Gender incongruence

Question 1

risk of suicide in patients with gender incongruence?

Answer 1

20-30x higher than gen pop

Question 2

conditions leading to intersex patient

Answer 2

turners syndrome
klinefelters syndrome
congenital adrenal hyperplasia, androgen insensitivity syndrome

Question 3

true/false - transgender ideology correlates with sexual orientation

Answer 3

false - they are separate

Question 4

what does gender recognition act allow

Answer 4

full recognition of acquired gender legally, with certification
it is an offence for anyone in an official position to dislose trans persons trans status woithout consent

Question 5

what does the equality act 2010 allow for trans patients

Answer 5

unlawful for clinicians to discriminate against those with protected characteristic

Question 6

ICD11 status of gender incongruence

Answer 6

desire to transition to life and be a person of the experienced gender instead of the current incongruent gender
achieved by hormonal therapy or surgical
cannot be diagnosed pre puberty

Question 7

ICD11 status of gender incongruence of childhood

Answer 7

incongruence of gender in pre-pubertal children
strong desire to be the experienced gender for >2yrs
strong dislike of sexual features of chilfd

Question 8

predictive factors that may lead to issues in gender transition

Answer 8

mental illness
absent partner/family support
unrealistic expectations
age >30
earlier adaptation to biological sex ie marriage/parenthood
suicidal attempt/ideation
morphological characteristics incompatible with new gender

Question 9

what is the objective of presurgical psychotherapy in gender incongruence

Answer 9

set realistic life expectations to new gender transiton

Question 10

true/false - all transgender patients should undergo preoperative psychotherapy

Answer 10

false - they should all be offered but forceful psychotherapy is deemed harmful

Question 11

when would hormone therapy be considered for trans person and what considerations need made prior to it being commenced

Answer 11

full social gender role transition
needs evaluated by more than one gender specialist
evidence of transition, gamete storage discussed, smoking cessation

Question 12

surgical options for trans women

Answer 12

bilateral breast enhancement 
vaginoplasty 
cricothyroid approximation 
thyroid chondroplasty 
facial feminisation surgery

Question 13

surgical options for trans men

Answer 13

phalloplasty/metidioplasty
hysterectomy
bilateral salpingo-oophorectomy
chest reconstructive surgery

Question 14

postoperative psychotherapy aims?

Answer 14

address suicide risk and post op regret

most regret is temporary and suicide risk is lower but still 30% higher than general population