Provision of Quality Contraceptive Services: Updates From National Guidelines.

In 2024, the Centers for Disease Control and Prevention and the US Department of Health and Human Services Office of Population Affairs updated national guidelines on provision of quality contraceptive services and sexual and reproductive health care. New recommendations systematically promote care that is person-centered and accessible for all people. Contraceptive services may be addressed through a stepwise approach in which the clinician asks about an individual's contraceptive preferences based on their needs, desires, and prior experiences and then collaboratively works with the patient to align methods with their values and preferences.

Incidence and Prevalence of Polycystic Ovary Syndrome in Adolescent and Young Adult US Military Dependents From 2018 to 2022.

Study Objective: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among people who menstruate. Adolescent and young adult (AYA) military dependents, a large, diverse subset of the United States population, have not been represented in prior reports of PCOS. This study estimated the incidence and prevalence of possible-PCOS (PCOS symptoms in the absence of a documented PCOS diagnosis) and PCOS in AYA military dependents, and described the length of time between possible-PCOS and first documented PCOS diagnosis for people who met both during the surveillance period.

Factors Associated With Contraception Use Among Active Duty Service Members at a Large Military Base.

Introduction: Active duty service members (ADSMs) experience higher rates of unintended pregnancy compared to the general population. While the military has introduced programs aimed at improving access to sexual and reproductive healthcare services (SRH), significant barriers to care remain.

Materials And Methods: A survey was completed by ADSMs with access to no-cost, walk-in SRH.

Transversus abdominis plane (TAP) blocks for prevention of postoperative pain in women undergoing laparoscopic and robotic gynaecological surgery.

Rationale: Pain control following laparoscopic gynaecologic surgery is key to successful recovery. The efficacy of the transversus abdominis plane (TAP) block compared to no block or a local anaesthetic injection has not been well established in this population.

Objectives: To evaluate the benefits and harms of single-shot transversus abdominis plane blocks for the prevention of postoperative pain in women undergoing laparoscopic and robotic gynaecological surgery compared to no block, sham block, or injection of local anaesthetic.

Factors associated with probability of inpatient hospitalization in military-affiliated adolescents and young adults with eating disorders.

This study examined demographic and military factors related to probability of hospitalization among military-affiliated adolescents and young adults (AYA) with an eating disorder (ED) diagnosis. Participants were military-affiliated AYA (spouses not included), ages 10-26 years. De-identified data were extracted from the Military Health System Data Repository from 2016-2021.

Oscillating US Department of Defense policies and medical record documentation of gender dysphoria in service members: an observational time-series analysis.

Background: United States military policies regarding service by transgender service members have shifted several times within the past decade. The relationships between policy changes and electronic health record documentation of gender dysphoria, a current and historic policy requisite for gender affirming care receipt, in active duty service members remain unknown.

Methods: Bayesian estimator of abrupt change, seasonality, and trend models identified changepoints in the proportion of service members who had new and then historical medical record documentation consistent with gender dysphoria from January 2015 to August 2022.

Statistically Significant Associations Between HPV33, HPV35, and HPV56 With Anal HSIL in a Population of MSMLWH.

Objective: The aim of the study is to determine the prevalence of high-risk human papillomavirus (hrHPV) genotypes in men who have sex with other men and are living with HIV and the factors associated with anal high-grade squamous intraepithelial lesions (HSIL).

Methods: Anal swabs were collected for hrHPV genotyping from a cross-sectional group ( N = 163) of eligible men who have sex with other men and are living with HIV attending a high-resolution anoscopy clinic. Persistent hrHPV infections were studied in a longitudinal subset ( n = 37).

Time to Gender-Affirming Hormone Therapy Among US Military-Affiliated Adolescents and Young Adults.

Importance: Use of exogenous sex steroid hormones, when indicated, may improve outcomes in adolescents and young adults with gender incongruence. Little is known about factors associated with the time from diagnosis of gender dysphoria to initiation of gender-affirming hormone therapy. Identification of inequities in time to treatment may have clinical, policy, and research implications.

Military Family Physicians' Readiness to Provide Gender-Affirming Care: A Serial Cross-Sectional Study.

Purpose: Family physicians are increasingly more likely to encounter transgender and gender-diverse (TGD) patients requesting gender-affirming care. Given the significant health inequities faced by the TGD community, this study aimed to assess changes in military-affiliated clinicians' perspectives toward gender-affirming care over time.

Methods: Using a serial cross-sectional survey design of physicians at the 2016 and 2023 Uniformed Services Academy of Family Physicians conferences, we studied participants' perception of, comfort with, and education on gender-affirming care using Fisher's Exact tests and logistic regression.

