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RRPA Clinical Decision Making I > Gender Affirming Care > Flashcards

Gender Affirming Care Flashcards

1
Q

What are the 3 diagnostic criteria for gender dysphoria?

A
  1. Incongruence between assigned gender and known gender > 6 months
  2. Distress or impairment of function
  3. Age > 18 or >16 with guardian consent
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2
Q

Is hx of a thromboembolism a contraindication to estrogen therapy?

A

No

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3
Q

What are contraindications to estrogen therapy?

A

Acute unstable physical or mental health condition

Active estrogen sensitive neoplasm

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4
Q

What are contraindications to testosterone?

A

Pregnancy
Acute unstable physical or mental health condition
Untreated polycythemia
Active testosterone sensitive neoplasm

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5
Q

Goal serum estradiol in estrogen based therapy?

A

50-200 pg/mL

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6
Q

Goal T in estrogen based therapy?

A

< 55ng/dl

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7
Q

What is the strongest, purest form of estrogen?

A

17-beta-estradiol

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8
Q

What route of administration of estradiol is the cheapest?

A

Oral/sublingual estradiol

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9
Q

What is the safest route of administration of estradiol if a patient has comorbidities?

A

Transdermal

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10
Q

After estrogen therapy is started, the expected onset of psychological benefits occurs?

A

Immediately

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11
Q

After estrogen therapy is started, the expected onset of breast development occurs?

A

3-6 months

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12
Q

What is the effect of estrogen on genetalia?

A

Decreased testicular volume, reduced sperm and semen quantity.

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13
Q

What is the effect of estrogen on body fat?

A

Increased subq fat

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14
Q

What medications can be used for anti-androgen therapy?

A 
Spironolactone
Finasteride
Dutasteride
Progesterone
GnRH analogs (leuprolide)
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15
Q

What class of medications can be used to block breast development in the setting of estrogen based therapy?

A

SERMs

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16
Q

List some adverse effects to estradiol.

A 
VTE
Osteoporosis
Increased CV risk
Insulin resistance
Prolactinoma
Breast cancer
Psychological
17
Q

If spironolactone is used as an anti-androgen, what metabolic findings should you worry about?

A

Hyperkalemia

18
Q

What is the goal range of T in testosterone therapy?

A

400-800mg/dl

19
Q

Are changes seen more rapidly in estrogen therapy or testosterone therapy?

A

Tesosterone

20
Q

How often should estrogen levels be checked in testosterone therapy?

A

They don’t have to be checked

21
Q

What are the routes of administration for testosterone?

A

IM/SC
Transdermal patches
Transdermal gels

22
Q

What form of testosterone is rarely used due to its high cost?

A

Transdermal patches

23
Q

What adverse effect of testosterone needs to be checked for every 3 months?

A

Polycythemia

24
Q

What medication would you consider in a patient undergoing testosterone therapy who begins to have hair loss?

A

Finasteride

RRPA Clinical Decision Making I (17 decks)

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