T1 L16: Transgender healthcare and hormone therapy Flashcards
What is a GIC?
A gender identity clinic
It provides counselling, psychotherapy, psychological support, speech and language therapy, endocrinology, and surgery
What are the effects of Oestrogen treatment?
Hair: Some effect on facial hair, more effect on body hair, no effect on lost scalp hair but can prevent further loss
Breasts: Can expect 1 cup size smaller than mothers
The maximum achievement is after 2 years of treatment and higher doses don’t result in greater effects
How is Oestrogen treatment administered?
Oral or transdermal through patches/gel
When would a transgender patient stop taking oestrogen treatment?
The treatment is individualised but they don’t stop at the normal age of menopause
What is the effect of a GnRH analogue as an endocrine therapy for transgender patients?
It suppresses testosterone
IM injection every 3 months but isn’t required after a gonadectomy
What are the effects of Testosterone treatment?
Hair: male-pattern hair growth and scalp hair loss dependent of genetics
The maximal effect is after 5 years
How is Testosterone treatment administered?
IM injection every 3 weeks or 3 months or a gel can be given
Why do transgender people getting testosterone treatment not need a GnRH analogue?
Because testosterone treatment usually supresses menstruation
What are the risks of Oestrogen treatment?
Venous thromboembolism risk increased so smoking and obesity is advised against
What are the risks of Testosterone treatment?
Risk of polycythaemia so haemoglobin and haematocrit is monitored. This risk is greater in smokers
Why do Trans-men need to be put on contraception?
Testosterone treatment is teratogenic
What are trans-women screened for throughout their life?
- Mammography from age 50 once on hormone treatment for 5 years
- DEXA (bone density scan) at 60 but sooner if there are other risk factors for osteoporosis
What are trans-men screened for throughout their life?
- Cervical and breasts screening as for XX unless they have been surgically removed
- 2 yearly endometrium scans unless surgically removed
- DEXA (bone density scan) after 60
What is the procedure for adolescents wanting to undergo trans-gender therapy?
It’s a specialist subject.
GnRH analogues are given to delay puberty and decisions are made about hormone therapy
What is Turner syndrome?
Caused by Monomy X
It causes developmental issues to do with puberty Eg. ovaries don’t develop, no puberty
