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As I have said before, we are facing a crisis in declining curriculum on sexuality education in medical schools across the United States and Canada. There is a very clear need to better prepare medical students to be able to attend to the myriad of sexual health problems that their patients face. We have a public health imperative to address these problems.

Last fall we brought together 55 experts for a summit on medical school education in sexual health. The purpose of the summit was to examine the situation, discuss the challenges and opportunities, share lessons learned, and make recommendations for ensuring that physicians are properly trained to address the sexual health needs of their patients as they go into practice. In April the meeting report was published in the Journal of Sexual Medicine.

The expert consensus recommended:

•  Sexual health education should be integrated longitudinally throughout four years of medical school.

•  Sexual health education should be "introduced early and often."

•  Working together should be the norm and not the exception. There are other disciplines and experts who have an interest and a need in sexual health education.

•  Developing evaluation mechanisms incorporating multiple methods of measurement to help medical schools understand how to best teach sexual health.

•  Much like students, faculty members need content and curricula to build their skills and comfort in sexual health.

•  Create a cross-organizational effort using multiple partnerships to advance the cause.

•  Participants strongly endorsed an initiative to commission an Institute of Medicine (IOM) report, which would also describe the need to address sexual health education for health care providers. This IOM report would be a collaborative project.

One approach to building a healthier society is to better train physicians. The training of medical students is an essential step to advance sexual health. It is time to ensure that in our society new doctors as well as practicing health professionals are prepared to address the sexual health needs of their patients from adolescence through seniority.

As Joycelyn Elders, MD, said in the closing of the summit, "A society grows great when old men and old women plant trees under whose shade they will never sit. At least we're planting trees." The passion displayed by the summit participants needs to continue. The group is committed to carrying out the recommendations.

The Program in Human Sexuality has been on the forefront of sexual health education for medical students since it began in 1970. We have been able to preserve one of the country's premier courses and curriculum. With the support of the Joycelyn Elders Chair in Sexual Health Education, we are committed to taking a leadership role in ensuring that not only our curriculum remains the best, but that we foster the highest quality sexual health education for other medical students in the United States and around the world.

Coleman, E., Elders, J., Satcher, D., Shindel, A., Parish, S., Kenagy, G., Bayer, C. R., Knudson, G., Kingsberg, S., Clayton, A., Lunn, M. R., Goldsmith, E., Tsai, P., & Light, A. (2013). Summit on Medical School Education in Sexual Health: Report of an Expert Consultation. Journal of Sexual Medicine, 10(4), 924-938. doi:10.1111/jsm.12142

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We are excited to announce the new Michael E. Metz Fellowship in Couples' Sexual Health that will help prepare postdoctoral fellows for a career that will combine clinical and scholarly endeavors in the area of couples' sexual health.

The Metz Fellowship was created with a generous gift from Hildy Bowbeer to honor the life and work of her husband, Michael E. Metz, PhD. Metz was a nationally respected psychologist and couples therapist, who for 12 years served on the faculty of PHS and directed the relationship and sex therapy program. Metz passed away in March 2012.

Bowbeer said, "Mike was not only committed to couples' sexual health in his own clinical and research work, but was also passionate about training the next generation of scholars and therapists in this field. I'm thrilled to be able to help PHS carry on his legacy in this way."

The Metz Fellowship is a two-year program that will follow the training model of our postdoctoral fellowship, but the Metz Fellow will focus her or his clinical work on couples' sexual health. Bowbeer's gift will enable the Metz fellow to dedicate thirty percent of their time to research in the area of couples' sexual health. "This is a great opportunity for a postdoctoral fellow to have more time to focus on research and scholarly work," said Eli Coleman, PhD, director.

As a clinician Metz worked with more than 6,000 couples, addressing and resolving relationship and sexual problems, improving their quality of life. He authored 4 books and more than 60 professional articles and book chapters in the areas of couple intimacy, relationship conflict styles, sexual health, sexual medicine, and cognitive-behavioral features of satisfying relationships. He conceptualized the "Good Enough Sex Model" which was greeted with great appreciation. Throughout his career, Metz received many awards and honors.

