Gender Dysphoria -- Transitioning, Detransitioning, Retransitioning

"The mainstream gender-affirming  care system largely presumes that gender identity/expression is immutable and that TGD [transgender and gender-diverse] people will engage in only one gender transition."

"While this may be the reality for many TGD people, this presumption can create environments in which multiple transitions, gender fluidity, and detransitions are misunderstood or even stigmatized."

"[Detransition] has been conceptualized as stopping, shifting or reversing aspects of an initial gender transition, often motivated by a shift in how one understands their sex/gender [although there is no universally agreed-upon definition]."

"Some people who detransition may self-label as 'detrans' for short."

"Irrespective of their current gender identity, those undergoing a detransition often retain 'atypical' sex characteristics from prior hormonal and surgical treatments, leading to vulnerability to gender minority stressors and, potentially, an experience of 'reverse dysphoria'." 

York University research team 

A woman who wished to keep her identity hidden de-transitioned after years of testosterone therapy she started at age 15, and a double mastectomy she had at 18. She's experienced "a lot of pain and regret." Photo by Michelle Berg /Saskatoon StarPhoenix

 

"I feel so alienated now, and super-isolated from the rest of the queer community" reported one of the study's subjects. Another said: "I lost every adult and friend in my life when I chose to detransition. I lost everything I had socially." It is obviously a very lonely journey to be  taken.

 

"Conservatives want us to speak to them to 'prove' that transitioning is 'evil'. Liberals want to silence us for fear that we'll somehow 'influence' trans people to detransition", said another.  "We're in a horrible space and it's nearly more painful detransitioning for me than it was just suffering through an identity that didn't fix my problems like everyone said it would."

 

A new form of stigma -- detransphobia -- is being exposed through the largest study of detransitioners in Canada and the United States in decades, revealing that the medical community is abandoning people who had undergone transition and in time made a decision to reverse that gender journey, finding themselves ignored by the very surgeons who had altered their bodies, while the communities that once embraced them, now choose to ostracize them. 

 

 Close to 1,000 people were included in the survey, to reveal that many who halt or reverse a gender transition end up feeling disappointingly poorly supported by LGBTQ groups and gender-affirming care practitioners, leaving them wistfully regretting their doctors' distancing themselves, wishing instead that they "took a more neutral approach to care".  The study was published in the International Journal of Transgender Health and funded by the Social Sciences and Humanities Research Council.

 

The ritual of name changing and pronouns, the halting of hormone therapy or seeking out reversal surgeries like breast reconstruction following a double mastectomy for masculinizing female-to-male chest surgery are difficult decisions to make in a total makeover of what had preceded that detransitioning process. Findings from earlier research are inconsistent with estimates for detransition ranging from less than one percent to as high as 30 percent. 

 

For some individuals, detransitioning may lead to a reversal - retransition -- particularly if their detransition was 'involuntary, forced' as a result of family pressure, discrimination or "the climate of fear around trans people". In other instances, the pressures are internal; a shift in identity of a realization that their gender dysphoria was related to some other issues "such as trauma or internalized homophobia".  

"According to the detransphobia model, individuals who shift their gender after an initial transition may encounter social rejection and barriers to accessing support within SGM [sexual and gender minority] communities due to misrecognition, gender identity fluidity and detransition-related stigma."

"Many shifted from  transgender to gender non-confirming lesbian, gay or detrans identities, and, in hindsight, wished they had access to providers who took a more neutral approach to care."

"[That backs previous research] and carries implications for gender-affirming care delivery."

York University research team 

The research team itself was comprised of a majority of LGBTQ researchers who stated that no formal health-care guidelines exist that would be of assistance to address the medical and psychological needs to detrans individuals when stigma from LGBTQ communities can also occur. The study is that of an anonymous survey taking place between 2023 and 2024, of 957 individuals from ages 16 and up in the U.S. (704)  and Canada (253) self-identifying, with experiences of detransition -- along with one-on-one interviews with 42 selected participants.

 

Gender detransitioning - going back to living as the gender one was assigned at birth, or identifying differently - is generating more and more headlines these days. Nouvelles Montreal

 

79 percent of participants were born female, a reflection of the surge in biological girls referred to gender clinics. Another Canadian study found that of 174 youth aged 15 and younger who were referred for puberty blocks to 10 gender clinics in the country, 82 percent were born female. Some 42 percent of the total reported a history of discontinuing, then later resuming transition.

 

Challenges to access medial care or financial support to cover detransition procedures such as voice training in response to voice deepening or laser hair removal for body and facial hair;  side-effects from testosterone therapy used in female-to-male transitions were mentioned by many of the study participants. "I was turned down by four surgeons and ghosted by the one who did the mastectomy", one participant said of the search for a breast reconstruction surgeon.

  

Some participants spoke of a wish to secure the services of "non-trans-affirming care providers" on the basis of past therapists appearing too eager to encourage their transition in the first place, or to retransition following detransitioning, "despite no expressed desire to do so". "I had no confidence in my providers when I stopped transitioning" , explained one study participant. 

 

A new research website launched by a multidisciplinary team led by York University Professor Kinnon MacKinnon aims to provide resources, support and data-driven information about gender detransition/retransition. York U Yfile

 

Deathly Suspense and Timely Rescue

"I had heard stories about miracles, but I saw a miraculous rescue happening with my own eyes."

"We suddenly felt a jolt, and it all happened so suddenly that we thought all of us are going to die."

"They were telling us don't worry, help is coming,"

"We cried, and tears were in our eyes, as we feared the cable car will go down."

Osama Sharif, 15, rescued schoolboy

 

"I thought I was the smallest and I would die before anyone. I had no hope when I did not see any help and failed the attempt till 4pm [….]"

"I became hopeful when the army rescued Irfanullah and I lost hope again when it became dark and the army halted heli operations. I regained hope when a local man rescued the second boy."

