According to the American Psychiatric Association's current classification system, what term is used to diagnose persons who are not satisfied with their designated gender?
Correct
Incorrect
This term is used in the DSM-5.
2. Question
What term did Magnus Hirschfeld coin in 1923 to describe people who want to live a life that corresponds with their experienced gender vs their designated gender?
Correct
Incorrect
The term became widely known after Harry Benjamin wrote “The Transsexual Phenomenon”.
3. Question
Which organization published the first Standards of Care for treating persons with GD/gender incongruence in 1979?
Correct
Incorrect
This organization was founded in September 1979 and is now called the World Professional Association for Transgender Health (WPATH).
4. Question
What is one of the future needs for endocrine treatment protocols for GD/gender incongruence mentioned in the guideline?
Correct
Incorrect
It involves the assessment of the effects of treatment on specific aspects of health.
5. Question
What is the main factor that increases the likelihood of childhood GD/gender incongruence persisting into adolescence?
Correct
Incorrect
The persistence of GD/gender incongruence into adolescence is more likely if this aspect of the child's experience was extreme.
6. Question
According to DSM-5 criteria for gender dysphoria, how long must a marked incongruence between one's experienced/expressed gender and natal gender persist?
Correct
Incorrect
The DSM-5 criteria specify a certain duration, in months, for a marked incongruence between one's experienced/expressed gender and natal gender to persist.
7. Question
What is one of the DSM-5 criteria for gender dysphoria related to primary and/or secondary sex characteristics?
Correct
Incorrect
This criterion involves a strong desire related to one's primary and/or secondary sex characteristics due to a marked incongruence with one's experienced/expressed gender.
8. Question
According to ICD-10 criteria for Transsexualism, how long should the transsexual identity be present persistently?
Correct
Incorrect
The correct answer is a duration in years mentioned in the ICD-10 criteria.
9. Question
During the diagnostic procedure for adolescents, what type of evaluation should be included to assess the family's ability?
Correct
Incorrect
The correct answer involves assessing different aspects of the family's capacity to support the adolescent.
10. Question
What is the primary focus of counseling during social transitioning?
Correct
Incorrect
The correct answer relates to the individual's feelings and interactions with others during the transitioning process.
11. Question
Which of the following is NOT a criterion for gender-affirming hormone therapy for adults?
Correct
Incorrect
The correct answer is not directly related to the individual's gender dysphoria/gender incongruence or mental health.
12. Question
When are adolescents eligible for GnRH agonist treatment?
Correct
Incorrect
The correct answer involves meeting specific criteria confirmed by qualified professionals.
13. Question
What are the criteria for trained mental health professionals (MHPs) to diagnose GD/gender incongruence in adults?
Correct
Incorrect
The correct answer includes all criteria, such as competence in DSM and ICD, distinguishing between conditions, diagnosing and treating psychiatric conditions, psychosocial assessment, and attending professional meetings.
14. Question
What is the main reason for using puberty-suppressing medication in adolescents with gender dysphoria or gender incongruence?
Correct
Incorrect
The main reason is related to the mental well-being of the adolescents.
15. Question
At which Tanner stage is it recommended to start pubertal suppression for adolescents with gender dysphoria/gender incongruence?
Correct
Incorrect
The recommended stage is when the first physical changes of puberty begin to occur.
16. Question
Which medication is recommended for suppressing pubertal hormones in adolescents with gender dysphoria/gender incongruence?
Correct
Incorrect
The recommended medication is known for its efficacy, safety, and reversibility.
17. Question
What is the primary reason for starting puberty suppression early in adolescents with GD/gender incongruence?
Correct
Incorrect
The reason is related to physical outcomes.
18. Question
What are some potential risks of pubertal suppression in GD/gender-incongruent adolescents?
Correct
Incorrect
The potential risks involve bone mineralization, fertility, and brain development.
19. Question
What is the suggested frequency of monitoring anthropometry and Tanner stages during suppression of puberty?
