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Transsexualism is a condition in which a person identifies with a physical sex different from the one that they were born with or assigned in cases where ambiguity of the child's sex organs led to assigning them a physical sex.
Transsexualism is considered a taboo subject in many parts of the world and has become more widely known in Western nations in the late 20th century due to the sexual revolution, but remains a highly controversial topic. Negativism and discrimination about transsexualism may stem from religious beliefs or cultural norms.
Descriptions from classical mythology, classical history, Renaissance and nineteenth-century history plus cultural anthropology point to the long-standing diversity of gender, and the ways it was expressed. Many cultures around the world and throughout time have not only held a place for transsexuals within their societies but even culturally sanction them, for example, the so-called two-spirit people in native American tribes[1].
- 1 Gender dysphoria
- 2 Defining transsexualism
- 3 Prevalence
- 4 Causes of transsexualism
- 5 Psychological treatment
- 6 Sex reassignment therapy
- 7 Legal and social aspects
- 8 Coming out
- 9 Regrets and detransitions
- 10 Depictions of transsexualism in the media
- 11 Transsexualism in non-Western cultures
- 12 See also
- 13 Discuss
Gender dysphoria
Most transsexuals agree with the idea proposed by Harry Benjamin, that gender is hard-wired in the brain before birth. As such, most transsexuals believe that being transsexual is instead an intersex condition, a congenital birth issue unseen by others due to its location in the brain: a mis-match in the sex of a person between that of the brain and that of the body. The main symptom of this condition is a unique type of depression, anxiety or even psychological pain: Gender Dysphoria. Most transsexuals assert that their brain-based inner perception of their sexual self, their identity, is who they really are, and so change their physical sex in an effort to be on the outside as they feel they are on the inside. If untreated, it can lead to mental and emotional problems, and sometimes suicide.
Most transsexual men and women desire to establish a permanent social role as a member of the gender with which they identify. Many transsexual people also desire various types of medical alterations to their bodies. These physical alterations are collectively referred to as sex reassignment therapy and often include hormone replacement therapy and surgery. The entire process of switching from one physical sex and social gender presentation to the other is often referred to as transition, and usually takes several years.
To obtain sex reassignment therapy, transsexual people are usually required to receive psychological therapy and a diagnosis of gender identity disorder in accordance with the Standards of Care (SOC) as issued by the World Professional Association for Transgender Health (formerly and until 2006 the Harry Benjamin International Gender Dysphoria Association). These are guidelines as the medical community struggles in how to deal with the treatment, and the nature of the treatment population changes, and are not obligatory. Some doctors may waive the psychotherapy requirement as an unnecessary expense in an emotionally mature and stable individual, or require only a psychological evaluation. The intentions of the standard are to prevent people from transitioning when such a transition would be inappropriate (as a dramatic example, a person seeking to transition in order to veil their identity from police), or ill-advised (e.g., a strong crossdresser, who still identifies themselves as their assigned gender), and other cases where if a transition were undertaken, it would be expected to have strongly negative consequences for the patient.
These standards are open to the criticism of being ineffective, or being too strict, discouraging genuinely transsexual people from seeking treatment. It is claimed that Meta-reviews of post-operative transsexuals prior to 1991 reveal a rate of serious regrets of less than 1% for transsexual men and less than 2% for transsexual women, while studies published after 1991 have reported a decrease in the rates for both, likely due to improved psychological and surgical treatments and increasing acceptance from society.[2]While such studies lend support for existing protocols concerning care of transsexuals, post-operative follow-up research is considered to be lacking. However a note on a report in the UK Guardian Newspaper states:
There is no conclusive evidence that sex change operations improve the lives of transsexuals, with many people remaining severely distressed and even suicidal after the operation, according to a medical review conducted exclusively for Guardian Weekend tomorrow.
The review of more than 100 international medical studies of post-operative transsexuals by the University of Birmingham's aggressive research intelligence facility (Arif) found no robust scientific evidence that gender reassignment surgery is clinically effective.[3]
Against the statistic above indicating that 1% to 2% of post-operative persons have serious regrets, the Report itself states:
Paradoxically, a growing number of post-operative transsexuals are scathing about their medical care. International research suggests that 3-18% of them come to regret switching gender.[4]
For both men and women, medical treatment typically begins with hormone replacement therapy. Trans women are usually required to live as members of their target sex for at least one year prior to genital surgery (so-called Real-Life Test or Real-Life Experience), although this time may be longer if the psychotherapist has concerns about the transsexual person's readiness. Trans men must generally wait two to three years after beginning testosterone treatment in order to allow for sufficient clitoral growth. However, some transsexuals, especially among men, may not wish to have this surgery. Others can spend years or even decades saving up enough money to pay for it. Some women may have only orchiectomy and forego vaginoplasty. There are many reasons why some transsexuals opt out of genital surgery. Among these are cost (female-to-male (FTM) surgery can cost up to $80,000), surgical risks, (including genital nerve damage), and acceptance of a certain amount of physical deformity.
For female-to-male (FTM) mastectomy and chest reconstruction, the requirement is only either 3 months of psychological therapy or the same amount of time of Real-Life-Test. The latter may be impossible for trans men with large breasts, and while binding smaller breasts is partially effective, this can cause many health issues if done over a long period of time. Many transsexuals find these requirements to be unjust as cisnatal men and women are not required to undergo any psychological evaluation or wait times to undergo chest reconstructive surgery. However, an 18 month requirement for trans women to have breast augmentation is typically to allow enough time for breast development due to hormones. Breast augmentation before the breasts have finished developing can result in poor shape.
Currently, the causes of transsexualism are unknown, and estimates of prevalence vary substantially. It is commonly believed that it is a multifactorial condition, having many and different causes, some of which may include a naturally occurring variation in fetal sex differentiation and development. Causes may include some medications or hormones given to pregnant mothers, such as diethylstilbestrol. According to a medical advisory bulletin from Gender.org (Sep. 2002), as many as 25% of the FTM population has polycystic ovarian syndrome, a condition known to cause hormonal fluctuations.
Defining transsexualism
Transsexualism (also known as transsexuality) is a complex condition that is defined differently by different people. Many terms have been proposed through the years to describe transsexual people and the processes they go through. As with any terms used by a group, or to refer to a particular group, some of these terms are controversial, or have become controversial, not only to society at large, but even among the transsexual community.
The definition of "transsexuality" is somewhat debated. One common definition is that a transsexual is a person who believes that his or her body does not reflect his or her true 'inner' identification of physical sex or gender. Another common definition is that a transsexual is a person who has had or plans to have medical or surgical treatments that alter his or her body to better reflect what the individual believes is his or her true gender. The first definition allows greater freedom for individuals to self-identify as a transsexual. The latter defines the term based on actual or planned operative status and makes it more an external label than a term of self-definition.
The two terms of sex and gender have become popularly used as one concept, which blurs distinction, but they have different meanings. Physical sex refers more to one's biology and anatomy (that is, male or female) where gender is a more socio-cultural term of how a person presents or is taken (that is more at man or woman, or "like" a male or female" (see Milton Diamond, Ph.D. 2001 or U.S.S.C. Justice Antonin Scalia saying "The word gender has acquired the new and useful connotation of cultural or attitudinal characteristics (as opposed to physical characteristics) distinctive to the sexes. That is to say, gender is to sex as feminine is to female and masculine is to male.")
When genital surgery is undertaken it is commonly referred to as sex reassignment surgery or genital reconstructive surgery or even gender reassignment surgery by some health care providers and community members. An older term, sex change surgery may be seen as disrespectful.
The Diagnostic and Statistical Manual of Mental Disorders accepts the expression of desire to be of the opposite sex, or assertion that one is of the sex opposite from the one with which they were assigned at birth, as sufficient for being transsexual.[5] The ICD-10 states in a similar way that transsexualism is defined by, "the desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his, or her body as congruent as possible with the preferred sex through surgery and hormone treatment." In contrast, transgenderists do not identify as being of, or desiring to be the opposite sex, but as being of or wanting to be another gender.
Transsexualism has been variously described as a trait, disease, behavior, desire, mental illness, perversion, paraphilia, political identity, and lifestyle. The term perversion is often used in a derogatory manner (especially by Western religions). People may consider the use of such labels offensive whether they are or are not transsexual, or involved with Western religions, themselves.
Transsexualism is often included within the broader term transgender, which is generally considered an umbrella term for people who do not conform to typical accepted gender roles, for example cross-dressers, drag queens, and people who identify as genderqueer. However, some transsexuals object to this inclusion. Historically the reason that transsexuals rejected associations with the transgender or broader LGBT community is largely that the medical community in the 1950s through the late 1980s encouraged (and in many ways required) this rejection of such a grouping in order to be a 'good transsexual' who would thus be allowed to access medical and surgical care. The animosity that is present today is no longer fed by this same kind of pressure from the medical community (indeed, today many gender therapists actively encourage their clients to explore support within the broader community.)
However, where some of the beliefs of modern day transsexual people that they are not transgender, is reflective of this historical division (Denny 176), other transsexual people state that someone choosing to retain their former physical sex (no SRS) is very different from someone who needs to be of "the other sex", that the groups have different issues and concerns and are not doing the same things. The latter view is rather contested, with opponents pointing out that merely having or not having some medical procedures hardly can have such far-reaching consequences as to put those who have them and those who have not into such distinctive categories.
