19 YO F W/GENDER IDENTITY DISORDER. Jess Hwang, Endocrinology fellow 6/5/14
|
|
|
- Gerard Lamb
- 5 years ago
- Views:
Transcription
1 19 YO F W/GENDER IDENTITY DISORDER Jess Hwang, Endocrinology fellow 6/5/14
2 19 YO F W/GENDER IDENTITY DISORDER DYSPHORIA Jess Hwang, Endocrinology fellow 6/5/14
3 History of Present Illness Consultation to start hormone therapy Reports feeling like he was born in the wrong body Has felt like this since kindergarten- used to play with boy s toys and dressed like a boy since childhood. Had been only on Lo Estrin for a short period to reduce menstrual cycles.
4 History of Present Illness During transition Wears a chest binder Wears a prosthesis for urinating Let axillary and leg hair grow out Had hymen surgery 1 year ago Calls himself Wesley
5 SOCIAL/Psychiatric History Saw psychiatry here in 1/2013 for transgender issues. No history of psychiatric hospitalizations, suicidal thoughts. No depression, anxiety, mania or psychosis. Was bullied in grade school but this went away in high school. Lives with parents who are very supportive. Dad is with him today. Freshman in college Not currently in a relationship but has been sexually active (only with women) in the past.
6 More History Past Medical History ADHD Social History Smokes half pack/day Smokes marijuana daily Family History Paternal grandfather: Heart Disease Paternal grandmother: Blood Clots Brother: Depression/Anxiety Medications Lo Estrin (has not taken for months)
7 Review of Systems General: No weight changes. HEENT: Normal vision. CV: No chest pain, no palpitations. Pulm: No dyspnea. GI: No abnominal pain. No diarrhea or constipation. MSK: No joint pain. Skin: No rash. Endo: Feels like she was supposed to be a boy. Psych: Anxious.
8 Physical Exam Vitals: BMI 20.25, BP 105/59, HR 72 Gen: no distress, appears stated age HEENT: no pharyngeal erythema. PERRLA. Neck: no thyromegaly, no palpable nodules. CV: regular rate and rhythm. Pulm: clear to auscultation GI: soft, non-tender/non-distended abdomen. GU: no pubic hair (shaves). MSK: normal range of motion. Neuro: alert and oriented Psych: normal mood.
9 Treatment Was started on testosterone, initially 100 mg q2 weeks. There was a mix-up and patient was taking 200 mg q2 weeks.
10 FOLLOW-UP Saw psych for possible mood changes associated with testosterone More irritable, more down, poor sleep. No suicidal thoughts. Working 2 jobs as well currently.
11 Labs CBC WBC 6.6, Hb 14.7, Platelet 316 LFTs TP 6.1, Alb 4.1, TBili 0.4, AlkPhos 73, AST 34, ALT 25 Testosterone 972 ng/dl (male adult ref range )
12 Clinical Questions Gender Identity Disorder Dysphoria Definition/Diagnostic Criteria Epidemiology Challenges Multidisciplinary Treatment Approach
13 Gender Dysphoria- Definition Sex = physical characteristics Gender = identity/self-image Transgender people experience their gender as being different from the sex that was assigned to them at birth, otherwise referred to as gender nonconformity. Gender dysphoria refers to the distress that can arise from gender nonconformity. In the upcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people whose gender at birth is contrary to the one they identify with will be diagnosed with gender dysphoria. Revision of DSM-IV s criteria for gender identity disorder
14 DSM-V Diagnostic Criteria A. Incongruence between one s experienced/expressed (E/E) gender & assigned gender (>6 months), as manifested by 2+ of the following: Incongruence between one s E/E gender & 1 o +/- 2 o sex characteristics Desire to be rid of one s 1 o +/- 2 o sex characteristics because of a marked incongruence with one s E/E gender Desire for the 1 o +/- 2 o sex characteristics of the other gender Desire to be of the other gender Desire to be treated as the other gender Belief that one has typical feelings and rxns of the other gender B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning, or with a significantly increased risk of suffering, such as distress or disability
15 Prevalence of trans persons 1:11,900 to 1:45,000 for male-to-female (MTF) 1:30,400 to 1:200,000 for female-to-male (FTM) 0.5% of the population (1.5 million in the US) Minimum estimates at best
16 Gender Dysphoria in the news now
17 Challenges Reluctance to disclose Social stigma, cultural prejudice Structural barriers Restrooms/inpatient rooms/labs+procedures Financial barriers Lack of healthcare provider experience Clinical Biochemistry 2014
18 Endocrine News May 2014