Ibrar Ahmed, 13

 

"After four hours, the first military helicopter hovered over our heads and he tried his best but it did not succeed."

"The second heli returned with no success as well. It made me very worried that helicopters were not succeeding and we will die soon."

"I was hell scared and all the children started screaming. We started holding each other as it kept dangling. I thought I was dead now."

Attualah, 16

"I could see death in front of my eyes."

"The wind pressure was too fast and the cable car was dangling and it had no doors from one side for over a year."

"Everyone was crying."

Rizwanullah, 15

 

"To be honest, no matter how I was making children calm and telling them we would survive, I did not see any chance that we would."

"It was a chaotic situation. But I was struggling to find ways and my phone saved us."

Gul Faraz, 24, local man

From left: Niaz, Attaullah, Usama, Ibrar Ahmed, Rizwanullah, Gul Faraz and Sher Nawaz, after their rescue. Photograph: Shah Meer Baloch/The Guardian

Pakistan suffered a day of suspense praying for the rescue of six children and two adults on a makeshift chairlift that regularly transported people living in the area over a deep and wide ravine, that had suddenly malfunctioned, losing one of its guideropes, a cable that had broken, leaving the car dangling hundreds of metres above the canyon in a remote part of Pakistan. 

The passengers, in a routine method of transportation for the area and many others like it in geologically mountainous terrain where these makeshift chairlifts act as the sole means of travel and communication, became trapped early in the day on Tuesday. They were crossing a river canyon in Khyber Pakhtunkhwa province, Battagram district. The six children, all adolescents on the car, were on their way to school.

 

Pakistani military and local rescue workers bring people from the dangling cable car to safety using ropes and harnesses. (Pakistan Rescue Military/The Associated Press)

 

Nearby residents watched in horror as the cable car was suspended on its single cable, hoping it too would not break and send those clinging to it to certain death, as they awaited a government response that would bring the trapped people to safety. Throughout the country Pakistanis in their offices, shops, restaurants, homes and hospitals crowded around televisions in the grip of drama, clasping hope of rescue.

"Relieved to know that ... all the kids have been successfully and safely rescued", commented caretaker Prime Minister Anwaar-ul-Haq Kakar as he congratulated the military and other rescuers for that ultimate success of their endeavours. "Great team work by the military, rescue departments, district administration as well as the local people."

The rescue helicopters were  unable to fly after sunset, and it was feared that the wind created by the helicopter blades might further weaken the remaining cable. That concern resulted in rescuers shifting from an airborne rescue effort to an operation with high risks involving the use of one cable still intact to approach the car with the chairlift.

The commandos' rope was seen swaying in the wind against the mountainous landscape on footage played on television stations showing a child in a harness pulled to safety. Helicopter rescues in these circumstances described by an expert, are extremely delicate, emphasizing wind generated by helicopter blades threatening to weaken the remaining cable, it alone holding the car aloft.

 

People watch as an army soldier slings down from a helicopter during the rescue mission. (AFP/Getty Images)

 

Most of the rescued children, handed over to their families burst into tears. "Everyone was praying for this moment" commented Nazir Ahmed, a senior police officer in the area where the rescue mission took place. Before the rescue was completed those on the stranded, swaying car were provided with food and water. Some of the trapped were enabled contact by cellphone with their families.

The cable cars are often poorly maintained to the extent that yearly people die or become injured while using them. They are a necessity in the region however, frequently used by villagers to get around the mountainous regions of Pakistan. After this heart-stopping episode that garnered the bated breath of the wider public, the president stated his intention that safety inspections be undertaken for the country's cable cars and chairlifts.

The group of eight, the two adults and six children, were marooned in those dangerous conditions for six hours, suspended precariously 350 metres above ground, even before the helicopters were dispatched after appeals were sent for an emergency response to a potentially deadly situation. In the event, the disaster management authority rose to the occasion.

 

Youngsters who were trapped in a broken cable car receive first aid following their rescue, in Pashto village, a mountainous area of Battagram district in Pakistan's Khyber Pakhtunkhwa province, on Tuesday. (Nazir Mahood/The Associated Press)

 

 

The Global Pandemic of Loneliness

"We now know that loneliness is a common feeling that many people experience. It's like hunger or thirst. It's a feeling the body sends us when something we need for survival is missing."

"Millions of people in America are struggling in the shadows, and that's not right."

"That's why I issued this advisory, to pull back the curtain on a struggle that too many people are experiencing."

Dr. Vivek Murthy, former U.S. Surgeon-General

 

"You’ve probably known people who seem to have a lot of friends, but when they talk about it, they’ll say, ‘I don’t really feel like anybody knows me,’ or ‘I don’t really feel close to many people’."

"If you’re stressed chronically, your body may be in a low-level fight-or-flight response all the time. So what we are looking at is whether some people are in a chronic state of mild inflammation."

Robert Waldinger, professor of psychiatry, psychiatrist at Massachusetts General Hospital

 

"Social psychologists define loneliness as the gap between the social connections you would like to have and those you feel you experience. According to a 2018 report by the Henry J. Kaiser Family Foundation, 22 percent of adults in the United States say they often or always feel lonely or socially isolated. A national 2019 survey led by health insurer Cigna found that 61 percent of Americans report feeling lonely. Books like Bowling Alone (2000), by Malkin professor of public policy emeritus Robert D. Putnam, have highlighted the decline of social capital in the United States, but more recently, loneliness has become a serious issue of public health. In 2017, former U.S. Surgeon General Vivek Murthy ’97 called loneliness a public-health “epidemic.” The United Kingdom appointed a “minister for loneliness” a year later."

Jacob Sweet, 'The Loneliness Pandemic', Harvard Magazine

Illustration by Francescoch/iStock

"The pandemic does appear to have increased loneliness. Given the small effect sizes, dire warnings about a ‘loneliness pandemic’ may be overblown."

