Nilivyo Amka Leo!

AMEN! AMINA!

Nani Kidume?

Nani Kidume?  Binafsi naona wote wawili wanahitaji kula ugali zaidi!

TTCIH and Zanzibar School of health (ZSH) Partnership

TTCIH and Zanzibar School of Health (ZSH) sign MOU to strengthen health training partnership

On 11th –Feb-2013 TTCIH and ZSH signed a three years memorandum of Understanding.  The management is delighted to share with you this important information of strengthening health training partnership in the United Republic of Tanzania. With this MoU TTCIH will provide technical support, study guidelines, curriculum, competent visiting lecturers and assessment tools.

The event was witnessed by Prof Senga Pemba on behalf of TTCIH and Dr. Amur Abdullah Amur for the Zanzibar School of health.

ZANZIBAR SCHOOL OF HEALTH
THE Zanzibar school of Health started operating since September 2011, but official inaugurated was on 30th June 2012 by the Speaker of the Zanzibar House of Representative, Honourable Pandu Ameir Kificho.

Vision:
To be the leading School in providing quality education and excellent qualification contributing to community service and development


Mission:
To mould our students to be role models in the academically professional arena by providing quality education through our enlightened management and committed faculty to ensure knowledge transfer, motivate, instill research attitude, promote skills and infuse ethical and cultural values to transform our students into disciplined and competent citizens to improve the quality of life

The aim of Zanzibar School of Health Diploma is to prepare Clinical Officers to be competent and effective primary health givers in health clinics and hospitals as well as assistants to medical officers and specialists in government and private sectors with regard to preventive, curative and rehabilitative aspects of health services.

The duration of Diploma in Clinical Medicine for Clinical Officers is 3 years. The Training covers theory and practical studies of basic medical sciences, and clinical practice in hospitals and health clinics.

1. Clinical Officers provide the following service to the community:
2. Primary and emergency treatment at health clinics, outpatient clinics, wards, casualty and emergency department at hospitals
3. Conduct preliminary and extensive check up on patients who need treatment
4.  Examine, diagnose and treat common illness

 Click here to view pictures

Why President Obama Should be Re-Elected!

RECEIVED BY E-MAIL:

President Obama is an intelligent, tough, and educated man, who has done more positive things for the U.S. (all Americans) in THREE years, than most Presidents (including GW Bush) have done in EIGHT years, in spite of the Obstructionist Republicans:

For example, here are the Top 7 Legislative and Foreign Policy Achievements Under President Obama’s Leadership and Administration . . .

1. Over 200 beneficial legislative and foreign policy accomplishments for the U.S. in his first three years, includingBanking and Financial Reform - 48, Civil Rights - 16, Economy - 41, Health Care Reform - 16, Housing - 15, Infrastructure - 23, Military and National Security - 33, Military Veterans and Families - 25, Taxes - 31, Recovery, Progress and Change - 24 . . . . . The sources for my stats: Google ’Obama Achievements’ or “Obama’s 244 Accomplishments’. . .

2. The death of Terrorist Osama bin Laden and many High Ranking Terrorists. U.S. drone strikes have killed over 2,150 al-Qaeda terrorists. (U.S .Drone strikes under President Bush killed less than 450 terrorists). . . .

3. Iraq withdrawal - Ending UNnecessay War by Bush Administration, costing Thousands in lives/Billions in U.S. dollars. . . .Libya/Death of Gadhafi - who planned the downing of U.S. flight 103, which killed many Americans. . . .

 4. New START Treaty (U.S. / Russia) Reduces nuclear arms with inspection verification, while ensuring U.S. will have proper arms to deter an invasion. . .

5. STOCK Act (Stop Trading on Congress Knowledge) - Congress and many executive branch members and aides can’t use inside job information to trade stocks/securities - doing so is criminal. . . . .

6. Affordable Healthcare Act . . .

 7. 27 consecutive months of JOB growth, 4.2 million created. . . . Also, Rescued U.S auto industry (GM is now #1 worldwide in sales/profitability), but Romney and Republicans wanted to block this rescue.


President Obama has also demonstrated that he is a good and smart man and wants the best for Americans, and he understands that the U.S. must have Shared Sacrifice and reforms on the spending AND revenue side so that our country can rebound from the disastrous policies of the 8 years during the Bush Administration.