19 Other shocking statistics 4-fold greater risk of contracting HIV Prevalence of unsupervised hormone use in urban transgender populations reportedly ranges from 29% to 63% 48% of trans persons had delayed seeking medical care when they were sick or injured because of cost 14% of the trans population is unemployed, nearly twice the national average <1% in more than 400 FtM expressed regret posttreatment, while 1.5% of more than 1000 MtF expressed regret
20 Multidisciplinary Treatment Sex reassignment is a multidisciplinary treatment Diagnostic assessment- Mental health professional & endocrinologist Psychotherapy or counseling Real-life experience Hormone therapy Address medical conditions that can be exacerbated by hormone depletion/cross-sex hormone treatment Surgical therapy EHRs should maintain an accurate record of the patient's medical transition history and current anatomy
21 FtM Masculinizing effects Endocrine Society Guidelines 2009
22 FtM Long-term Care Evaluate patient every 2-3 months (year 1), then 1-2 times (yearly thereafter) Testosterone every 2-3 months Estradiol during the first 6 months of testosterone treatment or until there has been no uterine bleeding for 6 months CBC, LFTs at baseline and every 3 months (year 1) and then 1-2 times (yearly thereafter) Weight, BP, lipids, FBS/A1c (if h/o DM) regularly Consider BMD at baseline (if risk factors for osteoporosis) If cervix is present, annual pap smear Mammograms as recommended Endocrine Society Guidelines 2009
23 FtM Surgery for Reassignment Breast/chest surgery: subcutaneous mastectomy, chest contouring Genital surgery: hysterectomy + salpingooophorectomy, metoidioplasty/phalloplasty +/- implantation of penile/scrotal prostheses, vaginectomy, scrotoplasty Virilizing procedures: liposuction, lipofilling, voice surgery, pectoral implants Care of the transgender patient. Am J Obstet Gynecol 2014.
24 Controversies- What Age to Start? 80-90% of very young children who experience distress about their gender identity grow out of these feelings with their discomfort often resolving during puberty. Gender dysphoria worsens during puberty for the remaining 10-20%. Clinicians can buy time for distressed adolescents to consider their options by arresting puberty using gonadotropin-releasing hormone (GnRH) analogues with ongoing counseling.
25 Take Home Points Transpatients face many barriers when it comes to basic health needs including health care Because of these barriers, many patients do not receive the proper health care that they need. Certain high-risk behaviors as well as long-term hormonal therapy, mandate different routine health care needs 99% of patients were happy with their gender change decision Biggest barrier to care for transgender patients is lack of physican comfort with the topic
26 References Endocrine Society Guidelines: Endocrine Treatment of Transsexual Persons. JCEM Sept 2009;94(9): Roberts TK et al. Barriers to Quality Health Care for the Transgender Population. Clinical Biochemistry Grant J et al. National transgender discrimination survey report on health and health care. National Gay and Lesbian Task Force Foundation; Unger. Care of the transgender patient. Am J Obstet Gynecol 2014.
Care for Transgender Patient: Providing Competent and Compassionate Care During a Time of Transition
Care for Transgender Patient: Providing Competent and Compassionate Care During a Time of Transition Jessica Francis, MD Assistant Professor Department of Obstetrics and Gynecology Froedtert and the Medical
8/17/2015. Objectives. Disclosures
NPANY Annual Conference Niagara Falls, NY October 2015 Laura Markwick, DNP, FNP C Associate Professor Wegmans School of Nursing St Joh Fisher College Objectives The learner will gain an understanding of
Guidelines for the Clinical Care of Persons with Gender Dysphoria
Guidelines for the Clinical Care of Persons with Gender Dysphoria Friday, May 27, 2016 2:15 5:00 PM 25 th Annual Scientific and Clinical Congress American Association of Clinical Endocrinologist Orlando,
NHS MEDICAL POLICY. Transgender Surgical Procedures Procedure
Effective Date: 12/13/2017 NHS MEDICAL POLICY Transgender Surgical Procedures Procedure 2017-003 Transgender surgical procedures may be indicated when ALL of the following are present: 1 The member is
GENder Education and Care Interdisciplinary Support (GENECIS) Feminizing Medications for Patients with Gender Dysphoria
GENder Education and Care Interdisciplinary Support (GENECIS) Feminizing Medications for Patients with Gender Dysphoria Patient Information and Informed Consent and Assent for Minors Before using medications
Patient education for transgender masculinizing hormone therapy
Date name DOB Patient education for transgender masculinizing hormone therapy o Some transsexual, transgender, and gender non-conforming people choose to take hormone therapy to treat gender dysphoria
