Week 8 Lecture Content (Sex & Gender II) Flashcards
Detail the hypothalamus-pituitary-gonad (HPG) axis and explain its role in Developmental Mechanisms
Be specific with brain regions, hormones, and downstream effects. How/where do kisspeptin and oxytocin fit into the HPG axis?
Lecture 24 on activational mechanisms, and the role of kisspeptin and oxytocin
- HPG axis suppression during childhood; circhoral (hourly) rhythm of GnRH secretion initiates puberty.
- Puberty triggers GnRH release from hypothalamus, leading to LH & FSH release from the anterior pituitary.
- LH & FSH stimulate gonads to produce sex hormones (testosterone, oestrogen) and gametes (sperm, eggs), enabling sexual maturation and secondary sex characteristic development.
- Kisspeptin acts as a permissive factor for puberty initiation. It stimulates GnRH-producing neurons and modulates HPG axis function.
- Oxytocin promotes pair bonding and sexual behaviours through modulation of the HPG axis and limbic system.
Detail the hypothalamus-pituitary-gonad (HPG) axis and explain its role in Activational Mechanisms
Be specific with brain regions, hormones, and downstream effects. How/where do kisspeptin and oxytocin fit into the HPG axis?
Lecture 24 on activational mechanisms, and the role of kisspeptin and oxytocin
In adulthood, HPG axis activation facilitates reproductive readiness:
- Secondary sex characteristics develop to attract mates.
- Libido activation encourages sexual behaviour.
- Pair bonding promotes successful reproduction and care of offspring.
Oxytocin also aids in pair bonding by increasing feelings of trust and attachment in intimate relationships.
Puberty triggers ____ release from hypothalamus, leading to ___ & ___ release from the anterior pituitary.
GnRH, LH & FSH
Puberty triggers GnRH release from ___________, leading to LH & FSH release from the __________ _________.
hypothalamus, anterior pituitary
___ & ___ stimulate gonads to produce sex hormones (testosterone, oestrogen) and gametes (sperm, eggs), enabling sexual maturation and secondary sex characteristic development.
LH & FSH
LH & FSH stimulate _______ to produce sex hormones (testosterone, oestrogen) and _______ (sperm, eggs), enabling sexual maturation and secondary sex characteristic development.
gonads, gametes
_______ acts as a permissive factor for puberty initiation. It stimulates _____-producing neurons and modulates HPG axis function.
Kisspeptin, GnRH
________ promotes pair bonding and sexual behaviours through modulation of the HPG axis and limbic system.
Oxytocin
In adulthood, HPG axis activation facilitates reproductive readiness:
- _________ _____ ________ develop to attract mates.
- Libido activation encourages sexual behaviour.
- _____ ________ promotes successful reproduction and care of offspring.
Secondary sex characteristics, Pair bonding
_______ also aids in pair bonding by increasing feelings of trust and attachment in intimate relationships.
Oxytocin
Explain the main stages of gender transitioning, including the phases of hormone therapy.
Lecture 22 notes on gender transitioning
Stage 1: Life experience & psychological assessment
- 2+ years of living in the preferred gender identity without hormone or surgical interventions.
- Psychological evaluations and behavioural changes (pronouns, dressing, etc.) improve mental well-being.
Stage 2: Gender Affirming Hormone Therapy (GAHT)
- Involves oestrogen-based (E-GAHT) or testosterone-based (T-GAHT) hormone therapy.
- Requires diagnosis of Gender Dysphoria and involves careful monitoring.
- Hormone initiation is slow and requires long-term follow-up with adjustments over time.
Stage 3: Surgical intervention
- Available only after 1+ year of continuous GAHT.
- Can include gonad removal, genital alterations, and breast augmentation.
Stage 4: Long-term follow-up
- Lifelong hormone therapy and psychological support required.
Explain Stage 1 of gender transitioning
Stage 1: Life experience & psychological assessment
- 2+ years of living in the preferred gender identity without hormone or surgical interventions.
- Psychological evaluations and behavioural changes (pronouns, dressing, etc.) improve mental well-being.
Explain Stage 2 of gender transitioning
Stage 2: Gender Affirming Hormone Therapy (GAHT)
- Involves oestrogen-based (E-GAHT) or testosterone-based (T-GAHT) hormone therapy.
- Requires diagnosis of Gender Dysphoria and involves careful monitoring.
- Hormone initiation is slow and requires long-term follow-up with adjustments over time.
Explain Stage 3 of gender transitioning
Stage 3: Surgical intervention
- Available only after 1+ year of continuous GAHT.
- Can include gonad removal, genital alterations, and breast augmentation.
Explain Stage 4 of gender transitioning
Stage 4: Long-term follow-up
- Lifelong hormone therapy and psychological support required.