Just imagine the other great positive things he could do FOR JOBS and OUR ECONOMY in the U.S. if he did not have the Republicans trying to block and sabotage his every move . . . . Obama is NOT the problem. We are being constantly and aggressively told that he is the problem and if we buy into that, then we are set up to buy into returning to the Bush/Cheney era, which IS the problem.

It literally is a con. Obama inherited the problems, he didn’t cause them, and ever since the Republicans have repeatedly, blatantly, stubbornly, relentlessly, and belligerently done everything they could to fault and block ALL efforts to address the problems.

The Republicans are obstructionists and they have put greed, bigotry, AND/OR their political ambitions above all else, at any cost to the people, and are striving to have Obama fail, which really means America fails. Take notice that the Republicans are willing to DESTROY our great country for their greed, bigotry, and/or political gains, and they are willing to focus primarily on protecting the greed (ie. Tax cuts, Outsourcing jobs, Undeserved Compensation, Deregulations, Loopholes, etc.) of the Top 1% of wealthy Americans and Corporations, to the DETRIMENT of the remaining 99% of Americans.

Didn't we learn anything from electing that meat head Bush? If you want the U.S to move FORWARD in a positive, effective, fair, and successful way, then WAKE UP and DON’T VOTE for Republicans . . .Vote for Democrats (Senate and House) Governors, etc. and re-elect Obama 2012!

Chuo Kipya cha Zanzibar School of Health

Chuo cha Zanzibar School of Health kinamilikiwa na Zanzibar School of Health Company Limited.

Tuna wingi wa Shukrani kwa vile Chuo cha Zanzibar School of Health kinatowa mafunzo ya Afya kutokana na ruhusa kutoka Wizara ya Afya Zanzibar.Wanafunzi wanaosoma hapo ni 45 kwa Fani ya Psychology na 88 kwa Fani ya Uuguzi.

Chuo kimeajiri Walimu wenye Sifa kusomesha Fani husika na pia kimeajiri Wafanyakazi wa ngazi mbali mbali ili kuleta ufanisi wa Chuo. Tunayo azma ya kuanzisha na kuendeleza mtandao wa Elimu ya Masafa
ikiwemo ushauri wa Afya wa Masafa yaani Tele Medicine kupitia mitandao ya kimataifa na ya kitaifa. Chuo kinafanya taratibu ya kuwawezesha wanafunzi kupata mazoezi ya vitendo nje na ndani ya Zanzibar. Kuna
azma pia ya kuanzisha Continuing Medical Education kupitia mtandao,semina ,na kongamano za kiwengo cha kimataifa.

Chuo kimepeleka Ombi Baraza la Taifa la Elimu ya Ufundi (Nacte), na kupata Form maalum kwa ajili ya usajili kwa ngazi ya NACTE baada ya kupata Usajili Rasmi kwa Ngazi ya Baraza la Wauguzi la Zanzibar kwa Fani ya Uuguzi na baada ya kupata barua ya kutokuwa na pingamizi kutoka Wizara ya Afya za Serikali ya Mapinduzi Zanzibar kuundesha Masomo ya Psychologia Nasaha yaani Counseling Psychology ya Tumaini University College Iringa. Chuo kimejisali na Taasisi ya kodi TRA ,ZRB Taassisi ya Usajili wa Kampuni ya Zanzibar na kupata Zanzibar Government Certificate of Incorporation.

Chuo kimepitisha Mtaala wake wa Diploma ya Nursing chini ya ukaguzi na masahihisho ya Zanzibar Council of Nurse Midwives na kupata School Registration Certificate number PNS/01 ya tarehe 29.09.2011 .

Chuo kitashukuru ikiwa Wawakilishi wetu watapata Nafasi kutembelea Chuo hich ili waweze kutupatia Ushauri wao wa Busara.

