The LGBT Health & Development Program

Transgender Health Quiz Text

Resources:
Transgender Basics video from The Lesbian, Gay, Bisexual, and Transgender Center in New York City
National Transgender Discrimination Survey Report
Transsexual Road Map
The Transitional Male
UK’s Department of Health – Guide to Hormone Therapy for Trans People
Center of Excellence for Transgender Health
OP TV: Transmale Culture, Episode 3
Fenway Community Health Center – Estrogen Therapy
Fenway Community Health Center – Testosterone Therapy
American Medical Student Association – Transgender Health Initiative – Hormone Therapy
Trans Social Work – MTF Medical Resources
Hudson’s FTM Resource Guide
National Transgender Discrimination Survey Report – Executive Summary
AVERT International HIV and AIDS Charity – Coming Out
Practical Androgyny
Transgender Law Center – Tips for Health Care Providers Working with Transgender Individuals

Questions:

1. All transgender people have surgery to alter their bodies.
FALSE: Transgender is an umbrella term that refers to people who do not conform to or identify with traditional male/female gender categories. Thus, the category of transgender includes people with very diverse identities, experiences, and bodies. For some, a surgical transition (creation or removal of breasts, genitals, and/or reproductive organs) is central to feeling “at home” in their body and/or identity. However, many transgender individuals do not undergo any surgery at all, particularly genital or “bottom” surgery. Because of the cost, risks, and variability in terms of desired results, bottom surgery is actually quite rare. Studies suggest only about 20% of male-to-female (MTF) individuals and 3-5% of female-to-male (FTM) individuals have undergone genital reassignment.
Additional Information:
Transgender Basics video from The Lesbian, Gay, Bisexual, and Transgender Center in New York City
National Transgender Discrimination Survey Report

2. Transitioning is a process, and it may take years to complete.
TRUE: An MTF or FTM transition is not something that happens overnight. It can involve a variety of procedures, activities, and experiences, all of which require different lengths of time. Some transgender people may desire a comprehensive medical transition, including hormone therapy and surgical procedures. Other people may choose to undergo certain procedures (e.g., laser hair removal, breast removal) but not others. Some individuals are also satisfied with hormone therapy and/or other less invasive forms of body alteration, such as breast-binding (flattening one’s breast tissue to create a male-appearing chest) or tucking (folding one’s penis back between the legs to create a flatter, female-appearing genital region). No matter what the transition process includes, the most important thing to remember is that an individual has the right to decide if/when they feel their personal transition is complete.
Additional Information:
Transsexual Road Map

3. All trans women (MTF) are attracted to men and all trans men (FTM) are attracted to women.
FALSE: Just as all men are not attracted to women and all women are not attracted to men, transgender individuals may identify as heterosexual, homosexual, gay, lesbian, bisexual, queer, asexual, etc. Sexual desires and behaviors are NOT determined by gender.
Additional Information:
The Transitional Male – T Myths

4. Hormone therapy poses no risks to your physical health.
FALSE: While hormone therapy can help you achieve many of your desired physical characteristics, there are several dangers associated with treatment. For trans women, estrogen may increase the risk of blood clots, high blood pressure, cardiovascular disease, and stroke, among other things. For trans men, testosterone may increase the risk for diabetes and liver damage. A person can minimize some of the dangers of hormone therapy by working closely with a doctor to determine appropriate dosages, follow a healthy low-fat diet, maintain a regular exercise routine, complete regular checkups, and discuss changes in their body.
Additional Information:
UK’s Department of Health – Guide to Hormone Therapy for Trans People

5. Trans men don’t have to worry about gynecological exams.
FALSE: When it comes to taking care of yourself, your physical body is just as important as your identity. For trans men who have not had their internal reproductive organs (uterus, ovaries, fallopian tubes) removed, it is still possible to get cancer in these organs. All trans men who still have these organs and/or their cervix should have routine gynecological exams. Regular breast exams should also be a part of every trans man’s health regimen, regardless of surgical status. Trans women must be equally aware of their bodies in order to adequately take care of themselves: If they have had genital surgery to construct a vagina, trans women should receive routine gynecological exams. Additionally, since the prostate is not removed as part of MTF genital surgery, all trans women should receive routine prostate exams to screen for any changes. Breast exams may also be necessary for trans women, particularly if they are taking hormones. The frequency of any exam will depend on a variety of factors, including age and sexual activity. Consult your doctor to determine what’s best for you.
Additional Information:
Center of Excellence for Transgender Health – General Prevention and Screening

6. Different individuals require different hormone dosage levels, delivery methods, and lengths of time to achieve their desired transition outcomes.
TRUE: Hormones can be administered in injection, gel, cream, patch, or tablet form. Dosages vary depending on the type of hormone medication and the effects desired. Most effects are visible within two to five years. While many individuals wish to continue hormone therapy indefinitely, others choose to lower or stop their dose after desired effects have been achieved. Because there are potential health risks associated with hormone therapy, it is important that you determine the most appropriate level for your body. Bottom line: Whether or not you take hormones is your choice. Do enough research and consult your doctor to decide what method and dosage is right for you.
Additional Information:
OP TV: Transmale Culture, Episode 3