Now accepting applications for fall 2013
http://z.umn.edu/metz

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Researcher, clinician, and educator Alex Iantaffi, PhD, joined the faculty at PHS on January 2, 2013.

Iantaffi is an assistant professor and a licensed marriage and family therapist, who originally trained in the United Kingdom as a systemic psychotherapist. Iantaffi has most recently worked on HIV research in the Department of Epidemiology at the University of Minnesota. In 2008 he came to the US from the UK to work on his postdoctoral fellowship at PHS, while serving as the project coordinator for the research project All Gender Health Online.

"We welcome Alex back to PHS. He is a great addition to our faculty, strengthening our research program and helping with clinical and teaching activities as well," said Eli Coleman, PhD, director.

Iantaffi is currently principal investigator for a study, funded by the National Institutes of Health, on Deaf Men who have Sex with Men (DMSM), HIV testing, prevention, and technology titled "D-P@RK." This study aims to overcome health disparities to HIV testing for DMSM through the development of Internet-based screening and prevention tools. The long-term objective of this line of research is to improve HIV screening, prevention, treatment, and access for Deaf people, by developing innovative, culturally and linguistically accessible Internet-based methods and interventions. The project has begun recruiting DMSM and individuals who have experience working with DMSM around issues of sexual health and/or HIV prevention, testing, and treatment.

Iantaffi has been the Editor-in-Chief for the Journal of Sexual and Relationship Therapy since June 2007, receiving its first impact factor in 2011. His therapeutic work is currently focused on transgender and gender non-conforming youth, and their families; sexuality, and relationships. Iantaffi has conducted research, and published on gender, disability, sexuality, deafness, education, sexual health, HIV prevention, and transgender issues. His scholarly work has been increasingly focused on issues of intersectionality and sexual health disparities. Iantaffi serves on the Transgender Commission leadership team as a past co-chair, as well as vice-chair on the Board of Directors at PFund, host for the GLBT Host Home Program, and core organizer for the newly formed Minnesota LGBTQ Health Collaborative.

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Rosemary Munns, PsyD, assistant professor, is the new coordinator of Sexual Offender Treatment at PHS.

Munns will bring her extensive skills in corrections, psychology, and sexual offender treatment to the role of coordinator. For more than a decade Munns has worked with sexual offenders in individual and group therapy through all stages of their treatment from assessment through after care. For many years, she has also worked with a therapy group for their partners. "Rose has extensive experience in this area and we are fortunate to have her take a leadership role in this treatment program," said Eli Coleman, PhD, director.

Munns is leading an effort to coordinate the types of data that is collected by sexual offender treatment providers throughout Minnesota. Munns said, "The first step in getting an accurate understanding sexual offender treatment in Minnesota and a clear picture of treatment effectiveness is for programs to collect the same types of data on their clients." Munns is proposing quarterly meetings with key constituents to develop this project.

PHS offers a Sexual Health Systems Model approach to sexual offender treatment that Munns believes works well for clients and their families. Munns does intend to make some changes in the training of postdoctoral fellows in sexual offender treatment. She would like to offer fellows a glimpse into other treatment environments including prison and civil commitment locations.

Beyond her work with sexual offenders, Munns has extensive clinical experience in assessment and treatment of substance abuse, working in correctional settings with juvenile delinquents and adults, as well as inpatient and outpatient psychiatry. Her areas of interest are sexual dysfunctions, relationship and sex therapy, transgender issues, abuse recovery, compulsive sexual behavior, sexual orientation, and HIV counseling. Munns received her PsyD from the Minnesota School of Professional Psychology and was a postdoctoral fellow at PHS.

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HIV infection among Somalis is increasing in Minnesota. Many Somalis living in Minnesota do not know they are infected and are not getting the medical treatment they need.

