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      Providing Patient-Centered Perinatal Care for Transgender Men and Gender-Diverse Individuals : A Collaborative Multidisciplinary Team Approach

      case-report
      , MD, MPH , , MD, MS, , MSW, , MD, MPH, , MD, MPH
      Obstetrics and Gynecology
      Lippincott Williams & Wilkins

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          Abstract

          Health care teams can create gender-affirming patient experiences for transgender men and gender-diverse people in and around pregnancy through advancing changes in perinatal health care settings.

          BACKGROUND:

          Little is documented about the experiences of pregnancy for transgender and gender-diverse individuals. There is scant clinical guidance for providing prepregnancy, prenatal, intrapartum, and postpartum care to transgender and gender-diverse people who desire pregnancy.

          CASE:

          Our team provided perinatal care to a 20-year-old transgender man, which prompted collaborative advocacy for health care systems change to create gender-affirming patient experiences in the perinatal health care setting.

          CONCLUSION:

          Systems-level and interpersonal-level interventions were adopted to create gender-affirming and inclusive care in and around pregnancy. Basic practices to mitigate stigma and promote gender-affirming care include staff trainings and query and use of appropriate name and pronouns in patient interactions and medical documentation. Various factors are important to consider regarding testosterone therapy for transgender individuals desiring pregnancy.

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          Most cited references19

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          Transgender men who experienced pregnancy after female-to-male gender transitioning.

          To conduct a cross-sectional study of transgender men who had been pregnant and delivered after transitioning from female-to-male gender to help guide practice and further investigation.
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            Integrated and Gender-Affirming Transgender Clinical Care and Research

            Abstract: Transgender (trans) communities worldwide, particularly those on the trans feminine spectrum, are disproportionately burdened by HIV infection and at risk for HIV acquisition/transmission. Trans individuals represent an underserved, highly stigmatized, and under-resourced population not only in HIV prevention efforts but also in delivery of general primary medical and clinical care that is gender affirming. We offer a model of gender-affirmative integrated clinical care and community research to address and intervene on disparities in HIV infection for transgender people. We define trans terminology, briefly review the social epidemiology of HIV infection among trans individuals, highlight gender affirmation as a key social determinant of health, describe exemplar models of gender-affirmative clinical care in Boston MA, New York, NY, and San Francisco, CA, and offer suggested “best practices” for how to integrate clinical care and research for the field of HIV prevention. Holistic and culturally responsive HIV prevention interventions must be grounded in the lived realities the trans community faces to reduce disparities in HIV infection. HIV prevention interventions will be most effective if they use a structural approach and integrate primary concerns of transgender people (eg, gender-affirmative care and management of gender transition) alongside delivery of HIV-related services (eg, biobehavioral prevention, HIV testing, linkage to care, and treatment).
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              Reproductive wish in transsexual men.

              Hormonal therapy and sex reassignment surgery (SRS) in transsexual persons lead to an irreversible loss of their reproductive potential. The current and future technologies could create the possibility for female-to-male transsexual persons (transsexual men) to have genetically related children. However, little is known about this topic. The aim of this study is to provide information on the reproductive wishes of transsexual men after SRS. METHODS A self-constructed questionnaire was presented to 50 transsexual men in a single-center study.
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                Author and article information

                Journal
                Obstet Gynecol
                Obstet Gynecol
                ong
                Obstetrics and Gynecology
                Lippincott Williams & Wilkins
                0029-7844
                1873-233X
                November 2019
                10 October 2019
                : 134
                : 5
                : 959-963
                Affiliations
                Departments of Family and Community Medicine and Obstetrics and Gynecology, University of California, San Francisco, and the Mission Neighborhood Health Center, San Francisco, California.
                Author notes
                Corresponding author: Monica Hahn, MD, MPH, MS, Department of Family and Community Medicine, San Francisco, CA; email: monica.hahn@ 123456ucsf.edu .
                Article
                ONG-19-771 00009
                10.1097/AOG.0000000000003506
                6814572
                31599839
                9e150556-2233-43e7-a08c-ab6cabe2363c
                © 2019 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : 17 April 2019
                : 3 July 2019
                : 18 July 2019
                Categories
                Contents
                LGBTQ+ Health: Case Report
                Custom metadata
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