LGBTQ Medicine - Eric Flashcards
when should any person with hormonally enhanced breast tissue obtain mammography
over the age of 50 and with a 5+ years of estrogen therapy
what is the HPV screening for transmen > 30 yo
self swab as a risk reduction model for those who are unwilling to have Pap
if positive - pap is indicated
where is the prostate assessed in a transwomen
pelvic exam as the prostate is not removed in transitional surgeries from male to female
what immunizations should be considered for people who engage in anal or transactional sex
Hepatitis and HPV vaccines
What is SOGI
Sexual Orientation
Gender Identity
what STDs are men who have sex with men at increased risk for
HPV
HIV
gonorrhea
chlamydia
syphilis
hepatitis
giardia
etc.
what is best practices for STD screening in the LGBTQ population
screen for HIV, hepatitis panel, RPR, GC/chlamydia every 3 months in high risk groups
- use swabs for each site at risk for GC/chlamydia (anal, vaginal, oral)
what medication is used for HIV prevention
PrEP (Pre-Exposure Prophylaxis)
What are the PrEP options and how are they administered
Truvada - oral once daily
Descovy - oral once daily
Apretude - IM (every 2 months)
how often are we screening for HIV in patient using oral PrEP
every 3 months
how often are we screening for HIV in patients using injection PrEP
every 2 months prior to injection
what is the medication for non-occupational post exposure prophylaxis of HIV (N-PEP)
Truvada AND isentress - start within 72 hours
take for 28 days
then test for HIV with 4th gen test
what should sex always be
safe
sane
consensual
what are recommendations for PE for paps in transmen
consider using lidocaine jelly prior to pap
use smallest speculum available
what are the recommendation for PE for sensitive exams
ask pt which gender chaperone they feel comfortable
What is the criteria to start hormonal affirmation therapy
persistent gender identity
sound mind to consent to treatment
over the age of 18 or with parental consent
well-managed chronic disease
Tanner 2 to start hormone blockers OR estrogen/testosterone use post-puberty
what is needed for feminizing hormones
need to overcome testosterone
need both estrogen and androgen blocker
what is the criteria for gender affirming surgery
WPATH standards (World Professional Association for Transgender Health)
persistent gender identity
age of majority or capacity for informed consent with parental consent
well controlled medical or mental health concerns
12 months living in gender role
12 months of hormone therapy
electrolysis is indicated (6-12 months)
What are the types of affirming surgeries
chest reconstruction
genital reconstruction
gonad removal
body contouring
facial feminization or masculinization
vocal cord surgery
hair transplantation