In 2009 the University of Minnesota and Midwest Community Development, Inc. launched a project to explore HIV risk and sexual behaviors in Somali women titled "Somali Women's Initiative for Sexual Health (SWISH)." On April 13, 2013, researchers shared their study results with the community.

This study is the first to examine HIV-related knowledge, attitudes, and behaviors of Somali women with the ultimate goal of meeting the critical need to reduce HIV and STD transmission among African-born Americans in Minnesota (and the US) as African-born Americans have the highest HIV/AIDS rates of any ethnic group. Participants were recruited through personal contacts as well as from Somali gathering places. Researchers interviewed 30 Somali women aged 18-40 from the Twin Cities area. Interviews were conducted in English (8) or Somali (22) by the project's bilingual Somali staff.

Key findings of the study include:

•    HIV testing was done at high rates, primarily due to immigration requirements. It is unknown how that may differ for those who were born in US.

•    Condoms are used, primarily for pregnancy prevention rather than disease prevention.  This may be due to a perceived low risk for disease.

•    Despite frequent mentions of prohibitions of many sexual behaviors, women also reported an encouragement within their religious tradition towards sexual pleasure within marriage.

•    Women often spoke of a culture of privacy in which discussions of sexuality are saved for one's spouse.

•    Vaginal intercourse seen as the only permissible form of sexual expression between spouses.

•    The more severe circumcision correlated with reported vaginal pain with intercourse.

•    This population reports a higher rate of pain with vaginal intercourse than the average US population (40% vs. 13%).

•    Generally, women had negative attitudes towards circumcision and would not choose to circumcise their daughters, despite high rates of personal circumcision.

The principal investigator of SWISH, Bean Robinson, PhD, said, "For this project, it was essential that we had strong, engaged community partners. Due to language barriers, we were challenged to develop interview questions that made sense and really got to the heart of what we were asking. For example, there is no Somali word for female or male 'orgasm' and our attempt at a description of an orgasm ended up being 59 words long and few participants understood what we were asking. We were not able to use that data."

The community presentation event was part of the Community Dialogue Series co-hosted by the University of Minnesota's Program in Health Disparities Research and the Center for Health Equity. The research project was funded by the Program in Health Disparities Research, the University's IDEA Multicultural Research Award, and the UCare Fund. The information gathered during this pilot study will be used to secure a larger grant to further study the knowledge, attitudes, and behaviors related to HIV/STD transmission and prevention within the Somali community. Ultimately the group will translate this knowledge to develop interventions for Somali women.

The research team included Bean Robinson, PhD, principal-investigator; Amira Ahmed, BA, co-investigator, founder and executive director at Midwest Community Development Inc.; Jennifer Connor, PhD, co-investigator, St. Cloud State University; Shanda Hunt, BA, project coordinator; Fatah Ahmed, BA, interviewer and recruiter; Amanda Ciesinski, MS, volunteer, Megan Finsaas, BA, volunteer; Fatima Noor, volunteer translator, and Professional Interpreting Inc.. The project's Community Advisory Board assisted and advised the research team in study development, recruitment, and data analysis and interpretation.

Community report in English

Community report in Somali

If you would like printed copies of the community report, please contact phsresearch@umn.edu

Photo: Bean Robinson, PhD, presenting; seated left to right: Amira Ahmed, BA; Shanda Hunt, MPH; Amanda Ciesinski, MS; Megan Finsaas, BA; Jennifer Connor, PhD


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Since the first of the year, PHS faculty and postdoctoral fellows have been busy giving presentations, participating in expert consultations, and publishing articles.