Incidence and prevalence of eating disorders among U.S. military service members, 2016-2021.

Objective: Despite unique experiences that may increase eating disorder risk, U.S. military service members are an understudied population.

Variation in Time-to-Gender-Affirming Hormone Therapy in US Active Duty Service Members.

Background: Beginning in July 2016, transgender service members in the US military were allowed to receive gender-affirming medical care, if so desired.

Objective: This study aimed to evaluate variation in time-to-hormone therapy initiation in active duty Service members after the receipt of a diagnosis indicative of gender dysphoria in the Military Health System.

Research Design: This retrospective cohort study included data from those enrolled in TRICARE Prime between July 2016 and December 2021 and extracted from the Military Health System Data Repository.

Health Care Utilization During the First 5½ Years of Authorized Service by Transgender U.S. Service Members (2016-2021).

This study examined the utilization of gender-affirming health care by active-duty service members during the initial 5½ years that transgender and gender-diverse (TGD) individuals were authorized to serve in the U.S. military.

Environmental Exposures and Risks During Pregnancy.

The Women in Wilderness Medicine Research Committee of the Wilderness Medical Society conducted a narrative review to address considerations for pregnant individuals in wilderness environments. There is limited evidence behind many opinion-based recommendations on the safety of various environmental exposures in pregnancy. The authors reviewed the literature for the best available evidence, including observational studies, case series, limited controlled trials, and extrapolation from physiological data, as well as evaluating expert consensus statements.

Over-the-counter access to hormonal contraception: a global perspective.

Purpose Of Review: Oral contraceptive pills are among the most popular contraceptives worldwide, including among adolescents, and are available over the counter in over 100 countries. However, when a prescription is required, oral contraceptives may be difficult to obtain, particularly for adolescents. Recent approvals of over-the-counter progestin-only pills in the United Kingdom and United States have brought widespread attention to this topic.

Emotional dysregulation moderates the relation between perceived stress and emotional eating in adolescent military dependents.

Objective: Adolescent children of US service members (i.e., military-dependent youth) face unique stressors that increase risk for various forms of disinhibited eating, including emotional eating.

Youth With Sexual or Gender-Diverse Identities and Military Connection: Recommendations to Optimize Clinical Care.

In the United States, an estimated 1.9 million youth 13 to 17 years of age (9.5%) identify as sexual and/or gender diverse (SGD), identifying as nonheterosexual and/or having a gender identity other than the assigned sex at birth.

Incidence and prevalence of eating disorders among active duty US military-dependent youth from 2016 to 2021.

Objective: The offspring of US military service members may be at increased risk for eating disorders. However, no epidemiological studies to date have evaluated eating disorder incidence rates and prevalence estimates among military-dependent youth.

Method: This retrospective cohort study examined eating disorder diagnoses in the military healthcare system (MHS) from 2016 through 2021.

The prospective relationship between weight-based discrimination and eating pathology among youth.

Among adults and adolescents, weight-based discrimination is associated with disordered eating. However, these relationships remain understudied in children. Given that weight-based discrimination is commonly reported among youth, and that childhood is a crucial developmental period for the onset of disordered eating, the current study assessed prospective associations between weight-based discrimination and eating pathology among participants in the Adolescent Brain Cognitive Development Study.

The Relationship Between Anxiety, Coping, and Disordered-Eating Attitudes in Adolescent Military-Dependents at High-Risk for Excess Weight Gain.

Adolescent military-dependents are an understudied population who face unique stressors due to their parents' careers. Research suggests that adolescent military-dependents report more anxiety and disordered-eating than their civilian counterparts. While anxiety symptoms predict the onset and worsening of disordered-eating attitudes, the mechanisms underlying this relationship remain unclear.

First-Trimester Pregnancy: Considerations for Wilderness and Remote Travel.

Women increasingly participate in outdoor activities in wilderness and remote environments. We performed a literature review to address diagnostic and therapeutic considerations during first-trimester pregnancy for remote multiday travel. Pretrip planning for pregnant patients traveling outside access to advanced medical care should include performing a transvaginal ultrasound to confirm pregnancy location and checking D rhesus status.

Stigma and Barriers in Health Care Among a Sample of Transgender and Gender-Diverse Active Duty Service Members.

Background: Transgender and/or gender-diverse (TGD) persons are vulnerable to stigma and health care inequities; however, data are particularly limited among TGD active duty military service members despite ongoing changes to service policies. TGD-related stressors may impede access to and utilization of health care due to fear of potential discrimination and distress, thereby adversely impacting military readiness.

Methods: We examined stigma and barriers in health care and associations with physical and mental health in an online sample of 177 active duty service members who self-identified as TGD.