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

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.

The goal of transgender endocrine therapy is to change secondary sex characteristics to reduce gender dysphoria and/or facilitate gender presentation that is consistent with the felt sense of self. To maximize desired effects and minimize adverse effects, endocrine therapy must be individualized based on the patient’s goals, the risk/benefit ratio of medications, the presence of other medical conditions, and consideration of social and economic issues. In this article we suggest protocols for the prescribing clinician relating to physical assessment, prescription planning, initiation of endocrine therapy, and ongoing maintenance in transgender adults.

Keywords:
Transgender, gender dysphoria, sex reassignment, hormones, sex steroids, endocrine therapy

Transgender medical care involves addressing general medical conditions and those related specifically to transgender issues. This article summarizes existing research in transgender medicine and provides guidance for family physicians and nurses in adapting standard primary care protocols relating to health maintenance, acute illness, and chronic disease management to address trans-specific clinical concerns. Trans-specific issues in physical examination, health history, interpretation of laboratory tests, vaccination, screening, and treatment are explored, and the role of the primary care provider in caring for patients undergoing hormonal or surgical change is discussed.

Keywords:
Transgender, primary medical care, primary care, sex reassignment

The effects of hormone therapy on glucose tolerance in male-to-female transgender patients have not been specifically addressed in the medical literature. Three cases of new onset type 2 diabetes mellitus during the course of feminizing therapy are examined in light of current literature regarding sex hormones and glucose tolerance. Feminizing therapy may contribute to the onset of diabetes in male-to-female patients with concomitant risk factors. Further research is needed to evaluate the effect of feminizing regimens on glucose tolerance, and to elucidate which patients may benefit from regular screening during the course of therapy.