Regardless of definition, transsexualism should not be confused with cross dressing or with the behaviour of drag queens and drag kings, which can be described as transgender but not transsexual. Also, transvestic fetishism usually has little, if anything, to do with transsexualism. As a general rule, transsexual people tend to dress and behave in a manner consistent with the gender they identify with, crossdressers tend to dress (and sometimes behave) in a manner consistent with stereotypical ideals of the opposite gender as opposed to the real-life behavior of that gender, and "drag queens" or "drag kings" tend to dress and behave in a flamboyant manner which parodies rather than emulates the opposite gender.
Gender terminology for transsexual people
Transsexual people almost universally prefer to be referred to by the gender pronouns and terms associated with their target gender. For example, a transsexual man is a person who was assigned the female sex at birth on the basis of his genitals, but despite that assignment identifies as a man and is transitioning or has transitioned to a male gender role and has or will have a masculine body. Transsexual people are sometimes referred to with "assigned-to-target" sex terms such as "female-to-male" for a transsexual man or "male-to-female" for a transsexual woman. These terms may be abbreviated as "M2F", "F2M", "MTF", "F to M", etc. These terms are particularly helpful in preventing confusion, because to some people the term "transsexual woman" is a female transitioning to become a male, and to others a male transitioning to become a female. When the terms trans men and trans women are used though, it is typical for them to be used to refer to the gender that the person identifies with, regardless of their appearance or state of transition.
Transsexual people are often considered as part of the LGBT community, and although many do identify with this community, others do not, or prefer not to use the terms at all. Transsexual people typically feel it important for people to understand that transsexualism neither depends upon, nor is related to, sexual orientation. Transsexual men and women exhibit a range of sexual orientations just as non-transsexual (some times referred to as Cisgender) people do, and they will almost always use terms for their sexual orientation that relate to the sex with which they identify. For example, someone assigned to the male sex but who identifies as a woman, and who is attracted solely to men, will identify as heterosexual, not gay. Likewise, someone who was assigned to the female sex, identifies as a man, and prefers male partners will identify as gay, not heterosexual. Transsexual people, like other people, can also be bisexual or asexual as well.
Older medical texts often referred to transsexual people as members of their original sex by referring to a male-to-female transsexual as a "male transsexual". They also described sexual orientation in relation to the person's assigned sex, not their gender of identity; in other words, referring to a male-to-female transsexual who is attracted to men as a "homosexual male transsexual." This usage is considered by many to be scientifically inaccurate and clinically insensitive today. As such someone who would have been referred to as a "homosexual male transsexual" would now be called and most likely identify herself as a heterosexual transsexual woman. Although this usage is dwindling, some medical textbooks still refer to transsexual people as members of their assigned sex, but now many use "assigned-to-target" terms.
Alternative terminology
The transsexual community typically use the short form "trans", or simply "T" as a substitution for the full word "transsexual", e.g. TS, trans guy, trans dyke, T-folk, trans folk. Some may even use term that have become controversial to some, such as tranny and/or trans, despite others considering these terms to be offensive. Those who do use these terms claim that they are diminishing the power of the term as an insult, just as some members of the gay and African-American communities have embraced slurs directed at them. Others feel that the terms are insulting or inaccurate regardless of the context. Some feel that such words are problematic because they do not differentiate between transsexual people, and people who are merely "playing" with gender.
Some individuals may prefer to spell transsexual with only one s, thus writing transexual. They will typically assert that they are attempting to divorce the word from the realm of psychiatry and medicine and place it in the realm of identity. This trend is most common in the United States, and is almost never used in the United Kingdom.[6]
Some prefer the term transsexed over transsexual, as they believe the term sexual found in transsexual is misleading and implies that transsexualism is a sexual orientation. Another justification made for this preference is that they feel it more closely parallels with the term intersex, which is considered by them to be important as more transsexual groups are welcoming them because they feel both groups have much in common. It is, by some definitions, possible to be both intersexed and transsexed. Other attempts to avoid the misleading -sexual have been the increasing acceptance of transgender or trans* and in some areas, transidentity.
Some transsexual people may also prefer transgendered over transsexual, because the issue is about gender rather than sexuality. They make a parallel with intergender, whose issue is about being between (inter) the genders rather than "intersexual". It is often assumed, particularly by transsexual people, that transsexualism is a subset of intersex. "Intersex" previously referred only to those who are genitally intersexed, i.e., with genitals that do not look classically male or female. (Despite the fact that human genitals show an extremely wide variation in general, intersexed people typically have quite obviously ambiguous genitalia that frustrate attempts to assign them within a binary sex system.) However, since sex in humans is composed of many different attributes, such as genes, chromosomes, regulatory proteins, hormones, hormone receptors, body morphology, brain sex, and gender identity, any variation among any of those attributes could fall under the rubric of "intersex." Transsexualism, in this view, simply becomes a form of being neurologically intersexed. (See below for research of physiological causes of transsexualism).
Harry Benjamin agreed with German sexologist Magnus Hirschfeld that transsexuals were a form of neurological intersex.[7] Hirschfeld coined the term "Transvestite" in his seminal work on the matter, Die Transvestitien. In this work, he describes what is now known as transvestic fetishism as well as transsexuals.[8] In 1930, he supervised the first genital reassignment surgery to be reported in detail in a peer-reviewed journal on Lili Elbe of Denmark.
The German term "Transsexualismus†was introduced by Hirschfeld in 1923.[9] The neo-Latin term "psychopathia transexualis†and English "transexual†(sic) were introduced by D. O. Cauldwell in 1949,[10] who subsequently also used the term "trans-sexual†in 1950.[11] Cauldwell appears to be the first to use the term in direct reference to those who desired a change of physiological sex.[12] (In 1969, Benjamin claimed to have been the first to use the term "transsexual†in a public lecture, which he gave in December 1953.[13]) This term continues to be used by the public and medical profession alike.[8] It was included for the first time in the DSM-III in 1980 and again in the DSM-III-R in 1987, where it was located under Disorders Usually First Evident in Infancy, Childhood or Adolescence.
The term "Gender Dysphoria" and "Gender Identity Disorder" were not used until the 1970s[8] when Laub and Fisk[14][15] published several works on transsexualism using these terms. "Transsexualism" was replaced in the DSM-IV by "Gender Identity Disorder in Adolescents and Adults".
Some people prefer that transsexualism be referred to as Harry Benjamin's Syndrome[16] as it follows the naming conventions of intersex conditions. This term is named for Harry Benjamin, a pioneer in sex reassignment and research on transsexual people, whose work of the 50's and 60's, which culminated in The Transsexual Phenomenon in 1966. Many transsexual people who prefer this term assert that scientific research has strongly suggested that their condition is biological rather than psychological in nature. They also feel that 'trans' is misleading, as they believe that their gender was fixed in their brains, and has never changed. Thus that nothing about their steps in correcting themselves is actually "trans" at all, but rather they are simply taking steps to assert what they feel that they are already. A small number of people who are post operative and living in their chosen role prefer to call themselves either a neo-woman or neo-man, thus omitting references in the term 'transsexual' to sexuality or being inbetween (trans).
While the above gives a fairly comprehensive view of terminology, it is important to note that some people may feel that both 'trans' and 'sexual', are misleading, and others may take objections to terminology that are unique to their perspective. While a large variety of other terms exist from those presented here, they have not been excluded with bias, although almost all of them are somewhat controversial.
There are no reliable statistics on the prevalence of transsexualism. The DSM-IV (1994) quotes prevalence of roughly 1 in 30,000 assigned males and 1 in 100,000 assigned females seek sex reassignment surgery in the USA. The most reliable population based estimate of the incidence occurrence is from the Amsterdam Gender Dysphoria Clinic[17] The data, spanning more than four decades in which the clinic has treated roughly 95% of Dutch transsexuals, gives figures of 1:10,000 assigned males and 1:30,000 assigned females.
In September 2007 however, Olyslager and Conway presented a paper[18] at the WPATH 20th International Symposium demonstrating that the data from this and similar studies actually implies much higher prevalence rates, with minimum lower bounds of 1:4,500 assigned males and 1:8,000 assigned females across a number of countries worldwide. They also present other evidence suggesting the actual prevalence might be as high as 1:500 births overall.
Other data presented in the paper implies that the U.S. population of assigned males having already undergone reassignment surgery by the top three U.S. SRS surgeons alone is enough to account for the entire transsexual population implied by the 1:10,000 prevalence number. This of course ignores all other U.S. SRS surgeons, the popularity among U.S. transsexuals of obtaining their surgery in other countries such as Thailand where the cost may be less prohibitive, and the high proportion of transsexuals who have not yet had reassignment surgery or have not yet even sought help for their condition, making that figure (1:10,000) clearly untenable.
Causes of transsexualism
Many psychological causes for transsexualism have been proposed, while research has been presented to suggest that the cause of transsexualism has its roots in biology. There remains no agreement, however, as to the cause of transsexualism.
Some transsexual people and professionals feel that research into causes of transsexualism assumes at face value the legitimacy of a normative gender identity, and/or that transsexualism is contrary to normal development, and could be considered a disease, or syndrome, which a transsexual may feel is stigmatizing. They usually consider such research to be unnecessary, and wonder if such studies might possibly be causing more harm than good for transsexual people.[citation needed]
Meanwhile, other transsexual individuals and professionals believe that transsexualism is, in fact, a syndrome with a physiological basis as a form of intersexuality. Those with this viewpoint generally support research as to the cause, believing that it will verify the theory of a biological origin and thereby reduce social stigma by demonstrating that it is not a delusion, a political statement, or a paraphilia.
