Deck 39: Health Care Maintenance for Transgendered Individuals

Question 1

A 45-year-old female-to-male (FTM) patient who has had top surgery only (removal of female breast tissue; mastectomy) presents to your clinic for a general "check-up." What healthcare maintenance items might be important to discuss at this visit?

A) Mammogram and fasting lipid panel
B) BP check and prostate exam
C) Cervical cancer screening and chest wall/axillary exam
D) Vaccines and liver ultrasound

Answer 1

C

Question 2

Some examples of how a healthcare provider can make their office and/or office visit more comfortable and inclusive for trans patients include all the following except:

A) Registration paperwork has an option for biological sex assignment and gender preference
B) Restrooms are gender neutral
C) Staff and providers ask patients about their preferred pronoun
D) Posters in the waiting room saying "Trannies are welcome."
Acceptable answers include registration paperwork including option for biological sex assignment and gender preference, gender-neutral restrooms, asking patients what their preferred pronoun is, including trans-friendly literature and posters in waiting room.

Answer 2

D

Question 3

All trans patients considering hormone therapy should be referred to a mental health clinician before the initiation of hormones.

Answer 3

False

Question 4

In the male-to-female (MTF) trans patient on spironolactone alone, the following should be monitored periodically:

A) Serum creatinine, potassium, sodium
B) Liver function tests, lipid panel
C) Complete blood count, TSH
D) Vitamin D, Vitamin B12

Question 5

All trans patients are at a higher risk of STDs and HIV and should be screened more frequently than biological males and females.

Question 6

An example of healthcare maintenance guidelines that are different for MTF patients, as compared with cisgender female patients include:

A) Pap smears
B) Routine LFTs
C) Prostate cancer screening
D) All the above

Question 7

Patients should be educated that it takes approximately 2 years to transition. However, increasing the dosage of hormones will hasten the transitioning process.

Question 8

A 33-year-old FTM patient presents to your clinic to establish care. He has been without medical care since establishing a therapeutic testosterone dose approximately 2 years ago. In addition to building a trusting relationship with this patient, what are your top priorities?

A) Cervical cancer screening and chest wall/axillary exam
B) Liver function tests and lipid panel
C) PSQ-9
D) Serum HCG level

Question 9

You order routine labs on a 53-year-old MTF patient who is currently taking spironolactone and estradiol. Lab results reveal impaired renal function. You decide to discontinue spironolactone. What medication might you use instead?

A) Premarin
B) Nafarelin
C) Progesterone
D) Finasteride

Question 10

You have an FTM patient who is well known to your clinic; he shares with you he was recently let go from his job. He believes this to be a result of discrimination. What resources can you provide for him? How might you advocate on his behalf or help him advocate for himself?