Baada ya kukamilisha hesabu za Budget ,Chuo kimewaslisha Form za Maombi kwa Usajili wa NACTE. Pia Chuo kina azma ya kuanzisha Fani zifuatatazo:

1. Diploma in Speech and Language Therapy

2. Diploma in Clinical Pharmacy

3. Diploma in Physiotherapy

4. Diploma in Clinical Medicine

5. Diploma in Medical Laboratory Technology

6. Doctor of Medicine Degree

Chuo kimeunda Board ya Taaluma na kimewaalika wajumbe kutoka Wizara ya Afya kueomo kwenye Board hio. Chuo kinachangia maendeleo ya Taifa kwa kutowa ajira kwa wataalam 10 wa Tanzania kufanya kazi Chuoni hapo . Aidha Chuo kimewasilisha Maombi Wizara ya Ardhi kwa kupatiwa Eneo la Kujenga Teaching Hospital yenye Vitanda 200 ,Maabara ya kisasa, na Taasisi ya Elimu ya Afya ambazo itakuwa na kiwango cha Kimataifa.

Vile vile Cho kimewasiliana na na Baraza la Mitihani yaani NECTA kwa madhumuni ya kuanzisha Shule ya Sekondari maalum na kituo cha kufanya Mitihani ya Kitaifa na Kimataifa.Sasa Chuo kinaandikisha Wanafunzi hao ili waweze kufanya Mitihani ya Kimataifa .

Uongozi wa Chuo unashukuru Wananchi wa Zanzibar na Tanzania kwa ujumla kwa kuwaunga mkono kwa kuleta vijana wao kusoma Chuoni hapo na unaahidi Umma wa Nchi hii Elimu bora yenye Ufanisi wa Hali ya Juu.

Chuo kingependa pia kuendelea kupata Ushirikiano ili kiweze kutimiza ahadi zake za kuendeleza Nchi yetu na kutumikia Umma.

Ahsante

AMUR

Asante Rais Obama! Republicans Mlie tu!

The Supreme Court backs all parts of President Obama’s signature health care law, including the individual mandate that requires all to have health insurance.


OBAMACARE OYEEEEEEEEE!

Tajiri Mitt Romney asiyejali maskini na Republicans wenzake walie tu! Hii ni pigo kubwa sana kwao! Hata kama mtu hana hela ni binadamu! walisema Romney akishinda uchaguzi Obamacare ingefutwa mara moja.  Asante Rais Obama, umeokoa maisha ya wengi! Lakini jamani, mbona Uncle Tom Justice Clarence Thomas kaipinga?

*************************************************************************
Kutoka CNN.com

Supreme Court Upholds Entire Health Care Law


Editor's note: We're live blogging from the Supreme Court today as the nation waits to see how the justices will rule on the health care law. You can follow along below as CNN Supreme Court Producer Bill Mears and Senior Legal Analyst Jeffrey Toobin get the latest details live from the court as well as analysis when the opinion is delivered. Watch live coverage and analysis on CNN TV, CNN’s mobile apps and http://cnn.com/live.

[Updated at 10:54 a.m. ET] House Speaker John Boehner renewed calls to reverse the Obama administration's signature health care overhaul after Thursday's Supreme Court decision upholding the act, saying the decision "underscores the urgency of repealing this harmful law in its entirety."

[Updated at 10:52 a.m. ET] House minority leader Nancy Pelosi declared the court's ruling a "victory for the American people."

"With this ruling, Americans will benefit from critical patient protections, lower costs for the middle class, more coverage for families, and greater accountability for the insurance industry," she said.

Pelosi further said that the Affordable Healthcare Act will prevent children from being denied coverage for pre-existing conditions, lower drug costs for seniors and allow students and young adults to stay on their parents’ plan.

“In passing health reform, we made history for our nation and progress for the American people," Pelosi said. "We completed the unfinished business of our society and strengthened the character of our country. We ensured health care would be a right for all, not a privilege for the few."

Matatizo ya Kijiji cha Nanja Wilaya ya Monduli

Nafanya kazi katika Asasi inayotoa elimu ya UKIMWI na Afya ya Uzazi kwa jamii iliyopo Arusha. Mwishoni mwa mwezi huu tulifanya survey ya UKIMWI katika vijiji vya Nanja na Makuyuni vilivyopo wilaya ya Monduli kwa ajili ya mradi tunaotaka kuanza hivi karibuni.

Kilichonisukuma kuandika katika jukwaa hili ni matatizo tuliyoyakuta katika kijiji cha Nanja

HAWANA MAJI

Yaani hakuna kisima wala bomba la maji hivyo hutegemea maji ya mvua ambayo watu wachache ndio wanamatenki ya kuvunia maji hayo. Katika kipindi ambacho si cha mvua hununua maji ndoo ya lita kumi kwa tsh 300 hadi 500.

