Transgender Healthcare And Hormone Therapy

Question 1

Transvestites?

Answer 1

A person who wears clothes designed for opposite sex

Question 2

Gender incongruent?

Answer 2

An individuals discontent with their assigned gender and identification with gender other than that of their birth sex.

Question 3

Gender dysphoria?

Answer 3

Distress and unease experienced

Question 4

How much of hormone treatment transition is reversible?

Answer 4

90, but breast development and hair.

Question 5

Oestrogen treatment risk?

Answer 5

Venous thromboembolism

Question 6

Trans female therapies?

Answer 6

GnRH analogue to suppress testosterone

Depot IM injection 3monthly

Not required after gonadectomy

Question 7

Testosterone treatment risk?

Answer 7

Polycythaemia (high conc of red blood cells in blood)

Measure Haemoglobin and haematocrit

Question 8

Trans male treatment having sex with men?

Answer 8

IUD/ progesterone

Question 9

For a trans female taking oestrogen for breats what should they do and how long for?

Answer 9

Gradual oestrogen for optimal breast development otherwise fuse breast buds, maximum effect achieved after 2 years treatment

Question 10

How is oestrigen given?

Answer 10

Oral or transdermal patches. Oestradiol much safer- measure in lab assay.

Question 11

Testosterone treatment?

Answer 11

Male pattern hair growth
Scalp hair loss
Intramuscular or transdermal gel, do not need GnHR analogue until 5 years maximal treatment

Question 12

Risk of testosterone treatment?

Answer 12

Polycythaemia, as testosterone causes blood cell production, haematocrit increases- proportion of blood which is made up of cells.

Question 13

Screening for transfemale?

Answer 13

Mammography at age 50

Dexa at 60

Question 14

Screening for trans male?

Answer 14

Cervical and breast screening, USS endometrium due to risk of hyperplasia
Dexa at 60

Question 15

How to delay puberty?

Answer 15

GnHR analogues

Question 16

Oestrogen effect on hair for a trans woman?

Answer 16

Some effect on facial hair
Mechanical forms of hair removal often still required
More effect on body hair
No effect on ‘lost’ scalp hair, but prevents further loss

Question 17

How to give oestrogen treatment?

Answer 17

Oral or transdermal oestradiol (patch/gel)
Higher doses than post-menopausal HRT
Oestradiol safer than ethinylestradiol or conjugated equine oestrogens

Question 18

Trans male treatment?

Answer 18

Intramuscular depot 3-weekly, 3 monthly

Transdermal gel testosterone

Don’t need to give GnRH analogue, because testosterone treatment will suppress menstruation

Max effect after 5 years

Question 19

Trans females, more death from various disease esp if smokers?

Answer 19

Cvd and stroke
Venous thromboembolism
Lung cancer
HIV related deaths