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Abstract
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Transgender and gender diverse are broad terms used to describe individuals whose gender identities and expressions differ from the gender attributed to the sex assigned at birth, typically either female or male. Estimates of the proportion of transgender and gender diverse individuals worldwide range from 0.6% to 3% and have increased in recent years, particularly among adolescents and young adults.
Transgender and gender diverse patients face multiple barriers to medical care, with a 2019 systematic review finding that 27% (range, 19%-40%) had been denied care by a health professional. A 2018 study of primary care clinicians found that 85% were willing to provide care for transgender and gender diverse persons, but 52% were unfamiliar with health care guidelines for transgender and gender diverse people.
In a population-based study, transgender and gender diverse participants self-reported mean poor mental health of 14.8 (95% CI, 13-16.7) days per month compared with 6.0 (95% CI, 5.2-6.8) for cisgender participants.4 Gender-affirming medical and surgical treatment (GAMST) can mitigate psychologic distress and reduce suicide risk by aligning physical characteristics with gender identity when there is marked, persistent incongruence with the sex assigned at birth (gender dysphoria).1 The guidelines address various gender identities and recommend comprehensive health care beyond hormonal or surgical treatments, including primary care, reproductive and sexual health care, mental health care, voice therapy, hair removal, and prosthetics. GAMST typically involves either feminizing therapy for transgender and gender diverse individuals assigned male at birth or masculinizing therapy for those assigned female at birth. The SOC-8 includes detailed recommendations on use of gender-affirming hormones and their doses, as well as recommendations for preventive care and screening. This synopsis provides an overview of guideline recommendations most relevant for primary care clinicians...
Language: en |