Stage 1 of gender transitioning:
_____ _________ & __________ __________
- __ years of living in the preferred gender identity without ______ or _______ interventions.
- ________ _________ and behavioural changes (pronouns, dressing, etc.) improve mental well-being.
Stage 1 of gender transitioning:
Life experience & psychological assessment
- 2+ years of living in the preferred gender identity without hormone or surgical interventions.
- Psychological evaluations and behavioural changes (pronouns, dressing, etc.) improve mental well-being.
Stage 2 of gender transitioning:
_______ _______ _______ _______
- Involves ________-based or ________-based hormone therapy.
- Requires diagnosis of ______ ______ and involves careful monitoring.
- Hormone initiation is slow and requires long-term follow-up with adjustments over time.
Gender Affirming Hormone Therapy (GAHT)
oestrogen-based (E-GAHT) or testosterone-(T-GAHT)
Gender Dysphoria
Stage 3 of gender transitioning:
_________ ________
- Available only after ___ year of continuous GAHT.
- Can include _____ removal, _____ alterations, and _______ augmentation.
Stage 3 of gender transitioning:
Surgical intervention
- Available only after 1+ year of continuous GAHT.
- Can include gonad removal, genital alterations, and breast augmentation.
Stage 4 of gender transitioning:
__________ _________
- ________ hormone therapy and psychological support required.
Stage 4 of gender transitioning:
Long-term follow-up
- Lifelong hormone therapy and psychological support required.
What are ‘puberty blockers’ and why/when would they be used? Why do they work?
Puberty blockers:
- GnRH analogs that suppress the HPG axis, halting the release of LH/FSH and preventing the production of testosterone/oestrogen.
- Used to delay puberty, especially in transgender youth, to give them time to explore gender identity without developing secondary sex characteristics.
Be able to describe histrelin’s (Supprelin’s™) mechanism of action, mode of action, and route of administration.
Histrelin (Supprelin™):
- Mechanism: Continuous activation of GnRH receptors leads to their desensitisation, thus stopping the HPG cascade.
- Mode: Administered via subcutaneous implant (usually in the upper arm), releasing over 12 months.
- Effects: Blocks development of unwanted features like breast growth or voice deepening.
Puberty blockers are _____ analogs that suppress the HPG axis, halting the release of ___/____ and preventing the production of testosterone/oestrogen.
GnRH, LH/FSH
Puberty blockers are GnRH analogs that suppress the ____ ____, halting the release of LH/FSH and preventing the production of _________/_________.
HPG axis, testosterone/oestrogen
Histrelin (Supprelin™) enables continuous activation of _____ receptors, leading to their desensitisation, thus stopping the ____ cascade.
GnRH, HPG
____________ enables continuous activation of GnRH receptors, leading to their desensitisation, thus stopping the HBG cascade.
Histrelin (Supprelin™)
Histrelin (Supprelin™) is administered via __________ ________, releasing over ___ months.
subcutaneous implant (usually in the upper arm), 12 months
From the lecture and video clip that was shown, what are the pros associated with puberty blockers and GAHT?
- Can be life-saving by preventing distress from gender-incongruent puberty.
- Claimed to be reversible and provide time for decision-making regarding GAHT or surgical options.
- Reduces suicidal ideation in transgender youth.
From the lecture and video clip that was shown, what are the cons associated with puberty blockers and GAHT?
- Unclear long-term effects, especially on bone health and brain development.
- 95% of individuals on puberty blockers proceed to GAHT, suggesting it may not be a true “pause.”
- Concerns about informed consent, especially for children under 18.
What is the evidence on Gender Identity and Transition Regret?
- Studies show a low rate of transition regret (0.5-8%), with detransition often due to external pressures rather than internal dissatisfaction.
- Debate about how persistent gender identity is in adolescence.
What was the “Cass Review”?
- Independent review of gender services for youth in the UK.
- Found weak evidence supporting puberty blockers, leading to their restriction except in clinical trials (as of June 2024).
__% of individuals on puberty blockers proceed to GAHT, suggesting it may not be a true “pause.”
95%
Studies show a ___ rate of transition regret (___-___%), with detransition often due to external pressures rather than internal dissatisfaction.
low, 0.5-8%
The ____ Review:
- Independent review of gender services for youth in the UK.
- Found weak evidence supporting puberty blockers, leading to their restriction except in clinical trials (as of June 2024).
Cass
Describe the 1st activation that occurs to prepare sexual behaviours in maturity.
Lecture 24 on activational mechanisms
Activation 1: Sexual maturation & secondary sex characteristics
- Driven by the HPG axis, the release of testosterone and oestrogen results in the development of secondary sexual characteristics like breast development, voice deepening, and muscle mass.
- These physical changes enhance mate attraction and reproductive readiness.
Describe the 2nd activation that occurs to prepare sexual behaviours in maturity.