CITY AND COUNTY OF SAN FRANCISCO
CITY AND COUNTY OF SAN FRANCISCO Department of Public Health Transgender Health Services 50 Lech Walesa Street San Francisco, CA 94102 Telephone: (415) 355-7498 FAX: (415) 355-7407 transgenderhealthservices@sfdph.org
Medical Policy. Transgender Reassignment Surgery. Policy Number: Policy History
Policy Number: 1069 Policy History Approve Date: 06/01/2018 Effective Date: 06/01/2018 Preauthorization All Plans Benefit plans vary in coverage and some plans may not provide coverage for certain service(s)
Endocrine Treatment of Gender-Dysphoric/ Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. Education Module June, 2017
Endocrine Treatment of Gender-Dysphoric/ Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline Education Module June, 2017 Introduction Wylie C. Hembree, MD Associate Attending Physician
Transgender Medicine: Essentials for the Primary Care Provider BENJAMIN J. BOH, DO, MS
Transgender Medicine: Essentials for the Primary Care Provider BENJAMIN J. BOH, DO, MS ASSISTANT PROFESSOR OF MEDICINE SECTION OF ENDOCRINOLOGY GEISEL SCHOOL OF MEDICINE AT DARTMOUTH Disclosure I will
Information About Hormonal Treatment for Trans men
Information About Hormonal Treatment for Trans men Leighton J Seal PhD FRCP Consultant Endocrinologist, Gender Identity Clinic, (Charing Cross) West London Mental Health NHS Trust 12/12/2016 Introduction...
Harold Husovsky, MD. Associate Professor of General Medicine at SUNY Health Science Center
Harold Husovsky, MD Associate Professor of General Medicine at SUNY Health Science Center Care of the Transgendered Syracuse University, 1/09/07 Goals Introductions Definitions Statistics Evaluation Treatments
Arti Barnes MD MPH Tuesday AM series ENCOMPASSING THE MARGINALIZED: CARE FOR THE TRANSGENDER COMMUNITY
Arti Barnes MD MPH Tuesday AM series 9-29-2015 ENCOMPASSING THE MARGINALIZED: CARE FOR THE TRANSGENDER COMMUNITY Disclosures None Objectives Increase awareness of HIV and STD epidemiology among Transgenders
Transgender Health Cases from the Transgender and Intersex Specialty Care Clinic
Transgender Health Cases from the Transgender and Intersex Specialty Care Clinic Caroline Davidge-Pitts, MD Todd B Nippoldt, MD Department of Endocrinology, Diabetes, Nutrition Mayo Clinic, Rochester 2017
Primary and HIV Care for Our Transgender Patients
Primary and HIV Care for Our Transgender Patients James Hekman, MD FACP AAHIVS Clinical Assistant Professor Community Internal Medicine CWRU/Cleveland Clinic. Who are our TG patients? Demographics Those
MEDICAL POLICY No R1 GENDER REASSIGNMENT SURGERY
GENDER REASSIGNMENT SURGERY Effective Date: January 1, 2017* Review Dates: 8/15, 8/16, 11/16 Date Of Origin: August 12, 2015 Status: Current *Note: For fully funded commercial (individual or group), this
Pharmacists' role in pharmacotherapy management of transgender patients
Pharmacists' role in pharmacotherapy management of transgender patients Ashley Floyd, Pharm.D. PGY1 Community Pharmacy Residency Program H-E-B Pharmacy The University of Texas at Austin 1 Objectives Recognize
Treatment of Vasomotor Symptoms in a Transgender Male After Hysterectomy. Isabel Casimiro, MD PhD Endocrinology Fellow
Treatment of Vasomotor Symptoms in a Transgender Male After Hysterectomy Isabel Casimiro, MD PhD Endocrinology Fellow Disclosure Information I have the following financial relationships to disclose: Consultant
Corporate Medical Policy
Corporate Medical Policy Gender Confirmation Surgery and Hormone Therapy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: gender_confirmation_surgery_and_hormone_therapy 7/2011 5/2018
Horizon BCBSNJ Uniform Medical Policy Manual Policy Number: 115 Effective Date: 01/01/2017
Horizon BCBSNJ Uniform Medical Policy Manual Section: Surgery Policy Number: 115 Effective Date: 01/01/2017 Original Policy Date: 05/25/2010 Last Review Date: 05/10/2016 Date Published to Web: 06/23/2010
Transgender Medical Benefits
Transgender Medical Benefits The following Transgender Medical Benefits are based on the Standards of Care published by the World Professional Association for Transgender Health (WPATH). All transgender
The Presence of Thyroid Autoantibodies in Pregnancy
The Presence of Thyroid Autoantibodies in Pregnancy Dr. O Sullivan does not have any financial relationships with any commercial interests. KATIE O SULLIVAN, MD FELLOW, ADULT/PEDIATRIC ENDOCRINOLOGY ENDORAMA
Please note that this should only be used for feedback and comments specifically related to this particular medical policy.