Presentations
In January, Alex Iantaffi, PhD, presented "Some health disparities in HIV: transgender populations, Men who have Sex with Men (MSM), and Deaf MSM," at the HIV/AIDS Awareness Week, University of Minnesota Medical School, Minneapolis, MN

In March Michelle van Ryn, PhD, MPH, along with Sean Phelan, PhD, and Diana Burgess, PhD presented "Influence of environmental, interpersonal, and individual factors on clinician bias in health care encounters," at the Physicians' Racial Bias and Discrimination Symposium hosted by the Society of Behavior Medicine at their annual meeting in San Francisco, CA

Sara Mize, PhD, presented two version of her workshop "Body-Oriented and Mindfulness Exercises for Treating Women's Sexual Health Concerns in Couples and Groups:  An Experiential Workshop," at the Minnesota Sexual Health Consortium in Minneapolis, MN, and the Meeting of The Society for Sex Therapy and Research in Baltimore, MD

In April, Alex Iantaffi, PhD, presented the keynote address "Gender Fluidity," at the MCPA Inclusion Institute: Supporting Gender Fluidity: Navigating Students' Identity Development, Anoka Ramsey Community College, Coon Rapids, MN

Michael Miner, PhD, presented a keynote address and workshop on the topic of technology "Issues at the Digital Divide," and "Issues at the Digital Divide:  How Adults Use and View Computers, the Internet, and Cell Phones," in Brooklyn Park, MN

Alex Iantaffi, presented "Recruiting Deaf MSM Online to Assess HIV Testing, Prevention, and Care Needs at Youth+Tech+Health Live in San Francisco, CA

Bean Robinson, PhD, gave two presentations on her research "Somali Women's Initiative for Sexual Health (SWISH), Presentation of Results to Community," at the Brian Coyle Center, Minneapolis, MN, and "Somali Women's Initiative for Sexual Health (SWISH)," Institute for Diversity, Equity, and Advocacy, Diversity Through the Disciplines, University of Minnesota, Minneapolis, MN

In May, Michael Miner, PhD, presented "Treatment of Juveniles with Sexual Behavior Problems," at the annual conference for the Dallas County Juvenile Department, Dallas, TX

Expert Consultations
Eli Coleman, PhD, recently participated in two expert consultations. First the International Classification of Diseases-11 Consensus Meeting for World Professional Association for Transgender Health in San Francisco, CA, in February; the second consultation was on the Blueprint for the Provision of Comprehensive Care to Transgender and Transsexual Persons and Their Communities in Latin America and the Caribbean for Pan American Health Organization and International Association for Physicians in AIDS Care, Port of Spain, Trinidad, in April.

Publications
Bockting, W.O., Miner, M.H., Swinburne Romine, R.E., Hamilton, A., & Coleman, E. (2013). Stigma, mental health, and resilience among an online sample of the U.S. transgender population. American Journal of Public Health, 103(5), 943-951. doi:10.2105/AJPH.2013.301241

Burgess, D. J.; Gravely, A. A.; Nelson, D. B.; van Ryn, M.; Bair, M. J.; Kerns, R. D.; . . . Partin, M. R. (2013). National study of racial differences in pain screening rates in the VA Health Care System. Clinical Journal of Pain, 29(2),118-23 February 2013 - Volume 29 - Issue 2 - p 118-123. doi: 10.1097/AJP.0b013e31826a86ae

Cantor, J. M., Klein, C., Lykins, A., Rullo, J. E., Thaler, L., & Walling, B. R. (2013). A treatment-oriented typology of self-identified hypersexuality referrals. Archives of Sexual Behavior. Published online ahead of print March 2, 2013. doi:10.1007/s10508-013-0085-1

Coleman, E., Elders, J., Satcher, D., Shindel, A., Parish, S., Kenagy, G., Bayer, C. R., Knudson, G., Kingsberg, S., Clayton, A., Lunn, M. R., Goldsmith, E., Tsai, P., & Light, A. (2013). Summit on Medical School Education in Sexual Health: Report of an Expert Consultation. Journal of Sexual Medicine, 10(4), 924-938. doi:10.1111/jsm.12142

Deutsch, M., & Feldman, J. (2013). Updated recommendations from the World Professional Association for Transgender Health Standards of Care. Editorial in American Family Physician, 87(2), 89-93.

Douglas, J. M., Jr., & Fenton, K. A. (Guest Eds.), Bolan, G., Coleman, E., Hook, E. W., III, & Keefe, M. (Contributing Eds.). (2013). Understanding Sexual Health [Special Issue]. Public Health Reports, 128(Supplement 1).

