How to Treat: Gender-affirming healthcare - assessment answers

1. Which THREE of the following should you do when working with a transgender or non-binary patient in primary care?
a. Affirm your patient’s gender and autonomy
e. Try to be your patient’s advocate and ally
f. Work with the patient in a way that aligns with their world view and meets their health needs

2. A couple comes to see you with their seven-year-old child, Max. Since the age of four, Max has insisted on wearing dresses most days and has been more interested in dolls than trucks and dinosaurs. Max now says, “I’m a girl, not a boy!” and is experiencing increasing social anxiety. What is your best course of action?
b. Provide support and information to whānau on affirming Max’s gender, and refer to a local gender-affirming service if Max continues to be insistent, consistent and persistent in their gender identity

3. Which TWO of the following statements regarding the care of transgender and non-binary teenagers are correct?
a. A HEEADSSS psychosocial interview can help explore how gender dysphoria is affecting a young person
d. Whānau may experience feelings of grief, loss, guilt and fear around their rangatahi’s gender identity or transition

4. Puberty blockers are best started at what stage of physical development?
b. Tanner stage 2–3

5. When should gender-affirming hormone therapy be commenced?
b. Age 16 or older

6. Which of the following is a permanent effect of masculinising hormone therapy?
b. Deepening of voice

7. Which of the following is a permanent effect of feminising hormone therapy?
a. Breast growth

8. Which FOUR of the following are recommended before starting feminising hormones?
a. Blood pressure, height and weight measurements
b. Fertility discussions
e. Mental health assessment and support
f. Prolactin level

9. Which TWO of the following statements regarding gender-affirming healthcare are TRUE?
a. Funded sperm storage is available for those wanting to start feminising hormone therapy
b. Long-term use of binders can result in breathing issues and permanent deformities

10. Which THREE of the following investigations are recommended every three months during the first year of masculinising therapy?
b. Full blood count
​​​​​​​d. Liver function tests
e. Testosterone level

11. Which THREE of the following are potential complications of feminising therapy?
a. Cardiovascular disease
c. Liver dysfunction
​​​​​​​e. Venous thromboembolism

12. Which TWO of the following statements regarding cancer screening for transgender and non-binary patients are correct?
a. Offer cancer screening as per usual guidelines to all those who have not undergone chest or genital reconstruction surgeries
​​​​​​​d. Recalls for cancer screening should refer to anatomy, not gender