Transgender health for medical students
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Transgender Health for Medical Students . Learning Objectives. Review terminology Review gender spectrum Identify Disparities Hormones and Surgery Preventative care What can we do as medical student and physicians?. Transgender Definitions Worksheet.

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Learning objectives
Learning Objectives

  • Review terminology

  • Review gender spectrum

  • Identify Disparities

  • Hormones and Surgery

  • Preventative care

  • What can we do as medical student and physicians?


Transgender definitions worksheet
Transgender Definitions Worksheet

  • Take 5 minutes in groups of 3 to fill out this worksheet


Definitions
Definitions

1. ______________ is an umbrella term that refers to people who live differently than the gender presentation and roles expected of them by society.

Transgender

2. ___________ people have physical characteristics that do not match the typical understandings of male and female; previously called hermaphrodites.

Intersex

3. ____________ refers to people who choose to wear the clothing generally associated with the opposite gender. They do so because they find it fulfilling in emotional or sexual ways.

Crossdresser


Definitions1
Definitions

4. ______________are abbreviations used by many female-to-male transgender persons (also known as transmen) and male-to-female transgender persons (also known as transwomen).

FTM and MTF

Gender

5. ___________refers to the societally-determined characteristics of a particular sex; these characteristics are commonly referred to as “feminine” and “masculine”.

Sex

6. ___________refers to the designation of the biological differences between females and males.

7. _________________ is a term historically used by gay men who dress in the clothing usually associated with women for the purposes of entertainment or personal fulfillment. There are also drag kings, who are biologically female and dress as men

Drag Queen


Definitions2
Definitions

8. _______________ is a term for people who seek to live in a gender different from the one assigned at birth and who may seek or want medical intervention (through hormones and/or surgery) for them to live comfortably in that gender.

Transsexual

9. ___________________ describes who people fall in love with and/or are sexually attracted to, while

Sexual Orientation

10. ________________ describes how people perceive their own internal sense of maleness or femaleness.

Gender Identity


Gender spectrum
Gender Spectrum

Sex

Male

Intersex

Female

Gender Identity

Genderqueer

Female

Male

Gender Presentation

Masculine

Androgynous

Feminine

Sexual Orientation

Gay

Bisexual

Straight


When health care isn t caring
When Health Care Isn’t Caring.

Source: When Heath Care isn’t Caring (Lambda Legal, 2010)


I was refused needed healthcare
I was refused needed healthcare

Source: When Health Care Isn’t Caring (Lambda Legal, 2010)


Health care professionals refused to touch me or used excessive precautions
Health care professionals refused to touch me or used excessive precautions

Source: When Health Care Isn’t Caring (Lambda Legal, 2010)


Health care professionals were physically harsh or abusive
Health care professionals were physically harsh or abusive excessive precautions

Source: When Health Care Isn’t Caring (Lambda Legal, 2010)


Fears and concerns
Fears and concerns excessive precautions

Source: When Health Care Isn’t Caring (Lambda Legal, 2010)


Do i tell or not
Do I tell or not? excessive precautions

  • Lack of disclosure about gender identity can lead to inadequate care.

  • Disclosing one’s gender identity can result in discriminatory practices by insurance companies and healthcare providers


Health disparities
Health Disparities excessive precautions

  • Violence

  • STIs

  • Depression

  • Suicide

  • Substance abuse

  • Smoking

  • Cancer


Why does my gender matter
Why does my gender matter? excessive precautions

  • Driver’s license

  • Passport

  • School

  • Restrooms

  • Employment

  • Prison

  • Doctor’s office

  • Domestic violence shelter

  • Housing

  • Birth Certificate

  • Marriage


Peeing in peace
Peeing in Peace excessive precautions

  • Why are bathrooms segregated by sex?

  • Name all the sex-segregated facilities you can think of.

    • How might these facilities affect transgender people?

  • Activity: Bathroom Awareness


Standards of care
Standards of Care excessive precautions


Standards of care1
Standards of Care excessive precautions

  • Diagnostic assessment

  • Psychotherapy

  • Real-life experience

  • Hormone Therapy

  • Surgery Therapy


Hormones male to female
Hormones: Male to Female excessive precautions

  • Estrogen

    • Breast growth

    • Redistribution of body fat

    • Decrease in upper body strength

    • Decrease in body hair

    • Softening of skin

    • Slowing or cessation of balding

    • Decrease in fertility and testicular size

    • Less frequent/firm erection


Side effects of estrogen
Side Effects of Estrogen excessive precautions

  • Blood clots

  • Benign pituitary prolactinomas

  • Infertility

  • Weight gain

  • Emotional lability

  • Liver disease

  • Gallstone formation

  • Somnolence

  • Hypertension

  • Diabetes Mellitus


Hormones female to male
Hormones: Female to Male excessive precautions

  • Testosterone

    • Permanent

      • Deepening of voice

      • Clitoral enlargement

      • Mild breast atrophy

      • Increased facial and body hair

      • Male pattern baldness

    • Reversible

      • Increased upper body strength

      • Weight gain

      • Increased libido

      • Decreased hip fat


Side effects of testosterone
Side Effects of Testosterone excessive precautions

  • Infertility

  • Acne

  • Emotional lability

  • Increased sexual desire

  • Shift in lipid profiles  increase risk of cardiovascular disease

  • Malignant and benign liver tumors and hepatic dysfunction


Surgery
Surgery excessive precautions

  • Breast surgery- augmentation or removal

  • MTF

    • Orchiectomy

    • Penectomy

    • Vaginoplasty

    • Clitoroplasty

    • Labiaplasty

    • Facial bone reduction

  • FTM

    • Hysterectomy

    • Salpingo-oophorectomy

    • Vaginectomy

    • Metoidioplasty

    • Scrotoplasty

    • Urethroplasty

    • Testicular prostheses

    • phalloplasty


Preventive care
Preventive Care excessive precautions

  • Cancer prevention/screening

  • Genital health maintenance

  • Mental health care

  • Violence prevention

  • Sexual health education

  • Substance abuse education

  • Routine medical checkups


What can you do
What can you do? excessive precautions


What can you do1
What can you do? excessive precautions

  • Create a welcoming environment

  • Respect your patients

  • Do not make assumptions

  • Gender friendly intake forms

  • Do not be afraid to ask your patients questions

  • Focus on care

  • Emphasize policies on confidentiality


Resources
Resources excessive precautions

  • Lambda Legal

  • Transgender Law Center

  • WPATH

  • Transequality.org

  • Fenway Health


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