Correct
Incorrect
The monitoring frequency is a range, not a fixed interval.
20. Question
Which diagnostic tool can be used to assess bone mineral density (BMD) in adolescents undergoing puberty suppression treatment?
Correct
Incorrect
The diagnostic tool involves X-ray absorptiometry.
21. Question
What is the recommended age for most adolescents to have sufficient mental capacity to give informed consent for sex hormone treatment?
Correct
Incorrect
The recommended age is around the middle of the teenage years.
22. Question
What is the suggested frequency for monitoring laboratory parameters such as LH, FSH, E2/T, and 25OH vitamin D during suppression of puberty?
Correct
Incorrect
The monitoring frequency is a range, not a fixed interval.
23. Question
For adolescents who request sex hormone treatment, which professionals should confirm the persistence of GD/gender incongruence and sufficient mental capacity to give informed consent?
Correct
Incorrect
The professionals involved are part of a team with diverse expertise.
24. Question
During the induction of puberty, what is the suggested frequency for monitoring clinical pubertal development in adolescents?
Correct
Incorrect
The monitoring frequency is a range, not a fixed interval.
25. Question
At what age do many adolescents achieve a reasonable level of competence for medical decision-making?
Correct
Incorrect
The age range is when adolescents are in high school.
26. Question
Which professionals should be involved in monitoring an adolescent throughout pubertal induction?
Correct
Incorrect
One professional focuses on mental health, while the other is a specialist in hormonal disorders.
27. Question
Which method of administering testosterone is mentioned as an option for transgender male adolescents during pubertal induction?
Correct
Incorrect
The method involves injections.
28. Question
What are the two major goals of hormonal therapy for transgender adults?
Correct
Incorrect
The goals involve reducing certain hormone levels and replacing them with others.
29. Question
Which medical conditions should be evaluated and addressed before beginning hormone therapy?
Correct
Incorrect
Focus on the conditions that could worsen due to hormone therapy.
30. Question
What should clinicians measure during hormone treatment?
Correct
Incorrect
The measurements should involve both naturally occurring and externally provided hormones.
31. Question
What should the treatment team for a transgender individual include?
Correct
Incorrect
The ideal team includes multiple professionals with specialized knowledge.
32. Question
What is the responsibility of the treating clinician in confirming the criteria for treatment?
Correct
Incorrect
The treating clinician should work with the treatment team and gather necessary information from the patient.
33. Question
What should the treating clinician discuss with the patient before starting hormone treatment?
Correct
Incorrect
The discussion should involve an important aspect related to the effects of hormone treatment.
34. Question
Which hormone is commonly used to induce masculinization in transgender males?
Correct
Incorrect
This hormone is responsible for male secondary sex characteristics.
35. Question
What are some of the effects of testosterone treatment in transgender males?
Correct
Incorrect
Testosterone treatment leads to a variety of physical changes in transgender males.
36. Question
What can be done if uterine bleeding continues despite testosterone treatment in transgender males?
Correct
Incorrect
Additional treatments can be considered to address persistent uterine bleeding.
37. Question
What is the typical testosterone value range for transgender males?
Correct
Incorrect
The desired testosterone value range is within the normal male range.
38. Question
Which route of administration is NOT mentioned for testosterone therapy in transgender males?
Correct
Incorrect
The mentioned routes of administration include parenteral and transdermal.
39. Question
What method can be used to stop menses prior to testosterone treatment in transgender males?
Correct
Incorrect
This method involves using hormones to stop menses before starting testosterone treatment.
40. Question
Why is treatment with physiologic doses of estrogen alone insufficient for transgender females?
Correct
Incorrect
The main goal is to suppress testosterone levels into the normal range for females.
41. Question
Which medication is widely used in Europe as an adjunctive therapy for transgender females?
Correct
Incorrect
This medication is a progestational compound with antiandrogenic properties.
42. Question
What is the recommended serum estradiol and serum testosterone levels for transgender females?
