Wk 32 - Transgender healthcare Flashcards
What is gender dysphoria?
Unease due to mismatch in assigned sex at birth + gender identity
What are the surgery options transitioning from FTM?
- Remove breasts
- Nipple repositioning
- Dermal implant
- Construction of penis
- Construction of scrotum
- Testicular implants
- Removal of womb + ovaries
What are the surgery options transitioning from MTF?
- Remove testes
- Remove penis
- Construction of vag, vulva + clit
Which treatment is given for gender dysphoria in MTF patients?
Estradiol + esters
What are the CI of using estradiol/testosterone?
- Hx oestrogen dependent tumours
- MI
- UA
- Stroke
- TIA
What are the cautions of using estradiol/testosterone?
- Obesity
- Smoking
- Breast cancer
- High CV risk
- Poorly controlled diabetes
- Severe liver disease
- Severe migraine
When undergoing surgery, what are the rules when taking oestrogen?
- Stop 6 wks before to red thromboembolic complications
- Start 2-4 wks after operation
Which treatment is given for gender dysphoria in FTM patients?
Testosterone
When would you consider a transdermal preparation when giving testosterone?
- Older patients
- Obese
- Smokers
- Low risk of liver dysfunction + thrombosis
What is given for gender dysphoria in FTM AND MTF AND puberty blocker?
GnRH
What is the role of GnRH in males?
Inhibit secretion of pituitary gonadotropins = low circulating testosterone
What is the role of GnRH in females?
- Suppress endogenous sex steroid prod tf stops menstruation
- Maximises masculinisation achieved by testosterone
- Inhibit secretion of pituitary gonadotropins = low circulation ovarian hormones
What is the role of GnRH in children?
Suppress puberty by delaying development of 2’ sexual characteristics
What are the CI + caution of GnRH?
- CI: pregnancy, breastfeeding
- Caution: metabolic bone disease + uncontrolled diabetes
