Care of the transgender patient: the role of the gynecologist

Gender dysphoria refers to distress that is caused by a sense of incongruity between an individual's self-identified gender and natal sex. Diagnosis is made in accordance with the Diagnostic and Statistical Manual of Mental Disorders and treatment first involves psychiatric therapy, which can h...

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Bibliographic Details
Published inAmerican journal of obstetrics and gynecology Vol. 210; no. 1; pp. 16 - 26
Main Author Unger, Cécile A., MD, MPH
Format Journal Article
LanguageEnglish
Published United States Mosby, Inc 2014
Subjects
Delivery of Health Care - methods
Female
gender dysphoria
Gender Identity
gender identity disorder
Humans
Male
Obstetrics and Gynecology
Physician's Role
sex reassignment
Sex Reassignment Procedures
Sexual Behavior - psychology
transsexual
Transsexualism - psychology
Transsexualism - therapy
gender dysphoria
sex reassignment
transsexual
gender identity disorder
transgender
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Summary:Gender dysphoria refers to distress that is caused by a sense of incongruity between an individual's self-identified gender and natal sex. Diagnosis is made in accordance with the Diagnostic and Statistical Manual of Mental Disorders and treatment first involves psychiatric therapy, which can help determine a patient's true goals in regards to achieving gender identity. Patients who wish to transition to the opposite sex must undergo a supervised real-life test and often are treated with hormonal therapy to develop physical characteristics consistent with their gender identity. Sex reassignment surgery is an option for patients who wish to transition completely. Transpatients face many barriers when it comes to basic health needs including education, housing, and health care. This is a result of long-standing marginalization and discrimination against this community. Because of these barriers, many patients do not receive the proper health care that they need. Additionally, because of certain high-risk behaviors as well as long-term hormonal therapy, transpatients have different routine health care needs that should be addressed in the primary care setting. Gynecologists play an important role in caring for transgender patients and should be knowledgeable about the general principles of transgender health.
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ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2013.05.035