HAWANA KITUO CHA AFYA

Hakuna kituo cha afya/Zahanati wala clinic ya kutibu wanakijiji. Ikitokea kuna mgonjwa mpaka wampeleke Monduli,Makuyuni au Mto wa mbu ili waweze kupata matibabu. Kwa upande wa kinamama wajawazito wengi wao huzalishwa na wakunga wa jadii hivyo kuna uwezekano mkubwa wa vifo vya mama a mtoto.

Ombi langu kwa wanabidii kama kuna mtu aliyewahi kufanya utafiti au ana uzoefu wa maeneo haya ya Nanja aieleze jamii kuhusu sehemu hii kwakua watanzania wenzetu wanateseka.

Nawakilisha

Malima P. Macha
PM - CHAWAKUA

Tarifa ya TPN Kuhusu Migogoro/Migomo Iliyopo Hususani Sekta Afya

Kwa muda mrefu sasa jamii yetu imekumbwa na migogoro na migomo ya mara
kwa mara katika sekta mbalimbali ikiwemo Afya, Elimu n.k.Na inaonekana
kwamba hali hii inataka kuzoeleka na kuonekana ni hali ya kawaida, na
kama haitathibitiwa kwa kupatiwa ufumbuzi wa kudumu basi inaweza
ikalifikisha Taifa letu mahali pabaya na kupunguza kasi ya ukuaji wa
uchumi na hivyo kuathiri mikakati ya kupunguza umasikini.

Kwa sasa dunia nzima iko katika hali tete kutokana na kudorora kwa
uchumi na baadhi ya nchi ukuaji wa uchumi umesimama au umeshuka sana
hivyo kwa namna moja au nyingine nchi zetu pia zinaathirika na hali
hii kwa njia moja au nyingine.

Kwa kuzingatia hali hiyo sisi wanataaluma tunaona kwamba kwa sasa
rasilimali tulizonazo ikiwemo watu, ardhi, maliasili n.k tuzitumie
vizuri ili zitusaidie kupambana na janga hilo.
Kwa hali hiyo ni dhahiri uwezo wa serikali kugharamia baadhi ya huduma
utapungua hivyo basi tunaomba kwa sasa wananchi waelewe hali hivyo na
ni jukumu letu sote sasa kushirikiana kupambana na changamoto hizo.

Chanzo kimojawapo cha migomo na migogoro hiyo ni kupungua kwa
mawasiliano miongoni mwa wadau husika hivyo kusababisha upande mmoja
kutojua au kutohusishwa katika kututua tatizo husika.

Hivyo basi tunashauri wadau wote yaani serikali, viongozi, watendaji
wa wizara na taasisi mbalimbali wakae na washirikishane katika sehemu
zao za kazi na kupashana habari kwa muda muafaka.

Kuhusu tatizo linaloendelea kwa sasa katika sekta ya afya tunawapa
pole nyingi sana watanzania wote waliopoteza maisha na waliaothirika
kwa namna moja au nyingine kutokana na athari za mgomo huu.

Baadhi wa waliaothirika yaani wagonjwa na baadhi ya madaktari ni
wanachama wetu.
Sisi kama wanataaluma tunaipongeza serikali kwa hatua zilizochokuliwa
hadi sasa za kupunguza athari za tatizo hili japokuwa bado sehemu
nyingine hali bado haijatengemaa lakini ni matumani yetu kila mtu
atatimiza wajibu wake kwa mujibu wa taaluma zao.

Tunaiomba Serikali iharakishe mazungumzo na madaktari na itoe ahadi ya
kutekeleza madai ya madaktari kadri uwezo utakavyoruhusu Tunaiomba
Serikali ifikire upya uamuzi wake wa awali wa kuwafukuza kazi wale
madaktari ambao walikuwa bado hawajaripoti kazini kama agizo la Mh.
Waziri Mkuu lilivyoelekeza badala yake tunashauri hatua nyingine za
kinidhamu zichukuliwe badala ya kuwafukuza kazi, kwa sasa bado nchi
ina upungufu mkubwa wa wataalamu katika sekta hii.

Tunawashauri madaktari wote nchini wakati madai yao yakishughulikiwa
warejee katika maeneo yao ya kazi na wafanye kazi kwa bidii na maarifa
yao yote, waonyeshe uzalendo kwa nchi yao.