Studies indicate that transsexualism is connected with a difference in the human brain called the bed nucleus of the stria terminalis. In one study, male-to-female transsexuals and cisgendered women were shown to have brains that were similar to each other in the BSTc area of the brain. Both heterosexual and homosexual men showed male brain structuring in this area. [19]
Psychological treatment
Psychological techniques that attempt to alter gender identity to one considered appropriate for the person's assigned sex have typically been shown to be ineffective. The internationally accepted and followed Standards of Care note that sometimes the only reasonable and effective course of treatment for transsexual people is to go through sex reassignment therapy.[20][21]
The need for treatment is emphasized by the high rate of mental health problems, including depression, anxiety, and various addictions, as well as a higher suicide rate among untreated transsexual people than in the general population.[22] Many of these problems, in the majority of cases, disappear or decrease significantly after a change of gender role and/or physical characteristics.[23]
Many transgender and transsexual activists, and many caregivers, point out that these problems usually are not related to the gender identity issues themselves, but to problems that arise from dealing with those issues and social problems related to them. Also, many feel that those problems are much more likely to be diagnosed in transsexual people than in the general population, because transsexual people are usually required to visit a mental health professional to obtain approval for hormones and sex reassignment surgery. This exposes the transsexual community to a higher level of evaluation for mental health issues than the general populace.[citation needed]
A growing number of transsexual people are resenting or even refusing psychological treatment which is mandated by the Harry Benjamin Standards of Care, because they believe that gender dysphoria itself is untreatable by psychological means, and that they have no other problems that need treatment. Unfortunately, this can often cause them significant problems when they attempt to obtain physical treatment as health professionals expect such therapy to be occurring concurrently with physical treatment.[citation needed]
Therapists' records reveal that many transsexual people do not believe they need psychological counseling, but rather they will acquiesce to legal and medical expectations in order to gain rights which are thusly granted through the medical/psychological hierarchy. (Brown 103) Legal needs such as a change of sex on legal documents, and medical needs, such as sex reassignment surgery, are usually impossible to obtain without a doctor and/or therapist's approval. Because of this, many transsexual people feel coerced into affirming pre-ordained symptoms of self-loathing, impotence, and sexual-preference, in order to overcome simple legal and medical hurdles. (Brown 107) Transsexual people who do not submit to this medical hierarchy typically face the option of remaining invisible, with no legal rights and possibly with identification documents incongruent with gender presentation.
Diagnosing transsexualism
The current diagnosis for transsexual people who present themselves for psychological treatment is "gender identity disorder" (leaving out those who have sexual identity disorders without gender concerns). As the DSM has changed its terminology, the diagnosis of "transsexualism" has become unused in recent years. This diagnostic label is often necessary to obtain sex reassignment therapy. However, some people diagnosed with gender identity disorder have no desire for sex reassignment therapy at all, particularly not genital reassignment surgery, and/or are not appropriate candidates for such treatment. While some feel that formal diagnosis helps to destigmatize transsexualism, others feel that it only adds stigma, essentially feeling that such a diagnosis is equivalent to saying something really is wrong with them. (Brown 105)
Some people who desire sex reassignment therapy do not have gender identity disorder, as the term is usually defined, and desire to transition for other reasons. This can include homosexual people who are unable to accept their homosexuality (or which were, up until the 1970s, encouraged by caretakers to change their gender role, including SRS), cross-dressers who feel more comfortable dressed as members of the opposite gender and may become confused (although, it may be important to realize that many transsexual women do go through a period where they self-identify as cross-dressers), and people with certain psychiatric disorders, such as schizophrenia, borderline personality disorder, dissociative identity disorder, and Munchausen syndrome. (Brown 106-107) Most professionals believe that sex reassignment therapy is not appropriate for such individuals. (Brown 107) If SRS is performed in such cases, the result is usually expected to be very negative for the individual, since it, unlike with patients with GID, typically does not alleviate issues for them, but rather leaves them with an intolerable body.[24].
However, some transsexual people may suffer from co-morbid psychiatric conditions unrelated to their gender dysphoria. The DSM-IV itself states that in rare instances, gender identity disorder may co-exist with schizophrenia, and that psychiatric disorders are generally not considered contraindications to sex reassignment therapy, that is unless they are the primary cause of the patient's gender dysphoria. (Brown 108) Despite this permissiveness, the process of psychological treatment is usually much more complicated for transsexual people with co-morbid psychiatric conditions.
Some transsexual people have pressured the American Psychiatric Association to remove Gender Identity Disorder from the DSM. Many of these people feel that at least some mental health professionals are being insensitive by labeling transsexualism as "a disease", rather than as an inborn trait. [25] Furthermore, many people express that some psychologists and psychiatrists in viewing transsexualism as "a disease" have sought to develop specific models of transsexualism, which they feel exclude many transsexual people, such as Ray Blanchard's model.
Andrea James in an article rejecting terminology and disease-models of transsexuality, has proposed the terms "interest in feminization" and "interest in masculinization" to refer to a desire for sex reassignment therapy, regardless of whether the person with the desire is transsexual.[26] Although she herself admitted that there are numerous difficulties and issues with this terminology that she herself could easily list, she hasn't advanced this terminology as a finalized terminology, but rather a start towards finding terminology that avoids the traditional issues surrounding transsexuality which describe it as a "disease" or a "deviant" condition.[26] Critics of her terminology would point out that she has swung the pendulum too far in the other direction, now equating transsexuality to a "life-style choice", which often offends those transsexuals who feel that their condition has a biological origin. Andrea herself agreed with this position that transsexuality is not a choice, but she was rather strong in rejecting any assertion that it should be classified as a disease rather than a part of typical human variance.[26]
Other people, under the position that transsexual is a physical condition and not a psychological issue, assert that sex reassignment therapy should be given if requested, and may even align with those who feel that all body modification should be offered on demand. (Brown 103)
Sex reassignment therapy
Main article: Sex reassignment therapy
Sex reassignment therapy (SRT) is an umbrella term for all medical procedures regarding sex reassignment of both transgender and intersexual people. Sometimes SRT is also called gender reassignment, even though many people consider this term inaccurate as SRT alters physical sexual characteristics to more accurately reflect the individual's psychological/social gender identity, rather than vice versa as is implied by the term "gender reassignment."
Sex reassignment therapy can consist of hormone replacement therapy (HRT) to modify secondary sex characteristics, sex reassignment surgery to alter primary sex characteristics, and permanent hair removal for trans women.
In addition to undergoing medical procedures, transsexual people who go through sex reassignment therapy usually change their social gender roles, legal names and legal sex designation. The entire process of change from one gender presentation to another is known as transition.
Many Western societies have procedures whereby an individual can change their name, and sometimes, their legal gender, to reflect their gender identity (see Legal aspects of transsexualism). Laws regarding changes to the legal status of transsexuals are different from country to country. Within the US, some state jurisdictions do allow amendments or complete replacement of the original birth certificates. Some jurisdictions may even seal earlier records against all but court orders in order to protect the transsexual's privacy.
In many other countries, it is still not possible to change birth records or other legal documents relating to ones gender status. Since many governments are revising the legal status of post-operative transsexuals, there are many individuals pioneering changes to these laws, such as Estelle Asmodelle whose book documents her struggle to change the Australian birth certificate and passport laws, although there are other individuals who are were instrumental in changing laws and thus attaining more acceptance for transsexual people in general.
Medical treatment for transsexual and transgender people is also available in most Western countries. However, transsexual and transgender people challenge the "normative" gender roles of many cultures and often face considerable hatred and prejudice. The film Boys Don't Cry chronicles the case of Brandon Teena, a transsexual man who was raped and murdered after his status was discovered. The project Remembering Our Dead, founded by Gwendolyn Ann Smith, archives numerous cases of transsexual and transgender people being murdered.[27] In the United States, November 20 has been set aside as the "Day of Remembrance" for all murdered transgender people.[28]
Some people who have switched their gender role enter into traditional social institutions such as marriage and the role of parenting. They sometimes adopt or provide foster care for children, as complete sex reassignment therapy inevitably results in infertility. Sometimes, they adopt children who are also transsexual or transgender and help them live according to their gender identity.[citation needed] Some transsexual people have children from before transition. Some of these children continue living with their transitioning/transitioned parent, or retain close contact with them. A recent study shows that this does not harm the development of these children in any way.[29]
The style guides of many media outlets prescribe that a journalist who writes about a transsexual person should use the name and pronouns used by that person. Family members and friends, who are often confused about pronoun usage or the definitions of sex, are frequently instructed in proper pronoun usage, either by the transsexual person or by professionals or other persons familiar with pronoun usage as it relates to transsexual people. Sometimes, transsexual people have to correct their friends and family members many times before they begin to use the proper pronouns consistently.
Coming out
Employment issues
Transsexual people have historically had difficulty maintaining employment. Most transsexual people find it necessary to remain employed during transition in order to cover the costs of living and transition. However, employment discrimination against trans people is rampant and many of them are fired when they come out or are involuntarily outed at work.[30] Transsexual people must decide whether to transition on-the-job[31], or to find a new job when they make their social transition. The transsexual community usually regards this as a personal decision, though those who are fired during transition will have to find new jobs. Finding employment is often a challenge, especially for those in mid-transition.
Legal policies regarding name and gender changes in many countries make it difficult for pre-op transsexual people to conceal their trans status from their employers.[32] Because the Harry Benjamin Standards of Care require a one year RLT prior to SRS, some feel this creates a Catch 22 situation which makes it difficult for transpeople to remain employed or obtain SRS.