"However, as loneliness constitutes a risk for premature mortality and mental and physical health, it should be closely monitored."

"We think that loneliness should be made a priority in large-scale research projects aimed at investigating the health outcomes of the pandemic."

Mareike Ernst, PhD, Johannes Gutenberg-University, Mainz, Germany

Heavy use of social media can actually increase isolation

"According to the National Institute on Ageing (NIA), a think-tank at Toronto Metropolitan  University, social isolation has been linked to poorer cognitive function and a 50 percent higher risk of dementia, not to mention a significantly higher risk of stroke, heart disease and cancer mortality. It can increase anxiety and depression, and a study showed that Canadians in 2020 were more likely to think suicidal thoughts if they experienced loneliness."

"Loneliness is by no means confined to the elderly. The 2021 Statistics Canada survey found nearly one in every four young people aged 15-24 said they always or often felt lonely, a rate higher than other age groups and a finding matched in other countries as well. It’s not uncommon for the young to feel alone, of course – they are often leaving home for the first time – but there’s more to it than that. Young people are not only getting married later, they are having more trouble finding friends and romantic partners. More than half of Americans aged 18-34 don’t have a steady boyfriend or girlfriend, up from 33 percent in 2004, and 30 percent have no best friend. The age of first marriage and first sexual experience is getting later, and Millennials and Gen-Zers are less likely to be sexually active than the generations that went before."

CtoC Journal 

The latest public health epidemic: loneliness. Research points to people having become less socially engaged, a phenomenon that has become global. In the United States, research indicates that Americans attend houses of worship much less frequently, as well as engage with community organizations less, and see and commune with their own family members and friends far less often in recent decades. These are the people who report feelings of loneliness, a situation that has increased in the last several years.

 

When the global pandemic arrived, loneliness was already at a crisis level. When schools and workplaces shuttered and people were sent into isolation mode, the emotional toll accelerated. People tended to break their emotional link and dependence on the presence of others, saw family and friends far less often with the coronavirus pandemic threatening health and longevity. But the resulting isolation and overwhelming loneliness left people bereft of the very social supports natural to human nature's needs and that alone threatened health and longevity.

 

Americans, for example, spent no more than 20 minutes daily in the company of others in 2020, decreased from 60 minutes of social interaction common to most people several decades earlier. Young people, ages 15 to 24, appear to have become the demographic most hit by the loneliness epidemic. Those in that age group reported 70 percent less time spent in the company of friends in the past several years.

The risk of premature death is increased in an atmosphere of chronic emotional loss in loneliness, by 30 percent. Reports reveal those with poor social relationships faced greater risk of stroke and heart disease. An individual's penchant for experiencing depression, anxiety and dementia is elevated by isolation. Loneliness risks deleterious impacts on health to the same extent as smoking a pack of cigarettes daily.

"Being together with other humans conveys a distinct survival advantage for our species.  We are not the strongest or fastest animals.  But with a combination of brains, opposable thumbs and interpersonal cooperation we now dominate the planet."

"In ancient times, being alone, being cut-off from family, or banished from social groups was more or less a death sentence. Up through the 19^th century, exile was still a form of punishment. And even today, some cultures will shun people who violate social or religious norms."

Dr. Grant Jackson, Holistic Primary Care

Chronic loneliness is a major health risk factor. According to a metanalysis of nearly 150 studies, people with weak social connections are 50% more likely to die prematurely than those who feel socially connected. The COVID pandemic has only exacerbated the problem. (Image: Studio4dich/Shutterstock)

Xi Jinping's Triumph in Leadership

"Until Omicron, I actually thought a COVID-zero approach could be plausible. [But] it's just so insidious, it can just spread so quickly."

"I feel it's kind of like a losing battle. You could do it for a week or two ... then it's going to come back again."

"I just don't know how China will be able o avoid what happened in Hong Kong, write large."

"If everyone stays home, the outbreak will get snuffed out. But ... even if Shanghai can snuff out this particular outbreak, there's going to be more introduction of it, because it's circulating everywhere else in the world."

Dr.Jeff Kwong, public-health professor, University of Toronto

"What happens to your pet if you test positive remains an unsettling grey area with no clear solution."

"Horror stories circulate online about pets being left behind and one was recently killed with a shovel by a person in a haz-mat suit."

CNN journalist David Culver, Shanghai

One clip shows a policeman in a hazmat suit removing a protester from the scene  BBC

 

CNN journalist Culver, as a resident of Shanghai, has his own very personal fears aside from his writing about regular morning marches of neighbourhood residents to designated areas where they are tested by health officials wearing haz-mat suits. Should they test positive they are immediately sequestered, not permitted to return home and must go into isolation. If they have pets at home the pets are confiscated and put to death. David Culver has nightmares of testing positive, worried about abandoning his dog, as he would be forced into quarantine.

 

Shanghai's 25-million residents have been cooped into lockdown for weeks, unable to leave their homes except for COVID testing, and living with food shortages caused by the enforced total lockdown. A lockdown originally meant to last a few days, but that has been ongoing now for weeks with no indication how long it may last, as long as COVID-positive cases continue to present and authorities continue to react with draconian methods of isolation. The situation led to people shouting in desperation from open windows in their apartments and from balconies.

 

People wearing personal protective equipment transfer food supplies and necessities for local residents during a COVID-19 lockdown in Shanghai, April 5, 2022. Photo by AFP via Getty Images

 

The protests spurred officials to seek a solution to the angry social protests, including media posts in a country not known to tolerate dissent. The solution? Drones, circulating in neighbourhoods with very specific messages: "Please comply with COVID restrictions. Control your soul's thirst for freedom. Do not open your windows and sing", the female voice instructs.

Children separated from their parents when found to be COVID-positive. This is a reflection of China's   COVID-zero policy meant to completely eradicate, not merely control SARS-CoV-2. The virus is not responding positively to that goal, however, and the method finds no wide public acceptance. Chinese health authorities who subscribe to the COVID-zero manoeuvres insisting on complete lockdown to effectively beat virus transmission, appear not to have reckoned with the high transmissibility of the Omicron strain.

