pollen, algae (prasinophyceae and chlorophyceae), zoomorphs/zooclasts, phytoclasts and amorphous organic matter. Only palynomorphs that were more than 50% complete and not obscured either by air bubbles or organic debris were considered 63. Reworked acritarchs and amorphous organic matter were excluded from the final sum of palynomorphs and thereby from the percentage calculations. Palynomorph-based paleoenvironmental indicators include the peridinioid/gonyaulacoid dinocyst (P/G) ratio 64–70, and salinity reconstructions based on the relative abundance of the high-salinity favoring Homotryblium spp. 43,71–73 and in the ratio of short-to-long process of dinocyst genus Spiniferites 74–78

X-ray fluorescence data for the Mossy Grove sediment core

Elemental composition of the sediment core was determined using two XRF techniques. 2,098 samples on the original core section were directly analyzed at a resolution of ~1.2 cm across the interval 17.1-109.4 m with a hand-held XRF analyzer at the core store of the Mississippi Department of Environmental Quality, in Jackson, Mississippi. A further 179 samples were collected every 20-30 cm downcore, spanning the interval 106.8-151.6 m, and were subsequently finely ground and dried before analysis as pressed powders in wax pellets. Pellets were analyzed with a Bruker S8 TIGER XRF spectrometer with an 8 min analysis time, at the School of Chemistry, University of Birmingham. We selected the (Al+Fe+K+Ti)/Ca ratio as a paleoenvironmental indicator of terrigenous-derived versus marine planktonic carbonate sediment 79,80. The two methodologies were cross-calibrated over an interval of overlap between 106.8 and 109.4 m, with a total of ~80 samples, spanning a range of compositions, cross-correlated from both analysis methods