14: Transgender Health

Question 1

gender identity vs gender expression

Answer 1

1. identity: internal sense of gender

2. expression: physical manifestation of gender identity thru clothes, hairstyle, voice, body shape, etc.

Question 2

gender dysphoria

Answer 2

significant distress related to incongruence of sex assigned at birth and gender identity

Question 3

lifetime suicide attempt in trans individuals vs whole population

Answer 3

trans: 41%
population: 1.6%

Question 4

masculizing H therapy

Answer 4

testosterone: injection or topical

Question 5

effects of masculinizing and feminizing hormone therapy

Answer 5

like a second puberty, may take years for full effects

Question 6

risks of taking testosterone

Answer 6

polycythemia**, OSA, HLD

Question 7

feminizing H therapy

Answer 7

estradoil + androgen blocker

Question 8

MC androgen blocker for feminizing hormone therapy

Answer 8

spironolactone

Question 9

risks of taking estradiol

Answer 9

DVT, decreased libido, ED

Question 10

why are androgen blockers used alongside estradiol?**

Answer 10

maximize blockage of T while avoiding supraphysiologic estrogen dosing which can be more dangerous

Question 11

metoidioplasty

Answer 11

elongating clitoris

Question 12

tracheal shave

Answer 12

reducing adam’s apple

Question 13

gender affirming H therapy and fertility

Answer 13

may reduce fertility for all pts - councel on sperm bank/egg freezing before starting

Question 14

best contraceptive options for transmasculine pts

Answer 14

IUDs**, Nexplanon, Depo-provera shot, hysterectomy

Question 15

breast cancer screening in transfeminine pts

Answer 15

mammo starting at age 50, if exposed to feminizing H for 5+ years