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5. Psychiatry > 3- LGBQT > Flashcards

3- LGBQT Flashcards

1
Q

Does “sex” mean “gender”?

A

NO

Sex is based on anatomy (biologically sex, XX vs XY)
Gender is based on sexual identity (Gender identity)

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2
Q

What is sexuality?

A

Who you are attracted to physically, romantically and/or emotionally

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3
Q

What is a transgender?

A

Someone whose gender identity is different than their birth sex

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4
Q

What is stress felt when one’s physical body or the way others see the person does not align w/ their gender identity?

A

Gender dysphoria

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5
Q

What is someone who is born w/ ambiguous genitalia or sex organs of both sexes?

A

Intersex

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6
Q

What is someone who may move along the gender spectrum at different time?

A

Gender fluid

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7
Q

What is someone who may identify as androgynous or closer to the middle of the gender spectrum?

A

Genderqueer

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8
Q

What is someone who felt like they are the gender they are born w/?

A

CIS gender

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9
Q

What is a Native American term for someone who posses two genders or the body one gender and the spirit of another?

A

Two spirit

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10
Q

What is a transman?

A

FtM

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11
Q

What is a transwomen?

A

MtF

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12
Q

What is the DSM5 criteria from gender dysphoria? (2)

A

A: Incongruence b/w one’s experience/expressed gender and natal gender for 6+ mos w/ 2+
- Incongruence b/w ones expressed gender and primary and/or secondary sex characteristic, desire to be rid of one’s primary and/or secondary sex characteristics, desire for primary and/or secondary sex characteristic of the other gender, desire to be the other gender, desire to be treated as the other gender, strong conviction that one has the feelings and reactions of the other gender

B. A/w distress/impairment

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13
Q

What are the specifiers of Gender dysphoria? (2)

A
  1. Does it exist w/ a d/o of sex development?

2. Is the condition post-transitional?

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14
Q

What is the role of the World Professional Associated for Transgender Health (WPATH)?

A

Supports pt autonomy in choosing whether or not to seek psychologists care for medical transition

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15
Q

Are psychologists letters required for gender confirming surgery?

A

Yes

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16
Q

Informed consent for the TransMale includes the expected effects of T therapy (take 3-5 yrs). What are the PERMANENT changes? (5)

A
  1. Pitch of voice becomes deeper
  2. Increased growth/thickening of body hair
  3. Facial hair
  4. Possible male patterned baldness
  5. Increase in size clitoris/phallus
17
Q

Informed consent for the TransMale includes the expected effects of T therapy (take 3-5 yrs). What are the NON- PERMANENT changes? (6)

A
  1. Menses will stop
  2. Weight gain to abdomen
  3. increased muscle mass/upper body strength
  4. Increased sex drive
  5. Changes in mood/thinking, decreased emotional reactions, increased aggression
  6. +/- more physical energy
18
Q

What are the SE of T therapy? (9)

A
  1. Loss of fertility (T is not reliable birth control, even if menses stop)
  2. M CV RF (higher BP, cholesterol)
  3. Increased risk of DM, sleep apnea
  4. Increased appetite/weight from muscle/fat
  5. Abn liver tests
  6. Weakening of tendons/increased risk of injury
  7. Worsening of HA/migraine
  8. Worsening of bipolar, schizophrenia, psych d/o
19
Q

TransMales are at VERY HIGH risk of what due to T therapy? (1)

A

Erythocytosis

20
Q

TransMales are at MODERATE risk of what due to T therapy? (3)

A
  1. Breast/Uterine CA (neglect screening exams)
  2. Liver disease
  3. CAD, CVD, HTN
21
Q

Informed consent for the TransFemale includes the expected effects of E therapy (take 3-5 yrs). What are the PERMANENT changes? (3)

A
  1. Breast growth
  2. Testicle get smaller/softer
  3. Testicle produce less sperm, +/- become infertile
22
Q

Informed consent for the TransFemale includes the expected effects of E therapy (take 3-5 yrs). What are the NON- PERMANENT changes? (9)

A
  1. Loss of muscle mass, decreased strength (esp. in upper body)
  2. Weight gain to buttocks, hips, thighs
  3. Skin becomes softer/less acne
  4. Facial/body hair get softer/light and grow more slowly
  5. Slowing of male patterned baldness
  6. Reduced sex drive
  7. Decreased strength of erections (less semen)
  8. Increased emotional rxns
  • No changes to bone structure
23
Q

What are the SE of E therapy? (6)

A
  1. Loss of fertility
  2. Increased risk of DVT, PE, MI, CVA
  3. HTN
  4. DM
  5. N/V
  6. Increase risk of breast CA
24
Q

TransFemales are at VERY HIGH risk of what due to E therapy? (1)

A

Thromboembolic disease

25
Q

TransFemales are at MODERATE risk of what due to E therapy? (7)

A
  1. Macroprolactinoma
  2. Breast CA
  3. CAD
  4. Cerebrovascular disease
  5. Cholelithiasis
  6. Hypertrigylceridemia
26
Q

What are the SE of Androgen Blockers (Spironolactone) in TransFemales?

A
  1. Increased urine production/frequency
  2. Drop in BP, lightheadedness
  3. Increased thirst
  4. Hyperkalemia
27
Q

What medications are used for TransMales (FtM)?

A

Testosterone IM (Cypionate, Ethanate), topical gel, patch

28
Q

What E medications are used for TransFemales (MtF)?

A
  1. Estradiol oral, transdermal, IM (Valerate, cypionate)
  2. Androgen blockers (Spironolactone, Finasteride)
  3. Progestin Preparation (Medroxyprogesterone acetate, micronized progesterone)
29
Q

What is included in the screening and prevention for TransMales?

A
  1. Evaluate H&H/hormone levels q3 months during first year, then annually (T b/w 400-700 ng/dl)
  2. Monitor for signs of virilization/ adverse effects
  3. BMI, BP, lipids
  4. Pap screening if cervical tissues remain
  5. Osteoporosis screening
  6. Mammography if breast tissue remain
30
Q

What is included in the screening and prevention for TransFemale?

A
  1. Evaluate hormone levels q3 months during first year, then annually (+ lytes if on spironolactone)
  2. Monitor for feminization, adverse effects
  3. Serum T < 50 ng/dl, estradiol b/w 100-200 pg/ml
  4. Prostate Ca screening
  5. Bone mineral density at baseline and 60/when stop hormone therapy
31
Q

What surgical procedures are available for TransFemales?

A
  1. Vaginoplasty/clitoro-labioplasty

2. Mammoplasty

32
Q

What surgical procedures are available for TransMales?

A
  1. Mastectomy (“Top surgery”)
  2. Metoidoplasty (frees enlarged clitoris)
  3. Phalloplasty
  4. Scrotoplasty

5. Psychiatry (19 decks)

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