Transgender Flashcards
What is “sex”?
Pattern of biological sexual characteristics, based on physical characteristics
What is “intersex”?
Anatomical or physiological aspects of the opposite sex, variations from the norm
What is “gender”?
Culturally dictated expectations, actions, and behaviors which are dictated by the genitals
True or false: gender is culturally specific, and variable over time
True
What is gender identity?
Inner sense of place on the male-female spectrum
When does gender identity set in?
2-3 years old
What is asexual?
Not being attracted to other people
What is the major issue with sexual identity in terms of sexual orientation?
Label
What are sexual preferences?
Sexual desires of chosen activities, actions, and behaviors
What is gender assignment?
The initial assignment at birth as male or female
What is “gender atypical”?
Features or behavior that are not “typical” for the assigned gender in a given society in a given time
What was gender identity disorder in the DSM IV?
Conflict between sexual identity and gender identity that causes distress
What is gender dysphoria?
An individual’s affective/cognitive discontent/distress with the gender assignment
What is the definition of transgender?
Broad spectrum of individuals who identify with a gender difference from their natal gender
What is a transexual?
An individual who seeks, or who has undergone, a social transition from male to female or v.v
What is the transition period?
The period during which an individual is moving from the assigned sex at birth to their gender identity
Is hormonal therapy FDA approved for transsexual?
No
What is gender reassignment?
Denotes an official, usually legal change of a gender
What are bigendered people?
People who identify as both masculine and feminine
Who are androgynes?
Midline between masculine and feminine
Who are agender people?
People who do not identify as a male or female
In terms of the diagnostic criteria for gender dysphoria, what is the duration that is needed? Of the 6 criteria, how many are needed?
-6 months
2/6
What are the six criteria that are used to diagnose gender dysphoria?
- Incongruence between one’s experienced/expressed gender
- Desire to be rid of primary and/or secondary sexual characteristics
- Strong desire for the primary/secondary characteristics of the other gender
- Strong desire to be of the other gender
- Desire to be treated as the other gender
- Conviction that one has the typical feelings and reactions of the other gender
True or false: the suicide risk associated with transgender pts can persist after reassignment
True
Often, cross gender behavior present before what age?
3
Who generally more often experiences gender dysphoria?
Males
What is the typical outcome of boys who express cross-gender behavior?
Homosexual men
True or false: in terms of trans people, if they’ve got it, it needs to be checked
True
What is cis-genderism?
The idea that everyone is comfortable with their assigned sex
What percent of trans people smoke?
45-75%
What are the mental health disorders with trans people?
- Depression
- Anxiety
- PTSD
True or false: trans people are more at risk of substance abuse
True
True or false: transgender people of color have a high risk of contracting HIV
True–63%
What are the immunizations that should be given to trans people? (3)
- Hep A
- Hep B
- HPV
What should be asked of transgender pts when seeing them for the first time?
-Ask name and pronoun use
Is it appropriate to ask if a person has had their surgery yet?
No, implies that they are not themselves until they undergo their surgery
What is the hormone care for transmen?
Testosterone
What is the hormone treatment for transwomen?
Estrogens
Antiandrogens
What is the dose for testosterone?
200 mcg/cc IM
Should you use oral or topical forms of testosterone?
Topical, sure. Oral, no.
What happens to the clitorus with testosterone?
Enlarges
What are the fertility issues with trans people?
Should store eggs / sperm if possible before hormonal therapy
What are “top” surgeries?
Mastectomy and male chest construction
What are “bottom” surgeries?
- Metoidioplasty
- Penile reconstruction/ phalloplasty
What are the three hormones needed for MTF pts?
Estrogens
Antiandrogens
Progesterone
What type of estrogen is used for hormonal therapy for MTF pts? Why?
Estradiol
SL route and it is pure physiologic estrogen
What are the advantages of using estradiol SL?
Avoids first pass by the liver
What is the major risk of using injected estrogen?
Longer duration of action = increased side effect risks
What are the contraindications for estrogen therapy use? (4)
- Estrogen dependent CAs
- h/o PE
- Thrombophlebitis
- pituitary adenoma
When should estrogen be stopped temporarily?
Surgery or trauma
What is the antiandrogen that is commonly used for MTF? Why?
Spironolactone
blocks both testosterone production and action at receptors
What is the role of progesterone for MTF pts? (3)
- not routinely used
- May assist in body fat redistribution
- Suppress testosterone
What is the role of speech coaches for trans people?
Need to adjust to sex
What is the common antiandrogen used for transsexual therapy?
Spironolactone
What is the MOA of spironolactone?
Aldosterone inhibitor (K sparing diuretic)
What are the drugs that can cause gynecomastia? (5)
“some drugs create awesome knockers”
- Spironolactone
- Digitalis
- Cimetidine
- Alcohol
- Ketoconazole