7. All physical changes from hormone therapy are reversible.
FALSE: Although many of the effects of hormone therapy will take months or years to become noticeable, some of these changes are permanent once they happen. Irreversible changes related to testosterone therapy include facial hair growth, deepening of the voice, and enlargement of the clitoris. For estrogen therapy, permanent changes include breast development and nipple enlargement. Hormone therapy also affects muscle mass, fat distribution, skin coarseness, and body odor, although these effects are more reversible.
Additional Information:
Fenway Community Health Center – Estrogen Therapy
Fenway Community Health Center – Testosterone Therapy

8. Hormone therapy may affect emotional health in addition to affecting physical health.
TRUE: Hormone therapy can have extremely positive effects on an individual’s emotional health and social functioning, bringing them greater comfort and happiness as they work to bring their body in line with their sense of self. However, it is also important to note some of the potentially negative effects of hormone treatment. Hormone therapy may cause mood swings and irritability, as well as the potential for increased aggression in trans men and depression in trans women. In trans women sexual libido tends to decrease, while it increases in trans men. Typically there is a period of adjustment to these effects, which some transgender individuals describe as a “second puberty.” A person can minimize some of the risks of hormone therapy by working closely with a doctor to take hormones consistently, follow a healthy low-fat diet, maintain a regular exercise routine, complete regular checkups, and discuss changes in their body.
Additional Information:
American Medical Student Association – Transgender Health Initiative – Hormone Therapy

9. Silicone injections are a safe and long-lasting alternative to surgery or hormones for trans women.
FALSE: Not only are silicone injections not long-lasting, they are also incredibly dangerous. Trans women sometimes use injectable silicone as a way to quickly achieve their desired body without the cost of surgery or the time commitment of estrogen therapy. Unfortunately, silicone is not a permanent or reliable solution and poses substantial risks to users. Silicone can gradually break down and move around in the body, leading to disfigurement and other health issues, including death. Additionally, trans women sometimes receive these injections illegally at social gatherings called “pumping parties” where the silicone is usually not medical grade and can contain contaminants. The individuals performing the injections at these parties are also generally not medically trained and may be using shared needles, which can lead to the transmission of HIV or hepatitis.
Additional Information:
Trans Social Work – MTF Medical Resources

10. Binding your breasts can cause skin irritations and breathing difficulties.
TRUE: If a binder’s material doesn’t breathe or wick away sweat, you can end up with sores or rashes on your skin. Minimize your risk by applying corn starch or Gold Bond powder to your skin before binding. OR wear a thin cotton undershirt (or any fabric that wicks away sweat) beneath your binder to help absorb moisture and prevent irritation. Remember: allow your skin time off from binding so it can breathe and don’t use tape directly on your skin, as it can cause painful rashes and even pull off skin when removed. Additionally, be careful to not bind your breasts too tightly (e.g. with an ace bandage), as this can restrict your movement, cause back pain, and make breathing difficult.
Additional Information:
Hudson’s FTM Resource Guide – Binding

11. The transgender community is disproportionately affected by HIV/AIDS.
TRUE: While HIV/AIDS affects people from all backgrounds, there are certain populations that do experience higher rates of infection. In the transgender community, HIV infection rates are over 4 times the national average, with rates even higher among transgender people of color. Issues such as poverty, drug use, and participation in sex work increase a person’s risk of contracting HIV, and transgender individuals, particularly those of color, are much more likely to encounter these issues as a result of stigma, discrimination, and other social and emotional stressors. However, it is important to note that simply being trans is NOT what puts a person at risk for HIV. Remember: It’s not who you ARE, but what you DO that increases your chance of getting HIV. Just like the rest of the population, transgender people should be aware of their status and do what they can to protect themselves from HIV and other infections.
Additional Information:
National Transgender Discrimination Survey Report – Executive Summary

12. The best way for people to know how to refer to you is by telling them which pronouns you prefer.
TRUE: Although your preferred pronoun(s) might seem obvious to you, your preference will not always be obvious to others. Avoid assumptions by taking the lead and introducing yourself according to the pronoun(s) you prefer, such as he or she. Also, if you are unsure about someone else’s preferred pronoun(s), the best thing to do is respectfully ask the person how you should refer to them.
Additional Information:
AVERT International HIV and AIDS Charity – Coming Out

13. Some people who have transitioned don’t identify as “transgender.”
TRUE: Some people remain connected to their transgender identity after transitioning, while others later identify as only their updated sex (for example, an FTM individual might identify as a man rather than a trans man). The vast majority of people with intersex conditions, or those with both male and female characteristics, identify as male or female rather than transgender. Most people who fall under the transgender umbrella are likely to have their own specific identity label that may or may not include some concept of transgender.
Additional Information:
Practical Androgyny

14. It is difficult but possible to find a healthcare provider who is sensitive to the needs of transgender patients.
TRUE: Unfortunately, many providers remain insensitive to the needs of transgender patients, and it may be difficult or unsafe to disclose one’s transgender status in some situations. However, an increasing number of LGBT and LGBT-friendly clinics provide free or sliding scale services to transgender individuals. Your local LGBT organization(s) may also be able to make referrals to transgender-friendly doctors, and transgender healthcare guides geared specifically to healthcare providers are available online.
Additional Information:
Transgender Law Center – Tips for Health Care Providers Working with Transgender Individuals
OP TV: Transmale Culture, Episode 3



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