Week 5 Flashcards
This is a designation based on one’s chromosomes and genitalia, biological.
Sex
This is a social construct that assigns roles and attributes to people based on their natal sex.
Gender
This refers to individuals inner understanding of themselves in regard to sexual orientation and the words they use to describe themselves as sexual beings.
Sexual identity
The sex assigned to a person at birth based on their genitalia.
Natal sex
An umbrella term used to describe those persons whose gender identity in some way is different from their natal sex assigned at birth.
Transgender
Behavior or expression of the mismatch gender identity vs the assigned sex.
Gender non-conforming
The way in which someone expresses their gender identity through their appearance, dress, and behavior.
Gender expression
The medical, social, physical, and legal changes to the perceived sex.
Transition
Male to female identifies as:
Transfemale
Female at birth to male identifies as
Trans male
The person identifies with the original/same sex as at birth.
Cis gendered
Lesbian patients have lower risk of:
HIV and syphilis
Lesbian patients are at high risk of:
Breast cancer
AIDS is the ___ defined by the ___ count and HIV is the ___.
AIDS- Syndrome defined by the CD4 count
HIV- virus
At risk populations for HIV and AIDS:
Primarily MSM
Women of color in heterosexual relationships
Patients with HIV are treated with:
HAART (highly active antiretroviral therapy) prescribed by specialist
Monitoring for HAART and considerations should include:
- High risk of drug-drug interactions
- Dyslipidemia
- Lipodystrophy- disfiguring distribution of fat
- Liver disease
- Check LFTs
PEP is:
Post exposure prophylaxis of 3 meds taken for 28 days and within 72 hours of possible HIV exposure (72 hours is the absolute window for efficacy).
PEP is only for:
HIV
PrEP is:
Pre-exposure prophylaxis first HIV prevention consisting of 2 medications in 1 pill taken daily.
PrEP is for:
Patients at repeated risk for exposure
What is the MOA Of PrEP?
It prevents the HIV from replicating in the body should the virus enter the body.
MTF aka trans women the goal of transition is:
To develop secondary female sex characteristics (feminization)
MTF transition is done by:
- Giving medication to cause feminization- estrogen
- Block testosterone- (anti-androgen agents) spironolactone, 5-Alpha-reductase-inhibitors like propecia (finasteride), and GnRH agonists
What should be monitored with spironolactone?
It is a diuretic so BP and K levels
This reduces the formation of the potent androgen dihydrotestosterone (DHT) from its precursor testosterone in certain tissues in the body such as the prostate, skin, and hair follicles. Effective to prevent hair loss.
Propecia (finasteride)
This is used on label to treat precocious puberty and it shuts down the LH and FSH production in the pituitary, therefore blocking testosterone at a very early stage in the chain of hormonal events.
GnRH
What do you need to monitor with trans women?
Testosterone levels- want between 40-80
Prolactin- don’t want consistently in the 100s
CBC- lower H/H is anticipated
CMP- K
Monitor for risks associated with estrogen (VTE, DVT)
What changes between 0-3 months with the trans women after starting hormones and what is permanent?
Lower libido
Softening skin
Breast budding- permanent
Emotional changes
What changes between 4-10 months with the trans women after starting hormones and what is permanent?
Change in genitals
Softening hair
Decrease in muscle mass
Cessation of spermatogenesis-permanent
What changes between 10 months- 4 years with the trans women after starting hormones and what is permanent?
Breast maturation- permanent
Body fat redistribution
Thickening of hair on head
Female to male transition aka trans males only need to take:
Testosterone
What needs to be monitored in trans males?
CBC- H/H will be normal values for males
Testosterone levels- 400-1000 (cis males range 300-1200)
Increase testosterone risk factors include:
High BP
Diabetes
Heart attack
Stroke
What changes at the 0-3 month mark with trans males with the start of testosterone and what is permanent?
Increase in libido
Increase in appetite (watch for weight gain)
Increase in body hair- permanent
What changes at the 3-6 month mark with trans males with the start of testosterone and what is permanent?
Genital changes- clitoral enlargement- permanent
Cessation of menses
Increase in muscle mass/strength
Change in vocal quality
What changes between 6month- 5 years with trans males after the start of testosterone and what is permanent?
Development of terminal facial hair- permanent
Body fat redistribution
Hair loss- permanent
Puberty delaying options for transgender children should be initiated at:
Tanner stage 2
Three things experts agree to look for in children with regard to gender identity:
- insistence on their gender identity
- Persistence- has been talking about for long time
- Consistency with regard to expression of the gender identity