In many countries, laws are providing increasing protection from workplace discrimination to transpeople, and an increasing number of companies are including "gender identity" in their non-discrimination policies.[33] However, these laws and policies often have gaps, and they are not always fully implemented and enforced. California has strigent anti-discrimination laws to protect transsexual persons in the workplace and specifically prohibits employers from terminating or refusing to hire persons who are discovered to be transsexual. Member states of the European Union provide employment protection as part of gender discrimination protections following the European Court of Justice decisions in P v S and Cornwall County Council[34]
After transsexual men and women are living full-time as members of their target gender, they may wish to blend in with other members of their new sex, and will avoid revealing their past. They do this believing that it will provide greater peace and security on the other side of a stressful and potentially dangerous transition, and/or because they wish to be seen only as members of their target sex, not as transsexuals.
This behaviour, known as stealth, is recognized by most people in the transsexual community as an individual decision that one must make. Some, however, within and outside the transsexual community, feel that one should be upfront about his or her past, and that stealth living would be dishonest. Some draw a parallel with a perceived need for lesbian and gay people to "come out", and may perceive a failure to do so as betrayal of a greater community, seeing hope for advancement of civil rights and public image in the visibility of greater numbers. However, most people within the community understand that revealing one's transsexual history is a deeply personal choice. Moreover, this is part of an individual's medical history, and as such should be his or hers alone to disclose.
Several examples also exist of people who have been denied medical treatment upon discovery of their trans status, whether it was revealed by the patient or inadvertently discovered by the doctors. For example, Leslie Feinberg was once turned away from a hospital emergency room where he had sought treatment for encephalitis.[35](Feinberg 2) Like Tipton, Feinberg was presenting as a man but had female genital anatomy. He nearly died after being denied treatment. Feinberg's case demonstrates one of the many dangers of actually being discovered. Additionally, Tyra Hunter died after being denied care by paramedics and emergency room physicians after she was injured in an automobile accident.
The equating of "coming out" (whereby a transsexual person who has hidden their true gender identity while maintaining their originally assigned gender role, reveals their true self) with honesty or social activism has been countered by the explanation that, because of prejudice, sensationalism, and the triggering of unconscious personal feelings and emotions, knowledge of someone's transsexual past can prevent the average person from being able to see the transitioned person's true self.
Regrets and detransitions
After transitioning, transsexual people sometimes regret their transition, or even choose to detransition to their original sex. However, every recent study done on the number of detransitions states that their number is well below 1%, and that the reasons for detransitioning are very diverse.[2]
In a 2001 study of 232 MTF patients who underwent GRS with Dr. Toby Meltzer, none of the patients reported complete regret and only 6% reported partial or occasional regrets.[36] Minister and former transgender Jerry Leach, in association with Exodus International, includes stories from regretful trans patients as part of his "sexual addiction" ministry website.[37]
These cases are often cited as reasons for the lengthy triadic process outlined in the Standards of Care, which specifies a treatment process combining psychological, hormonal, and surgical care. While many have criticized this process as being too slow for some, it is argued that without the safeguards within the Standards of Care, the incidence of unsuccessful surgical transitions would be much higher. This is also questioned by many critics, especially with regard to particular demands of some caregivers. The article above states that in some of these cases, transitioning could have been prevented if some demands made by caregivers, or demands perceived as coming from the caregivers, had been less rigid; particularly, if the patients had not felt that talking about any problems or doubts would jeopardize their further treatment. An unwavering demand for medical treatment and the absolute conviction of "doing the right thing" is often seen as a necessity for the diagnosis of transsexualism, and therefore the prerequisite for any further treatment; consequently, further treatment has been denied to people who uttered any doubts or even questions.
Critics claim that when patients cannot talk about problems or doubts, but have to present themselves as having neither, the patients, anxious to get treatment they perceive at this point to be absolutely necessary, will face these problems or doubts after transitioning, when dealing with them may be much more difficult, and this will often lead to social problems, depression, anxiety, or other problems. They believe that, in some cases, this may lead to a retransitioning. While there is no scientific study on the question, many trans*-organizations and groups claim that patients who feel less pressure to conform to any particular stereotype will have more satisfactory outcomes after transition. This does not preclude any screening for mental problems which might lead to pseudo-transsexualism, nor supportive psychological therapy, if necessary.
Additionally, some people detransition after SRS because their desire was to undergo SRS and continue living in the gender role assigned to them at birth.[38] However, they transition temporarily in order to satisfy the requirement of a real-life test.
Depictions of transsexualism in the media
Although many transsexual people are modest about their bodies, and are found in all walks of life and professions, transsexual women are commonly featured in pornographic works. When depicted without having undergone vaginoplasty, they are usually referred to as "shemales". While some pre-operative trans women call themselves and others like them "shemales," the term is regarded as offensive by many transsexual people.[39]
Films depicting transgender issues include The World According to Garp and The Crying Game. The film Different for Girls is notable for its depiction of a transsexual woman who meets up with, and forms a romantic relationship with, her former best friend from her all-male boarding school. Ma Vie en Rose portrays a six-year-old child who is gender variant.
Two notable films depict transphobic violence based on true events: Soldier's Girl (about the relationship between Barry Winchell and Calpernia Addams, and Winchell's subsequent murder) and Boys Don't Cry (about Brandon Teena's murder).
Transsexual people have also been depicted in some popular television shows. In Just Shoot Me!, David Spade's character meets up with his childhood male friend, who has transitioned to living as a woman. After initially being frightened, he eventually forms sexual attraction to his friend, but is scorned, as he is 'not her type'. In an episode of Becker Dr. Becker gets an out-of-town visit from an old friend who turns out to have undergone SRS, it plays out very similar to the situations in Just Shoot Me!. In a 1980s episode of The Love Boat, McKenzie Phillips portrays a trans woman who is eventually accepted as a friend by her old high school classmate, series regular Fred Grandy. In the 80's. on "The Jefferson" one of George's navy buddies 'Eddie' shows up as a woman 'Edie' and is eventually accepted by George.
In the television show, "Ugly Betty", the character Alexis Meade (Portrayed by Rebecca Romijn), formerly Alex Meade, is a post-op transsexual who, before transitioning, faked her own death so she could start her life over as a woman. When Alexis realizes that she can get back at her father (who said he would rather see her dead than as a woman) she comes out of stealth and takes over their business after she tips the authorities off that her father killed Fey Sommers, a character whose death immediately preceded the start of the first series. A serious car accident later leaves Alexis with amnesia, and she forgets the entire previous two years - including her transition from male to female.
The series Law & Order and Nip/Tuck have had transsexual characters, but they were played by non-transsexual women or professional cross-dressers. The series Without a Trace featured an episode in which a transsexual woman went missing and is almost killed by her ex-wife's husband after visiting her family, which she abandoned before transtioning. CSI: Crime Scene Investigation had an episode dealing with a transsexual victim, Ch-Ch-Changes.[40] Many transsexual actresses and extras appeared on the episode, including Marci Bowers and Calpernia Addams.[41] The trans woman victim, Wendy, was played by Sarah Buxton, a cisgender woman. Addams has appeared in numerous movies and television shows, including the 2005 movie Transamerica, in which Felicity Huffman portrays a pre-op transsexual woman.[42]
Recently, Candis Cayne, a transsexual performer, appeared in CSI: NY as a transsexual character. Beginning in the fall 2007 TV season, Candis will also play a transsexual character (this time reoccurring) in the new ABC series, Dirty Sexy Money.
In fall 2005, the Sundance Channel aired a documentary series known as TransGeneration. This series focused on four transsexual college students, including two trans women and two trans men, in various stages of transition.[43] In February 2006, LOGO aired Beautiful Daughters, a documentary film about the first all-trans cast of The Vagina Monologues, which included Addams, Lynn Conway, Andrea James, and Leslie Townsend.[44]
Thomas Harris' Silence of the Lambs included a serial killer who considered himself a transsexual. After being turned down for sex reassignment surgery due to not meeting necessary psychological evaluations, he then harvested female bodies to make a feminine suit. While the movie and novel initially sparked more intolerance toward transsexuals, it has since diminished from public criticism of transsexuality.[45]
Transsexualism in non-Western cultures
Transsexual people experience varying degrees of acceptance in non-Western societies.
Before the Islamic Revolution in 1979, the issue of transsexualism in Iran had never been officially addressed by the government. Beginning in the mid-1980s, however, transgendered individuals have been officially recognized by the government and allowed to undergo sex reassignment surgery. (See Transsexuality in Iran)
This stance is also seen in countries such as Brazil and Thailand. Thailand is thought to have the highest prevalence of transsexualism in the world. In Thailand, kathoey (who are often, but not always, transsexual) are accepted to a greater extent than in most countries, but are not completely free of societal stigma. Feminine transsexual kathoey are much more accepted than gay male kathoey; this may be seen as an example of heteronormativity. Due to the relative prevalence and acceptance of transsexualism in Thailand, there are many accomplished Thai surgeons who are specialized in sex reassignment surgery. Thai surgeons are a popular option for Western transpeople seeking surgery, largely due to the lower cost of surgery in Thailand.
Transsexual people are gaining acceptance in much of Latin America, and sex reassignment surgeries are on the rise in Mexico, Argentina and Brazil. [citation needed]
Transgender-related issues remain largely taboo in much of Africa and in developing countries around the world.[46]
See also
- ↑ Two-Spirit People: Native American Gender Identity, Sexuality, and Spirituality 1997 U. Illinois, p.100 Sabine Lang et. al.
- ↑ 2.0 2.1 Kuiper, A.J; P.T. Cohen-Kettenis (September 1998). "Gender Role Reversal among Postoperative Transsexuals". International Journal of Transgenderism 2 (3). Retrieved on 2007-02-25.