 

Staff members organize mass food orders from locked down Shanghai residents. Photo: Reuters

"Judging from how this pandemic is being handled by different leaderships and systems ... [we can] clearly see who has done better", China's President Xi Jinping has boasted in the past. And it did realize a good measure of success with pop-up cases here and there and swift responses in fragmented areas, quickly contained. Until Omicron arrived and infections began reaching into the stratosphere, as much as 15,000 daily of late. Beijing's firm orders for Shanghai's total lockdown reflected its wish to avoid the disaster in Hong Kong.

Hong Kong's own COVID-zero achievements were blown to smithereens when three million people were infected and mass deaths occurred. In both areas low vaccination rates among people aged 80 and over and lack of access to mRNA vaccines seem partly to blame. That the most vulnerable age group in the populations have not been vaccinated seems like an an avoidable Achilles heel that should not have gone unaddressed. China's home-grown vaccines have a relatively low efficacy rate; somewhere around 50% and less, compared to the mRNA vaccines.

Locked into their homes the population has been unable to work, attend school, shop, attend medical appointments. The government plan to supply people with food deliveries has overburdened commercial delivery services, the result of which has been that a great many people face starvation, deprived of food access. Clearly, China's approach to stifling the virus that originated in Wuhan, China and went on speedily to infect the global population, has been nothing to celebrate as a success.

Workers in protective suits disinfect an old residential area under lockdown amid the COVID-19 pandemic, in Shanghai on April 15.  ALY SONG/Reuters

Increasing Pandemic Femicide

"We know that the pandemic is a perfect storm for increasing abuse in the home."

"Where there's social isolation, it adds more stress. There might be more financial precarity in the home, adding stress to the situation, let alone never getting space. Social isolation is a tool of an abuser where someone's self-esteem just gets ground down."

"The risk of femicide increases at the time of separation or in the months and weeks after. One thing that we've heard from people who are preparing to leave is that it feels safer for them to just leave -- when their partners are at work or out of the house -- and it might be a strategy for others to consider."

Erin Leigh, executive director, Ottawa Coalition to End Violence Against Women 

 

"The pattern that we've seen over the past couple of years is that we go into lockdown and our lives would actually get pretty quiet."

"The minute the lockdown lifts, the line just rings off the hook because people who were trapped now have this opportunity to get out again."

"Supporting someone who is experiencing violence is tricky. Blame for the abuse and blame for this femicide, in particular, rests solely on the shoulders of the person who committed the crime."

"In terms of learning from this and what to tell other people who maybe have friends or family members who may be experiencing violence or who are concerned, it's to reach out for help."

Keri Lewis, executive director, Interval House, Ottawa

 

"It's really important that once they make the decision [to leave] and they have the supports in place there's rapid movement."

"We'll get a call and within a couple of days, we're moving the person. Done."

"Were getting them out the door."

Wendy Mitchell, director, Shelter Movers, Ottawa

 

An estimated 55 women and girls were killed in the first three months of 2022 across Canada, according to the Canadian Femicide Observatory for Justice and Accountability. Over a nine-month period in 2021, Interval House found itself at capacity and was forced due to such circumstances to turn away requests from 500 women. Shelter Movers, an organization which provides moving and storage at no cost to women and children fleeing abuse, found during the pandemic that they had to respond to 40 percent more requests for help in moves.

In 2021, Shelter Movers completed 275 moves and is anticipating that 2022 will see requests far surpassing that record. When they're called upon, logistical urgency reflects their mode of operation. According to data, the very time when a victim makes a decision to leave an abusive relationship becomes the most dangerous and the most likely time when an abuser can suddenly become a murderer. When family members blame themselves for not having insisted on taking action, they must understand the blame for an outcome of femicide rests squarely with the abuser.

Abuse, elaborates Keri Lewis, can occur in many ways; physical, but not necessarily. Abuse frequently manifests as control. Complete control; over finances, emotions and of relationships. This is when shelters become needed resources for those people facing abuse. Shelter crisis lines excel in explaining to callers how they can be of assistance in responding to the need to help in such abusive relationships.

People hold signs as they march prior to a candlelight vigil held in honour of Rebekah Love Harry, a victim of domestic violence, in Montreal on April 3.  CHRISTINNE MUSCHI/Reuters

A Tsunami of Omicron

"We just can't have everybody just being taken out of circulation because they just happen to be at a particular place at a particular time."

Australian Prime Minister Scott Morrison

"Delta and Omicron are now twin threats driving up cases to record numbers, leading to spikes in hospitalization and deaths."

"I am highly concerned that Omicron, being highly transmissible and spreading at the same time as Delta, is leading to a tsunami of cases."

Director-General Tedros Adhanom Ghebreyesus, World Health Organization

People wait outside a COVID-19 testing centre, amid the coronavirus disease (COVID-19) outbreak in Manchester, Britain, December 28 , 2021. REUTERS/Phil Noble

 

Britain, Italy, Spain Portugal, Greece, Cyprus and Malta have all registered record numbers of new cases. In the United States, the seven-day average of new daily cases hit its own record of 258,312, a Reuters tally confirmed...as opposed to the previous peak last January when 250,141 cases were registered. The saving grace is that surge aside, deaths and hospitalizations remain comparatively low, CDC director Dr.Rochelle Walensky pointed out.

Over the past seven-day period, according to Reuters data, global COVID-19 infections reached record highs as the Omicron variant sped uncontrollably through populations, leaving governments to wrestle with how they might conceivably contain the spread, and at the same time sparing fragile economies from paralysis.

