ott

Question 1

endocrine society

Answer 1

2017

Question 2

fenway health

Answer 2

2021

Question 3

UCSF transgender care

Answer 3

2016

Question 4

wpath

Answer 4

2022

Question 5

Why do we have to diagnose gender dysphoria?

Answer 5

billing code for medical care
not everyone who identifies as transgender has gender dysphoria
gender dysphorida indentifies the mood symptoms related to a persons experience of their body and their place in the world
identifyinf as transgender or nonbinary itself is NOT a mental health disorder

Question 6

Gender affirming hormone therpay (gaht)

Answer 6

suppress endogenous sex hormone secretion determined by the person’s genetic/gonadal sex
maintain sex hormone levels within the normal range for the person’s affirmed gender

Question 7

fertility preservation and sexual health

Answer 7

transgender men-testosterone
possible loss of fertility

Question 8

transgender women-estradiol

Answer 8

decreases sperm production, may be unable to produce healthy sperm after stopping estradiol
may desire to bank sperm prior to starting estradiol

Question 9

Trans men- testosterone

Answer 9

cypionate injection (cottonseed oil) or enanthate injection (seasme see oil)
topical gel packets or pump formulation
counseling about site of gel application, drying for at least 2 hours, avoid skin contact with others
patch

Question 10

what do you give trans men once youve gotten them to the appropriate test. level?

Answer 10

norithendrone

Question 11

testonsterone side effects

Answer 11

migraine HA
hair loss
plycystic ovarian syndrome
acne
screen for osteoporosis and risk of bone loss
medical risks- CAD, erebrovascular disease, HTN, cancer

Question 12

testosterone lab monitoring

Answer 12

CBC for hemoglobin- may cause erythropoietic effects
Lipid profile
liver function tests
fasting glucose/Hgba1c
serum test.
sex hormone binding gloulin
estradiol

Question 13

trans women- estradiol

Answer 13

past use of ethinyl estradiol that increase rick of VTE and conjugated estrogens that cant be monitored
Prefer bioindentical 17-beta estradiol

Question 14

trans women-estradiol hormone therapies

Answer 14

valerate injection (sesame or castor oil) and cypionate estradiol injections (cottonseed oil)
patch- preferred if pt uses tobacco or at higher VTE risk
Tablet- oral and sublingual dosing

Question 15

estradiol side effects

Answer 15

hyperprolactinemia and galactorrhea- monitor prolactin
weight gain
migraine
screen for osteoporosis
medical risks include breast cancer, cad, cholelithiasis

Question 16

transgender women- anti-androgens

Answer 16

used to minimise male secondary sex charactertics
spironolactone- direct anti-androgen, may suppress test. synthesis
can use finasteride or dutasteride is spironolactone is not tolertated-block conversion of test. to dihydrotest.
biclutamide may be used but conern for liver function abnormalities limits use

Question 17

anti-androgen SE SPIRONOLACTONE

Answer 17

may reduce breast development due to estrogen receptor activity
orthostasis and polyuria can occur, counsel pt to take in the mroning to decrease getting upa t night

Question 18

anti-androgen SE finasteride/dutasteride

Answer 18

decreased libido, ED

Question 19

trans women- progesterone

Answer 19

once daily oral capsule, contains peanut pil, check for peanut allergy
medroxyprogesterone- oral dosing is preferred can be considered id the pt has peanut allergy
anecdotal improved breast/areolar developmetn but limited evidence of effectiveness
pt may request to try it