Endo E2 -Transgender Health

What is gender expression?

outward manner in which an individual expresses or displays gender

What is gender dysphoria?

well-documented and persistent gender identity that differs from their sex assigned at birth and are experiencing distress as a result of this mismatch

What is a transgender male?

Male gender identity and female birth-assigned sex

What is a transgender woman?

Female gender identity and male birth-assigned sex

What is a non-transgender person?

AKA cisgender, gender identity and birth-assigned sex are the same

What is non-binary, gender nonconforming or genderqueer person?

gender identity differs from birth-assigned sex but may be more complex, fluid, multifaceted

What is a cross dresser?

wear clothing of opposite gender without a clear identification with that gender

What is transgender?

older term, refers to someone who seeks medical interventions

What is drag?

cross dressing for performance purposes

What is sexual orientation?

describes sexual attraction & behaviors, not directly related to gender identity

What is considered medically necessary by the WPATH’s Standards of Care?

Hormone therapy; gender affirming medical, surgical, or related interventions

With feminizing hormone therapy, estrogen should be given with what?

androgen blocker (progestogen)

In feminizing hormone therapy, how does estrogen and anti-androgen therapy change after gonadectomy?

continue estrogen without reduction in dose; anti-androgens can be d/c

What is Spironolactone used for in feminizing hormone therapy?

inhibits synthesis & action of testosterone (used for female hirsutism or adult acne)

What role do progestins play in feminizing hormone therapy?

No current studies show role- may help with breast development, mood or libido

What drugs are given for feminizing hormone therapy?

Estrogen & anti-androgen (spironolactone)

What is the primary risk with estrogen therapy?

VTE

What is the preferred route of estrogen if pt smokes or has other RF for VTE?

transdermal estradiol

What is the DOC for masculinizing hormone therapy?

Testosterone

What are some common side effects of testosterone therapy?

Acne, male pattern baldness; monitor Hb and Hct (if elevated dec dose)

What conditions have an inc prevalence in transgender men prior to beginning testosterone therapy?

PCOS and obesity

It may take how long to reach the maximal effect of hormone therapy?

5 years

When ordering labs which reference range should you use?

ranges driven by current hormonal status of pt

Should you make modifications to screening recommendations for cancers?

NO -take an organ based approach

Transgender (men/women) are 34x more likely to have HIV than the general population

Women