Gender and sexuality

Question 1

Define transgender

Answer 1

Used to describe someone whose gender identity does not correspond with the sex they were assigned at birth

Question 2

Define gender dysphoria

Answer 2

Describes a sense of unease that a person may have because of a mismatch between biological sex and gender identity

Question 3

Define transsexualism

Answer 3

Desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with anatomic sex and a wish to have surgery or hormonal treatment to make one’s body as congruent as possible with the desired sex

Question 4

What is the gender identity clinic pathway in adults?

Answer 4

GP referral > initial appointment > second appt > request for GP to prescribe and monitor hormones, pschology, fertility preservation, hair removal, speech and language therapy > referral for surgery

Question 5

What are the different transitions?

Answer 5

Social transition: changing appearance, name, pronouns
Medical transition: hormone treatment
Surgical transition: top surgery or lower surgery

Question 6

What hormones are available to transitioning people?

Answer 6

AFAB: testosterone +/- anti-androgen
AMAB: estradiol +/- anti-androgen

Question 7

What are the types of surgery?

Answer 7

AFAB
Chest masculinising surgery: chest masculinising surgery
Genital surgery - phalloplasty, metoidioplasty, hysterectomy
AMAB:
Genital surgery - orchiectomy, vaginoplasty, vulvoplasty

Question 8

What is the minority stress theory?

Answer 8

Circumstances: minority status > minority identity > internal minority stress
General stress: external minority stress
Social resources and individual resources
ALL impact mental health

Question 9

What is heterosexism vs cissexism

Answer 9

Heterosexism: system of attitudes and bias, discrimination against gay people on the assumption that heterosexuality is the normal sexual orientation.
Cissexism: system of attitudes, bias and discrimination in favour of the cisgender identity

Question 10

Why may access to healthcare - cervical screening be difficult?

Answer 10

Smear test can be dysphoria inducing as is traditionally perceived as feminine so is incongruous with a masculine identity
Testosterone treatment can cause vaginal atrophy - so can be uncomfortable
Health care lacks knowledge of trans health needs

Question 11

How can you make trans or non/binary people feel more comfortable?

Answer 11

Ensure use of correct name and pronouns
Try to make the environment gender neutral
Ask the patient what language they would like to use for their anatomy
Clear explanation of what you’re doing