E-Mail Us Close Please note that this email should only be used for feedback and comments specifically related to this particular medical policy. Horizon BCBSNJ Uniform Medical Policy Manual Section: Surgery
Protocol. Gender Reassignment Surgery
Protocol Gender Reassignment Surgery Medical Benefit Effective Date: 07/01/18 Next Review Date: 03/19 Preauthorization Yes Review Dates: 03/15, 03/16, 03/17, 03/18, 05/18 Preauthorization is required.
10 yo boy w/chiari/pseudotumor seen for obesity. 8/22/13 Jess Hwang
10 yo boy w/chiari/pseudotumor seen for obesity 8/22/13 Jess Hwang HPI Kids at school have been teasing him about his weight and the skin darkening around his neck 127lb was peak weight Quit desserts/soda
Transgender: A broad spectrum of individuals who transiently or persistently identify with a gender different from their natal gender.
POLICY TITLE: Gender Reassignment Surgery POLICY STATEMENT: Gender reassignment surgery is one treatment option for extreme cases of Gender Dysphoria Disorder. Gender dysphoria disorder (formerly termed
More than meets the eye
More than meets the eye Ana Paula Abreu, MD, PhD American Association of Clinical Endocrinologists New England Chapter Annual Meeting September 8, 2018 Disclosures No conflict of interest or significant
HEALTH: Presented by: Alsean R. Bryant, Pharm.D., AAHIVP AIDS Healthcare Foundation
HEALTH: Presented by: Alsean R. Bryant, Pharm.D., AAHIVP AIDS Healthcare Foundation 1 The presenter has no actual or potential conflict of interest in relation to this presentation program. 2 Pharmacists:
Payal Patel, MD Pediatric endocrinology fellow January 9, 2014
Payal Patel, MD Pediatric endocrinology fellow January 9, 2014 14 8/12yo F with newly diagnosed Graves disease presents for a 2 nd opinion 2 wks prior: pt seen by PCP for evaluation of a "large neck mass
HD CLINIC MEDICAL HISTORY FORM
HD CLINIC MEDICAL HISTORY FORM Welcome to the HDSA Center of Excellence HD Clinic. Please take a few moments to answer the questions below as best as you can. If you need assistance, a caregiver/companion
3 year old boy with puberty. Katie Stanley, MD August 1, 2013
3 year old boy with puberty Katie Stanley, MD August 1, 2013 Initial presentation 3 and 11/12 year old boy with signs of puberty Presented to outside endocrinologist in 2002 with: Pubic hair since 2.5
Gender Identity Services
Gender Identity Services www.sandyford.org 2 Contents Welcome to Sandyford....... 4 The Gender Identity Clinic...... 4 Treatment Options for Transsexual Women Male to Female (MTF)........ 6 Treatment Options
Name: Date of Birth: Age: Address: City State Zip
Today s Date: Client History Name: Date of Birth: Age: Address: City State Zip Cell Phone: Home Phone: Work Phone: Email Address: Female Male Emergency Contact: Phone Number: How did you hear about us?
Division: Medical Management Department: Utilization Management
Retired Date: Page 1 of 1 1. POLICY DESCRIPTION: Gender Reassignment Surgery 2. RESPONSIBLE PARTIES: Medical Management Administration, Utilization Management, Integrated Care Management, Pharmacy, Claims
Transgender Medicine beyond the guidelines.
