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The participation of transgender athletes in sex-based sports has become one of the most politically and culturally fraught issues of our time. As of May 2024, twenty-five states have passed laws or regulations that categorically prohibit transgender women and girls in K-12 schools and/or college from playing sex-based sports with other women and girls. Like so many areas of transgender people's lives--from access to healthcare to use of public restrooms--participation in sex-based sports is now a legal issue that will be decided by courts. Debate over the proper legal response to the participation of transgender athletes in sex-based sports has focused almost exclusively on sex discrimination law. This Article offers a different but complementary way to address the categorical exclusion of transgender women and girls from sex-based sports based on a source of civil rights that has been noticeably missing from the current debate: disability rights law. "Gender dysphoria" is the clinically significant distress a transgender person experiences if they are not allowed to live as who they are. For over thirty years, the Americans with Disabilities Act and the Rehabilitation Act have excluded from their protection "gender identity disorders not resulting from physical impairments." In recent years, numerous federal courts and agencies have interpreted these laws to prohibit discrimination based on gender dysphoria, culminating in the Fourth Circuit's landmark decision in Williams v. Kincaid in 2022-the first circuit-level case to recognize gender dysphoria as a protected disability under disability rights laws. Accordingly, state laws that categorically ban transgender women and girls from playing sex-based sports discriminate based on gender dysphoria in violation of disability rights law. [ABSTRACT FROM AUTHOR]

I. INTRODUCTION 314 II. TRANSGENDER STATUS AND GENDER DYSPHORIA 317 III. THE REFUSAL TO CHANGE THE SEX DESIGNATION ON A BIRTH Certificate Absent Proof of GCS Violates Title II of [...]

The Americans with Disabilities Act (ADA) does not protect everyone. It notably excludes people with Gender Identity Disorder (GID), an impairment involving the misalignment between one's anatomy and gender identity. [...]

Abstract Background The development of novel chemotherapeutic agents in colorectal cancer has improved survival. Following initial response to chemotherapeutic strategies many patients develop refractory disease. This poses a significant challenge common to many cancer subtypes. Newer agents such as Bevacizumab have successfully targeted the tyrosine kinase receptor epidermal growth factor receptor in metastatic colorectal cancer. Human epidermal growth factor receptor-2 is another member of the tyrosine kinase receptor family which has been successfully targeted in breast cancer. This may play a role in colorectal cancer. We conducted a clinicopathological study to determine if overexpression of human epidermal growth factor receptor-2 is a predictor of outcome in a cohort of patients with colorectal cancer. Methods Clinicopathological data and paraffin-embedded specimens were collected on 132 consecutive patients who underwent colorectal resections over a 24-month period at Mayo General Hospital. Twenty-six contained non-malignant disease. Her-2/neu protein overexpression was detected using immunohistochemistry (IHC). The HER-2 4B5 Ventana monoclonal antibody was used. Fluorescent insitu hybridisation (FISH) was performed using INFORM HER-2/Neu Plus. Results were correlated with established clinical and pathological predictors of outcome including TNM stage. Statistical analysis was performed using SPSS version 11.5. Results 114 were HER-2/Neu negative using IHC, 7 showed barely perceptible positivity (1+), 9 showed moderate staining (2+) and 2 were strongly positive (3+). There was no correlation with gender, age, grade, Dukes' stage, TNM stage, time to recurrence and 5-year survival (p > 0.05). FISH was applied to all 2+ and 3+ cases as well as some negative cases selected at random. Three were amplified (2 were 3+ and 1 was 2+). Similarly, HER-2 gene overexpression did not correlate with established prognostic indicators. Conclusion HER-2 protein is over expressed in 11% of colorectal cancer patients. The gene encoding HER-2 is amplified in 3% of cases. Overexpression of HER-2 is not a predictor of outcome. However, patients who over express HER-2 may respond to Herceptin therapy.

Abstract Fibroadenomas are common benign breast tumours that display a characteristic pathological morphology, although several epithelial and stromal variations exist. A very rare histological finding is the presence of multinucleated giant cells throughout the stroma of a benign fibroadenoma. Cells of this type, which are more commonly found incidentally within the interlobular stroma of breast tissue, are benign and should not be mistaken for malignant cells on microscopic examination. Unfortunately a lack of awareness of this pathological entity can lead to diagnostic confusion amongst pathologists resulting in the multinucleate giant cells being mistaken for highly mitotic cells and consequently the fibroadenoma being mistaken for a malignant lesion. This may have serious implications for the subsequent management of the patient. The presence of this unusual cell type in the stroma does not alter the prognosis of otherwise benign lesion. We encountered two such cases at our institution in a six month period recently. We present their histories along with relevant radiological, microscopic and immunohistochemical features, followed by a discussion of this unusual pathological entity.

The article reveals how transgender exclusion from the Americans with Disabilities Act (ADA) came to be. Topics covered include a matrix of discrimination that the ADA and Section 504 were intended to redress prejudice, stereotypes and societal neglect, the discrimination that people with gender dysphoria routinely experience and details of reported cases to have alleged gender dysphoria discrimination under the ADA and Section 504 since 2015.