Purpose: There is a paucity of data regarding transgender and gender diverse (TGD) people who ''detransition,'' or go back to living as their sex assigned at birth. This study examined reasons for past detransition among TGD people in the United States. Methods: A secondary analysis was performed on data from the U.S. Transgender Survey, a cross-sectional nonprobability survey of 27,715 TGD adults in the United States. Participants were asked if they had ever detransitioned and to report driving factors, through multiple-choice options and free-text responses. A mixed-methods approach was used to analyze the data, creating qualitative codes for free-text responses and applying summative content analysis. Results: A total of 17,151 (61.9%) participants reported that they had ever pursued gender affirmation, broadly defined. Of these, 2242 (13.1%) reported a history of detransition. Of those who had detransitioned, 82.5% reported at least one external driving factor. Frequently endorsed external factors included pressure from family and societal stigma. History of detransition was associated with male sex assigned at birth, nonbinary gender identity, bisexual sexual orientation, and having a family unsupportive of one's gender identity. A total of 15.9% of respondents reported at least one internal driving factor, including fluctuations in or uncertainty regarding gender identity. Conclusion: Among TGD adults with a reported history of detransition, the vast majority reported that their detransition was driven by external pressures. Clinicians should be aware of these external pressures, how they may be modified, and the possibility that patients may once again seek gender affirmation in the future.

Background: Inclusive STEM (traditionally known to stand for "Science, Technology, Engineering, and Math") high schools are emerging across the country as a mechanism for improving STEM education and getting more and diverse students into STEM majors and careers. However, there is no consensus on what these schools are or should be, making it difficult to both evaluate their effectiveness and scale successful models. We addressed this problem by working with inclusive STEM high school leaders and stakeholders to articulate and understand their intended school models. This "bottom-up" approach is in contrast with other studies that have taken a "top-down," literature-based approach to defining STEM schools. Results: Through this process, we identified 76 critical components of STEM schools and derived a theoretical framework of eight elements that represent the common goals and strategies employed by inclusive STEM high schools across the country: Personalization of Learning; Problem-Based Learning; Rigorous Learning; Career, Technology, and Life Skills; School Community and Belonging; External Community; Staff Foundations; and External Factors. This framework offers a clear picture of what exactly inclusive STEM schools are and common language for both researchers and practitioners. Interestingly, STEM disciplinary content did not emerge as a defining component across school models.

As HIV-infected patients live longer, the increasing burden of noncommunicable diseases may complicate their clinical management, requiring primary care providers to be trained in chronic disease management for this population.

Disasters provide a distinctive context in which to study the robustness and resilience of response systems. Therefore, in the aftermath of a large-scale crisis, every effort should be invested in forming a coalition and collecting critical lessons so they can be shared and incorporated into best practices and preparations. Novel communication strategies, flexible leadership structures, and improved information systems will be necessary to reduce morbidity and mortality during future events.