Transgender Medicine beyond the guidelines. Rachel Hopkins, MD Assistant Professor of Medicine SUNY Upstate Medical University Division of Endocrinology and Metabolism Overview Definitions and history
State of California, California Health and Human Services Agency, Department of Managed Health Care 2013:
This policy has been developed through review of medical literature, consideration of medical necessity, generally accepted medical practice standards, and approved by the IEHP Pharmacy and Therapeutics
GENDER DYSPHORIA. Guideline Number: BH727GD_ Effective Date: October, 2017
GENDER DYSPHORIA Optum Coverage Determination Guideline Guideline Number: BH727GD_102017 Effective Date: October, 2017 Table of Contents Page INSTRUCTIONS FOR USE... 1 BENEFIT CONSIDERATIONS... 1 COVERAGE
Please answer all questions in blue or black ink by filling in the blank or circling. SOCIAL HISTORY
PATIENT QUESTIONNAIRE / ASSESSMENT Endocrinology Form Please answer all questions in blue or black ink by filling in the blank or circling. SOCIAL HISTORY Date Phone (H) (W) (C) Age Male Female Marital
Supporting Documents Case Studies
Supporting Documents Case Studies ONA Presentation/Case Studies 1 CASE STUDY #1 CC: Right Breast Lump History of Present Illness: 41 yr old G3P0 with an LMP of 08/01/2017 who presents today to discuss
Primary Care of LGBT Patients
Primary Care of LGBT Patients Basics Primary care of LGBT patients is primary care of a population with unique barriers to care Like any patient population there are population specific disease risks concerns
61 yo M w/heart disease presenting in decompensated HF. 1/24/13 Jess Hwang
61 yo M w/heart disease presenting in decompensated HF 1/24/13 Jess Hwang HPI 3 weeks worsening orthopnea, PND, DOE Referred to UCMC for transplant evaluation Found to have 100% afib burden 1 month prior
Endocrinology and the Transgender Patient
Endocrinology and the Transgender Patient Matthew Leinung MD Professor of Medicine Albany Medical College This project is supported by the Health Resources and Services Administration (HRSA) of the U.S.
CLIENT INFORMATION and INFORMED CONSENT TESTOSTERONE THERAPY
CLIENT INFORMATION and INFORMED CONSENT TESTOSTERONE THERAPY This form explains the use of testosterone for someone who wishes to become more masculine as part of a gender transitioning process. Testosterone
Objectives. Patient Assessment Methadone and Suboxone Addiction History. Patient Assessment. Initial Screen. Cost 14/04/2016
Objectives Patient Assessment Methadone and Suboxone 2016 Proper assessment of a Patient with Opioid Addiction Clinical assessment Informed consent regarding OST, side effects and program restrictions
Beyond Trans 101: Psychological Practice & Advocacy with Transgender & Gender Nonconforming (TGNC) Clients
Beyond Trans 101: Psychological Practice & Advocacy with Transgender & Gender Nonconforming (TGNC) Clients Michael L. Hendricks, PhD, ABPP Washington Psychological Center, P.C. Workshop Overview Conceptualization
Patient Information: Date: Last Name: Street Address: City: SS #: First Name: Sex: M F Birthdate: Contact Information:
Welcome to PHC Family Medicine! We know you have a choice and appreciate your choosing us to provide care to your family. Dr. Frankhouser will be asking about your concerns today, but so that we can learn
Case Studies in Primary care
Case Studies in Primary care Holistic care of Transgender and Gender-nonconforming People Katy Kropf DO Ohio University Heritage College of Osteopathic medicine pronouns she/her/hers kropf@ohio.edu My
WEIGHT LOSS PATIENT INFORMATION RECORD
WEIGHT LOSS PATIENT INFORMATION RECORD PLEASE BRING THIS COMPLETED FORM TO YOUR APPOINTMENT Date: / / Last Name: First: MI: Date of Birth: / / Sex: Age: Home Phone: ( ) Mobile Phone: ( ) Address: City:
City: State: Zip Code: Home Phone: Work Phone: Cell Phone: Address: Emergency Contact: Relationship: Phone
Patient Name: DOB: SS #: Address: City: State: Zip Code: Home Phone: Work Phone: Cell Phone: Email Address: Emergency Contact: Relationship: Phone Referring Physician: Primary Physician: Other Physicians
NEW PATIENT QUESTIONNAIRE
NEW PATIENT QUESTIONNAIRE PLEASE PRINT Full name: Age: Preferred Contact number: Email address: Why are you here today? To establish primary care Annual exam Consultation from another doctor If consultation,
Please be sure to check with your insurance company to make sure that Dr. Kohli is covered under your plan.
