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Social and Behavioral Medicine > Transgender Health > Flashcards

Transgender Health Flashcards

1
Q

What is sexual orientation?

A

an individuals’ attraction to the same and/r opposite sex

preferred to sexual preference

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2
Q

What is gender?

A

internal sense of being male/female/other

other meaning somewhere on the cotinuum between male and female

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3
Q

What is transgender?

A

self identity and general sense of self that does nto conform to one’s physical gender

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4
Q

What is transsexual?

A

a person who has undergone treatment to become recognizable as the opposite sex

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5
Q

What is gender non-conforming?

A

not corresponding to usual male.female identify of that culture

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6
Q

WHat is gender dysphoria

A

biologic gender does not align with psychological gender and the stress that it causes

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7
Q

What is the treatment for gender dysphoria?

A

reduce the distress it causes

feminizing or masculinizing hormones, sex reassignment surgery, counseling. effective treatment is unique to each person.

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8
Q

What is the probable prevalence of this/

A

0.3%

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9
Q

What is the high incidence of anxiety andd epression in these goups probably due to?

A

the stress of being in a minority group

not inherent to being transgender

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10
Q

What percentage of transgender youth have attempted suicide?

A

54%

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11
Q

What percentage of gender dysphoria will still persist into adulthood for children?

A

12-27%

so most resolve

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12
Q

But if the first occurrence is in adolescence, what percentage persists into adulthood?

A

100%

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13
Q

In children, which gender is more often affected?

A

males (but this could be social tolerance)

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14
Q

At what age can symptoms of this start showing? At what age will it typically resolve (if it will resolve)?

A

2

around puberty

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15
Q

FOr those that start in adolescents, when does body aversion start?

A

increases as secondary sex characteristics develop

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16
Q

What is pubertal suppression

A

it’s a treatment for children with gender dysphoria - it suspends the develpoment of secondary sex characteristics

it’s reversible - so it provides some time to explore exactly what’s going on

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17
Q

what hormone is used for male to female?

A

GnRH analogues or progesterone to suppress pituitary hormones and testosterone production

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18
Q

What hormone is used for female ot male?

A

GnRH analogues

19
Q

WHat are the complications of these treatments?

A

decreased bone mineral density
decreased attainment of height
insufficient development of penile tissue for vaginoplasty

20
Q

What is the effect on fertility?

A

hormone therapy suppresses ovulation and sperm production

in adults, there is an option for cryopreservation of the gamete in surrogate, but pubertal suppression would not allow sperm banking or ova harvesting

21
Q

What percentage of TG individuals will use illegally obtained hromones due to barriers to health care?

A

50%

22
Q

WHat are the barriers here?

A

lack of insurance
lack of providers willing to prescribe
lack of coverage of hormones and surgery and mental health care

23
Q

What must the individual carry a diagnosis of before hormone therapy starts?

A

gender dysphoria established by a qulified mental health provider

24
Q

How long are individuals encouraged to live openly as the other gender before starting?

A

1 year

25
Q

Once you start estrogen therapy, when is the onset of change?

A

3-6 months to onset, but expected maximum effect takes 6 months to 2 years

26
Q

What are the desired effects of estrogen here?

A

breast growth, body fat redistribution, softening of skin, slowed body hair growth, decreased testicular size

27
Q

What are the adverse effects of estrogen?

A

decreased libido, decreased erectile function (can be a desired effect depending on sex life), decreased muscle mass

28
Q

What is the contraindication against estrogen?

A

previous DVT, estrogen, dependent neoplasm or end-stage liver disease

29
Q

What are some of the increased risks with estrogen

A

clotting, gall bladder disease, weight gain, hypertriglicerides, liver function abnormalities, cardiovascular disease, HTN, type 2 diabetes

30
Q

What are the expected effect of andoren hormone therapy?

A

deepend voice, clitoral enlargement, growth of facial and body hair, cessation of menses, atrophy of breast tissue, increased muscle mass

31
Q

WHat thnigs should you monitor in people on hormone therapy?

A

lFTs, prolactin, BP

32
Q

What is the antiandrogen drug in the US?

A

spironolactone

33
Q

What are the most effective at suppressing testosterone production though?

A

the GnRH analogues

34
Q

What is finasteride?

A

a 5 -alha reductase inhibitor to inhibit the formation ot metabolic testosterone production

35
Q

What are the risks for androgen therapy?

A

weight gain, acne, polycythemia, alopecia, hyperlipidemia, cardiovascular disease, hypertension

36
Q

What is the typical length of delay between hormone therapy and actual sex reassignment surgery?

A

29 years

37
Q

Does the ACA provide coverage for gender reassignment surgery?

A

yes, but the providers still aren’t available so the out of network crap still applies

38
Q

What is intersex?

A

variation in sex determination at birth

need t check baby’s genitalia thoroughly and never remove newborn’s genitalia tissu3

39
Q

What should you do if you deliver a baby with questionalb genitalia?

A

image, do genetic testing, and explain everything to the parents

do not remove any of the tissue and just wait until the individuals grows up

40
Q

True or false: men who have sex with men all identify as gay?

A

false - some gay men will ahve sex with women - either by crossing or covering

41
Q

true or false: youth lesbians have higher pregnancy rates

A

true

don’t get contraception and maybe have more sex with men to compensate

42
Q

true or false: trans-males don’t need pap and clinical breast exams

A

false - still need them

standardized care!

43
Q

So what should you include in an exam of a trans-female?

A
  1. yearly clinical breast exam
  2. testicular and prostate health
  3. birth control options/parenting desires
44
Q

What should you include in an exam of a trans-male?

A
  1. pap
  2. yearly breast exam
  3. discuss birth control to stop period/prevent pregnancy
  4. parenting desires

Social and Behavioral Medicine (17 decks)

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