- ↑ Sex changes are not effective, say researchers | Society | Society Guardian
- ↑ The Guardian Saturday July 31, 2004
- ↑ BehaveNet - Gender Identity Disorder
- ↑ Transexual, transsexual, and restricted Google searches - Language Log
- ↑ Detail of conversation between Benjamin and Hirschfeld re. neurological intersex
- ↑ 8.0 8.1 8.2 Pauly MD, Ira B. (28 May 1993). "Terminology and Classification of Gender Identity Disorders". Journal of Psychology & Human Sexuality 5 (4): 1-12. Template:ISSN. Retrieved on 2007-02-26.
- ↑ Hirschfeld, Magnus; "Die intersexuelle Konstitution†in Jarhbuch fuer sexuelle Zwischenstufen 1923.
- ↑ Cauldwell, David Oliver. "Psychopathia Transexualisâ€, Sexology: Sex Science Magazine vol. 16 (1949),
- ↑ Cauldwell, David Oliver. Questions and Answers on the Sex Life and Sexual Problems of Trans-Sexuals: Trans-Sexuals Are Individuals of One Sex and Apparently Psychologically of the Opposite Sex. Trans-Sexuals Include Heterosexuals, Homosexuals, Bisexuals and Others. A Large Element of Transvestites Have Trans-Sexual Leanings. (1950) Haldeman-Julius Big Blue Book B-856.
- ↑ Meyerowitz, Joanne Jay; How Sex Changed: A History of Transsexuality in the United States.
- ↑ Benjamin, H. "Introductionâ€, Transsexualism and Sex Reassignment Green, R. and Money, J. (editors, 1969) Baltimore: The Johns Hopkins Press.
- ↑ Laub, D. R.; N. Fisk (April 1974). "A rehabilitation program for gender dysphoria syndrome by surgical sex change". Plast Reconstr Surg. 53 (4): 388-403. PMID 4592953. Retrieved on 2007-02-26.
- ↑ Fisk, N. (1974). "Gender Dysphoria Syndrome. In D. Laub & P. Gandy (Eds.)". Proceedings of the Second Interdisciplinary Symposium on Gender Dysphoria Syndrome: 7-14.
- ↑ Harry Benjamin's Syndrome - definition and aetiology - HBS group
- ↑ van Kesteren, Paul J. M; Henk Asscheman, Jos A. J Megens, Louis J. G Gooren (1997). "Mortality and morbidity in transsexual subjects treated with cross-sex hormones". J. Clin. endocrinol. 47 (3): 337–343. Blackwell, Oxford, UK. doi:10.1046/j.1365-2265.1997.2601068.x. PMID 9373456. Retrieved on 2007-02-25.
- ↑ Olyslager, Femke; Lynn Conway (2007). "On the Calculation of the Prevalence of Transsexualism".
- ↑ Brain Study on Transsexuals - BSTc shows biological link
- ↑ Endocrine Treatment of Transsexual People: A Review of Treatment Regimens, Outcomes, and Adverse Effects, Eva Moore, Amy Wisniewski and Adrian Dobs
- ↑ Standards of Care, WPATH
- ↑ Seattle and King County Health - Transgender Health
- ↑ The International Transsexual Sisterhood - Study On Transsexuality
- ↑ What can I do about this? Is there hope for me? - transsexual.org
- ↑ Becoming a Visible Man p.79, Vanderbilt University Press (May 2004), Jamison Green
- ↑ 26.0 26.1 26.2 A defining moment in our history - TS Road Map
- ↑ Remembering Our Dead - a memorial to transgender people who have been murdered
- ↑ Don't Forget Transgender Day of Rememberance by Jamie Tyroler, January 18, 2008 Kansas City Camp
- ↑ Green, MD JD FRCPsych, Richard (December 1998). "Transsexuals´ Children". International Journal of Transgenderism 2 (4). Retrieved on 2007-02-25.
- ↑ Work transition for transsexual women - TS Road Map
- ↑ Making a successful transition at work - helpful guide by Jessica McKinnon and sample transition-related documents
- ↑ Weiss, Jillian Todd (2001). "The Gender Caste System: Identity, Privacy and Heteronormativity". Tulane Law School. Retrieved on 2007-02-25.
- ↑ Workplace Discrimination: Gender Identity or Expression - Human Rights Campaign Foundation
- ↑ Judgment of the Court of 30 April 1996. - P v S and Cornwall County Council. - Reference for a preliminary ruling: Industrial Tribunal, Truro - United Kingdom. - Equal treatment for men and women - Dismissal of a transsexual. - Case C-13/94 - European Court reports 1996 Page I-02143
- ↑ Leslie Feinberg, Trans Liberation: Beyond Pink Or Blue pages 2-4; Beacon Press, 1998; ISBN 0807079510
- ↑ Factors Associated with Satisfaction or Regret Following Male-to-Female SRS - Anne Lawrence, M.D., Ph.D
- ↑ Reality Resources Publications
- ↑ Potential complications of vaginoplasty - TS Road Map
- ↑ What's Offensive - discussion of offensive transsexual terminology
- ↑ CSI: Crime Scene Investigation / Ch-Ch-Changes at the Internet Movie Database
- ↑ Calpernia Addams
- ↑ Transamerica at the Internet Movie Database
- ↑ TransGeneration at the Internet Movie Database
- ↑ Beautiful Daughters - LOGO (TV channel) Documentary
- ↑ Silence of the Lambs at the Internet Movie Database
- ↑ Template:Cite conference
- Burns, Christine: Why Phrasebook Diversity is not Enough (Press for Change)
- Brown, Mildred L.; Chloe Ann Rounsley (1996). True Selves: Understanding Transsexualism - For Families, Friends, Coworkers, and Helping Professionals. Jossey-Bass. ISBN 978-0787967024.
- Feinberg, Leslie (1999). Trans Liberation : Beyond Pink or Blue. Beacon Press. ISBN 978-0807079515.
- Standards of Care for Gender Identity Disorders, Sixth Version. - World Professional Association for Transgender Health (2001)
- Kruijver, Frank P. M.; Jiang-Ning Zhou, Chris W. Pool, Michel A. Hofman, Louis J. G. Gooren and Dick F. Swaab (2000). "Male-to-Female Transsexuals Have Female Neuron Numbers in a Limbic Nucleus". Journal of Clinical Endocrinology & Metabolism 85 (5): 2034-2041. doi:10.1126. Retrieved on 2007-02-25.
- Schneider, Harald J.; Johanna Pickel, Günter K. Stalla (2006). "Typical female 2nd-4th finger length (2D:4D) ratios in male-to-female transsexuals-possible implications for prenatal androgen exposure". International Society of Psychoneuroendocrinology 31 (2): 265-269. Elsevier, Oxford, UK. Template:ISSN PMID 16140461. Retrieved on 2007-02-25.
- Xavier, J., Simmons, R. (2000) - The Washington transgender needs assessment survey, Washington, DC: The Administration for HIV and AIDS of the District of Columbia Government
- Rathus, Spencer A.; Jeffery S. Nevid, Lois Fichner-Rathus (2002). Human Sexuality in a World of Diversity. Allyn & Bacon. ISBN 978-0205406159.
- Denny, Dallas, (2006); Transgender Communities in Transgender Rights.
Links: General
- Basic TG/TS/IS Information - including Successful Transwomen and Successful Transmen
- How to Respect a Transsexual Person
- Press for Change - UK information about the trans rights campaign, and details about the legal, medical, political and social issues surrounding the people it represents
- The Gender Trust - The UK Charity for the support of trans individuals, their friends & family, employers and professionals
- Definition and Synopsis of the Etiology of Adult Gender Identity Disorder and Transsexualism - prepared by 24 internationally recognized experts, published by the Gender Identity Research and Education Society (GIRES)(See: http://www.gires.org.uk)
- Gender.org - The home of Gender Education & Advocacy, a nonprofit corporation using the web to provide education and advocacy for transsexual and transgender issues.
- TransParentcy - Organization to support transgender parents and their advocates (lawyers, mental health professionals, friends, family) by providing information and resources to diffuse and/or disspell the myths about any adverse impact being transgendered/transsexual might have on ones children.
Links: For trans women
- Mom, I Need to Be a Girl - a book by the mother of a transsexual child
- Transsexual Road Map - practical and medical information
- Annelawrence.com Medical and Other Resources for Transsexual Women
Links: For trans men
- FTM International - practical and medical information
- Hudson's FTM Resource Guide - Comprehensive information for female to male trans men and allies - USA-based
- FTM Australia - Comprehensive information for all men identified female at birth in Australia.
- Readers may use this email link to report errors and/or omissions they have discovered, or to add additional material or comments regarding this article "Transsexualism"
- Wiki Staff should discuss this article in the Wiki Staff Forum
- Susan's Place Transgender Resources Forums
- Susan's Place Transgender Chat
Browse: Gender | Cross-dressing | Intersexuality | Transgender topics | Transsexualism | Hormone Therapy | Surgery | Standards of Care | Legal Information | Psychology | Transitioning | Family & Friends | People | Books | Abbreviations | Browse All TopicsRead the FAQ | Return to the Main Page
Want to help us? Write New Articles and/or Expand Current Articles
|Related Forum on Susan's Place:
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*Some information provided in whole or in part by http://en.wikipedia.org/


text:
Seeking lung donors after at-home death
yahoo news | 2013-12-01 21:06
AP IMPACT: Seeking lung donors after at-home death
The pair of lungs sits inside a clear dome, gently inflating as doctors measure how well they'll breathe if implanted into a patient who desperately needs a new set.
It's a little-known twist of nature — your lungs can live on for a while after you die. The air left inside keeps them from deteriorating right away as other organs do.