On average every day worldwide, between December 22 and 28, close to 900,000 cases were registered, many countries posting new all-time highs in a previous 24-hour period. Among them the United States, Australia and many European countries, as well as Bolivia. Studies suggest Omicron is less deadly than previous variants yet even so, huge numbers of positive tests equate with some countries' hospitals soon becoming overwhelmed and at the same time businesses may struggle to carry on, with workers quarantining.

 

A situation that has led some governments to consider shortening the period of isolation for people who test COVID-positive, or have been exposed to someone who is positive, through sheer fear of the impact on the economy resulting from too many people being kept at home. Spain announced a reduction of their quarantine period for those testing positive to seven days from the current ten.

 

Italy is planning to relax isolation rules for people coming into close contact with infected people. U.S. health authorities released new guidelines this week that would shorten the isolation period for people with confirmed infection to five days from ten, confined to people who are asymptomatic. Olivier Veran, French health minister, informed lawmakers that his country was being overcome by a "dizzying" rise in cases where 208,000 have been reported in the space of a day -- representing a national and European record.

 

People wearing protective masks queue for booster injections of a coronavirus disease (COVID-19) vaccine as the pandemic continues, at a vaccination centre at the University of Malta in Tal-Qroqq, Malta December 29, 2021. Reuters

 

An increase of 60 percent over the previous week was seen in the United States where current seven-day daily average cases sit at close to 240,400, while the hospitalization rate for the same period is up 14 percent to about 9,000 per day over the same period, with deaths about seven percent, to 1,100 daily, given early data from Britain, South Africa and Denmark. The risk of hospitalization from Omicron is lower than from Delta according to the WHO.

Mike Ryan, the WHO top emergencies expert stated it to be too premature to draw definitive conclusions since Omicron so far was in circulation largely among younger, less vulnerable age groups. 182,027 COVID cases were reported in Britain, a new record exceeding the previous highest figure registered by fully 50,000, according to government statistics. Record cases were reported in Ireland as well, with over 16,000 new infections.

Prime Minister Boris Johnson, however, has been persuaded not to bring in new restrictions in England to limit the Omicron spread, now accounting for 90 percent of all community infections. Almost 18,300 new cases have been registered in Australia, eclipsing the previous high of around 13,300. Demand for free testing kits in Spain from the Madrid regional government has far outstripped supply, with long queues forming outside pharmacies.

 

The economic impact of huge numbers of people being forced into self-isolation as a result of having had contact with an infected person has governments increasingly concerned. Spain and Italy took steps to relax some isolation rules, but China is adamant about its policy of zero tolerance to the extent that it has placed the 13-million people in Xian, capital of central Shaanxi province, under rigid lockdown for a seventh day, where people cannot leave their homes even to shop for food.

Residents take nucleic acid tests in Xi'an on December 27, during a city-wide lockdown.

Pandemic Restraints Fallout

"Things were changing prior to COVID, big time, within the bra industry. What has happened alongside the pandemic is exploding interest in comfort, more flexible wires, softer fabrics and thinner fabrics."

"The bottom line is that all this fabric innovations mean you have a choice of softer, thinner and more comfortable fabrics We no longer have just two choices; thick padded or totally thin fabrics."

"If you take a look back at the last 100 years of bra manufacturing and design, it's easy to see how often styles change, as fashion does."

"There's a bra out there to meet everyone's needs, from super sexy to super sporty and everything in between."

Elisabeth Dale, founder, Breast Life 

"Intimate apparel used to serve as an item of clothing that was really worn for someone else. Now it's become a symbol of empowerment."

"It's about how it makes me feel versus how I look to you."

Kristen Classi-Zummo, apparel analyst, market research firm

"It used to be just cotton, but now Lycra, tricot, spandex, Spanette, latex and nylon are all blended together to achieve specific purposes."

"Higher spandex typically means more support and form will provide shaping."

Jene Luciani Sena, author, The Bra Book

And then there's another option. No bra. Freedom, comfort, truly 'relaxed fit'. "My body doesn't want me to strap it in for fashion's sake or because culture says I should. Nope. No more", was the expressed view of 51-year-old  Colorado life coach, Kate Chapman. "It's a delicious feeling". Well, it is for women who don't boast large breasts. For women who normally take D-size cups it's another ball game altogether. Unless they dress constantly in shapeless, large and wide garments like a MuuMuu and reconcile themselves to a tent-like appearance, they haven't the cultural/social freedom to go without.

 

Sales associate Rita King finds a specific size for a customer at Top Drawer Lingerie, a store in Uptown Park, on Thursday, June 3, 2021  Annie Mulligan, Houston Chronicle

Broadly speaking, however, the effect of the novel coronavirus pandemic has been to isolate people, to convince health and government authorities to instruct on the virtues of keeping people safe by transitioning to remote work, working from home in an effort to control the spread of the SARS-CoV-2 virus that brought the social order and the world economy to an abrupt pause. Not going out to the office any longer and working from home? Dressing casually, what could be more comfortable than ditching that bra? Instant relief. 

Little wonder there's been a drop in the sale of brassieres. The popularity of soft 'sports' bras has risen, as an alternative to the more pointed, structured architecture of the usual under-worn accoutrement of female attire. The obligatory, polite bra. The uncomfortable, stricturing brassiere. Women waking to the reality of pleasing themselves, ditching the intention to present a structured profile that exacts a fairly uncomfortable price on comfort.

 

They've experienced the freedom of being without a bra for well over a year, and it's been a huge hit. Some women will willingly revert to wearing a bra as they return to work in person in an office or shop setting. Others will be reluctant to, but feel that it is required of them. Others yet will devise alternatives new to the market and to satisfy convention by covering up their nipples to ensure that embarrassing shapes don't reveal their choice; stickies meant for that purpose come in handy.

"Some women have so thoroughly enjoyed not wearing a bra throughout this time working from home that they are telling clinicians that they are internally debating if they will ever go back to wearing one."

"Anecdotally, some women coming to the clinic share that it can be incredibly difficult finding a bra that works for them."