Dear You are scheduled for an appointment with Dr. Manoj Kohli at Christie Clinic in the Department of Rheumatology on at. Please check in on the first floor. The office is located on the 2 nd floor of
* Note: please reference the Highmark Health Options Gender Transition Services (MP- 033-MD-DE) policy for all gender dysphoria requests.
Request for Prior Authorization for Lupron, Lupron Depot (leuprolide acetate) Website Form www.highmarkhealthoptions.com Submit request via: Fax - 1-855-476-4158 All requests for Lupron (leuprolide acetate)
Feminising hormone treatment for trans women and non-binary people: Information for primary care professionals
1 Feminising hormone treatment for trans women and non-binary people: Information for primary care professionals Introduction The following information has been produced by the Nottingham Centre for Transgender
Gender Health Center, Hormone Clinic th St #201 Sacramento, CA 95817
MTF Clinical Approach and Protocols Gender Health Center, Hormone Clinic Sacramento, CA Katherine Gardner, MD Revised 11/6/2015 Name and Pronouns: Preferred names and pronouns are used at all times when
Trans Affirming Letter Writing: Best Practices and Challenges for BHP. Justin Wheeler, LISW-S Michelle Pride, Ph.D.
Trans Affirming Letter Writing: Best Practices and Challenges for BHP Justin Wheeler, LISW-S Michelle Pride, Ph.D. Disclosures The speakers and members of the planning committee do not have a conflict
Disclosures. Endocrine Care of the Transgender Patient. Objectives. Start where you are. Use what you have. Do what you can. Vocabulary.
Disclosures Endocrine Care of the Transgender Patient Kathryn Tierney, MSN, APRN, FNP-BC Medical Director, Middlesex Hospital Transgender Medicine Program Middlesex Multispecialty Group Division of Endocrinology
FAMILY MEDICINE New Patient Medical History Form
FAMILY MEDICINE New Patient Medical History Form Personal History : Name: Date of Birth / / (mm/dd/yyyy) Age Occupation Birthplace (City&Country) Marital Status (check one): Single Married Divorced Separated
Breast implants Breast reduction surgery Breast biopsy Breast lumpectomy Chest reconstruction Other:
New Patient Intake Form This form lets us get to know you and know how we can help. Not every question is important to everyone, but the more you can answer, the more we can help. If there is a question
What to Know a 21 st Century Approach to Transgender Medical Care
What to Know a 21 st Century Approach to Transgender Medical Care Joshua Safer, MD Transgender Medicine Research Group Center for Transgender Medicine and Surgery Patient / Mental Health Provider Gatekeeper
SUSQUEHANNA HEALTH CANCER CENTER HEMATOLOGY & ONCOLOGY NEW PATIENT HEALTH QUESTIONNAIRE. Name: Date of Birth:
Name: Date of Birth: What is the reason for your visit today? What doctor referred you to this office? PAST MEDICAL HISTORY: Do you have any of the following: Please check all that apply Anxiety /depression
16 YEAR-OLD OBESE FEMALE WITH OLIGOMENORRHEA
16 YEAR-OLD OBESE FEMALE WITH OLIGOMENORRHEA Katie O Sullivan, MD Adult/Pediatric Endocrinology Fellow University of Chicago ENDORAMA Thursday, September 4th, 2014 Disclosures No financial interests. Will
Female New Patient Package
Female New Patient Package The contents of this package are your first step to restore your vitality. Please take time to read this carefully and answer all the questions as completely as possible. In
There are four areas where you can expect changes to occur as your hormone therapy progresses. 1) Physical
You are considering taking feminizing hormones, so you should learn about some of the risks, expectations, long term considerations, and medications associated with medical transition. It is very important
06-Mar-17. Premature menopause. Menopause. Premature menopause. Menstrual cycle oestradiol. Premature menopause. Prevalence ~1% Higher incidence:
Menopause Dr Sonia Davison MBBS FRACP PhD Endocrinologist and Clinical Fellow, Jean Hailes for Women s Health Women s Health Research Program, Monash University = the last natural menstrual period depletion
Medical History Form
Medical History Form NAME DOB / / TODAY S DATE MEDICAL HISTORY What medical Conditions do you have? Select all that apply, or write in if not listed: Diabetes High Blood Pressure Thyroid Disorder Heart
