A comprehensive and important text for health care professionals

Gender variance is widely misunderstood, and few medical texts examine the social, legal, emotional, historical, biological, and economic issues involved. Principles of Transgender Medicine and Surgery provides medical and health care guidelines and comprehensive information on all aspects of treatment of gender diverse individuals. This one-of-a-kind resource examines a full range of relevant data important to health care professionals. Each chapter addresses a different aspect of care, written by an authority on that sub-specialty. This practical guide instructs both novices and experienced practitioners on the state-of-the-art treatments and knowledge.

Principles of Transgender Medicine and Surgery presents the foremost international specialists on the issues, offering their expert knowledge on the wide spectrum of issues encountered by gender diverse individuals. In this handy text, professionals of all types can get important information about various aspects of transgender health care. This essential text is extensively referenced, and includes numerous photos, tables, and figures to clearly illustrate information.

Topics in Principles of Transgender Medicine and Surgery include:

• etiology
• primary medical care
• evidence-based preventive care
• hormone treatment of adults and juvenile transsexual patients
• general principles of surgical therapy
• reassignment surgery
• mental health issues
• developmental stages of the coming out process
• reproduction issues
• fertility issues
• karyotyping and genetics
• intersex individuals
• gender identity disorders
• aging and the care of elderly transgender patients

Principles of Transgender Medicine and Surgery is an essential guide for health care professionals, educators, students, patients, and patients’ families.

• Introduction
• Early Theories of the Etiology of Transsexualism
• Recent Theories of the Etiology of Transsexualism
• The Current Status of the Attempt to Identify the Etiology of Gender Variation

• Introduction
• The Spectrum of Gender Identity and Expression
• Transgender Health Care
• Ten Principles of Transgender Medical Care
• Conclusion

• Introduction
• Challenges in Providing Preventive Care to the Transgendered Population
• Evidence-Based Transgender Health Care
• Preventive Care Recommendations
• Conclusion

• Introduction
• General Principles of Treatment
• Hormonal Sex Reassignment
• Side Effects of Hormonal Sex Reassignment
• Sexual Function After Sex Reassignment
• Regrets After Sex Reassignment
• Juvenile Gender Dysphoria

• Introduction
• Controversies Surrounding Surgery
• Ethical and Legal Challenges
• Financial Aspects
• Surgeries for Gender Reassignment
• Conditions for Surgical Interventions
• Standards of Care of the Harry Benjamin International Gender Dysphoria Association

• History of Male-to-Female Surgery
• Male-to-Female Gender Reassignment Surgery: An Overview

• History of Female-to-Male Surgery
• Subcutaneous Mastectomy
• Phalloplasty
• The Importance of a Multidisciplinary Approach

• Mental Health Issues in the History of Sex Reassignment
• Practical Aspects of Clinical Care
• Writing Recommendations and Reports

• Introduction
• Coming Out As a Developmental Process
• Conclusion

• Introduction
• Transpeople and Their Children
• Ethical Arguments in Favor of Fertility Preservation
• Cryopreservation of Sperm in Transwomen
• Donor Inseminations in Partners of Transmen
• Cryopreservation of Oocytes, Embryos, or Ovarian Tissue in Transmen
• Future Possibilities

• Introduction
• What Is a Karyotype?
• What Is a Variant Karyotype?
• Chromosomal Variance, Phenotypic Variance, and Gender Identity
• Variant Karyotypes or Forms of Intersex in the Transgender Population
• Is Gender Identity Genetic?
• Intersexed or Transgendered?
• Recommendations
• Conclusion

• Introduction
• Intersexuality Defined
• Typical Sexual Differentiation Process
• Intersex Syndromes and Related Conditions
• Appendix A

• Introduction
• Classification
• Epidemiology
• Clinical Picture
• Appendix A: DSM-IV Criteria for Gender Identity Disorder in Children and Adolescents

• Introduction
• Successful Aging and its Predictors: The Concept of “Aging Well”
• Transgender Aging and Health Care
• Transgender Aging and Social Adjustment
• Graceful Exits: Living and Dying Well
• Conclusion

This paper demonstrates a revised gender scale which we have designed for use in clinical medicine. Our gender schema identifies a continuum of gender identification, and is designed for representation of the self, rather than being primarily relational. In addition, it accommodates ungendered and “other gendered” identities, and permits evolution of the self-perception over time. It is intended to be used in a primary medical care setting, by providing patients with blended identities or other gender concerns with a mechanism with which to discuss these issues with their treating physicians. Its clinical application will be illustrated through the histories of three prototypic individuals, all of whom are genetically female, but only one of whom presented to a gender program. The commonalities in childhood and adolescence among these three people, and their differing adult gender identities, will also be discussed. Currently, one has undergone sex reassignment and is now a man. The other two consider themselves genderblended, and have incorporated this identity into their adult lives. Our goal in presenting this paper is to encourage discussion of gender identity in general medical practice and to improve the medical care of patients with non-traditional gender identities.