An innovative experiment now aims to use that hour-or-more window of time to boost lung transplants by allowing donations from people who suddenly collapse and die at home instead of in a hospital.
"There aren't enough lungs. We're burying them," said Dr. Thomas Egan of the University of North Carolina, Chapel Hill, who is leading the project. "It turns out your lungs don't die when you do."
This is a new frontier for transplants.
Today, registered organ donors don't get to fulfill that last wish if they die outside of a hospital. The U.S. doesn't have a system to recover their organs quickly enough. It can be an added shock to grieving families, and a waste of potentially good organs that might ease transplant shortages.
"The general public does not understand how hard it is to become an organ donor. They assume if they sign their card, when they die, then it will happen," said bioethicist Arthur Caplan of New York University's Langone Medical Center. "Only 2 to 3 percent of people die in circumstances that let them be organ donors."
The new study in the Research Triangle area of North Carolina is trying to change that, focusing on lungs because Egan's research suggests they last the longest.
Here's how it works.
Someone collapses with cardiac arrest. Emergency workers exhaust attempts at CPR. If the driver's license lists the person as a registered donor, the local organ recovery agency tracks down next-of-kin for permission to participate in the research.
If that happens within about an hour of death, then workers pump a little air into the lungs to preserve them while the body is transported to an operating room for organ recovery.
View gallery."
Workers wheeled a cooler bearing the first set of lungs donated in the experiment into Egan's lab for the next crucial step — determining if they're really healthy.
Inside the science fiction-looking domed machine, a ventilator slowly filled the lungs. They resembled a turkey awaiting roasting. Some black speckles on the outside didn't worry Egan. They're a sign of city living, or maybe earlier smoking. It's deeper inside that counts.
Egan infused them with a special fluid that flows like blood normally would. This so-called ex vivo lung perfusion preserves the lungs even longer. It can tell if they transfer oxygen properly or help spot signs of disease. Egan also peeked inside with a bronchoscope, looking for abnormalities.
These lungs didn't pass the test because Egan found some early disease. But they did show it was possible to get a donation in time to try.
Lungs that do pass will be transplanted into patients willing to take a chance on these nontraditional organs, as part of the study funded by the National Institutes of Health.
"That would be the greatest thing, to be able to breathe normal," said Lisa Bowman, 51, of Union Grove, N.C.
Bowman has been on the waiting list for new lungs for two years after a rare genetic disease gradually damaged her own until, she says, it became like "breathing through a pinhole." She hopes Egan's research will help her find a match more quickly.
Some previous U.S. attempts at out-of-hospital donation of another organ, kidneys, didn't pan out because of logistical hurdles. But transplant specialists are watching this newest experiment closely, saying that if it works, it eventually could open the way to many more donations — not just lungs but maybe other organs, too.
"We've had a number of very disgruntled family members that wanted to donate (a loved one's organs) and weren't able to," said Dr. Jeffrey Punch, transplant surgery chief at the University of Michigan. Spurred by that family reaction, in a few months, his team plans to try recovering kidneys from cardiac arrest victims who are rushed to the emergency room but can't be saved and turn out to be registered donors.
In North Carolina, Egan's study likewise will try to recover lungs from people who die in the ER as well as in the community.
Today, the vast majority of donated organs come from people who suffer a severe injury and are hooked to a ventilator for days, even weeks, until doctors determine they are brain-dead. Machinery keeps blood and oxygen flowing until surgeons can collect organs deemed healthy enough.
What about registered donors who collapse with cardiac arrest at home, the office or the gym — and efforts at CPR fail? Experience overseas shows it's possible to take quick steps to preserve and recover their organs. Doctors in Spain have transplanted kidneys, livers and lungs from these unconventional donors. France has reported some success with kidneys.
In the United States, more than 6,000 people died last year while awaiting one of those organs.
Lungs are in particularly short supply. Only 15 percent to 20 percent of donated lungs are usable, often because complications during the donor's hospitalization damaged them. Just 1,700 lungs transplants are performed each year, compared with nearly 11,000 kidney transplants from deceased donors.
Egan, a cardiothoracic surgeon, said doctors don't even suggest the possibility of a lung transplant to thousands who might benefit because there aren't enough donors.
View gallery."
Yet the Institute of Medicine has estimated that as many as 22,000 people a year who die outside of hospitals could be potential organ donors if scientists settle some ethical and practical questions.
Buying time to recover those organs means doing some things not normally done to dead bodies, noted bioethicist Caplan, and that can mean ventilating lungs or filtering blood to the kidneys.
How will grieving families react? Is it possible to tell who's a registered donor, and find next-of-kin, in time to try?
New York City studied kidney donations after at-home deaths in 2011.
Dr. Stephen Wall of Bellevue Hospital Center said community and religious groups met with researchers and were interested. But study rules restricted which deaths were eligible, and researchers had just 20 minutes to get initial family permission. In six months, nine deaths were considered but didn't qualify, often because the deceased hadn't previously registered as an organ donor, Wall said. New York is among states with low donor registration rates.
Wall's team is considering trying again with lungs, because of the longer time window.
Lung cells don't depend on blood flow for oxygen, Egan explained. When the heart stops beating, they use what oxygen is left in the air sacs and airways.
For how long? In a series of experiments with animals, Egan showed lungs stay viable for an hour, or four hours if they are ventilated, before they're cooled to await transplant.
That ventilation is one key to the $4 million, three-year study, because when emergency workers exhaust attempts at CPR and declare someone dead, they typically leave behind the breathing tube inserted in the person's throat. That makes it simple to restart ventilation to preserve the lungs, Egan said.
"If we can get the lungs ventilated within an hour, and then removed within an hour or two and cooled, we think they'll work just fine," he said.
Kidneys don't have as long a survival window. But in Michigan, Punch has a similar preservation plan: Insert a few tubes near the kidneys to filter blood to them until they're recovered.
Fast retrieval isn't the only issue. Surgeons don't know if nontraditional organs work as well, cautioned Dr. Bryan Meyers of Washington University School of Medicine in St. Louis.
Chest X-rays and other in-hospital donor testing determine the quality of today's traditionally donated lungs.
"This trial is very timely and very pertinent," Meyers said, to see if testing in that domed machine could substitute for that hospital track record.
Egan notes that lung disease is the nation's third-leading killer. He says the untapped pool of potential donors who die outside of the hospital could expand transplants significantly.
"There are huge logistical hurdles," he said. "But if we're right, this would have a profound impact on the number of lungs that are available for transplant."
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So some of my students have sent me this WSJ piece citing Joel Kotkin about the future of California. According to him, California's future looks terrible, due to its welfare and regulatory state. The piece is written by Allysia Finley, and here's the bit of information that should scare us a bit:
Nearly four million more people have left the Golden State in the last two decades than have come from other states. This is a sharp reversal from the 1980s, when 100,000 more Americans were settling in California each year than were leaving. According to Mr. Kotkin, most of those leaving are between the ages of 5 and 14 or 34 to 45. In other words, young families.
The pithy quote:
"The new regime"—his name for progressive apparatchiks who run California's government—"wants to destroy the essential reason why people move to California in order to protect their own lifestyles.
Kotkin's point, a bit overstated perhaps, is that Californians are making it so miserable to
to try to start up a new business or buy a house that they are cutting their own legs out from under themselves–and they are doing it not because they really wish to protect the environment, but because they want to maintain the exclusivity of their neighborhoods and schools.
Leaving aside Kotkin, who comes off as abrasive in this piece, it's hard to justify the regulatory and approvals process in California when you read stories like this one about Julie Pries working for two years in a recession to start up an ice cream shop in San Francisco.
Ms. Pries said it took two years to open the restaurant, due largely to the city's morass of permits, procedures and approvals required to start a small business. While waiting for permission to operate, she still had to pay rent and other costs, going deeper into debt each passing month without knowing for sure if she would ever be allowed to open.
The mayor's response: a $1.5 million fund to help small businesses, which is chump change in a place where commercial rents are very high. How about just cutting approvals time in half, for starters, instead?
And that's Kotkin's point, once you cut through the WSJ's "let's all hate on California" nonsense: California is not doing itself any favors with this stuff, given how the state's economy is not bouncing back. And Kotkin's point about the state being divided into a playground for the rich and a haven for the poor simply echoes a point made by Californian's superstar historian Kevin Starr several years ago. Like it or not, those of us with financial security in the state seem to feel little urgency to change the regulatory and approvals process to help out those who need a job at an ice cream shop.
As to his bashing on welfare: that doesn't make any sense to me. With the recent budget cuts, the state has fallen from being first in services for the poor waaaaaaaay down to banana republic/deep south social safety net levels. So you can't blame the state holding onto social support for impoverished people. It's not doing so. So you've had your austerity/neoliberal fix there, WSJ/Rupert Murdoch. Where is all our economic growth that supposedly falls out of the sky with unicorns and rainbows once you grind the faces of the poor into the dirt and make them all work?
Dowell Myers, one of my brilliant colleagues, just released a major report showing that the state's growth numbers are not good. Here's the shorter news story.
The analysis also estimated that growth among California's seniors, those 65 and older, will quadruple within the next 20 years, driven by the aging of the large baby boomer generation.
At the same time, growth among the main working-age population ages 25 to 64 is expected to slow, and virtually all the projected growth, or 98 percent, is comprised of native-born children of immigrants, or second-generation immigrants.
"In less than 20 years, the baby boom generation will all be senior citizens, and these projections show their replacements in the workforce will be the children of immigrants," Pitkin said.