Eckman, P.M., Dhungel, V., Mandras, S., Brisco, M.A., Emani, S., Duval, S., Lindenfeld, J., Sulemanjee, N., Sokos, G.G., Feldman, J. (2013). Sexual Function After Left Ventricular Assist Device, Journal of the American College of Cardiology, 61(19), 2021-2022. doi:10.1016/j.jacc.2013.02.022

Grey, J.A., Robinson, B.E., Coleman, E., & Bockting, W.O. (2013). A Systematic Review of Instruments that Measure Attitudes Toward Homosexual Men.  Journal of Sex Research, 50(3-4), 329-352. doi:10.1080/00224499.2012.746279

Miner, M.H., & Coleman, E. (2013). Compulsive sexual behavior and its relationship to risky sexual behavior. Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention, 20(1-2), 127-138. doi:10.1080/10720162.2013.768133

Mize, S., & Iantaffi, A. (2013). The Place of Mindfulness in a Sensorimotor Intervention to Improve Women's Sexual Health. Sexual and Relationship Therapy, 28(1-2), 63-76. doi:10.1080/14681994.2013.770144

Nuttbrock, L., Bockting, W., Rosenblum, A., Hwahng, S., Mason, M., Macri, M., & Becker, J. (2013). Gender Abuse, Depressive Symptoms, and HIV and Other Sexually Transmitted Infections Among Male-to-Female Transgender Persons:  A Three-Year Prospective Study.  American Journal of Public Health, 103(2), 300-307. doi:10.2105/AJPH.2011.300568

Phelan, S. M., Griffin, J. M., Jackson, G. L., Zafar, S. Y., Hellerstedt, W., Stahre, M., . . . van Ryn, M. (2013), Stigma, perceived blame, self-blame, and depressive symptoms in men with colorectal cancer. Psycho-Oncology, 22(1), 65-73. doi: 10.1002/pon.2048

Robinson, B.E., Galbraith, J.S., Swinburne Romine, R.E., Zhang, Q.C., & Herbst, J.H. (2013). Differences between HIV-Positive and HIV-Negative African American Men who have Sex with Men in Two Major U.S. Metropolitan Areas. Archives of Sexual Behavior, 42(2), 267-278. doi:10.1007/s10508-011-9891-5

Rosser, B.R.S., Smolenski, D.J., Erickson, D., Iantaffi, A., Brady, S.S., Grey, J.A., Hald, G.M., Horvath, K.J., Kilian, G., Traeen, B., Wilkerson, J.M. (2013). The effects of gay sexually explicit media on the HIV risk behavior of men who have sex with men. AIDS and Behavior. Published online ahead of print, April 6, 2013.  doi:10.1007/s10461-013-0454-8

Strassberg, D.S., McKinnon, R., Sustaita, M., & Rullo, J.E. (2013). Sexting by High School Students:  An Exploratory and Descriptive Study. Archives of Sexual Behavior, 42(1), 15-21. doi:10.1007/s10508-012-9969-8


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Eli Coleman, PhD, has been elected as president of Society for Sex Therapy and Research (SSTAR). His two-year term began at the annual SSTAR conference in Baltimore, MD, on Saturday, April 9, 2013.

Outgoing SSTAR president Marta Meana, PhD, said, "The current sexuality association landscape is a complex one and SSTAR is fortunate to count on the capable leadership of Dr. Eli Coleman for the next two years. I am confident that under his direction SSTAR will continue to thrive, as well as to develop well-articulated relationships with sister associations."

SSTAR is an organization for professionals who have clinical and/or research interests in human sexual concerns. Its goals are to facilitate communication among clinicians who treat problems of sexual function, sexual identity, and reproductive life.

Photo:  Eli Coleman, PhD, and Marta Meana, PhD

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PHS welcomes the newest additions to our team: Adena Kingbird and Jennifer Obinna, PhD

Adena Kingbird is the new Patient Representative at the Center for Sexual Health. She is currently working on her Bachelor's Degree in Accounting at Metropolitan State University.


