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Already suffering from insecurity, malnutrition and poverty, they are also subject to the pressures of puberty and the country's severe gender inequality.
Female convicts were brought in by the shipload to address the Tasmanian penal colony's severe gender imbalance; a roaring "wife" trade saw them sold for as little as £5 and a gallon of rum.
Doctors for Michelle L. Kosilek, a transsexual prisoner who was convicted of murdering his wife in 1990, say gender reassignment surgery is the only way to treat his severe gender identity disorder.
This brought to light its severe gender imbalance.
-A study of 2,000 screenplays shows how severe gender and age discrimination is in the film industry.
And in February, after an ex-employee published a blog post alleging severe gender discrimination, the company launched an internal investigation, hiring former U.S. Attorney General Eric Holder to help lead it.
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To our knowledge no documented cases of such severe gender-biased natural mass mortality exist for seals, or other marine mammals.
But for those with severe, persistent gender dysphoria, gender reassignment surgery is "a medically necessary intervention to end lifelong suffering," said Dr. Ettner, the Illinois psychologist, who co-edited "Principles of Transgender Medicine and Surgery".
But she still suffered from what one expert describes as "the cosmic toothache" that plagues people with severe, persistent gender dysphoria.
She did not mention, however, that her country faces a looming demographic crisis resulting from family planning practices with an aging population, a reduced workforce, and a severe nationwide gender imbalance from sex-selective abortions.
Without individual patient data, we will not be able to explore, for example, subgroups of patients with mild or severe disease, gender differences and the relative contributions of these factors.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com