"This is a valid point — why should women return to wearing something that's uncomfortable, expensive no matter the price point, and a bit hit-and-miss with fabric options, lining, underwiring, padding, straps, presentation and long-lasting wear?"

Spokeswoman for Osteopathy Australia  

Many women have chosen to go without the restrictive item of clothing while working from home. (Unsplash: Mathilde Langevin)

The Depressing Trauma of COVID Oppression

Amid the COVID-19 pandemic, psychologists are worried about the mental health toll of rising cases and tightened restrictions during the winter ahead. (Evan Mitsui/CBC)

 

"When we saw that everything we were doing was having an effect and the numbers were dropping, that empowered us. It made us feel like we're beating this thing, And that is great until the numbers start to go up and we start hearing that more restrictions are going to be in place and ... we might start to feel like everything we did didn't matter. It came back anyway."

"It requires a much quicker step towards getting somebody that really knows what they're doing to help. So if we're heading into winter with less sunshine, less ability to get social interaction, less opportunity for aerobic activity, less job security for some ... I worry we might see depression rates increase."

"It does feel like we're heading into a long, dark winter."

"[Physical signs of depression include very low levels of energy. Anxiety, meanwhile, can cause elevations in heart rate, breathing and sweating as it] basically makes our muscles ready to fight or flee. But we don't know how to fight, and we can't flee. So we're left with this feeling that's becoming chronic, it's engaged all the time." 

"Mental health is not something somebody else struggles with anymore — it's something we're all struggling with now, The critical point to remember is that it certainly will get better. It's a matter of persevering through the dark days and coming out to a better spring and a better summer next year." 

Steve Joordens, psychology professor, University of Toronto

The news, the news. Not very inspiring at the best of times and these are not the best of times. On the one hand we have the almost-imminent appearance of a vaccine that it is hoped will obliterate the presence of the horrible novel coronavirus that has afflicted the global community for almost a year.  The world economy has suffered, but above all, there is now one-and-a-half million dead whose family members will never come to terms with their loss.

But there appears to be another type of affliction that people suffer under, apart from the physical distress, apart from the disabling physical effects of the SARS-CoV-2 virus that so mysteriously entered the pantheon of deadly diseases preying on the animal kingdom, and that has relentlessly stalked the world in such a sinister manner. 

People have been doubly victimized, their organs succumbing to the dire destructive effects of the virus on the respiratory system and other vital organs, and aside from and together with that there is the psychological affect. People already suffering mental insecurity, and those newly introduced to the intensity of fear and loneliness are experiencing a greater loss of equilibrium; debilitating mental illness.

 

A new poll just released by the Mental Health Commission of Canada and the Canadian Centre on Substance Abuse has revealed that respondents who claim to be in "strong mental health" has realized a fall in numbers by 23 percent over the time the global pandemic was set loose on humanity. In 2019, 67 percent of Canadians felt themselves to be in a condition of strong mental health, and that number has now declined to 44 percent. Over half of Canadians now think of themselves as being at a perilous level of mental health. 

A pedestrian walks past a mental health advertisement during the COVID-19 pandemic. Canada invests just 7.2 per cent of $219 billion in total health spending on mental health. Photo by Peter J. Thompson/National Post

Suicide help lines have been beleaguered by a wholesale increase in calls of desperation, vastly outstretching their ability to effectively cope with a mental health crisis that has afflicted youth in particular with one in five seen to be acquiring or worsening a mental health disorder, according to the Canadian Institute for Health Information. Emergency department visits and hospitalizations for mental health disorders among young people rose in the last decade by 60 percent even as hospitalizations for other issues fell by 26 percent. And the numbers are rising, thanks to COVID.

In effect, this disaster that the public has been warned about for years has been realized at a time when no one appeared to take the warning seriously, that a global pandemic was due to appear, and would have to be dealt with. Governments ignored the warning, health authorities took heed but did little to prepare, since it takes financing to do so and public health is financed by the public through taxation, a dirty word when it is suggested that more taxes need to be forthcoming to handle an immense problem that might or might not appear in the near-to-distant future.

Well, it appeared in the near-enough future and that future is now, and we are living through the disaster that just about everyone found too difficult to assimilate into their unreceptive minds as being something that had to be prepared for. That lack of preparation has resulted in horrendous consequences. On the other hand, it's difficult to imagine  how matters could have turned out differently. There are simply so many issues of vital importance that have to be seen to and dealt with, even absent the appearance of a global pandemic.

Things have certainly changed for youth everywhere, from toddlers at day care to elementary-school children, through to high school and university. How comfortable and 'child friendly' would it seem to a child looking around and seeing everyone wearing masks? Conformity may make it appear non-threatening, but it is also, undeniably, off-putting not to be able to see peoples' faces, their smiles the kind of facial language that we learn to read so effortlessly from birth to adulthood. Now denied the young.

Close physical contact another denial, when this is precisely what the human psyche thrives on. And to explain to a child the necessity of distancing is to introduce to that child the concept of an evil, unseen threat waiting to pounce. Which may be true but would be of no comfort to a child being informed that life has its dangers. Teens have seen their casual world of pairing up, joining groups, sport activities suddenly disappear in the interests of health safety. Strictures of caution are introducing them to a solitary existence.

University students, masked and distancing are as exposed to the feeling of suspicion of the 'other' as a potential vector of a disease that may merely inconvenience them, or that may, under certain physical conditions of receptivity when their particular immune system goes amok may alternately result in internal organ disruptions that can be pretty serious, and in rare circumstances lead to life-long impairment, and possibly an early death.

Not very reassuring to those setting out on what should be a long, 'normal' trajectory toward adulthood and aspirational lifestyles. Now, the new normal is isolation and loneliness, confusion and resentment. And mental illness, newly arrived or lingering in the background and newly exacerbated. And there is this kind of whistling-in-the dark:

"Being alone doesn't have to mean being in isolation, We're going to be finding more creative ways of [interacting] again — having game night over Zoom, having a movie night where you're both watching the same movie separately."

