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Clinical Management of Transgender Inmates

Introduction

1. The most common comorbid conditions seen in TG adults with GD are:

A. Suicidality and depression

B. Anxiety and depression

C. HIV and suicidality

D. HIV and depression


Transgender-Identifying Characteristics

2. Which of the following may be useful in identifying a person’s status as TG?

A. Strong feelings about primary or secondary sex characteristics.

B. Strong feelings about being treated as or becoming another gender.

C. Belief that one’s actions, feelings, or mannerisms are more characteristic of another gender.

D. All of the above.


Assessment and Management of the TG Individual - A Multidisciplinary Approach

3. What is the first step for transgender individuals seeking medical intervention to assist with gender transition needs?

A. Medical assessment

B. Individualized treatment

C. Mental health assessment

D. Hormone therapy


4. Hormonal interventions may improve GD, mental health comorbidities, and overall quality of life.

A. True

B. False


Mental Health Assessment

5. When is it appropriate to conduct a mental health evaluation?

A. When a transgender individual requests mental health services.

B. When a transgender individual is referred to Psychology Services.

C. When medical intervention for TG transition is being considered.

D. All of the above.


6. A psychiatry consult is needed for a diagnosis of GD.

A. True

B. False


Medical Assessment

7. Thrombotic, hepatic, and oncological comorbidities are a contraindication to hormonal therapy.

A. True

B. False


Hormone Treatment: Eligibility, Goals, Overview

8. What is the goal of hormone treatment?

A. To suppress endogenous hormones and physical characteristics of the natal sex.

B. To supplement hormones and enhance characteristics of the preferred gender, utilizing the principles of hormone replacement therapy for hypogonadal individuals of the TG individual’s identified gender.

C. Both (A) and (B).

D. None of the above.


9. All of the following are WPATH criteria, except for:

A. There are no medical and/or mental health conditions present.

B. Gender dysphoria that is persistent and documented.

C. Legal age of majority.

D. Informed consent.


10. All of the following changes may be seen within the first six months of feminizing hormonal treatment, except for:

A. Slowing of body / facial hair growth

B. Voice alteration

C. Breast growth

D. Testicular atrophy


11. Pregnancy is still possible during masculinizing hormonal treatment.

A. True

B. False


Medications for MTF Individuals

12. Which of the following is contraindicated in those with renal insufficiency?

A. Spironolactone

B. Finasteride

C. GnRH agonists

D. Progestins


13. Lower doses and transdermal formulations of estrogen should be used in which population at high risk for thromboembolism?

A. Greater than 35 years old

B. Smokers

C. Those that are obese

D. All of the above


14. Which of the following can cause greater peaks and troughs in estrogen levels, causing more mood issues?

A. Intramuscular injections

B. Oral formulations

C. Transdermal preparations

D. All of the above have equal effects


Medications for FTM Individuals

15. Which of the following testosterone treatment methods is not used due to extensive liver metabolism and the associated potential for hepatic complications?

A. Intramuscular injections

B. Oral formulations

C. Transdermal preparations

D. All of the above


16. Transdermal patches or gels is the preferred testosterone treatment method in the correctional environment.

A. True

B. False


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