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MO1 > transgender healthcare > Flashcards

transgender healthcare Flashcards

1
Q

what is binary gender?

A

only two distinct genders exist- man and
woman

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2
Q

what is cisgender?

A

a person whose gender corresponds to the sex
that they were assigned at birth

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3
Q

what is gender?

A

a range of attributes linked to male and female, not linked to an individual’s biological sex

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4
Q

what is gender expression?

A

how an individual performs their sense
of self, through their actions, interests, and appearance

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5
Q

what is gender dysphoria?

A

an individual’s unhappiness at the
disparity between the gender which they were assigned at birth and their gender identity

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6
Q

what is gender identity?

A

an individual’s feeling of what gender
they most associate with

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7
Q

what is heteronormativity?

A

: the idea that heterosexuality is
the norm for sexual orientation and gender binaries of male and female are the only ones that exist

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8
Q

what is medicalisation?

A

the process by which non-medical
problems and conditions become known by and treated as medical ones

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9
Q

what is pharmacotherapy?

A

the treatment of a disorder,
disease, or condition with medication

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10
Q

what is queering?

A

a method of questioning and challenging
processes and systems in society that focus on, or are based upon, heterosexuality or gender binaries

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11
Q

what is sexuality?

A

the way in which an individual expresses
themselves sexually through different feelings and behaviours

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12
Q

what is transgender?

A

desire to move away from a gender that
has been assigned to that person at birth

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13
Q

what is transphobia?

A

a collection of ideas that incorporate a
range of negative attitudes, feelings, or actions towards transgender people

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14
Q

how is equality and diversity regulated in healthcare?

A
  • All healthcare services have a duty to treat their patients with respect and adhere to relevant legislation, such as the Equality Act, 2010, and Gender Recognition Act, 2004
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15
Q

how did the medical professional medicalised transgender patients?

A
  • Transgender patients forced to conform to pre-existing medical beliefs to access care (Hird, 2022)
  • Labelling these patients as ‘ill’ or ‘needing cured’
    perpetuates the idea that they need ‘healed’ or ‘cured’
  • This medical and psychiatric scrutiny allows the pursuit for a ‘cause’ of transgenderism to continue
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16
Q

what did medicalisation of trans patients lead to?

A

n led to inclusion in Diagnostic and
Statistical Manual of Mental Health Disorders (DSM) of the American Psychiatric Association (APA)

17
Q

what are general health concerns?

A
  • Co-morbidities:
    – Consider if existing conditions may be exacerbated by treatment with or deficiency of oestrogen and testosterone
  • Obesity- why is this a concern?
    – Increased risk of adverse effects and complications related to hormone treatment.
18
Q

what are the effects of gender dysphoria?

A

This sense of unease or dissatisfaction may be so intense it can lead to depression and anxiety and have a harmful impact on daily life

19
Q

when can HCP refer for gender dysphoria? how do they help?

A

(>17 years) to the Gender Dysphoria service (Currently developing a self referral route)
* Clinics offer services such as: psychological support and counselling, speech and language therapy and cross-sex hormone therapy
* May apply to legally change their gender

20
Q

what sugery options are there for trans people from female to male?

A
  • In patients transitioning female to male (FTM) may involve: removal of both breasts (bilateral
    mastectomy), nipple repositioning, dermal implant, construction of a penis (phalloplasty) construction of a scrotum (scrotoplasty) and testicular implants and a penile implant.
  • In addition, removal of the womb (hysterectomy) and the ovaries and fallopian tubes (salpingo-oophorectomy) may also be considered
21
Q

what surgery options are there for mens transitioning to women?

A
  • In patients transitioning male to female (MTF) may involve: removal of the testes (orchidectomy), removal of the penis (penectomy), construction of a
    vagina (vaginoplasty), construction of a vulva
    (vulvoplasty) and construction of a clitoris
    (clitoroplasty)
  • Breast implants and facial feminisation surgery are not routinely available on the NHS
22
Q

what is the aim of hormone treatment?

A

– Reduce gender dysphoria
– Alter secondary sex characteristics
– It can provide significant comfort to people who experience gender dysphoria

23
Q

when is hormone treatment indicated?

A

– Persistent, well-documented gender dysphoria
– Capacity to make a fully informed decision and to consent for treatment
– If significant medical or mental concerns are present, they must be reasonably well-controlled

24
Q

when is estradiol recommended?

A
  • Alleviation of gender dysphoria in MTF patients
  • Only estradiol and its esters are recommended for treatment of gender dysphoria.
25
Q

what are the contraindications/ cautions for estradiol?

A
  • Contradindications
    – Hx oestrogen dependent tumours. Recent thrombotic disease
    (new / unstable angina or recent myocardial infarction / stroke / TIA)
  • Cautions:
  • Obesity, smoking, breast cancer, hx thromboembolic disease, CAD, high CV risk, poorly controlled diabetes, severe migraine,
    hypertriglyceridemia, severe liver disease
26
Q

who would testosterone be indicated in?

A
  • Testosterone for alleviation of gender dysphoria in FTM patients
  • Goal to achieve trough serum testosterone levels in the lower third of the male reference ranges
27
Q

who would transdermal testosterone preparations be recommended for?

A

– Consider in older patients, obesity and smokers. May confer lower risk of polycythaemia, thrombosis and
liver dysfunction.
– Allow smaller doses and increments

28
Q

who would testosterone be contraidicated in/ cautioned?

A
  • Contradindications
    – Hx oestrogen dependent tumours. Recent thrombotic disease (new / unstableangina or recent myocardial infarction / stroke / TIA)
    – Sustanon® contains arachis (peanut) oil and should not
    be prescribed for patients known to be allergic to peanut
  • Cautions:
  • Obesity, smoking, breast cancer, hx thromboembolic disease, CAD, high CV risk, poorly controlled diabetes, severe migraine, hypertriglyceridemia, severe liver disease
29
Q

who are GnRH analogues indicated in?

A
  • Alleviation of gender dysphoria in FTM patients AND MTF patients AND as ‘puberty blocker’
    Used to achieve maximum suppression of endogenous sex hormones
30
Q

what is the role of GnRH analogues in male assigned?

A
  • Inhibit the secretion of pituitary gonadotrophins leading to low circulating
    levels of testosterone
  • Treatment goal is to achieve equivalent female levels of testosterone
31
Q

what is the role of GnRH analogues in female assigned?

A
  • Suppression of endogenous sex steroid production and, thereby,
    attenuation of secondary female sexual characteristics such as menstruation
  • Maximises masculinisation achieved by testosterone
  • They inhibit the secretion of pituitary gonadotrophins leading to low
    circulating levels of ovarian hormones
32
Q

what is the role of GnRH analogues in children and young people?

A
  • Suppress puberty by delaying the development of 2’ sexual characteristics.
    Alleviate distress associated with the development of 2’ sex characteristics,
    providing time for on-going discussion and exploration of gender identity
    before deciding whether to take less reversible steps
33
Q

who are GnRH analogues contraindicated in/ cautioned in?

A
  • Contraindications:
    – Pregnancy, breastfeeding
  • Caution:
    – Metabolic bone disease, uncontrolled diabetes
34
Q

who are antiandrogens indicated in?

A
  • Alleviation of gender dysphoria in male
    assigned adults
  • Not as commonly used in the UK

MO1 (50 decks)

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