Gender Diversity
An individual's internal sense of being male, female, or some other gender. Since gender is internal, one's gender identity is not necessarily visible to others.
Gender Identity
Gender dysphoria replaces ____________ in the DSM-V to focus on the clinical symptoms rather than the pathology of a mental health disorder.
Gender Identity Disorder
A term for individuals whose gender expression is different from societal expectations related to gender.
Gender Non-conforming
What are the irreversible treatment options for gender dsyphoria?
Gender affirming surgical procedures
A gender identity that often changes, so that a person may feel one day like a boy, and another day like a girl.
Genderfluid
A term used by some individuals who identity as neither entirely male nor entirely female.
Genderqueer
To refer to someone using a word (pronoun, form of address) that does not correctly reflect the gender with which they identify.
Misgender
An umbrella term for all who don't identify as entirely male or entirely female
Non-binary
A term for a person whose gender identity is different from that typically associated with their assigned sex at birth
Transgender
A transgender individual who was AFAB but currently identifies as a man (FTM)
Transman
A transgender individual who was AMAB but currently identifies as a woman (MTF)
Transwoman
____________ is the distress that may accompany the discrepancy between the gender one experiences versus one's assigned gender
Gender Dysphria
What do transgender people suffer at the hands of others?
- Being kicked out of the house - Family member violence - Verbal, physical and sexual harassment/assault - Severe school mistreatment
What are the reversible treatment options for gender dysphoria?
- Change of clothing, hair, binders, prosthetics - Suppressing puberty - Suppressing Menses
What is the common *femanizing hormones regimen?*
- Estrogens - Anti-androgen
What are the risks associated with masculizing hormones?
- Increased Hgb (and Hct?) - Effects on cholesterol - Increased insulin resistance
What are the risks associated with femanizing agents?
- Increased VTE risk - Increased vascular events - Increased insulin resistance
What medications suppress menses?
- Progestins (progestin only pills, depo-provera, nexplanon) - Continuous oral contraceptives - IUD
What are the barriers to treatment of transgender patients?
- Refusal of care - Harassed by provider's staff or provider - Postponed care - Unemployment/homelessness - Lack of transportation - Lack of insurance - Afraid to use insurance
What are the *four main barriers of healthcare treatment* for transgender patients?
1. Reluctance to disclose 2. *Lack of provider experience and resources* 3. Structural barriers 4. Financial barriers
Follow up lab work for femanizing or masculinizing hormone therapy should be done every _______ months for 1-2 years.
3 months
Testosterone level for those on femanizing hormone therapy should be ________ ng/dL.
< 55 ng/dL
How a person presents or expresses their gender identity to others, often through behavior, clothing, hairstyles, voice or body characteristics.
Gender Expression
____________ reduces the effect of endorgenous male sex hormones.
Anti-Androgen Therapy
AFAB
Assigned female at birth
AMAB
Assigned male at birth
A term for a person whose gender identity is the same as that typically associated with their assigned sex at birth.
Cisgender
What are the partially reversible treatment options for gender dysphoria?
Cross hormone therapy
Most children aged 5-12 years of age diagnosed with gender dysphoria "do/do not" persist as adolescents.
DO NOT
Gender identify starts in _________ and becomes more developed in adolescense.
Early Childhood
______________ induce development of female secondary sexual characteristics.
Estrogens
According to DSM-V criteria, adolescents and adults with gender dysphoria must have marked _____________ between one's experienced/expressed gender and assigned sex for 6+ months and _______ of the following: - Marked incongruence between one's experienced gender and 1o & 2o sex characteristics - Strong desire to be rid of 1o/2o sex characteristics - Strong desire for the 1o/2o sex characteristics of the other gender - Strong desire to be of the other gender (or some other gender) - Strong desire to be treated as the other gender - Strong conviction that one has the typical feelings & reactions of the other gender
Incongruence; 2+
According to DSM-V criteria, children with gender dysphoria must have marked _____________ between one's experienced/expressed gender and assigned sex for 6+ months and _______ of the following: - Strong desire to be of the other gender, insistence that one is the other gender - Strong preference for cross-dressing or wearing clothing of the other gender - Strong preference for cross-gender roles in play - Strong preference for toys/games/activities of the other gender - Strong preference for playmates of the other gender - Strong rejection for toys/games/activities of assigned sex - Strong dislike of one's sexual anatomy - Strong desire for 1o or 2o sex characteristics that match one's experienced gender
Incongruence; 6+
Usually male or female, assigned based on external anatomy, gonads, or chromosome testing
Sex Assigned at Birth
___________ has an off label use as a competitive inhibitor of the androgen receptor, 5-alpha reductase activity, and testicular steroidogenesis
Spironolactone
What is the common *masculinizing hormone regimen?*
Testosterone
__________ induces development of male secondary sexual characteristics.
Testosterone