Jennifer Obinna, PhD, has joined PHS as a research associate working on the project Sex Offender Treatment and Intervention Process Scale Implementation Evaluation project (Michael Miner, PhD, principal investigator). She received her MSSW in social work and PhD in social welfare from the University of Wisconsin-Madison. Her past research explores sexual violence in the Deaf community, racial disparities in the criminal justice system and program evaluation of sexual and domestic violence primary prevention programs. She is currently the owner of World Bridge Research in Minnetonka, Minnesota, which is a research and evaluation company that bridges culturally competent research and program evaluation approaches together with efforts to promote social justice. Previously she served as the Associate Director of Rainbow Research, Inc. in Minneapolis, Minnesota and Vice President of Projects and Research for the Minnesota Council on Crime and Justice.

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So what does the New Year hold for the future of sexual health? Can we be optimistic? I think so. There are four broad reasons to feel optimistic.

1.  As governments struggle with the complexities of the sexual problems and declining resources to commit to alleviate the myriad of problems, they will have no choice but to create broad strategies to promote sexual health. We have a public health imperative. We have an opportunity to use an evidence-based approach to public policy. Public health policies recognize that there is no choice but to address the barriers and opportunities for all citizens to enjoy the right to sexual health. They also recognize more and more that sexual health is a function of the recognition of basic human rights for all citizens.

2.  Sexual Health has taken root in public health policy and sexual science will be needed to guide it. Now is the time of a unique opportunity in history of which we must take advantage.

3.  The field of sexology has clearly established itself as a key player in the effort to promote a healthier society in the new millennium. The HIV pandemic alone continues to drive home the need to understand human sexuality in its full complexity--from the interdisciplinary perspective of sexology. Now sexologists are being asked to come to the table and help direct public policy by sharing our knowledge, research, and expertise.

4.  Public health officials recognize more than any other time that comprehensive sexuality education is essential. They need to support sexuality research and we see a flourishing of funding that is rooted in sound theory and scientific methodology. We see an increase in research publications which add to our knowledge and legitimacy of our scientific field.

In the United States, we have seen major developments that are guiding lights for the future of sexual health. There have been 5 major developments which will have a major impact in the coming year.

1.  In 2010, the Centers for Disease Control and Prevention (CDC) held a sexual health consultation to develop a broad consensus of how we could develop a strong, comprehensive, broad and integrated approach to sexual health. The meeting report was published in 2011. After another year of further consultation, the CDC is about to publish a white paper outlining the basic and fundamental strategies for the coming decades. The CDC adopted its own sexual health definition that could guide its work in this area.

2.  In 2010, the office of the President of the United States published a National HIV Strategy - the first comprehensive national strategy since the beginning of the epidemic! In this strategy, there was a strong statement that we must move away from thinking that one approach to HIV prevention will work, whether it is condoms, pills, information or prevention programs. Instead, we need to develop, evaluate, and implement effective comprehensive prevention strategies and combination therapies. While obvious, it was stated clearly that all Americans should have access to a shared base of factual information about HIV - a revival of the basic premise that US Surgeon General Koop stood upon in disseminating frank and scientifically accurate information to all households in the mid-1980s. Finally, this new strategy outlined a public health approach to sexual health that includes HIV prevention as one component. This was the first time the term sexual health was used in public policy in the United States. The President and Secretary of State Hillary Clinton have called for a concerted approach to creating an AIDS-free generation.

3.  In 2011, the office of the US Surgeon General released a report that was developed by the National Prevention Council. This report was the first national strategy on prevention that called for us to work together to improve health and quality of life by moving from a focus on sickness and disease to one based on prevention and wellness. Reproductive and sexual health is one of the seven targeted priorities. Many of these recommendations have been incorporated and will be funded by the Affordable Care Act.