Lecture 24 on activational mechanisms
Activation 2: Libido activation (Sexual desire)
- Sex hormones, particularly testosterone, stimulate the areas of the brain associated with libido and sexual motivation.
- Kisspeptin plays a role in stimulating the HPG axis and indirectly promotes sexual desire.
Describe the 3rd activation that occurs to prepare sexual behaviours in maturity.
Lecture 24 on activational mechanisms
Activation 3: Pair bonding and social behaviour
- Oxytocin and vasopressin are crucial for pair bonding, promoting attachment and social bonding between partners.
- These hormones influence areas of the brain like the limbic system, which is linked to emotional regulation and attachment behaviours.
Name the 3 main ‘activations’ that occur to prepare sexual behaviours in maturity.
- Activation 1:
- Activation 2:
- Activation 3:
Lecture 24 on activational mechanisms
- Activation 1: Sexual maturation & secondary sex characteristics
- Activation 2: Libido activation (Sexual desire)
- Activation 3: Pair bonding and social behaviour
Activation 1: Sexual maturation & secondary sex characteristics
- Driven by the ____ ____, the release of __________ and ________ results in the development of _________ sexual characteristics like breast development, voice deepening, and muscle mass.
- These physical changes enhance mate attraction and reproductive readiness.
Activation 1: Sexual maturation & secondary sex characteristics
- Driven by the HPG axis, the release of testosterone and oestrogen results in the development of secondary sexual characteristics like breast development, voice deepening, and muscle mass.
- These physical changes enhance mate attraction and reproductive readiness.
Activation 2: Libido activation (Sexual desire)
- Sex __________, particularly _______, stimulate the areas of the brain associated with libido and sexual motivation.
- ________ plays a role in stimulating the _____ _____ and indirectly promotes sexual desire.
Activation 2: Libido activation (Sexual desire)
- Sex hormones, particularly testosterone, stimulate the areas of the brain associated with libido and sexual motivation.
- Kisspeptin plays a role in stimulating the HPG axis and indirectly promotes sexual desire.
Activation 3: Pair bonding and social behaviour
- ________ and ________ are crucial for pair bonding, promoting attachment and social bonding between partners.
- These hormones influence areas of the brain like the _______ _______, which is linked to emotional regulation and attachment behaviours.
Activation 3: Pair bonding and social behaviour
- Oxytocin and vasopressin are crucial for pair bonding, promoting attachment and social bonding between partners.
- These hormones influence areas of the brain like the limbic system, which is linked to emotional regulation and attachment behaviours.
In theory, how would a GnRH analogue influence the HPG axis and subsequently fertility? Assume that it comes in an effective oral ROA, taken daily.
Mimics GnRH and leads to continuous activation, which desensitises GnRH receptors and suppresses LH/FSH release, halting gonadal function and fertility.
In theory, how would a testosterone analogue influence the HPG axis and subsequently fertility? Assume that it comes in an effective oral ROA, taken daily.
Exogenous testosterone provides negative feedback to the hypothalamus and pituitary, reducing GnRH, LH, and FSH, thereby lowering sperm production and fertility.
In theory, how would an oestrogen-progestogen combination pill influence the HPG axis and subsequently fertility? Assume that it comes in an effective oral ROA, taken daily.
Works similarly to female contraceptives, suppressing the HPG axis through negative feedback, preventing ovulation in females or reducing spermatogenesis in males.
In theory, how would a kisspeptin receptor antagonist influence the HPG axis and subsequently fertility? Assume that it comes in an effective oral ROA, taken daily.
Blocks kisspeptin from activating GnRH-producing neurons, reducing the release of GnRH, and subsequently lowering fertility by decreasing LH/FSH.
In theory, how would a combination pill containing FSH+LH receptor antagonists influence the HPG axis and subsequently fertility? Assume that it comes in an effective oral ROA, taken daily.
Directly block the effects of LH and FSH at the gonads, preventing spermatogenesis in males and ovulation in females.
In theory, how would an oxytocin receptor agonist influence the HPG axis and subsequently fertility? Assume that it comes in an effective oral ROA, taken daily.
Primarily affects social bonding and pair-bonding behaviours rather than direct reproductive functions, with minimal impact on fertility.
In theory, how would a PDE5 inhibitor influence the HPG axis and subsequently fertility? Assume that it comes in an effective oral ROA, taken daily.
Works by enhancing blood flow and does not affect the HPG axis or fertility directly. It facilitates erections but has no effect on hormonal regulation. (E.g. Viagra)
GnRH __________ mimics GnRH and leads to continuous activation, which desensitises GnRH receptors and suppresses LH/FSH release, halting gonadal function and fertility.
GnRH analogue mimics GnRH and leads to continuous activation, which desensitises GnRH receptors and suppresses LH/FSH release, halting gonadal function and fertility.
