INTERNAL MEDICINEPEDIATRICS INDIANA UNIVERSITY SCHOOL OF MEDICINEWEST LAFAYETTE Goals and Objectives What is gender and what does it mean when it is trans Why should I care How can ID: 803830
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Slide1
TRANSGENDER HEALTH CARE
Julianne Stout, M.D
.
INTERNAL
MEDICINE/PEDIATRICS
INDIANA UNIVERSITY SCHOOL OF
MEDICINE-WEST LAFAYETTE
Slide2Goals and Objectives:
What is gender and what does it mean when it is “trans”?
Why should I care?
How can
I support medical care for transgender individuals
in my community?
Slide3DefinitionsChromosomal Sex- genetic sex
XX = “female”
XY = “male”
Assigned Gender- in the US, gender is usually assigned based on visible external genitalia
vagina = “female”
penis and testicles = “male”
Slide4DefinitionsSexual orientation- an individual’s pattern of physical and emotional arousal toward other persons
“sexual attraction”
Gender identity- your personal concept of yourself (male, female, neither, other)
Gender expression- outward manifestations of personality that reflect your gender identity
activities
clothing
Slide5DefinitionsIdentities
Behaviors
Gender Identity
Sexual Identity
Relationship structure
possibilities
Gender ExpressionSexual BehaviorsCurrent Relationship
“Alternative combinations” of biology, identity, and behavior result in gender diversity
Slide6Other Cultures Recognize Gender DiversityHawaii-
Kanaka
Maoli
indigenous society
“Mahu”- biological males or females inhabiting a gender role somewhere between. Sacred social role as educators, maintaining ancient traditions and rituals.
http://www.pbs.org/independentlens/two-spirits/map.html
Slide7Transgender persons have a mismatch between biological sex and gender identity resulting in gender dysphoria.
Slide8Medical Care of Transgender Individuals is not a new concept
Harry Benjamin MD
1885-1986
Christine Jorgensen
1926-1989
"Harry Benjamin" by Source. Licensed under Fair use via Wikipedia - http://en.wikipedia.org/wiki/File:Harry_Benjamin.jpg#/media/File:Harry_Benjamin.jpg
Slide9Goals and Objectives:What is gender and what does it mean when it is “trans”?
Why should I care
?
Health Care Disparities in the LGBTQ+ population
How can
I support medical care for transgender individuals
in my community? Medical and Mental Health Aspects of Transgender Care Community Education and Advocacy
Slide10National Transgender Discrimination SurveyConducted in 2008 by the National Center for Transgender Equality and the National LGBTQ Task Force
Over a six month period 6456 transgender and gender non-conforming people answered a 70 question survey
Results released in 2011
Update planned for 2016
Grant, Jaime M., Lisa A.
Mottet
, Justin Tanis, Jack Harrison, Jody L. Herman, and Mara Keisling. Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force, 2011.
Slide1119% of transgender Hoosiers were refused medical care due to their gender identity
18% of transgender Hoosiers postponed medical care due to discrimination
42% of transgender Hoosiers reported attempting suicide at some point in their life, 26 times the general population rate of 1.6%
Grant, Jaime M., Lisa A.
Mottet
, Justin Tanis, Jack Harrison, Jody L. Herman, and Mara
Keisling. Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force, 2011.
Slide12http://transequality.org/issues/resources/transgender-healthcare-insurance-laws
. January 30, 2015.
Slide13General Primary Care
Transgender hormone management
Surgical treatment options
Collaboration with mental health professionals
Patient Advocacy (housing, employment, court documents)
Tasks of the Medical Professional
Slide14Tasks of the Mental Health Professional
1. Assess gender dysphoria
2. Provide information regarding options for gender identity expression and possible medical interventions
3. Assess, diagnose, and discuss treatment options for co-existing mental health concerns
4. If applicable, assess eligibility, prepare, and refer for hormone therapy
5. If applicable, assess eligibility, prepare, and refer for surgery