4.  In 2011, a report commissioned by the Secretary of Health and Human Services and conducted by the Institute of Medicine, was released on the health of gay, lesbian, and transgendered individuals. This report called upon more understanding and research on these marginalized populations and outlined a broad strategy to promote the health and wellbeing of these American citizens. This report has already had profound positive impact on public policies and public attitudes.

5.  In 2011, the Department of Health and Human Services set broad health goals for the coming decade entitled --Healthy People 2020. In this broad health strategy "Reproductive and Sexual Health" was clearly identified as a leading health indicator. The outcomes of the recent national elections have ensured that these broad strategies to promote sexual health will go forward with commitment, leadership, and essential funding.

So, I think we can look forward to 2013 with a sense of optimism. We cannot be complacent, but we can ride this wave of renewed commitment to the promotion of sexual health for all Americans.

The Program in Human Sexuality will do its part - but it will be made easier by this social and political climate that shares our ideals of creating a sexually healthier climate and overcoming barriers to sexual health.

Thank you all for your support of the Program's activities and we wish you the very best in the coming year!

Eli Coleman, PhD
Director and Professor
Chair in Sexual Health

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A recent summit hosted by PHS gathered key medical school educators and sexual health experts to discuss the challenges and opportunities for ensuring physicians are properly trained to address the sexual health needs of their patients.

Participants included former US Surgeons General Joycelyn Elders, MD, and David Satcher, MD, PhD, as well as representatives from the Centers for Disease Control and Prevention, the American Medical Association, the Association of American Medical Colleges, the American Medical Student Organization, and a wide range of medical schools, universities, and organizations. The summit's premise was based upon a series of recently published papers, covering the state of sexual health education in the US and Canada and recommended curriculum changes. Invited speakers shared their perspectives in a think-tank format culminating in a working group session. A meeting report will be prepared and shared with interested parties and key stakeholders.

Eli Coleman, PhD, the event organizer said, "It is our hope that this summit and meeting report will serve as a catalyst for re-invigorating the necessary sexual health curriculum to meet the needs of physicians of the future."

During the summit participants heard from educators, students, and researchers, including many of the authors whose articles were used for background. Educators from a range of medical schools shared information about their sexual health curricula and training programs. On Tuesday morning participants gathered into work groups around the topics of curriculum placement, evaluation, faculty development, inter-professional education and training for integrated care, and cooperative strategies and partnerships.

The event was held on December 3 - 4, 2012, at the Commons Hotel in Minneapolis, Minnesota. The event was made possible through funds from the Joycelyn Elders Chair in Sexual Health Education and the University of Minnesota Medical School through support of a Herz Grant and the Office of Minority Affairs and Diversity.

PHOTO: summit participants; credit Duane Rost

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Michael Miner, PhD, will be the principal investigator on a new five-year research grant from the National Institutes of Justice of the Department of Justice totaling $1.5 million. The aim of the project is to conduct a rigorous analysis of the utility of a newly developed, dynamic risk factor assessment for sexual offenders, Sex Offender Treatment Intervention and Progress Scale (SOTIPS).

For over a decade, risk detection for sexual offenders has been the domain of static actuarial instruments. By adding dynamic factors to a risk assessment, specifically ones that have been linked to risk of reoffending and are amenable to treatment, has the potential to greatly improve our ability to assess risk, and changes in risk, over time. At the same time, it can improve treatment by systematically tracking progress, and identifying areas for intervention.

"This project could result in a major step forward in sex offender management, in that we may identify an empirically valid method for tracking changes in risk status. This will allow for a more nuanced strategy toward sex offender management, since intervention intensity could be modified as predicted offender risk changes over time," said Miner.

On January 2, 2013, researchers at the PHS will begin working with sex offender treatment and management systems in New York City, NY, and Maricopa County, AZ, to collect data on 500 sexual offenders in treatment at each location, interview directors of treatment programs, and conduct focus groups with treatment providers and probation/parole agents. Follow-up data will assess sexual recidivism, non-sexual violent recidivism, any recidivism, returns to confinement, and violations of conditional release (parole or probation).