"So it's [about] being cautious, but still continuing to do the same activities that we normally use to ground us." 

Noreen Sibanda, registered provisional psychologist, Edmonton

Healthcare workers talk to a woman at a COVID-19 testing clinic Montreal, Sunday, October 11, 2020, as the COVID-19 pandemic continues in Canada and around the world.THE CANADIAN PRESS/Graham Hughes

Micro-Earth, Biosphere 2 -- The Ultimate Haven

"We were in quarantine for two years. Or we put the rest of the world in quarantine for two years."
"Any time there was a special occasion of drink or food, all the conflict [among the eight people who volunteered to live within the confines of Biosphere 2 for two years] drained away. No one wanted to spoil it."
"Whatever food and drink really makes people happy in quarantine should be pursued. This isn't fun unless we can have feasts and parties and do home brewing [under quarantine from COVID-19]."
"Wherever you are, you are supported, and you are living, because we have a healthy Earth biosphere. Fall in love with every bit of it. The plant on the windowsill, the tree on the corner. We have to understand that every breath of air that we take, every drop of water, every bit of food is produced by our biosphere."
"That's the awareness we need to come out of this pandemic. We're all connected. It's showing us the downside of it. But we need to recognize the flip side. Think of this amazing biosphere that's given us birth."
"Biosphere 2 was so far ahead of its time that it offered an understandable way of getting around what a biosphere was. We weren't making a model of planet Earth, thank you very much. It was a little slice."
"It totally transformed me, and everyone else who was in there. I'm still digesting it. The incredible bodily connection that all of us felt with that living system, to where it was unthinkable that we would harm it in any way. The mindfulness with which we took care of the biome. The tender loving care that we took, and the visceral sense that we were connected was also part of the human dimension."
"That knowledge and that love went from my brain, my mind, to my body. To where my body got it. My bodily understanding that I was connected to that world."
On one level being alone with seven people was like being in an encounter group, or group therapy, for two years. I got to see ways I related to other people that I didn't like. I had to change who I was."
Mark Nelson, 77, former 'Biospherian'

Biosphere 2, Mark Nelson, 1991

"Leonardo da Vinci talked about flying machines. Centuries later the Wright brothers built one. Biosphere 2 may prove to be the Kitty Hawk of biospheric life-support systems."
"Then again it may prove to be one of those airplanes everybody sees in the movies and laughs at that had 16 wings flapping at the same time."
Biosphere 2 patron Ed Bass, 1991

It was an imaginative, forward-looking experiment. A costly one, to invest in the needed infrastructure, to develop a system that was as true to the Earth's atmosphere and support of living creatures and vegetation as possible, to allow for self-isolation in a grand experiment where a group of eight people intended to see whether they might succeed at being self-sufficient, as stewards of a miniature Earth, drawing from its resources whatever they needed to sustain life, not only for themselves but for the creatures living alongside them, from insects to birds, mammals to vegetation.

It was quite an ad hoc experiment. The inhabitants of Biosphere 2 who named themselves 'Biospherians', were five Americans, two Brits and a Belgian, comprising four of each gender, included among them a botanist, a marine biologist and a physician. The very same professions, in fact, that sea-voyaging geographical exploratory missions of the past setting out to discover new continents and other inhabited locations worldwide with different cultures and levels of civilization generally brought along, in humanity's search to know the world they lived within, through the ages.

In cloistering themselves and shutting themselves away from the outside world, their adventure in living was meant to instruct the participants on how to manage lives separated from all that was familiar as they re-acquainted themselves with the natural world at a level none had ever before experienced and developed sustainable techniques. Biosphere 2 was planned and created to enable the eight people within to creatively live independently. The complex into which they had sequestered themselves was of an immense size, purpose-built through the 1980s in the Arizona desert..

The Biosphere had an ocean with coral reefs, a miniature rainforest, a desert, and a wide range and plenitude of flora and fauna, living among the eight humans. One of whom badly injured herself which mandated she be withdrawn from the closed atmosphere to undergo surgery on her hand. Once her injury was resolved, she returned to the Biosphere. Among a few controversial revelations was that the 'all-natural system', of the breathing, living atmosphere meant to sustain life 'naturally' through its micro eco-system, was the presence of a carbon dioxide scrubber to ensure fresh air could be pumped in to avoid potential hypoxia.

As Mark Nelson wrote for publication in a Dartmouth College journal, as a former Dartmouth alumni, the group grew all their food, raising and slaughtering livestock. They had a laboratory, they were busy maintaining equipment and had their personal living quarters. Everyone was required to work from three to four hours daily, five days a week, to help produce the food they depended on for nutritious health. With no agricultural background among any of them, they were spurred by the reality that if they didn't produce they wouldn't eat.

And eat they did, learning to produce 80 various crops, from rice to yams, peanuts, sorghum, millet, beets, wheat, carrots, peppers, bananas, figs, tomatoes, kale, eggplant, onions, papaya, beans, sweet and white potatoes, squash and herbs. Biosphere 2 was host to 3,000 species of plants and animals.
Crops were grown with biological controls, and organic matter was recycled for composting. And lessons were learned; the cockroaches they hosted meant to recycle organic matter grew exponentially in numbers and began threatening the crops. A situation seen in ants, as well.

Bees and hummingbirds, two of the most delightful animals, and reliable pollinators eventually failed to survive the atmosphere. And eventually the atmosphere itself failed in its purpose to sustain life when oxygen thinned out necessitating the opening of the sealed domes so fresh air could be circulated and replenished. Despite inconveniences and downright emergencies where the inhabitants of Biosphere 2 had little option but to temporarily abandon the airtight sanctity of the domes, they persevered and lived for the appointed two years, isolated and self-sufficient.