So basically, California turns into a great, big retirement village. Will those seniors stay or will they go? It's hard to tell: if it's difficult for people to start up the sort of businesses that help seniors cope with their new needs in the market, seniors just might leave for places that are more friendly to them where housing costs are lower. That means some of the concern about housing prices might alleviate.
All of this, however, is bad news for the bullet train, the other object of Kotkin's scorn. The projected use for the train and justifying investment has hinged on population numbers that don't fit the state's new reality of economic stagnation. Myers is too optimistic and polite to say it, but that's essentially what his report shows. If there aren't any new opportunities, people can't be pulled to the state.
All that just brings up the typical Keynesian arguments that if you spend state money on the train, the economy will grow, there will be jobs, etc etc and so what if we over-estimated the future population of the potential customer base? If you are not a Keynesian, spending billions on the train makes little sense in the light of these projections.


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Under the agreement, Etihad Airways customers are able to enjoy convenient connections via Rome and Madrid to Buenos Aires (EZE) and onwards to nine other popular Argentinian destinations – Córdoba (COR), Mendoza (MDZ), Rosario (ROS), Iguazú (IGR), Salta (SLA), Mar del Plata (MDQ), Bariloche (BRC), Trelew (REL) and Ushuaia (USH).
In turn, Aerolíneas Argentinas guests can have access to Etihad Airways' network of over 100 destinations from its Abu Dhabi hub via the Italian and Spanish capitals.
Mohammad Al Bulooki, Etihad Airways Executive Vice President Commercial, said: "This codeshare demonstrates the importance of Argentina as a vital travel market for Etihad Airways in Latin America given the growing tourism, cultural and business opportunities that exist between the UAE and Argentina.
"We wish to give travellers flying Aerolíneas Argentinas the opportunity to enjoy the acclaimed service and hospitality for which Etihad Airways is renowned throughout the world. This codeshare will make the experience that much easier."
Diego Garcia, Aerolíneas Argentinas Chief Commercial Officer, said: "This is a very good opportunity to consolidate and increase our offer to one of the most important hubs in the Middle East. It also allows us to improve our load factors, optimise the use of the fleet and strengthen the image of Aerolíneas Argentinas in the Asian market. We hope that this agreement will also be the gateway for many tourists to visit some of the most attractive landmarks in our country."
Codeshare agreements offer customers countless benefits, such as baggage check-in to their final destination and extra assistance during connections. Members of both airlines' loyalty programmes – Etihad Guest and Aerolíneas Plus – will soon be able to earn and redeem miles on the codeshare flights.


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Notre Dame de Paris – LED Lit 3D Jigsaw Puzzle
Puzzle Pieces: 149Maker: CubicFunSize When Completed: 39.5 cm x 22 cm x 28 cm / 15.5 in x 8.6 in x 11 in This beautiful LED lit model of Notre Dame de Paris requires 2 AA batteries (not included). The site of the Notre dame is the cradle of Paris and has always been the religious center of the city. The Celts had their sacred ground here, the Romans built a temple to worship Jupiter. A Christian basilica was built in the 6th century and the last religious structure before the Notre-Dame construction started was a Romanesque church.Bishop Maurice de Sully started the construction in 1163. The Cathedral was to be built in the new gothic style and had to reflect Paris's status as the capital of the Kingdom France. It was the first cathedral built on a monumental scale and became the prototype for future cathedrals in France, like the cathedrals of Amiens, Chartres or Rheims, just to name the most famous.
Sold by: Puzzle Master


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There's been an awful lot of talk recently about the Facebook IPO and what the future will hold for Mark Zuckerberg's social creation. While many are sure that the behemoth network will continue to grow and share prices will soar, there are also those who are beginning to see cracks appear that might well lead to some serious problems.
It's been argued that there is too much tinkering with the original layout and functionality that will cause some users to pack up and leave. The quiet grunts of discontent when Facebook Timelines first reared its head are turning into louder protests with each poll on the issue, and according to some research, 88% of users are concerned about the privacy implications of all the data that Timeline aggregates.
Ad revenues are the lifeblood of Facebook, yet not all companies are that enamoured with the ROI that Facebook has given them. General Motors – one of the three biggest advertisers in the US – is pulling all of its Facebook ads due to lack of effectiveness. But why is this happening?
People primarily use Facebook to 'hang out' and interact with friends. You just don't want to be bombarded with adverts when you're commenting on a photo or replying to a message, the same way that you don't want someone to come up to you and reel off a sales pitch while you've out for coffee with a friend. Services such as Google's AdSense have proven to be more affective as it actually targets people who are looking to buy – or at least research – a product.
Another contributing factor to the apparent decline of Facebook's average revenue per user is the increased access from mobile devices. There simply aren't any adverts on the mobile apps, so that's a whole chunk of the target market taken out right there. Facebook even admitted as much during its S-1 filing, by saying that more people were using the mobile apps than originally thought, and revenue was going down.
Please be clear – I don't see this as the death knell for Facebook – it's still head and shoulders above the competition in terms of user base and reach. There simply isn't another service out there that can connect you with as many people and on as many levels as Facebook does. However, everyone thought MySpace was going to rule the world, and then Facebook came along.
So the questions are these… What must Facebook do in order to keep its revenues climbing, and what would need to come along to cause a wholesale exodus from the world's largest social network?


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Looking for cheap Kenya Cameroon Flights? Cameroon's capital city is Yaoundé.
It stands on seven hills Like Kampala City in Uganda. But our main issue on this site is Cheap air Flights to Cameroon from Kenya or from Cameron to Kenya. If you are looking for cheap tickets between the above 2 countries in Africa, here is a site to guide you.
More information about Cameroon
Situated on the west coast of Africa, Cameroon is bordered to the west by the Gulf of Guinea, to the northwest by Nigeria, to the northeast by Chad (with Lake Chad at its northern tip), to the east by the Central African Republic and to the south by Congo, Gabon and Equatorial Guinea.
The far north of the country is a semi-desert broadening into the vast Maroua Plain, with game reserves and mineral deposits. This is bordered to the west by the lush Mandara Mountains. The Benue River rises here and flows westwards into the Niger.
The official languages are French and English. They are given equal importance in the Constitution but French is the more commonly spoken. Spanish is spoken in some urban centers. Pidgin English is widely spoken, particularly in coastal areas. Around 250 different African languages are also spoken.
It has two major cities; Douala and Yaoundé'
Yaoundé, is the capital city of Cameroon and second largest city in the country after Douala. It lies in the centre of the nation.Yaoundé Nsimalen International Airport is a major civilian hub, while nearby Yaoundé Airport is used by the military.
Railway lines run west to the port city of Douala and north to N'Gaoundéré. Many bus companies operate from the city, particularly in the Nsam and Mvan neighborhoods.
Travel time by road between Douala and Yaounde is approximately 3 hours. Traffic in the city can be heavy during weekdays, but is very little during the weekends.Yaounde has made a great progress in infrastructure especially road construction.
Douala is the largest city in Cameroon and the capital of Cameroon's Littoral Province. Home to Cameroon's largest port and its major international airport, Douala Airport, it is the commercial capital of the country.
Consequently, it handles most of the country's major exports, such as oil, cocoa and coffee, as well as trade with Chad. It is also home to the Eko Market, the country's largest market.
The city is divided into quarters with Akwa and Bonajo being the most important with Akwa being Douala's nightlife center and Bonanjo its center of commerce and administration.
Along the city's main thoroughfare lie some of Cameroon's best restaurants, coffee houses and French-style patisseries; along the waterfront, many bars and bistros may be found, commanding views of the Gulf of Guinea and nearby mangrove swamps.
Many of these are frequented by the city's large expatriate population, mainly French or Lebanese, most of whom work in the petroleum industry.
Sep 21, 14 03:38 PM
Sep 03, 14 12:32 AM
Sep 03, 14 12:24 AM


text: I love animals and creating art and would really like to help shelter animals in anyway I can. I am a member of HeARTs Speak and I think they are a wonderful organization really making a difference for shelter animals. Please take a look, hopefully you see something you like! Artwork profits are donated to HeARTS Speak. http://www.heartsspeak.org/ Thank you!Read More


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I turned up much earlier than I usually do (mainly because today is gross and rainy, and so I didn't think my usual method of flying down the freeway in order to dash into the studio at the last minute would be the most safe and sensible option), to discover the guys working like bees to get everything running smoothly with a minimum of glitches. I got to see the refurbished studios for the first time, and gee whiz, the control room is sweet, with shiny new Sony 16:9 1080P monitors everywhere. Looks better than many studios I've actually worked in for pay. And yet somehow, all this technical advancement has been resulting in the glitchiest shows we've done in ages.
The stream dropped out for about half an hour, I'm told, because some idiot has blasted the studio's computers with a goddamn virus. So you Ustream viewers, please hang on, and we'll get a clean audio file up to the website ASAP. Otherwise, I thought the show went well today. We tried out a stunning new opening video sequence provided to us by a fan, and the background chroma key looked cool, except for the fact I had stupidly decided to wear a shirt today that was just green enough to turn my torso translucent. Perhaps it was an improvement. The callers all told us they could hear us fine, without any echo or odd reverb feeding back. And we got a dumb theist caller who got us both into rant mode, which I always enjoy. So, we're working through these teething pains, people, slowly but surely.
Oh yeah. One sucky note. After next Sunday's show, we're off for the next two Sundays. Sigh. Things, I'm sure, will settle in after the holidays.


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Many of the Medjugorje Must Do's center on the apparition of the Virgin Mary in 1981. This is a famous pilgrimage spot and enjoys mild weather all year round, which makes it a great location to visit in Bosnia and Herzegovina. Many thousands of people visit this spot every year.
