Transgender Medicine Flashcards
What is the definition of transsexualism?
A desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with or inappropriateness of one’s anatomical sex and a wish to have treatment to make one’s body as congruent as possible to one’s preferred sex
What is the definition of dual-role transvestism?
The wearing of clothes of the opposite sex for part of the individual’s existence in order to enjoy the temporary experience of membership of the opposite sex but without any desire for a more permanent sex change or associated surgical reassignment and without sexual excitement accompanying the cross-dressing
What is the definition of fetishistic transvestism?
The wearing of clothes of the opposite sex principally to obtain sexual excitement and to create the appearance of a person of the opposite sex - it has a clear association with sexual arousal and a strong desire to remove the clothing once orgasm occurs and sexual arousal declines
What is gender identity disorder of childhood?
A disorder with usually manifests during early childhood and always well before puberty that is characterised by persistent and intense distress about the assigned sex, together with a desire to be or an insistence that one is of the other sex
Before undergoing hormonal treatment, transgender patients may undergo fertility preservation. What does this involve?
The collection and storage of either oocytes or sperm
What are the qualifying criteria for hormone therapy in transgender patients?
Well-documented gender dysphoria
Capacity to make a fully informed decision and consent to treatment
Age of majority
Significant medical/mental health concerns reasonably well-controlled
GnRH analogues are given to transgender patients in order to…?
Suspend pubertal development of secondary sex characteristics
What hormonal treatment suspends facial hair growth, voice changes, Adam’s apple formation and male skeletal, facial and musculature changes in trans patients?
AMAB
What hormonal treatment stops periods and halts breast growth in trans patients?
AFAB
At what age can surgery be undertaken for transgender patients?
18
What drug is given as the initial hormonal treatment for transmen?
Sustanon
If testosterone alone does not suppress menstruation, what other drugs can be given to transmen?
Deep provera
GnRH analogues such as triptorelin
If a transman is sexually active with a male partner then testosterone alone is sufficient for contraception. T/F?
False - progesterone is required by deep proverb, implant or IUS
What effect does testosterone hormonal treatment have an transmen?
Lowers voice Increases facial and body hair growth Increases muscle bulk Amenorrhea Clotoromegaly Increased libido Agression
What side effects can hormonal treatments have on transmen?
Polycythaemia Liver dysfunction Increased risk of cardiovascular disease Increased weight Diabetes Mental health disturbances
Oestradiol valerate is taken as a hormonal treatment for transwomen at what dose initially?
1-2mg
What drugs can be used by transwomen as anti-androgens?
Triptorelin
Cyproterone acetate
spironolactone
What are the effects of hormonal treatment on transwomen?
Breast growth Softer skin Less facial and body hair Fat redistribution to hips Increased emotions
What are the potential side effects of hormonal treatment for transwomen?
Increased risk for venous thromboembolism and breast cancer
increased weight
increased blood pressure
migraines
What surgeries can be undertaken by transmen?
bilateral mastectomy hysterectomy oophorectomy metoidioplasty phalloplasty
What are the potential adverse effects of surgery for transmen?
Neo-urethral stenosis Urethral fistulas Dislodgement Erectile cylinders Mechanical failure of erectile mechanism
Do transmen need to be on the SCCRS for cervical smears?
Only if they have not had a hysterectomy
What surgeries can be undertaken by transwomen?
Thyroid chondroplasty Penectomy Orchidectomy Clitiroplasty Vulvoplasty Penile inversion Vaginoplasty Colovaginoplasty Breast augmentation
What are the potential adverse effects of surgery for transwomen?
Urinary spraying Increased risk of UTIs Granulation tissue formation Neovaginal hair growth Neovaginal structure Vascular occlusion of arterial supply to neoclitoris Ongoing need for dilation
Are transwomen given screening tests for cervical cancer prostate cancer or breast cancer?
Only for prostate and breast cancer
What is the normal hormone level of testosterone in transmen?
8-15nmol/l
What is the normal hormone level of estradiol in transwomen?
200-600pmol/l
