Question

Which is considered "gender affirming care" when working with the LGBTQ community?

		Using birth gender for consistency
		Performing a complete sexual history, regardless of visit purpose.
		Avoid discussion of gender issues to avoid embarrassing the patient.
		Using patient preferred terms regarding gender.

Answer 1

Ans=Guidelines for the Primary and Gender-Affirming Care of
Transgender and Gender Nonbinary People. Transgender people have a gender identity that differs
from the sex which they were assigned at birth, and are estimated to represent 0.5% of the U.S.
population.Numerous needs assessments have demonstrated that transgender people
encounter a range of barriers to accessing primary health care. A 2006 survey of more than 600
transgender people in California found that 30% postponed seeking medical care due to prior
disrespect or discrimination, and that 10% were primary care outright.The 2011 National
Transgender Discrimination Survey of more than 6000 transgender people in all 50 U.S. states
found several noteworthy disparities, including 28% who delayed care due to past discrimination
and 19% who were denied care outright. Most alarmingly, 50% of respondents reported having to
teach their providers about their own healthcare.

These guidelines aim to address these disparities by equipping primary care providers and health
systems with the tools and knowledge to meet the health care needs of their transgender and
gender nonconforming patients. These guidelines expand on the original UCSF Primary Care
Protocol for Transgender Care, which since its launch in 2011 has served thousands of providers
and policymakers across the U.S. and around the world; the page on hormone administration alone
received more than 5000 visitors in the month of November, 2015.

These Guidelines complement
the existing World Professional Association for Transgender Health Standards of Care and the
Endocrine Society Guidelines in that they are specifically designed for implementation in every day
evidence-based primary care, including settings with limited resources.

Sex: Historically has referred to the sex assigned at birth, based on assessment of external
genitalia, as well as chromosomes and gonads. In everyday language is often used
interchangeably with gender, however there are differences, which become important in the context
of transgender people.
Gender expression: The outward manner in which an individual expresses or displays their
gender. This may include choices in clothing and hairstyle, or speech and mannerisms. Gender
identity and gender expression may differ; for example a woman (transgender or non-transgender)
may have an androgynous appearance, or a man (transgender or non-transgender) may have a
feminine form of self-expression.
Transgender: A person whose gender identity differs from the sex that was assigned at birth. May
be abbreviated to trans. A transgender man is someone with a male gender identity and a female
birth assigned sex; a transgender woman is someone with a female gender identity and a male
birth assigned sex. A non-transgender person may be referred to as cisgender (cis=same side in
Latin).
Gender nonconforming: A person whose gender identity differs from that which was assigned at
birth, but may be more complex, fluid, multifaceted, or otherwise less clearly defined than a
transgender person. Genderqueer is another term used by some with this range of identities.
Nonbinary: transgender or gender nonconforming person who identifies as neither male nor
female.
Trans-masculine/trans-feminine: Terms to describe gender non-conforming or nonbinary
persons, based on the directionality of their gender identity. A trans-masculine person has a
masculine spectrum gender identity, with the sex of female listed on their original birth certificate. A
trans-feminine person has a feminine spectrum gender identity, the sex of the male listed on their
original birth certificate. In portions of these Guidelines, in the interest of brevity and clarity,
transgender men/women are inclusive of gender non-conforming or nonbinary persons on the
respective spectrae.
They/Them/Their: Neutral pronouns used by some who have a nonbinary or nonconforming
gender identity.
Transsexual: A more clinical term which had historically been used to describe those transgender
people who sought medical intervention (hormones, surgery) for gender affirmation. Term is less
commonly used in present day, however some individuals and communities maintain a strong and
affirmative connection to this term.
Cross dresser / drag queen / drag king: These terms generally refer to those who may wear the
clothing of a gender that differs from the sex which they were assigned at birth for entertainment,
self-expression, or sexual pleasure. Some cross dressers and people who dress in drag may
exhibit an overlap with components of a transgender identity. The term transvestite is no longer
used in the English language and is considered pejorative.

Sexual orientation:

Describes sexual attraction only, and is not directly related to gender identity.
The sexual orientation of transgender people should be defined by the individual. It is often
described based on the lived gender; a transgender woman attracted to other women would be a
lesbian, and a transgender man attracted to other men would be a man.
For the purposes of clarity and simplicity, the term transgender will be used throughout these
guidelines to refer to transgender, gender nonconforming, and genderqueer people as a set, unless
otherwise indicated. Non-transgender people will be referred to as such.

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