Purpose: Members of the transgender community face significant health disparities within our society, especially within the state of West Virginia, which is primarily rural. We sought to examine and compare existing attitudes and knowledge of resident and faculty physician medical professionals at our institution about treating transgender individuals within a rural tertiary care center.Methods: The Medical Practitioner Attitudes Towards Transgender Patients (MP-ATTS) survey and the Medical Practitioner Beliefs and Knowledge about Treating Transgender Patients (MP-BKTTP) survey were sent to all faculty and resident physicians at West Virginia University Hospitals. Demographics included information about gender, rurality of hometown, race, and description of medical practitioner status (i.e., years out of residency, residency status).Findings: In general, there were positive attitudes and reception of the survey among residents and faculty physicians. 76.45% of providers assumed that their patients were not transgender. More than 40% of respondents believed that they would need further education about transgender patients to provide appropriate health care. Male health care providers had significantly higher negative perceptions of the transgender community (N=85, M=4.46, standard deviation [SD]=0.55, p<0.0001) and perceived fewer barriers due to personnel (N=80, M=3.24, SD=0.96, p<0.0001).Conclusion: A clear need exists for increased training in transgender health care among physicians taking care of this patient population. A gender divide exists among health care providers within West Virginia over attitudes regarding the transgender community. Further studies are needed to fully understand the health care needs and barriers of the transgender population.

Background Characterizing normal heart rate variability (HRV) and resting heart rate (RHR) in healthy women over the course of a pregnancy allows for further investigation into disease states, as pregnancy is the ideal time period for these explorations due to known decreases in cardiovascular health. To our knowledge, this is the first study to continuously monitor HRV and RHR using wearable technology in healthy pregnant women. Methods A total of 18 healthy women participated in a prospective cohort study of HRV and RHR while wearing a WHOOP® strap prior to conception, throughout pregnancy, and into postpartum. The study lasted from March 2019 to July 2021; data were analyzed using linear mixed models with splines for non-linear trends. Results Eighteen women were followed for an average of 405.8 days (SD = 153). Minutes of logged daily activity decreased from 28 minutes pre-pregnancy to 14 minutes by third trimester. A steady decrease in daily HRV and increase in daily RHR were generally seen during pregnancy (HRV Est. = − 0.10, P < 0.0001; RHR Est. = 0.05, P < 0.0001). The effect was moderated by activity minutes for both HRV and RHR. However, at 49 days prior to birth there was a reversal of these indices with a steady increase in daily HRV (Est. = 0.38, P < 0.0001) and decrease in daily RHR (Est. = − 0.23, P < 0.0001), regardless of activity level, that continued into the postpartum period. Conclusions In healthy women, there were significant changes to HRV and RHR throughout pregnancy, including a rapid improvement in cardiovascular health prior to birth that was not otherwise known. Physical activity minutes of any type moderated the known negative consequences of pregnancy on cardiovascular health. By establishing normal changes using daily data, future research can now evaluate disease states as well as physical activity interventions during pregnancy and their impact on cardiovascular fitness.

Male hormonal contraception may become a reality in the near future. Nonsteroidal methods including contraceptive vaccines targeting various molecules are an exciting proposition and are under investigation.

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BACKGROUNDCharacterizing normal heart rate variability (HRV) and resting heart rate (RHR) in healthy women over the course of a pregnancy allows for further investigation into disease states, as pregnancy is the ideal time period for these explorations due to known decreases in cardiovascular health. To our knowledge, this is the first study to continuously monitor HRV and RHR using wearable technology in healthy pregnant women.METHODSA total of eighteen healthy women participated in a prospective cohort study of HRV and RHR while wearing a WHOOP® strap prior to conception, throughout pregnancy, and into postpartum. The study lasted from March 2019 to July 2021; data were analyzed using linear mixed models with splines for non-linear trends.RESULTSEighteen women were followed for an average of 405.8 days (SD=153). Minutes of logged daily activity decreased from 28 minutes pre-pregnancy to 14 minutes by third trimester. A steady decrease in daily HRV and increase in daily RHR were generally seen during pregnancy (HRV Est. = -0.10, P<0.0001; RHR Est. = 0.05, P<0.0001). The effect was moderated by activity minutes for both HRV and RHR. However, at 49 days prior to birth there was a reversal of these indices with a steady increase in daily HRV (Est.=0.38, P< 0.0001) and decrease in daily RHR (Est. = -0.23, P< 0.0001), regardless of activity level, that continued into the postpartum period.CONCLUSIONSIn healthy women, there were significant changes to HRV and RHR throughout pregnancy, including a rapid improvement in cardiovascular health prior to birth that was not otherwise known. Physical activity minutes of any type moderated the known negative consequences of pregnancy on cardiovascular health. By establishing normal changes using daily data, future research can now evaluate disease states as well as physical activity interventions during pregnancy and their impact on cardiovascular fitness.