Intro; Series Editor Foreword; Preface; Contents; Contributors; 1 History and Prevalence of Gender Dysphoria; Introduction; A Short History of Gender Diversity; Being Counted; A Brief Review of Diagnostic Changes Over Time; An Evolution of Guidelines; References; 2 Review of Medical, Socioeconomic, and Systemic Barriers to Transgender Care; Background; Barriers Within Health Care; Gaps in Medical Education; Future Directions-Addressing the Gaps; Evidence for Experiential Learning; Social Barriers and Considerations; Socioeconomic Considerations; Transgender and Gender Nonconforming Youth
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Challenges in Primary CareAffirming Environments/Facilitating Coming Out; Creating Affirming Spaces; Documentation and Use of the Electronic Medical Record (EMR); Inside the Clinician-Patient Interaction; Gender Identity Development for the PCP; Gender Development for TNG Youth: Persistence of TNG Identity; Gender Development for TNG Youth: Puberty; Gender Development: A Lifelong Journey; Family Support; Social Transition; Health Maintenance for Transgender and Gender Nonconforming Children and Adolescents; School Experiences; Sports Participation; Mental Health
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Considerations in Management of Mental Health ConcernsA Word on Conversion Therapy; Mental Health Referrals; Sexual Health; Contraception; Sexually Transmitted Infections (STIs); Gender-Affirming Medical Care in Primary Care; Conclusion; Appendix; References; 6 Geriatric Transgender Care; Introduction; Epidemiology; Overview of Relevant Constructs; Overview of the Healthcare Needs and Disparities; Unique Healthcare Issues; Hormone Use in the Aging Transgender Patient; Sexuality and Aging; Aging Across Care Settings; Advance Care Planning; References
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Defects in Androgen Biosynthesis and Structural DSDGenetics and Gender Identity; Neurobiological Basis for Gender Nonconforming Identity; Conclusions; References; 4 Primary Care of Transgender Adults; Introduction; Clinical Guidelines and Primary Care; Provider/Staff-Patient Interactions; Initial Encounter; Cardiovascular Risk; Cancer Screening; Cervical Cancer Screening; Breast Cancer; Colorectal Cancer; Prostate Cancer; Bone Health; Sexual and Reproductive Health; Immunizations; Summary; References; 5 Primary Care of Transgender Children and Adolescents; Introduction
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Future DirectionsInstitutional and Systemic Barriers; Insurance Coverage and State Policies; Future Directions; Health Systems Barriers and Data Collection Issues; Future Plans; Conclusion; References; 3 Biology of Gender Identity and Gender Incongruence; Concepts of Gender Identity Development; Development of Gender Variant Identity; Psychosocial Factors Related to Gender Identity; Differences in Sexual Development and the Role of Androgen Exposure in Gender Identity Development; 46,XX Individuals with Congenital Adrenal Hyperplasia (CAH); Androgen Insensitivity Syndromes
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SUMMARY OR ABSTRACT
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Although transgender persons have been present in various societies throughout human history, it is only during the last several years that they have become widely acknowledged in our society and their right to quality medical care has been established. In the United States, endocrinologists have been providing hormonal therapy for transgender individuals for decades; however, until recently, there has been only limited literature on this subject, and non-endocrine aspects of medical care for transgender individual have not been well addressed in the endocrine literature. The goal of this volume is not only to address the latest in hormonal therapy for transgender individuals (including pediatric and geriatric age groups), but also to familiarize the reader with other aspects of transgender care, including primary and surgical care, fertility preservation, and the management of HIV infection. In addition to medical issues, psychological, social, ethical and legal issues pertinent to transgender individuals add to the complexities of successful treatment of these patients. A final chapter includes extensive additional resources for both transgender patients and providers. Thus, an endocrinologist providing care to a transgender person will be able to use this single resource to address most of the patient's needs. While Transgender Medicine is intended primarily for endocrinologists, this book will be also useful to primary care physicians, surgeons providing gender-confirming procedures, mental health professionals participating in the care of transgender persons, and medical residents and students.