Welcome to About Women by Women
Welcome to About Women by Women Today s Date New Patient Questionnaire Name: Birth Date: / / Home Phone: Address: Cell Phone: Work Phone: Occupation: Employer: Marital Status: Married Living w/ Partner
DISCLOSURES LEARNING OBJECTIVES. 21st Century Strategies: Transgender Hormone Care. Patient/PCP. Medical model
21st Century Strategies: Transgender Hormone Care DISCLOSURES Joshua Safer, MD Center for Transgender Medicine and Surgery No conflicts of interest Just about the entire talk is "off label" LEARNING OBJECTIVES
Addiction History. Patient Assessment. Objectives. Cost. Initial Screen. Patient Assessment 25/04/2017. Substances. Age Started
Addiction History Patient Assessment Methadone and Suboxone 2017 Dr. Morris Markentin, 2017 Substances Current substance use and amount Age Started Each substance Route of use each substance Inhalation
Medical Necessity Guidelines: Transgender Surgical Procedures
Medical Necessity Guidelines: Transgender Surgical Procedures Effective: September 13, 2017 Clinical Documentation and Prior Authorization Required Applies to: Coverage Guideline, No Prior Authorization
Adult Health History New Patient
Adult Health History New Patient Today s Date PREFERRED NAME DATE OF BIRTH Reason for visit: What are your health goals for the next year? Previous Primary care Provider? Last visit? Specialists (Past
Name: Date of Birth: Street Address: Apt.# City: State: ZIPCODE: Home Phone: Work Phone: Cell Phone: Pharmacy name & address: Phone#:
Stephen L. Aronoff, M.D., F.A.C.E. Diplomate of the American Board of Internal Medicine and the Subspecialty Board of Endocrinology and Metabolism 2400 Lakeside Blvd., Suite 130, Richardson, TX 75082 Phone:
MANAGEMENT OF CAH IN ADULT PATIENTS. Mizuho Mimoto, MD, PhD Endorama June 22, 2017
MANAGEMENT OF CAH IN ADULT PATIENTS Mizuho Mimoto, MD, PhD Endorama June 22, 2017 22 yo M with CAH presents with pruritis HPI: Several month history of progressive pruritis, worse in extremities (antecubital
New Patient Information Form
Urogynecology New Patient Information Form NAME: UROGYNECOLOGY: NEW PATIENT INFORMATION FORM Why are you coming for this evaluation? How long have you had this problem? Has it been getting worse? yes no
Stelios Mantis, MD DuPage Medical Group Pediatric Endocrinology
Stelios Mantis, MD DuPage Medical Group Pediatric Endocrinology 4 11 13 Initial Presentation Pt initially presented to pediatrician for school physical in fall 2012. Pt was found to be overweight (BMI:
PATIENT HISTORY RECORD FACULTY INTERNAL MEDICINE. Date of Appt: / / Name: Date of Birth: / / Last First Middle
PATIENT HISTORY RECORD FACULTY INTERNAL MEDICINE Date of Appt: / / Name: Date of Birth: / / Last First Middle The information you provide today is very important in regards to your healthcare. Please answer
Guidelines for the Clinical Care of Persons with Gender Dysphoria
Guidelines for the Clinical Care of Persons with Gender Dysphoria Friday, May 27, 2016 2:15 5:00 PM 25 th Annual Scientific and Clinical Congress American Association of Clinical Endocrinologist Orlando,
Trust Women Seattle Client Information for Informed Consent MASCULIZING MEDICATIONS FOR TRANSGENDER CLIENTS
Client Information for Informed Consent MASCULIZING MEDICATIONS FOR TRANSGENDER CLIENTS Before using medications to transition and Masculinize, you need to know the possible advantages, disadvantages and
THE AUTISM TRANSGENDER CONNECTION. One Family s Story
Meet Zack!!! THE AUTISM TRANSGENDER CONNECTION One Family s Story ZACK S STORY MOM S STORY Autism is often overlooked in the presence of a gender identity diagnosis; gender identity is often overlooked
Pharmacy Policy. Adult transgender hormonal therapy may be approved when all of the following criteria are met:
Pharmacy Policy Class: Transgender Hormonal Treatment for Adults Line of Business: Medi-Cal Effective date: February 15, 2017 Revision date: February 15, 2017 This policy has been developed through review
GoPrivateMD General Information & History
Date: Date of Birth: Age: Sex: Male Female Address: City: State: Zip: Telephone: Email: PREFFERED PHARMACY NAME & LOCATION: PRIMARY PHYSICIAN: SPECIALISTS: INSURANCE GoPrivateMD will not bill your insurance.