Wale wote walitajwa katika taarifa mbalimbali kwa tuhuma mbalimbali
ikiwa ni pamoja na kushindwa kuwajibika kwa kutoa kauli zilizochochea
au kukuza mgogoro huu basi waombe radhi mara moja na kama wakishindwa
basi hatua za kinidhamu zichukuliwe haraka dhidi yao.
Tunaomba watanzania wote, viongozi, watendaji wa Taasisi za umma na
binafsi tuwe waadilifu tuzingatie dhana ya utawala na uongozi bora,
tuwe wazalendo wa kweli na tuweke mbele Utaifa na maslahi ya walio
wengi.

Phares Magesa
Rais- TPN

KITAMBI/UNENE: Ni dalili ya Utajiri au Ugonjwa?

(Picha kwa hisani ya Michuzi Jr.)

Imeandikwa na Malkiory William Matiya

Katika baadhi ya jamii zetu nyingi hasa kutoka bara la Afrika, kumejengeka dhana kuwa kitambi /unene huashiria utajiri. Mila, imani na desturi hii kwa kiasi fulani huchangia watu kutozingatia kanuni na taratibu za lishe bora, pengine hii inatokana na mwamko mdogo wa elimu ya afya jamii.

Wakati hali ikiwa hivyo miongoni mwa watu toka bara letu la Afrika, kwa upande wa nchi zilizoendelea, watu huamini kuwa unene/kitambi ni dalili tosha ya ugonjwa. Siyo hivyo tu bali pia historia ya magonjwa katika fani ya elimu afya jamii inatueleza hivyo.

Kuna unene wa aina kuu mbili, kwanza ni ule unaosababishwa na kutozingatia kanuni na taratibu za lishe bora / balance diet. Kwa mfano ulaji wa vyakula vyenye kiasi kikubwa cha mafuta na wanga, unywaji wa mara kwa mara wa pombe kama vile bia pamoja na kutofanya mazoezi ya mwili na viungo. Aina ya pili ya unene ni ule unaotokana na urithi japo kwenye mada hii msisitizo zaidi ni kwenye aina ya kwanza ya unene.


Kuna matatizo mbali mbali yanayo ambatana na unene/kitambi. Mosi, madhara ya kiafya kama vile ugonjwa wa moyo, shinikizo la damu, kisukari aina ya pili /diabetes type II. Pili, madhara ya kisaikolojia, hasa pale mtu anapojishuku kupoteza mvuto/ aesthetic beauty. Hali imeshamiri sana hasa katika nchi zilizoendelea ambapo watu huchukulia unene/kitambi kama ulemavu fulani wa kimwili.

Pamoja na hayo, nadhani wakati mwingine tunafanya makosa kuwahukumu binadamu kulingana na mwonekano wa maumbile yao, kwani hakuna hata moja kati yetu anaweza kuingilia kazi ya uumbaji, ninasema hivi kwasababu hatuwezi kujua ni nini chanzo hasa ambacho kinapelekea mtu kuwa mnene au kuwa na kitambi. Kama nilivyosema awali, kuna aina ya unene/kitambi kinachotokana au kusababishwa na urithi.

Namna ya kukabiliana na matatizo yatokanayo na unene/kitambi, wakati watu katika mataifa yanayoendelea, hujikita zaidi kwenye matumizi ya magari hasa magari binafsi, kidogo hali ni tofauti katika nchi zilizoendelea ambapo msisizito kwao ni kwenaye matumizi ya usafiri wa umma, matumizi ya baiskeli na hata matembezi ya miguu kwa sehemu zinazofikika. Kwa hili wenzetu wa mataifa yaliyoendelea wamefanikiwa vya kutosha kwa kuwekeza na kutenganisha barabara za magari na zile za waendesha baiskeli na watembea kwa miguu.

Mwisho, njia pekee ya kukabiliana na changamoto hii ya unene/kitambi, ni kwa kuzingitia kanuni za lishe bora kwa kujisomea majarida yanayohusu elimu ya afya kwa jamii na kujijengea tabia ya kufanya mazoezi ya mwili na viungo. Muhimu kuliko yote, kama itawezekana ni kupunguza ulaji wa nyama choma na unywaji wa bia wa mara kwa mara.


