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The Curbsiders Internal Medicine Podcast

Supercharge your learning as these board-certified Internists interview the experts to bring you clinical pearls, practice changing knowledge, and a healthy dose of humor. 

Dec 11, 2017

Trans patients need excellent primary care and you can provide it with expert tips from endocrinologists, Dr Vin Tangpricha, Professor of Medicine at Emory University School of Medicine, and Dr Jeffrey Colburn, Assistant Professor of Medicine at Uniformed Services University. Learn practical tips in caring for transgender patients including: defining terms like gender dysphoria, gender nonconformity, transgender; use of pronouns; patient counseling; fertility concerns; initiating and monitoring hormonal therapy; surgical options; and how to help trans patients navigate the complexities of gender affirming therapy.

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Time Stamps

  • 00:00 Intro and disclaimer
  • 01:00 Guest bios
  • 03:27 Getting to know our guest
  • 08:00 Clinical case of a trans female
  • 09:00 Defining terms and discussion of gender
  • 14:15 What’s the difference between transgender and transexual?
  • 16:05 How to handle mistakes in use of pronouns
  • 17:12 How to set up a welcome practice environment
  • 19:03 Maintaining confidentiality
  • 20:37 Back to the case: What needs to be done before starting hormone therapy?
  • 25:20 Evaluating for comorbidities, mental health issues and social risk factors
  • 27:26 Is gender dysphoria driven by biology?
  • 27:54 Evidence for hormone therapy and surgery as treatment for gender dysphoria
  • 29:00 Cost and availability of medical and surgery therapy
  • 34:00 Initial history and laboratory evaluation prior to hormone therapy
  • 36:00 Choice of hormonal agent and route of administration
  • 37:38 Fertility in trans women and men
  • 40:30 When to expect body changes after starting therapy
  • 43:00 Dr Tangpricha’s take home points
  • 45:25 Monitoring of trans female on hormone therapy
  • 46:57 Therapy and Monitoring of trans male on hormone therapy
  • 49:56 Surgical therapy for MtF transition
  • 52:33 Surgical therapy for FtM transition
  • 55:50 Mental health clearance prior to surgery
  • 57:54 Dr Colburn’s take home points
  • 60:16 Outro

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