You should not miss a mass at the St. James Church. The first church was built in 1897 on a quake prone area, and after WWI a larger church was completed in 1936. It was not until 1969 that the interior of the church was finished. After the Virgin Mary appeared, funds became available to renovate the church. Today there is a gazebo and house of Prayer. There is also a hall specifically for pilgrims and 20 different outdoor confessionals.
The spot where the Virgin Mary first appeared is today known as Apparition Hill. You can follow a steep path to the exact spot of the apparitions. There are also many bronze reliefs that depict the mysteries of the Rosary. Along the path there is a large cross where the Virgin Mary gave the first call for peace. A statue of the Queen of Peace was erected where the apparitions occurred. This statue was erected for the 10th anniversary of the events.
Cross Mountain is the main mountain above the town. There is a large cross at the top which has Roman relics in the crossbar. There is a custom to celebrate Mass at the cross on the following Sunday after the Feast of the Nativity. Along the climb to the tomb, there are 14 Stations of the Cross. To display their devotion, many pilgrims make the climb to the top barefoot.
A great half day trip to the Kravice waterfalls is fantastic. These waterfalls are some of the largest in the country and very impressive. It takes about 5 hours to reach and is a popular swimming spot. The best time to see the falls is in the spring when the winter snow has melted and the falls are at their fullest. There is a camping area, picnic area and cafe. Make sure you get directions from a local as they can be very difficult to find.
One of the best places to go for birding is Hutovo Blato (see: http://www.Holidays.ba ). This is where most of the birds go during the winter in Europe. You can see more than 200 different types of birds during the winter months. This is a great side trip into the country.
Source: world66.com
Donate to Medjugorje I would like to thank you sincerely for your trust and support on the past of 2015. I wish you and your family and friends a God bless You and a prosperous ,peaceful and most of all healthy all years . Please consider supporting our efforts in Medjugorje. Make your donation to Our Lady's work. Thank You.
The_Medjugorje.pro and webMedjugorje.com with 2Checkout.com, Inc. is an authorized retailer of goods and services provided by Medjugorje.pro and webMedjugorje.com & Studio Leonardo . ) accept Visa, MasterCard, JCB, Diners, American express, Discovery and PayPal. All information you submit is secure (https: protocol) .


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Abstract View
Volume 21 Issue 9 (September 2011)
GSA Today
Article, pp. 5-7 | Full Text | PDF (468KB)
Learning from failure: The SPREE Mid-Continent Rift Experiment
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Special 2011 Annual Meeting–Themed Science Article Section
In a departure from GSA Todays usual single lead science article format, the following four articles are meant to familiarize you with the span of geologic time represented in the Upper Midwest and the expertise of its geoscience community as we prepare to assemble at the Annual Meeting in Minneapolis. These articles also emphasize the critical role geologists are being asked to play in a society that is increasingly focused on sustainable resource use and the long-term resilience of the planet.
The first two papers treat geologic events from opposite ends of the timeline as a controlled experiment that can be studied to help understand, and thereby forecast, system responses. The latter two speak directly to our role in society.
The EarthScope USArray is currently deployed in Minnesota. Seth Stein and colleagues describe how the information coming in regarding the failed, 1.1-Ga midcontinent rift, frozen in time, will provide a way to test the two leading theories about the fundamental cause of rifting.
Next, Karen Gran and colleagues describe Holocene valley evolution. A well-constrained downcutting event is driving continuing adjustment on tributaries to the Minnesota River, the history of which has a strong influence on modern sediment loads and direct resource-management implications.
Ken Bradbury and Tony Runkel, geologists with two state surveys, partnered up for the third article, which examines how the mechanical behavior of Paleozoic rocks affects groundwater flow systems. This information is critical for sustainable groundwater use in the face of challenges ranging from the presence of live viruses deep beneath Madison, Wisconsin, USA, to evolving cones of depression that change hydraulic gradients.
Finally, Cathy Manduca introduces readers to the process of producing an educated citizenry (and a well-prepared geoscience community) that understands the ways that Earth and society are linked. The article also illustrates the need to act collectively to share experiences, develop them into classroom activities, and accurately diagnose student challenges.
Carrie Jennings, Minnesota Geological Survey
Vice Chair, 2011 Annual Meeting Organizing Committee
Engineers have long realized that much can be learned about how complicated systems like aircraft or nuclear reactors really—as opposed to ideally—work by studying their failures. The same is likely to be true for the rifting phase of the Wilson cycle, in which continents drift apart to form new oceans that may grow to the size of the Atlantic and Pacific before closing and vanishing.
However, many continental rifts fail to develop into seafloor spreading centers. Such failed rifts become an important part of the fabric of the continents.
Rifting—successful or failed—shapes the continents and has crucial effects for society. It provides conditions for the deposition of hydrocarbons and other mineral resources. Moreover, some earthquakes within generally stable continents occur on failed rifts.
Manuscript received 27 Feb. 2011; accepted 17 Apr. 2011.


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Sony has released three new Walkman players from the S, E, and B series that suit the needs of different tastes and budgets. The S and E series products also offer full video playback support, including DRM-protected WMV files. The Walkman players allow users to enjoy music from various download stores in addition to stored audio files. The simple drag and drop file transfer makes copying music, videos, and podcasts onto the players quick and easy. The players support most popular audio and video formats, and offer high quality audio and video performance.
Prices range from $45 to $180, depending on the model and storage capacity.


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The Screwtape Letters
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The Screwtape Letters
C. S. Lewis
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Who among us has never wondered if there might not really be a tempter sitting on our shoulders or dogging our steps? C.S. Lewis dispels all doubts. In The Screwtape Letters, one of his bestselling works, we are made privy to the instructional correspondence between a senior demon, Screwtape, and his wannabe diabolical nephew Wormwood. As mentor, Screwtape coaches Wormwood in the finer points, tempting his "patient" away from God. Each letter is a masterpiece of reverse theology, giving the reader an inside look at the thinking and means of temptation. Tempters, according to Lewis, have two motives: the first is fear of punishment, the second a hunger to consume or dominate other beings. On the other hand, the goal of the Creator is to woo us unto himself or to transform us through his love from "tools into servants and servants into sons." It is the dichotomy between being consumed and subsumed completely into another's identity or being liberated to be utterly ourselves that Lewis explores with his razor-sharp insight and wit. The most brilliant feature of The Screwtape Letters may be likening hell to a bureaucracy in which "everyone is perpetually concerned about his own dignity and advancement, where everyone has a grievance, and where everyone lives the deadly serious passions of envy, self-importance, and resentment." We all understand bureaucracies, be it the Department of Motor Vehicles, the IRS, or one of our own making. So we each understand the temptations that slowly lure us into hell. If you've never read Lewis, The Screwtape Letters is a great place to start. And if you know Lewis, but haven't read this, you've missed one of his core writings. --Patricia Klein
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We thought yesterday's series of wacky Facebook posts appearing on MLB team pages was the work of a very skilled—and very quick—hacker. As it turns out, we were wrong. Not long after we put up our post a Facebook spokesperson issued us the following statement:
Recently, several Pages made unauthorized posts as a result of actions from a single rogue administrator of these Pages. Our team responded quickly and worked with our partners to eliminate the spam caused by this attack. This was an unique, isolated incident and we are always working to improve our systems to better protect our users and their data.
We're a bit concerned that Facebook would consider any of those Facebook posts "spam," but maybe that's why the company's stock price is sinking faster than a pitch from Justin Masterson. Furthermore, we've learned that Facebook didn't remove any of the posts themselves—the "rogue administrator" did.
We actually talked to that individual, though they're a bit timid to share a lot of details. Here's what we learned:
- Access to all 30 MLB teams' Facebook pages is put in the hands of employees making less than living wage.
- The posts were made as a stunt, and not intended to be seen by the public.
- None of us ever saw "the best ones."
The incident sheds light on one of MLB's lasting issues: the control MLB Advanced Media attempts to wield upon anything affiliated with Major League Baseball. MLBAM runs all the teams' web and Facebook pages. That's a lot of responsibility—and power—put in the hands of people who apparently aren't being paid very much. It also appears the roles of MLB employees (both inside and outside of the MLBAM arm) can be, at times, ambiguous or confusing.
We've written about MLBAM in the past, and this season they've been remarkably more realistic in the way they deal with the intersection of traditional media and the Internet. Heck, they even have embeddable video now! We hope they continue to follow the hypermedia approach that other major sports leagues are taking (and you should count MLS in that group, because they're better than anybody) but as long as all the power is centralized, incidents like yesterday's Facebook fiasco are bound to happen again.
PREVIOUSLY: New York Yankees Facebook Page Announces Derek Jeter To Miss Rest Of Season Due To Sex Change [UPDATE: A Bunch Of Other Teams Hacked Too]


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I'm a Celebrity Get Me Out of Here!
5.7 60 min
I'm a Celebrity...Get Me Out of Here! is a British reality television show, first screened in 2002, in which celebrities live in jungle conditions with few creature comforts. The show has been hosted by Ant & Dec since its inception. It is filmed in Murwillumbah, New South Wales, Australia and broadcast on ITV in the UK and on 3e in Ireland. The show is one of the largest in the world, with more than 700 staff working on the show 24 hours a day for three weeks. It is sponsored in the UK by supermarket chain Iceland and in Ireland by MultiTrip.com.
Country: United Kingdom
Released: 2002-08-25
Production: N/A
Casts: Declan Donnelly, Holly Willoughby,


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