10/07/18. Conflict of interest statement
Care: principles, best practices in Europe and how reproductive/sexual health care providers might contribute Petra De Sutter University Hospital Gent Conflict of interest statement My department occasionally
27 F with new onset hypertension and weight gain. Rajesh Jain Endorama 10/01/2015
27 F with new onset hypertension and weight gain Rajesh Jain Endorama 10/01/2015 HPI 27 F with hypertension x 1 year BP 130-140/90 while on amlodipine 5 mg daily She also reports weight gain, 7 LB, mainly
Determining a Client s Readiness for Gender Transition:
Determining a Client s Readiness for Gender Transition: Clinical Evaluation and Recommendation VARUNEE FAII SANGGANJANAVANICH, PHD, LPCC-S THE UNIVERSITY OF AKRON Session Overview Identify DSM 5 diagnostic
New Patient Questionnaire. Name DOB Date
Medical History (This refers to medical problems that have already been diagnosed or treated. Please explain how this is treated, such as diet, medication, surgery, etc.) Condition Abnormal Pap smear Alcohol
Female New Patient Package
Female New Patient Package The contents of this package are your first step to restore your vitality. Please take time to read this carefully and answer all the questions as completely as possible. Thank
Introduction to surgery
Introduction to surgery Make an outline of the surgical clinical history Describe the abdominal quadrants and its content Name at least 5 types of surgical intruments What is the informed consent? Name
Columbus Oncology and Hematology Associates 810 Jasonway Ave. Columbus, OH 43214, Ph: , Fax:
Columbus Oncology and Hematology Associates 810 Jasonway Ave. Columbus, OH 43214, www.coainc.cc Ph: 614.442.3130, Fax: 614.442.3145 Name (Last, First, Middle) Birth Date Age Social Security # Appointment
66 M with erectile dysfunction and abnormal labs RAJESH JAIN ENDORAMA 10/29/2015
66 M with erectile dysfunction and abnormal labs RAJESH JAIN ENDORAMA 10/29/2015 HPI 66 M presenting as a referral for erectile dysfunction and abnormal labs Has been seeing a facility specializing in
2.0 Synopsis. Lupron Depot M Clinical Study Report R&D/09/093. (For National Authority Use Only) to Part of Dossier: Name of Study Drug:
2.0 Synopsis Abbott Laboratories Individual Study Table Referring to Part of Dossier: Name of Study Drug: Volume: Abbott-43818 (ABT-818) leuprolide acetate for depot suspension (Lupron Depot ) Name of
Female Patient Questionnaire & History
!! Female Patient Questionnaire & History Name: Today s Date: (Last) (First) (Middle) Date of Birth: Age: Weight: Occupation: Home Address: City: State: Zip: Home Phone: Cell Phone: Work: E-Mail Address:
Virtual Mentor American Medical Association Journal of Ethics August 2010, Volume 12, Number 8:
Virtual Mentor American Medical Association Journal of Ethics August 2010, Volume 12, Number 8: 673-677. MEDICINE AND SOCIETY Proposed DSM-5 Revisions to Sexual and Gender Identity Disorder Criteria Robert
Coding... 4 Benefit Application... 6 Description of Services... 7 Clinical Evidence... 8
Title: TABLE OF CONTENTS Product Variations.... 1 Policy Statement.... 1 Related Policies.... 3 Policy Guidelines..... 3 Coding.... 4 Benefit Application........ 6 Description of Services..... 7 Clinical
Patient education for transgender feminizing hormone therapy
Date name DOB Patient education for transgender feminizing hormone therapy o Some transsexual, transgender, and gender non-conforming people choose to take hormone therapy to treat gender dysphoria and
Sexual health screening
Sexual health screening This guideline provides screening recommendations that are based on anatomy and is inclusive of genderaffirming surgeries and hormone therapy. All patients should be screened according
Client Information for Informed Consent FEMINIZING MEDICATIONS FOR TRANSGENDER CLIENTS
Client Information for Informed Consent FEMINIZING MEDICATIONS FOR TRANSGENDER CLIENTS Before using medications to transition and feminize, you need to know the possible advantages, disadvantages and risks
MEDICAL ASSESSMENT PART 1 - SOCIAL HISTORY
Smoking history Alcohol history Never Quit Never Quit PART 2 - MEDICAL HISTORY Date of last colonoscopy? Date of last mammogram? Date of last pap smear? Date of last flu vaccine? Date of last pneumonia