GLBTQ- Johnson

Question 1

Gender Identity

Answer 1

Internal sense of being male/female/ not conforming to either

Same thing as assigned gender

Question 2

Sexual Orientation

Answer 2

An individual’s attraction to the same and/or other sexd

Question 3

Gay

Answer 3

Attracted to same sex

Question 4

Lesbian

Answer 4

Gay women

Question 5

Define transgender

Answer 5

self identity and general sense of self does not conform to the physical gender

Question 6

Define transsexual

Answer 6

a person who has undergone treatment to become recognizable as a gender different from birth or assigned gender

Question 7

Gender non-conforming

Answer 7

Not corresponding to usual male/female identity of that culture

Question 8

Gender dysphoria

Answer 8

Physical or assigned gender does not align with gender identity and causes distress

Previously called gender identity disorder

**the physical and psychological mismatch is NOT a pathology but the STRESS THAT IS CAUSES IS

Question 9

Treatment for gender dysphoria?

Answer 9

Feminizing or masculiniing hormones
Sex reassignment surgery
Counseling

*unique to each person

Question 10

What is the prevalence of gender dysphoria?

Answer 10

0.3% of the population

Question 11

What does 46 XX classical congenital adrenal hyperplasia result in?

Answer 11

Excess androgen exposure prenatally

Results in ambiguous genitalia at birth

Question 12

5-alpha reductase 2 deficiency

17 beta-hydroxylase deficiency

Answer 12

in 46 XY individuals cause impaired virilization during fetal development due to blocked conversion of testostersone to its active form

Genetic male with female or ambiguous genitalia

Question 13

What percent of 46 XY individuals raised as girls have gender role change at puberty?

Answer 13

56-64%

**Suggests influence of pre and post natal androgen exposure on gender identity

Question 14

When can symptoms of gender dysphoria start?

Answer 14

As early as age 2

Question 15

Do majority of gender dysphoria resolve by puberty?

Answer 15

Yes

Question 16

What is the best mental health outcome for children with gender dysphoria?

Answer 16

Achieved with allowing gender expression and observing for persistence

Question 17

What is pubertal suppression?

Answer 17

Reversible
Delays development of secondary sex characteristics

Provides time to explore gender identity before permanent changes in hormones occur

GnRH analogue or progesterone to suppress pituitary horomones and testosterone production

**does NOT allow for sperm banking or ova harvesting

Question 18

What percent of TG individuals use illegally obtained hormones due to barriers in health care?

Answer 18

50%

Question 19

Male to female HT

Answer 19

Estrogen + androgen inhibitor

Onset of change is 3-6 months

Maximum effect 6 months-2years

Effect is unpredictable

Question 20

What are 3 contraindications of estrogen therapy?

Answer 20

History of:

DVT
Estrogen dependent neoplasm
End stage liver disease

Question 21

What anti-androgen is available in US?

Answer 21

Spironolactone

Blocks testosterone receptor and suppresses testosterone excretion

Question 22

What are the most effective drugs to suppress FSH and LH?

Answer 22

GnRH analogous

Prohibitively expensive

Question 23

Approach to hormone therapy

Answer 23

• manage expectation
• Assess baseline risk for medical complications
• continue other appropriate screening exams appropriate for biologic sex