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Behavioral Health: Week 1 > Woods: Transgender Health > Flashcards

Woods: Transgender Health Flashcards

1
Q

What is sexual orientation?

A

Individual’s attraction to the same or opposite sex (sexual preference)

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2
Q

What is gender?

A

Internal sense of being male/female/other

other= on the continuum between M and F

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3
Q

Define transgender

A

self identity that doesn’t conform to one’s physical gender

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4
Q

Define transsexual

A

a person who has undergone tx to become recognizable as opposite sex

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5
Q

Define gender non-conforming

A

not corresponding to usual M/F identity of that culture

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6
Q

What is gender dysphoria?

A

Mismatch between biologic self and gender identity and the STRESS that conflict causes

Tx: reduce distress–counseling, hormones, surgery (varies for each individual)

*DSM dx

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7
Q

High rates of anxiety and depression in transgender individuals is related to….

A

minority stress NOT being transgender

*54% transgender youth attempt suicide

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8
Q

What does gender identity develop?

A

early childhood

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9
Q

T or F. Most gender dysphoria experienced in childhood resolves in adult.

A

T

*100% persistence when onset is in adolescence

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10
Q

When do gender dysphoria sxs present in childhood?

A

Age 2

Can be associated w/ anxiety, depression, autism in children

Usually resolves in puberty

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11
Q

When does gender dysphoria present in adolescence?

A

body aversion increases as secondary sex characteristics develop

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12
Q

How do you tx children w/ gender dysphoria?

A

No evidence based guidelines on when to seek medical treatments

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13
Q

What is pubertal suppression?

A

fully reversible

delays development of secondary sex characteristics (breast development, voice change, pubic hair)

Provides time to explore gender identity before permanent changes of native hormones occur

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14
Q

What medication is used for pubertal suppression?

A

M–>F: GnRH analogues or progresterone to suppress pituitary hormones and testosterone production

F->M: GnRH Analogues

Early use averts social and emotional consequences

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15
Q

What complications are associated w/ pubertal suppression?

A

decreased bone mineral density/height

decreased development of penile tissue for vaginoplasty

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16
Q

What are some fertility complications with pubertal suppression?

A

Pubertal suppression does not allow sperm banking/ova harvesting

17
Q

What are barriers to hormone therapy?

A

50% of TG individuals attain hormones illegally

lack of insurance, providers, willing to prescribe

18
Q

Before providing hormone therapy…

A

Mental health dx must be made
Pt must provide consent to tx
mental health issues must be addressed

19
Q

What is the “real life experience” criteria?

A

pt must have lived as desired gender openly for 12 mos; real life experience

Tests ability to fxn in job, family, relationships

20
Q

M to F Hormone therapy

A

Estrogen + androgen inhibitor

Individual response
onset of change 3-6 mos
max effect 6 mos-2 yrs
estrogen pills/patch, injections
spironolactone (antihypertensive that has antiandrogenic properties--widely used)
21
Q

What are adverse effects of M to F HT?

A

decreased libido, erectile fxn, muscle fass

22
Q

When is estrogen therapy contraindicated?

A

Hx of DVT
estrogen dependent neoplasm
end stage liver disease

23
Q

What are impt things to monitor in a pt on HT therapy?

A

prolactin
liver fxn
bp

24
Q

What is an antiandrogen?

A

spironolactone

blocks testosterone receptor

25
Q

What is the most effective androgen suppressors?

A

GnRH suppress FSH and LH but are expensive

Cyproterone- progestin, not available in US

5 alpha reductase inhibitors

26
Q

What are risks of F to M HT?

A 
weight gain
acne
polycythemia
alopecia
hyperlipidemia
CVD
HTN

medroxyprogesterone to inhibit menses

27
Q

What percent of pts undergo sexual reassignment surgery?

A

1/3

28
Q

Does the ACA require coverage for transgender therapy?

A

YES but providers are often not available and are “out of network”

29
Q

Define intersex

A

variation in sex determination

check baby’s genitalia thoroughly

30
Q

You deliver a baby w/ cloacal extrophy what should you do?

A

consult, image, explain

31
Q

You are going to do a PAP on a 22 y/o who dressses male and considers herself male and wants to be called a male name. A year ago the PAP showed ASCUS w/ HPV high risk. You should:

A

State you hear his request and explain how guidelines still reflect that a PAP is indicated

Behavioral Health: Week 1 (14 decks)

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