Question 1

Gender-affirming therapy in transmasculine adults includes:&#10;A)Testosterone&#10;B)Spironolactone&#10;C)Bicalutamide&#10;D)Finasteride&#10;

Accepted Answer

Testosterone is the primary hormone used in gender-affirming hormone therapy for transmasculine individuals (those assigned female at birth who identify as male or masculine). It promotes the development of masculine secondary sexual characteristics. Spironolactone, Bicalutamide, and Finasteride are medications used in the context of transfeminine hormone therapy or for other conditions, but not typically for transmasculine hormone therapy.

Question 2

The goals of treatment in treating transfeminine adults are to:&#10;A)Lower serum estradiol levels&#10;B)Suppress testosterone levels&#10;C)Raise vocal pitch to feminine levels&#10;D)Decrease male pattern facial and body hair&#10;

Accepted Answer

Suppress testosterone levels

Question 3

Monitoring of transgender adolescents on gonadotropin-releasing hormone (GnRH) agonists to delay puberty includes:&#10;A)&#9;Height and weight&#10;B)&#9;Hair growth patterns&#10;C)&#9;Erections&#10;D)&#9;All of the above&#10;

Accepted Answer

Monitoring transgender adolescents on GnRH agonists involves a comprehensive approach that includes assessing height and weight to monitor growth, observing hair growth patterns to evaluate the suppression of secondary sexual characteristics, and monitoring erections to assess the effectiveness of puberty suppression.

Question 4

When prescribing testosterone for gender-affirming therapy in transmasculine adults the provider needs to educate the patient regarding the following adverse effects:&#10;A)Erythrocytosis, leading to thrombosis&#10;B)Increased risk for ovarian cancer&#10;C)Significant increase in low-density lipoproteins (LDL)&#10;D)Increased breast size&#10;

Accepted Answer

Testosterone therapy in transmasculine individuals can lead to erythrocytosis, which is an increase in red blood cells. This condition can increase the risk of thrombosis (blood clots), making it an important adverse effect for patients to be aware of. Testosterone does not significantly increase LDL levels or breast size, and there is no direct evidence linking it to an increased risk of ovarian cancer.

Question 5

Testosterone may exacerbate the following in transmasculine adults:&#10;A)Migraines&#10;B)Dysmenorrhea&#10;C)Constipation&#10;D)Prostatitis&#10;

Accepted Answer

Testosterone therapy in transmasculine individuals can lead to an increase in migraines due to its effects on hormone levels, which can influence migraine patterns.

Question 6

Contraception options for a transmasculine adult include:&#10;A)Combined oral contraceptive pills&#10;B)Levonorgestrel intrauterine (IUD)&#10;C)NuvaRing vaginal ring&#10;D)Vasectomy&#10;

Accepted Answer

The answer of Contraception options for a transmasculine adult include:&#10;A)Combined...

Question 7

Spironolactone is used in gender-affirming therapy:&#10;A)As a potassium-sparing diuretic to prevent hypertension&#10;B)To treat hypertension associated with estrogen therapy&#10;C)As an antiandrogen and to suppress testosterone synthesis&#10;D)To prevent male-pattern body hair growth&#10;

Accepted Answer

Spironolactone is used in gender-affirming therapy primarily as an antiandrogen to suppress testosterone synthesis, which helps in reducing masculinizing features.

Question 8

The estrogen formulation that most reliably leads to physiological target levels of estrogen is:&#10;A)Patch&#10;B)Spray&#10;C)Topical cream&#10;D)Intramuscular (IM) injection&#10;

Accepted Answer

Intramuscular (IM) injection delivers estrogen directly into the bloodstream, ensuring more consistent and reliable physiological levels compared to other methods that may have variable absorption rates.

Question 9

Permanent effects of estrogen therapy in transfeminine adults include:&#10;A)Breast development&#10;B)Decrease in muscle mass&#10;C)Decreased libido&#10;D)Softening of the skin&#10;

Accepted Answer

Estrogen therapy in transfeminine adults leads to breast development, which is considered a permanent change even if hormone therapy is stopped. Other effects like decreased muscle mass, decreased libido, and skin softening are not permanent and can revert if hormone therapy is discontinued.

Question 10

Advantages of treating adolescents with gender affirming therapy include:&#10;A)Higher levels of testosterone are achieved in transfeminine adolescents.&#10;B)Puberty can be delayed allowing time for exploration of gender identity.&#10;C)If started by Tanner Stage 3, secondary sex characteristics can be reversed.&#10;D)Fertility is preserved if treatment is started early.&#10;

Accepted Answer

Puberty blockers, a form of gender affirming therapy, can delay puberty, providing adolescents time to explore their gender identity without the added stress of developing unwanted secondary sexual characteristics. This can be particularly beneficial for mental health and well-being.

Deck 54: Transgendered Clients As Patients