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Medical Management of Transgender Inmates

1. Which of the following statements is most accurate?

A. Gender dysphoria refers to persistent feelings of identification with the opposite gender and discomfort with one’s own assigned sex. B. Gender dysphoria refers to the condition of feeling that one’s emotional and psychological identity as male or female is different from one’s biological sex. C. Gender identity disorder refers to behavior or appearances that do not match the societal roles or expectations for one’s assigned gender. D. " Gender identity disorder refers to the condition of feeling that one’s emotional and psychological identity as male or female is different from one’s biological sex. "

2. Which of the following statements is most accurate?

A. Transgender status is based on a clinical report of identifying characteristics. B. Transgender status is based on a physician's report of identifying characteristics. C. Transgender status is based on a health care team's report of identifying characteristics. D. Transgender status is based on an individual’s self-report of identifying characteristics.

3. A 32-year-old transgender patient was recently initiated on hormone therapy. The patient has questions about hormone therapy. Which of the following counseling points should be expressed to the patient regarding hormone therapy?

A. The goal of hormone therapy is to increase endogenous hormones. B. A goal of hormone therapy is to suppress endogenous hormones, while enhancing physical characteristics of the natal sex. C. A goal of hormone therapy is to suppress endogenous hormones, while suppressing the physical characteristics of the natal sex. D. Hormone therapy does not aim to supplement hormones.

4. Which of the following statements regarding male-to-female hormone therapy regimens is most accurate?

A. Goal levels of treatment are serum estradiol <50 pg/ml (premenopausal level) and testosterone less than 200 ng/dl. B. Goal levels of treatment are serum estradiol <200 pg/ml (premenopausal level) and testosterone less than 55 ng/dl. C. Goal levels of treatment are serum estradiol less than 100 pg/ml (premenopausal level) and testosterone less than 55 ng/dl. D. Goal levels of treatment are serum estradiol less than 200 pg/ml (premenopausal level) and testosterone less than 45 ng/dl.

5. A 28-year-old transgender patient was recently initiated on female-to-male hormone therapy. The patient has questions about the hormone therapy. Which of the following counseling points should be expressed to the patient regarding female-to-male hormone therapy?

A. Body fat redistribution will not occur within the first 6 months of therapy. B. An increase in libido will not occur within the first 6 months of therapy. C. Vaginal atrophy will most likely occur within the first 6 months of therapy. D. Alterations in hair growth and voice depth will most likely occur within the first 6 months of therapy.

6. Regarding medications for male-to-female individuals, anti-androgens increase testosterone levels, allowing estrogen therapy to be used in lower doses while still reaching a maximum effect.

A. True B. False

7. Which of the following statements is most accurate?

A. " Testosterone transdermal patches are the preferred formulation in the correctional environment. " B. Testosterone gel is the preferred formulation in the correctional environment. C. Injectable testosterone is the preferred formulation in the correctional environment. D. Injectable testosterone should not be used in the correctional environment.

8. Which of the following estradiol sublingual doses is most likely to be used to initiate therapy in male-to-female individuals?

A. Estradiol sublingual 0.5-1 mg B. Estradiol sublingual 2-4 mg C. Estradiol sublingual 4-6 mg D. Estradiol sublingual 6-8 mg

9. What is the recommended max dose of testosterone gel for female-to-male individuals?

A. 5 mg every morning B. 10 mg every morning C. 15 mg every morning D. 20 mg every morning

10. Medroxyprogesterone and GnRH agonists may be used to suppress menstruation in female-to-male individuals.

A. True B. False


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