Malkiory William Matiya

Mtebelee Blog yake: http://malkiory-matiya.blogspot.com/

Ngono, Afya na Uzee

Haya, mkitaka kufanya ngono kwa muda mrefu maishani mwako, uwe na afya bora! Pia wanaume wanafikiria ngono zaidi ya wanawake! Nini kipya? Soma wataalamu walivyosema kuhusu ngono leo.

***********
(CNN) -- Healthier men, no matter their age, are going to have better sex more frequently and desire it more often than healthier women.
And a healthier sex life could mean a longer life.
That's according to a paper written by University of Chicago researchers that was published Tuesday in the British Medical Journal. While the supposition that men think about sex more than women isn't new, the paper's findings have wider implication for attitudes toward public health and how patients respond to doctors' advice, said Dr. Stacy Tessler Lindau, an associate professor of obstetrics and gynecology and geriatric medicine who spearheaded the research.
"If you are a man diagnosed with diabetes or high blood pressure and I tell you that you need to lose weight and take medication, and I can say the benefit is five extra years of sex life, you might be more inclined to do what I tell you," she explained.
Lindau said that women generally reported wanting less sex or receiving it less often for three reasons: Women outlive men by an average of five to six years and without a partner, women are less likely to engage in sex. Secondly, there's a Western cultural acceptance -- and removal of stigma -- of men who have erectile dysfunction and have turned to relatively recently marketed drugs such as Viagra; women don't have that.
"Also, there's a difference in how we treat women for other diseases that affect their sexual desire," Lindau said. "If a woman is diagnosed with breast cancer and she has, for example, her breasts removed, and we never counsel her about her sexual function, we start to realize how many years of life she's losing. Not doing those things could mean 10 years of lost sexual activity."
There are no FDA approved treatments for female sexual dysfunction other than estrogen to treat pain with intercourse, she said.
Lindau's paper was sponsored by the nonprofit National Institutes of Health.
The paper considers data from two previously published studies that included more than 6,000 men and women, split into two co-ed groups: The first was age 25 to 74. The second group was age 57 to 85. Ninety-eight percent of participants reported having sexual partners only of the opposite sex, she said. Roughly 80 percent of men and 65 percent of women in the study were married or living with a partner.
None of the study's participants was in a nursing home.
Questions were presented that asked them to give their relationship status and rate their health and the quality of their sex life from poor to excellent.
Excellent was defined not by the number of times someone had sex but the emotional and physical satisfaction of the experience. But, the survey described having sex "regularly" as two to three times a month, said Lindau.
Sex was defined to the 57- to 85-year-old group as "any mutually voluntary activity with another person that involves sexual contact, whether or not intercourse or orgasm occurs" in the past year. For the same time frame, those in the 25-74 age group were asked if they had "had sex with anyone."
Participants had the option of assigning a number rating to their sex life, including "0" for "the worst possible situation." That phrase was up to them to interpret, said Lindau.
Women who initiate relationships later in life -- they describe passionate love and sex like the way younger people do.--Stacy Tessler Lindau, study author
The physician concluded that men are more likely to be sexually active, have what they believe is better sex and are consistently more interested in sex than women. This drive for sex among men and the feeling that the sex they get is high quality doesn't diminish with age. Lindau said it was difficult to ascertain exactly how many of these participants might have taken erectile dysfunction drugs.
If men stay in good shape, they can enjoy more years of good sex, the study says. At age 55, men in very good or excellent health on average gained five to seven years of sexually active life compared with their peers in poorer health. Women in very good shape gained 3 to 6 more years of a quality sex life than women who are less healthy.
For women 60 years and older, sex dropped off significantly overall and was even lower among those without partners. For men in that age range, having a partner didn't matter -- they still wanted sex consistently, the study found.
Among 75- to 85-year-old men, four out of 10 were still having sex, compared with two out of 10 women that age. Women whose partners were still alive, however, were having just as much sex as men, said Lindau.
"I don't want to perpetuate the notion that older women don't desire sex," she said. "There's a glass half full here. There's a big hunk of older women still having sex. Women who initiate relationships later in life -- they describe passionate love and sex like the way younger people do."
Lindau said she was frustrated that her sampling was limited to heterosexuals, a typical quandary many experience when testing this topic, she said. She hopes to conduct another study focusing on aging homosexuals, bisexuals or people whose biological sex cannot be classified as either male or female.