Mr. Nelson himself now lives and works on a working farm, serving as an ecology research centre and retreat in New Mexico, called Synergia Ranch, a group he first joined after graduation from Dartmouth College in 1968.

Biosphere 2's 91-foot-tall rain forest contains more than 150 plant species and now provides scientists a test ground for ecosystem experiments. Douglas Adesko

Suicidal Children

"We're seeing a significant increase in suicidal behaviour since 2014. Everyone is wondering why the rates of ideation [suicidal thoughts] and behaviour are increasing."
"It [isolation] contributes to disconnection. They're sleeping more poorly [teens].  Any peer issues at school are following them home. If you're being bullied at school, you're not getting a break."
"People want to make sure that when a teen is in distress, they get the help they need."
"Conversations with teens involve mostly listening. Avoid giving advice. A good night's sleep means good mental health."
"If you suspect your teen is thinking about suicide, ask him or her. Asking questions won't prompt a suicide."
Dr. Allison Kennedy, psychologist, Children's Hospital of Eastern Ontario

"A single suicide attempt is the strongest predictor of future completed suicide."
"Community and general emergency departments are not resourced to give these children the comprehensive assessments and follow-up they need for optimal care."
Dr. Brett Burstein, pediatric emergency room physician, Montreal Children's Hospital

Strelka/Flickr

"There is an overwhelming amount of data from many different sources, and it all points in the same direction: more mental health issues among American young people."
"This is always a tough question to answer, as we can’t prove for sure what the causes are. But there was one change that impacted the lives of young people more than older people, and that was the growth of smartphones and digital media like social media, texting and gaming."
"[While older adults also use these technologies], their adoption among younger people was faster and more complete, and the impact on their social lives much larger."
"[The way young people communicate and spend their leisure time] has fundamentally changed. They spend less time with their friends in person and less time sleeping, and more time on digital media."
Jean Twenge, professor of psychology, San Diego State University

"There’s a lot we don’t know, and we can’t say conclusively what’s driving these [mental health] trends. But in the real world when dealing with the health of children, you need to make your best guess and move ahead before things are unequivocally proven."
"It makes sense to pay attention to adolescent behaviors we know are changing and to target those behaviors for intensive scrutiny, and in the meantime to have [young people] engage in behaviors that don’t lead to poor well-being. There’s this overload of information and stimulation and a much bigger sphere of influence that they’re being exposed to."
"Given what we know about adolescent development and vulnerability and the intensive need for intimate and healthy social connection during these years, you can see how social media may not be developmentally appropriate."
Mary Helen Immordino-Yang, professor of psychology and education, University of Southern California

"I think every generation of adults tries to pin a negative trend they see in young people on whatever the current technological fad is."
"[The data may show depression rising among young people, but he can't see] a clear cost [associated with technology or social media use]."
"Certainly there are some stressors that are inherent in social media use, but there are other stressors as well; [increased competition to get into college and] parents hovering -- It’s probably not one thing, but the cumulative impact of a lot of things."
Laurence Steinberg, distinguished professor of psychology, Temple University

A new study by researchers in Canada found annual visits to American emergency rooms for suicidal thoughts and suicide attempts among children between the ages of five to 18 almost doubled between the years 2007 and 2015, from 580,000 to a staggering 1.12 million. Dr. Burstein, a pediatric emergency room physician at Montreal Children's Hospital, the co-author of the study and his colleagues sampled 300 U.S. emergency rooms to analyze public health data from the Centers for Disease Control and Prevention.

Among the findings' most disturbing conclusions was that 43 percent of children taken to an emergency room were aged between five and 12. There is no available comparable national Canadian data, but Dr. Burstein noted that at Montreal Children's Hospital a 55 percent increase in suicidal behaviour was noted between 2015 and 2018. In the U.S. study an eight-year period was involved whereas in the Canadian one a three-year period produced the results, indicating that the rise in suicide attempts is faster in Canada than in the U.S.

Health professionals, particularly those considered experts in the field of teen studies are uncertain how and what to attribute these figures to. Theories appear for the most part to centre around social isolation due to the rise and impact of technology-driven products where young people have turned increasingly to social media attraction which draws them away from personal real-world interaction, leading them toward an isolated lifestyle with few real social emotional supports.

This situation leaves teens spending more time by themselves. The more time spent on social media, the more time teens spend in their rooms, and consequently less time interacting with others, even with family members and that, even while they're at home. The disconnect between personal and one-on-one relationships in real time with real people has its isolating effect, leaving children adrift and lacking both peer and parental support.

This has led to the appalling realization that the second most common cause of death among adolescents in Canada is suicide, after accidents. Over 10 teen suicides for every 1,000,000 teens distinguishes Canada as one of five countries with the highest teenage suicide rates in 2015, according to a report by the O'Brien Institute for Public Health at University of Calgary. Twenty-two percent of teens between the ages of 13 and 18 had considered suicide in a 12-month period, according to a 2016 survey conducted by Kids Help Phone.

Of the children in the American study, fewer than 13 percent arrived in the emergency room for isolated suicidal thoughts; most -- 87 percent -- were present in the wake of an actual suicidal gesture or attempt; they had gone beyond thinking to action. To Dr. Burstein this suggests that an actual increasing burden of mental health problems among children is involved. Dr. Burstein points out the need for more community-based mental health resources, along with emergency department preparedness, as well as risk reduction interventions once the patient leaves the emergency department.

Signs of suicidal behavior in teens

As with many medical conditions, there typically is no single sign a family can point back to that explicitly indicated a teen was suicidal. There are several signs that may indicate suicide risk, including the following behaviors:
● Depressed mood/mood disorders
● Difficulty regulating emotions
● Difficulty with problem solving
● Hopelessness
● Impulsivity
● Hostility and aggression
● Quitting or struggling to enjoy favorite activities
● Social or interpersonal problems, interpersonal skill deficits
● High situational stress
● Insomnia