II. Epidemiology

  1. Prevalence: 700,000 or 0.3% (U.S., 2011)

III. Approach

  1. Ask patients their preferred name, gender and pronoun (may differ from medical record)
  2. Preventive health screening should be directed towards their birth gender
    1. Billing for preventive services should be based on birth gender
    2. Transgender men who have intact Breast tissue should have Breast Cancer Screening
    3. Transgender men who have intact Uterus and Cervix should have Cervical Cancer Screening
    4. Base medical calculations (e.g. GFR, Cardiac Risk) on birth gender
  3. Ask about mental health
    1. Anxiety Disorder
    2. Major Depression (esp. Suicidality)
    3. Bullying

IV. Management: Understanding medications used in Transgender patients

  1. Adolescents (Puberty to 16 years old)
    1. GnRH agonists (e.g. Lupron) are used to suppress Sexual Development of their birth gender
  2. Adults (and adolescents over age 16 years old)
    1. Transgender women (male to female transition)
      1. Estrogens
      2. Antiandrogens (Spironolactone, Finasteride)
    2. Transgender men (female to male transition)
      1. Testosterone
      2. Non-estrogen Contraception (e.g. IUD, Implanon, depo-Provera)

V. Resources

VI. References

  1. (2016) Presc Lett 23(11)
  2. UCSF Primary Care Guidelines
    1. http://transhealth.ucsf.edu/trans?page=guidelines-home

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Ontology: Transgendered Persons (C3266856)

Definition (MSH) Persons having a sense of persistent identification with, and expression of, gender-coded behaviors not typically associated with one's anatomical sex at birth, and with or without a desire to undergo SEX REASSIGNMENT PROCEDURES.
Concepts Population Group (T098)
MSH D063106
SnomedCT 407374003
English Transgender, transgenderal, transgender, transgendered, transgenders, Person, Transgender, Person, Transgendered, Transgender Person, Persons, Transgendered, Persons, Transgender, Transgendered Person, Transgender Persons, Transgenders, Transgendered Persons, transgender (history), Transgendered
Czech transgender
French Transgenres, Personnes transgenres
German Transgender
Italian Transgender, Persone transgender
Spanish Personas Transgénero
Polish Transseksualiści
Portuguese Pessoas Transgênero
Norwegian Transkjønnede personer