Not every transgender person experiences gender dysphoria.
Correct Answer
True
True. Gender dysphoria is distress that can occur when gender identity and sex assigned at birth do not align, and many transgender people do not have it; not everyone with dysphoria identifies as transgender either.
Category: Gender Terminology
Question 2
Sexual orientation and gender identity are two terms for the same characteristic.
Correct Answer
False
False. Gender identity is a person's internal sense of their own gender, while sexual orientation describes whom a person is attracted to; a transgender person may have any sexual orientation.
Category: Gender Terminology
Question 3
A person must take hormones or have surgery to be considered transgender.
Correct Answer
False
False. Transgender describes a gender identity that differs from sex assigned at birth; some transgender people transition medically, while others transition socially or not at all.
Category: Gender Terminology
Question 4
Spironolactone reduces the effects of testosterone in part by blocking androgen receptors.
Correct Answer
True
True. Spironolactone competes with androgens at their receptors, which slows male-pattern hair growth and other androgen effects, so it is a common antiandrogen in feminizing therapy.
Category: Antiandrogen Therapy
Question 5
Estrogen alone usually suppresses androgen effects so fully that an antiandrogen is rarely needed.
Correct Answer
False
False. Estrogen alone often does not suppress testosterone enough, so in US practice an antiandrogen such as spironolactone is commonly added to feminizing regimens; it may no longer be needed after the testes are removed.
Category: Feminizing Estrogens
Question 6
Finasteride lowers the amount of testosterone the testes produce.
Correct Answer
False
False. Finasteride blocks 5-alpha-reductase so less testosterone is converted to dihydrotestosterone, but it does not reduce testosterone production, which makes it a weaker antiandrogen than spironolactone.
Category: Antiandrogen Therapy
Question 7
Feminizing hormone therapy can reduce fertility, and the loss may not reverse after stopping, so fertility options are discussed before it begins.
Correct Answer
True
True. Estrogen and antiandrogens lower sperm production, and recovery after stopping is not assured, so patients are offered counseling and options such as sperm banking before therapy starts.
Category: Monitoring and Fertility
Question 8
Breast growth and other feminizing changes are complete soon after the first dose of estrogen.
Correct Answer
False
False. Feminizing changes develop gradually, starting over months and continuing for years, so patients are counseled to expect slow progress rather than rapid change.
Category: Feminizing Estrogens
Question 9
GnRH agonists impair fertility while they are being taken.
Correct Answer
True
True. By suppressing LH and FSH, GnRH agonists halt sperm or egg maturation during treatment, so fertility plans are discussed before therapy begins.
Category: GnRH Agonists
Question 10
Hot flashes are a common adverse effect of GnRH agonists.
Correct Answer
True
True. GnRH agonists sharply lower sex hormone levels, which commonly produces hot flashes; in feminizing therapy, estrogen given with the agonist helps limit them.
Category: GnRH Agonists
Question 11
Androgens cause the body to retain sodium and water, so patients with heart failure or kidney disease are watched for edema.
Correct Answer
True
True. Testosterone and related androgens increase retention of sodium, water and other electrolytes, which can worsen edema in patients with cardiac or renal disease.
Category: Testosterone Therapy
Question 12
Transgender women who take estrogen develop breast tissue and need breast cancer screening.
Correct Answer
True
True. Estrogen therapy produces breast tissue, so transgender women are included in breast cancer screening, with timing set by current screening guidance and hormone history.
Category: Monitoring and Fertility
Question 13
Male-pattern scalp hair loss can develop during testosterone therapy.
Correct Answer
True
True. Testosterone can cause hairline recession and male-pattern baldness, especially in people with a family history of it, and patients are told about this before starting.
Category: Testosterone Therapy
Question 14
Testosterone can cause vaginal dryness and thinning of the vaginal tissue.
Correct Answer
True
True. By suppressing ovarian estrogen, testosterone can thin and dry vaginal tissue, which may cause discomfort or pelvic pain that patients should report.
Category: Testosterone Therapy
Question 15
A complete medication history for a transgender patient includes asking about hormones obtained without a prescription.
Correct Answer
True
True. Some patients use hormones obtained from friends or online sources, and knowing about them is needed to assess safety, interactions and monitoring needs; the question should be asked without judgment.
Category: Affirming Communication
Question 16
Estrogen therapy increases muscle mass in transgender women.
Correct Answer
False
False. Estrogen with androgen suppression decreases muscle mass and strength over time, along with fat redistribution and softer skin.
Category: Feminizing Estrogens
Question 17
Spironolactone increases facial and body hair growth.
Correct Answer
False
False. Spironolactone blocks androgen effects, so it slows facial and body hair growth, which is one reason it is used in feminizing therapy.
Category: Antiandrogen Therapy
Question 18
A nurse can identify a patient's gender identity reliably from the patient's appearance.
Correct Answer
False
False. Gender identity is internal and cannot be judged from appearance, so the nurse asks each patient about their name, pronouns and gender identity.
Category: Affirming Communication
Question 19
Gender-affirming hormone therapy is used only by people who identify as a man or a woman.
Correct Answer
False
False. Some nonbinary people also use gender-affirming hormones, with goals set together with the provider to match the changes they want.
Category: Gender Terminology
Question 20
Testosterone therapy tends to raise HDL cholesterol.
Correct Answer
False
False. Testosterone tends to lower HDL cholesterol and can raise LDL and triglycerides, so a lipid profile is checked before therapy and at follow-up.
Category: Testosterone Therapy