Miner's research team includes Bean Robinson, PhD (co-investigator), Chris Hoefer (project coordinator), Cathy Strobel (research staff), Karl Hanson, PhD (consultant from Ottawa, Ontario, Canada), and David Thornton, PhD (consultant from Mauston, Wisconsin).

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Katie Spencer, PhD, assistant professor, is the new coordinator of Transgender Health Services at PHS. Spencer is eager to continue to bring the program in line with current best practices in transgender care, increase operational transparency, and deepen community collaborations.

Spencer believes that, "In recent years there has been a huge and welcomed shift in health care for transgender and gender nonconforming individuals. Across the nation and locally more physicians and mental health providers are being trained to provide quality care for transgender and gender nonconforming patients, which increases access for trans clients. Part of our role is to continue to engage in cutting-edge research, training, and clinical service to break down barriers to competent care for trans clients. We have also seen a ground swell in community organizations that provide support to individuals across the gender spectrum. It is an exciting time to be in transgender health care, with multiple opportunities for collaboration, capacity building, and expanding the framework of how we provide trans clients the best holistic health care."

Over the last month Spencer has started to systematically incorporate the recommendations from the revised Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People as well as science-based research on trans health into the operations of the Center for Sexual Health. This process includes updating staff and patient materials as well as clinical procedures. She is also meeting with community organizations, community health care providers, and colleagues in the region to discuss possible collaborations and partnerships. Spencer will be reviving a community advisory board to focus on the Transgender Health Services program. Spencer's longer-term goals include developing a patient peer mentor program, revamping the group therapy model, and creating a community support space for patients and families that would include a library or resource materials on health, legal, and social support issues.

Spencer believes in empowering patients to have more say in their own and their community's care, revising our model of care to reflect patient-centered, patient-informed, and collaborative models of care, consistent with feedback from trans health care advocates and research on best outcomes for patient care. Spencer said, "My goal is to build on our successes in developing innovative research and public policy in the area of transgender health and incorporate these principles into a strong and cohesive framework that supports all aspects of our work in clinical care, new research, and community advocacy."

In addition to her clinical work, Spencer works with multiple community organizations working to educate about LGBT healthcare issues and primarily transgender healthcare. She works with the Minnesota Trans Youth Support Network on the Community Hormone Access Project, partnering with community advocates and trans youth to develop community based hormone protocols for transgender care, in hopes to increase access to competent care and hormone provision for trans youth. She recently participated in the development of a theatre educational project for high schools on transgender youth issues. Spencer provides training, education, and consultation on sexual health and transgender issues, and has worked with the Family Tree Clinic, Face to Face Health and Counseling Services, Fairview Clinics, the University of North Dakota, and the Minneapolis Veterans Administration. Spencer often speaks about the intersections of LGBT rights and impact on wellbeing, and recently presented a First Friday Forum for the Minnesota Psychological Association on the psychological research on same sex marriage.

Spencer received her MA and PhD in counseling psychology from the University of Missouri-Columbia. She received her BA in women's studies and psychology from the University of Wisconsin-Madison. Her internship was completed at the University of Illinois-Chicago Counseling Center, and she was a postdoctoral fellow at PHS. She has a strong interest social justice, and education and training of therapists and medical providers in sexual health and transgender health care competency. Her primary clinical practice is working with transgender and gender non-conforming, adolescents, and adults, women's sexual health, and LGBT sexual health and wellbeing. She co-facilitates several groups, including the gender exploration group for youth and their families, the women's sexual health group, and transgender adult interpersonal groups. She has experience working with compulsive sexual behavior and general sexual dysfunction concerns. Her research and clinical interests focus on cultural competency in working with LGB and transgender populations, LGBT sexual health, sex therapy with LGBT couples, trans youth, and feminist embodied approaches to sexual health.

Spencer became coordinator of Transgender Health Services in October 2012, when the former coordinator Walter Bockting, PhD, joined the Initiative for LGBT Health a new program at the New York Psychiatric Institute and the Columbia University.

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