Transgender population 2019

Question 1

Dose of oestrogen for male to female hormone treatment?

Answer 1

PO 1-6mg/day estradiol

Question 2

What can be given if excess testosterone despite GnRHa in male-to-female?

Answer 2

Finasteride

Question 3

How does finasteride work?

Answer 3

Blocks conversation of testosterone to dihydrotestosterone

Question 4

Most serious risk of taking testosterone in female-to-male hormone treatment?

Answer 4

Polycythaemia which can predispose to CV event

Question 5

How to offer endometrial protection for female-to-male hormone treatment

Answer 5

Offer hysterectomy after 4-5 years of hormone Tx (unopposed oestrogen produced by aromatisation of testosterone)
Or if decline USS every 2 years

Question 6

What is the impact of gender reassignment on fertility?

Answer 6

Irreversible sterility

Question 7

When should fertility preserving strategies before offered?

Answer 7

Before hormone therapy or interrupt hormone therapy for 3 months

Question 8

Overall birth rate per embryo for transfer of frozen eggs (2016)

Answer 8

19%

Question 9

What can be given to transmen if still bleeding despite GnRHa

Answer 9

Norethisterone or medrpxyporgesterone
If no bleeding and suddenly bleeding consider hyperplasia/cancer