Serum estradiol: 50 to 100 pg/mL; serum testosterone: <200 ngdL
Serum estradiol: 200 to 400 pg/mL; serum testosterone: <100 ngdL
Correct
Incorrect
These levels are consistent with premenopausal females.
43. Question
What is the main concern with ethinyl estradiol in transgender treatment plans?
It causes severe liver dysfunction
It is less effective than other estrogen options
It is associated with an increased risk of thromboembolic events
It has a high incidence of adverse reactions
Correct
Incorrect
This concern is related to a specific type of adverse event.
44. Question
What is the main reason for adjunctive therapy in hormonal treatment for transgender females?
To suppress testosterone levels
To increase estrogen levels
To increase muscle mass
To reduce body hair
Correct
Incorrect
It deals with regulating a specific hormone.
45. Question
Which route of estrogen administration is considered less thrombogenic due to avoiding the “first pass effect”?
Oral
Transdermal
Parenteral
Sublingual
Correct
Incorrect
It involves direct application to the skin.
46. Question
What physical change is generally maximal at 2 years after initiating hormones in transgender females?
Breast development
Decreased facial and body hair
Increased muscle mass
Redistribution of fat mass
Correct
Incorrect
It involves a change in the chest area.
47. Question
What is the major concern for transgender females in relation to hormone therapy?
Muscle loss
Voice changes
Breast development
Redistribution of body fat
Correct
Incorrect
It is related to the chest area.
48. Question
How often should laboratory monitoring of sex steroid hormone levels be conducted during the first year of hormone therapy for transgender individuals?
Every month
Every 3 months
Every 6 months
Once a year
Correct
Incorrect
It is a quarterly frequency.
49. Question
Which effect is not expected to occur during the first 1 to 6 months of testosterone therapy for transgender males?
Cessation of menses
Increased facial and body hair
Deepening of the voice
Redistribution of fat mass
Correct
Incorrect
It is related to a change in sound.
50. Question
What is the onset time for breast growth in transgender females undergoing hormone therapy?
1-3 months
3-6 months
6-12 months
1-2 years
Correct
Incorrect
It is between two options that involve months.
51. Question
Which physical change is not expected in transgender females during the first 3 to 12 months of estrogen and antiandrogen therapy?
Decreased facial and body hair
Increased muscle mass
Redistribution of fat mass
Decreased oiliness of skin
Correct
Incorrect
It is a change that would be more typical in transgender males.
52. Question
Which of the following is not a potential adverse event resulting from excess testosterone therapy in transgender males?
Erythrocytosis
Sleep apnea
Hypertension
Decreased muscle mass
Correct
Incorrect
It is a change that would be more typical in transgender females.
53. Question
What is the target serum testosterone level for transgender males receiving testosterone enanthate/cypionate injections?
200-400 ng/dL
300-600 ng/dL
400-700 ng/dL
500-800 ng/dL
Correct
Incorrect
The correct range falls between 400 and 800 ng/dL.
54. Question
In transgender females undergoing hormone therapy, what is the recommended maximum serum estradiol level?
50-100 pg/mL
100-200 pg/mL
200-300 pg/mL
300-400 pg/mL
Correct
Incorrect
The correct range is between 100 and 300 pg/mL.
55. Question
What is the recommended frequency for measuring hematocrit or hemoglobin in transgender males during the first year of hormone therapy?
Every month
Every 3 months
Every 6 months
Every year
Correct
Incorrect
It is more frequent than every 6 months but less frequent than every month.
56. Question
In transgender females treated with estrogens, what percentage may have elevations in prolactin levels associated with enlargement of the pituitary gland?
5%
10%
15%
20%
Correct
Incorrect
The correct percentage is between 15% and 25%.
57. Question
For individuals on spironolactone, how often should serum electrolytes, particularly potassium, be monitored during the first year?
Every month
Every 3 months
Every 6 months
Every year
Correct
Incorrect
It is more frequent than every 6 months but less frequent than every month.
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